WorldWideScience

Sample records for clinical review communication

  1. Effects of clinical communication interventions in hospitals: a systematic review of information and communication technology adoptions for improved communication between clinicians.

    Science.gov (United States)

    Wu, Robert C; Tran, Kim; Lo, Vivian; O'Leary, Kevin J; Morra, Dante; Quan, Sherman D; Perrier, Laure

    2012-11-01

    To conduct a systematic review of the literature to identify, describe and assess interventions of information and communication technology on the processes of communication and associated patient outcomes within hospital settings. Studies published from the years 1996 to 2010 were considered and were selected if they described an evaluation of information and communication technology interventions to improve clinical communication within hospitals. Two authors abstracted data from full text articles, and the quality of individual articles were appraised. Results of interventions were summarized by their effect. There were 18 identified studies that evaluated the use of interventions that included alphanumeric paging, hands-free communication devices, mobile phones, smartphones, task management systems and a display based paging system. Most quantitative studies used a before and after study design and were of lower quality. Of all the studies, there was only one prospective randomized study, but this study used only simulated communication events. Quantitative studies identified improved perceptions of communication and some improvement in communication metrics. Qualitative studies described improvements in efficiency of communication but also issues of loss of control and reliability. Despite the rapid advancement in information and communications technology over the last decade, there is limited evidence suggesting improvements in the ability of health professionals to communicate effectively. Given the critical nature of communication, we advocate further evaluation of information and communication technology designed to improve communication between clinicians. Outcome measures should include measures of patient-oriented outcomes and efficiency for clinicians. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. The analysis of verbal interaction sequences in dyadic clinical communication: a review of methods.

    Science.gov (United States)

    Connor, Martin; Fletcher, Ian; Salmon, Peter

    2009-05-01

    To identify methods available for sequential analysis of dyadic verbal clinical communication and to review their methodological and conceptual differences. Critical review, based on literature describing sequential analyses of clinical and other relevant social interaction. Dominant approaches are based on analysis of communication according to its precise position in the series of utterances that constitute event-coded dialogue. For practical reasons, methods focus on very short-term processes, typically the influence of one party's speech on what the other says next. Studies of longer-term influences are rare. Some analyses have statistical limitations, particularly in disregarding heterogeneity between consultations, patients or practitioners. Additional techniques, including ones that can use information about timing and duration of speech from interval-coding are becoming available. There is a danger that constraints of commonly used methods shape research questions and divert researchers from potentially important communication processes including ones that operate over a longer-term than one or two speech turns. Given that no one method can model the complexity of clinical communication, multiple methods, both quantitative and qualitative, are necessary. Broadening the range of methods will allow the current emphasis on exploratory studies to be balanced by tests of hypotheses about clinically important communication processes.

  3. FDA drug safety communications: a narrative review and clinical considerations for older adults.

    Science.gov (United States)

    Marcum, Zachary A; Vande Griend, Joseph P; Linnebur, Sunny A

    2012-08-01

    The US Food and Drug Administration (FDA) has new regulatory authorities intended to enhance drug safety monitoring in the postmarketing period. This has resulted in an increase in communication from the FDA in recent years about the safety profile of certain drugs. It is important to stay abreast of the current literature on drug risks to effectively communicate these risks to patients, other health care providers, and the general public. To summarize 4 new FDA drug safety communications by describing the evidence supporting the risks and the clinical implications for older adults. The FDA Web site was reviewed for new drug safety communications from May 2011 to April 2012 that would be relevant to older adults. Approved labeling for each drug or class was obtained from the manufacturer, and PubMed was searched for primary literature that supported the drug safety concern. FDA drug safety communications for 4 drugs were chosen because of the potential clinical importance in older adults. A warning for citalopram was made because of potential problems with QT prolongation in patients taking less than 40 mg per day. The evidence suggests minor changes in QT interval. Given the flat dose-response curve in treating depression with citalopram, the new 20-mg/d maximum dose in older adults is sensible. Another warning was made for proton pump inhibitors (PPIs) and an increased risk of Clostridium difficile infection. A dose-response relationship was found for this drug risk. With C. difficile infections on the rise in older adults, along with other safety risks of PPI therapy, PPIs should only be used in older adults indicated for therapy for the shortest duration possible. In addition, a warning about dabigatran was made. There is strong evidence from a large clinical trial, as well as case reports, of increased bleeding risk in older adults taking dabigatran, especially in older adults with decreased renal function. This medication should be used with caution in older

  4. Clinical review

    DEFF Research Database (Denmark)

    Groth, Kristian; Skakkebæk, Anne; Høst, Christian

    2013-01-01

    Recently, new clinically important information regarding Klinefelter syndrome (KS) has been published. We review aspects of epidemiology, endocrinology, metabolism, body composition, and neuropsychology with reference to recent genetic discoveries.......Recently, new clinically important information regarding Klinefelter syndrome (KS) has been published. We review aspects of epidemiology, endocrinology, metabolism, body composition, and neuropsychology with reference to recent genetic discoveries....

  5. [Review of 1,172 clinical cases with human communication disorders].

    Science.gov (United States)

    de Díaz, M R; de Pustilnik, N F; Tortolero, Y

    1976-01-01

    The study comprised 1,172 clinical cases that were classified according to sex, age and speech disorders. A review is made on the most common alterations that they present, the selective treatment in each type and their rehabilitation.

  6. A systematic review of assessment and intervention strategies for effective clinical communication in culturally and linguistically diverse students.

    Science.gov (United States)

    Chan, Annie; Purcell, Alison; Power, Emma

    2016-09-01

    Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills. Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures. One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on student satisfaction, only eight reported improved skills post-training. The development of effective

  7. Informing web-based communication curricula in veterinary education: a systematic review of web-based methods used for teaching and assessing clinical communication in medical education.

    Science.gov (United States)

    Artemiou, Elpida; Adams, Cindy L; Toews, Lorraine; Violato, Claudio; Coe, Jason B

    2014-01-01

    We determined the Web-based configurations that are applied to teach medical and veterinary communication skills, evaluated their effectiveness, and suggested future educational directions for Web-based communication teaching in veterinary education. We performed a systematic search of CAB Abstracts, MEDLINE, Scopus, and ERIC limited to articles published in English between 2000 and 2012. The review focused on medical or veterinary undergraduate to clinical- or residency-level students. We selected studies for which the study population was randomized to the Web-based learning (WBL) intervention with a post-test comparison with another WBL or non-WBL method and that reported at least one empirical outcome. Two independent reviewers completed relevancy screening, data extraction, and synthesis of results using Kirkpatrick and Kirkpatrick's framework. The search retrieved 1,583 articles, and 10 met the final inclusion criteria. We identified no published articles on Web based communication platforms in veterinary medicine; however, publications summarized from human medicine demonstrated that WBL provides a potentially reliable and valid approach for teaching and assessing communication skills. Student feedback on the use of virtual patients for teaching clinical communication skills has been positive,though evidence has suggested that practice with virtual patients prompted lower relation-building responses.Empirical outcomes indicate that WBL is a viable method for expanding the approach to teaching history taking and possibly to additional tasks of the veterinary medical interview.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  10. Malignant tumour stroma gonads Sertoli-Leydig:a communication clinic case and bibliographic review

    International Nuclear Information System (INIS)

    Krygier Waltier, G.; Rodriguez Lemes, R.; Carlevaro Elizondo, T.

    1995-01-01

    The malignant tumors of the stroma gonads represent 0.2% of all the tumors of the testicle, and they are almost exclusive of the relatively refractory to the radiotherapy and the chemotherapy, and the medium survive of the illness is of two years. it presents a clinical case of tumour to cells of Sertoli-Leydig in a 45 year-old man that heI consulted for sterility . A review of the literature it is made for finish [es

  11. Information and Communication Technologies for the Dissemination of Clinical Practice Guidelines to Health Professionals: A Systematic Review.

    Science.gov (United States)

    De Angelis, Gino; Davies, Barbara; King, Judy; McEwan, Jessica; Cavallo, Sabrina; Loew, Laurianne; Wells, George A; Brosseau, Lucie

    2016-11-30

    The transfer of research knowledge into clinical practice can be a continuous challenge for researchers. Information and communication technologies, such as websites and email, have emerged as popular tools for the dissemination of evidence to health professionals. The objective of this systematic review was to identify research on health professionals' perceived usability and practice behavior change of information and communication technologies for the dissemination of clinical practice guidelines. We used a systematic approach to retrieve and extract data about relevant studies. We identified 2248 citations, of which 21 studies met criteria for inclusion; 20 studies were randomized controlled trials, and 1 was a controlled clinical trial. The following information and communication technologies were evaluated: websites (5 studies), computer software (3 studies), Web-based workshops (2 studies), computerized decision support systems (2 studies), electronic educational game (1 study), email (2 studies), and multifaceted interventions that consisted of at least one information and communication technology component (6 studies). Website studies demonstrated significant improvements in perceived usefulness and perceived ease of use, but not for knowledge, reducing barriers, and intention to use clinical practice guidelines. Computer software studies demonstrated significant improvements in perceived usefulness, but not for knowledge and skills. Web-based workshop and email studies demonstrated significant improvements in knowledge, perceived usefulness, and skills. An electronic educational game intervention demonstrated a significant improvement from baseline in knowledge after 12 and 24 weeks. Computerized decision support system studies demonstrated variable findings for improvement in skills. Multifaceted interventions demonstrated significant improvements in beliefs about capabilities, perceived usefulness, and intention to use clinical practice guidelines, but

  12. Teaching clinically experienced physicians communication skills: a review of evaluation studies.

    NARCIS (Netherlands)

    Hulsman, R.L.; Ros, W.J.G.; Winnubst, J.A.M.; Bensing, J.M.

    1999-01-01

    Interest in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more

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

    Science.gov (United States)

    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.

  14. Clinical review

    DEFF Research Database (Denmark)

    Hjortrup, Peter Buhl; Haase, Nicolai; Wetterslev, Mik

    2013-01-01

    Neutrophil gelatinase-associated lipocalin (NGAL) may be an early marker of acute kidney injury (AKI), but elevated NGAL occurs in a wide range of systemic diseases. Because intensive care patients have high levels of comorbidity, our objective was to conduct a systematic review of the literature...

  15. The communication process in clinical settings.

    Science.gov (United States)

    Mathews, J J

    1983-01-01

    The communication of information in clinical settings is fraught with problems despite avowed common aims of practitioners and patients. Some reasons for the problematic nature of clinical communication are incongruent frames of reference about what information ought to be shared, sociolinguistic differences and social distance between practitioners and patients. Communication between doctors and nurses is also problematic, largely due to differences in ideology between the professions about what ought to be communicated to patients about their illness and who is ratified to give such information. Recent social changes, such as the Patient Bill of Rights and informed consent which assure access to information, and new conceptualizations of the nurse's role, warrant continued study of the communication process especially in regard to what constitutes appropriate and acceptable information about a patient's illness and who ought to give such information to patients. The purpose of this paper is to outline characteristics of communication in clinical settings and to provide a literature review of patient and practitioner interaction studies in order to reflect on why information exchange is problematic in clinical settings. A framework for presentation of the problems employs principles from interaction and role theory to investigate clinical communication from three viewpoints: (1) the level of shared knowledge between participants; (2) the effect of status, role and ideology on transactions; and (3) the regulation of communication imposed by features of the institution.

  16. The communication process in Telenursing: integrative review.

    Science.gov (United States)

    Barbosa, Ingrid de Almeida; Silva, Karen Cristina da Conceição Dias da; Silva, Vladimir Araújo da; Silva, Maria Júlia Paes da

    2016-01-01

    to identify scientific evidence about the communication process in Telenursing and analyze them. integrative review performed in March 2014. The search strategy, structured with the descriptors "telenursing" and "communication", was implemented in the databases Medline, Bireme, Cinahl, Scopus, Web of Science, Scielo, and Cochrane. ten studies were selected after inclusion and exclusion criteria. The main challenges were: the clinical condition of patients, the possibility for inadequate communication to cause misconduct, the absence of visual references in interactions without video, and difficulty understanding nonverbal communication. distance imposes communicative barriers in all elements: sender, recipient and message; and in both ways of transmission, verbal and nonverbal. The main difficulty is to understand nonverbal communication. To properly behave in this context, nurses must receive specific training to develop abilities and communication skills.

  17. Digital Clinical Communication for Families and Caregivers of Children or Young People With Short- or Long-Term Conditions: Rapid Review.

    Science.gov (United States)

    Armoiry, Xavier; Sturt, Jackie; Phelps, Emma Elizabeth; Walker, Clare-Louise; Court, Rachel; Taggart, Frances; Sutcliffe, Paul; Griffiths, Frances; Atherton, Helen

    2018-01-05

    The communication relationship between parents of children or young people with health conditions and health professionals is an important part of treatment, but it is unclear how far the use of digital clinical communication tools may affect this relationship. The objective of our study was to describe, assess the feasibility of, and explore the impact of digital clinical communication between families or caregivers and health professionals. We searched the literature using 5 electronic databases. We considered all types of study design published in the English language from January 2009 to August 2015. The population of interest included families and caregivers of children and young people aged less than 26 years with any type of health condition. The intervention was any technology permitting 2-way communication. We included 31 articles. The main designs were randomized controlled trials (RCTs; n=10), cross-sectional studies (n=9), pre- and postintervention uncontrolled (pre/post) studies (n=7), and qualitative interview studies (n=2); 6 had mixed-methods designs. In the majority of cases, we considered the quality rating to be fair. Many different types of health condition were represented. A breadth of digital communication tools were included: videoconferencing or videoconsultation (n=14), and Web messaging or emails (n=12). Health care professionals were mainly therapists or cognitive behavioral therapists (n=10), physicians (n=8), and nurses (n=6). Studies were very heterogeneous in terms of outcomes. Interventions were mainly evaluated using satisfaction or acceptance, or outcomes relating to feasibility. Clinical outcomes were rarely used. The RCTs showed that digital clinical communication had no impact in comparison with standard care. Uncontrolled pre/post studies showed good rates of satisfaction or acceptance. Some economic studies suggested that digital clinical communication may save costs. This rapid review showed an emerging body of literature on

  18. Representing clinical communication knowledge through database management system integration.

    Science.gov (United States)

    Khairat, Saif; Craven, Catherine; Gong, Yang

    2012-01-01

    Clinical communication failures are considered the leading cause of medical errors [1]. The complexity of the clinical culture and the significant variance in training and education levels form a challenge to enhancing communication within the clinical team. In order to improve communication, a comprehensive understanding of the overall communication process in health care is required. In an attempt to further understand clinical communication, we conducted a thorough methodology literature review to identify strengths and limitations of previous approaches [2]. Our research proposes a new data collection method to study the clinical communication activities among Intensive Care Unit (ICU) clinical teams with a primary focus on the attending physician. In this paper, we present the first ICU communication instrument, and, we introduce the use of database management system to aid in discovering patterns and associations within our ICU communications data repository.

  19. Provider-to-provider communication in dermatology and implications of missing clinical information in skin biopsy requisition forms: a systematic review.

    Science.gov (United States)

    Comfere, Nneka I; Sokumbi, Olayemi; Montori, Victor M; LeBlanc, Annie; Prokop, Larry J; Murad, M Hassan; Tilburt, Jon C

    2014-05-01

    Various components of the skin biopsy requisition form (SBRF) may contribute to accurate dermatopathologic interpretation. A search of electronic databases, including those of Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Scopus, was conducted from inception to October 2011. Two authors independently screened all articles for eligibility. Inclusion criteria required material to represent original studies on skin biopsy and pathology requisition forms. Data abstracted from each article that met the inclusion criteria included details of the study characteristics, including the study location, type of pathology practice, specimen type, type of dermatoses, medical specialty of the requesting provider, suggested clinical components, and format of the SBRF. Of 32 titles and abstracts reviewed, seven articles were included. From these, we determined that dermatologists, general practitioners and surgeons completed SBRFs. Commonly included components were patient demographics and requesting clinician characteristics. Clinical information and differential diagnosis were provided in 4% (two of 48 surgeons) to 36% (18 of 50 dermatologists) of requisitions. Most SBRFs did not include information on specimen type, clinical morphology, photographs or clinical history. The limited medical literature demonstrates variation in the content of SBRFs across clinicians and practices, and suggests an important target for improvement in the quality of communication and dermatologic care by requesting clinicians and pathologists. © 2013 The International Society of Dermatology.

  20. Let your communication skills equal your clinical skills.

    Science.gov (United States)

    Demarais, Ann; Baum, Neil

    2012-01-01

    Relating effectively with patients is among the most valued skills of clinical care. Honing your communication skills is an art that every physician needs to learn and understand. In this era of increased volume of patients there is a tendency to lose sight of the importance of having good communication skills. This article will review 11 suggestions for letting your communication skills equal your clinical skills.

  1. Email for clinical communication between healthcare professionals.

    Science.gov (United States)

    Goyder, Clare; Atherton, Helen; Car, Mate; Heneghan, Carl J; Car, Josip

    2015-02-20

    Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals. To assess the effects of email for clinical communication between healthcare professionals on healthcare professional outcomes, patient outcomes, health service performance, and service efficiency and acceptability, when compared to other forms of communicating clinical information. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9 2013), MEDLINE (OvidSP) (1946 to August 2013), EMBASE (OvidSP) (1974 to August 2013), PsycINFO (1967 to August 2013), CINAHL (EbscoHOST) (1982 to August 2013), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched November 2013). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies, and interrupted time series studies examining interventions in which healthcare professionals used email for communicating clinical information in the form of: 1) unsecured email, 2) secure email, or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed studies for inclusion, assessed the included studies' risk of bias, and extracted data. We contacted study authors for additional information and have reported all measures as per the study report. The previous version of this review included one randomised controlled

  2. Clinical review: Riedel's thyroiditis: a clinical review.

    Science.gov (United States)

    Hennessey, James V

    2011-10-01

    Riedel's thyroiditis is a rare inflammatory process involving the thyroid and surrounding cervical tissues and is associated with various forms of systemic fibrosis. Riedel's presentation is complex, including a thyroid mass associated with local symptoms, characteristic biochemical abnormalities such as hypocalcemia and hypothyroidism, as well as the involvement of a wide range of other organ systems. Diagnosis of Riedel's thyroiditis requires histopathological confirmation, but due to high complication rates, the role of surgical intervention is limited to airway decompression and diagnostic tissue retrieval. Unique among processes of the thyroid, Riedel's is commonly treated with long-term antiinflammatory medications to arrest progression and maintain a symptom-free course. Due to its rarity, Riedel's may not be immediately diagnosed, so clinicians benefit from recognizing the constellation of findings that should make prompt diagnosis possible. A review of print and electronic reviews was conducted. Source references were identified, and available literature was reviewed. A search of the PubMed database using the search term "Riedel's thyroiditis" was cross-referenced with associated clinical findings, systemic fibrosis diagnoses, and therapeutic search terms. Because most of the literature consisted of case reports and very small series, inclusion of identified articles was based on clinical descriptions of the subjects included and the criteria for diagnosis reported. More weight was attributed to series, using contemporary criteria for diagnosis. Case reports were included if the diagnosis was clear and clinical presentation was unique to illustrate the spectrum of disease. Because the majority of therapeutic intervention data were based upon case reports and very small series, an evidence-based approach was problematic, but information is presented as objectively and with as much balance as the limited quality of the data allows. Clinical awareness of the

  3. How to attain expertise in clinical communication?

    NARCIS (Netherlands)

    Wouda, Jan C.; van de Wiel, Harry B. M.

    2013-01-01

    Several factors complicate the attainment of expertise in clinical communication. Medical curricula and postgraduate training insufficiently provide the required learning conditions of deliberate practice to overcome these obstacles. In this paper we provide recommendations for learning objectives

  4. Communication Partner Training in Aphasia: An Updated Systematic Review.

    Science.gov (United States)

    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

  5. Review of idiopathic eosinophilic meningitis in dogs and cats, with a detailed description of two recent cases in dogs : review and clinical communication

    Directory of Open Access Journals (Sweden)

    J.H. Williams

    2008-05-01

    Caesarian section after developing a non-responsive inertia 8 days prior to presentation. This animal's clinical signs included status epilepticus seizures unrelated to hypocalcaemia and warranted induction of a barbiturate coma. She died 4 hours later. Post mortem and histopathological findings in the brain were almost identical to those of the Boerboel and she also showed histological evidence of recent active intravascular haemolysis with microcyte formation. Rabies, distemper and Neospora caninum immunohistochemical stains were negative in the brains of both dogs. Immunohistochemical staining of the cerebral and meningeal exudates of the Beagle for T- and B-lymphocyte (CD3 and CD79a markers showed a predominance of T-lymphocytes with fewer scattered B lymphocytes. A possible allergic response to amoxicillin / clavulanate is considered, as this appeared to be the only feature common to the recent history of both animals. An overview of EME in humans, dogs and cats is given and the previously published cases of idiopathic EME in dogs and the single published cat case are briefly reviewed.

  6. Nurse-physician communication - An integrated review.

    Science.gov (United States)

    Tan, Tit-Chai; Zhou, Huaqiong; Kelly, Michelle

    2017-12-01

    To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the

  7. Tianeptine - A Clinical Review.

    Directory of Open Access Journals (Sweden)

    More Patil Vidita

    2016-06-01

    Full Text Available Depression is a wide spread disorder. The development of effective pharmacotherapy for major depression is important because it is such a widespread and debilitating mental disorder. The following review is based on the preclinical and clinical studies carried out on Tianeptine, an atypical antidepressant that lowers the adverse effects of stress on brain and memory. It is one of the many drugs being tested these days in the market as nootropics; it is presented as a “Smart Drug”. These are believed to be of low-risk and work to improve, enhance, or repair damage done to the brain via injury or disease.

  8. Communication skills: an essential component of medical curricula. Part I: Assessment of clinical communication: AMEE Guide No. 51.

    Science.gov (United States)

    Laidlaw, Anita; Hart, Jo

    2011-01-01

    This AMEE Guide in Medical Education is Part 1 of a two part Guide covering the issues of Communication. This Guide has been written to provide guidance for those involved in planning the assessment of clinical communication and provides guidance and information relating to the assessment of various aspects of clinical communication; its underlying theory; its practical ability to show that an individual is competent and its relationship to students' daily performance. The advantages and disadvantages of assessing specific aspects of communication are also discussed. The Guide draws attention to the complexity of assessing the ability to communicate with patients and healthcare professionals, with issues of reliability and validity being highlighted for each aspect. Current debates within the area of clinical communication teaching are raised: when should the assessment of clinical communication occur in undergraduate medical education?; should clinical communication assessment be integrated with clinical skills assessment, or should the two be separate?; how important should the assessment of clinical communication be, and the question of possible failure of students if they are judged not competent in communication skills? It is the aim of the authors not only to provide a useful reference for those starting to develop their assessment processes, but also provide an opportunity for review and debate amongst those who already assess clinical communication within their curricula, and a resource for those who have a general interest in medical education who wish to learn more about communication skills assessment.

  9. Public dialogues on flood risk communication: Literature review : Literature review

    NARCIS (Netherlands)

    Orr, Paula; Forrest, Steven; Brooks, Katya; Twigger-Ross, Clare

    2015-01-01

    This literature review summarises the state of knowledge on communicating the risk of flooding to the public as of January 2014. The review considers how different audiences respond to risk communication and the factors which influence that response. The current systems and techniques for flood risk

  10. Communication partner training in aphasia: a systematic review.

    Science.gov (United States)

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

    2010-12-01

    To describe the effects of communication partner training on persons with aphasia and their communication partners. Specifically the systematic review addressed 3 clinical questions regarding the impact of partner training on language, communication activity and participation, psychosocial adjustment, and quality of life for adults with aphasia and their communication partners. Twenty-three terms were used to search 12 electronic databases (eg, PubMed, CINAHL, PsychINFO, PsychArticles, CSA Linguistics and Language Behavior Abstracts, Social Sciences Citation Index [Web of Science], SUMSearch, TRIP, EMBASE, REHABDATA, National Library for Health, Cochrane Database of Systematic Reviews) and the journal "Aphasiology." References from all relevant articles were hand-searched. Two reviewers independently applied inclusion criteria to select potential relevant articles from the titles and abstracts of references retrieved by the literature search. The full text of the remaining articles was reviewed by a 5-member panel, resulting in a corpus of 31 studies that met the final inclusion criteria. Two independent reviewers extracted the descriptive data related to the participants, the intervention, the outcome measures, and the results. The 5-member review team by consensus classified the studies using the American Academy of Neurology system for classification of evidence (2004). Evidence shows that communication partner training is effective in improving communication activities and/or participation of the communication partner and is probably effective in improving communication activities and/or participation of persons with chronic aphasia when they are interacting with trained communication partners. There is insufficient evidence to make recommendations related to the impact of partner training on persons with acute aphasia or the impact of training on language impairment, psychosocial adjustment, or quality of life for either the person with aphasia or the

  11. Quantitative Communication Research: Review, Trends, and Critique

    Directory of Open Access Journals (Sweden)

    Timothy R. Levine

    2013-01-01

    Full Text Available Trends in quantitative communication research are reviewed. A content analysis of 48 articles reporting original communication research published in 1988-1991 and 2008-2011 is reported. Survey research and self-report measurement remain common approaches to research. Null hypothesis significance testing remains the dominant approach to statistical analysis. Reporting the shapes of distributions, estimates of statistical power, and confidence intervals remain uncommon. Trends over time include the increased popularity of health communication and computer mediated communication as topics of research, and increased attention to mediator and moderator variables. The implications of these practices for scientific progress are critically discussed, and suggestions for the future are provided.

  12. How to attain expertise in clinical communication?

    Science.gov (United States)

    Wouda, Jan C; van de Wiel, Harry B M

    2013-12-01

    Several factors complicate the attainment of expertise in clinical communication. Medical curricula and postgraduate training insufficiently provide the required learning conditions of deliberate practice to overcome these obstacles. In this paper we provide recommendations for learning objectives and teaching methods for the attainment of professional expertise in patient education. Firstly, we propose to use functional learning objectives derived from the goals and strategies of clinical communication. Secondly, we recommend using teaching and assessment methods which: (1) contain stimulating learning tasks with opportunities for immediate feedback, reflection and corrections, and (2) give ample opportunity for repetition, gradual refinements and practice in challenging situations. Video-on-the-job fits these requirements and can be used to improve the competency in patient education of residents and medical staff in clinical practice. However, video-on-the-job can only be successful if the working environment supports the teaching and learning of communication and if medical staff which supervises the residents, is motivated to improve their own communication and didactic skills. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Li, Sherly X; Ye, Zheng; Whelan, Kevin; Truby, Helen

    2016-09-01

    Genetic risk prediction of chronic conditions including obesity, diabetes and CVD currently has limited predictive power but its potential to engage healthy behaviour change has been of immense research interest. We aimed to understand whether the latter is indeed true by conducting a systematic review and meta-analysis investigating whether genetic risk communication affects motivation and actual behaviour change towards preventative lifestyle modification. We included all randomised controlled trials (RCT) since 2003 investigating the impact of genetic risk communication on health behaviour to prevent cardiometabolic disease, without restrictions on age, duration of intervention or language. We conducted random-effects meta-analyses for perceived motivation for behaviour change and clinical changes (weight loss) and a narrative analysis for other outcomes. Within the thirteen studies reviewed, five were vignette studies (hypothetical RCT) and seven were clinical RCT. There was no consistent effect of genetic risk on actual motivation for weight loss, perceived motivation for dietary change (control v. genetic risk group standardised mean difference (smd) -0·15; 95 % CI -1·03, 0·73, P=0·74) or actual change in dietary behaviour. Similar results were observed for actual weight loss (control v. high genetic risk SMD 0·29 kg; 95 % CI -0·74, 1·31, P=0·58). This review found no clear or consistent evidence that genetic risk communication alone either raises motivation or translates into actual change in dietary intake or physical activity to reduce the risk of cardiometabolic disorders in adults. Of thirteen studies, eight were at high or unclear risk of bias. Additional larger-scale, high-quality clinical RCT are warranted.

  14. HIV communication capacity strengthening: a critical review.

    Science.gov (United States)

    Lettenmaier, Cheryl; Kraft, Joan Marie; Raisanen, Keris; Serlemitsos, Elizabeth

    2014-08-15

    HIV communication is most effective and sustainable when it is designed and implemented locally and tailored to the local context. This requires capacity strengthening at national, subnational, and community levels. Through a review of the published and selected "grey" literature, we examine HIV communication capacity strengthening: definitions, measurements, implementation, and effects. We found limited documentation of HIV communication capacity needs or systematic approaches to address them. Most HIV communication capacity strengthening to date has focused on building individual competencies to design and manage social and behavior change communication programs through training courses, often coupled with networking opportunities for participants, post-training mentoring, and technical assistance. A few of these efforts have been evaluated through pre- and post-training tests and qualitative interviews with participants and have shown potential for improvement in individual skills and knowledge. Health communication capacity assessment tools that measure individual and organizational competencies exist, but they have most often been used to identify capacity building needs, not for evaluating capacity strengthening efforts. A new definition of capacity strengthening, grown out of recent efforts to improve effectiveness of international health and development programs, focuses on improving organizational and societal systems that support performance and individual competencies. We propose a holistic model for HIV communication capacity strengthening and call for rigorous documentation and evaluation to determine and scale-up optimal capacity building interventions for strengthening social and behavior change communication for HIV prevention, care, and treatment in developing countries.

  15. Communications: A Literature Review for Future Communications Mitigations

    Science.gov (United States)

    Wilder, Anderson

    2015-01-01

    There are many concerns with humans living and working in space. These are only compounded by the length of time and distance from Earth that the humans are travelling. For NASA to figure out countermeasures to these problems, they need to be looked at from different directions from a variety of domains. Psychological concerns will be one of the determining factors to whether or not humans will be able to successfully make a journey to Mars or beyond. Communications will be one of the pivotal factors that will affect a crew from a psychological standpoint. During this summer internship, this intern was tasked with looking into delving into this problem. The intern was tasked with performing a literature review on the topic of comparing communications from how they are conducted now to how they will be carried out in the future. These communications have many methods and functions for when and where they happen. A matrix was created to illustrate how these specific communications methods and functions currently are and could be carried out in the future from a time/location perspective. This research will used to help determine what future research will need to focus on in a psychological and technological aspect to better help the crew of a long duration mission.

  16. Book review Information and Communication Technologies for ...

    African Journals Online (AJOL)

    Book review. Information and Communication Technologies for Development in Africa: Volume 2. The Experience with Community Telecentres By Florence Etta and Sheila Parvyn-Wamahiu (2003). Kibet A Ngetich. Abstract. No Abstract Available Africa Development Vol. XXX (1&2) 2005: 254-256. Article Metrics. No metrics ...

  17. Book review Information and Communication Technologies for ...

    African Journals Online (AJOL)

    Book review. Information and Communication Technologies for Development in Africa: Volume 2. The Experience with Community Telecentres By Florence Etta and Sheila Parvyn-Wamahiu (2003). Kibet A Ngetich. Abstract. No Abstract Available Africa Development Vol. XXX (1&2) 2005: 254-256.

  18. Increasing clinical presence of mobile communication technology: avoiding the pitfalls.

    Science.gov (United States)

    Visvanathan, Akila; Gibb, Alan P; Brady, Richard R W

    2011-10-01

    Mobile communication technologies are employed in many diverse areas of healthcare delivery to provide improved quality and efficiency of communication and facilitate increased rapidity of data or information transfer. Mobile phones enable healthcare professionals to possess a portable platform from which to provide many healthcare-related applications and are a popular means to directly communicate with colleagues and patients. As involvement of mobile communication technology in healthcare delivery continues to rapidly expand, there are also important considerations of relevance to patient safety and security as a result. Here, we review the previous evidence of reported clinical risks associated with mobile communication technology, such as electromagnetic interference, confidentiality and data security, distraction/noise, infection control, and cross contamination. In conclusion, although mobile phones provide much putative potential improvement to healthcare delivery, further evaluation and research are required to both inform and protect health professionals and users of such technology in the healthcare environment and provide the evidence base to support the provision of clear and comprehensive guidelines.

  19. Computer communications and graphics for clinical radiology

    International Nuclear Information System (INIS)

    Rhodes, M.L.; Azzawi, Y.; Tivattanasuk, E.S.; Pang, A.T.; Ly, K.; Panicker, H.

    1985-01-01

    Computer graphics has many forms. When applied in medicine, it can range from simple two dimensional charts and graphs to rendering of three-dimensional scenes. Computer graphic displays of molecular or large anatomic structures have been used to great advantage by numerous medical researchers. In addition, graphic presentations can be dynamic where displays are controlled by physician-user commands, or the presentations can be static, where views are recorded in discrete frames for later distribution or permanent archival. In medicine both interactive and static forms of computer graphics have their proper place in the effective delivery of health care. Computer graphics, however, changes constantly in the area of software techniques, hardware improvements and its clinical application. What may be medically appropriate today in the use of computer graphics can soon become inadequate and well behind the new advances that so quickly follow. In this paper the key feature of computer communication is discussed that aids in the clinical utility of computer graphics in medicine. It is distribution. Distribution in terms of instantaneous computer graphic software updates and more importantly, distribution of meaningful three-dimensional presentations to referring physicians. Physicians who, working in their private offices, have no routine access to medical work stations. In this environment three dimensional presentations of anatomy are static in nature, but must deliver realistic views of critical structures. This paper outlines how computer communication provides the essential ingredient to the provision of this service. As an illustration, the electronic distribution of software to generate three dimensional views of complex anatomoic structures is discussed. Sample views are included

  20. Doctor-patient communication: a review of the literature

    NARCIS (Netherlands)

    Ong, L. M.; de Haes, J. C.; Hoos, A. M.; Lammes, F. B.

    1995-01-01

    Communication can be seen as the main ingredient in medical care. In reviewing doctor-patient communication, the following topics are addressed: (1) different purposes of medical communication; (2) analysis of doctor-patient communication; (3) specific communicative behaviors; (4) the influence of

  1. Communication Partners Supporting Children with Complex Communication Needs Who Use AAC: A Systematic Review

    Science.gov (United States)

    Shire, Stephanie Y.; Jones, Nancy

    2015-01-01

    Communication partners who efficiently use augmentative and alternative communication (AAC) are essential interaction partners for children learning to communicate using AAC. This systematic review examines studies targeting interventions designed to help communication partners support children with complex communication needs who use AAC.…

  2. [Clinical pharmacy and surgery: Review].

    Science.gov (United States)

    Jarfaut, A; Nivoix, Y; Vigouroux, D; Kehrli, P; Gaudias, J; Kempf, J-F; Levêque, D; Gourieux, B

    2014-05-01

    Clinical pharmacy has been developed and evaluated in various medical hospital activities. Reviews conducted in this area reported a higher value of this discipline. In surgical services, evenly adverse drug events may occur, so clinical pharmacy activities must also help to optimize the management of drug's patient. The objectives of this literature review is to determine the profile of clinical pharmacy activities developed in surgical services and identify indicators. The research was conducted on Pubmed(®) database with the following keywords (2000-2013), "surgery", "pharmacy", "pharmacist", "pharmaceutical care", "impact" and limited to French or English papers. Studies dealing on simultaneously medical and surgical areas were excluded. Twenty-one papers were selected. The most frequently developed clinical pharmacy activities were history and therapeutic drug monitoring (antibiotics or anticoagulants). Two types of indicators were identified: activity indicators with the number of pharmaceutical interventions, their description and clinical signification, the acceptance rate and workload. Impact indicators were mostly clinical and economic impacts. The development of clinical pharmacy related to surgical patients is documented and appears to have, as for medical patients, a clinical and economical value. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Detailed clinical models: a review.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke; van der Zel, Michael

    2010-12-01

    Due to the increasing use of electronic patient records and other health care information technology, we see an increase in requests to utilize these data. A highly level of standardization is required during the gathering of these data in the clinical context in order to use it for analyses. Detailed Clinical Models (DCM) have been created toward this purpose and several initiatives have been implemented in various parts of the world to create standardized models. This paper presents a review of DCM. Two types of analyses are presented; one comparing DCM against health care information architectures and a second bottom up approach from concept analysis to representation. In addition core parts of the draft ISO standard 13972 on DCM are used such as clinician involvement, data element specification, modeling, meta information, and repository and governance. SIX INITIATIVES WERE SELECTED: Intermountain Healthcare, 13606/OpenEHR Archetypes, Clinical Templates, Clinical Contents Models, Health Level 7 templates, and Dutch Detailed Clinical Models. Each model selected was reviewed for their overall development, involvement of clinicians, use of data types, code bindings, expressing semantics, modeling, meta information, use of repository and governance. Using both a top down and bottom up approach to comparison reveals many commonalties and differences between initiatives. Important differences include the use of or lack of a reference model and expressiveness of models. Applying clinical data element standards facilitates the use of conceptual DCM models in different technical representations.

  4. Privacy enhanced group communication in clinical environment

    Science.gov (United States)

    Li, Mingyan; Narayanan, Sreeram; Poovendran, Radha

    2005-04-01

    Privacy protection of medical records has always been an important issue and is mandated by the recent Health Insurance Portability and Accountability Act (HIPAA) standards. In this paper, we propose security architectures for a tele-referring system that allows electronic group communication among professionals for better quality treatments, while protecting patient privacy against unauthorized access. Although DICOM defines the much-needed guidelines for confidentiality of medical data during transmission, there is no provision in the existing medical security systems to guarantee patient privacy once the data has been received. In our design, we address this issue by enabling tracing back to the recipient whose received data is disclosed to outsiders, using watermarking technique. We present security architecture design of a tele-referring system using a distributed approach and a centralized web-based approach. The resulting tele-referring system (i) provides confidentiality during the transmission and ensures integrity and authenticity of the received data, (ii) allows tracing of the recipient who has either distributed the data to outsiders or whose system has been compromised, (iii) provides proof of receipt or origin, and (iv) can be easy to use and low-cost to employ in clinical environment.

  5. A comparison of clinical communication skills between two groups of ...

    African Journals Online (AJOL)

    a comprehensive clinical model and a “golden thread” for communication skills in the ... sity, South Africa, based on the primary ..... Planning: shared decision making ... Explanation and planning. Incorporate clinical reasoning skills. Develop.

  6. Communication about environmental health risks: a systematic review.

    Science.gov (United States)

    Fitzpatrick-Lewis, Donna; Yost, Jennifer; Ciliska, Donna; Krishnaratne, Shari

    2010-11-01

    Using the most effective methods and techniques for communicating risk to the public is critical. Understanding the impact that different types of risk communication have played in real and perceived public health risks can provide information about how messages, policies and programs can and should be communicated in order to be most effective. The purpose of this systematic review is to identify the effectiveness of communication strategies and factors that impact communication uptake related to environmental health risks. A systematic review of English articles using multiple databases with appropriate search terms. Data sources also included grey literature. Key organization websites and key journals were hand searched for relevant articles. Consultation with experts took place to locate any additional references.Articles had to meet relevance criteria for study design [randomized controlled trials, clinical controlled trials, cohort analytic, cohort, any pre-post, interrupted time series, mixed methods or any qualitative studies), participants (those in community-living, non-clinical populations), interventions (including, but not limited to, any community-based methods or tools such as Internet, telephone, media-based interventions or any combination thereof), and outcomes (reported measurable outcomes such as awareness, knowledge or attitudinal or behavioural change). Articles were assessed for quality and data was extracted using standardized tools by two independent reviewers. Articles were given an overall assessment of strong, moderate or weak quality. There were no strong or moderate studies. Meta-analysis was not appropriate to the data. Data for 24 articles were analyzed and reported in a narrative format. The findings suggest that a multi-media approach is more effective than any single media approach. Similarly, printed material that offers a combination of information types (i.e., text and diagrams) is a more effective than just a single type, such

  7. Communication about environmental health risks: A systematic review

    Directory of Open Access Journals (Sweden)

    Ciliska Donna

    2010-11-01

    Full Text Available Abstract Background Using the most effective methods and techniques for communicating risk to the public is critical. Understanding the impact that different types of risk communication have played in real and perceived public health risks can provide information about how messages, policies and programs can and should be communicated in order to be most effective. The purpose of this systematic review is to identify the effectiveness of communication strategies and factors that impact communication uptake related to environmental health risks. Methods A systematic review of English articles using multiple databases with appropriate search terms. Data sources also included grey literature. Key organization websites and key journals were hand searched for relevant articles. Consultation with experts took place to locate any additional references. Articles had to meet relevance criteria for study design [randomized controlled trials, clinical controlled trials, cohort analytic, cohort, any pre-post, interrupted time series, mixed methods or any qualitative studies, participants (those in community-living, non-clinical populations, interventions (including, but not limited to, any community-based methods or tools such as Internet, telephone, media-based interventions or any combination thereof, and outcomes (reported measurable outcomes such as awareness, knowledge or attitudinal or behavioural change. Articles were assessed for quality and data was extracted using standardized tools by two independent reviewers. Articles were given an overall assessment of strong, moderate or weak quality. Results There were no strong or moderate studies. Meta-analysis was not appropriate to the data. Data for 24 articles were analyzed and reported in a narrative format. The findings suggest that a multi-media approach is more effective than any single media approach. Similarly, printed material that offers a combination of information types (i.e., text and

  8. Integrating clinical communication with clinical reasoning and the broader medical curriculum.

    Science.gov (United States)

    Cary, Julie; Kurtz, Suzanne

    2013-09-01

    The objectives of this paper are to discuss the results of a workshop conducted at EACH 2012. Specifically, we will (1) examine the link between communication, clinical reasoning, and medical problem solving, (2) explore strategies for (a) integrating clinical reasoning, medical problem solving, and content from the broader curriculum into clinical communication teaching and (b) integrating communication into the broader curriculum, and (3) discuss benefits gained from such integration. Salient features from the workshop were recorded and will be presented here, as well as a case example to illustrate important connections between clinical communication and clinical reasoning. Potential links between clinical communication, clinical reasoning, and medical problem solving as well as strategies to integrate clinical communication teaching and the broader curricula in human and veterinary medicine are enumerated. Participants expressed enthusiasm and keen interest in integration of clinical communication teaching and clinical reasoning during this workshop, came to the idea of the interdependence of these skills easily, and embraced the rationale immediately. Valuing the importance of communication as clinical skill and embracing the interdependence between communication and thought processes related to clinical reasoning and medical problem solving will be beneficial in teaching programs. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Communication course for midwives teaching students in clinical practice

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe; Pedersen, Pernille Mølholt

    taking place in clinical practice and try to align the educational efforts in school and clinical settings for the benefit of the students PERSPECTIVES It is known that students in medical education find that clinical learning experiences do not reinforce the communication skills they learn pre......-clinically (Rosenbaum et al. 2013) and our own experience teaching Danish midwifery students indicates the same problem in our program. Providing an opportunity for the clinical teachers to learn, discuss and practice communication issues with each other and with theoretical teachers can represent an important...

  10. Evidence-Based Clinical Voice Assessment: A Systematic Review

    Science.gov (United States)

    Roy, Nelson; Barkmeier-Kraemer, Julie; Eadie, Tanya; Sivasankar, M. Preeti; Mehta, Daryush; Paul, Diane; Hillman, Robert

    2013-01-01

    Purpose: To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method: The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language…

  11. Effective teaching of communication to health professional undergraduate and postgraduate students: A Systematic Review.

    Science.gov (United States)

    MacDonald-Wicks, Lesley; Levett-Jones, Tracy

    The objective is to identify and assess the effectiveness of tools and methods of teaching communication skills to health professional students in undergraduate and postgraduate programs, to facilitate communication in hospitals, nursing homes and mental health institutions.For this review, effective communication will be defined as that which enhances patient satisfaction, safety, symptom resolution, psychological status, or reduces the impact/burden of disease and/or improved communication skills within undergraduate or postgraduate studentsThe review question is: What is the best available evidence on strategies to effectively teach communication skills to undergraduate and postgraduate medical, nursing and allied health students (nutrition and dietetics, occupational therapy, physiotherapy, speech pathology etc)? Communication is a two-way interaction where information, meanings and feelings are shared both verbally and non-verbally. Effective communication is when the message being conveyed is understood as intended. Effective communication between the health professional and patient is increasingly being recognised as a core clinical skill. Research has identified the far reaching benefits of effective communication skills including enhanced patient satisfaction, patient safety, symptom resolution and improvements in functional and psychological status. Poor communication can result in omitted or misinterpretation of information resulting in declining health of the patient. Despite the importance of effective communication in ensuring positive outcomes for both the patient and health professional, there is concern that contemporary teaching and learning approaches do not always facilitate the development of a requisite level of communication skills, both verbal and written and a difficulty for the current generation of communication skills teachers is that many have not had the experience of being taught communication skills themselves.Studies have shown that

  12. Fournier's gangrene. A clinical review.

    Science.gov (United States)

    Singh, Ariana; Ahmed, Kamran; Aydin, Abdullatif; Khan, Muhammad Shamim; Dasgupta, Prokar

    2016-10-05

    Fournier's gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier's gangrene with emphasis on early diagnosis and management. This review aims to highlight the relevant research surrounding Fournier's gangrene, in particular the various prognostic indicators and management strategies. A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. In addition to which a search of the European Association of Urology, the British Association for Urological Surgeons and the British Medical Journal was conducted for the most recent recommendations. Immediate broad-spectrum antibiotic therapy and urgent surgical debridement are the core managerial principles of Fournier's gangrene. The use of adjunctive therapies such as hyperbaric oxygen and vacuum assisted closure are supported in some aspects of the literature and disputed in others. The lack of randomized controlled studies limits the use of these potential additional therapies to patients unresponsive to conventional management. The value of unprocessed honey as a topical antimicrobial agent has been highlighted in the literature for small lesions in uncomplicated patients. Fournier's gangrene is a urological emergency with a high mortality rate despite advances in the medical and surgical fields. The aggressive nature of the infection advocates the need for early recognition allowing immediate surgical intervention. The opposing results of available research as well as the lack of high quality evidence surrounding emergent therapies prevents

  13. Cerebral cysticercosis in a cat : clinical communication

    Directory of Open Access Journals (Sweden)

    E.V. Schwan

    2002-07-01

    Full Text Available The metacestode of Taenia solium, Cysticercus cellulosae, was recovered from the brain of a cat showing central nervous clinical signs ante mortem. This is the first record of cerebral cysticercosis in a cat in South Africa.

  14. Dental student attitudes towards communication skills instruction and clinical application.

    Science.gov (United States)

    McKenzie, Carly T

    2014-10-01

    This study investigated dental students' attitudes towards communication skills instruction and clinical application and explored the impact of a one-semester course and year in school on students' attitudes, measured by the Communication Skills Attitude Scale. Demographic characteristics and self-assessment of communication skills were also analyzed. The study employed a pretest-posttest survey design combined with cross-sectional data. Participants were first- and fourth-year students at a U.S. dental school. Out of a possible 120 students, 106 (fifty-seven D1 and forty-nine D4) participated in the pretest, an 88 percent response rate; out of a possible 121 students, 115 (fifty-seven D1 and fifty-eight D4) participated in the posttest, a 95 percent response rate. In the results, D4 students consistently demonstrated less positive attitudes towards communication skills instruction and more negative attitudes regarding the importance of interpersonal skills in clinical encounters than did their D1 counterparts. A single communications course had no discernible effect on attitudes or self-assessments for either cohort. Females reported more positive attitudes towards clinical application of interpersonal skills than did males. Gender significantly interacted with two demographic variables: primary language and parent as health care professional. Female children of health care professionals reported poorer attitudes towards clinical communication skills training and application than did their male counterparts. Generally, parental occupation in health care moderated the decrease in positive attitudes over time towards clinical usefulness of communication skills. The D4 students rated their communication skills higher than did the D1 students. Students who demonstrated more positive attitudes towards communication skills training and application were more likely to say their own skills needed improvement.

  15. Physician communication via Internet-enabled technology: A systematic review.

    Science.gov (United States)

    Barr, Neil G; Randall, Glen E; Archer, Norman P; Musson, David M

    2017-10-01

    The use of Internet-enabled technology (information and communication technology such as smartphone applications) may enrich information exchange among providers and, consequently, improve health care delivery. The purpose of this systematic review was to gain a greater understanding of the role that Internet-enabled technology plays in enhancing communication among physicians. Studies were identified through a search in three electronic platforms: the Association for Computing Machinery Digital Library, ProQuest, and Web of Science. The search identified 5140 articles; of these, 21 met all inclusion criteria. In general, physicians were satisfied with Internet-enabled technology, but consensus was lacking regarding whether Internet-enabled technology improved efficiency or made a difference to clinical decision-making. Internet-enabled technology can play an important role in enhancing communication among physicians, but the extent of that benefit is influenced by (1) the impact of Internet-enabled technology on existing work practices, (2) the availability of adequate resources, and (3) the nature of institutional elements, such as privacy legislation.

  16. Should we use philosophy to teach clinical communication skills?

    Directory of Open Access Journals (Sweden)

    Berna Gerber

    2016-11-01

    Full Text Available Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession’s (mistaken understanding of itself as a natural science on doctor–patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient’s psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.

  17. Should we use philosophy to teach clinical communication skills?

    Science.gov (United States)

    Gerber, Berna

    2016-11-16

    Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession's (mistaken) understanding of itself as a natural science on doctor-patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient's psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.

  18. Should we use philosophy to teach clinical communication skills?

    Science.gov (United States)

    2016-01-01

    Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession’s (mistaken) understanding of itself as a natural science on doctor–patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient’s psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication. PMID:28155325

  19. "Best practice" for patient-centered communication: a narrative review.

    Science.gov (United States)

    King, Ann; Hoppe, Ruth B

    2013-09-01

    Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes "best practice" for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills.

  20. Clinical use of Skype: a review of the evidence base.

    Science.gov (United States)

    Armfield, Nigel R; Gray, Leonard C; Smith, Anthony C

    2012-04-01

    Skype is a popular and free software application that allows PCs and mobile devices to be used for video communication over the Internet. We reviewed the literature to determine whether the clinical use of Skype is supported by evidence. One small (n = 7) controlled clinical trial had assessed the effect of nursing communication using Skype on elderly patients with dementia and their carers. However, we were unable to identify any large, well-designed studies which had formally evaluated the safety, clinical effectiveness, security and privacy of Skype for the routine delivery of patient care. While there were many case reports and small studies, no firm evidence either in favour of, or against the use of Skype for clinical telehealth was found. The risks and benefits of using Skype for clinical purposes are not known.

  1. Editorial Note FQS Reviews: Editorial Work is "Communication Work"

    Directory of Open Access Journals (Sweden)

    Günter Mey

    2004-01-01

    Full Text Available Editorial Notes provide a view "behind the scenes" of FQS Reviews, reporting and describing the editorial process. The first topic in this Editorial Note focuses on changes in the way reviewers are found. As FQS Reviews began we preferred finding reviewers by posting on different listservs to inform others about review copies of books and other media. In the next phase of FQS Reviews—aside from postings—we attempted to establish a core of authors who would exclusively write reviews. The second topic describes an analyses of 131 archived files (first drafts of reviews published in FQS and the analyses of the e-mail contacts between the reviewers and the editorial team which accompany the peer review process. One result of our analyses is that the quality of a review is independent from way the reviewer was recruited (postings on listservs or established core reviewer; no significant differences can be seen between the two groups (reviewers found via listservs or established reviewers. More, important, however, is the intensive "communication work" between editors and reviewers—a necessary communication to guarantee standardization and maintenance of quality. This is critical as our focus is on the review as a "unique contribution" within the research community. To give an insight into the intensive communication work an anonymous case study of a "failed" review is included. URN: urn:nbn:de:0114-fqs040115

  2. Communication in healthcare: a narrative review of the literature and practical recommendations.

    Science.gov (United States)

    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.

  3. The Group Objective Structured Clinical Experience: building communication skills in the clinical reasoning context.

    Science.gov (United States)

    Konopasek, Lyuba; Kelly, Kevin V; Bylund, Carma L; Wenderoth, Suzanne; Storey-Johnson, Carol

    2014-07-01

    Students are rarely taught communication skills in the context of clinical reasoning training. The purpose of this project was to combine the teaching of communication skills using SPs with clinical reasoning exercises in a Group Objective Structured Clinical Experience (GOSCE) to study feasibility of the approach, the effect on learners' self-efficacy and attitude toward learning communication skills, and the effect of providing multiple sources of immediate, collaborative feedback. GOSCE sessions were piloted in Pediatrics and Medicine clerkships with students assessing their own performance and receiving formative feedback on communication skills from peers, standardized patients (SPs), and faculty. The sessions were evaluated using a retrospective pre/post-training questionnaire rating changes in self-efficacy and attitudes, and the value of the feedback. Results indicate a positive impact on attitudes toward learning communication skills and self-efficacy regarding communication in the clinical setting. Also, learners considered feedback by peers, SPs, and faculty valuable in each GOSCE. The GOSCE is an efficient and learner-centered method to attend to multiple goals of teaching communication skills, clinical reasoning, self-assessment, and giving feedback in a formative setting. The GOSCE is a low-resource, feasible strategy for experiential learning in communication skills and clinical reasoning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

    Science.gov (United States)

    Carruthers, Helen; Astin, Felicity; Munro, Wendy

    2017-10-01

    To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Communication in a Diverse Classroom: An Annotated Bibliographic Review

    Science.gov (United States)

    Brown, Rachelle

    2016-01-01

    Students have social and personal needs to fulfill and communicate these needs in different ways. This annotated bibliographic review examined communication studies to provide educators of diverse classrooms with ideas to build an environment that contributes to student well-being. Participants in the studies ranged in age, ability, and cultural…

  6. Couples Communication Skills and Anxiety of Pregnancy: A Narrative Review.

    Science.gov (United States)

    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.

  7. Clinical supervisors' perceived needs for teaching communication skills in clinical practice.

    Science.gov (United States)

    Perron, N Junod; Sommer, J; Hudelson, P; Demaurex, F; Luthy, C; Louis-Simonet, M; Nendaz, M; De Grave, W; Dolmans, D; van der Vleuten, C P M

    2009-07-01

    Lack of faculty training is often cited as the main obstacle to post-graduate teaching in communication skills. To explore clinical supervisors' needs and perceptions regarding their role as communication skills trainers. Four focus group discussions were conducted with clinical supervisors from two in-patient and one out-patient medical services from the Geneva University Hospitals. Focus groups were audio taped, transcribed verbatim and analyzed in a thematic way using Maxqda software for qualitative data analysis. Clinical supervisors said that they frequently addressed communication issues with residents but tended to intervene as rescuers, clinicians or coaches rather than as formal instructors. They felt their own training did not prepare them to teach communication skills. Other barriers to teach communication skills include lack of time, competing demands, lack of interest and experience on the part of residents, and lack of institutional priority given to communication issues. Respondents expressed a desire for experiential and reflective training in a work-based setting and emphasised the need for a non-judgmental learning atmosphere. Results suggest that organisational priorities, culture and climate strongly influence the degree to which clinical supervisors may feel comfortable to teach communication skills to residents. Attention must be given to these contextual factors in the development of an effective communication skills teaching program for clinical supervisors.

  8. Digital Inclusion & Health Communication: A Rapid Review of Literature.

    Science.gov (United States)

    Borg, Kim; Boulet, Mark; Smith, Liam; Bragge, Peter

    2018-06-11

    Information and communication technologies can be a valuable tool for enhancing health communication. However, not everyone is utilising the wide suite of digital opportunities. This disparity has the potential to exacerbate existing social and health inequalities, particularly among vulnerable groups such as those who are in poor health and the elderly. This review aimed to systematically identify the common barriers to, and facilitators of, digital inclusion. A comprehensive database search yielded 969 citations. Following screening, seven systematic reviews and three non-systematic reviews were identified. Collectively, the reviews found that physical access continues to be a barrier to digital inclusion. However, provision of access alone is insufficient, as digital ability and attitude were also potential barriers. Social support, direct user experience and collaborative learning/design were identified as key strategies to improve inclusion. These review findings provide guidance for health communication practitioners in designing and implementing effective programmes in the digital environment.

  9. High-technology augmentative communication for adults with post-stroke aphasia: a systematic review.

    Science.gov (United States)

    Russo, Maria Julieta; Prodan, Valeria; Meda, Natalia Nerina; Carcavallo, Lucila; Muracioli, Anibal; Sabe, Liliana; Bonamico, Lucas; Allegri, Ricardo Francisco; Olmos, Lisandro

    2017-05-01

    Augmentative and alternative communication (AAC) systems were introduced into clinical practice by therapists to help compensate for persistent language deficits in people with aphasia. Although, there is currently a push towards an increased focus on compensatory approaches in an attempt to maximize communication function for social interaction, available studies including AAC systems, especially technologically advanced communication tools and systems, known as 'high-technology AAC', show key issues and obstacles for these tools to become utilized in mainstream clinical practice. Areas covered: The current review synthesizes communication intervention studies that involved the use of high-technology communication devices to enhance linguistic communication skills for adults with post-stroke aphasia. The review focuses on compensatory approaches that emphasized functional communication. It also summarizes recommendations for the report of studies evaluating high-technology devices that may be potentially relevant for other researchers working with adults with post-stroke aphasia. Expert commentary: Taken together with positive results in heterogeneous studies, high-technology devices represent a compensatory strategy to enhance communicative skills in individuals with post-stroke aphasia. Improvements in the design of studies and reporting of results may lead to better interpretation of the already existing scientific results from aphasia management.

  10. Information and communication in the context of a clinical trial

    DEFF Research Database (Denmark)

    Hietanen, P; Aro, A R; Holli, K

    2000-01-01

    The aim of this study was to determine the communicative needs of the patients in the context of being invited to participate in a clinical trial. A questionnaire was sent to 299 patients with breast cancer randomised in a trial of adjuvant therapy. It was returned by 261 (87%) of them. Ninety...

  11. Space Communications Capability Roadmap Interim Review

    Science.gov (United States)

    Spearing, Robert; Regan, Michael

    2005-01-01

    Contents include the following: Identify the need for a robust communications and navigation architecture for the success of exploration and science missions. Describe an approach for specifying architecture alternatives and analyzing them. Establish a top level architecture based on a network of networks. Identify key enabling technologies. Synthesize capability, architecture and technology into an initial capability roadmap.

  12. Assistive technology for communication of older adults: a systematic review.

    Science.gov (United States)

    Pedrozo Campos Antunes, Thaiany; Souza Bulle de Oliveira, Acary; Hudec, Robert; Brusque Crocetta, Tania; Ferreira de Lima Antão, Jennifer Yohanna; de Almeida Barbosa, Renata Thais; Guarnieri, Regiani; Massetti, Thais; Garner, David M; de Abreu, Luiz Carlos

    2018-02-16

    Describe the use of assistive technology to enhance communication opportunities for older adults. A systematic review was conducted in two databases, PubMed and Web of Science, by using two different searches in each. The search was limited to original articles, in English language, including people aged 60 years and older that used any type of assistive technology for communication. The articles found in the initial search were filtered by title, abstracts and the remaining articles were fully read. Eighteen studies were included in this review after the reading of full-texts. Most of the studies included apparently healthy participants with communication limitations due to aging related changes and the others included people with some pathology that prevent them from normal communication. Four categories of assistive technology were identified: assistive technology for people with speech problems; robot or videoconferencing systems; Information and Communication Technologies and, other types of assistive technology for communication, such as hearing aids and scrapbooks. Assistive technology for communication of older adults is not only used by people with disabilities that prevent them from usual communication. They are mostly for older adults without a pathological communication problem.

  13. Digital communication to support clinical supervision: considering the human factors.

    Science.gov (United States)

    Mather, Carey; Marlow, Annette; Cummings, Elizabeth

    2013-01-01

    During the last three years the School of Nursing and Midwifery at the University of Tasmania has used a needs assessment survey to explore the needs of organizations and nursing professionals that facilitate and clinically supervise Bachelor of Nursing students in the workplace. Findings from the survey indicated that staff at healthcare organizations wanted a communication strategy that was easily accessible by clinicians who supervised students during work integrated learning placements. In particular they wanted to receive timely information related to the role and function of supervisors in practice. The development of the digital strategy to strengthen the development of a community of practice between the University, organizations, facilities and clinical supervisors was identified as the key method of improving communication. Blogging and micro blogging were selected as methods of choice for the implementation of the digital strategy because they were easy to set up, use and enable equity of access to geographically dispersed practitioners in urban and rural areas. Change champions were identified to disseminate information about the strategy within their workplaces. Although clinicians indicated electronic communication as their preferred method, there were a number of human factors at a systems and individual level identified to be challenges when communicating with clinical supervisors who were based off-campus. Information communication technology policies and embedded culture towards social presence were impediments to using this approach in some organizations. Additionally, it was found that it is necessary for this group of clinicians to be educated about using digital methods to undertake their role as clinical supervisors in their varied clinical practice environments.

  14. Communicating Qualitative Research Study Designs to Research Ethics Review Boards

    Science.gov (United States)

    Ells, Carolyn

    2011-01-01

    Researchers using qualitative methodologies appear to be particularly prone to having their study designs called into question by research ethics or funding agency review committees. In this paper, the author considers the issue of communicating qualitative research study designs in the context of institutional research ethics review and offers…

  15. Communication between hospitals and isolated aboriginal community health clinics.

    Science.gov (United States)

    Mackenzie, G; Currie, B J

    1999-04-01

    This study described the communication dynamics, identified problems and recommended changes to improve patient follow-up and communication between Royal Darwin Hospital (RDH) and isolated Aboriginal community health clinics (CHC) in the Northern Territory (NT). In 1995, staff interviews were conducted and an audit of isolated Aboriginal patients' RDH discharge summaries (DS). Eighteen per cent of RDH DSs never arrived in CHCs. DSs were often prepared late and more likely to be in CHC records if written on time and if the referral source was specified. Interviews revealed discontent between CHCs and RDH regarding: communication, DS documentation, the supply of discharge medication, as well as different hospital and community perceptions of Aboriginies' reliability to carry a DS and CHC desire for patients to be given DSs at discharge. Aboriginal patients should be given a DS at discharge and resident medical officers should be educated as to the function and importance of the DS. In 18 months following this study, RDH appointed unit-based Aboriginal health workers and a policy was produced for written communication between hospital and CHCs, as well as a discharge planning manual for Aboriginal communities. Projects investigating communication between hospitals and isolated Aboriginal clinics and patient follow-up may result in significant policy changes concerning these processes.

  16. Companion animal veterinarians' use of clinical communication skills.

    Science.gov (United States)

    McArthur, M L; Fitzgerald, J R

    2013-09-01

    To describe the communication techniques used by clients and veterinarians during companion animal visits in Australia. A cross-sectional descriptive study. A total of 64 veterinary consultations were audiotaped and analysed with the Roter Interaction Analysis System (RIAS); clients completed appointment level measures, including their satisfaction and perceptions of relational communication. Participants were 24 veterinarians and 64 clients. Statements intended to reassure clients were expressed frequently in the consultations, but in 59% of appointments empathy statements were not expressed towards either the client or the patient. In 10% of appointments, veterinarians did not used any open-ended questions. Overall client satisfaction was high and veterinarians' expressions of empathy directed to the client resulted in higher levels of client satisfaction. Clients' perceptions of relational communication were related to several veterinarian and client nonverbal scales. A focus on developing evidence-based clinical communication skills is expected to further enhance the veterinarian-client-patient relationship and associated clinical outcomes. Particular recommendations include the development of a broader emotion-handling repertoire, increased emphasis on the use of open-ended enquiry, including assessment of the client's perspective, as well as attention to aspects of nonverbal communication. The study provides preliminary evidence for the importance of verbal expressions of empathy during the companion animal consultation. © 2013 Australian Veterinary Association.

  17. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  18. Shared Communications: Volume 1. A Summary and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Franzese, O

    2004-09-22

    This paper provides a review of examples from the literature of shared communication resources and of agencies and/or organizations that share communication resources. The primary emphasis is on rural, intelligent transportation system communications involving transit. Citations will not be limited, however, to rural activities, or to ITS implementation, or even to transit. In addition, the term ''communication'' will be broadly applied to include all information resources. Literature references to issues that contribute to both successful and failed efforts at sharing communication resources are reviewed. The findings of this literature review indicate that: (1) The most frequently shared communication resources are information/data resources, (2) Telecommunications infrastructure and technologies are the next most frequently shared resources, (3) When resources are successfully shared, all parties benefit, (4) A few unsuccessful attempts of sharing resources have been recorded, along with lessons learned, (5) Impediments to sharing include security issues, concerns over system availability and reliability, service quality and performance, and institutional barriers, (6) Advantages of sharing include financial benefits to agencies from using shared resources and benefits to the public in terms of congestion mitigation, information transfer (e.g., traveler information systems), mobility (e.g., welfare-to-work paratransit), and safety (e.g., speed of incident response, incident avoidance), (7) Technology-based solutions exist to address technology-based concerns, and (8) Institutional issues can be addressed through leadership, enhanced knowledge and skills, open communication, responsiveness, and attractive pricing structures.

  19. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Xi Huang

    2018-01-01

    Full Text Available Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC: real-time communication that takes place between human beings via the instrumentality of computers in forms of text, audio and video communication, such as live chat and chatrooms as socially-oriented meaning construction. This review begins by considering the adoption of social interactionist views to identify key paradigms and supportive principles of computer-supported collaborative learning. A special focus on two components of communicative competence is then presented to explore interactional variables in synchronous computer-mediated communication along with a review of research. There follows a discussion on a synthesis of interactional variables in negotiated interaction and co-construction of knowledge from psycholinguistic and social cohesion perspectives. This review reveals both possibilities and disparities of language socialization in promoting intersubjective learning and diversifying the salient use of interactively creative language in computer-supported collaborative learning environments in service of communicative competence.

  20. Attitudes of Portuguese medical residents' towards clinical communication skills.

    Science.gov (United States)

    Loureiro, Elizabete; Severo, Milton; Ferreira, Maria Amélia

    2015-08-01

    To explore the attitudes and perceptions of Portuguese residents towards Clinical Communication Skills (CCS) and the need for complementary training. 78 medical residents responded to an on-line questionnaire which comprised demographic data, open-ended questions and a Portuguese version of the Communication Skills Attitude Scale (CSAS). Residents gave significantly higher scores (Pcommunication skills in general, compared to CSAS2 (attitudes towards the teaching/learning process of CCS). Residents doing their residency training in other parts of the country, other than the north, reveal a higher perception of insufficient training (72.7% vs. 38.7%, P=0.036). Residents showed more positive attitudes towards communication skills than towards the teaching/learning process. They admit to need more training in CCS in their residency year and highlight that the clinical cycle of undergraduate education should integrate these topics. Content analysis indicates that residents' perceptions are context-influenced. Integration of CCS in the undergraduate education, enhanced during post-graduate training. Training of clinical faculty and supervisors/tutors and the role that stakeholders have to play in order to promote continuous training in CCS; encourage patient-centeredness and reflective practice, as to facilitate transfer of acquired skills to clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Use of simulated patients to develop communication skills in nursing education: An integrative review.

    Science.gov (United States)

    MacLean, Sharon; Kelly, Michelle; Geddes, Fiona; Della, Phillip

    2017-01-01

    Registered nurses are expected to communicate effectively with patients. To improve on this skill education programmes in both hospital and tertiary settings are increasingly turning to simulation modalities when training undergraduate and registered nurses. The roles simulated patients (SPs) assume can vary according to training purposes and approach. The first aim is to analyse how SPs are used in nursing education to develop communication skills. The second aim is to evaluate the evidence that is available to support the efficacy of using SPs for training nurses in communication skills and finally to review the SP recruitment and training procedure. An Integrative review. A search was conducted on CINAHL, Psych-info, PubMed, Google Scholar, Scopus, Ovid, Medline, and ProQuest databases. Keywords and inclusion/exclusion criteria were determined and applied to the search strategy. The integrative review included Nineteen studies from 2006-2016. Critical Appraisal Skills Program (CASP) method of evaluation was utilised. Emergent themes were extracted with similar and divergent perspectives. Analysis identified seven clinical contexts for communication skills training (CST) and two SP roles from the eighteen studies. SPs were either directly involved in the teaching of communication (active role) or used in the evaluation of the effectiveness of a communication skills program (passive role). A majority of studies utilised faculty-designed measurement instruments. The evidence presented in the 19 articles indicates that the use of SPs to teach nurse-patient communication skills targets more challenging clinical interactions. Engaging SPs in both CST program facilitation and course evaluation provides nurse educators with a strong foundation to develop further pedagogical and research capacity. Expanding the utilisation of SPs to augment nurses' communication skills and ability to engage with patients in a broader range of clinical contexts with increased

  2. Dependence and caring in clinical communication: the relevance of attachment and other theories.

    Science.gov (United States)

    Salmon, Peter; Young, Bridget

    2009-03-01

    Clinical relationships are usually asymmetric, being defined by patients' dependence and practitioners' care. Our aims are to: (i) identify literature that can contribute to theory for researching and teaching clinical communication from this perspective; (ii) highlight where theoretical development is needed; and (iii) test the utility of the emerging theory by identifying whether it leads to implications for educational practice. Selective and critical review of research concerned with dependence and caring in clinical and non-clinical relationships. Attachment theory helps to understand patients' need to seek safety in relationships with expert and authoritative practitioners but is of limited help in understanding practitioners' caring. Different theories that formulate practitioners' care as altruistic, rewarded by personal connection or as a contract indicate the potential importance of practitioners' emotions, values and sense of role in understanding their clinical communication. Extending the theoretical grounding of clinical communication can accommodate patients' dependence and practitioners' caring without return to medical paternalism. A broader theoretical base will help educators to address the inherent subjectivity of clinical relationships, and researchers to distinguish scientific questions about how patients and clinicians are from normative questions about how they should be.

  3. Dependence and caring in clinical communication: The relevance of attachment and other theories

    Science.gov (United States)

    Salmon, Peter; Young, Bridget

    2009-01-01

    Objective Clinical relationships are usually asymmetric, being defined by patients’ dependence and practitioners’ care. Our aims are to: (i) identify literature that can contribute to theory for researching and teaching clinical communication from this perspective; (ii) highlight where theoretical development is needed; and (iii) test the utility of the emerging theory by identifying whether it leads to implications for educational practice. Methods Selective and critical review of research concerned with dependence and caring in clinical and non-clinical relationships. Results Attachment theory helps to understand patients’ need to seek safety in relationships with expert and authoritative practitioners but is of limited help in understanding practitioners’ caring. Different theories that formulate practitioners’ care as altruistic, rewarded by personal connection or as a contract indicate the potential importance of practitioners’ emotions, values and sense of role in understanding their clinical communication. Conclusion Extending the theoretical grounding of clinical communication can accommodate patients’ dependence and practitioners’ caring without return to medical paternalism. Practice implications A broader theoretical base will help educators to address the inherent subjectivity of clinical relationships, and researchers to distinguish scientific questions about how patients and clinicians are from normative questions about how they should be. PMID:19157761

  4. [Cell phone communication: hygienic characteristics, biological action, standardization (a review)].

    Science.gov (United States)

    Gudina, M V; Volkotrub, L P

    2010-01-01

    The paper considers the topical issues concerning the functioning of the cellular communication system. It provides the hygienic characteristics of its individual elements. The factors influencing the size of an electromagnetic field generated by mobile phones are stated. Research data on the impact of electromagnetic radiation from a mobile phone on users' health are reviewed. The pivots of present-day Russian hygienic rating regarding the permissible exposures to nonionizing electromagnetic energy generated by the elements of the cellular communication system are identified.

  5. A Review on Human Body Communication: Signal Propagation Model, Communication Performance, and Experimental Issues

    Directory of Open Access Journals (Sweden)

    Jian Feng Zhao

    2017-01-01

    Full Text Available Human body communication (HBC, which uses the human body tissue as the transmission medium to transmit health informatics, serves as a promising physical layer solution for the body area network (BAN. The human centric nature of HBC offers an innovative method to transfer the healthcare data, whose transmission requires low interference and reliable data link. Therefore, the deployment of HBC system obtaining good communication performance is required. In this regard, a tutorial review on the important issues related to HBC data transmission such as signal propagation model, channel characteristics, communication performance, and experimental considerations is conducted. In this work, the development of HBC and its first attempts are firstly reviewed. Then a survey on the signal propagation models is introduced. Based on these models, the channel characteristics are summarized; the communication performance and selection of transmission parameters are also investigated. Moreover, the experimental issues, such as electrodes and grounding strategies, are also discussed. Finally, the recommended future studies are provided.

  6. Using a communication audit to improve communication on clinical placement in pre-registration nursing.

    Science.gov (United States)

    Hogard, Elaine; Ellis, Roger; Ellis, Jackie; Barker, Chris

    2005-02-01

    This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.

  7. An Integrated Review of Emoticons in Computer-Mediated Communication.

    Science.gov (United States)

    Aldunate, Nerea; González-Ibáñez, Roberto

    2016-01-01

    Facial expressions constitute a rich source of non-verbal cues in face-to-face communication. They provide interlocutors with resources to express and interpret verbal messages, which may affect their cognitive and emotional processing. Contrarily, computer-mediated communication (CMC), particularly text-based communication, is limited to the use of symbols to convey a message, where facial expressions cannot be transmitted naturally. In this scenario, people use emoticons as paralinguistic cues to convey emotional meaning. Research has shown that emoticons contribute to a greater social presence as a result of the enrichment of text-based communication channels. Additionally, emoticons constitute a valuable resource for language comprehension by providing expressivity to text messages. The latter findings have been supported by studies in neuroscience showing that particular brain regions involved in emotional processing are also activated when people are exposed to emoticons. To reach an integrated understanding of the influence of emoticons in human communication on both socio-cognitive and neural levels, we review the literature on emoticons in three different areas. First, we present relevant literature on emoticons in CMC. Second, we study the influence of emoticons in language comprehension. Finally, we show the incipient research in neuroscience on this topic. This mini review reveals that, while there are plenty of studies on the influence of emoticons in communication from a social psychology perspective, little is known about the neurocognitive basis of the effects of emoticons on communication dynamics.

  8. Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

    Science.gov (United States)

    Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

    2017-09-01

    Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  9. Clinical review: Percutaneous dilatational tracheostomy

    Science.gov (United States)

    Al-Ansari, Mariam A; Hijazi, Mohammed H

    2006-01-01

    As the number of critically ill patients requiring tracheotomy for prolonged ventilation has increased, the demand for a procedural alternative to the surgical tracheostomy (ST) has also emerged. Since its introduction, percutaneous dilatational tracheostomies (PDT) have gained increasing popularity. The most commonly cited advantages are the ease of the familiar technique and the ability to perform the procedure at the bedside. It is now considered a viable alternative to (ST) in the intensive care unit. Evaluation of PDT procedural modifications will require evaluation in randomized clinical trials. Regardless of the PDT technique, meticulous preoperative and postoperative management are necessary to maintain the excellent safety record of PDT. PMID:16356203

  10. Huntington's disease: a clinical review

    Directory of Open Access Journals (Sweden)

    Roos Raymund AC

    2010-12-01

    Full Text Available Abstract Huntington disease (HD is a rare neurodegenerative disorder of the central nervous system characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. Prevalence in the Caucasian population is estimated at 1/10,000-1/20,000. Mean age at onset of symptoms is 30-50 years. In some cases symptoms start before the age of 20 years with behavior disturbances and learning difficulties at school (Juvenile Huntington's disease; JHD. The classic sign is chorea that gradually spreads to all muscles. All psychomotor processes become severely retarded. Patients experience psychiatric symptoms and cognitive decline. HD is an autosomal dominant inherited disease caused by an elongated CAG repeat (36 repeats or more on the short arm of chromosome 4p16.3 in the Huntingtine gene. The longer the CAG repeat, the earlier the onset of disease. In cases of JHD the repeat often exceeds 55. Diagnosis is based on clinical symptoms and signs in an individual with a parent with proven HD, and is confirmed by DNA determination. Pre-manifest diagnosis should only be performed by multidisciplinary teams in healthy at-risk adult individuals who want to know whether they carry the mutation or not. Differential diagnoses include other causes of chorea including general internal disorders or iatrogenic disorders. Phenocopies (clinically diagnosed cases of HD without the genetic mutation are observed. Prenatal diagnosis is possible by chorionic villus sampling or amniocentesis. Preimplantation diagnosis with in vitro fertilization is offered in several countries. There is no cure. Management should be multidisciplinary and is based on treating symptoms with a view to improving quality of life. Chorea is treated with dopamine receptor blocking or depleting agents. Medication and non-medical care for depression and aggressive behavior may be required. The progression of the disease leads to a complete dependency in daily life, which

  11. Enhancing clinical communication in dermatologists: a personalized educational intervention.

    Science.gov (United States)

    Tsimtsiou, Zoi; Stavropoulou, Charitini; Papastefanou, Noni; Lionis, Christos

    2017-11-01

    Effective communication is a vital component of patient-centered consultations with favorable treatment outcomes. This study aimed in testing the effectiveness of a personalized, communication training program for dermatologists in their practices. Fifteen dermatologists were offered the educational intervention NO.TE.S. (Non-Technical Skills). Depending on the dermatologists' needs, seven to nine sessions with a 60-min duration were performed, focusing on: patient-centered care, principles of Neurolinguistic Programming, a guide to the medical interview, principles of motivational interviewing and self-care. After the program's completion, participants completed anonymously an 18-item evaluation questionnaire. All 14 participants would suggest NO.TE.S to a colleague. According to the main themes identified, their participation led to (i) re-consideration of the physician-patient relationship, (ii) more conscious application of the patient-centered model, (iii) improvement in communication skills, (iv) awareness of medical interview guides, (v) increase in self-confidence, and (vi) techniques of self-care. Eleven physicians (78.6%) declared improvement in patients' satisfaction, 14 (100%) in their own satisfaction, seven (50%) in adherence to therapeutic plan and seven (50%) in treatment outcomes. The one-to-one coaching is a convenient and well-received personalized means of enhancing clinical communication in dermatologists, leading to more patient-centered medical encounters with better treatment outcomes.

  12. 'Communicative competence' in the field of augmentative and alternative communication: a review and critique.

    Science.gov (United States)

    Teachman, Gail; Gibson, Barbara E

    2014-01-01

    Understandings of 'communicative competency' (CC) have an important influence on the ways that researchers and practitioners in augmentative and alternative communication (AAC) work toward achieving positive outcomes with AAC users. Yet, very little literature has critically examined conceptualizations of CC in AAC. Following an overview of the emergence of the concept of CC and of the field of AAC, we review seven conceptualizations of CC identified in the literature. To consider the contributions and potential shortcomings of conceptualizations of CC in AAC. We use a critical theoretical approach to review, critique and synthesize conceptualizations of CC in AAC, with a particular focus on uncovering 'taken for granted' assumptions. By historically situating the reviewed literature, we examine the shifting boundaries and tensions among theoretical conceptualizations of CC in AAC and their potential impacts on practice. We suggest ways that revisiting past scholarly work, alongside emergent, innovative conceptualizations of CC might shift ways of thinking about CC in AAC which tend to focus on the individual who communicates differently, toward (re)location of CC as a shared, socially incorporated and performed communication construct. We propose that emerging critical perspectives drawn from AAC and other interdisciplinary literatures offer innovative ways of theorizing communication difference, which might inform evolving conceptualizations of CC in AAC. © 2013 Royal College of Speech and Language Therapists.

  13. Communication Assessment for Individuals with Rett Syndrome: A Systematic Review

    Science.gov (United States)

    Sigafoos, Jeff; Kagohara, Debora; van der Meer, Larah; Green, Vanessa A.; O'Reilly, Mark F.; Lancioni, Giulio E.; Lang, Russell; Rispoli, Mandy; Zisimopoulos, Dimitrios

    2011-01-01

    We reviewed studies that aimed to determine whether behaviors, such as body movements, vocalizations, eye gaze, and facial expressions, served a communicative function for individuals with Rett syndrome. A systematic search identified eight studies, which were summarized in terms of (a) participants, (b) assessment targets, (c) assessment…

  14. Specific Syndromes and Associated Communication Disorders: A Review.

    Science.gov (United States)

    Sanger, Dixie D.; And Others

    1984-01-01

    The review, intended to provide speech-language pathologists and special educators with an awareness of genetics and specific syndromes involving speech, language, and hearing components, discusses basic etiologies of abnormal development and selected syndromes (such as Down's and Klinefelter's) that include communication disorders. (CL)

  15. Effective Nurse Communication With Type 2 Diabetes Patients : A Review

    NARCIS (Netherlands)

    Mulder, Bob C.; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to

  16. Evaluating clinical librarian services: a systematic review.

    Science.gov (United States)

    Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

    2011-03-01

      Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  17. Engaging patients and families in communication across transitions of care: an integrative review protocol.

    Science.gov (United States)

    Bucknall, Tracey K; Hutchinson, Alison M; Botti, Mari; McTier, Lauren; Rawson, Helen; Hewitt, Nicky A; McMurray, Anne; Marshall, Andrea P; Gillespie, Brigid M; Chaboyer, Wendy

    2016-07-01

    To describe an integrative review protocol to analyse and synthesize peer-reviewed research evidence in relation to engagement of patients and their families in communication during transitions of care to, in and from acute care settings. Communication at transitions of care in acute care settings can be complex and challenging, with important information about patients not always clearly transferred between responsible healthcare providers. Involving patients and their families in communication during transitions of care may improve the transfer of clinical information and patient outcomes and prevent adverse events during hospitalization and following discharge. Recently, optimizing patient and family participation during care transitions has been acknowledged as central to the implementation of patient-centred care. Integrative review with potential for meta-analysis and application of framework synthesis. The review will evaluate and synthesize qualitative and quantitative research evidence identified through a systematic search. Primary studies will be selected according to inclusion criteria. Data collection, quality appraisal and analysis of the evidence will be conducted by at least two authors. Nine electronic databases (including CINAHL and Medline) will be searched. The search will be restricted to 10 years up to December 2013. Data analysis will include content and thematic analysis. The review will seek to identify all types of patient engagement activities employed during transitions of care communication. The review will identify enablers for and barriers to engagement for patients, families and health professionals. Key strategies and tools for improving patient engagement, clinical communication and promoting patient-centred care will be recommended based on findings. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  18. Changes in communication skills of clinical residents through psychiatric training.

    Science.gov (United States)

    Yutani, Motoki; Takahashi, Megumi; Miyaoka, Hitoshi

    2011-10-01

    The objective of this study was to clarify whether the communication skills (CS) of clinical residents change before and after psychiatric training and, if so, what factors are related to the change. The 44 clinical residents who agreed to participate in this study were provided with an originally developed self-accomplished questionnaire survey on CS (communication skills questionnaire [CSQ]) and a generally used questionnaire on self-esteem, anxiety, and depressive mood considered to be related to CS at the start and end of a 2-month psychiatric training session. Statistical analysis was conducted for the 34 residents who completed both questionnaires. The CSQ score (t[32]: -2.17, P self-esteem and negatively with anxiety and depressive tendency. The amount of change in assertive CS score showed a weakly positive correlation with self-esteem. The results suggested that CS, including assertive CS and cooperative CS, were improved by the psychiatric training. Increasing self-esteem and reducing the tendency toward depression and anxiety are considered to be useful for further improving CS. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

  19. Communication skills assessment in the final postgraduate years to established practice: a systematic review.

    Science.gov (United States)

    Gillis, Amy E; Morris, Marie C; Ridgway, Paul F

    2015-01-01

    Communication breakdown is a factor in the majority of all instances of medical error. Despite the importance, a relative paucity of time is invested in communication skills in postgraduate curricula. Our objective is to systematically review the literature to identify the current tools used to assess communication skills in postgraduate trainees in the latter 2 years of training and in established practice. Two reviewers independently reviewed the literature identifying communication skill assessment tools, for postgraduate trainees in the latter 2 years of training and in established practice following Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, and inclusion/exclusion criteria from January 1990 to 15 August 2014. PubMed/CINAHL/ERIC/EMBASE/PsycInfo/Psyc Articles/Cochrane. 222 articles were identified; after review, 34 articles fulfilled criteria for complete evaluation; the majority (26) had a high level of evidence scoring 3 or greater on the Best Evidence Medical Education guide. 22 articles used objective structured clinical examination/standardised patient (SP)-based formats in an assessment or training capacity. Evaluation tools included author-developed questionnaires and validated tools. Nineteen articles demonstrated an educational initiative. The reviewed literature is heterogeneous for objectives and measurement techniques for communication. Observed interactions, with patients or SPs, is the current favoured method of evaluation using author-developed questionnaires. The role of self-evaluation of skill level is questioned. The need for a validated assessment tool for communication skills is highlighted. 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.

  20. Patient-Clinician Communication About Pain: A Conceptual Model and Narrative Review.

    Science.gov (United States)

    Henry, Stephen G; Matthias, Marianne S

    2018-02-01

    Productive patient-clinician communication is an important component of effective pain management, but we know little about how patients and clinicians actually talk about pain in clinical settings and how it might be improved to produce better patient outcomes. The objective of this review was to create a conceptual model of patient-clinician communication about noncancer pain, review and synthesize empirical research in this area, and identify priorities for future research. A conceptual model was developed that drew on existing pain and health communication research. CINAHL, EMBASE, and PubMed were searched to find studies reporting empirical data on patient-clinician communication about noncancer pain; results were supplemented with manual searches. Studies were categorized and analyzed to identify crosscutting themes and inform model development. The conceptual model comprised the following components: contextual factors, clinical interaction, attitudes and beliefs, and outcomes. Thirty-nine studies met inclusion criteria and were analyzed based on model components. Studies varied widely in quality, methodology, and sample size. Two provisional conclusions were identified: contrary to what is often reported in the literature, discussions about analgesics are most frequently characterized by patient-clinician agreement, and self-presentation during patient-clinician interactions plays an important role in communication about pain and opioids. Published studies on patient-clinician communication about noncancer pain are few and diverse. The conceptual model presented here can help to identify knowledge gaps and guide future research on communication about pain. Investigating the links between communication and pain-related outcomes is an important priority for future research. © 2018 American Academy of Pain Medicine. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  1. Communication skills in the training of psychiatrists: A systematic review of current approaches.

    Science.gov (United States)

    Ditton-Phare, Philippa; Loughland, Carmel; Duvivier, Robbert; Kelly, Brian

    2017-07-01

    A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. The heterogeneity of communication skills training is a barrier to evaluating the efficacy of

  2. New challenges for communication for sustainable development and social change: a review essay

    NARCIS (Netherlands)

    Servaes, J.; Lie, R.

    2015-01-01

    This article provides an overview of subdisciplines in the field of Communication for Development and Social Change. Different subdisciplines of communication science are analyzed to assess their connection to the field. Building on these subdisciplines the article reviews health communication,

  3. 76 FR 30714 - Information Collection Being Reviewed by the Federal Communications Commission

    Science.gov (United States)

    2011-05-26

    ... not required to file post-consummation notices of pro forma transactions, except that a post... FEDERAL COMMUNICATIONS COMMISSION Information Collection Being Reviewed by the Federal Communications Commission AGENCY: Federal Communications Commission. ACTION: Notice and request for comments...

  4. [Clinical communication – a comparison of patients’ and doctors’ opinions].

    Science.gov (United States)

    Sobczak, Krzysztof; Leoniuk, Kararzyna; Pawłowski, Leszek; Spolak, Natalia

    The main aim of the research was to assess medical communication from the point of view of clinicians and their patients. 100 doctors and 378 patients were included in the study. Original tools prepared by the interdisciplinary team were used during the research. The research tools consisted of closed questions concerning the quality assessment of medical communication, and they were the same for both groups. Discontinuous variables as well as the statistical heterogeneity of groups were analysed with Pearson’s χ² test, assessing the value p doctor–patient communication given by patients in a 1–11 point scale was 6.79 (median 8.0 points). Objections were raised mostly by women with higher education, aged 30–40 years. Only one out of two patients declared that he/she was continuously updated with medical information by the attending physician. Although all the surveyed doctors considered that the clinical information given by them was clear and accurate, 38.8% of patients said that they were left with doubts after conversations with their doctors. As many as 77.4% of patients said that they were not sufficiently informed about possible complications and therapeutic risks, while 96.9% of doctors claimed that they provided this kind of information. Analyses show that patients were satisfied with the quality of medical communication. On the other hand, the study revealed a deficit in the relationship between patients and doctors, which was caused by the fact that patients were not informed about the diagnostic and therapeutic process.

  5. Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

    Science.gov (United States)

    Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

    2017-10-01

    A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

  6. The importance of communication for clinical leaders in mental health nursing: the perspective of nurses working in mental health.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Broadbent, Marc; Reid-Searl, Kerry

    2013-11-01

    Communication has been identified as an important attribute of clinical leadership in nursing. However, there is a paucity of research on its relevance in mental health nursing. This article presents the findings of a grounded theory informed study exploring the attributes and characteristics required for effective clinical leadership in mental health nursing, specifically the views of nurses working in mental health about the importance of effective communication in day to day clinical leadership. In-depth interviews were conducted to gain insight into the participants' experiences and views on clinical leadership in mental health nursing. The data that emerged from these interviews were constantly compared and reviewed, ensuring that any themes that emerged were based on the participants' own experiences and views. Participants recognized that effective communication was one of the attributes of effective clinical leadership and they considered communication as essential for successful working relationships and improved learning experiences for junior staff and students in mental health nursing. Four main themes emerged: choice of language; relationships; nonverbal communication, and listening and relevance. Participants identified that clinical leadership in mental health nursing requires effective communication skills, which enables the development of effective working relationships with others that allows them to contribute to the retention of staff, improved outcomes for clients, and the development of the profession.

  7. Assessing RN-to-RN peer review on clinical units.

    Science.gov (United States)

    Pfeiffer, Judith A; Wickline, Mary A; Deetz, Jill; Berry, Elise S

    2012-04-01

    The primary purpose of this study was to measure informal registered nurse (RN)-to-RN peer review (defined as collegial communication about the quality of nursing care) at the work-unit level. Survey design with cluster sampling of 28 hospital or ambulatory care units (n = 541 respondents). Results were compared with existing patient safety and satisfaction data. A chi-squared test was used to compare responses against nurse characteristics. Nurses agreed that RN-to-RN peer review takes place on their units, but no correlation with patient safety and satisfaction data was found. Misunderstandings about the meaning of peer review were evident. Open-ended comments revealed barriers to peer review: fear of retribution, language barriers and lack of professionalism. Nurses need clarification of peer review. Issues with common language in a professional environment need to be addressed and nurses can learn collaboration from each other's cultures. Managers should support RN-to-RN peer review on clinical units. Methods used here may be useful to assess current departmental nurse peer review. © 2011 Blackwell Publishing Ltd.

  8. Improving Communication About Serious Illness in Primary Care: A Review.

    Science.gov (United States)

    Lakin, Joshua R; Block, Susan D; Billings, J Andrew; Koritsanszky, Luca A; Cunningham, Rebecca; Wichmann, Lisa; Harvey, Doreen; Lamey, Jan; Bernacki, Rachelle E

    2016-09-01

    The Institute of Medicine recently called for systematic improvements in clinician-led conversations about goals, values, and care preferences for patients with serious and life-threatening illnesses. Studies suggest that these conversations are associated with improved outcomes for patients and their families, enhanced clinician satisfaction, and lower health care costs; however, the role of primary care clinicians in driving conversations about goals and priorities in serious illness is not well defined. To present a review of a structured search of the evidence base about communication in serious illness in primary care. MEDLINE was searched, via PubMed, on January 19, 2016, finding 911 articles; 126 articles were reviewed and selected titles were added from bibliography searches. Review of the literature informed 2 major topic areas: the role of primary care in communication about serious illness and clinician barriers and system failures that interfere with effective communication. Literature regarding the role that primary care plays in communication focused primarily on the ambiguity about whether primary care clinicians or specialists are responsible for initiating conversations, the benefits of primary care clinicians and specialists conducting conversations, and the quantity and quality of discussions. Timely and effective communication about serious illness in primary care is hampered by key clinician barriers, which include deficits in knowledge, skills, and attitudes; discomfort with prognostication; and lack of clarity about the appropriate timing and initiation of conversations. Finally, system failures in coordination, documentation, feedback, and quality improvement contribute to lack of conversations. Clinician and system barriers will challenge primary care clinicians and institutions to meet the needs of patients with serious illness. Ensuring that conversations about goals and values occur at the appropriate time for seriously ill patients will

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

    Science.gov (United States)

    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.

  10. Effective Nurse Communication With Type 2 Diabetes Patients: A Review.

    Science.gov (United States)

    Mulder, Bob C; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2015-08-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-patient communication and to review potentially effective communication methods. Important communication barriers are lack of skills and self-efficacy, possibly because nurses work in a context where they have to perform biomedical examinations and then perform patient-centered counseling from a biopsychosocial approach. Training in patient-centered counseling does not seem helpful in overcoming this paradox. Rather, patient-centeredness should be regarded as a basic condition for counseling, whereby nurses and patients seek to cooperate and share responsibility based on trust. Nurses may be more successful when incorporating behavior change counseling based on psychological principles of self-regulation, for example, goal setting, incremental performance accomplishments, and action planning. © The Author(s) 2014.

  11. The effect of patient-practitioner communication on pain: a systematic review.

    Science.gov (United States)

    Mistiaen, P; van Osch, M; van Vliet, L; Howick, J; Bishop, F L; Di Blasi, Z; Bensing, J; van Dulmen, S

    2016-05-01

    Communication between patients and health care practitioners is expected to benefit health outcomes. The objective of this review was to assess the effects of experimentally varied communication on clinical patients' pain. We searched in July 2012, 11 databases supplemented with forward and backward searches for (quasi-) randomized controlled trials in which face-to-face communication was manipulated. We updated in June 2015 using the four most relevant databases (CINAHL, Cochrane Central, Psychinfo, PubMed). Fifty-one studies covering 5079 patients were included. The interventions were separated into three categories: cognitive care, emotional care, procedural preparation. In all but five studies the outcome concerned acute pain. We found that, in general, communication has a small effect on (acute) pain. The 19 cognitive care studies showed that a positive suggestion may reduce pain, whereas a negative suggestion may increase pain, but effects are small. The 14 emotional care studies showed no evidence of a direct effect on pain, although four studies showed a tendency for emotional care lowering patients' pain. Some of the 23 procedural preparation interventions showed a weak to moderate effect on lowering pain. Different types of communication have a significant but small effect on (acute) pain. Positive suggestions and informational preparation seem to lower patients' pain. Communication interventions show a large variety in quality, complexity and methodological rigour; they often used multiple components and it remains unclear what the effective elements of communication are. Future research is warranted to identify the effective components. © 2015 European Pain Federation - EFIC®

  12. Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

    Science.gov (United States)

    Cragun, Deborah; Zierhut, Heather

    2018-02-01

    Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

  13. Leveraging mobile smart devices to improve interprofessional communications in inpatient practice setting: A literature review.

    Science.gov (United States)

    Aungst, Timothy Dy; Belliveau, Paul

    2015-01-01

    As mobile smart device use has increased in society, the healthcare community has begun using these devices for communication among professionals in practice settings. The purpose of this review is to describe primary literature which reports on the experiences with interprofessional healthcare communication via mobile smart devices. Based on these findings, this review also addresses how these devices may be utilized to facilitate interprofessional education (IPE) in health professions education programs. The literature search revealed limited assessments of mobile smart device use in clinical practice settings. In available reports, communication with mobile smart devices was perceived as more effective and faster among interdisciplinary members. Notable drawbacks included discrepancies in the urgency labeling of messages, increased interruptions associated with constant accessibility to team members, and professionalism breakdowns. Recently developed interprofessional competencies include an emphasis on ensuring that health profession students can effectively communicate on interprofessional teams. With the increasing reliance on mobile smart devices in the absence of robust benefit and risk assessments on their use in clinical practice settings, use of these devices may be leveraged to facilitate IPE activities in health education professions programs while simultaneously educating students on their proper use in patient care settings.

  14. Implementing web-based ping-pong-type e-communication to enhance staff satisfaction, multidisciplinary cooperation, and clinical effectiveness

    Science.gov (United States)

    Yeh, Pei-Han; Hung, Shih-Kai; Lee, Moon-Sing; Chiou, Wen-Yen; Lai, Chun-Liang; Tsai, Wei-Ta; Hsieh, Hui-Ling; Shih, Yi-Ting; Chen, Liang-Cheng; Huang, Li-Wen; Lin, Yi-An; Lin, Po-Hao; Lin, Yung-Hsiang; Liu, Dai-Wei; Hsu, Feng-Chun; Tsai, Shiang-Jiun; Liu, Jia-Chi; Chung, En-Seu; Lin, Hon-Yi

    2016-01-01

    Abstract Background: Frequent multidisciplinary communication is essential in conducting daily radiotherapy (RT) practice. However, traditional oral or paper-based communication has limitations. E-communication has been suggested, but its effects are still not well demarcated in the field of radiation oncology. Objects: In our web-based integrated information platform, we constructed a ping-pong-type e-communication function to transfer specific notations among multidisciplinary RT staffs. The purpose was to test whether applying this e-communication can increase effectiveness of multidisciplinary cooperation when compared with oral or paper-based practice. Staff satisfaction and clinical benefits were also demonstrated. Design and setting: A real-world quality-improving study was conducted in a large center of radiation oncology. Participants and dataset used: Before and after applying multidisciplinary e-communication (from 2014 to 2015), clinical RT staffs were surveyed for their user experience and satisfaction (n = 23). For measuring clinical effectiveness, a secondary database of irradiated head and neck cancer patients was re-analyzed for comparing RT toxicities (n = 402). Interventions: Applying ping-pong-type multidisciplinary reflective e-communication was the main intervention. Outcome measures: For measuring staff satisfaction, eight domains were surveyed, such as timeliness, convenience, and completeness. For measuring clinical effectiveness of multidisciplinary cooperation, event rates of severe (i.e., grade 3–4) RT mucositis and dermatitis were recorded. Results: Overall, when compared with oral communication only, e-communication demonstrated multiple benefits, particularly on notation-review convenience (2.00 ± 1.76 vs 9.19 ± 0.81; P communication showed statistically significant benefits on all eight domains, especially on notation-review convenience (5.05 ± 2.11 vs 9.19 ± 0.81; P communication (8.76 ± 0

  15. Validating relationships among attachment, emotional intelligence and clinical communication.

    Science.gov (United States)

    Cherry, M Gemma; Fletcher, Ian; O'Sullivan, Helen

    2014-10-01

    In a previous study, we found that emotional intelligence (EI) mediates the negative influences of Year 1 medical students' attachment styles on their provider-patient communication (PPC). However, in that study, students were examined on a relatively straightforward PPC skill set and were not assessed on their abilities to elicit relevant clinical information from standardised patients. The influence of these psychological variables in more demanding and realistic clinical scenarios warrants investigation. This study aimed to validate previous research findings by exploring the mediating effect of EI on the relationship between medical students' attachment styles and their PPC across an ecologically valid PPC objective structured clinical examination (OSCE). Year 2 medical students completed measures of attachment (the Experiences in Close Relationships-Short Form [ECR-SF], a 12-item measure which provides attachment avoidance and attachment anxiety dimensional scores) and EI (the Mayer-Salovey-Caruso Emotional Intelligence Test [MSCEIT], a 141-item measure on the perception, use, understanding and management of emotions), prior to their summative PPC OSCE. Provider-patient communication was assessed using OSCE scores. Structural equation modelling (SEM) was used to validate our earlier model of the relationships between attachment style, EI and PPC. A total of 296 of 382 (77.5%) students participated. Attachment avoidance was significantly negatively correlated with total EI scores (r = -0.23, p < 0.01); total EI was significantly positively correlated with OSCE scores (r = 0.32, p < 0.01). Parsimonious SEM confirmed that EI mediated the negative influence of attachment avoidance on OSCE scores. It significantly predicted 14% of the variance in OSCE scores, twice as much as the 7% observed in the previous study. In more demanding and realistic clinical scenarios, EI makes a greater contribution towards effective PPC. Attachment is perceived to be stable

  16. Audiology Students' Perspectives of Enacting and Learning Clinical Communication: A Qualitative Interview and Video Reflexivity Study.

    Science.gov (United States)

    Tai, Samantha; Woodward-Kron, Robyn; Barr, Caitlin

    2018-03-27

    Effective clinical communication is pivotal to the provision of quality hearing health care. To date, audiology students reportedly felt ill-prepared when counseling patients about their hearing impairment, yet there is a paucity of studies exploring how clinical communication is taught and learned in audiology programs. Thus, the aims of the study were (a) to explore final year audiology students' perspectives of their own clinical communication skills during an in-house university clinical placement and (b) to explore students' perceptions of their clinical communication education. Using a qualitative description approach, students were asked to coview their filmed clinical encounter using video reflexivity during a semistructured interview on clinical communication education. Fifteen final year graduate audiology students from The University of Melbourne, Australia, participated in the study. The interviews were audio-recorded and analyzed thematically. The overarching themes of striving to be patient-centered, assessment shapes behavior, and power relations emerged from students' reflection of their own clinical encounter. In addition, the theme what students want described the perceived teaching methods that assisted students' clinical communication practices. The findings of this study highlight the challenges that students perceived during their clinical placement as they strive to enact a patient-centered interaction. An assessment rubric that incorporates communication skills can provide greater opportunities for feedback and self-reflection. Additionally, clinical communication education that adopts experiential learning and is longitudinally integrated into the curriculum can further reinforce students' communication learning needs.

  17. Manual signs as augmentative and alternative communication system. Review article

    Directory of Open Access Journals (Sweden)

    Fàtima Vega Llobera

    2014-06-01

    Full Text Available There is a long tradition of scientific evidence about using hand signals simultaneously with oral language to promote the development of communication and language in children with or without disabilities. This article aims to review and analyze intervention work focused on the use of manual signs as augmentative communication system (AAC in hearing participants. Several criteria were used to narrow the search, selection, coding and synthesis of the 50 original scientific papers have finally been part of the review. The included studies were edited from 1970 to the present, at a national and international level and were published in English and Spanish. The bibliographic compilation was performed through searches by keyword in bibliographic databases, with the help of search engines (Google Scholar and through secondary searches. From each of the scientific articles the following data was extracted: year of the study, the country of origin, the characteristics of the participants, the design and the methodology and the obtained results. This information has been analyzed and compared. The results of the study highlight that, despite the diversity in results, the signing use as augmentative communication system is effective to improve language development, receptive and expressive level.

  18. An exploration of pharmacist-patient communication in clinic-style consultations

    OpenAIRE

    Greenhill, Nicola H.

    2010-01-01

    The importance of communication skills for pharmacists has been widely acknowledged. Research has shown that the use of good communication skills can improve patient health outcomes but little research has focussed on communication within new consultation based roles of pharmacists. This study aimed to explore the communication between pharmacists and patients in clinic style consultations and to investigate participant perceptions of communication and consultations. Eleven pharmacists ...

  19. Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

    Science.gov (United States)

    Afifi, Ladan; Shinkai, Kanade

    2017-03-01

    Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

  20. A review of cost communication in oncology: Patient attitude, provider acceptance, and outcome assessment.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Chien, Chun-Ru

    2017-05-15

    The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified. Although most articles that addressed patient attitude suggested that cost communication is desired by >50% of patients in the respective study cohorts, only communication. When asked about whether cost communication actually took place in their practice, percentages reported by physicians varied widely from 60%. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality. Both patients and physicians expressed a strong need for accurate, accessible, and transparent information about the cost of cancer care. Cancer 2017;123:928-39. © 2016 American Cancer Society. © 2016 American Cancer Society.

  1. Communication Concepts for Prevention and Early Intervention in Aesthetic Medicine: Consensus and Literature Review.

    Science.gov (United States)

    Gout, Uliana; Anand, Chytra V; Braz, Andre; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Kerscher, Martina; Landau, Marina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Besins, Thierry

    2017-09-01

    Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. To introduce the framework for P&E communication strategies within a younger population and explore the barriers that may be encountered. A literature review on P&E communication strategies in aesthetic medicine and related topics of interest was conducted and used to construct a working framework that may be applied in clinical practice. Examination of existing literature revealed a need for a more structured communication framework for P&E encompassing up-to-date evidence-based learning and educational marketing that is tailored to individual needs and target populations. Message framing-the way in which a message is presented-is an important consideration in the dissemination of information to promote changes in health behaviour. A structured consultation is key to optimising patient engagement and ensures a tailored approach to understanding and catering to the specific needs of each patient. This is the first paper to discuss the communication concepts behind P&E within aesthetic medicine and paves the way for further research and focus in this significant field. J Drugs Dermatol. 2017;16(9):859-864..

  2. Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews.

    Science.gov (United States)

    French, David P; Cameron, Elaine; Benton, Jack S; Deaton, Christi; Harvie, Michelle

    2017-10-01

    The assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption. The present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews. This systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews. The nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used. Presenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour.

  3. The clinical educator and complexity: a review.

    Science.gov (United States)

    Schoo, Adrian; Kumar, Koshila

    2018-02-08

    Complexity science perspectives have helped in examining fundamental assumptions about learning and teaching in the health professions. The implications of complexity thinking for how we understand the role and development of the clinical educator is less well articulated. This review article outlines: the key principles of complexity science; a conceptual model that situates the clinical educator in a complex system; and the implications for the individual, organisation and the system. Our conceptual model situates the clinical educator at the centre of a complex and dynamic system spanning four domains and multiple levels. The four domains are: personal (encompassing personal/professional needs and expectations); health services (health agencies and their consumers); educational (educational institutions and their health students); and societal (local community/region and government). The system also comprises: micro or individual, meso or organisational, and macro or socio-political levels. Our model highlights that clinical educators are situated within a complex system comprising different agents and connections. It emphasises that individuals, teams and organisations need to recognise and be responsive to the unpredictability, interconnectedness and evolving nature of this system. Importantly, our article also calls for an epistemological shift from faculty development to capacity building in health professions education, aimed at developing individual, team, organisational and system capabilities to work with(in) complexity. Clinical educators are situated within a complex system comprising different agents and connections. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  4. Teaching self-concept and self-esteem in a clinical communications course.

    Science.gov (United States)

    Medina, Melissa S

    2006-10-15

    Effective interpersonal communication skills are needed for pharmacists to deliver patient-centered care. To achieve this outcome with pharmacists, communication skills are emphasized in pharmacy school in required coursework, such as a clinical communication course. One important concept to include in communication coursework is content on perceptions because perceptions influence communication interactions. Specific emphasis should include a focus on self-perceptions and self-concept, because related empirical literature demonstrates that accurate academic self-concepts predict academic success. These results were extrapolated to a pharmacy clinical communications course where a lecture and laboratory series was designed to emphasize self-concept and facilitate communication skills improvement. The instructional design of this series promoted the advancement of students' communication skills by using communication inventories, self-reflection activities, peer and class discussion, and lecture content. Class discussions, self-reflections, and baseline, and follow-up counseling activities throughout the semester provided evidence of improvements.

  5. Teaching Self-concept and Self-esteem in a Clinical Communications Course

    Science.gov (United States)

    2006-01-01

    Effective interpersonal communication skills are needed for pharmacists to deliver patient-centered care. To achieve this outcome with pharmacists, communication skills are emphasized in pharmacy school in required coursework, such as a clinical communication course. One important concept to include in communication coursework is content on perceptions because perceptions influence communication interactions. Specific emphasis should include a focus on self-perceptions and self-concept, because related empirical literature demonstrates that accurate academic self-concepts predict academic success. These results were extrapolated to a pharmacy clinical communications course where a lecture and laboratory series was designed to emphasize self-concept and facilitate communication skills improvement. The instructional design of this series promoted the advancement of students’ communication skills by using communication inventories, self-reflection activities, peer and class discussion, and lecture content. Class discussions, self-reflections, and baseline, and follow-up counseling activities throughout the semester provided evidence of improvements. PMID:17149428

  6. Use of Social Network Sites for Communication Among Health Professionals: Systematic Review.

    Science.gov (United States)

    Chan, Windy Sy; Leung, Angela Ym

    2018-03-28

    Although much research has been done investigating the roles of social network sites (SNSs) in linking patients and health professionals, there is a lack of information about their uses, benefits, and limitations in connecting health professions only for professional communication. This review aimed to examine the utilization of SNSs for communication among health professionals in (1) frontline clinical practice, (2) professional networks, and (3) education and training to identify areas for future health communication research. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search of the literature published in the last 10 years (January 1, 2007, to March 1, 2017) was performed in March 2017, using the following electronic databases: MEDLINE via OvidSP, EMBASE, CINAHL Complete, and InfoSci-Journals. The searches were conducted using the following defined search terms: "social media" OR "social network" OR "social network site" OR "Facebook" OR "Twitter" OR "Linkedin" OR "Instagram" OR "Weibo" OR "Whatsapp" OR "Telegram" OR "WeChat" AND "health" OR "health profession." Of the 6977 papers retrieved, a total of 33 studies were included in this review. They were exploratory in nature, and the majority used surveys (n=25) and interviews (n=6). All retrieved studies stated that SNSs enhanced effective communication and information sharing. SNSs were used for supporting delivering of clinical services, making referrals, and sharing information. They were beneficial to network building and professional collaboration. SNSs were novel tools to enhance educational interactions among peers, students, instructors, and preceptors. The application of SNSs came with restraints in technical knowledge, concerns on data protection, privacy and liability, issues in professionalism, and data protection. SNSs provide platforms facilitating efficient communication, interactions, and connections among health

  7. Perspective: clinical communication education in the United Kingdom: some fresh insights.

    Science.gov (United States)

    Brown, Jo

    2012-08-01

    Clinical communication education is now part of the core curriculum of every medical school in the United Kingdom and the United States. It has emerged over 30 years because of various societal, political, and policy drivers and is supported by an impressive evidence base.For a variety of reasons, however, clinical communication has become separated from other parts of medical education and tends to be positioned in the early years of the curriculum, when students have limited experience of being in the clinical workplace and working with patients. The teachers of clinical communication, whether medical-school-based or clinically based, may not share learning goals for the subject and this may, therefore, provide a disintegrated learning experience for students.Clinical communication teachers need to inject fresh thinking into the teaching and learning of the subject to unite it with clinical practice in the authentic clinical workplace. Engaging with theories of workplace learning, which aim to overcome the theory/practice gap in vocational education, may be the way forward. The author suggests various ways that this might be achieved-for example, by situating clinical communication education throughout the whole undergraduate curriculum, by integrating the topic of clinical communication with other areas of medical education, by developing coteaching and curriculum design partnerships between medical school and clinical workplace, and by developing a greater range of postgraduate education that offers opportunities for professional development in clinical communication for qualified doctors that is complementary with what is taught in undergraduate education.

  8. Review of optical wireless communications for data centers

    Science.gov (United States)

    Arnon, Shlomi

    2017-10-01

    A data center (DC) is a facility either physical or virtual, for running applications, searching, storage, management and dissemination of information known as cloud computing, which consume a huge amount of energy. A DC includes thousands of servers, communication and storage equipment and a support system including an air conditioning system, security, monitoring equipment and electricity regulator units. Data center operators face the challenges of meeting exponentially increasing demands for network bandwidth without unreasonable increases in operation and infrastructure cost. In order to meet the requirements of moderate increase in operation and infrastructure cost technology, a revolution is required. One way to overcome the shortcomings of traditional static (wired) data center architectures is use of a hybrid network based on fiber and optical wireless communication (OWC) or free space optics (FSO). The OWC link could be deployed on top of the existing cable/fiber network layer, so that live migration could be done easily and dynamically. In that case the network topology is flexible and adapts quickly to changes in traffic, heat distribution, power consumption and characteristics of the applications. In addition, OWC could provide an easy way to maintain and scale up data centers. As a result total cost of ownership could be reduced and the return on investment could be increased. In this talk we will review the main OWC technologies applicable for data centers, indicate how energy could be saved using OWC multichannel communication and discuss the issue of OWC pointing accuracy for data center scenario.

  9. Clinical Aspects of Feline Retroviruses: A Review

    Directory of Open Access Journals (Sweden)

    Katrin Hartmann

    2012-10-01

    Full Text Available Feline leukemia virus (FeLV and feline immunodeficiency virus (FIV are retroviruses with global impact on the health of domestic cats. The two viruses differ in their potential to cause disease. FeLV is more pathogenic, and was long considered to be responsible for more clinical syndromes than any other agent in cats. FeLV can cause tumors (mainly lymphoma, bone marrow suppression syndromes (mainly anemia, and lead to secondary infectious diseases caused by suppressive effects of the virus on bone marrow and the immune system. Today, FeLV is less commonly diagnosed than in the previous 20 years; prevalence has been decreasing in most countries. However, FeLV importance may be underestimated as it has been shown that regressively infected cats (that are negative in routinely used FeLV tests also can develop clinical signs. FIV can cause an acquired immunodeficiency syndrome that increases the risk of opportunistic infections, neurological diseases, and tumors. In most naturally infected cats, however, FIV itself does not cause severe clinical signs, and FIV-infected cats may live many years without any health problems. This article provides a review of clinical syndromes in progressively and regressively FeLV-infected cats as well as in FIV-infected cats.

  10. The role of emotion in computer-mediated communication: A review

    NARCIS (Netherlands)

    Derks, D.; Fischer, A.H.; Bos, A.E.R.

    2008-01-01

    It has been argued that the communication of emotions is more difficult in computer-mediated communication (CMC) than in face-to-face (F2F) communication. The aim of this paper is to review the empirical evidence in order to gain insight in whether emotions are communicated differently in these

  11. NON-COMMUNICABLE DISEASE PROGRAM IN AMPANGAN HEALTH CLINIC

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2010-01-01

    Full Text Available Non-communicable diseases (NCDs represent among the most common and debilitating conditions seen in primary care. Patients’ care will often involves multiple providers and follow-up requires persistence by patients and clinicians alike, therefore ideal outcomes are often difficult to achieve. The need for better disease management policies and practice is growing. This is due to the changing demographic profile of the population, the increasing cost of managing people in acute care hospitals and the availability of new technologies and services. All these changes enable a different care paradigm which is more cost effective and provides people with chronic conditions an improved quality of life. Management of the NCDs therefore offers an excellent opportunity to practice chronic disease management - a systems approach designed to ensure excellent care. The NCD team has developed a comprehensive approach to chronic disease care. We would like to describe the NCD Program in Ampangan Health Clinic which represents many typical government health clinics in Malaysia and the processes by which it was developed. Included are specific examples of the tools and how they can be used by individual clinicians incaring for patients. The integration of Chronic Disease Management Services into health care systems is the direction being undertaken to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector.

  12. WhatsApp in Clinical Practice: A Literature Review.

    Science.gov (United States)

    Mars, Maurice; Scott, Richard E

    2016-01-01

    Several spontaneous telemedicine services using WhatsApp Messenger have started in South Africa raising issues of confidentiality, data security and storage, record keeping and reporting. This study reviewed the literature on WhatsApp in clinical practice, to determine how it is used, and users' satisfaction. Pubmed, Scopus, Science Direct and IEE Expert databases were searched using the search term WhatsApp and Google Scholar using the terms WhatsApp Telemedicine and WhatsApp mHealth. Thirty-two papers covering 17 disciplines were relevant with the most papers, 12, from India. Seventeen papers reported the use of WhatsApp Groups within departments, 14 of which were surgery related disciplines. Groups improved communication and advice given on patient management. Confidentiality was mentioned in 19 papers and consent in five. Data security was partially addressed in 11 papers with little understanding of how data are transmitted and stored. Telemedicine services outside of departmental groups were reported in seven papers and covered emergency triage in maxillofacial, plastic, neuro and general surgery, and cardiology and telestroke. WhatsApp is seen to be a simple, cheap and effective means of communication within the clinical health sector and its use will grow. Users have paid little attention to confidentiality, consent and data security. Guidelines for using WhatsApp for telemedicine are required including downloading. WhatsApp messages to computer for integration with electronic medical records.

  13. The role of teamwork and communication in the emergency department: a systematic review.

    Science.gov (United States)

    Kilner, Emily; Sheppard, Lorraine A

    2010-07-01

    The aim of this study was to develop a systematic review using international research to describe the role of teamwork and communication in the emergency department, and its relevance to physiotherapy practice in the emergency department. Searches were conducted of CINAHL, Academic Search Premier, Scopus, Cochrane, PEDro, Medline, Embase, Amed and PubMed. Selection criteria included full-text English language research papers related to teamwork and/or communication based directly in the emergency department, involvement of any profession in the emergency department, publication in peer-reviewed journals, and related to adult emergency services. Studies were appraised using a validated critical appraisal tool. Fourteen eligible studies, all of mid-range quality, were identified. They demonstrated high levels of staff satisfaction with teamwork training interventions and positive staff attitudes towards the importance of teamwork and communication. There is moderate evidence that the introduction of multidisciplinary teams to the ED may be successful in reducing access block, and physiotherapists may play a role in this. The need for teamwork and communication in the ED is paramount, and their roles are closely linked, with the common significant purposes of improving patient safety, reducing clinical errors, and reducing waiting times. 2009 Elsevier Ltd. All rights reserved.

  14. Electronic health record tools' support of nurses' clinical judgment and team communication.

    Science.gov (United States)

    Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin

    2013-11-01

    Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

  15. Programs to Strengthen Parent-Adolescent Communication About Reproductive Health: A Systematic Review.

    Science.gov (United States)

    Gavin, Loretta E; Williams, Jessica R; Rivera, Maria I; Lachance, Christina R

    2015-08-01

    When caring for an adolescent client, providers of contraceptive services must consider whether and how to encourage parent/guardian-child communication about the adolescent's reproductive health. The objective of this systematic review was to summarize the evidence on the effectiveness of programs designed to increase parent-child communication about reproductive health. The review was used to inform national recommendations on quality family planning services. Data analysis occurred from mid-2011 through 2012. Several electronic bibliographic databases were used to identify relevant articles, including PubMed, CINAHL, PsycINFO, and Popline, published from January 1985 through February 2011. Sixteen articles met the inclusion criteria: all studies examined the impact on at least one medium- or short-term outcome, and two studies assessed the impact on teen pregnancy. One study examined the impact of a program conducted in a clinic setting; the remainder examined the impact of programs in community settings. All studies showed a positive impact on at least one short-term outcome, and 12 of 16 studies showed an increase in parent-child communication about reproductive health. Four of seven studies found an impact on sexual risk behavior. Most programs increased parent-child communication, and several resulted in reduced sexual risk behavior of adolescents. This suggests that delivering a clinic-based program that effectively helps parents/guardians talk to their adolescent child(ren) about reproductive health, or referring parents/guardians to an evidence-based program in the community, may be beneficial. However, further rigorous research on delivery of these programs in clinical settings is needed. Published by Elsevier Inc.

  16. Clinical review: Ethnic differences in bone mass--clinical implications.

    Science.gov (United States)

    Leslie, William D

    2012-12-01

    Differences in bone mineral density (BMD) as assessed with dual-energy x-ray absorptiometry are observed between geographic and ethnic groups, with important implications in clinical practice. PubMed was employed to identify relevant studies. A review of the literature was conducted, and data were summarized and integrated. The available data highlight the complex ethnic variations in BMD, which only partially account for observed variations in fracture rates. Factors contributing to ethnic differences include genetics, skeletal size, body size and composition, lifestyle, and social determinants. Despite BMD differences, the gradient of risk for fracture from BMD and other clinical risk factors appears to be similar across ethnic groups. Furthermore, BMD variation is greater within an ethnic population than between ethnic populations. New imaging technologies have identified ethnic differences in bone geometry, volumetric density, microarchitecture, and estimated bone strength that may contribute to a better understanding of ethnic differences in fracture risk. Factors associated with ethnicity affect BMD and fracture risk through direct and indirect mechanisms.

  17. Connecting with patients and instilling realism in an era of emerging communication possibilities: a review on palliative care communication heading to telecare practice

    NARCIS (Netherlands)

    van Gurp, J.; Hasselaar, J.; van Leeuwen, E.; Hoek, P.; Vissers, K.; van Selm, M.

    2013-01-01

    Objective: Appropriate palliative care communication is pivotal to optimizing the quality of life in dying patients and their families. This review aims at describing communication patterns in palliative care and discussing potential relations between communication patterns and upcoming telecare in

  18. Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

    Science.gov (United States)

    Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

    2016-01-01

    The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

  19. 75 FR 1790 - Draft Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: IRB...

    Science.gov (United States)

    2010-01-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0605... clinical investigators and sponsors better understand their responsibilities related to continuing review...-463-6332 or 301-796-3400); or the Office of Communication, Outreach and Development (HFM-40), Center...

  20. Clinical Management of Priapism: A Review

    Directory of Open Access Journals (Sweden)

    Kazuyoshi Shigehara

    2016-04-01

    Full Text Available Priapism is defined as a persistent and painful erection lasting longer than four hours without sexual stimulation. Based on episode history and pathophysiology, priapism is classified into three subtypes: ischemic (low-flow, non-ischemic (high-flow, and stuttering priapism. Ischemic priapism is characterized by a persistent, painful erection with remarkable rigidity of the corpora cavernosa caused by a disorder of venous blood outflow from this tissue mass, and is similar to penile compartment syndrome. Stuttering priapism is characterized by a self-limited, recurrent, and intermittent erection, frequently occurring in patients with sickle cell disease. Non-ischemic priapism is characterized by a painless, persistent nonsexual erection that is not fully rigid and is caused by excess arterial blood flow into the corpora cavernosa. Because ischemic and non-ischemic priapism differ based on emergency status and treatment options, appropriate discrimination of each type of priapism is required to initiate adequate clinical management. The goal of management of priapism is to achieve detumescence of the persistent penile erection and to preserve erectile function after resolution of the priapism. To achieve successful management, urologists should address this emergency clinical condition. In the present article, we review the diagnosis and clinical management of the three types of priapism.

  1. Hepatic lipidosis: Clinical review drawn from collective effort.

    Science.gov (United States)

    Webb, Craig B

    2018-03-01

    Practical relevance: Hepatic lipidosis (HL) is the most common form of liver dysfunction in cats. If recognized early and treated appropriately, the prognosis is good; if not, the prognosis is grave. Clinical challenges: Distinguishing HL as idiopathic or secondary is critical since the presence of a concurrent disease affects the therapeutic plan and the prognosis. Despite the unique and severe nature of a cat's response to anorexia and the complexity of the metabolic changes underlying this condition, the clinical acumen and technical ability to effectively diagnose and treat HL are readily available to all small animal practitioners. Patient group: Although many species develop a 'fatty liver', the cat is one of relatively few species that suffer from HL. The classic presentation is that of an overweight cat that stops eating for days to weeks, losing weight in the process. Equipment: Abdominal ultrasound is frequently employed in the diagnostic work-up of an anorectic cat; ultrasonographic findings often support a presumptive diagnosis, provide samples for cytology and, perhaps most importantly, help identify concurrent conditions that must be addressed for therapeutic success. All of the equipment necessary for essential nutritional intervention in an anorectic cat is readily available and easily affordable. Evidence base: The material for this review draws heavily on a relatively large number of original studies, excellent reviews by recognized experts, and informative communication with experienced clinicians, hence the term 'collective effort'.

  2. Knowing 'something is not right' is beyond intuition: development of a clinical algorithm to enhance surveillance and assist nurses to organise and communicate clinical findings.

    Science.gov (United States)

    Brier, Jessica; Carolyn, Moalem; Haverly, Marsha; Januario, Mary Ellen; Padula, Cynthia; Tal, Ahuva; Triosh, Henia

    2015-03-01

    To develop a clinical algorithm to guide nurses' critical thinking through systematic surveillance, assessment, actions required and communication strategies. To achieve this, an international, multiphase project was initiated. Patients receive hospital care postoperatively because they require the skilled surveillance of nurses. Effective assessment of postoperative patients is essential for early detection of clinical deterioration and optimal care management. Despite the significant amount of time devoted to surveillance activities, there is lack of evidence that nurses use a consistent, systematic approach in surveillance, management and communication, potentially leading to less optimal outcomes. Several explanations for the lack of consistency have been suggested in the literature. Mixed methods approach. Retrospective chart review; semi-structured interviews conducted with expert nurses (n = 10); algorithm development. Themes developed from the semi-structured interviews, including (1) complete, systematic assessment, (2) something is not right (3) validating with others, (4) influencing factors and (5) frustration with lack of response when communicating findings were used as the basis for development of the Surveillance Algorithm for Post-Surgical Patients. The algorithm proved beneficial based on limited use in clinical settings. Further work is needed to fully test it in education and practice. The Surveillance Algorithm for Post-Surgical Patients represents the approach of expert nurses, and serves to guide less expert nurses' observations, critical thinking, actions and communication. Based on this approach, the algorithm assists nurses to develop skills promoting early detection, intervention and communication in cases of patient deterioration. © 2014 John Wiley & Sons Ltd.

  3. Preventing non-communicable disease in Oman, a legislative review.

    Science.gov (United States)

    Al-Bahlani, Sabah; Mabry, Ruth

    2014-06-01

    The burden of non-communicable disease (NCD) is a major global concern and is projected to increase by 15% over the next 10 years. NCD is the leading cause of mortality in Oman and other countries of the Gulf Cooperation Council (GCC). Some of the most successful interventions to address NCD include legislations like banning smoking in public places. A desk review of available policies and legislations related to the behavioural risk factors of NCD from the GCC and from Oman was conducted with a focus on policies and legislations related to food, physical activity and tobacco. The review identified numerous documents; most were policies and resolutions related to tobacco control. Although only a few documents were laws, a majority were issued by non-health sectors. This policy review is the first effort in the GCC to consolidate information on the regulatory framework for the three key risk behaviours in the region, tobacco use, unhealthy diet and physical inactivity. Further work is needed to strengthen the regulatory framework, at both the national and regional levels, to strengthen tobacco control as well as to improve dietary patterns and physical activity levels. Given that a bulk of laws, regulations and policies are beyond the scope of the health sector, significant advocacy efforts are required to generate a multisectoral response. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Real-time feedback on nonverbal clinical communication. Theoretical framework and clinician acceptance of ambient visual design.

    Science.gov (United States)

    Hartzler, A L; Patel, R A; Czerwinski, M; Pratt, W; Roseway, A; Chandrasekaran, N; Back, A

    2014-01-01

    This article is part of the focus theme of Methods of Information in Medicine on "Pervasive Intelligent Technologies for Health". Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. Although nonverbal skill training is a recognized need, few efforts to enhance patient-clinician communication provide visual feedback on nonverbal aspects of the clinical encounter. We describe a novel approach that uses social signal processing technology (SSP) to capture nonverbal cues in real time and to display ambient visual feedback on control and affiliation--two primary, yet distinct dimensions of interpersonal nonverbal communication. To examine the design and clinician acceptance of ambient visual feedback on nonverbal communication, we 1) formulated a model of relational communication to ground SSP and 2) conducted a formative user study using mixed methods to explore the design of visual feedback. Based on a model of relational communication, we reviewed interpersonal communication research to map nonverbal cues to signals of affiliation and control evidenced in patient-clinician interaction. Corresponding with our formulation of this theoretical framework, we designed ambient real-time visualizations that reflect variations of affiliation and control. To explore clinicians' acceptance of this visual feedback, we conducted a lab study using the Wizard-of-Oz technique to simulate system use with 16 healthcare professionals. We followed up with seven of those participants through interviews to iterate on the design with a revised visualization that addressed emergent design considerations. Ambient visual feedback on non- verbal communication provides a theoretically grounded and acceptable way to provide clinicians with awareness of their nonverbal communication style. We provide implications for the design of such visual feedback that encourages empathic patient

  5. The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review

    Directory of Open Access Journals (Sweden)

    Thompson Laura

    2012-07-01

    Full Text Available Abstract Background Nonadherence to mental health treatment incurs clinical and economic burdens. The clinician-patient alliance, negotiated through clinical interaction, presents a critical intervention point. Recent medical reviews of communication and adherence behaviour exclude studies with psychiatric samples. The following examines the impact of clinician-patient alliance and communication on adherence in mental health, identifying the specific mechanisms that mobilise patient engagement. Methods In December 2010, a systematic search was conducted in Pubmed, PsychInfo, Web of Science, Cochrane Library, Embase and Cinahl and yielded 6672 titles. A secondary hand search was performed in relevant journals, grey literature and reference. Results 23 studies met the inclusion criteria for the review. The methodological quality overall was moderate. 17 studies reported positive associations with adherence, only four of which employed intervention designs. 10 studies examined the association between clinician-patient alliance and adherence. Subjective ratings of clinical communication styles and messages were assessed in 12 studies. 1 study examined the association between objectively rated communication and adherence. Meta-analysis was not possible due to heterogeneity of methods. Findings were presented as a narrative synthesis. Conclusions Clinician-patient alliance and communication are associated with more favourable patient adherence. Further research of observer rated communication would better facilitate the application of findings in clinical practice. Establishing agreement on the tasks of treatment, utilising collaborative styles of communication and discussion of treatment specifics may be important for clinicians in promoting cooperation with regimens. These findings align with those in health communication. However, the benefits of shared decision making for adherence in mental health are less conclusive than in general medicine.

  6. Nonverbal Communication in Politics: A Review of Research Developments, 2005-2015

    OpenAIRE

    Dumitrescu, Delia

    2016-01-01

    This article reviews research contributions in political science and communication to the topic of nonverbal communication and politics from 2005 to 2015. The review opens with research on the content of nonverbal communication, then considers studies examining what moderates the impact of nonverbal aspects of political messages on attitudes and behavior and the mechanisms that underpin these effects. Over the period reviewed here, research shows that the nonverbal channel is rich in politica...

  7. Assessment of first-year veterinary students' communication skills using an objective structured clinical examination: the importance of context.

    Science.gov (United States)

    Hecker, Kent G; Adams, Cindy L; Coe, Jason B

    2012-01-01

    Communication skills are considered to be a core clinical skill in veterinary medicine and essential for practice success, including outcomes of care for patients and clients. While veterinary schools include communication skills training in their programs, there is minimal knowledge on how best to assess communication competence throughout the undergraduate program. The purpose of this study was to further our understanding of the reliability, utility, and suitability of a communication skills Objective Structured Clinical Examination (OSCE). Specifically we wanted to (1) identify the greatest source of variability (student, rater, station, and track) within a first-year, four station OSCE using exam scores and scores from videotape review by two trained raters, and (2) determine the effect of different stations on students' communication skills performance. Reliability of the scores from both the exam data and the two expert raters was 0.50 and 0.46 respectively, with the greatest amount of variance attributable to student by station. The percentage of variance due to raters in the exam data was 16.35%, whereas the percentage of variance for the two expert raters was 0%. These results have three important implications. First, the results reinforce the need for communication educators to emphasize that use of communication skills is moderated by the context of the clinical interaction. Second, by increasing rater training the amount of error in the scores due to raters can be reduced and inter-rater reliability increases. Third, the communication assessment method (in this case the OSCE checklist) should be built purposefully, taking into consideration the context of the case.

  8. What characterizes the communication between patients with cancer and nurses in an outpatient clinic

    DEFF Research Database (Denmark)

    Prip, Anne

    predominantly are treated in outpatient clinics today, little is known about what constitutes communication when the encounters between patients and nurses are brief and takes place in outpatient settings. The aim of the study was to explore communication between nurses and patients with cancer undergoing...... chemotherapy in an outpatient clinic. Methods The study is based on ethnographic fieldwork that explored through multiple observations and adhoc interviews, the communicative practice between nurses and patients with cancer. A thematic analysis guided by Interpretive Description was carried out to identify...... characteristics and variations in the nurse-patient communication. Results We identified three themes: Communication on the run, reflects the nurses’ multitasking approach to communication; Treatment-centered communication illustrates how topics and issues related to the patient’s treatment guided conversations...

  9. Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module.

    Science.gov (United States)

    Boggan, Joel C; Swaminathan, Aparna; Thomas, Samantha; Simel, David L; Zaas, Aimee K; Bae, Jonathan G

    2017-04-01

    Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified "significant" results communicated within 72 hours. A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P  Communication of "significant" results was more likely to occur via telephone, compared with communication of nonsignificant results. Participation in a shared audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.

  10. Meningococcal disease, a clinical and epidemiological review.

    Science.gov (United States)

    Batista, Rodrigo Siqueira; Gomes, Andréia Patrícia; Dutra Gazineo, Jorge Luiz; Balbino Miguel, Paulo Sérgio; Santana, Luiz Alberto; Oliveira, Lisa; Geller, Mauro

    2017-11-01

    Meningococcal disease is the acute infection caused by Neisseria meningitidis, which has humans as the only natural host. The disease is widespread around the globe and is known for its epidemical potential and high rates of lethality and morbidity. The highest number of cases of the disease is registered in the semi-arid regions of sub-Saharan Africa. In Brazil, it is endemic with occasional outbreaks, epidemics and sporadic cases occurring throughout the year, especially in the winter. The major epidemics of the disease occurred in Brazil in the 70's caused by serogroups A and C. Serogroups B, C and Y represent the majority of cases in Europe, the Americas and Australia. However, there has been a growing increase in serogroup W in some areas. The pathogen transmission happens for respiratory route (droplets) and clinically can lead to meningitis and sepsis (meningococcemia). The treatment is made with antimicrobial and supportive care. For successful prevention, we have some measures like vaccination, chemoprophylaxis and droplets' precautions. In this review, we have described and clarify clinical features of the disease caused by N. meningitidis regarding its relevance for healthcare professionals. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  11. Osteoarthritis Year in Review 2015: Clinical

    Science.gov (United States)

    Sharma, Leena

    2015-01-01

    The purpose of this review is to highlight clinical research in osteoarthritis. A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms “osteoarthritis [All Fields] AND treatment [All Fields]” and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms “osteoarthritis [All Fields] AND epidemiology [All Fields]”, with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 148 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing. PMID:26707991

  12. Osteogenesis Imperfecta: A Review with Clinical Examples

    Science.gov (United States)

    van Dijk, F.S.; Cobben, J.M.; Kariminejad, A.; Maugeri, A.; Nikkels, P.G.J.; van Rijn, R.R.; Pals, G.

    2011-01-01

    Osteogenesis imperfecta (OI) is characterized by susceptibility to bone fractures, with a severity ranging from subtle increase in fracture frequency to prenatal fractures. The first scientific description of OI dates from 1788. Since then, important milestones in OI research and treatment have, among others, been the classification of OI into 4 types (the ‘Sillence classification’), the discovery of defects in collagen type I biosynthesis as a cause of most cases of OI and the use of bisphosphonate therapy. Furthermore, in the past 5 years, it has become clear that OI comprises a group of heterogeneous disorders, with an estimated 90% of cases due to a causative variant in the COL1A1 or COL1A2 genes and with the remaining 10% due to causative recessive variants in the 8 genes known so far, or in other currently unknown genes. This review aims to highlight the current knowledge around the history, epidemiology, pathogenesis, clinical/radiological features, management, and future prospects of OI. The text will be illustrated with clinical descriptions, including radiographs and, where possible, photographs of patients with OI. PMID:22570641

  13. Roles of Cognitive Status and Intelligibility in Everyday Communication in People with Parkinson's Disease: A Systematic Review.

    Science.gov (United States)

    Barnish, Maxwell S; Whibley, Daniel; Horton, Simon M C; Butterfint, Zoe R; Deane, Katherine H O

    2016-03-16

    Communication is fundamental to human interaction and the development and maintenance of human relationships and is frequently affected in Parkinson's disease (PD). However, research and clinical practice have both tended to focus on impairment rather than participation aspects of communicative deficit in PD. In contrast, people with PD have reported that it is these participation aspects of communication that are of greatest concern to them rather than physical speech impairment. To systematically review the existing body of evidence regarding the association between cognitive status and/or intelligibility and everyday communication in PD. Five online databases were systematically searched in May 2015 (Medline Ovid, EMBASE, AMED, PsycINFO and CINAHL) and supplementary searches were also conducted. Two reviewers independently evaluated retrieved records for inclusion and then performed data extraction and quality assessment using standardised forms. Articles were eligible for inclusion if they were English-language original peer-reviewed research articles, book chapters or doctoral theses investigating the associations between at least one of cognitive status and level of intelligibility impairment and an everyday communication outcome in human participants with PD. 4816 unique records were identified through database searches with 16 additional records identified through supplementary searches. 41 articles were suitable for full-text screening and 15 articles (12 studies) met the eligibility criteria. 10 studies assessed the role of cognitive status and 9 found that participants with greater cognitive impairment had greater everyday communication difficulties. 4 studies assessed the role of intelligibility and all found that participants with greater intelligibility impairment had greater everyday communication difficulties, although effects were often weak and not consistent. Both cognitive status and intelligibility may be associated with everyday communicative

  14. Do safety checklists improve teamwork and communication in the operating room? A systematic review.

    Science.gov (United States)

    Russ, Stephanie; Rout, Shantanu; Sevdalis, Nick; Moorthy, Krishna; Darzi, Ara; Vincent, Charles

    2013-12-01

    The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether this clinical improvement is related to an improvement in OR teamwork and communication. A systematic search strategy of MEDLINE, EMBASE, PsycINFO, Google Scholar, and the Cochrane Database for Systematic Reviews was undertaken to obtain relevant articles. After de-duplication and the addition of limits, 315 articles were screened for inclusion by 2 researchers and all articles meeting a set of prespecified inclusion criteria were retained. Information regarding the type of checklist, study design, assessment tools used, outcomes, and study limitations was extracted. Twenty articles formed the basis of this systematic review. All articles described an empirical study relating to a case-specific safety checklist for surgery as the primary intervention, with some measure of change/improvement in teamwork and/or communication relating to its use. The methods for assessing teamwork and communication varied greatly, including surveys, observations, interviews, and 360° assessments. The evidence suggests that safety checklists improve the perceived quality of OR teamwork and communication and reduce observable errors relating to poor team skills. This is likely to function through establishing an open platform for communication at the start of a procedure: encouraging the sharing of critical case-related information, promoting team coordination and decision making, flagging knowledge gaps, and enhancing team cohesion. However, the evidence would also suggest that when used suboptimally or when individuals have not bought in to the process, checklists may conversely have a negative impact on the function of the team. Safety checklists are beneficial for OR teamwork and

  15. Programas de formación en comunicación clínica: una revisión de su eficacia en el contexto de la enseñanza médica. Clinical Communication teaching programs: a review in the context of medical education

    Directory of Open Access Journals (Sweden)

    Roger Ruiz Moral

    2003-12-01

    of clinical interviewing teaching programs in pre-postgraduate and CME settings. Material & Methods: Narrative review of experimental studies in teaching communication skills. A bibliographic searching in Medline and Cochrane data bases with or without time boundaries and using the following descriptors: interviewing skills & randomized controlled trial & training; doctor-patient communication & randomize was carried out. Results: 24 papers were accepted and analysed, 11 in vocational training period, 8 in CME, and 5 with medical students. Metodological quality was higher in those studies more recents and in those from CME. Best designs, behavior as main outcome measured, intensive courses or seminars in the context of a clinical rotation related with the topic, adult and learned centred approaches with structured feedback and an early introduction in students and residents, were associated with positive results. Conclusions: An evidence based approach is useful for planning future teaching strategies and methodologies in patient-physician relationship courses or seminars. The early stages in the development of this field in Spain recommend first a teachers teaching program, developing basic skills oriented and well structured programs, and to keep in mind local resources and a adult learning focused methodologies.

  16. Predicting failing performance on a standardized patient clinical performance examination: the importance of communication and professionalism skills deficits.

    Science.gov (United States)

    Chang, Anna; Boscardin, Christy; Chou, Calvin L; Loeser, Helen; Hauer, Karen E

    2009-10-01

    The purpose is to determine which assessment measures identify medical students at risk of failing a clinical performance examination (CPX). Retrospective case-control, multiyear design, contingency table analysis, n = 149. We identified two predictors of CPX failure in patient-physician interaction skills: low clerkship ratings (odds ratio 1.79, P = .008) and student progress review for communication or professionalism concerns (odds ratio 2.64, P = .002). No assessments predicted CPX failure in clinical skills. Performance concerns in communication and professionalism identify students at risk of failing the patient-physician interaction portion of a CPX. This correlation suggests that both faculty and standardized patients can detect noncognitive traits predictive of failing performance. Early identification of these students may allow for development of a structured supplemental curriculum with increased opportunities for practice and feedback. The lack of predictors in the clinical skills portion suggests limited faculty observation or feedback.

  17. Reputation, relationships, risk communication, and the role of trust in the prevention and control of communicable disease: a review.

    Science.gov (United States)

    Cairns, Georgina; de Andrade, Marisa; MacDonald, Laura

    2013-01-01

    Population-level compliance with health protective behavioral advice to prevent and control communicable disease is essential to optimal effectiveness. Multiple factors affect perceptions of trustworthiness, and trust in advice providers is a significant predeterminant of compliance. While competency in assessment and management of communicable disease risks is critical, communications competency may be equally important. Organizational reputation, quality of stakeholder relationships and risk information provision strategies are trust moderating factors, whose impact is strongly influenced by the content, timing and coordination of communications. This article synthesizes the findings of 2 literature reviews on trust moderating communications and communicable disease prevention and control. We find a substantial evidence base on risk communication, but limited research on other trust building communications. We note that awareness of good practice historically has been limited although interest and the availability of supporting resources is growing. Good practice and policy elements are identified: recognition that crisis and risk communications require different strategies; preemptive dialogue and planning; evidence-based approaches to media relations and messaging; and building credibility for information sources. Priority areas for future research include process and cost-effectiveness evaluation and the development of frameworks that integrate communication and biomedical disease control and prevention functions, conceptually and at scale.

  18. The Patient-Healthcare Professional Relationship and Communication in the Oncology Outpatient Setting: A Systematic Review.

    Science.gov (United States)

    Prip, Anne; Møller, Kirsten Alling; Nielsen, Dorte Lisbet; Jarden, Mary; Olsen, Marie-Helene; Danielsen, Anne Kjaergaard

    2017-07-27

    Today, cancer care and treatment primarily take place in an outpatient setting where encounters between patients and healthcare professionals are often brief. The aim of this study was to summarize the literature of adult patients' experiences of and need for relationships and communication with healthcare professionals during chemotherapy in the oncology outpatient setting. The systematic literature review was carried out according to PRISMA guidelines and the PICO framework, and a systematic search was conducted in MEDLINE, CINAHL, The Cochrane Library, and Joanna Briggs Institute Evidence Based Practice Database. Nine studies were included, qualitative (n = 5) and quantitative (n = 4). The studies identified that the relationship between patients and healthcare professionals was important for the patients' ability to cope with cancer and has an impact on satisfaction of care, that hope and positivity are both a need and a strategy for patients with cancer and were facilitated by healthcare professionals, and that outpatient clinic visits framed and influenced communication and relationships. The relationship and communication between patients and healthcare professionals in the outpatient setting were important for the patients' ability to cope with cancer. Healthcare professionals need to pay special attention to the relational aspects of communication in an outpatient clinic because encounters are often brief. More research is needed to investigate the type of interaction and intervention that would be the most effective in supporting adult patients' coping during chemotherapy in an outpatient clinic.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  19. Theory as metaphor: clinical knowledge and its communication.

    Science.gov (United States)

    Colman, Warren

    2009-04-01

    This paper investigates the relationship between clinical knowledge and psychological theory and considers the implications for clinical writing. I argue that clinical knowledge is a way of understanding rather than a body of facts and compare clinical material to 'texts' that generate multiple and indeterminate meanings. Analytic theories, which represent the crystallization of ways of understanding clinical phenomena, have an inherently metaphorical 'as if' quality since they are derived from and adapted to the clinical process of making meaning by representing psychic states in symbolic form. Thus good clinical writing demonstrates an integration of theory and clinical material into a unified network of symbolic meanings. Redfearn's paper, 'The captive, the treasure, the hero and the "anal" stage of development' (1979), is discussed as an exemplar of such integration. It is suggested that clinical knowledge is equivalent to the skill of making effective interpretations.

  20. EQClinic: a platform for learning communication skills in clinical consultations.

    Science.gov (United States)

    Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

    2016-01-01

    Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of

  1. EQClinic: a platform for learning communication skills in clinical consultations

    Directory of Open Access Journals (Sweden)

    Chunfeng Liu

    2016-07-01

    Full Text Available Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs, with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7, and reported that the structure (5.4/7 and information (5.8/7 were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non

  2. Patients' perspectives on psychiatric consultations in the Gender Identity Clinic: implications for patient-centered communication.

    Science.gov (United States)

    Speer, Susan A; McPhillips, Rebecca

    2013-06-01

    To explore transsexual patients' perceptions of communication with psychiatrists in a Gender Identity Clinic and advance understanding of patient centered communication (PCC) in psychiatric, 'gatekeeping' settings. 21 qualitative interviews with a convenience sample of clinic patients. Interviews were coded at a semantic level and subject to an inductive thematic analysis. Patients' perceptions clustered into three themes: (1) aspects of communication that patients described liking; (2) aspects of communication that patients described disliking; and (3) aspects of communication that patients deemed challenging but necessary or useful. Patients described liking or disliking aspects of communication that reflect existing understandings of PCC. However, a striking feature of their accounts was how they were able to rationalize and reflect pragmatically on their negative communication experiences, welcoming doctors' challenges as an opportunity to consider their life-changing decision to transition from their natal gender. In certain clinical settings, current operationalizations of PCC may not apply. Patients' perceptions of communication may be enhanced if an analysis of their experiences formed part of the professional training of doctors, who could be invited to consider the functional specificity of communication across settings and the consequences (both immediate and post hoc) of their communication practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Fournier’s gangrene. A clinical review

    Directory of Open Access Journals (Sweden)

    Ariana Singh

    2016-10-01

    Full Text Available Introduction and Hypothesis: Fournier’s gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier’s gangrene with emphasis on early diagnosis and management. This review aims to highlight the relevant research surrounding Fournier’s gangrene, in particular the various prognostic indicators and management strategies. Methods: A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. In addition to which a search of the European Association of Urology, the British Association for Urological Surgeons and the British Medical Journal was conducted for the most recent recommendations. Results: Immediate broad-spectrum antibiotic therapy and urgent surgical debridement are the core managerial principles of Fournier’s gangrene. The use of adjunctive therapies such as hyperbaric oxygen and vacuum assisted closure are supported in some aspects of the literature and disputed in others. The lack of randomized controlled studies limits the use of these potential additional therapies to patients unresponsive to conventional management. The value of unprocessed honey as a topical antimicrobial agent has been highlighted in the literature for small lesions in uncomplicated patients. Conclusion: Fournier’s gangrene is a urological emergency with a high mortality rate despite advances in the medical and surgical fields. The aggressive nature of the infection advocates the need for early recognition allowing immediate surgical intervention. The opposing results of available

  4. [Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

    Science.gov (United States)

    Alonso, E; Rubio, A; March, J C; Danet, A

    2011-01-01

    The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  5. Tailored Communication Within Mobile Apps for Diabetes Self-Management: A Systematic Review.

    Science.gov (United States)

    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

  6. A clinical review of phototherapy for psoriasis.

    Science.gov (United States)

    Zhang, Ping; Wu, Mei X

    2018-01-01

    Psoriasis is an autoimmune inflammatory skin disease. In the past several decades, phototherapy has been widely used to treat stable psoriatic lesions, including trunk, scalp, arms and legs, and partial nail psoriasis. A variety of light/lasers with different mechanisms of action have been developed for psoriasis including ultraviolet B (UVB), psoralen ultraviolet A (PUVA), pulsed dye laser (PDL), photodynamic therapy (PDT), intense pulsed light (IPL), light-emitting diodes (LED), and so on. Because light/laser each has specific therapeutic and adverse effects, it is important to adequately choose the sources and parameters in management of psoriasis with different pathogenic sites, severities, and duration of the disorder. This review aims at providing most updated clinic information to physicians about how to select light/laser sources and individual therapeutic regimens. To date, UV light is primarily for stable plaque psoriasis and PDL for topical psoriatic lesions with small area, both of which are safe and effective. On the other hand, PUVA has better curative effects than UVB for managing refractory psoriasis plaques, if its side effects can be better controlled. PDL provides optimal outcomes on nail psoriasis compared with other lasers. Although the trails of low-level light/laser therapy (LLLT) are still small, the near infrared (NIR) and visible red light with low energy show promise for treating psoriasis due to its strong penetration and encouraging photobiomodulation. IPL is rarely reported for psoriasis treatment, but PDT-IPL has been found to offer a moderate effect on nail psoriasis. In brief, various phototherapies have been used either in different combinations or as monotherapy. The modality has become a mainstay in the treatment of mild-to-moderate psoriasis without systemic adverse events in today's clinical practice.

  7. The Contributions of Speech Communication Scholarship to the Study of Terrorism: Review and Preview.

    Science.gov (United States)

    Dowling, Ralph E.

    Based on the premise that existing research into terrorism shows great promise, this paper notes that, despite widespread recognition of terrorism's communicative dimensions, few studies have been done from within the discipline of speech communication. The paper defines the discipline of speech communication and rhetorical studies, reviews the…

  8. CSR communication: Quo vadis? A systematic review of the literature and introduction to the special issue

    NARCIS (Netherlands)

    Golob, U.; Elving, W.; Thomsen, C.; Podnar, K.; Nielsen, A.; Schultz, F.

    2013-01-01

    This paper aims to introduce the special issue on CSR communication attached to the First International CSR Communication Conference held in Amsterdam in October 2011. The aim of the introduction is also to review CSR communication papers published in scholarly journals in order to make a summary of

  9. 78 FR 15013 - Information Collection Being Reviewed by the Federal Communications Commission

    Science.gov (United States)

    2013-03-08

    ... notify LECs when an IXC customer informs an IXC directly of the customer's desire to change IXCs. In the... FEDERAL COMMUNICATIONS COMMISSION Information Collection Being Reviewed by the Federal Communications Commission AGENCY: Federal Communications Commission. ACTION: Notice and request for comments...

  10. International nursing students and what impacts their clinical learning: literature review.

    Science.gov (United States)

    Edgecombe, Kay; Jennings, Michele; Bowden, Margaret

    2013-02-01

    This paper reviews the sparse literature about international nursing students' clinical learning experiences, and also draws on the literature about international higher education students' learning experiences across disciplines as well as nursing students' experiences when undertaking international clinical placements. The paper aims to identify factors that may impact international nursing students' clinical learning with a view to initiating further research into these students' attributes and how to work with these to enhance the students' clinical learning. Issues commonly cited as affecting international students are socialisation, communication, culture, relationships, and unmet expectations and aspirations. International student attributes tend to be included by implication rather than as part of the literature's focus. The review concludes that recognition and valuing of international nursing students' attributes in academic and clinical contexts are needed to facilitate effective strategies to support their clinical practice in new environments. Copyright © 2012. Published by Elsevier Ltd.

  11. Email for clinical communication between patients/caregivers and healthcare professionals.

    Science.gov (United States)

    Atherton, Helen; Sawmynaden, Prescilla; Sheikh, Aziz; Majeed, Azeem; Car, Josip

    2012-11-14

    Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been demonstrated in health care this has included its use for communication between patients/caregivers and healthcare professionals for clinical purposes, but the effects of using email in this way is not known.This review addresses the use of email for two-way clinical communication between patients/caregivers and healthcare professionals. To assess the effects of healthcare professionals and patients using email to communicate with each other, on patient outcomes, health service performance, service efficiency and acceptability. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010) and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions using email to allow patients to communicate clinical concerns to a healthcare professional and receive a reply, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed the risk of bias of included studies and extracted data. We contacted study authors for additional information. We assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. For continuous measures, we report effect sizes as mean

  12. Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics

    OpenAIRE

    Desjarlais-deKlerk, Kristen; Wallace, Jean E

    2013-01-01

    Background Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. Methods We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either ins...

  13. BEHAVIOUR CHANGE AND COMMUNICATION : - a descriptive literature review of behavior change and communication in Sub-Saharan countries

    OpenAIRE

    Kauppi, Susanna

    2015-01-01

    ABSTRACT Susanna Kauppi. Behavior change and communication. Descriptive literature review. 63 pages 2 appendices. Language: English. Fall 2015. Diaconia University of Applied Sciences. Master’s Degree in Global Health Care. Degree: Master of Health Care. The great majority of the diseases are preventable and human behavior plays a central role in the prevention of disease and in the maintenance. By understanding behavior and barriers of behavior change as well as used communication chan...

  14. On Human Communication: A Review, a Survey, and a Criticism.

    Science.gov (United States)

    Cherry, Colin

    This book, uniting the material from numerous lectures on communication theory, is designed to serve as the introduction to a series entitled "Studies in Communication," which will appear during the next few years. It is not intended for the expert in each of the many fields related to human communication, but, rather, it is designed for the…

  15. Communication Development in Young Children with Deaf-Blindness: Literature Review.

    Science.gov (United States)

    Bullis, Michael, Ed.; Fielding, Glen, Ed.

    This review summarizes and discusses literature relevant to the communication development of young children (0-5 years) with deaf-blindness. The review is divided into topical areas. The topical areas and the contributors for each area are as follows: "Perspectives on Communication Assessment" (Charity Rowland); "Research in Tactile…

  16. 77 FR 40072 - Assessment of the Program for Enhanced Review Transparency and Communication for New Molecular...

    Science.gov (United States)

    2012-07-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0603] Assessment of the Program for Enhanced Review Transparency and Communication for New Molecular Entity New... statement of work for an assessment of the Program for Enhanced Review Transparency and Communication for...

  17. A Review of the Efficacy of the Picture Exchange Communication System Intervention

    Science.gov (United States)

    Preston, Deborah; Carter, Mark

    2009-01-01

    The Picture Exchange Communication System (PECS) is a communication program that has become widely used, especially with children with autism. This paper reports the results of a review of the empirical literature on PECS. A descriptive review is provided of the 27 studies identified, which included randomized controlled trials (RCTs), other group…

  18. Informing people about radiation risks: a review of obstacles to public understanding and effective risk communication

    International Nuclear Information System (INIS)

    Covello, V.T.

    1988-01-01

    This paper reviews the literature on informing people about radiation risks. The paper focuses on obstacles to public understanding and effective risk communication. The paper concludes with a set of guidelines for communicating information about radiation risks to the public. The paper also includes an appendix that reviews the literature on one of the most important tools for communicating information about radiation risks: risk comparisons

  19. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    OpenAIRE

    Xi Huang

    2018-01-01

    Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC): real-time communication that takes place between human beings via the instrumentality of computers in forms of text, audio and video communication, such as live chat and chatrooms as socially-oriented meaning c...

  20. Clinical education and student satisfaction: An integrative literature review

    Directory of Open Access Journals (Sweden)

    Karen F. Phillips, EdD, MSN, IBCLC, ICCE

    2017-04-01

    Full Text Available The clinical component of undergraduate clinical education is a critical area in nursing programs. Faculty shortages have made recruitment of clinical faculty and clinical teaching more challenging. As such, alternate models of clinical faculty assignments are being explored to address faculty shortages. This article contains an extensive literature review conducted to survey models of clinical education and student satisfaction with the clinical environment. The purpose of this paper is to examine student satisfaction in the clinical learning environment using articles employing the Clinical Learning Environment Inventory (CLEI along with examining the use of alternate clinical staffing models in differing levels of undergraduate nursing students. A literature search focusing on studies published between 2002 and 2015 was conducted from 5 electronic databases. Thirty-five articles were reviewed and 22 were selected for this literature review. The studies reviewed concluded that students favored a more positive and favorable clinical environment than they perceived as being actually present. A supportive clinical learning environment is of paramount importance in securing positive teaching learning outcomes. Nurse educators can apply the results of this review in order to develop and maintain quality clinical teaching and to promote a positive, student-centric, clinical learning environment.

  1. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    Science.gov (United States)

    Huang, Xi

    2018-01-01

    Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC): real-time communication that takes place between human beings…

  2. [Effect of doctor-patient communication education on oral clinical practice].

    Science.gov (United States)

    Wang, Yi; Tang, Yu; He, Yan; Zhu, Ya-qin

    2012-08-01

    To evaluate the effect of doctor-patient communication education on dental clinical practice. The process of 61 dental interns' clinical practice was divided into two stages. The dental interns were taught with traditional teaching method in the first stage. Doctor-patient communication and communication skill training were added to the second stage. Scale of medical student's doctor-patient communication behavior was used to evaluate the dental interns' behavior by themselves after two stages. The SEGUE frame work was used to evaluate the dental interns' behavior by teachers after two stages. All statistical analysis was performed using SPSS 13.0 software package. The result of scale of medical student's doctor-patient communication behavior was analyzed using Fisher exact test or Chi-square test. The score of the SEGUE frame work was analyzed using Student's t test. The result of Scale of medical student's doctor-patient communication behavior showed only 37.71% of dental interns could establish good doctor-patient relationship in the first stage. After doctor-patient communication and communication skill training, the percentage became 75.4%. The result of the SEGUE frame work showed the score was raised from 16.066±3.308 to 21.867±2.456, and a significant difference was found between the two stages. Doctor-Patient communication education can improve dental interns' communication skills and help to establish a good doctor-patient relationship.

  3. Learning clinical communication skills: outcomes of a program for professional practitioners.

    Science.gov (United States)

    Carvalho, Irene P; Pais, Vanessa G; Almeida, Susana S; Ribeiro-Silva, Raquel; Figueiredo-Braga, Margarida; Teles, Ana; Castro-Vale, Ivone; Mota-Cardoso, Rui

    2011-07-01

    To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing. Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS. Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants). The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence. While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Communication masking in marine mammals: A review and research strategy.

    Science.gov (United States)

    Erbe, Christine; Reichmuth, Colleen; Cunningham, Kane; Lucke, Klaus; Dooling, Robert

    2016-02-15

    Underwater noise, whether of natural or anthropogenic origin, has the ability to interfere with the way in which marine mammals receive acoustic signals (i.e., for communication, social interaction, foraging, navigation, etc.). This phenomenon, termed auditory masking, has been well studied in humans and terrestrial vertebrates (in particular birds), but less so in marine mammals. Anthropogenic underwater noise seems to be increasing in parts of the world's oceans and concerns about associated bioacoustic effects, including masking, are growing. In this article, we review our understanding of masking in marine mammals, summarise data on marine mammal hearing as they relate to masking (including audiograms, critical ratios, critical bandwidths, and auditory integration times), discuss masking release processes of receivers (including comodulation masking release and spatial release from masking) and anti-masking strategies of signalers (e.g. Lombard effect), and set a research framework for improved assessment of potential masking in marine mammals. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Clinical social networking--a new revolution in provider communication and delivery of clinical information across providers of care?

    Science.gov (United States)

    Kolowitz, Brian J; Lauro, Gonzalo Romero; Venturella, James; Georgiev, Veliyan; Barone, Michael; Deible, Christopher; Shrestha, Rasu

    2014-04-01

    The adoption of social media technologies appears to enhance clinical outcomes through improved communications as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). The ability of providers to more effectively, directly, and rapidly communicate among themselves as well as with patients should strengthen collaboration and treatment as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). This paper is a case study in one organization's development of an internally designed and developed social technology solution termed "Unite." The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization. Modeling Unite as a social technology may ease adoption barriers. Developing a social network that is integrated with healthcare information systems in the clinical space opens the doors to capturing and studying the way in which providers communicate. The Unite system appears to have the potential to breaking down existing communication paradigms. With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care.

  6. Enhancing communication in dental clinics with linguistically different patients.

    Science.gov (United States)

    Rowland, Michael L

    2008-01-01

    The United States is becoming substantially more diverse in its citizenry, with numerous racial and ethnic cultural groups and immigrants living and working in this country. In addition, there has been an increase in the number of languages other than English spoken in homes, as well as an increase in the number of individuals with limited English-speaking abilities. Given the emerging racial, ethnic, and cultural trends in U.S. society, it is important that dental students as future practitioners have knowledge of interpreter services, working with professionally trained interpreters, and the legal responsibilities and requirements of interpretation. The purposes of this study were to 1) describe the role of interpreters in dental health care settings; 2) identify challenges they face; and 3) propose approaches and strategies to improve communication between dental students as future practitioners and non-English-speaking patients. Data were collected through a series of individual in-depth, face-to-face interviews using a semi-structured open-question format and email communications with three key informants who were purposefully selected to participate in this study based on their comprehensive knowledge and experience as interpreters. The qualitative analysis revealed themes or stories related to the following areas of this study: 1) the role of professional interpreters in dental and other health care settings; 2) challenges faced by interpreters and providers working with patients with limited English-speaking ability; and 3) strategies and approaches used to improve communication and address challenges. By understanding the unique interpreting needs of non- or limited English-speaking patients, dental students have an opportunity to broaden their cultural competency skills. Dental schools have an obligation to ensure that students, faculty, and staff know and understand the legal rights of patients and health care providers to communicate effectively when

  7. Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics.

    Science.gov (United States)

    Desjarlais-deKlerk, Kristen; Wallace, Jean E

    2013-07-08

    Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to "cure-oriented interactions" and tends to be more task-oriented focusing on the patient's health concerns and reason for the appointment. In contrast, socioemotional communication refers to more "care-oriented interactions" that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient visit. Research suggests that socioemotional

  8. Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics

    Science.gov (United States)

    2013-01-01

    Background Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. Methods We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to “cure-oriented interactions” and tends to be more task-oriented focusing on the patient’s health concerns and reason for the appointment. In contrast, socioemotional communication refers to more “care-oriented interactions” that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. Results The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Conclusions Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient

  9. See, Do, Teach? A Review of Contemporary Literature and Call to Action for Communication Skills Teaching in Urology.

    Science.gov (United States)

    Kieran, Kathleen; Jensen, Norman M; Rosenbaum, Marcy

    2018-04-01

    To assess the current state of published literature on communication skills teaching in urology to inform future directions for research and teaching. Excellent patient-physician communication skills increase understanding of medical conditions, facilitate shared decision-making regarding treatment planning, improve clinical outcomes, and decrease lawsuits. Surgical and procedure-based subspecialties, including urology, have generally been slow to incorporate formal communication skills teaching into curricula for postgraduate trainees. We performed a PubMed literature search using multiple keywords, selecting and reviewing articles published in English, and addressing 1 of 3 domains (curriculum development, teaching methods, and assessment methods) of communication skills teaching. The distribution of articles within the urology-specific literature was compared with that of procedure-based specialties as a whole. Eight articles were found in the urology literature, and 24 articles were found in other procedure-based specialties. Within the urology-specific literature, all 8 articles (100%) acknowledged the need for communication curriculum development, 1 article (12.5%) described how communication skills were taught, and 1 article (12.5%) discussed how communication skills were assessed. Fewer articles in other procedure-based specialties acknowledged the need to develop curricula (29.2%, P = .0007) but were equally likely to discuss communication skills teaching (37.5%, P = .63) and assessment (33.3%, P = .73). Orthopedic surgery is the only surgical subspecialty with ongoing, adaptable, formal training for physicians. Most current publications addressing communication skills in procedure-based specialties are specialty specific and focus on only 1 of the 3 communication domains. Opportunities exist to share information and to create more integrated models to teach communication skills in urology. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. National survey of clinical communication assessment in medical education in the United Kingdom (UK).

    Science.gov (United States)

    Laidlaw, Anita; Salisbury, Helen; Doherty, Eva M; Wiskin, Connie

    2014-01-13

    All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition.

  11. Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments.

    Science.gov (United States)

    McKenzie, Carly T

    2016-05-01

    The aim of this study was to use structured assessments to assess dental students' clinical communication skills exhibited during patient appointments. Fourth-year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student-patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students' clinical communication. Both instructor assessments and student self-assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non-verbal behavior. There was also relative agreement between instructor assessments and student self-assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider-patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension.

  12. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

    Science.gov (United States)

    Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P

    2015-10-25

    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

  13. Seeking informed consent to Phase I cancer clinical trials: identifying oncologists' communication strategies.

    Science.gov (United States)

    Brown, Richard; Bylund, Carma L; Siminoff, Laura A; Slovin, Susan F

    2011-04-01

    Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. Subjects were consecutive cancer patients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions. Copyright © 2010 John Wiley & Sons, Ltd.

  14. Augmentative and alternative communication in adolescents with severe intellectual disability: a clinical experience.

    Science.gov (United States)

    Uliano, D; Falciglia, G; Del Viscio, C; Picelli, A; Gandolfi, M; Passarella, A

    2010-06-01

    Augmentative and alternative communication devices proved to be effective in patients with severe intellectual disability to overcome their communication impairments. In order to give a contribution for design of augmentative and alternative communication systems that better meet the needs of beginning communicators we decided to report our clinical experience about using augmentative and alternative communication in adolescents with severe intellectual disability. Five patients who underwent a long time traditional speech rehabilitation program (at least 5 years) with scant improvements in linguistic function were recruited and evaluated by means of the Vineland Adaptive Behaviour Scale before and after a three years augmentative and alternative communication intervention carried out by a multidisciplinary team. After the rehabilitative intervention patients showed an improvement in communication, daily living skills and socialization as measured by the Vineland Adaptive Behaviour Scale. Augmentative and alternative communication is an effective rehabilitation approach to people with severe intellectual disability and impairments in linguistic expression. Moreover augmentative and alternative communication is a useful tool allowing these patients to increase their social participation also enhancing their self-esteem. Our clinical experience confirmed these topics also in adolescents who underwent a long time traditional speech rehabilitation program with scant improvements, providing practical information to clinicians.

  15. Social communication : the impact of online customer reviews on purchase intention

    OpenAIRE

    Johansen, Kai Vegard; Hovland, Filip Lundberg

    2013-01-01

    Consumer-generated product reviews have proliferated online. Driven by the notion that customers’ decision to purchase a product is influenced by the information they obtain from online customer reviews, this thesis examines the impact of online customer reviews on purchase intention. To do so, the research integrates traditional communication theories, in particular social communication by Hovland (1948), with the Elaboration Likelihood Model (ELM) to build a theoretical model. Importantly, ...

  16. Adoption and perception of electronic clinical communications in Scotland

    Directory of Open Access Journals (Sweden)

    Claudia Pagliari

    2005-06-01

    Conclusions Significant progress was observed in the implementation of ECCI facilities across Scotland. Users reported that these improved communication and were beneficial, but system reliability, incompatibility and duplication of data hindered more widespread uptake. Data were collected at a transitional phase of the programme. Whilst, among users of ECCI facilities, perceptions of the programme and its potential benefits were generally positive, its full impact will not become evident until the new electronic tools are implemented nationally and have been more fully integrated into normal work routines.

  17. Effective Communication Barriers in Clinical Teaching among Malaysian Medical Students in Zagazig Faculty of Medicine (Egypt).

    Science.gov (United States)

    Abass, Marwa Ahmed; Said, Nagwa Samy; Zahed, Eman Salah El; Hussein, Wafaa Fawzy; Hamid, Omaima Ibrahim Abdel

    2015-12-01

    effective communication in a clinical environment plays a vital role in patient assessment and treatment. The aim of this study was to understand the experiences of Malaysian medical students concerning communication barriers during clinical practice. The goal was to provide answers for three important research questions, i.e., 1) Are communication barriers an impediment to Malaysian students during clinical teaching? 2) What is the nature of the language barriers that the students encounter? and 3) What are the best ways of reducing these barriers during clinical teaching? The qualitative method was used to conduct the research, and open-ended questionnaires were used to collect the data. The study was conducted on 95 fourth-, fifth-, and sixth-year students, 80% of whom completed the study. Medical students from Malaysia who have limited knowledge of the Arabic language experience some difficulties in communicating with staff members, patients, and nurses during their clinical practices. Successful orientation of students to the language used in the clinical environment will help the students overcome the communication barriers they encounter during their clinical practices.

  18. The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review.

    Science.gov (United States)

    Gharaveis, Arsalan; Hamilton, D Kirk; Pati, Debajyoti

    2018-01-01

    The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

  19. Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews

    Science.gov (United States)

    Rouleau, Geneviève; Côté, José; Payne-Gagnon, Julie; Hudson, Emilie; Dubois, Carl-Ardy

    2017-01-01

    Background Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care. Objective An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs. Methods Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses’ practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses’ and patients’ perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered. Results A total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses’ competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients

  20. Incorporating Standardized Colleague Simulations in a Clinical Assessment Course and Evaluating the Impact on Interprofessional Communication.

    Science.gov (United States)

    Shrader, Sarah; Dunn, Brianne; Blake, Elizabeth; Phillips, Cynthia

    2015-05-25

    To determine the impact of incorporating standardized colleague simulations on pharmacy students' confidence and interprofessional communication skills. Four simulations using standardized colleagues portraying attending physicians in inpatient and outpatient settings were integrated into a required course. Pharmacy students interacted with the standardized colleagues using the Situation, Background, Assessment, Request/Recommendation (SBAR) communication technique and were evaluated on providing recommendations while on simulated inpatient rounds and in an outpatient clinic. Additionally, changes in student attitudes and confidence toward interprofessional communication were assessed with a survey before and after the standardized colleague simulations. One hundred seventy-one pharmacy students participated in the simulations. Student interprofessional communication skills improved after each simulation. Student confidence with interprofessional communication in both inpatient and outpatient settings significantly improved. Incorporation of simulations using standardized colleagues improves interprofessional communication skills and self-confidence of pharmacy students.

  1. A Clinical and Genetic Review of Aniridia

    Directory of Open Access Journals (Sweden)

    Reza Jafari

    2015-07-01

    Full Text Available Aniridia is a congenital pan-ocular, bilateral disorder. The term aniridia is a misleading misnomer, since at least a rudimentary iris is always present. Varied forms range from almost total absence to only mild hypoplasia of the iris. It is inherent in a number of syndromes, including Wilms tumor Aniridia-Genital anomalies-retardation (WAGR. Aniridia has been shown to be associated with mutations in the PAX6 gene, located on chromosome 11p13, telomeric to the Wilms’ tumor predisposition gene (WT1. The pair box gene 6 (PAX6 situated at 11p13 has been confirmed to be the leading gene associated with aniridia. The PAX6 mutation is present in individuals worldwide and has been studied in Indian, Malaysian, Chinese and Mexican families. Several categories of PAX6 mutations include: nonsense mutations, splicing mutations, frameshift mutations (deletion or insertion, in-frame insertion or deletion, missense mutations and run-on mutations. A novel de novo frameshift mutation in PAX6 most possibly occurred in the paternal gamete. Mutation in PAX6 brings about amino acid substitution for instance proline to glutamine. Deletion of 11p13 involves the PAX6 (aniridia locus and the adjacent WT1 (Wilms tumor locus. Haploinsufficiency at the PAX6 locus brings on aniridia, a pan-ocular eye condition characterized by iris hypoplasia and various other anterior and posterior eye defects, subtle hypogonadotropic hypogonadism and borderline Growth Hormone (GH deficiency. Aniridia may also be affiliated with retinal tears and detachments. Electroretinograms (ERGs done in aniridia illustrate definite retinal dysfunction. Other clinical aspects related to aniridia are ptosis with reduced levator function and anterior polar cataracts. The PAX6 gene mutation was also associated with early-onset diabetes mellitus and aniridia. Aniridia combined with zonular cataract and polydactyly was also described in a patient with Bardet-Biedl syndrome. Aniridia with sensorineural

  2. Spanish-speaking patients' satisfaction with clinical pharmacists' communication skills and demonstration of cultural sensitivity.

    Science.gov (United States)

    Kim-Romo, Dawn N; Barner, Jamie C; Brown, Carolyn M; Rivera, José O; Garza, Aida A; Klein-Bradham, Kristina; Jokerst, Jason R; Janiga, Xan; Brown, Bob

    2014-01-01

    OBJECTIVE To assess Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity, while controlling for patients' sociodemographic, clinical, and communication factors, as well as pharmacist factors, and to identify clinical pharmacists' cultural factors that are important to Spanish-speaking patients. DESIGN Cross-sectional study. SETTING Central Texas during August 2011 to May 2012. PARTICIPANTS Spanish-speaking patients of federally qualified health centers (FQHCs). MAIN OUTCOME MEASURE(S) A Spanish-translated survey assessed Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity. RESULTS Spanish-speaking patients (N = 101) reported overall satisfaction with their clinical pharmacists' communication skills and cultural sensitivity. Patients also indicated that pharmacists' cultural rapport (e.g., ability to speak Spanish, respectfulness) was generally important to Spanish speakers. Multiple linear regression analyses showed that cultural rapport was significantly related to satisfaction with pharmacists' communication skills and demonstration of cultural sensitivity. CONCLUSION Overall, patients were satisfied with pharmacists' communication skills and cultural sensitivity. Patient satisfaction initiatives that include cultural rapport should be developed for pharmacists who provide care to Spanish-speaking patients with limited English proficiency.

  3. Informed consent for clinical trials: a review | Lema | East African ...

    African Journals Online (AJOL)

    Data sources: Published original research findings and reviews in the English literature, together with anecdotal information from our current professional experiences with clinical trials. Design: Review of peer-reviewed articles. Data extraction: Online searches were done and requests for reprints from corresponding ...

  4. Factors influencing intercultural doctor-patient communication: a realist review.

    NARCIS (Netherlands)

    Paternotte, E.; Dulmen, S. van; Lee, N. van der; Scherpbier, A.J.J.A.; Scheele, F.

    2015-01-01

    Objective: Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This

  5. Clinical review: Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review.

    Science.gov (United States)

    Fenske, Wiebke; Allolio, Bruno

    2012-10-01

    The differential diagnosis of diabetes insipidus (DI) is often challenging but essential, because treatment may vary substantially. This article analyzes the database and performance of currently used differential diagnostic tests for DI and discusses future perspectives for diagnostic improvement. A review of electronic and print data comprising original and review articles retrieved from the PubMed or Cochrane Library database up to January 2012 was conducted. The search term "polyuria polydipsia syndrome" was cross-referenced with underlying forms of disease and associated clinical, diagnostic, and therapeutic MeSH terms. In addition, references from review articles and textbook chapters were screened for papers containing original data. Search results were narrowed to articles containing primary data with a description of criteria for the differential diagnosis of DI. Fifteen articles on differential diagnosis of DI were identified, mainly consisting of small series of patients, and mostly covering only part of the differential diagnostic spectrum of DI. Test protocols differed, and prospective validation of diagnostic criteria was consistently missing. Inconsistent data were reported on the diagnostic superiority of direct plasma arginine vasopressin determination over the indirect water deprivation test. Both test methods revealed limitations, especially in the differentiation of disorders with a milder phenotype. The available data demonstrate limitations of current biochemical tests for the differential diagnosis of DI, potentially leading to incorrect diagnosis and treatment. The newly available assay for copeptin, the C terminus of the vasopressin precursor, holds promise for a higher diagnostic specificity and simplification of the differential diagnostic protocol in DI.

  6. Skills in clinical communication: Are we correctly assessing them at undergraduate level?

    Directory of Open Access Journals (Sweden)

    Alberto Zamora Cervantes

    2014-07-01

    Full Text Available Communicating with the patient in clinical practice refers to the way in which the doctor and the patient interact both verbally and nonverbally, in order to achieve a shared understanding of problems and solutions. Traditional learning and assessment systems are overwhelmed when it comes to addressing the complex and multi-dimensional problems of professional practice. Problem Based Learning (PBL has been put forward as an alternative to the mere reproduction of knowledge and pre-established patterns, enabling students to develop their own learning strategies to overcome problems in their future professional practice. The challenge is to determine how to assess the acquisition of clinical communication skills. The authors have recommended a summative assessment of clinical communication skills based on the combination of different methods. It highlights the importance of feedback-based formative assessment. This raises the need to develop and validate assessment scales in clinical communication at an undergraduate level. Based on this work, the authors put forward a "fanned out" assessment in terms of clinical communication skills in Medicine degrees, with the use of different instruments in a "spiraled" manner, where the greater the contact with clinical practice in the various degree and integral courses, the greater difficulty experienced, with the participation of all the stakeholders involved (self, hetero and peer assessment without precluding the involvement of patients (real or simulated in the design of assessment instruments.

  7. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic

    DEFF Research Database (Denmark)

    Rask, Mette Trøllund; Jensen, Mette Lund; Andersen, Jørn

    2009-01-01

    skills training program in nursing cancer care. Twenty-four nurses in an oncology outpatient clinic participated and were randomly assigned to the intervention program or a control group. A total of 413 patients treated in the clinic during 2 recruitment periods (before and after the communication skills...

  8. Clinical application of minimizing picture archiving and communication system

    International Nuclear Information System (INIS)

    Chen Lixin; Zhao Weijiang; Jin Qiongying; Gu Wenxiang; Yuan Quan

    2003-01-01

    Objective: To investigate the use of the minimizing picture archiving and communication system (mini-PACS) in practical work and to realize the advent of filmless radiology. Methods: A PC-based ethernet was set up. The medical imaging equipments including CT, MR, digital fluoroscopy, DSA, and a laser camera were combined with the ethernet, and the digital imaging network (DIN) was integrated with the medical diagnostic imaging system (MDIS). In this way, the radiology information system (RIS) was established. Through one of the PC workstations with a double network card, this RIS was connected to the hospital information system (HIS). Results: The mini-PACS has been repeatedly used for more than 2 years. The system in Radiology department has been established and improved. With the present digital imaging system, such functions as the acquiring, storing, transmitting, printing, and browsing of digital images have been put into practice, all in accordance with the manners of the digital imaging communication in medicine 3.0 (DICOM 3.0). Digital imaging and diagnostic reports were managed through Microsoft Access database. Images may be kept on line in different kinds of equipment for 3-6 months. All images have been recorded on CD-R disks, so as to be kept off line permanently. So far, over 32700 reports have been stored in the database. From mini-PACS HIS terminals images and diagnostic information may be acquired on a limited scale. Conclusion: mini-PACS needs only a low cost of investment and operation. Its maintenance is simple and its performance is efficient. The main functions of the PACS can mostly be achieved. There lies a bright prospect for its use in small and medium hospitals

  9. Analyzing communication skills of Pediatric Postgraduate Residents in Clinical Encounter by using video recordings.

    Science.gov (United States)

    Bari, Attia; Khan, Rehan Ahmed; Jabeen, Uzma; Rathore, Ahsan Waheed

    2017-01-01

    To analyze communication skills of pediatric postgraduate residents in clinical encounter by using video recordings. This qualitative exploratory research was conducted through video recording at The Children's Hospital Lahore, Pakistan. Residents who had attended the mandatory communication skills workshop offered by CPSP were included. The video recording of clinical encounter was done by a trained audiovisual person while the resident was interacting with the patient in the clinical encounter. Data was analyzed by thematic analysis. Initially on open coding 36 codes emerged and then through axial and selective coding these were condensed to 17 subthemes. Out of these four main themes emerged: (1) Courteous and polite attitude, (2) Marginal nonverbal communication skills, (3) Power game/Ignoring child participation and (4) Patient as medical object/Instrumental behaviour. All residents treated the patient as a medical object to reach a right diagnosis and ignored them as a human being. There was dominant role of doctors and marginal nonverbal communication skills were displayed by the residents in the form of lack of social touch, and appropriate eye contact due to documenting notes. A brief non-medical interaction for rapport building at the beginning of interaction was missing and there was lack of child involvement. Paediatric postgraduate residents were polite while communicating with parents and child but lacking in good nonverbal communication skills. Communication pattern in our study was mostly one-way showing doctor's instrumental behaviour and ignoring the child participation.

  10. Talking About Trials: Overcoming Bottlenecks in Clinical Communication

    Science.gov (United States)

    Participation in clinical trials by adult patients is dismally low. No one knows how many patients are offered the opportunity to enroll in trials. NCI researchers are studying how patients hear about trials, whether they discuss enrollment with their providers, and the roles they play in deciding to participate in a trial.

  11. Residents' perceived needs in communication skills training across in- and outpatient clinical settings.

    Science.gov (United States)

    Junod Perron, Noelle; Sommer, Johanna; Hudelson, Patricia; Demaurex, Florence; Luthy, Christophe; Louis-Simonet, Martine; Nendaz, Mathieu; De Grave, Willem; Dolmans, Diana; Van der Vleuten, Cees

    2009-05-01

    Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics and amount of prior training in communication skills. In focus groups, outpatient residents felt that communication skills were especially useful in addressing chronic diseases and social issues. In contrast, inpatient residents emphasized the importance of good communication skills for dealing with family conflicts and end-of-life issues. Felt needs reflected residents' differing service priorities: outpatient residents saw the need for skills to structure the consultation and explore patients' perspectives in order to build therapeutic alliances, whereas inpatient residents wanted techniques to help them break bad news, provide information and increase their own well-being. The survey's overall response rate was 56%. Its data showed that outpatient residents received more training in communication skills and more of them than inpatient residents considered communication skills training to be useful (100% vs 74%). Outpatient residents' perceived needs in communication skills were more patient

  12. Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice.

    Science.gov (United States)

    Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

    2015-12-01

    Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. To assess the potential impact of the availability of digital clinician-patient communication on marginalised groups' access to general practice in the UK. Realist review in general practice. A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician-patient relationship. Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. © British Journal of General Practice 2015.

  13. Medical students' communication skills in clinical education: Results from a cohort study.

    Science.gov (United States)

    Bachmann, Cadja; Roschlaub, Silke; Harendza, Sigrid; Keim, Rebecca; Scherer, Martin

    2017-10-01

    To assess students' communication skills during clinical medical education and at graduation. We conducted an observational cohort study from 2007 to 2011 with 26 voluntary undergraduate medical students at Hamburg University based on video-taped consultations in year four and at graduation. 176 consultations were analyzed quantitatively with validated and non-validated context-independent communication observation instruments (interrater reliability ≥0.8). Based on observational protocols each consultation was also documented in free-text comments, salient topics were extracted afterwards. 26 students, seven males, were enrolled in the survey. On average, graduates scored higher in differential-diagnostic questioning and time management but showed deficiencies in taking systematic and complete symptom-oriented histories, in communication techniques, in structuring consultations and in gathering the patients' perspectives. Patient-centeredness and empathy were rather low at graduation. Individual deficiencies could barely be eliminated. Medical students were able to enhance their clinical reasoning skills and their time management. Still, various communication deficiencies in final year students became evident regarding appropriate history taking, communication skills, empathy and patient-centeredness. The necessity of developing a longitudinal communication curriculum with enhanced communication trainings and assessments became evident. A curriculum should ensure that students' communication competencies are firmly achieved at graduation. Copyright © 2017. Published by Elsevier B.V.

  14. Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

    Science.gov (United States)

    Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

    2006-09-01

    This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

  15. Multiple cutaneous inverted papillomas in a dog : clinical communication

    Directory of Open Access Journals (Sweden)

    E.P. Lane

    2007-06-01

    Full Text Available Cutaneous inverted papillomas are described in an 8-month-old mixed breed domestic dog from Windhoek, Namibia. Multiple firm, rapidly growing, doughnut-shaped masses formed on the ventral abdomen, which histologically consisted of a cup-shaped rim of marked epithelial hyperplasia, giant keratohyaline granules and prominent koilocytes and marked hyperkeratosis filling the centre of the mass. Current literature on canine papillomas is briefly reviewed.

  16. Adenoid cystic carcinoma: a retrospective clinical review.

    Science.gov (United States)

    Khan, A J; DiGiovanna, M P; Ross, D A; Sasaki, C T; Carter, D; Son, Y H; Haffty, B G

    2001-06-20

    Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors of outcome. All patients registered with the tumor registry as having had ACC were identified. Demographic and survival variables were retrieved from the database. Additionally, a chart review of all patients was done to obtain specific information. Minor gland tumors were staged using the American Joint Committee on Cancer's criteria for squamous cell carcinomas in identical sites. Histopathologic variables retrieved included grade of the tumor, margins, and perineural invasion. Treatment modalities, field sizes, and radiation doses were recorded in applicable cases. An effort to retrieve archival tumor specimens for immunohistochemical analysis was undertaken. A total of 69 patients were treated for ACC from 1955 to 1999. One patient, who presented with fatal brain metastasis, was excluded from further analysis. Of the remaining 68 patients, 30 were men and 38 were women. The average age at diagnosis was 52 years, and mean follow-up was 13.2 years. Mean survival was 7.7 years. Overall survival (OS) rates at 5, 10, and 15 years were 72%, 44%, and 34%, and cause-specific survival was 83%, 71%, and 55%, respectively. Recurrence-free survival rates were 65%, 52%, and 30% at 5, 10, and 15 years, with a total of 29 of 68 (43%) eventually suffering a recurrence. Overall survival was adversely affected by advancing T and AJCC stage. Higher tumor grades were also associated with decreased OS, although the numbers compared were small. Primaries of the nasosinal region fared poorly when compared with other locations. Total recurrence-free survival, local and distant recurrence rates were distinctly better in primaries of the oral cavity/oropharynx when compared with those in other locations. Reduced distant recurrence-free survival was

  17. Effects of peer review on communication skills and learning motivation among nursing students.

    Science.gov (United States)

    Yoo, Moon Sook; Chae, Sun-Mi

    2011-04-01

    The purpose of this study was to investigate the effects of video-based peer review on communication skills and learning motivation among nursing students. A non-equivalent control with pretest-posttest design was used. The participants were 47 sophomore nursing students taking a fundamentals of nursing course at a nursing college in Korea. Communication with a standardized patient was videotaped for evaluation. The intervention group used peer reviews to evaluate the videotaped performance; a small group of four students watched the videotape of each student and then provided feedback. The control group assessed themselves alone after watching their own videos. Communication skills and learning motivation were measured. The intervention group showed significantly higher communication skills and learning motivation after the intervention than did the control group. The findings suggest that peer review is an effective learning method for nursing students to improve their communication skills and increase their motivation to learn. Copyright 2011, SLACK Incorporated.

  18. Improving health outcomes for young people with long term conditions: The role of digital communication in current and future patient-clinician communication for NHS providers of specialist clinical services for young people - LYNC study protocol.

    Science.gov (United States)

    Griffiths, Frances E; Atherton, Helen; Barker, Jack R; Cave, Jonathan Ak; Dennick, Kathryn; Dowdall, Peter; Fraser, Joe; Huxley, Caroline; Kim, Sung-Wook; Madan, Jason J; Matharu, Harjit; Musumadi, Luhanga; Palmer, Tom M; Paul, Moli; Sankaranarayanan, Sailesh; Slowther, Anne-Marie; Sujan, Mark A; Sutcliffe, Paul A; Sturt, Jackie

    2015-01-01

    Young people living with long term conditions are vulnerable to health service disengagement. This endangers their long term health. Studies report requests for digital forms of communication - email, text, social media - with their health care team. Digital clinical communication is troublesome for the UK NHS. In this article we aim to present the research protocol for evaluating the impacts and outcomes of digital clinical communications for young people living with long term conditions and provide critical analysis of their use, monitoring and evaluation by NHS providers (LYNC study: Long term conditions, Young people, Networked Communications). The research involves: (a) patient and public involvement activities with 16-24 year olds with and without long term health conditions; (b) six literature reviews; (c) case studies - the main empirical part of the study - and (d) synthesis and a consensus meeting. Case studies use a mixed methods design. Interviews and non-participant observation of practitioners and patients communicating in up to 20 specialist clinical settings will be combined with data, aggregated at the case level (non-identifiable patient data) on a range of clinical outcomes meaningful within the case and across cases. We will describe the use of digital clinical communication from the perspective of patients, clinical staff, support staff and managers, interviewing up to 15 young people and 15 staff per case study. Outcome data includes emergency admissions, A&E attendance and DNA (did not attend) rates. Case studies will be analysed to understand impacts of digital clinical communication on patient health outcomes, health care costs and consumption, ethics and patient safety.

  19. A systematic review of communication strategies for people with dementia in residential and nursing homes.

    Science.gov (United States)

    Vasse, Emmelyne; Vernooij-Dassen, Myrra; Spijker, Anouk; Rikkert, Marcel Olde; Koopmans, Raymond

    2010-03-01

    The impairment of verbal skills of people with dementia challenges communication. The aim of this review was to study the effects of nonpharmacological interventions in residential and nursing homes on (1) communication between residents with dementia and care staff, and (2) the neuropsychiatric symptoms of residents with dementia. Pubmed, PsychInfo, Web of Science, the Cochrane Library, and reference lists from relevant publications were systematically searched to find articles about controlled interventions with communication strategies. The data collected were pooled and subjected to a meta-analysis. Nineteen intervention studies were selected for this review. They included structured and communicative "sessions at set times" for residents (e.g. life review) and communication techniques in activities of "daily care" applied by care staff (e.g. sensitivity to nonverbal communication). A meta-analysis of five set-time interventions (communication) and another meta-analysis of four set-time interventions (neuropsychiatric outcomes) found no significant overall effects. Individual set-time intervention studies report positive effects on communication when interventions are single-task sessions, like life review or one-on-one conversation. Interventions around daily care activities had positive effects on communication outcomes. Effects of both types of interventions on neuropsychiatric symptoms were divergent. This review indicates that care staff can improve their communication with residents with dementia when strategies are embedded in daily care activities or interventions are single-task sessions at set times. These results offer the possibility of improving the quality of care, but not of directly reducing neuropsychiatric symptoms. More research is needed to study the effect of communication interventions on neuropsychiatric symptoms.

  20. Picture archiving and communication systems (PACS) in clinical practice

    International Nuclear Information System (INIS)

    Carreno Pedemonte, J.C.; Piqueras Pardellans, J.; Lucaya Layret, J.

    1994-01-01

    Picture archiving and communication systems (PACS) were developed as a technological response to the complex management of the growing amount of information generated by the different diagnostic imaging methods. This article documents the process of the progressive implementation, starting in January 1991, of the first complete PACS installed in our country. The system installed in our center is composed of acquisition modules for all the imaging methods (computed radiography, ultrasound, computed tomography, digital fluoroscopy and magnetic resonance), a central processing unit, an automatic optical disk for storage and a network of image viewing and diagnostic stations. The preliminary results obtained with its implementation demonstrate that PACS provide a series of functional advantages, especially at the image storage and display levels. In spite of these conveniences, the present high costs of acquisition and maintenance, together with certain technical problems as a result of its complexity, will signify that its generalized application for all imaging methods will not become a reality at most centers in the near future

  1. Attributes of clinical leadership in contemporary nursing: an integrative review.

    Science.gov (United States)

    Mannix, Judy; Wilkes, Lesley; Daly, John

    2013-08-01

    Effective clinical leadership is offered as the key to healthy, functional and supportive work environments for nurses and other health professionals. However, as a concept it lacks a standard definition and is poorly understood. This paper reports on an integrative review undertaken to uncover current understandings of defining attributes of contemporary clinical leadership in nursing. Data collection involved a search of relevant electronic databases for a 10-year period. Keywords for the search were 'clinical leadership' and 'nursing'. Ten research papers met the inclusion criteria for the integrative review. Analysis of these studies indicated clinical leadership attributes had a clinical focus, a follower/team focus or a personal qualities focus; attributes necessary to sustain supportive workplaces and build the capacity and resilience of nursing workforces. The small number of research-based studies yielded for the review indicates the need for further research in the area of clinical leadership.

  2. A systematic review of the cost and cost-effectiveness of electronic discharge communications.

    Science.gov (United States)

    Sevick, Laura K; Esmail, Rosmin; Tang, Karen; Lorenzetti, Diane L; Ronksley, Paul; James, Matthew; Santana, Maria; Ghali, William A; Clement, Fiona

    2017-07-02

    The transition between acute care and community care can be a vulnerable period in a patients' treatment due to the potential for postdischarge adverse events. The vulnerability of this period has been attributed to factors related to the miscommunication between hospital-based and community-based physicians. Electronic discharge communication has been proposed as one solution to bridge this communication gap. Prior to widespread implementation of these tools, the costs and benefits should be considered. To establish the cost and cost-effectiveness of electronic discharge communications compared with traditional discharge systems for individuals who have completed care with one provider and are transitioning care to a new provider. We conducted a systematic review of the published literature, using best practices, to identify economic evaluations/cost analyses of electronic discharge communication tools. Inclusion criteria were: (1) economic analysis and (2) electronic discharge communication tool as the intervention. Quality of each article was assessed, and data were summarised using a component-based analysis. One thousand unique abstracts were identified, and 57 full-text articles were assessed for eligibility. Four studies met final inclusion criteria. These studies varied in their primary objectives, methodology, costs reported and outcomes. All of the studies were of low to good quality. Three of the studies reported a cost-effectiveness measure ranging from an incremental daily cost of decreasing average discharge note completion by 1 day of $0.331 (2003 Canadian), a cost per page per discharge letter of €9.51 and a dynamic net present value of €31.1 million for a 5-year implementation of the intervention. None of the identified studies considered clinically meaningful patient or quality outcomes. Economic analyses of electronic discharge communications are scarcely reported, and with inconsistent methodology and outcomes. Further studies are needed

  3. A review of molecular imaging studies reaching the clinical stage

    International Nuclear Information System (INIS)

    Wong, Franklin C.; Kim, E. Edmund

    2009-01-01

    The practice of molecular imaging in the clinics is examined across various imaging modalities to assess the current status of clinical molecular imaging. The various physiologic and scientific bases of clinical molecular imaging are surveyed to assess the possibilities and opportunities for the deployment of the different imaging modalities in the near future. The requisites for successful candidate(s) of clinical molecular imaging are reviewed for future development.

  4. A systematic review of interactive multimedia interventions to promote children’s communication with health professionals: implications for communicating with overweight children

    Science.gov (United States)

    2014-01-01

    Background Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. Methods An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11-years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. Results A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children’s health-related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. Conclusions The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research

  5. Factors influencing intercultural doctor-patient communication: a realist review.

    Science.gov (United States)

    Paternotte, Emma; van Dulmen, Sandra; van der Lee, Nadine; Scherpbier, Albert J J A; Scheele, Fedde

    2015-04-01

    Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works. A systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication. In total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors' assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training. The quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication. Training for improving ICC can be developed as an extension of the existing training for patient-centered communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Rewarding peer reviewers: maintaining the integrity of science communication.

    Science.gov (United States)

    Gasparyan, Armen Yuri; Gerasimov, Alexey N; Voronov, Alexander A; Kitas, George D

    2015-04-01

    This article overviews currently available options for rewarding peer reviewers. Rewards and incentives may help maintain the quality and integrity of scholarly publications. Publishers around the world implemented a variety of financial and nonfinancial mechanisms for incentivizing their best reviewers. None of these is proved effective on its own. A strategy of combined rewards and credits for the reviewers1 creative contributions seems a workable solution. Opening access to reviews and assigning publication credits to the best reviews is one of the latest achievements of digitization. Reviews, posted on academic networking platforms, such as Publons, add to the transparency of the whole system of peer review. Reviewer credits, properly counted and displayed on individual digital profiles, help distinguish the best contributors, invite them to review and offer responsible editorial posts.

  7. Costs and financial benefits of video communication compared to usual care at home: a systematic review.

    NARCIS (Netherlands)

    Peeters, J.M.; Mistiaen, P.; Francke, A.L.

    2011-01-01

    We conducted a systematic review of video communication in home care to provide insight into the ratio between the costs and financial benefits (i.e. cost savings). Four databases (PUBMED, EMBASE, COCHRANE LIBRARY, CINAHL) were searched for studies on video communication for patients living at home

  8. 77 FR 69501 - Certain Devices for Mobile Data Communication; Determination Not To Review an Initial...

    Science.gov (United States)

    2012-11-19

    ... certain devices for mobile data communication by reason of infringement of certain claims of United States... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-809] Certain Devices for Mobile Data Communication; Determination Not To Review an Initial Determination Granting a Motion By Complainant To...

  9. A Review of Communication Elements and Learner Support Services in Turkish Distance Education System

    Science.gov (United States)

    Usun, Salih

    2003-01-01

    The aim of this study is to review the Turkish distance education system, Open Education Faculty (OEF), from the point of view of the communication' elements and learner support services. The study, firstly, introduces the related literature and the growth of distance education in Turkey; explains generally the communication and interaction…

  10. An Evidence-Based Systematic Review on Communication Treatments for Individuals with Right Hemisphere Brain Damage

    Science.gov (United States)

    Blake, Margaret Lehman; Frymark, Tobi; Venedictov, Rebecca

    2013-01-01

    Purpose: The purpose of this review is to evaluate and summarize the research evidence related to the treatment of individuals with right hemisphere communication disorders. Method: A comprehensive search of the literature using key words related to right hemisphere brain damage and communication treatment was conducted in 27 databases (e.g.,…

  11. Attention to gender in communication skills assessment instruments in medical education: a review.

    NARCIS (Netherlands)

    Dielissen, P.W.; Bottema, B.J.A.M.; Verdonk, P.; Lagro-Janssen, T.

    2011-01-01

    CONTEXT: Gender is increasingly regarded as an important factor in doctor-patient communication education. This review aims to assess if and how gender is addressed by current assessment instruments for communication skills in medical education. METHODS: In 2009 at Radboud University Nijmegen

  12. Risk/Benefit Communication about Food—A Systematic Review of the Literature

    NARCIS (Netherlands)

    Frewer, L.J.; Fischer, A.R.H.; Brennan, M.; Bánáti, D.; Lion, R.; Meertens, R.M.; Rowe, G.; Siegrist, M.; Verbeke, W.; Vereijken, C.M.J.L.

    2016-01-01

    A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit

  13. Hypercalcaemia in a dog with primary hypothyroidism : clinical communication

    Directory of Open Access Journals (Sweden)

    R. G. Lobetti

    2011-05-01

    Full Text Available A 7-year old female beagle was evaluated for symptomatic hypercalcaemia and primary hypothyroidism. Clinical findings were typical for hypothyroidism. Plasma parathyroid hormone was low and obvious causes for the hypercalcaemia were ruled out by means of abdominal ultrasonography, ultrasonography of the parathyroid glands, survey thoracic radiographs, and fine needle aspirate cytology of the spleen, liver, and peripheral lymph nodes. Treatment with thyroxine resulted in resolution of the hypercalcaemia after approximately 9 weeks of therapy. This is the 1st report of primary adult-onset hypothyroidism associated with symptomatic hypercalcaemia in a dog.

  14. Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review

    NARCIS (Netherlands)

    Janssen, S.M.; Lagro-Janssen, A.L.M.

    2012-01-01

    OBJECTIVE: Review of studies published in the last 10 years about women seeking gynecological- or obstetrical care and physician's gender in relation to patient preferences, differences in communication style and patient satisfaction. METHODS: Studies were identified by searching the online

  15. Access to augmentative and alternative communication: new technologies and clinical decision-making.

    Science.gov (United States)

    Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

    2012-01-01

    Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

  16. Pairing students in clinical assignments to develop collaboration and communication skills.

    Science.gov (United States)

    Bartges, Mali

    2012-01-01

    Skillful collaboration and communication among healthcare team members are associated with favorable patient outcomes. Student nurses need opportunities for supervised development of these crucial and intertwined skills. The author describes the implementation of a practice-change project for simultaneously developing collaboration and communication skills by pairing prelicensure student nurses in clinical assignments. This easily adapted strategy increases options for faculty looking to stimulate student acquisition of these professional skills.

  17. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan.

    Science.gov (United States)

    Obregón, Rafael; Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-08-01

    Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.

  18. First report of oligodendroglioma in a sheep : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Derakhshanfar

    2010-05-01

    Full Text Available Oligodendrogliomas occur most commonly in the dog, but have also been reported in cattle, horses and cats. A 1-year-old sheep with neurological disturbances, including blindness, ataxia, circling and incoordination was referred to the veterinary clinic of Shahid Bahonar University of Kerman. Following euthanasia and necropsy, a soft, relatively well-demarcated mass was observed in the white and grey matter of the right cerebral hemisphere, close to the sylvian fissure in the right cerebral hemisphere. Microscopic examination revealed a sheet of densely packed tumour cells with hyperchromatic nuclei, lightly staining cytoplasm and characteristic perinuclear halo effect which is consistent with a diagnosis of oligodendroglioma. This is the 1st report of oligodendroglioma in sheep.

  19. Acute normovolaemic haemodilution - 2 case studies : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2008-05-01

    Full Text Available Acute normovolaemic haemodilution (ANH is a technique used to preserve a patient's owns red blood cells and reduce the incidence of heterogeneous blood transfusion. This paper describes the use of the technique in a dog and a kitten. A significant benefit of ANH can be shown in the canine case presented. The dog lost 1800m of blood during surgery but the haematocrit was only reduced to 33% 6 hours after the end of surgery. The kitten, however, did not benefit from ANH. It lost a small volume of blood during surgery and developed complications. This paper also describes some of the potential complications that may occur. To the best of my knowledge, this is the 1st clinical description of ANH in a dog and a cat.

  20. Clinical and diagnostic importance of proteinuria: A review | Oni ...

    African Journals Online (AJOL)

    Clinical and diagnostic importance of proteinuria: A review. ... shown that diabetis mellitus, cardiovascular disease and hypertension could provoke secondary ... Proteinuria is also significant in some non-pathological cases such as pregnancy

  1. Childhood bruxism: a clinical review and case report.

    Science.gov (United States)

    Gupta, B; Marya, C M; Anegundi, R

    2010-01-01

    The present case report refers to a patient who reported to the department with the complaint of teeth grinding (Bruxism). A brief review of the literature is reported concerning the aetiology, clinical diagnosis and the therapeutic approach of the disease.

  2. Obstructive sleep apnea: a clinical review

    Directory of Open Access Journals (Sweden)

    M. Marvisi

    2013-05-01

    Full Text Available BACKGROUND Since the original classification of the obstructive nature of obstructive sleep apnea syndrome (OSAS in 1965, much has been learned about the disorder. In 1990 respiratory disturbances during sleep have come to be recognized as extremely common disorders with important clinical consequences. DISCUSSION It is a condition with high prevalence of obesity as a major risk factor. Premenopausal women are relatively protected from the disorder: its prevalence in women rises after menopause. Although OSAS is a risk factor for excessive daytime sleepiness, there is developing evidence that it is also a risk factor for hypertension, acute cardiovascular events, and insulin resistance. Definitive diagnosis still depends on in-laboratory polysomnography. This involves recording of multiple variables during sleep, including electroencephalogram. There is a considerable interest in the role of unattended home sleep-monitoring and some evidence of its usefulness has yet to be established. The first line of therapy is nasal continuous positive airway pressure (CPAP. Data into the efficacy of CPAP in severe OSAS have come from randomized, placebo-controlled clinical trials the endpoints of which being sleepiness, quality of life, and 24-h ambulatory blood pressure. Data are currently less convincing for treatment outcomes in mild to moderate OSAS, and new clinical trails to assess outcomes in this group are underway. CONCLUSION The field of sleep medicine has now firmly entered the mainstream of clinical practice, substantial progress has been made, and OSAS has increasingly emerged as a major public health concern. The Internal Medicine specialist has to recognize this clinical entity.

  3. Clinical review: Management of difficult airways

    Science.gov (United States)

    Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric

    2006-01-01

    Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway. PMID:17184555

  4. Clinical review: management of difficult airways.

    Science.gov (United States)

    Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric

    2006-01-01

    Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway.

  5. Review of Key Technologies of 5G Wireless Communication System

    Directory of Open Access Journals (Sweden)

    Shi Sha

    2015-01-01

    Full Text Available The 5th generation mobile communication system (5G is oriented towards a new generation of mobile communication system to the year of 2020 and beyond, and its development is still at the exploratory stage. Combining the latest trends in mobile communication development at home and abroad, in this article, we describe the key technologies of driving the 5G research direction. Furthermore, the technical innovation of 5G comes from both wireless and network technologies. In the field of wireless technologies, massive multiple-input multiple-output (MIMO, ultra-wideband spectral, ultra-dense heterogeneous networks, have already become the focus of global industry. In the field of network technologies, a new network architecture based on software-defined networking (SDN becomes the prevailing view worldwide. Additionally, there are some other potential technologies for 5G, such as NOMA, FBMC, mm Waves, and Multi-carrier technology aggregation.

  6. A Review and Analysis of the Picture Exchange Communication System (PECS) for Individuals With Autism Spectrum Disorders Using a Paradigm of Communication Competence

    Science.gov (United States)

    Ostryn, Cheryl; Wolfe, Pamela S.; Rusch, Frank R.

    2008-01-01

    Research related to the use of the Picture Exchange Communication System (PECS) with individuals having autism spectrum disorders (ASDs) was examined using a communication competence paradigm detailed by J. C. Light (1988, 1989, 2003). Communication components were operationalized based on skills identified in ASD research. A review was conducted…

  7. [Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting].

    Science.gov (United States)

    Gachoud, D; Félix, S; Monti, M

    2015-11-04

    Communication between trainer and trainee plays a central role in teaching and learning in the clinical environment. There are various strategies to frame the dialogue between trainee and trainer. These strategies allow trainers to be more effective in their supervision, which is important in our busy clinical environment. Communication strategies are well adapted to both in- and out-patient settings, to both under- and postgraduate contexts. This article presents three strategies that we think are particularly useful. They are meant to give feedback, to ask questions and to present a case.

  8. The role of effective communication in achieving informed consent for clinical trials.

    Science.gov (United States)

    Pick, Andrew; Gilbert, Kayleigh; McCaul, James

    2014-11-11

    Informed consent is fundamental to the protection of the rights, safety and wellbeing of patients in clinical research. For consent to be valid, patients must first be given all the information they need about the proposed research to be able to decide whether they would like to take part. This material should be presented in a way that is easy for them to understand. This article explores the importance of communication in clinical research, and how more effective communication with patients during the informed consent process can ensure they are fully informed.

  9. An evaluation of remote communication versus face-to-face in clinical dental education.

    Science.gov (United States)

    Martin, N; Lazalde, O Martínez; Stokes, C; Romano, D

    2012-03-23

    Distance learning and internet-based delivery of educational content are becoming very popular as an alternative to real face-to-face delivery. Clinical-based discussions still remain greatly face-to-face despite the advancement of remote communication and internet sharing technology. In this study we have compared three communication modalities between a learner and educator: audio and video using voice over internet protocol (VoIP) alone [AV]; audio and video VoIP with the addition of a three dimensional virtual artefact [AV3D] and physical face-to-face [FTF]. Clinical case discussions based on fictitious patients were held between a 'learner' and an 'expert' using the three communication modalities. The learner presented a clinical scenario to the experts, with the aid of a prop (partially dentate cast, digitised for AV3D), to obtain advice on the management of the clinical case. Each communication modality was tested in timed exercises in a random order among one of three experts (senior clinical restorative staff) and a learner (from a cohort of 15 senior clinical undergraduate students) all from the School of Clinical Dentistry, University of Sheffield. All learners and experts used each communication modality in turn with no prior training. Video recording and structured analysis were used to ascertain learner behaviour and levels of interactivity. Evaluation questionnaires were completed by experts and learners immediately after the experiment to ascertain effectiveness of information exchange and barriers/facilitators to communication. The video recordings showed that students were more relaxed with AV and AV3D than FTF (p = 0.01). The evaluation questionnaires showed that students felt they could provide (p = 0.03) and obtain (p = 0.003) more information using the FTF modality, followed by AV and then AV3D. Experts also ranked FTF better than AV and AV3D for providing (p = 0.012) and obtaining (p = 0) information to/from the expert. Physical face

  10. Promoting practical clinical management learning: the current situation about Information and Communications Technology capability development in student nurses.

    Science.gov (United States)

    Willmer, Marian

    2005-11-01

    This paper is about work-based learning in information management for student nurses. It seeks, through a literature review, to make a case for and promote Information and Communications Technology capability development in student nurses within their clinical environment. The profession of nursing, like many other jobs, is facing the increasing usage of information technology in day-to-day operations. Admission and discharges of patients have been held on computer databases since at least the 1980s. With the new Labour Government in 1997, increasing focus was placed on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. Nurse education therefore needed to reflect this need and support trainee nurses to acquire skills in Information and Communications Technology. This paper is part of an ongoing professional doctorate inquiry into Information and Communications Technology capability development in student nurses. A literature search was conducted on teaching information and technology skills via Cumulative Index to Nursing and Allied Health Literature. Most of the available studies were neither based on the UK nor were they about student nurses. As there is a dearth of published work in this specific area, relevant, related and tangential literature was reviewed. It is argued that current practice and published work on Information and Communications Technology capability development by student nurses hardly exists. The literature confirmed that success in this area requires sound change management, an understanding of National Health Service culture, and effective people leadership skills. Nurse educators and managers need to pay more attention to understand how organizations work, particularly organizations where student nurses carry out their work. As the search revealed a significant gap in the literature in this area, a practical conceptual framework to fully analyse, develop and

  11. Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

    Science.gov (United States)

    Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius

    2010-08-26

    Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), ptransfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.

  12. Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

    Science.gov (United States)

    Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

    2018-04-01

    LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

  13. Partial facial duplication (diprosopus in a goat kid : clinical communication

    Directory of Open Access Journals (Sweden)

    S. Mukaratirwa

    2006-06-01

    Full Text Available The anatomical and clinical features of a live-born diprosopic goat kid are described. The kid had two faces with two eyes each, two complete oral cavities and nostrils and two ears. Caudal to the neck, the kid grossly appeared normal. Both mouths of the kid showed synchronous suckling motions. Elevated respiratory and heart rates were recorded and the temperature was subnormal. Radiological examination showed a single trunk and vertebral column, normal limbs, two sets of jaws, three orbits, and contrast radiography revealed a single patent oesophagus. There was maxillary and mandibular duplication resulting in two faces. There was a cleft palate. The oropharyngeal regions of each face merged to form a single laryngopharynx and oesophagus. There was a single brain with hypoplasia of the cerebellum. The left and right cerebral hemispheres were fused rostrally, and there was duplication of the optic chiasma and the pituitary gland. The olfactory tract was absent and the superficial origins of most of the cranial nerves were not discernible.

  14. Atypical dermatophilosis of sheep in Kenya : clinical communication

    Directory of Open Access Journals (Sweden)

    J.K. Wabacha

    2007-06-01

    Full Text Available An outbreak of an atypical form of ovine dermatophilosis affecting the lips and muzzle with a very high morbidity in weaners and hoggets in Kenya is reported. Clinical diagnosis of ovine dermatophilosis was made and confirmed by direct microscopic examination as well as isolation and identification of Dermatophilus congolensis from scab material from the affected sheep. The morbidity rate within the flock was 31.8 % (237 / 745 with 98.3 % (233 / 237 of the affected sheep being weaners and hoggets. No fatalities were recorded. The lesions, confined in the lips and the muzzle, were swelling of both the upper and lower lips, circumscribed lumps in the skin of both the upper and lower lips, oedema of the head and the submandibular area and scabs and crusts on the lips and muzzle. Within 1 week following treatment with long acting oxytetracycline (20 % at a rate of 20 mg/kg body weight, intramuscularly and a topical application of oxytetracycline spray, lumps regressed in size and were covered by dark-brown scabs. Removal of the dark-brown scabs revealed erythematous areas covered with purulent material and horny erythematous projections (papillae projecting from the surfaces. Within the 2nd week, the horny erythematous projections formed greyish scabs, which later peeled off leaving alopaecic areas around the lips. The paper highlights atypical dermatophilosis of sheep and we believe that this is the first published report of an outbreak of ovine dermatophilosis in Kenya.

  15. The Journal of Allergy and Clinical Immunology: In Practice - 2016 Year in Review.

    Science.gov (United States)

    Schatz, Michael; Sicherer, Scott H; Zeiger, Robert S

    As editors, we concluded that it would be helpful to our readers to write a Year in Review article that highlights the Review, Original, and Clinical Communication articles published in 2016 in The Journal of Allergy and Clinical Immunology: In Practice. We summarized articles on the topics of asthma, rhinitis/rhinosinusitis, food allergy, anaphylaxis, drug allergy, urticarial/angioedema, eosinophilic disorders, and immunodeficiency. Within each topic, epidemiologic findings are presented, relevant aspects of prevention are described, and diagnostic and therapeutic advances are enumerated. Diagnostic tools described include history, skin tests, and in vitro tests. Treatments discussed include behavioral therapy, allergen avoidance therapy, positive and negative effects of pharmacologic therapy, and various forms of immunologic and desensitization management. We hope this review will help you, our readers, consolidate and use this extensive and practical knowledge for the benefit of your patients. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. A systematic review of pediatric obesity and family communication through the lens of addiction literature.

    Science.gov (United States)

    Mogul, Ashley; Irby, Megan B; Skelton, Joseph A

    2014-06-01

    Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.

  17. The impact of team characteristics and context on team communication: An integrative literature review.

    Science.gov (United States)

    Tiferes, Judith; Bisantz, Ann M

    2018-04-01

    Many studies on teams report measures of team communication; however, these studies vary widely in terms of the team characteristics, situations, and tasks studied making it difficult to understand impacts on team communication more generally. The objective of this review is systematically summarize relationships between measures of team communication and team characteristics and situational contexts. A literature review was conducted searching in four electronic databases (PsycINFO, MEDLINE, Ergonomics Abstracts, and SocINDEX). Additional studies were identified by cross-referencing. Articles included for final review had reported at least one team communication measure associated with some team and/or context dimension. Ninety-nine of 727 articles met the inclusion criteria. Data extracted from articles included characteristics of the studies and teams and the nature of each of the reported team and/or context dimensions-team communication properties relationships. Some dimensions (job role, situational stressors, training strategies, cognitive artifacts, and communication media) were found to be consistently linked to changes in team communication. A synthesized diagram that describes the possible associations between eleven team and context dimensions and nine team communication measures is provided along with research needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Clinical reasoning in undergraduate nursing education: a scoping review

    OpenAIRE

    Menezes,Sáskia Sampaio Cipriano de; Corrêa,Consuelo Garcia; Silva,Rita de Cássia Gengo e; Cruz,Diná de Almeida Monteiro Lopes da

    2015-01-01

    Abstract OBJECTIVE This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. METHODS A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. RESULTS From the 1380 citations retrieved in the search, 23 were kept for review and their co...

  19. Psychotherapy mediated by remote communication technologies: a meta-analytic review

    Directory of Open Access Journals (Sweden)

    Richards David

    2008-07-01

    Full Text Available Abstract Background Access to psychotherapy is limited by psychopathology (e.g. agoraphobia, physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy. Methods Systematic review (including electronic database searching and correspondence with authors of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006, PsycInfo (1967–2006, EMBASE (1980–2006 and CINAHL databases (1982–2006. The Cochrane Central Register of Controlled Trials (CENTRAL and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR. All searches were conducted to include studies with a publication date to July 2006. Results Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726 and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168. There were few comparisons of remote versus face-to-face psychotherapy. Conclusion Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to

  20. Review of the Clinical Effect of Orlistat

    Science.gov (United States)

    Qi, Xiguang

    2018-01-01

    Obesity has been a main risk for the development of diabetes mellitus, cardiovascular diseases and many other chronic problems worldwide. Lifestyle modification is the best way to lose weight but very hard to implement, thus pharmacotherapy is regarded as a good add-on to dietary and lifestyle therapies. This review provides an overview of the olistat, a drug for obesity approved by FDA, about its mechanism of action, efficacy for obesity and some other diseases including cardiovascular disease, type 2 diabetes and some cancers, as well as its safety and adverse effects.

  1. Post-anaesthetic myelomalacia in a horse : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2005-06-01

    Full Text Available This article describes a rare neurological complication of anaesthesia in a 2 year-old Clydesdale colt undergoing castration. Anaesthesia was induced with glyceryl guaiacol ether and ketamine and maintained with halothane. Following an uneventful anaesthetic of 40 minutes, the horse recovered from anaesthesia in a padded recovery stall. After approximately 70 minutes in the recovery stall, the horse attempted to stand and adopted a dog sitting position. One hundred and fifty minutes later, the horse became distressed and was sedated with xylazine. Clinical examination of the horse did not reveal any evidence of myositis or fractures. A neurological examination revealed an intact anal reflex, deep pain response in the hind legs, tail tone and voluntary movement of the hind legs was possible. The horse deteriorated neurologically over the next 24 hours and was euthanased on humane grounds. The horse was submitted for necropsy. Gross pathology was unremarkable except for a small amount of haemorrhage around the right kidney. Histopathology revealed no abnormalities in any muscle groups or peripheral nerves. Congestion and axonal swelling of the spinal cord was evident from T16 to S1. Ischaemic neurons were evident from L 1 to L 6. The most prominent lesions were at L4 and L5. A diagnosis of myelomalacia was made. This is a rare complication of anaesthesia in horses with 9 case studies appearing in the literature since 1979. This is the 1st case to be reported in South Africa. The speculated pathophysiology and risk factors for this complication are discussed.

  2. A Review of Technical Communication Programs Outside the United States.

    Science.gov (United States)

    Alred, Gerald J.

    2001-01-01

    Examines technical communication programs outside the United States and comments on such features as their location in the university structure, links with public relations, the inclusion of internships or practicums, the balance of theory and practice, and typical course offerings. Lists a dozen major programs in seven countries. Concludes that…

  3. Unmet clinical needs and burden in Angelman syndrome: a review of the literature.

    Science.gov (United States)

    Wheeler, Anne C; Sacco, Patricia; Cabo, Raquel

    2017-10-16

    Angelman syndrome (AS) is a rare disorder with a relatively well-defined phenotype. Despite this, very little is known regarding the unmet clinical needs and burden of this condition, especially with regard to some of the most prevalent clinical features-movement disorders, communication impairments, behavior, and sleep. A targeted literature review using electronic medical databases (e.g., PubMed) was conducted to identify recent studies focused on specific areas of the AS phenotype (motor, communication, behavior, sleep) as well as epidemiology, diagnostic processes, treatment, and burden. 142 articles were reviewed and summarized. Findings suggest significant impairment across the life span in all areas of function. While some issues may resolve as individuals get older (e.g., hyperactivity), others become worse (e.g., movement disorders, aggression, anxiety). There are no treatments focused on the underlying etiology, and the symptom-based therapies currently prescribed do not have much, if any, empirical support. The lack of standardized treatment protocols or approved therapies, combined with the severity of the condition, results in high unmet clinical needs in the areas of motor functioning, communication, behavior, and sleep for individuals with AS and their families.

  4. Language, literacy, and communication regarding medication in an anticoagulation clinic: a comparison of verbal vs. visual assessment.

    Science.gov (United States)

    Schillinger, Dean; Machtinger, Edward L; Wang, Frances; Palacios, Jorge; Rodriguez, Maytrella; Bindman, Andrew

    2006-01-01

    Despite the importance of clinician-patient communication, little is known about rates and predictors of medication miscommunication. Measuring rates of miscommunication, as well as differences between verbal and visual modes of assessment, can inform efforts to more effectively communicate about medications. We studied 220 diverse patients in an anticoagulation clinic to assess concordance between patient and clinician reports of warfarin regimens. Bilingual research assistants asked patients to (1) verbalize their prescribed weekly warfarin regimen and (2) identify this regimen from a digitized color menu of warfarin pills. We obtained clinician reports of patient regimens from chart review. Patients were categorized as having regimen concordance if there were no patient-clinician discrepancies in total weekly dosage. We then examined whether verbal and visual concordance rates varied with patient's language and health literacy. Fifty percent of patients achieved verbal concordance and 66% achieved visual concordance with clinicians regarding the weekly warfarin regimen (P visual discordance. Shifting from verbal to visual modes was associated with greater patient-provider concordance across all patient subgroups, but especially for those with communication barriers.Clinician-patient discordance regarding patients' warfarin regimen was common but occurred less frequently when patients used a visual aid. Visual aids may improve the accuracy of medication assessment, especially for patients with communication barriers.

  5. Communication attitudes in children who stutter: A meta-analytic review.

    Science.gov (United States)

    Guttormsen, Linn Stokke; Kefalianos, Elaina; Næss, Kari-Anne B

    2015-12-01

    This article presents a meta-analytic review of differences in communication attitudes between children who stutter (CWS) and children who do not stutter (CWNS). To be included in this review, the studies had to include a group of CWS and CWNS between the ages of 3-18 years and a measurement of communication attitudes. The journal articles were identified by using the key words stutter*, speech disfluenc*, fluency disorder*, and stammer* cross-referenced to awareness*, reaction*, attitude*, KiddyCAT, CAT, A-19 Scale, PASS and OASES. A total of 18 studies met the inclusion criteria for this meta-analysis. The results showed that CWS exhibit more negative communication attitudes than CWNS from the preschool years. The differences between the groups increased with age, but were not influenced by gender. The results indicate that negative communication attitudes can be an effect of stuttering. Key issues requiring further investigation are whether communication attitudes differ as a function of age at stuttering onset and whether communication attitudes influence the development of stuttering. After reading this article, the reader will be able to: (a) summarise empirical findings with regard to the relationship between communication attitudes and childhood stuttering; (b) describe the different instruments used to measure communication attitudes; (c) discuss the relationship between communication attitudes, age and gender. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Determining Recommendations for Improvement of Communication Skills Training in Dental Education: A Scoping Review.

    Science.gov (United States)

    Ayn, Caitlyn; Robinson, Lynne; Nason, April; Lovas, John

    2017-04-01

    Professional communication skills have a significant impact on dental patient satisfaction and health outcomes. Communication skills training has been shown to improve the communication skills of dental students. Therefore, strengthening communication skills training in dental education shows promise for improving dental patient satisfaction and outcomes. The aim of this study was to facilitate the development of dental communication skills training through a scoping review with compilation of a list of considerations, design of an example curriculum, and consideration of barriers and facilitators to adoption of such training. A search to identify studies of communication skills training interventions and programs was conducted. Search queries were run in three databases using both text strings and controlled terms (MeSH), yielding 1,833 unique articles. Of these, 35 were full-text reviewed, and 17 were included in the final synthesis. Considerations presented in the articles were compiled into 15 considerations. These considerations were grouped into four themes: the value of communication skills training, the role of instructors, the importance of accounting for diversity, and the structure of communication skills training. An example curriculum reflective of these considerations is presented, and consideration of potential barriers and facilitators to implementation are discussed. Application and evaluation of these considerations are recommended in order to support and inform future communication skills training development.

  7. Male contraception: a clinically-oriented review.

    Science.gov (United States)

    Kanakis, George A; Goulis, Dimitrios G

    2015-01-01

    Despite the variety of available female contraceptive methods, many pregnancies (~50%) are still undesired. Many men (>60%) want to participate equally with their partner in family planning; however, male contraceptive methods (MCMs) account for only 14% of those used worldwide and no pharmaceutical MCM is available so far. The only two MCMs currently available are condoms, which despite protecting against sexually transmitted diseases have high failure rates (~19%), and vasectomy, which though very efficient (99%) is poorly reversible (<50%). Among MCMs under investigation, male hormonal contraceptives (MHCs) are those that have come closest to commercialization. The action of MHCs relies on the disruption of spermatogenesis that exogenous androgen administration evokes by suppressing the hypophyseal-gonadal axis. Various regimens of androgens as monotherapy or in combination with progestins have been tested in clinical trials achieving a Pearl Index <1.0 (equal to that of the female oral contraceptive pill); however, concerns regarding the variable response rates observed (non-responders: 5-20%), the impracticality of parenteral administration and long-term prostate-associated or cardiovascular morbidity have deflected the interest of the pharmaceutical industry from further research. Non-hormonal contraception methods may be, at least theoretically, more specific by selectively disrupting spermatogenesis and sperm transport or fertilizing ability. Nevertheless, only a few have been tested in clinical trials (Reversible Inhibition of Sperm Under Guidance, RISUG, and Intra Vas Plugs); most of them are still in pre-clinical development or have been abandoned due to toxicity (gossypol). Consequently, until a reliable, safe and practical MCM is developed, women will continue to bear most of the contraception burden.

  8. Effects of exam room EHR use on doctor-patient communication: a systematic literature review.

    Science.gov (United States)

    Kazmi, Zainab

    2013-01-01

    High levels of funding have been invested in health information technologies, especially electronic health records (EHRs), in an effect to coordinate and organize patient health data. However, the effect of EHRs in the exam room on doctor-patient communication has not been sufficiently explored. Objective The purpose of this systematic review was to determine how physician use of EHRs in medical consultations affects doctor-patient communication, both in terms of patient perceptions and actual physician behaviours. The reviewer conducted a comprehensive online database search in March 2013 of EMBASE, MEDLINE, and SCOPUS, using a combination of synonyms of the terms "patient", "doctor", "communication", and "EHR" or "computing". For inclusion in this review, articles had to be published in English, take place in an outpatient setting and demonstrate an empirical investigation into whether EHR affects doctor-patient communication. The reviewer then analysed 13 articles that met the inclusion criteria. Studies showed EHR use encouraged biomedical questioning of the patient, and encouraged patient-led questioning and doctor-led information provision. EHR-related behaviours such as keyboarding and screen gaze impaired relationships with patients, by reducing eye contact, rapport, and provision of emotional support. EHRs negatively affected physician-led patient-centred communication. Computer use may have amplified existing physician behaviours regarding medical record use. We noted both positive and negative effects of EHR use. This review highlights the need for increased EHR-specific communication training to mitigate adverse effects and for continued acknowledgement of patient perspectives.

  9. Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare

    Directory of Open Access Journals (Sweden)

    Griffiths Frances

    2011-01-01

    Full Text Available Abstract Background Research has investigated whether communication technologies (e.g. mobile telephony, forums, email can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Methods Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Results Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2; mobile telephony (n = 3; telephone support (n = 3; novel electronic communication devices for transferring clinical information (n = 10; and web-based discussion boards (n = 1. Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patient-caregiver interaction, self-care and metabolic transmission were reported for some communication technologies. Conclusions The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication

  10. Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare.

    Science.gov (United States)

    Sutcliffe, Paul; Martin, Steven; Sturt, Jackie; Powell, John; Griffiths, Frances; Adams, Ann; Dale, Jeremy

    2011-01-06

    Research has investigated whether communication technologies (e.g. mobile telephony, forums, email) can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony (n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n = 10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patient-caregiver interaction, self-care and metabolic transmission were reported for some communication technologies. The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication technologies between young people and healthcare professionals.

  11. Clinical review of inner ear malformation

    International Nuclear Information System (INIS)

    Kokai, Hiromi; Oohashi, Masami; Ishikawa, Kazuo; Harada, Kouji; Hiratsuka, Hitoshi; Ogasawara, Makoto; Miyashita, Souji; Terayama, Yoshihiko

    2003-01-01

    We had 126 patients with inner ear malformation diagnosed with temporal bone computed tomography (CT) scans at Azabu Triology Hospital between 1996 and 2002. We classified cases of inner ear malformation according to Jackler et al. The incidence of inner ear malformation in our series was as follows; labyrinthine anomalies 61% (isolated lateral semicircular canal dysplasia 56%, compound semicircular canal dysplasia 4%, semicircular canal aplasia 1%), cochlear anomalies 24%, enlargement of the vestibular aqueduct 12%, narrow internal auditory canal 2%, complete labyrinthine aplasia 1%, enlargement of the cochlear aqueduct 0%. The most frequent anomaly was isolated lateral semicircular canal dysplasia. We did not detect any significant clinical features in this anomaly. There were 2 patients with cochlear anomalies who had past histories of meningitis. Some patients with enlargement of the vestibular aqueduct had frequent attacks of fluctuating hearing. Clinically it is important to detect patients with inner ear malformation such as cochlear anomalies and enlargement of the vestibular aqueduct usually accompanied by congenital sensorineural hearing loss. For patients with congenital sensorineural hearing loss, we recommend temporal bone CT scan. (author)

  12. Plasma-Lyte 148: A clinical review

    Science.gov (United States)

    Weinberg, Laurence; Collins, Neil; Van Mourik, Kiara; Tan, Chong; Bellomo, Rinaldo

    2016-01-01

    AIM To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine. METHODS We performed an electronic literature search from Medline and PubMed (via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: “surgery”, “anaesthesia”, “anesthesia”, “anesthesiology”, “anaesthesiology”, “fluids”, “fluid therapy”, “crystalloid”, “saline”, “plasma-Lyte”, “plasmalyte”, “hartmann’s”, “ringers” “acetate”, “gluconate”, “malate”, “lactate”. All relevant articles were accessed in full. We summarized the data and reported the data in tables and text. RESULTS We retrieved 104 articles relevant to the choice of Plasma-Lyte 148 for fluid intervention in critical illness, surgery and perioperative medicine. We analyzed the data and reported the results in tables and text. CONCLUSION Plasma-Lyte 148 is an isotonic, buffered intravenous crystalloid solution with a physiochemical composition that closely reflects human plasma. Emerging data supports the use of buffered crystalloid solutions in preference to saline in improving physicochemical outcomes. Further large randomized controlled trials assessing the comparative effectiveness of Plasma-Lyte 148 and other crystalloid solutions in measuring clinically important outcomes such as morbidity and mortality are needed. PMID:27896148

  13. Cell-to-cell communication in plants, animals, and fungi: a comparative review.

    Science.gov (United States)

    Bloemendal, Sandra; Kück, Ulrich

    2013-01-01

    Cell-to-cell communication is a prerequisite for differentiation and development in multicellular organisms. This communication has to be tightly regulated to ensure that cellular components such as organelles, macromolecules, hormones, or viruses leave the cell in a precisely organized way. During evolution, plants, animals, and fungi have developed similar ways of responding to this biological challenge. For example, in higher plants, plasmodesmata connect adjacent cells and allow communication to regulate differentiation and development. In animals, two main general structures that enable short- and long-range intercellular communication are known, namely gap junctions and tunneling nanotubes, respectively. Finally, filamentous fungi have also developed specialized structures called septal pores that allow intercellular communication via cytoplasmic flow. This review summarizes the underlying mechanisms for intercellular communication in these three eukaryotic groups and discusses its consequences for the regulation of differentiation and developmental processes.

  14. Morphological and clinical risk factors for posterior communicating artery aneurysm rupture.

    Science.gov (United States)

    Matsukawa, Hidetoshi; Fujii, Motoharu; Akaike, Gensuke; Uemura, Akihiro; Takahashi, Osamu; Niimi, Yasunari; Shinoda, Masaki

    2014-01-01

    Recent studies have shown that posterior circulation aneurysms, specifically posterior communicating artery (PCoA) aneurysms, are more likely to rupture than other aneurysms. To date, few studies have investigated the factors contributing to PCoA aneurysm rupture. The authors aimed to identify morphological and clinical characteristics predisposing to PCoA aneurysm rupture. The authors retrospectively reviewed 134 consecutive patients with PCoA aneurysms managed at their facility between July 2003 and December 2012. The authors divided patients into groups of those with aneurysmal rupture (n = 39) and without aneurysmal rupture (n = 95) and compared morphological and clinical characteristics. Morphological characteristics were mainly evaluated by 3D CT angiography and included diameter of arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery), size of the aneurysm, dome-to-neck ratio, neck direction of the aneurysmal dome around the PCoA (medial, lateral, superior, inferior, and posterior), aneurysm bleb formation, whether the PCoA was fetal type, and the existence of other intracranial unruptured aneurysm(s). Patients with ruptured PCoA aneurysms were significantly younger (a higher proportion were PCoA aneurysms showed a lateral direction of the aneurysmal dome around the PCoA, had bleb formation, and the aneurysm was > 7 mm in diameter and/or the dome-to-neck ratio was > 2.0. Multivariate logistic regression analysis showed age PCoA (OR 6.7, p = 0.0001), and bleb formation (OR 11, p PCoA aneurysm rupture. The present results demonstrated that lateral projection of a PCoA aneurysm may be related to rupture.

  15. Combining interdisciplinary and International Medical Graduate perspectives to teach clinical and ethical communication using multimedia.

    Science.gov (United States)

    Woodward-Kron, Robyn; Flynn, Eleanor; Delany, Clare

    2011-01-01

    In Australia, international medical graduates (IMGs) play a crucial role in addressing workforce shortages in healthcare. Their ability to deliver safe and effective healthcare in an unfamiliar cultural setting is intrinsically tied to effective communication. Hospital-based medical clinical educators, who play an important role in providing communication training to IMGs, would benefit from practical resources and an understanding of the relevant pedagogies to address these issues in their teaching. This paper examines the nature of an interdisciplinary collaboration to develop multimedia resources for teaching clinical and ethical communication to IMGs. We describe the processes and dynamics of the collaboration, and outline the methodologies from applied linguistics, medical education, and health ethics that we drew upon. The multimedia consist of three video clips of challenging communication scenarios as well as experienced IMGs talking about communication and ethics. The multimedia are supported by teaching guidelines that address relevant disciplinary concerns of the three areas of collaboration. In the paper's discussion we point out the pre-conditions that facilitated the interdisciplinary collaboration. We propose that such collaborative approaches between the disciplines and participants can provide new perspectives to address the multifaceted challenges of clinical teaching and practice.

  16. 75 FR 35027 - Notice of Public Information Collection Being Reviewed by the Federal Communications Commission...

    Science.gov (United States)

    2010-06-21

    ... FEDERAL COMMUNICATIONS COMMISSION Notice of Public Information Collection Being Reviewed by the... paperwork burden invites the general public and other Federal agencies to take this opportunity to comment... 73.1125, Station Main Studio Location. Form Number: N/A. Type of Review: Extension of a currently...

  17. Interventions to enhance effective communication during over-the-counter consultations in the community pharmacy setting: A systematic review.

    Science.gov (United States)

    Seubert, Liza J; Whitelaw, Kerry; Hattingh, Laetitia; Watson, Margaret C; Clifford, Rhonda M

    2017-12-13

    Easy access to effective over-the-counter (OTC) treatments allows self-management of some conditions, however inappropriate or incorrect supply or use of OTC medicines can cause harm. Pharmacy personnel should support consumers in their health-seeking behaviour by utilising effective communication skills underpinned by clinical knowledge. To identify interventions targeted towards improving communication between consumers and pharmacy personnel during OTC consultations in the community pharmacy setting. Systematic review and narrative analysis. Databases searched were MEDLINE, EMBASE, Psycinfo, Cochrane Central Register and Cochrane Database of Systematic Reviews for literature published between 2000 and 30 October 2014, as well as reference lists of included articles. The search was re-run on 18 January 2016 and 25 September 2017 to maximise the currency. Two reviewers independently screened retrieved articles for inclusion, assessed study quality and extracted data. Full publications of intervention studies were included. Participants were community pharmacy personnel and/or consumers involved in OTC consultations. Interventions which aimed to improve communication during OTC consultations in the community pharmacy setting were included if they involved a direct measurable communication outcome. Studies reporting attitudes and measures not quantifiable were excluded. The protocol was published on Prospero Database of Systematic Reviews. Of 4978 records identified, 11 studies met inclusion criteria. Interventions evaluated were: face-to-face training sessions (n = 10); role-plays (n = 9); a software decision making program (n = 1); and simulated patient (SP) visits followed by immediate feedback (n = 1). Outcomes were measured using: SP methodology (n = 10) and a survey (n = 1), with most (n = 10) reporting a level of improvement in some communication behaviours. Empirical evaluation of interventions using active learning techniques

  18. Reviewing CSR management and marketing communication research: A discourse approach

    DEFF Research Database (Denmark)

    Nielsen, Anne Ellerup; Thomsen, Christa

    To judge from the rapidly growing body of research in the field of corporate social responsibility (CSR) management and marketing communication, there is an increasing interest in exploring the role of communication along with the transmission from implicit towards explicit CSR in the European...... context (Matten & Moon 2008). Many corporations today are concerned with gaining legitimacy through integrating the expectations of their stakeholders (employees, customers, NGOs, activists, government institutions, institutions of international governance) in the overall company strategy. This also...... includes stakeholders in or around business units established in developing countries and emerging markets (e.g. Jamali 2010; Reimann 2012). Along with the growing pressure on corporations to engage in CSR a seemingly growing number of these are concerned with disclosure, reporting, reputation, etc. issues...

  19. Attention to gender in communication skills assessment instruments in medical education: a review.

    Science.gov (United States)

    Dielissen, Patrick; Bottema, Ben; Verdonk, Petra; Lagro-Janssen, Toine

    2011-03-01

    Gender is increasingly regarded as an important factor in doctor-patient communication education. This review aims to assess if and how gender is addressed by current assessment instruments for communication skills in medical education. In 2009 at Radboud University Nijmegen Medical Centre, an online search was conducted in the bibliographic databases PubMed, PsycINFO and ERIC for references about communication skills assessment instruments designed to be completed by trained faculty staff and used in medical education. The search strategy used the following search terms: 'consultation skills'; 'doctor-patient communication'; 'physician-patient relations'; 'medical education'; 'instruments'; 'measurement', and 'assessment'. Papers published between January 1999 and June 2009 were included. The assessment instruments identified were analysed for gender-specific content. The search yielded 21 communication skills assessment instruments. Only two of the 17 checklists obtained explicitly considered gender as a communication-related issue. Only six of 21 manuals considered gender in any way and none gave specific details to explain which aspects of communication behaviour should be assessed with regard to gender. Very few communication assessment instruments in medical education focus on gender. Nevertheless, interest exists in using gender in communication skills assessment. The criteria for and purpose of assessing gender in communication skills in medical education are yet to be clarified. © Blackwell Publishing Ltd 2011.

  20. Teaching Method in Situational Crisis Communication Theory: A Literature Review

    OpenAIRE

    Proud Arunrangsiwed

    2016-01-01

    Crisis management strategies could be found in various curriculums, not only in schools of business, but also schools of communication. Young students, such as freshmen and sophomores of undergraduate schools, may not care about learning crisis management strategies. Moreover, crisis management strategies are not a topic art students are familiar with. The current paper discusses a way to adapt entertainment media into a crisis management lesson, and the importance of learning crisis manageme...

  1. Scientific communication in clinical psychology: examining patterns of citations and references.

    Science.gov (United States)

    Kiselica, Andrew M; Ruscio, John

    2014-01-01

    Previous studies of scientific communication used citation mapping, establishing psychology as a 'hub science' from which many other fields draw information. Within psychology, the clinical and counselling discipline is a major 'knowledge broker'. This study analyzed scientific communication among three major subdisciplines of clinical psychology-the cognitive-behavioural, psychodynamic and humanistic schools of thought-by examining patterns of references within and citations to 305 target articles published in leading journals of these subdisciplines. The results suggest that clinical researchers of each theoretical orientation engage in more insular scientific communication than an integrationist would find desirable and that cognitive-behavioural articles are more closely connected to mainstream psychology and related fields. Eclectic practitioners draw on several different theoretical orientations to inform their practice; as such, they should be interested in understanding the patterns of scientific communication within and across theoretical orientations. Practitioners work in a variety of different mental health settings, with a variety of other professionals in psychology-related fields, and should be interested in how much influence their particular theoretical orientation has on the work of colleagues. Many practitioners rely on new, evidence-based research to inform their work. The results of this study provide these individuals with an objective measure of the influence of empirical work in different areas of clinical psychology. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Delivering Communication Strategy Training for People with Aphasia: What Is Current Clinical Practice?

    Science.gov (United States)

    Beckley, Firle; Best, Wendy; Beeke, Suzanne

    2017-01-01

    Background: Communication strategy training (CST) is a recognized part of UK speech and language therapists' (SLTs) role when working with a person with aphasia. Multiple CST interventions have been published but, to date, there are no published studies exploring clinical practice in this area. Aims: To investigate UK SLTs' current CST practices.…

  3. Using Hermeneutic Phenomenology to Investigate How Experienced Practitioners Learn to Communicate Clinical Reasoning

    Science.gov (United States)

    Ajjawi, Rola; Higgs, Joy

    2007-01-01

    This paper is primarily targeted at doctoral students and other researchers considering using hermeneutic phenomenology as a research strategy. We present interpretive paradigm research designed to investigate how experienced practitioners learn to communicate their clinical reasoning in professional practice. Twelve experienced physiotherapy…

  4. Dysarthria in Adults with Cerebral Palsy: Clinical Presentation and Impacts on Communication

    Science.gov (United States)

    Schölderle, Theresa; Staiger, Anja; Lampe, Renée; Strecker, Katrin; Ziegler, Wolfram

    2016-01-01

    Purpose: Although dysarthria affects the large majority of individuals with cerebral palsy (CP) and can substantially complicate everyday communication, previous research has provided an incomplete picture of its clinical features. We aimed to comprehensively describe characteristics of dysarthria in adults with CP and to elucidate the impact of…

  5. Clinical librarian support for rapid review of clinical utility of cancer molecular biomarkers.

    Science.gov (United States)

    Geng, Yimin; Fowler, Clara S; Fulton, Stephanie

    2015-01-01

    The clinical librarian used a restricted literature searching and quality-filtering approach to provide relevant clinical evidence for the use of cancer molecular biomarkers by institutional policy makers and clinicians in the rapid review process. The librarian-provided evidence was compared with the cited references in the institutional molecular biomarker algorithm. The overall incorporation rate of the librarian-provided references into the algorithm was above 80%. This study suggests the usefulness of clinical librarian expertise for clinical practice. The searching and filtering methods for high-level evidence can be adopted by information professionals who are involved in the rapid literature review.

  6. Clinical outcomes of facial transplantation: a review.

    Science.gov (United States)

    Shanmugarajah, Kumaran; Hettiaratchy, Shehan; Clarke, Alex; Butler, Peter E M

    2011-01-01

    A total of 18 composite tissue allotransplants of the face have currently been reported. Prior to the start of the face transplant programme, there had been intense debate over the risks and benefits of performing this experimental surgery. This review examines the surgical, functional and aesthetic, immunological and psychological outcomes of facial transplantation thus far, based on the predicted risks outlined in early publications from teams around the world. The initial experience has demonstrated that facial transplantation is surgically feasible. Functional and aesthetic outcomes have been very encouraging with good motor and sensory recovery and improvements to important facial functions observed. Episodes of acute rejection have been common, as predicted, but easily controlled with increases in systemic immunosuppression. Psychological improvements have been remarkable and have resulted in the reintegration of patients into the outside world, social networks and even the workplace. Complications of immunosuppression and patient mortality have been observed in the initial series. These have highlighted rigorous patient selection as the key predictor of success. The overall early outcomes of the face transplant programme have been generally more positive than many predicted. This initial success is testament to the robust approach of teams. Dissemination of outcomes and ongoing refinement of the process may allow facial transplantation to eventually become a first-line reconstructive option for those with extensive facial disfigurements. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Clinician characteristics, communication, and patient outcome in oncology: a systematic review.

    Science.gov (United States)

    De Vries, A M M; de Roten, Y; Meystre, C; Passchier, J; Despland, J-N; Stiefel, F

    2014-04-01

    The aim of this study was to review the literature on clinician characteristics influencing patient-clinician communication or patient outcome in oncology. Studies investigating the association of clinician characteristics with quality of communication and with outcome for adult cancer patients were systematically searched in MEDLINE, PSYINFO, PUBMED, EMBASE, CINHAL, Web of Science and The Cochrane Library up to November 2012. We used the preferred reporting items for systematic reviews and meta-analyses statement to guide our review. Articles were extracted independently by two of the authors using predefined criteria. Twenty seven articles met the inclusion criteria. Clinician characteristics included a variety of sociodemographic, relational, and personal characteristics. A positive impact on quality of communication and/or patient outcome was reported for communication skills training, an external locus of control, empathy, a socioemotional approach, shared decision-making style, higher anxiety, and defensiveness. A negative impact was reported for increased level of fatigue and burnout and expression of worry. Professional experience of clinicians was not related to communication and/or to patient outcome, and divergent results were reported for clinician gender, age, stress, posture, and confidence or self-efficacy. Various clinician characteristics have different effects on quality of communication and/or patient outcome. Research is needed to investigate the pathways leading to effective communication between clinicians and patients. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Hemicrania continua: clinical review, diagnosis and management

    Directory of Open Access Journals (Sweden)

    Prakash S

    2017-06-01

    Full Text Available Sanjay Prakash,1 Payal Patel2 1Department of Neurology, Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India; 2Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH, USA Abstract: Hemicrania continua (HC is an indomethacin-responsive primary headache disorder which is currently classified under the heading of trigeminal autonomic cephalalgias (TACs. It is a highly misdiagnosed and underreported primary headache. The pooled mean delay of diagnosis of HC is 8.0 ± 7.2 years. It is not rare. We noted more than 1000 cases in the literature. It represents 1.7% of total headache patients attending headache or neurology clinic. Just like other TACs, it is characterized by strictly unilateral pain in the trigeminal distribution, cranial autonomic features in the same area and agitation during exacerbations/attacks. It is different from other TACs in one aspect. While all other TACs are episodic, HC patients have continuous headaches with superimposed severe exacerbations. The central feature of HC is continuous background headache. However, the patients may be worried only for superimposed exacerbations. Focusing only on exacerbations and ignoring continuous background headache are the most important factors for the misdiagnosis of HC. A large number of patients may have migrainous features during exacerbation phase. Up to 70% patients may fulfill the diagnostic criteria for migraine during exacerbations. Besides migraine, its exacerbations can mimic a large number of other primary and secondary headaches. The other specific feature of HC is a remarkable response to indomethacin. However, a large number of patients develop side effects because of the long-term use of indomethacin. A few other medications may also be effective in a subset of patients with HC. Various surgical interventions have been suggested for patients who are intolerant to indomethacin. Several aspects of HC

  9. Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

    Science.gov (United States)

    Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

    2018-07-01

    We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Geoscience on television: a review of science communication literature in the context of geosciences

    Science.gov (United States)

    Hut, Rolf; Land-Zandstra, Anne M.; Smeets, Ionica; Stoof, Cathelijne R.

    2016-06-01

    Geoscience communication is becoming increasingly important as climate change increases the occurrence of natural hazards around the world. Few geoscientists are trained in effective science communication, and awareness of the formal science communication literature is also low. This can be challenging when interacting with journalists on a powerful medium like TV. To provide geoscience communicators with background knowledge on effective science communication on television, we reviewed relevant theory in the context of geosciences and discuss six major themes: scientist motivation, target audience, narratives and storytelling, jargon and information transfer, relationship between scientists and journalists, and stereotypes of scientists on TV. We illustrate each theme with a case study of geosciences on TV and discuss relevant science communication literature. We then highlight how this literature applies to the geosciences and identify knowledge gaps related to science communication in the geosciences. As TV offers a unique opportunity to reach many viewers, we hope this review can not only positively contribute to effective geoscience communication but also to the wider geoscience debate in society.

  11. Communication between nurses and family caregivers of hospitalised older persons: a literature review.

    Science.gov (United States)

    Bélanger, Louise; Bourbonnais, Anne; Bernier, Roxanne; Benoit, Monique

    2017-03-01

    To review the literature concerning the feelings, thoughts and behaviours of nurses and family caregivers of hospitalised older persons when they communicate with one another. Communication between nurses and family caregivers of hospitalised older persons is not always optimal. Improving the frequency and quality of this communication might be a way to make the most of available human capital in order to better care for hospitalised older people. A literature review was carried out of qualitative, quantitative and mixed-design studies relating to communication between nurses and family caregivers. Findings were analysed thematically. Family caregiver thoughts, feelings and behaviours relative to nurse control and authority, nurse recognition of their contribution, information received from and shared with nurses and care satisfaction could influence communication with nurses. Nurse thoughts regarding usefulness of family caregivers as care partners and their lack of availability to meet family caregiver demands could influence communication with family caregivers. The thoughts, feelings and behaviours of family caregivers and nurses that might create positive or negative circular patterns of communication are evidenced. Further research is required to gain a more comprehensive understanding of the phenomenon. Nurses must be trained in how to communicate with family caregivers in order to form a partnership geared to preventing complications in hospitalised older persons. Results could be used to inform policy regarding the care of hospitalised older persons. © 2016 John Wiley & Sons Ltd.

  12. [Clinical reasoning in undergraduate nursing education: a scoping review].

    Science.gov (United States)

    Menezes, Sáskia Sampaio Cipriano de; Corrêa, Consuelo Garcia; Silva, Rita de Cássia Gengo E; Cruz, Diná de Almeida Monteiro Lopes da

    2015-12-01

    This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

  13. Palliative Care in Critical Care Settings: A Systematic Review of Communication-Based Competencies Essential for Patient and Family Satisfaction.

    Science.gov (United States)

    Schram, Andrew W; Hougham, Gavin W; Meltzer, David O; Ruhnke, Gregory W

    2017-11-01

    There is an emerging literature on the physician competencies most meaningful to patients and their families. However, there has been no systematic review on physician competency domains outside direct clinical care most important for patient- and family-centered outcomes in critical care settings at the end of life (EOL). Physician competencies are an essential component of palliative care (PC) provided at the EOL, but the literature on those competencies relevant for patient and family satisfaction is limited. A systematic review of this important topic can inform future research and assist in curricular development. Review of qualitative and quantitative empirical studies of the impact of physician competencies on patient- and family-reported outcomes conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines for systematic reviews. The data sources used were PubMed, MEDLINE, Web of Science, and Google Scholar. Fifteen studies (5 qualitative and 10 quantitative) meeting inclusion and exclusion criteria were identified. The competencies identified as critical for the delivery of high-quality PC in critical care settings are prognostication, conflict mediation, empathic communication, and family-centered aspects of care, the latter being the competency most frequently acknowledged in the literature identified. Prognostication, conflict mediation, empathic communication, and family-centered aspects of care are the most important identified competencies for patient- and family-centered PC in critical care settings. Incorporation of education on these competencies is likely to improve patient and family satisfaction with EOL care.

  14. A Clinical Review of Zika Virus (ZIKAV

    Directory of Open Access Journals (Sweden)

    Muhammad Hashim Raza

    2017-02-01

    Full Text Available Zika virus (ZIKAV is a flavi-virus, first isolated in 1947 in the Zika Forest of Uganda. ZIKAV is a positive-sense single-stranded RNA virus. ZIKAV is made up of two noncoding regions (5′ and 3′ that verge an open reading frame, which put into code a polyprotein smote into the capsid, precursor of membrane, envelope, and 7 nonstructural proteins. Inoculation of a human host is by Mosquito. After cellular en¬try, the virus enters skin cells through cellular receptors, enabling migration to the lymph nodes and blood circulation. ZIKAV may also enter to skin fibroblasts, keratino¬cytes, and immature dendritic cells. Several entry and adhesion factors enable infection, and cellular autophagy, needed for flaviviral replication. Transmission is by infected mosquito dur¬ing a blood meal. After endorsement, the virus replicates and is pass on to a reservoir animal at the next blood mealtime. ZIKAV is also transmitted via congenital, perinatal, and sexual, possible transmission by blood transfusion, ani¬mal bite and intrauterine transmission. Trans-mission via breast-feeding has not been reported. Incubation period from mosquito bite to symptom commencement is 3–12 days. Infection is likely subclinical in 80% of cases. Symptoms, which last for almost two to seven days include fever, conjunctivitis, arthralgia, myalgia, and pervasive rash, which may be itchy. Headache, retro-orbital pain, peripheral oedema, and gastrointestinal fracas have also been witnessed. Diagnosis is directed by history and consideration. The symptoms and clinical signs do not have adequate positive or negative prognostic value, and therefore laboratory testing is needed for dependable diagnosis. Laboratory testing includes polymerase chain reaction (PCR of ZIKAV RNA. There is formerly no vaccine against ZIKAV, nor definite antiviral for the management of ZIKAV. Treatment is suggestive. Vector control by insecticides and removal of small pools of still water, the breeding

  15. Vitamin D in schizophrenia: a clinical review.

    Science.gov (United States)

    Chiang, Mathew; Natarajan, Radhika; Fan, Xiaoduo

    2016-02-01

    Vitamin D (vitD) is known for its essential role in calcium homeostasis and bone health. VitD is made endogenously in the skin from UVB radiation from sunlight. VitD is now considered as a potent neurosteroid hormone, critical to brain development and normal brain function, and is known for its anti-inflammatory property affecting various aspects of human health. VitD ligand-receptor, a receptor that mediates much of vitD's biological actions, has been found throughout the body including the central nervous system. VitD deficiency is common in patients with severe mental illness such as schizophrenia. Schizophrenia is a debilitating chronic mental illness characterised by positive symptoms, such as hallucinations and delusions, and negative symptoms including flat affect and lack of motivation. Several environmental risk factors for schizophrenia, such as season of birth, latitude and migration, have been linked to vitD deficiency. Recent studies have suggested a potential role of vitD in the development of schizophrenia. For example, neonatal vitD status is associated with the risk of developing schizophrenia in later life obesity, insulin resistance, diabetes, hyperlipidaemia and cardiovascular disease, which are commonly seen in patients with schizophrenia. It has been well established that vitD deficiency is related to these metabolic problems. The biological mechanism is most likely related to vitD's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia. Potential benefits of vitD supplementation to improve schizophrenia symptoms as well as physical health in patients with schizophrenia should be further explored in future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Characteristics of leadership that influence clinical learning: a narrative review.

    Science.gov (United States)

    Walker, Rachel; Cooke, Marie; Henderson, Amanda; Creedy, Debra K

    2011-11-01

    Leadership has been consistently implied in fostering clinical learning. However there is a lack of clarity about the form leadership should take. Limited quantitative research indicated a narrative approach to review literature from a broad perspective. A framework to guide the synthesis was developed to ensure a rigorous review process. Preliminary reading and review of papers using search terms nursing and leadership and clinical learning and learning culture narrowed the inclusion criteria to 245 papers published between 2000 and 2010. Given the diversity of the papers' focus, aim and context, a refined screening process justified the inclusion of twenty-six papers in the review. A critical appraisal of these peer-reviewed quantitative, qualitative and commentary papers identified factors/elements integral to effective leadership. Across the literature leadership was discussed in relation to two broad themes: influence of leadership on organisational learning and development and; influence of leadership on undergraduate clinical education. The factors central to leadership emerged as transformative principles, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling. The review has raised some suggestions for future research aimed at examining the impact of a leadership capacity building intervention that supports clinical learning. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  18. Transfer of communication skills training from workshop to workplace: the impact of clinical supervision.

    Science.gov (United States)

    Heaven, Cathy; Clegg, Jenny; Maguire, Peter

    2006-03-01

    Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting. This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process. A randomised controlled trial was conducted involving 61 clinical nurse specialists. All attended a 3-day communication skills training workshop. Twenty-nine were then randomised to 4 weeks of clinical supervision, aimed at facilitating transfer of newly acquired skills into practice. Assessments, using real and simulated patients, were carried out before the course, immediately after the supervision period and 3 months later. Interviews were rated objectively using the Medical Interview Aural Rating Scale (MIARS) to assess nurses' ability to use key skills, respond to patient cues and identify patient concerns. Assessments with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas. However, only those who experienced supervision showed any evidence of transfer. Improvements were found in the supervised groups' use of open questions, negotiation and psychological exploration. Whilst neither group facilitated more disclosure of cues or concerns, those in the experimental group responded more effectively to the cues disclosed, reduced their distancing behaviour and increasing their exploration of cues. The study has shown that whilst training enhances skills, without intervention, it may have little effect on clinical practice. The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated. PRACTISE IMPLICATIONS: This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element, and provides evidence to support the need for clinical supervision for clinical nurse specialist.

  19. Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews.

    Science.gov (United States)

    Rouleau, Geneviève; Gagnon, Marie-Pierre; Côté, José; Payne-Gagnon, Julie; Hudson, Emilie; Dubois, Carl-Ardy

    2017-04-25

    Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care. An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs. Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses' practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses' and patients' perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered. A total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses' competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients and families; communication and care

  20. A model for educational feedback based on clinical communication skills strategies: beyond the "feedback sandwich".

    Science.gov (United States)

    Milan, Felise B; Parish, Sharon J; Reichgott, Michael J

    2006-01-01

    Feedback is an essential tool in medical education, and the process is often difficult for both faculty and learner. There are strong analogies between the provision of educational feedback and doctor-patient communication during the clinical encounter. Relationship-building skills used in the clinical setting-Partnership, Empathy, Apology, Respect, Legitimation, Support (PEARLS)-can establish trust with the learner to better manage difficult feedback situations involving personal issues, unprofessional behavior, or a defensive learner. Using the stage of readiness to change (transtheoretical) model, the educator can "diagnose" the learner's stage of readiness and employ focused interventions to encourage desired changes. This approach has been positively received by medical educators in faculty development workshops. A model for provision of educational feedback based on communication skills used in the clinical encounter can be useful in the medical education setting. More robust evaluation of the construct validity is required in actual training program situations.

  1. Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.

    Science.gov (United States)

    Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica

    2017-12-01

    This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.

  2. Closing the patient-oncologist communication gap: a review of historic and current efforts.

    Science.gov (United States)

    Pham, A Khoa; Bauer, Marianne T; Balan, Stefan

    2014-03-01

    Effective communication is essential in developing any relationship--this is particularly true between oncologists and their patients. The patient-oncologist relationship is one of the most delicate in medicine, and given the strong emotions associated with cancer, successful communication plays a paramount role in the wellbeing of patients and oncologists. Significant advances to close the communication gap have occurred over the past several decades, largely by addressing deficiencies in the various stages of an oncologist's lengthy training: undergraduate medical education, residency and fellowship, and continuing medical education. Stemming from several milestones achieved by highly motivated groups of individuals, including the creation of consensus statements and guidelines by communication education experts, progress has been made to improve patient-oncologist communication. This progress is marked by the development of evidence-based communication skills training programs, such as Oncotalk and Comskil, in addition to the creation of distant-learning modalities, such as the Studying Communication in Oncologist-Patient Encounters trial. This review article outlines the history of communication education during medical education and training, and brings to light more recent efforts to promote competent, communication-minded physicians necessary for effective cancer care.

  3. The Use of Social Networking Sites (SNSs) in Health Communication Campaigns: Review and Recommendations.

    Science.gov (United States)

    Shi, Jingyuan; Poorisat, Thanomwong; Salmon, Charles T

    2018-01-01

    The past decade has witnessed a rapid increase in the use of Social Networking Sites (SNSs) in health communication campaigns seeking to achieve an ambitious range of health-related impacts. This article provides a review of 40 studies and research protocols, with a focus on two key factors that differentiate SNSs from more traditional health communication approaches of the past. The first is the potential dualism between message sender and receiver, in which receivers become receiver-sources who forward and amplify the content and reach of health messages. The second is the potential dualism between message and message impact, in which the act of forwarding and modifying messages by receiver-sources itself becomes a measure of message impact. Each of these dualisms has implications for the design and evaluation of contemporary health communication campaigns. The review concludes with a series of observations and recommendations for future health communication research.

  4. A Clinical Communication Strategy to Enhance Effectiveness and CAHPS Scores: The ALERT Model.

    Science.gov (United States)

    Hardee, James T; Kasper, Ilene K

    2008-01-01

    The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program is a national annual report that surveys patients and rates health plans on a variety of metrics, including claims processing, customer service, office staff helpfulness, and ability to get needed care. Although physicians may feel they have no immediate control over many aspects of this questionnaire, there is an important area of the survey where they do have direct control: "how well the doctor communicates."It is well established that effective physician-patient communication has beneficial effects not only on physician and patient satisfaction but also on adherence to medical advice, diagnostic accuracy, and malpractice risk. The creators of the CAHPS survey developed and incorporated four questions seeking to ascertain the patient's impression of the physician's communication skills. These questions assess how well the physician listened carefully to the patient, how often the physician explained things understandably, how often the physician showed respect for what the patient said, and how often the physician spent enough time with the patient.Many excellent clinical communication models exist that touch on aspects of the CAHPS topics, but it behooves physicians to be mindful of the exact survey questions. The ALERT model of communication was developed to facilitate physicians' recall of these measures. By incorporating key verbal and nonverbal communication skills, clinicians can address and improve their scores on this important area of the CAHPS survey.

  5. Physiotherapy-led arthroplasty review clinic: a preliminary outcomes analysis.

    Science.gov (United States)

    Large, Kate E; Page, Carolyn J; Brock, Kim; Dowsey, Michelle M; Choong, Peter F M

    2014-11-01

    With the rising demand for Orthopaedics in the healthcare sector, service delivery innovations need to be explored to accommodate the increasing workload. Senior Musculoskeletal Physiotherapists have the specialised skills in the assessment of musculoskeletal conditions to determine the impact of surgery on patient outcomes. The aim of the present study was to compare outcomes between a physiotherapy-led arthroplasty review clinic (PT clinic) and the traditional model of orthopaedic surgeon review (OS clinic) after hip and knee replacement. This study was a retrospective case-controlled audit using a comprehensive database. Twenty-four patients who had a hip arthroplasty and 52 patients who had a knee arthroplasty were reviewed solely by the PT clinic at 3, 6 and 12 months after surgical reviews. These patients were matched 1:2 against patients seen only by the OS clinic. The outcome measures included International Knee Score (IKS), Harris Hip Score (HHS) and the Short Form (SF)-12. There were no significant differences in HHS or SF-12 scores for patients after hip arthroplasty. Significant differences for knee arthroplasty were observed favouring the PT clinic; IKS, PT clinic 147.6 (37.07), OS clinic 135.4 (35.68), P≤0.01, and physical component of the SF-12, PT clinic 41.98 (10.45), OS clinic 37.20 (10.44), Pphysiotherapy-led arthroplasty review clinic appears to be a safe and effective service alternative to reviews conducted by orthopaedic surgeons. WHAT IS KNOWN ABOUT THE TOPIC?: Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability and the burden of the disease is rapidly increasing. Joint arthroplasty surgery is the mainstay of treatment for people with end-stage OA; it is a high-cost, high-volume procedure that dominates surgical wait lists around Australia. Long-term follow up is encouraged by the Arthroplasty Society of Australia and endorsed by the Australian Orthopaedics Association, but it is acknowledged that it is impossible

  6. Mock Pages Are a Valid Construct for Assessment of Clinical Decision Making and Interprofessional Communication.

    Science.gov (United States)

    Boehler, Margaret L; Schwind, Cathy J; Markwell, Stephen J; Minter, Rebecca M

    2017-01-01

    Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills. Mock page cases (n = 16) were administered to 213 senior medical students from 12 medical schools participating in a national surgical resident preparatory curriculum in 2013 and 2014. Clinical decision making and interprofessional communication were measured by case-specific assessments evaluating these skills which have undergone rigorous standard-setting to determine pass/fail cut points. Students' performance improved in general for both communication and clinical decision making over the 4-week course. Cases have been identified that seem to be best suited for differentiating high- from low-performing students. Chest pain, pulmonary embolus, and mental status change cases posed the greatest difficulty for student learners. Simulated mock pages demonstrate an innovative technique for training students in both effective interprofessional communication and management of common postoperative conditions they will encounter as new surgical interns.

  7. Taking care: practice and philosophy of communication in a critical care follow-up clinic.

    Science.gov (United States)

    Hazzard, Anthony; Harris, Wendy; Howell, David

    2013-06-01

    Human consciousness is inextricable from communication. The conditions of communication in the clinical context are defined by the caring intention and the unequal relationship, which imply special responsibilities on the part of the clinician. The conventional hermeneutic model of communication proposes a close examination of the context of the other, and an objective effort to get close to their consciousness by interpretation of their expressions. The clinician is supposed to lay aside subjective factors but make use of her/his clinical knowledge and skills. At University College Hospital Critical Care follow-up clinic, the communicative task involves history taking; partly by questionnaire and partly by attention to the patient's agenda - assessing needs, providing information and facilitating access to further help. In recent years the provision of Critical Care has become ever more complex, both in terms of the sophisticated medical and nursing techniques it can offer to patients and in the range of conditions it can undertake to treat. This range and complexity is reflected in the variety of problems and consequences that may be encountered at follow-up. Communicative techniques should take account of the emotional vulnerability of patients emerging from severe illness. Attentive listening should identify special anxieties, and care with phraseology aims to avoid further distress. Issues of memory, depression and trauma may be expected, and the interview technique must be flexible enough to offer emotional containment if need be. The consultation should be therapeutic in its conduct but should not embark upon actual psychotherapy or seek to dismantle the patient's defences. Contemporary hermeneutic perspectives emphasise the contextual situatedness of the clinician's consciousness, and propose a model of communication as 'blending of horizons' rather than as objective interpretation. Systems theory contributes to an understanding of the influence on

  8. Interprofessional communication supporting clinical handover in emergency departments: An observation study.

    Science.gov (United States)

    Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

    2017-08-01

    Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  9. Open circuit mouthpiece ventilation: Concise clinical review

    Directory of Open Access Journals (Sweden)

    G. Garuti

    2014-07-01

    ventilator modes, wider knowledge of this technique is now warranted. This review highlights the indications, techniques, advantages and disadvantages of mouthpiece NIV. Resumo: Em 2013, foram introduzidos novos modos de «ventilação por peça bucal», para ventiladores portáteis disponíveis comercialmente. Apesar disto, há pouco conhecimento sobre como usar a ventilação não invasiva por pressão positiva intermitente (NIV em oposição à pressão positiva bi-nível (PAP e ambas têm sido referidas, quase exclusivamente, como sendo utilizadas através de interfaces nasais ou oro-nasais, em vez de através de uma simples peça bucal.É referido com frequência a falência da ventilação não invasiva, devido à acumulação de secreções nas vias respiratórias, devido à hipercapnia por deficiente ajuste dos parâmetros da PAP ou devido a uma reduzida tolerância à interface. Esta última pode ser causada por fatores como pressão excessiva na face devido a um ajuste defeituoso, fuga excessiva de ar pela boca, ansiedade, claustrofobia e falta de sincronia entre o doente e o ventilador. Deste modo, a interface tem um papel crucial na tolerância e eficácia. Interfaces que cobrem o nariz e/ou a boca (oro-nasal são as mais habitualmente usadas, mas são as que apresentam maior propensão a provocarem lesões na pele e claustrofobia. A maioria dos inconvenientes associados pode ser evitada usando VNI por bocal. A VNI de circuito aberto por peça bucal está a ser usada por um número significativo de doentes em alguns centros, na assistência ventilatória diurna e como complemento da VNI noturna através de «máscara». A VNI por peça bucal é igualmente utilizada durante o sono com o bucal fixo na posição, através de uma orla de cobertura do lábio. As peças bucais mais utilizadas são as pequenas anguladas de 15 e 22 mm e as de tipo

  10. Reviewing Organizational Communication Concepts with the Movie "Office Space"

    Science.gov (United States)

    Bunz, Ulla

    2006-01-01

    Undergraduate students often memorize a keyword or definition for an exam without a deeper understanding or the ability to apply the meaning of the concept. While using examples during a lecture may help, the combination of movies and verbal review has been shown to be a valuable instructional tool, increasing recall (Elischberger & Roebers, 2001)…

  11. The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review.

    Science.gov (United States)

    Omura, Mieko; Maguire, Jane; Levett-Jones, Tracy; Stone, Teresa Elizabeth

    2017-11-01

    Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students. The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety. The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered. The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants. Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools. Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight

  12. Impact of stress on dentists' clinical performance. A systematic review.

    Science.gov (United States)

    Plessas, A; Delgado, M B; Nasser, M; Hanoch, Y; Moles, D R

    2018-03-01

    Dentistry is recognised as a stressful profession and dentists perceive their profession to be more stressful than other healthcare professions. While earlier studies have shown a link between stress and well-being among dentists, whether stress negatively impacts their clinical performance is an important and open question. We do know, however, that stress is associated with reduced performance in other health (and non-health) related professions. This systematic review aimed to answer the question: how does stress impact on dentists' clinical performance? This systematic review was registered in PROSPERO (CRD42016045756). The CINHAL, Embase, Medline, PsycINFO, EThOS and OpenGrey electronic databases were searched according to PRISMA guidelines. Two reviewers independently screened the citations for relevance. The citation list of potentially eligible papers was also searched. Prospective empirical studies were considered for inclusion. The inclusion criteria were applied at the full-text stage by the two same reviewers independently. The search yielded 3535 titles and abstracts. Twelve publications were considered potentially eligible, eleven of which were excluded as they did not meet the predefined inclusion criteria. This systematic review identified a gap in the literature as it found no empirical evidence quantifying the impact of stress on dentists' clinical performance. Prospective well-designed experimental simulation studies, comparing stress with non-stress situations on clinical performance and decision making, as well studies evaluating prospectively real-life dentists' performance under stress are warranted. Copyright© 2018 Dennis Barber Ltd.

  13. Factors associated with clinical inertia: an integrative review

    Science.gov (United States)

    Aujoulat, Isabelle; Jacquemin, Patricia; Rietzschel, Ernst; Scheen, André; Tréfois, Patrick; Wens, Johan; Darras, Elisabeth; Hermans, Michel P

    2014-01-01

    Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. PMID:24868181

  14. Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.

    Science.gov (United States)

    Berkhof, Marianne; van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

    2011-08-01

    Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Exposing barriers to end-of-life communication in heart failure: an integrative review.

    Science.gov (United States)

    Garland, Ella L; Bruce, Anne; Stajduhar, Kelli

    2013-01-01

    End-of-life (EOL) communication is lacking despite patients with heart failure (HF) and their caregivers desiring it. To review the existing literature to identify barriers that inhibit EOL communication in the HF population. We chose an integrative literature review method and began by searching CINAHL, Medline, PsychInfo, Web of Science, Health Source Nursing Academic, Evidence-Based Medicine Reviews (EBMR), dissertations and theses searches through the University of Victoria and through Proquest from 1995 to 2011. DATA EVALUATION: EOL communication regarding wishes, prognosis and options for care rarely happen. We noted that patients lacked understanding of HF, feared engaging health care professionals (HCP), did not wish to talk about EOL, or waited for HCPs to initiate the conversation. HCPs lacked communication skills, focused on curative therapies and found diagnosing and prognosticating HF difficult. Limited time and space for conversations played a role. The challenge of diagnosing and prognosticating HF, its unpredictable trajectory, HCP inexperience in recognizing nearing EOL and lack of communication skills lead to HCPs avoiding EOL conversations. Four categories of barriers to communication were identified: patient/caregiver, HCP, disease-specific and organizational challenges.

  16. Impact of information and communication technology on interprofessional collaboration for chronic disease management: a systematic review.

    Science.gov (United States)

    Barr, Neil; Vania, Diana; Randall, Glen; Mulvale, Gillian

    2017-01-01

    Objectives Information and communication technology is often lauded as the key to enhancing communication among health care providers. However, its impact on interprofessional collaboration is unclear. The objective of this study was to determine the extent to which it improves communication and, subsequently, enhances interprofessional collaboration in chronic disease management. Methods A systematic review of academic literature using two electronic platforms: HealthSTAR and Web of Science (core collection and MEDLINE). To be eligible for inclusion in the review, articles needed to be peer-reviewed; accessible in English and focused on how technology supports, or might support, collaboration (through enhanced communication) in chronic disease management. Studies were assessed for quality and a narrative synthesis conducted. Results The searches identified 289 articles of which six were included in the final analysis (three used qualitative methods, two were descriptive and one used mixed methods). Various forms of information and communication technology were described including electronic health records, online communities/learning resources and telehealth/telecare. Three themes emerged from the studies that may provide insights into how communication that facilitates collaboration in chronic disease management might be enhanced: professional conflict, collective engagement and continuous learning. Conclusions The success of technology in enhancing collaboration for chronic disease management depends upon supporting the social relationships and organization in which the technology will be placed. Decision-makers should take into account and work toward balancing the impact of technology together with the professional and cultural characteristics of health care teams.

  17. 21st Century Parent-Child Sex Communication in the United States: A Process Review.

    Science.gov (United States)

    Flores, Dalmacio; Barroso, Julie

    Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

  18. Building supply chain communication systems: a review of methods and techniques

    Directory of Open Access Journals (Sweden)

    A F Cutting-Decelle

    2006-06-01

    Full Text Available With the increasing importance of computer-based communication technologies, communication networks are becoming crucial in supply chain management. Given the objectives of the supply chain, supply chain management is situated at the intersection of different professional sectors, each of them with its own vocabulary, its own knowledge and rules. This paper provides a review of the main approaches to supply chain communications through the analysis of different ways of modelling a supply chain and the presentation of new semantic-based approaches that have been and are being developed to improve the quality of the information exchanges within the supply chain.

  19. Detailed prospective peer review in a community radiation oncology clinic.

    Science.gov (United States)

    Mitchell, James D; Chesnut, Thomas J; Eastham, David V; Demandante, Carlo N; Hoopes, David J

    In 2012, we instituted detailed prospective peer review of new cases. We present the outcomes of peer review on patient management and time required for peer review. Peer review rounds were held 3 to 4 days weekly and required 2 physicians to review pertinent information from the electronic medical record and treatment planning system. Eight aspects were reviewed for each case: 1) workup and staging; 2) treatment intent and prescription; 3) position, immobilization, and simulation; 4) motion assessment and management; 5) target contours; 6) normal tissue contours; 7) target dosimetry; and 8) normal tissue dosimetry. Cases were marked as, "Meets standard of care," "Variation," or "Major deviation." Changes in treatment plan were noted. As our process evolved, we recorded the time spent reviewing each case. From 2012 to 2014, we collected peer review data on 442 of 465 (95%) radiation therapy patients treated in our hospital-based clinic. Overall, 91 (20.6%) of the cases were marked as having a variation, and 3 (0.7%) as major deviation. Forty-two (9.5%) of the cases were altered after peer review. An overall peer review score of "Variation" or "Major deviation" was highly associated with a change in treatment plan (P peer review. Indicators on position, immobilization, simulation, target contours, target dosimetry, motion management, normal tissue contours, and normal tissue dosimetry were significantly associated with a change in treatment plan. The mean time spent on each case was 7 minutes. Prospective peer review is feasible in a community radiation oncology practice. Our process led to changes in 9.5% of cases. Peer review should focus on technical factors such as target contours and dosimetry. Peer review required 7 minutes per case. Published by Elsevier Inc.

  20. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan

    Science.gov (United States)

    Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-01-01

    Abstract Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies – such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined – have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions. PMID:19705014

  1. Understanding the impact of simulated patients on health care learners' communication skills: a systematic review.

    Science.gov (United States)

    Kaplonyi, Jessica; Bowles, Kelly-Ann; Nestel, Debra; Kiegaldie, Debra; Maloney, Stephen; Haines, Terry; Williams, Cylie

    2017-12-01

    Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap exists in the body of research on the effectiveness of SP-based education to teach communication skills that impact patient outcomes. The aim of this systematic review was to critically analyse the existing research, investigating whether SP-based communication skills training improves learner-patient communication, how communication skill improvement is measured, and who measures these improvements. The databases Medline, ProQuest (Health & Medical Complete, Nursing and Allied Health Source) and CINAHL (EBSCOhost) Education Resources Information Centre (ERIC) were searched for articles that investigated the effects of SP-based education on the communication skills of medical, nursing and allied health learners. There were 60 studies included in the review. Only two studies reported direct patient outcomes, one reporting some negative impact, and no studies included an economic analysis. Many studies reported statistically significant third-party ratings of improved communication effectiveness following SP-based education; however, studies were unable to be pooled for meta-analysis because of the outcome collection methods. There were a small number of studies comparing SP with no training at all and there were no differences between communication skills, contradicting the results from studies reporting benefits. Of the 60 studies included for analysis, 54 (90%) met the minimum quality score of 7/11, with four articles (7%) scoring 11/11. SP-based education is widely accepted as a valuable and effective means of teaching communication skills but there is limited evidence of how this translates to patient outcomes and no indication of economic benefit for this

  2. An integrative review of communication between parents and nurses of hospitalized technology-dependent children.

    Science.gov (United States)

    Giambra, Barbara K; Stiffler, Deborah; Broome, Marion E

    2014-12-01

    With advances in health care, the population of children who are technology-dependent is increasing and, therefore, the need for nurses to understand how best to engage in communication with the parents of these children is critical. Shared communication between the parents of hospitalized technology-dependent children and their nurses is essential to provide optimal care for the child. The components and behaviors of the parent-nurse communication process that improve mutual understanding of optimal care for the child had not previously been examined. Among parents of hospitalized technology-dependent children and their nurses, what communication behaviors, components, concepts, or processes improve mutual understanding of optimal care for the child? An integrative review of both qualitative and quantitative studies was conducted. Key words including communication, hospitalized, nurse, parent, pediatric, and technology-dependent were used to search databases such as Cumulative Index to Nursing and Allied Health and Medline for years 2000-2014. The data regarding the process of parent-nurse communication were extracted as they related to the mutual understanding of optimal care for the child. The data were grouped into themes and compared across studies, designs, populations, and settings. Six articles were identified that provided information regarding the processes of shared communication among the parents of hospitalized technology-dependent children and their nurses. Providing clear information, involving parents in care decisions, trust and respect for each other's expertise, caring attitudes, advocacy, and role negotiation were all found to be important factors in shared parent-nurse communication. The results of this integrative review inform our understanding of the parent-nurse communication process. The findings provide nurses with an understanding of strategies to better engage in respectful, engaging, and intentional communication with parents of

  3. Face-to-face communication between patients and family physicians in Canada: A scoping review.

    Science.gov (United States)

    Armas, Alana; Meyer, Samantha B; Corbett, Kitty K; Pearce, Alex R

    2018-05-01

    Patient-provider communication is critical in primary care. Canada's unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary care settings and identify research agendas for patient-provider communication in Canada. Using Arksey and O'Malley's framework we searched four literature databases: Medline, Web of Science, CINAHL and EMBASE. We extracted 21,932 articles published between 2010 and 2017. A total of 108 articles met the inclusion criteria. The articles were analyzed qualitatively using thematic analysis to identify major themes. Four major themes were identified: information sharing, relationships, health system challenges, and development and use of communication tools. Our review identified a need for Canadian research regarding: communication in primary care with Aboriginal, immigrant, and rural populations; the impact of medical tourism on primary care; and how to improve communication to facilitate continuity of care. Challenges providers face in primary care in Canada include: communicating with linguistically and culturally diverse populations; addressing issues that emerge with the rise of medical tourism; a need for decision aids to improve communication with patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. A systematic review of surgeon-patient communication: strengths and opportunities for improvement.

    Science.gov (United States)

    Levinson, Wendy; Hudak, Pamela; Tricco, Andrea C

    2013-10-01

    Effective communication is critical to patient satisfaction, outcomes of care and malpractice prevention. Surgeons need particularly effective communication skills to discuss complicated procedures and help patients make informed choices. We conducted a systematic review of the literature on surgeon-patient communication. Searches were conducted in MEDLINE, PsycINFO, and Sociological Abstract. Two reviewers screened citations and full-text articles. Quality was appraised using the Critical Appraisal Skills Program tool. Studies were categorized into content of communication, patient satisfaction, relationship of communication to malpractice, and duration of visits. 2794 citations and 74 full-text articles, 21 studies and 13 companion reports were included. Surgeons spent the majority of their time educating patients and helping them to make choices. Surgeons were generally thorough in providing details about surgical conditions and treatments. Surgeons often did not explore the emotions or concerns of patients. Potential areas of improvement included discussing some elements of informed decision making, and expressing empathy. Surgeons can enhance their communication skills, particularly in areas of relative deficiency. Studies in primary care demonstrate communication programs are effective in teaching these skills. These can be adapted to surgical training and ultimately lead to improved outcomes and satisfaction with care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Language and communication development in preschool children with visual impairment: A systematic review.

    Science.gov (United States)

    Mosca, Renata; Kritzinger, Alta; van der Linde, Jeannie

    2015-01-01

    Language and communication difficulties of young children with visual impairment (VI) are ascribed to intellectual disability, multiple disabilities and autism spectrum disorder (ASD) rather than their sensory impairment. Consequently, the communication difficulties of children with VI may have been underestimated and undertreated. This report aims to critically appraise recent peer reviewed literature relating to communication and language development in children with VI. A systematic search of the literature (2003–2013) was completed using the PRISMA guidelines, and primary and secondary search phrases. Nine publications were reviewed in terms of the strength of recent evidence. Thematic analysis was used to describe the early language and communication characteristics of children with VI. All the selected articles (n = 9) were from developed countries and participants from seven of the studies had congenital VI. Five of the studies received an evidence level rating of III while four articles were rated as IIb. Two main themes emerged from the studies: early intervention, and multiple disabilities and ASD. Language and communication development is affected by VI, especially in the early stages of development. Speech-language therapists should therefore be included in early intervention for children with VI. Recent evidence on the early language and communication difficulties of children with VI exists, but children in developing countries with acquired VI appear to not be investigated. The identified language and communication developmental characteristics may assist speech-language therapists to build a knowledge base for participation in early intervention for young children with VI and their families.

  6. A review of the clinical implications of bisphosphonates in dentistry.

    Science.gov (United States)

    Borromeo, G L; Tsao, C E; Darby, I B; Ebeling, P R

    2011-03-01

    Bisphosphonates are drugs that suppress bone turnover and are commonly prescribed to prevent skeletal related events in malignancy and for benign bone diseases such as osteoporosis. Bisphosphonate associated jaw osteonecrosis (ONJ) is a potentially debilitating, yet poorly understood condition. A literature review was undertaken to review the dental clinical implications of bisphosphonates. The present paper briefly describes the postulated pathophysiology of ONJ and conditions with similar clinical presentations. The implications of bisphosphonates for implantology, periodontology, orthodontics and endodontics are reviewed. Whilst bisphosphonates have potential positive applications in some clinical settings, periodontology particularly, further clinical research is limited by the risk of ONJ. Prevention and management are reviewed, including guidelines for reducing cumulative intravenous bisphosphonate dose, cessation of bisphosphonates prior to invasive dental treatment or after ONJ development, and the use of serum beta-CTX-1 in assessing risk. In the context of substantial uncertainty, the implications of bisphosphonate use in the dental clinical setting are still being determined. © 2010 Australian Dental Association.

  7. Peer review: a tool to enhance clinical teaching.

    Science.gov (United States)

    Gusic, Maryellen; Hageman, Heather; Zenni, Elisa

    2013-10-01

    The system used by academic health centres to evaluate teaching must be valued by the large number of faculty staff that teach in clinical settings. Peer review can be used to evaluate and enhance clinical teaching. The objective of this study was to determine the perceptions of clinical faculty about the effects of participating in peer review. Faculty members were observed teaching in a clinical setting by trained peer observers. Feedback was provided using a checklist of behaviours and descriptive comments. Afterwards, semi-structured interviews were conducted to assess the faculty member's perception about the process. Notes from the interviews were analysed using a grounded theory approach. The study was approved by the institutional review boards of all the institutions involved. Three themes emerged from the interviews with faculty members: (1) they found the process to be valuable - they received information that affirmed "good" teaching behaviours, and were prompted to be more focused on their teaching; (2) they were motivated to enhance their teaching by being more deliberate, interactive and learner-centred; and (3) they were inspired to explore other opportunities to improve their teaching skills. Peer review is a process that promotes the open discussion and exchange of ideas. This conversation advances clinical teaching skills and allows high-quality teaching behaviours to be strengthened. © 2013 John Wiley & Sons Ltd.

  8. Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.

    Science.gov (United States)

    McKenzie, Carly T; Tilashalski, Ken R; Peterson, Dawn Taylor; White, Marjorie Lee

    2017-10-01

    The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

  9. Resilience moderates the relationship between emotional intelligence and clinical communication ability among Chinese practice nursing students: A structural equation model analysis.

    Science.gov (United States)

    Kong, Linghua; Liu, Yun; Li, Guopeng; Fang, Yueyan; Kang, Xiaofei; Li, Ping

    2016-11-01

    To examine the positive association between emotional intelligence and clinical communication ability among practice nursing students, and to determine whether resilience plays a moderating role in the relationship between emotional intelligence and clinical communication ability among Chinese practice nursing students. Three hundred and seventy-seven practice nursing students from three hospitals participated in this study. They completed questionnaires including the Emotional Intelligence Inventory (EII), Connor-Davidson Resilience Scale (CD-RISC-10), and Clinical Communication Ability Scale (CCAS). Structural equation modeling was used to analyze the relationships among emotional intelligence, resilience, and clinical communication ability. Emotional intelligence was positively associated with clinical communication ability (Pintelligence and clinical communication ability (Pintelligence is positively related to clinical communication ability among Chinese practice nursing students, and resilience moderates the relationship between emotional intelligence and clinical communication ability, which may provide scientific evidence to aid in developing intervention strategies to improve clinical communication ability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Developing authentic clinical simulations for effective listening and communication in pediatric rehabilitation service delivery.

    Science.gov (United States)

    King, Gillian; Shepherd, Tracy A; Servais, Michelle; Willoughby, Colleen; Bolack, Linda; Strachan, Deborah; Moodie, Sheila; Baldwin, Patricia; Knickle, Kerry; Parker, Kathryn; Savage, Diane; McNaughton, Nancy

    2016-10-01

    To describe the creation and validation of six simulations concerned with effective listening and interpersonal communication in pediatric rehabilitation. The simulations involved clinicians from various disciplines, were based on clinical scenarios related to client issues, and reflected core aspects of listening/communication. Each simulation had a key learning objective, thus focusing clinicians on specific listening skills. The article outlines the process used to turn written scenarios into digital video simulations, including steps taken to establish content validity and authenticity, and to establish a series of videos based on the complexity of their learning objectives, given contextual factors and associated macrocognitive processes that influence the ability to listen. A complexity rating scale was developed and used to establish a gradient of easy/simple, intermediate, and hard/complex simulations. The development process exemplifies an evidence-based, integrated knowledge translation approach to the teaching and learning of listening and communication skills.

  11. Development and Initial Validation of the Caregiver Perceptions About Communication With Clinical Team Members (CAPACITY) Measure.

    Science.gov (United States)

    Van Houtven, Courtney Harold; Miller, Katherine E M; O'Brien, Emily C; Wolff, Jennifer L; Lindquist, Jennifer; Kabat, Margaret; Campbell-Kotler, Margaret; Henius, Jennifer; Voils, Corrine I

    2017-12-01

    Despite the important role that family caregivers play managing the care of persons with complex health needs, little is known about how caregivers perceive themselves to be recognized and valued by health care professionals. Our objective was to develop and validate a novel measure, the CAregiver Perceptions About Commun Ication with Clinical Team members (CAPACITY) instrument. Questions focus on perceived quality of communication with the health care team and the extent to which caregivers believe that the health care team considers their capacity and preferences in decision making. A confirmatory factor analysis supported a two-factor solution addressing communication and capacity. Internal consistency reliability was .90 for the communication domain and .93 for the capacity domain. Correlations between these two subscales and individual difference measures provided evidence of convergent and discriminant validity. The CAPACITY instrument may be a useful performance measure that quantifies the extent to which caregivers' experience person- and family-centered health care.

  12. Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

    Directory of Open Access Journals (Sweden)

    Aurore Liénard

    2010-08-01

    Full Text Available Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds.Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm. Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models.Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92 compared to patients interacting with untrained residents (Median=88 (p=.046. Second, trained residents used more assessment utterances (Relative Risk (RR=1.17; 95% Confidence intervals (95%CI=1.02-1.34; p=.023. Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018 and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042 (respectively 1.15 (RR, 1.08-1.23 (95%CI, p<.001 for empathy and 0.95 (RR, 0.92-0.99 (95%CI, p=.012 for reassurance was proportional to the number of hours of training attendance.The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills

  13. An assessment of student satisfaction with peer teaching of clinical communication skills.

    Science.gov (United States)

    Mills, Jonathan K A; Dalleywater, William J; Tischler, Victoria

    2014-10-13

    Peer teaching is now used in medical education with its value increasingly being recognised. It is not yet established whether students differ in their satisfaction with teaching by peer-teachers compared to those taught by academic or clinical staff. This study aimed to establish satisfaction with communication skills teaching between these three teaching groups. Students participated in a role-play practical facilitated either by clinicians, peer-teachers or non-clinical staff. A questionnaire was administered to first-year medical students after participating in a communication skills role-play session asking students to evaluate their satisfaction with the session. Data were analysed in SPSS 20. One hundred and ninety eight students out of 239 (83%) responded. Students were highly satisfied with the teaching session with no difference in satisfaction scores found between those sessions taught by peers, clinical and non-clinical staff members. 158 (80%) considered the session useful and 139 (69%) strongly agreed tutors facilitated their development. There was no significant difference in satisfaction scores based on tutor background. Satisfaction is as high when tutored by peer-teachers compared to clinicians or non-clinical staff. Constructive feedback is welcomed from a range of personnel. Final-year students could play an increasing role in the teaching of pre-clinical medical students.

  14. Risk/Benefit Communication about Food-A Systematic Review of the Literature.

    Science.gov (United States)

    Frewer, L J; Fischer, A R H; Brennan, M; Bánáti, D; Lion, R; Meertens, R M; Rowe, G; Siegrist, M; Verbeke, W; Vereijken, C M J L

    2016-07-26

    A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit attitudes and behaviors. Fifty four papers were identified. The analysis revealed that (primarily European or US) research interest has been relatively recent. Certain food issues were of greater interest to researchers than others, perhaps reflecting the occurrence of a crisis, or policy concern. Three broad themes relevant to the development of best practice in risk (benefit) communication were identified: the characteristics of the target population; the contents of the information; and the characteristics of the information sources. Within these themes, independent and dependent variables differed considerably. Overall, acute risk (benefit) communication will require advances in communication process whereas chronic communication needs to identify audience requirements. Both citizen's risk/benefit perceptions and (if relevant) related behaviors need to be taken into account, and recommendations for behavioral change need to be concrete and actionable. The application of theoretical frameworks to the study of risk (benefit) communication was infrequent, and developing predictive models of effective risk (benefit) communication may be contingent on improved theoretical perspectives.

  15. A Systematic Review of Wearable Patient Monitoring Systems - Current Challenges and Opportunities for Clinical Adoption.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Moqeem, Aasia A; Mirza, Farhaan; Lindén, Maria

    2017-07-01

    The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and 'silo' solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.

  16. Ocular gene transfer in the spotlight: implications of newspaper content for clinical communications.

    Science.gov (United States)

    Benjaminy, Shelly; Bubela, Tania

    2014-07-16

    Ocular gene transfer clinical trials are raising hopes for blindness treatments and attracting media attention. News media provide an accessible health information source for patients and the public, but are often criticized for overemphasizing benefits and underplaying risks of novel biomedical interventions. Overly optimistic portrayals of unproven interventions may influence public and patient expectations; the latter may cause patients to downplay risks and over-emphasize benefits, with implications for informed consent for clinical trials. We analyze the news media communications landscape about ocular gene transfer and make recommendations for improving communications between clinicians and potential trial participants in light of media coverage. We analyzed leading newspaper articles about ocular gene transfer (1990-2012) from United States (n = 55), Canada (n = 26), and United Kingdom (n = 77) from Factiva and Canadian Newsstand databases using pre-defined coding categories. We evaluated the content of newspaper articles about ocular gene transfer for hereditary retinopathies, exploring representations of framing techniques, research design, risks/benefits, and translational timelines. The dominant frame in 61% of stories was a celebration of progress, followed by human-interest in 30% of stories. Missing from the positive frames were explanations of research design; articles conflated clinical research with treatment. Conflicts-of-interest and funding sources were similarly omitted. Attention was directed to the benefits of gene transfer, while risks were only reported in 43% of articles. A range of visual outcomes was described from slowing vision loss to cure, but the latter was the most frequently represented even though it is clinically infeasible. Despite the prominence of visual benefit portrayals, 87% of the articles failed to provide timelines for the commencement of clinical trials or for clinical implementation. Our analysis confirms

  17. Nanophthalmos: A Review of the Clinical Spectrum and Genetics

    Directory of Open Access Journals (Sweden)

    Pedro C. Carricondo

    2018-01-01

    Full Text Available Nanophthalmos is a clinical spectrum of disorders with a phenotypically small but structurally normal eye. These disorders present significant clinical challenges to ophthalmologists due to a high rate of secondary angle-closure glaucoma, spontaneous choroidal effusions, and perioperative complications with cataract and retinal surgeries. Nanophthalmos may present as a sporadic or familial disorder, with autosomal-dominant or recessive inheritance. To date, five genes (i.e., MFRP, TMEM98, PRSS56, BEST1, and CRB1 and two loci have been implicated in familial forms of nanophthalmos. Here, we review the definition of nanophthalmos, the clinical and pathogenic features of the condition, and the genetics of this disorder.

  18. Communication education for pre-licensure nursing students: literature review 2002-2013.

    Science.gov (United States)

    Grant, Marian S; Jenkins, Louise S

    2014-11-01

    Effective communication skills are fundamental to good nursing care and required by certification bodies for nursing education. The purpose of this literature review was to update one done in 2002 of communication education to pre-licensure registered nursing students. That review concluded that it was unclear which interventions were most effective due to methodological and other quality issues. The goal of this review was to identify recent educational methods, frameworks, and evaluation tools and to assess the quality of this recent evidence. Literature review. PubMed, CINAHL, and PsychINFO. Inclusion criteria were articles in English, 2002 to 2013, full text available, addressing nurse:patient communication, and educational interventions. Exclusion criteria were inter-professional interventions as they are not yet as widely available. Studies were evaluated using the Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Rating Scale. This scale categorizes the levels of evidence and methodological quality. The search yielded 457 titles, 115 abstracts, and 38 articles. Twenty studies met inclusion and exclusion search criteria. They included a range of research designs, samples, and outcomes. In line with recent communication educational trends, the interventions all involved active learning. Using the JHNEBP scale, the quality of the 20 studies was low due to both research design and methodological issues. Despite the importance of communication in nursing education, the quality of evidence to support specific communication interventions continues to be low. Recommendations for future communication education research are to (1) explore the highest quality designs available and use randomization where possible; (2) more consistently use theoretical frameworks and their accompanying outcome measures; and (3) that tools be tested for evidence of reliability and validity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Associations between clinical and sociodemographic data and patterns of communication in pediatric oncology

    Directory of Open Access Journals (Sweden)

    Marina Kohlsdorf

    2016-01-01

    Full Text Available Abstract Pediatric communication directly contributes to treatment adherence, fewer symptoms, better clinical responses, healthier treatment adaptation and management of psychosocial issues. This study aimed to evaluate associations between the clinical and sociodemographic data of caregivers and children and the communicative patterns of pediatricians. Three oncohematology physicians and 44 child-caregiver dyads took part, with audio recording of 146 medical consultations. The physicians interacted more often with older children, offering more guidance, clarifying doubts, and asking for information. The number of questions from children and caregivers was positively correlated with the physician’s communicative behaviors. However, there was no association between the age of the children and the number of doubts of the patients. The diagnosis, treatment time, family income, marital status and caregiver’s level of education were associated with the amount of interaction provided by physicians to the children and caregivers. This study offers subsides relevant to psychosocial interventions that may improve communication in pediatric oncohematology settings.

  20. Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses.

    Science.gov (United States)

    Kim, MinYoung; Oh, Seieun

    2016-01-01

    The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. "Assimilating to the hierarchical culture" emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses' perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members' satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression.

  1. Non-verbal communication between nurses and people with an intellectual disability: a review of the literature.

    Science.gov (United States)

    Martin, Anne-Marie; O'Connor-Fenelon, Maureen; Lyons, Rosemary

    2010-12-01

    This article critically synthesizes current literature regarding communication between nurses and people with an intellectual disability who communicate non-verbally. The unique context of communication between the intellectual disability nurse and people with intellectual disability and the review aims and strategies are outlined. Communication as a concept is explored in depth. Communication between the intellectual disability nurse and the person with an intellectual disability is then comprehensively examined in light of existing literature. Issues including knowledge of the person with intellectual disability, mismatch of communication ability, and knowledge of communication arose as predominant themes. A critical review of the importance of communication in nursing practice follows. The paucity of literature relating to intellectual disability nursing and non-verbal communication clearly indicates a need for research.

  2. Clinical placements in mental health: a literature review.

    Science.gov (United States)

    Happell, Brenda; Gaskin, Cadeyrn J; Byrne, Louise; Welch, Anthony; Gellion, Stephen

    2015-01-01

    Gaining experience in clinical mental health settings is central to the education of health practitioners. To facilitate the ongoing development of knowledge and practice in this area, we performed a review of the literature on clinical placements in mental health settings. Searches in Academic Search Complete, CINAHL, Medline and PsycINFO databases returned 244 records, of which 36 met the selection criteria for this review. Five additional papers were obtained through scanning the reference lists of those papers included from the initial search. The evidence suggests that clinical placements may have multiple benefits (e.g. improving students' skills, knowledge, attitudes towards people with mental health issues and confidence, as well as reducing their fears and anxieties about working in mental health). The location and structure of placements may affect outcomes, with mental health placements in non-mental health settings appearing to have minimal impact on key outcomes. The availability of clinical placements in mental health settings varies considerably among education providers, with some students completing their training without undertaking such structured clinical experiences. Students have generally reported that their placements in mental health settings have been positive and valuable experiences, but have raised concerns about the amount of support they received from education providers and healthcare staff. Several strategies have been shown to enhance clinical placement experiences (e.g. providing students with adequate preparation in the classroom, implementing learning contracts and providing clinical supervision). Educators and healthcare staff need to work together for the betterment of student learning and the healthcare professions.

  3. Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions.

    Science.gov (United States)

    Grönlund, Catarina Fischer; Dahlqvist, Vera; Zingmark, Karin; Sandlund, Mikael; Söderberg, Anna

    2016-12-01

    Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) inspired by Habermas' theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.

  4. Augmentative and alternative communication: from qualification to speech, language and hearing science clinical practice

    Directory of Open Access Journals (Sweden)

    Carla Ciceri Cesa

    Full Text Available ABSTRACT Purpose: to investigate the qualification of the speech language and hearing therapists and their clinical performance with Augmentative and Alternative Communication. Methods: a descriptive, transversal, individual and contemporary study. Data were collected through a questionnaire, filled by twenty-four speech therapists, selected by a convenience sample. Content analysis was chosen for data study. Results: regarding access to the information media, all speech therapists in the sample presented the initiative to supply the absence of language training with Augmentative and Alternative Communication by different means. Regarding the dual focus on intervention, all speech therapists were favorable to this practice. However, according to experience, they reported resistance from the family, school and other therapists. The results showed two different types of introduction implementation and use of Augmentative and Alternative Communication, predominantly formed by strategies contemplating the pragmatic use of language through the contextualization of significant activities for the user. The other way used the Picture Exchange Communication System. Conclusion: the speech-language and hearing therapists in the present study inserted different interlocutors in the intervention, guided by implicit or explicit linguistic principles, by theoretical frameworks specific to the area of Augmentative and Alternative Communication knowledge, by global neuromotor elements and, finally, by principles of functionality and general wellness.

  5. Direct observation of weight-related communication in primary care: a systematic review.

    Science.gov (United States)

    McHale, Calum T; Laidlaw, Anita H; Cecil, Joanne E

    2016-08-01

    Primary care is ideally placed to play an effective role in patient weight management; however, patient weight is seldom discussed in this context. A synthesis of studies that directly observe weight discussion in primary care is required to more comprehensively understand and improve primary care weight-related communication. To systematically identify and examine primary care observational research that investigates weight-related communication and its relationship to patient weight outcomes. A systematic review of literature published up to August 2015, using seven electronic databases (including MEDLINE, Scopus and PsycINFO), was conducted using search terms such as overweight, obese and/or doctor-patient communication. Twenty papers were included in the final review. Communication analysis focused predominantly on 'practitioner' use of specific patient-centred communication. Practitioner use of motivational interviewing was associated with improved patient weight-related outcomes, including patient weight loss and increased patient readiness to lose weight; however, few studies measured patient weight-related outcomes. Studies directly observing weight-related communication in primary care are scarce and limited by a lack of focus on patient communication and patient weight-related outcomes. Future research should measure practitioner and patient communications during weight discussion and their impact on patient weight-related outcomes. This knowledge may inform the development of a communication intervention to assist practitioners to more effectively discuss weight with their overweight and/or obese patients. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Conceptualizing and measuring pharmacist-patient communication: a review of published studies.

    Science.gov (United States)

    Shah, Bupendra; Chewning, Betty

    2006-06-01

    Pharmacist-patient communication in community pharmacies has been studied for over 25 years with little effort to evaluate this research comprehensively. The main objective of this review is to examine and summarize how researchers have conceptualized, defined, and measured pharmacist-patient communication across studies and identify gaps in the literature. Articles were compiled from a search of (1) Medline, IPA, CINAHL, and PubMed databases using the keywords, "counseling", "patient communication", "patient counseling", "patient education", "patient consult( *)", and/or "pharmacists", (2) bibliographies of selected articles. The search generated 56 studies on community pharmacy, of which 39 studies met the inclusion criteria. Most studies (72%) have used the term patient counseling, although pharmacist-patient communication and patient education were also used. The definition of patient counseling varies across studies. Almost half of the studies (49%) conceptualized pharmacist-patient communication solely as a pharmacist information provision activity. A total of 16 studies (41%) also focused on pharmacists' interpersonal behavior in addition to the information provision activity of the pharmacist. In contrast, patient communication behavior and the exchange process between both parties has been understudied. A total of 16 studies (41%) used a retrospective design. All studies used a cross-sectional design, with varying modes of data collection such as mail surveys, telephone interviews, nonparticipant observation, and shopper studies. Taped encounters are rare. SUMMARY/IMPLICATIONS: This review revealed that most studies have focused on a one way communication of pharmacists to patients. A need for examining the patient-pharmacist dyad is apparent. Future research could explore a greater use of taped encounters to analyze the interactive communication process, affective components of communication such as collaborative problem solving, interpersonal

  7. Communication About Sexual Matters With Women Attending a Danish Fertility Clinic: A Descriptive Study

    DEFF Research Database (Denmark)

    Fiil Eldridge, Katrine; Giraldi, Annamaria

    2017-01-01

    Introduction: Several studies have shown that sexuality is an important aspect of life. Nevertheless, sexual matters are only rarely discussed between patients and doctors. Other studies have suggested that women undergoing fertility treatment compose a group of patients with low satisfaction...... in their sexual life. Aim: To investigate how women at a fertility clinic desire and experience communication about sexual matters with doctors and to investigate the sexual function of these women. Methods: A cross-sectional self-administered questionnaire survey of women attending a Danish fertility clinic over...... 4 months was performed. Descriptive statistics were calculated and presented as frequencies. Main Outcome Measure: Communication about sexual matters with doctors included the women’s comfort, preferred and actual frequency of discussion, and initiation of the conversation. Sexual function included...

  8. The National Institutes of Health Clinical Center Digital Imaging Network, Picture Archival and Communication System, and Radiology Information System.

    Science.gov (United States)

    Goldszal, A F; Brown, G K; McDonald, H J; Vucich, J J; Staab, E V

    2001-06-01

    In this work, we describe the digital imaging network (DIN), picture archival and communication system (PACS), and radiology information system (RIS) currently being implemented at the Clinical Center, National Institutes of Health (NIH). These systems are presently in clinical operation. The DIN is a redundant meshed network designed to address gigabit density and expected high bandwidth requirements for image transfer and server aggregation. The PACS projected workload is 5.0 TB of new imaging data per year. Its architecture consists of a central, high-throughput Digital Imaging and Communications in Medicine (DICOM) data repository and distributed redundant array of inexpensive disks (RAID) servers employing fiber-channel technology for immediate delivery of imaging data. On demand distribution of images and reports to clinicians and researchers is accomplished via a clustered web server. The RIS follows a client-server model and provides tools to order exams, schedule resources, retrieve and review results, and generate management reports. The RIS-hospital information system (HIS) interfaces include admissions, discharges, and transfers (ATDs)/demographics, orders, appointment notifications, doctors update, and results.

  9. Anthracycline extravasation: a comprehensive review of experimental and clinical treatments

    DEFF Research Database (Denmark)

    Langer, S.W.; Sehested, M.; Jensen, P.B.

    2009-01-01

    , and is the only approved treatment against anthracyline extravasation. It is thus now widely recommended. The present article represents a comprehensive review of, and historical insight to, the experimental and clinical studies of surgical and non-surgical treatments of extravasation during forty years...

  10. Review on clinical trials of targeted treatments in malignant mesothelioma

    DEFF Research Database (Denmark)

    Jakobsen, Jan Nyrop; Sørensen, Jens Benn

    2011-01-01

    Malignant mesothelioma (MM) is an aggressive tumor of the serosal surfaces with a poor prognosis. Advances in the understanding of tumor biology have led to the development of several targeted treatments, which have been evaluated in clinical trials. This article is a comprehensive review of all...

  11. Awareness in dementia: a review of clinical correlates

    NARCIS (Netherlands)

    Aalten, Pauline; van Valen, Evelien; Clare, Linda; Kenny, Geraldine; Verhey, Frans

    2005-01-01

    This article provides a review of the literature on clinical correlates of awareness in dementia. Most inconsistencies were found with regard to an association between depression and higher levels of awareness. Dysthymia, but not major depression, is probably related to higher levels of awareness.

  12. Clinical skill center: a review of present situation and importance in medical education curriculum

    Directory of Open Access Journals (Sweden)

    Haleh Talaei

    2002-07-01

    Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

  13. Public titles of clinical trials should have ethics review.

    Science.gov (United States)

    Saenz, Carla; Reveiz, Ludovic; Tisdale, John F

    2015-09-01

    A key aspect to guarantee that research with human subjects is ethical is being overlooked. Ethics review committees invest great effort examining the informed consent documents of research protocols to ensure that potential participants can provide consent validly and are not deluded into thinking that the experimental intervention they may sign up for is already known to be therapeutic. However, these efforts to avoid what is called the "therapeutic misconception" might be in vain if the title with which the studies are being introduced to the potential participants escapes ethics review. Research participants might be deceived by clinical trials entitled "novel therapy" when the point of the trial is precisely to find out whether the intervention at stake is therapeutic or not. Providing potential research participants with such misleading information hampers their ability to make informed decisions. The well-established scrutiny that ethics review committees exercise with regard to consent forms is limited if the registration of clinical trials, for which a public title is chosen, constitutes a process that is independent from the ethics review. In this article, we examine this problem, assess recent measures to integrate clinical trial registration with ethics review processes, and provide specific recommendations to solve the problem and ultimately enhance the accountability, transparency, and ethics of research with human subjects. Copyright © 2015 Pan American Health Organization. Published by Elsevier Inc. All rights reserved.

  14. Clinical recommendations of Cochrane reviews in pediatric gastroenterology: systematic analysis.

    Science.gov (United States)

    Goda, Yvonne; Sauer, Harald; Schöndorf, Dominik; Hennes, Pia; Gortner, Ludwig; Gräber, Stefan; Meyer, Sascha

    2015-01-01

    Systematic and up-to-date Cochrane reviews in pediatrics in general and in pediatric gastroenterology in particular are important tools in disseminating the best available evidence to the medical community, thus providing the physician at the bedside with invaluable information and recommendations with regard to specific clinical questions. A systematic literature review was conducted, including all Cochrane reviews published by the Cochrane Review Group in the field of pediatric gastroenterology between 1993 and 2012, with regard to the percentage of reviews that concluded that a certain intervention provided a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence was inconclusive. In total, 86 reviews in the field of pediatric gastroenterology were included. The majority of reviews assessed pharmacological interventions (46/86); other important fields included prevention (15/86) and nutrition (9/86). A total of 33/86 reviews issued definite recommendations (positive, 19/86; negative, 14/86). The remaining 53/86 reviews were either inconclusive (24/86) or only of limited conclusiveness (29/86). The percentage of inconclusive reviews increased from 9% (1998-2002) to 19% (2003-2007; P < 0.05) to finally 24% (2008-2012) (P < 0.05). The three most common reasons for the need for further research were heterogeneity of studies (26/86), small number of patients (18/86), and insufficient data (16/86). Further high-quality research is necessary to increase the proportion of reviews with clear recommendations. Funding and research agencies are key to selecting the most appropriate research programs. © 2014 Japan Pediatric Society.

  15. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

    OpenAIRE

    Claudia C. Dobler; Sinthia Bosnic-Anticevich; Carol L. Armour

    2018-01-01

    The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explain...

  16. Conceptualizations of clinical leadership: a review of the literature

    Science.gov (United States)

    Mianda, Solange; Voce, Anna S

    2017-01-01

    Introduction Poor patient outcomes in South African maternal health settings have been associated with inadequately performing health care providers and poor clinical leadership at the point of care. While skill deficiencies among health care providers have been largely addressed, the provision of clinical leadership has been neglected. In order to develop and implement initiatives to ensure clinical leadership among frontline health care providers, a need was identified to understand the ways in which clinical leadership is conceptualized in the literature. Design Using the systematic quantitative literature review, papers published between 2004 and 2016 were obtained from search engines (Google Scholar and EBSCOhost). Electronic databases (CINHAL, PubMed, Medline, Academic Search Complete, Health Source: Consumer, Health Source: Nursing/Academic, ScienceDirect and Ovid®) and electronic journals (Contemporary Nurse, Journal of Research in Nursing, Australian Journal of Nursing and Midwifery, International Journal of Clinical Leadership) were also searched. Results Using preselected inclusion criteria, 7256 citations were identified. After screening 230 potentially relevant full-text papers for eligibility, 222 papers were excluded because they explored health care leadership or clinical leadership among health care providers other than frontline health care providers. Eight papers met the inclusion criteria for the review. Most studies were conducted in high-income settings. Conceptualizations of clinical leadership share similarities with the conceptualizations of service leadership but differ in focus, with the intent of improving direct patient care. Clinical leadership can be a shared responsibility, performed by every competent frontline health care provider, regardless of the position in the health care system. Conclusion Conceptualizations of clinical leadership among frontline health care providers arise mainly from high-income settings. Understanding the

  17. Conceptualizations of clinical leadership: a review of the literature.

    Science.gov (United States)

    Mianda, Solange; Voce, Anna S

    2017-01-01

    Poor patient outcomes in South African maternal health settings have been associated with inadequately performing health care providers and poor clinical leadership at the point of care. While skill deficiencies among health care providers have been largely addressed, the provision of clinical leadership has been neglected. In order to develop and implement initiatives to ensure clinical leadership among frontline health care providers, a need was identified to understand the ways in which clinical leadership is conceptualized in the literature. Using the systematic quantitative literature review, papers published between 2004 and 2016 were obtained from search engines (Google Scholar and EBSCOhost). Electronic databases (CINHAL, PubMed, Medline, Academic Search Complete, Health Source: Consumer, Health Source: Nursing/Academic, ScienceDirect and Ovid ® ) and electronic journals ( Contemporary Nurse , Journal of Research in Nursing , Australian Journal of Nursing and Midwifery , International Journal of Clinical Leadership ) were also searched. Using preselected inclusion criteria, 7256 citations were identified. After screening 230 potentially relevant full-text papers for eligibility, 222 papers were excluded because they explored health care leadership or clinical leadership among health care providers other than frontline health care providers. Eight papers met the inclusion criteria for the review. Most studies were conducted in high-income settings. Conceptualizations of clinical leadership share similarities with the conceptualizations of service leadership but differ in focus, with the intent of improving direct patient care. Clinical leadership can be a shared responsibility, performed by every competent frontline health care provider, regardless of the position in the health care system. Conceptualizations of clinical leadership among frontline health care providers arise mainly from high-income settings. Understanding the influence of context on

  18. Using Texting for Clinical Communication in Surgery: A Survey of Academic Staff Surgeons.

    Science.gov (United States)

    Firdouse, Mohammed; Devon, Karen; Kayssi, Ahmed; Goldfarb, Jeremy; Rossos, Peter; Cil, Tulin D

    2018-03-01

    Text messaging has become ubiquitous and is being increasingly used within the health care system. The purpose of this study was to understand texting practices for clinical communication among staff surgeons at a large academic institution. Staff surgeons in 4 subspecialties (vascular, plastics, urology, and general surgery) were surveyed electronically. A total of 62 surgeons from general surgery (n = 33), vascular surgery (n = 6), plastic surgery (n = 13), and urology (n = 10) completed the study (response rate 30%). When conveying urgent patient-related information, staff surgeons preferred directly calling other staff surgeons (61.5%) and trainees (58.8%). When discussing routine patient information, staff surgeons used email to reach other staff surgeons (54.9%) but preferred texting (62.7%) for trainees. The majority of participants used texting because it is fast (65.4%), convenient (69.2%) and allows transmitting information to multiple recipients simultaneously (63.5%). Most felt that texting enhances patient care (71.5%); however, only half believed that it enhanced trainees' educational experiences. The majority believed that texting identifiable patient information breaches patient confidentiality. Our data showed high adoption of text messaging for clinical communication among surgeons, particularly with trainees. The majority of surgeons acknowledge security concerns inherent in texting for patient care. Existing mobile communication platforms fail to meet the needs of academic surgeons. Further research should include guidelines related to texting in clinical practice, educational implications of texting, and technologies to better meet the needs of clinicians working in an academic surgical settings.

  19. 21st Century Parent-Child Sex Communication in the U.S.: A Process Review

    Science.gov (United States)

    Flores, Dalmacio; Barroso, Julie

    2018-01-01

    Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk reduction strategies. Parent-child sex communication’s potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the U.S. by reviewing studies published from 2003 to 2015. We used CINAHL, PsycInfo and Pubmed, the key-terms “parent child” AND “sex education” for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today’s parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents. PMID:28059568

  20. Raising Public Awareness of Clinical Trials: Development of Messages for a National Health Communication Campaign.

    Science.gov (United States)

    Massett, Holly A; Dilts, David M; Bailey, Robert; Berktold, Jennifer; Ledsky, Rebecca; Atkinson, Nancy L; Mishkin, Grace; Denicoff, Andrea; Padberg, Rose Mary; Allen, Marin P; Silver, Karen; Carrington, Kelli; Johnson, Lenora E

    2017-05-01

    Clinical trials are essential for developing new and effective treatments and improving patient quality of life; however, many trials cannot answer their primary research questions because they fall short of their recruitment goals. This article reports the results of formative research conducted in two populations, the public and primary care physicians, to identify messages that may raise awareness and increase interest in clinical trials and be used in a national communication campaign. Results suggested that participants were primarily motivated to participate in clinical trials out of a self-interest to help themselves first. Messages illustrated that current treatments were tested via clinical trials, helped normalize trials as routine practices, and reduced concerns over trying something new first. Participants wanted messages that portray trials as state-of-the-art choices that offer some hope, show people like themselves, and are described in a clear, concise manner with actionable steps for them to take. The study revealed some differences in message salience, with healthy audiences exhibiting lower levels of interest. Our results suggest that targeted messages are needed, and that communication with primary health-care providers is an important and necessary component in raising patient awareness of the importance of clinical trials.

  1. Putative clinical piroplasmosis in a Burchell's zebra (Equus quagga burchelli : clinical communication

    Directory of Open Access Journals (Sweden)

    F. Lampen

    2009-05-01

    Full Text Available A 10-year-old tame zebra gelding was presented after suffering from lethargy, nervousness, reported anaemia and icterus as well as a decreased appetite. These symptoms were seen over some months, with changing severity. The animal was immobilised, treated, and blood specimens were submitted for haematology and biochemistry. This report describes molecular characterisation of Theileria equi recovered from this animal, as well as the clinical findings, treatment and historical relevance of piroplasmosis in zebra in southern Africa.

  2. Usefulness of Cochrane Skin Group reviews for clinical practice.

    Science.gov (United States)

    Davila-Seijo, P; Batalla, A; Garcia-Doval, I

    2013-10-01

    Systematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice. The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). Our analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/25) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  3. Augmentative and alternative communication in daily clinical practice: strategies and tools for management of severe communication disorders.

    Science.gov (United States)

    Frankoff, Denise J; Hatfield, Brooke

    2011-01-01

    Research indicates that augmentative and alternative communication (AAC) approaches can be used effectively by patients and their caregivers to improve communication skills. This article highlights strategies and tools for re-establishing communication competence by considering the complexity and diversity of communication interactions in an effort to maximize natural speech and language skills via a range of technologies that are implemented across the continuum of care rather than as a last resort.

  4. [Teaching methods for clinical settings: a literature review].

    Science.gov (United States)

    Brugnolli, Anna; Benaglio, Carla

    2017-01-01

    . Teaching Methods for clinical settings: a review. The teaching process during internship requires several methods to promote the acquisition of more complex technical skills such as relational, decisional and planning abilities. To describe effective teaching methods to promote the learning of relational, decisional and planning skills. A literature review of the teaching methods that have proven most effective, most appreciated by students, and most frequently used in Italian nursing schools. Clinical teaching is a central element to transform clinical experiences during internship in professional competences. The students are gradually brought to become more independent, because they are offered opportunities to practice in real contexts, to receive feedback, to have positive role models, to become more autonomous: all elements that facilitate and potentiate learning. Clinical teaching should be based on a variety of methods. The students value a gradual progression both in clinical experiences and teaching strategies from more supervised methods to methods more oriented towards reflecting on clinical practice and self-directed learning.

  5. Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review.

    Science.gov (United States)

    Slort, W; Schweitzer, B P M; Blankenstein, A H; Abarshi, E A; Riphagen, I I; Echteld, M A; Aaronson, N K; van der Horst, He; Deliens, L

    2011-09-01

    While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic review seven computerized databases were searched to find empirical studies on GP-patient communication in palliative care. Fifteen qualitative studies and seven quantitative questionnaire studies were included. The main perceived barriers were GPs' lack of availability, and patients' and GPs' ambivalence to discuss 'bad prognosis'. Main perceived facilitators were GPs being available, initiating discussion about several end-of-life issues and anticipating various scenarios. Lack of availability and failure to discuss former mistakes appear to be blind spots of GPs. GPs should be more forthcoming to initiate discussions with palliative care patients about prognosis and end-of-life issues. Empirical studies are needed to investigate the effectiveness of the perceived barriers and facilitators.

  6. A Review of Communications Protocol for Intelligent Remote Terminal Unit Development

    Directory of Open Access Journals (Sweden)

    Mohd Ruddin Ab. Ghani

    2013-11-01

    Full Text Available This paper reviewed all the possible interfacing communication protocols for remote terminal unit (RTU. Supervisory Control and Data Acquisition (SCADA system is a central station that can communicate with other network using the protocol. Fundamentally, the architectures of all networks are based on the seven layers of open system interconnection (OSI and International Standard Organization (ISO. The objective of designing the protocols is to check the status of all the input and output field devices and send the report according to that status. The corresponding protocol and communication parameters between the connecting devices will be included in designing a complex SCADA system. The available protocols to develop the communication of RTU are Modbus/ASCII, distributed network protocol (DNP3, controller area network (CAN, International Electro-technical Commission (IEC 60870, transmission control protocol/internet protocol (TCP/IP.

  7. Doctor-patient-child communication: a (re)view of the literature.

    NARCIS (Netherlands)

    Tates, K.; Meeuwesen, L.

    2001-01-01

    Studies on doctor-patient communication focus predominantly on dyadic interactions between adults; even when the patient is a child, the research focus is usually on doctor-parent interaction. The aim of this review study is to evaluate the state of the art of research into doctor-parent-child

  8. Identity and collective action via computer-mediated communication: A review and agenda for future research

    NARCIS (Netherlands)

    Priante, Anna; Ehrenhard, Michel L; van den Broek, Tijs; Need, Ariana

    2017-01-01

    Since the start of large-scale waves of mobilisation in 2011, the importance of identity in the study of collective action via computer-mediated communication (CMC) has been a source of contention. Hence, our research sets out to systematically review and synthesise empirical findings on identity

  9. 78 FR 34381 - Information Collection Being Reviewed by the Federal Communications Commission Under Delegated...

    Science.gov (United States)

    2013-06-07

    ... collection techniques or other forms of information technology; and ways to further reduce the information.... The information collection is used to calculate the effective radiated power (ERP) that the station is... FEDERAL COMMUNICATIONS COMMISSION Information Collection Being Reviewed by the Federal...

  10. Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example

    Science.gov (United States)

    Silverman, Michael J.

    2008-01-01

    This article presents a review of nonverbal literature relating to therapy, music, autism, and music therapy. Included is a case study of a woman with autism who was nonverbal. The case highlights and analyzes behaviors contextually. Interpretations of communication through the music therapy, musical interactions, and the rapport that developed…

  11. 76 FR 5157 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

    Science.gov (United States)

    2011-01-28

    ... or other forms of information technology, and (e) ways to further reduce the information collection... as an examination manager. If the information were not maintained, it is conceivable that fraud and... FEDERAL COMMUNICATIONS COMMISSION Notice of Public Information Collection(s) Being Reviewed by the...

  12. A Systematic Review of Fidelity of Implementation in Parent-Mediated Early Communication Intervention

    Science.gov (United States)

    Lieberman-Betz, Rebecca G.

    2015-01-01

    This article examined the reporting of four elements of fidelity of implementation (FOI) in parent-mediated early communication treatment studies. Thirty-five studies were reviewed to extract information regarding reporting of dosage, adherence, quality, and participant responsiveness for both practitioners and parents involved in parent-delivered…

  13. A Review of Information and Communication Technology Enhanced Social Work Interventions

    Science.gov (United States)

    Chan, Chitat; Holosko, Michael J.

    2016-01-01

    Objectives: Information and communications technology (ICT) has impacted almost all human service disciplines and currently is evolving in social work. This study provides a systematic review of ICT-enhanced social work interventions, with particular reference to their intervention fidelity (IF), validity, and the role of ICT in the helping…

  14. The Computer as Means of Communication for Peer-Review Groups

    NARCIS (Netherlands)

    van der Geest, Thea; Remmers, Tim

    1994-01-01

    In a scientific-writing course, 15 of 54 students used a review-supporting computer program, PREP-EDITOR (PREP), to communicate with their peers about drafts. In an exploratory study, 10 students were interviewed regularly: 5 used PREP and 5 met face-to-face to exchange comments on drafts. The study

  15. Identity and collective action via computer-mediated communication : A review and agenda for future research

    NARCIS (Netherlands)

    Priante, Anna; Ehrenhard, Michel Léon; van den Broek, Tijs Adriaan; Need, Ariana

    2017-01-01

    Since the start of large-scale waves of mobilisation in 2011, the importance of identity in the study of collective action via computer-mediated communication (CMC) has been a source of contention. Hence, our research sets out to systematically review and synthesise empirical findings on identity

  16. 77 FR 60721 - Certain Devices for Mobile Data Communication; Notice of Commission Determination Not To Review...

    Science.gov (United States)

    2012-10-04

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-809] Certain Devices for Mobile Data Communication; Notice of Commission Determination Not To Review an Initial Determination Granting in Part... importation, and the sale within the United States after importation of certain devices for mobile data...

  17. 78 FR 45192 - Information Collection Being Reviewed by the Federal Communications Commission

    Science.gov (United States)

    2013-07-26

    ... Communications Commission, via the Internet at [email protected] . To submit your PRA comments by email send....1223 and 95.1225--Medical Device Radiocommunications Service (MedRadio). Form No.: N/A. Type of Review... amended. Total Annual Burden: 9,120 hours. Total Annual Cost: $462,600. Privacy Act Impact Assessment: N/A...

  18. A Communication Process: Electronic Media in Distance Education--A Review.

    Science.gov (United States)

    George, Donald; And Others

    1989-01-01

    Reviews the current use of electronic media in distance education, emphasizing Canadian examples. Examines broadcast television, videotape, satellite, telephone, radio, audiocassette, and computer. Discusses trends in media use and institutional development, focusing on education as communication and on the importance of combining different media.…

  19. 76 FR 21739 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

    Science.gov (United States)

    2011-04-18

    ... 73.3526(b) and 73.3527(b) require that the public inspection file be maintained at the main studio of... that maintain their main studios and public file outside their communities of license are required to... FEDERAL COMMUNICATIONS COMMISSION Notice of Public Information Collection(s) Being Reviewed by the...

  20. Assessment of Oral Communication: A Major Review of the Historical Development and Trends in the Movement from 1975 to 2009

    Science.gov (United States)

    Morreale, Sherwyn; Backlund, Philip; Hay, Ellen; Moore, Michael

    2011-01-01

    This comprehensive review of the assessment of oral communication in the communication discipline is both descriptive and empirical in nature. First, some background on the topic of communication assessment is provided. Following the descriptive background, we present an empirical analysis of academic papers, research studies, and books about…

  1. Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis.

    Science.gov (United States)

    Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L

    2017-04-07

    The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Family communication and decision making at the end of life: a literature review.

    Science.gov (United States)

    Wallace, Cara L

    2015-06-01

    Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research. Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest. The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life. Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

  3. Fermented Food and Non-Communicable Chronic Diseases: A Review

    Directory of Open Access Journals (Sweden)

    Doreen Gille

    2018-04-01

    Full Text Available Fermented foods represent a significant fraction of human diets. Although their impact on health is positively perceived, an objective evaluation is still missing. We have, therefore, reviewed meta-analyses of randomized controlled trials (RCT investigating the relationship between fermented foods and non-transmissible chronic diseases. Overall, after summarizing 25 prospective studies on dairy products, the association of fermented dairy with cancer was found to be neutral, whereas it was weakly beneficial, though inconsistent, for specific aspects of cardio-metabolic health, in particular stroke and cheese intake. The strongest evidence for a beneficial effect was for yoghurt on risk factors of type 2 diabetes. Although mechanisms explaining this association have not been validated, an increased bioavailability of insulinotropic amino acids and peptides as well as the bacterial biosynthesis of vitamins, in particular vitamin K2, might contribute to this beneficial effect. However, the heterogeneity in the design of the studies and the investigated foods impedes a definitive assessment of these associations. The literature on fermented plants is characterized by a wealth of in vitro data, whose positive results are not corroborated in humans due to the absence of RCTs. Finally, none of the RCTs were specifically designed to address the impact of food fermentation on health. This question should be addressed in future human studies.

  4. Strategic learning and information and communication technology: a critical review

    Directory of Open Access Journals (Sweden)

    Carles Monerero Font

    2013-08-01

    Full Text Available 0 0 1 93 514 USAL 4 1 606 14.0 Normal 0 21 false false false ES JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-ansi-language:ES; mso-fareast-language:EN-US;} This article presents an outline of a learning strategy redefinition, based on recent contributions from learning technologies. This new definition addresses the question of how technological affordances of the software, of the technological tools, or an educational environment, allow a learner or a group of learners develop a new ways to perform a strategic learning action. We review how different characteristics of learning strategy definition have been transformed because of introduction of ICT into education. Finally, the article points toward conceptual challenges and future research questions.

  5. Fermented Food and Non-Communicable Chronic Diseases: A Review.

    Science.gov (United States)

    Gille, Doreen; Schmid, Alexandra; Walther, Barbara; Vergères, Guy

    2018-04-04

    Fermented foods represent a significant fraction of human diets. Although their impact on health is positively perceived, an objective evaluation is still missing. We have, therefore, reviewed meta-analyses of randomized controlled trials (RCT) investigating the relationship between fermented foods and non-transmissible chronic diseases. Overall, after summarizing 25 prospective studies on dairy products, the association of fermented dairy with cancer was found to be neutral, whereas it was weakly beneficial, though inconsistent, for specific aspects of cardio-metabolic health, in particular stroke and cheese intake. The strongest evidence for a beneficial effect was for yoghurt on risk factors of type 2 diabetes. Although mechanisms explaining this association have not been validated, an increased bioavailability of insulinotropic amino acids and peptides as well as the bacterial biosynthesis of vitamins, in particular vitamin K2, might contribute to this beneficial effect. However, the heterogeneity in the design of the studies and the investigated foods impedes a definitive assessment of these associations. The literature on fermented plants is characterized by a wealth of in vitro data, whose positive results are not corroborated in humans due to the absence of RCTs. Finally, none of the RCTs were specifically designed to address the impact of food fermentation on health. This question should be addressed in future human studies.

  6. Clinical management of alcohol withdrawal: A systematic review

    Directory of Open Access Journals (Sweden)

    Shivanand Kattimani

    2013-01-01

    Full Text Available Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed.

  7. Liposomal Formulations in Clinical Use: An Updated Review

    Directory of Open Access Journals (Sweden)

    Upendra Bulbake

    2017-03-01

    Full Text Available Liposomes are the first nano drug delivery systems that have been successfully translated into real-time clinical applications. These closed bilayer phospholipid vesicles have witnessed many technical advances in recent years since their first development in 1965. Delivery of therapeutics by liposomes alters their biodistribution profile, which further enhances the therapeutic index of various drugs. Extensive research is being carried out using these nano drug delivery systems in diverse areas including the delivery of anti-cancer, anti-fungal, anti-inflammatory drugs and therapeutic genes. The significant contribution of liposomes as drug delivery systems in the healthcare sector is known by many clinical products, e.g., Doxil®, Ambisome®, DepoDur™, etc. This review provides a detailed update on liposomal technologies e.g., DepoFoam™ Technology, Stealth technology, etc., the formulation aspects of clinically used products and ongoing clinical trials on liposomes.

  8. Learning in context: identifying gaps in research on the transfer of medical communication skills to the clinical workplace.

    NARCIS (Netherlands)

    Eertwegh, V. van den; Dulmen, S. van; Dalen, J. van; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der

    2013-01-01

    Objective: In order to reduce the inconsistencies of findings and the apparent low transfer of communication skills from training to medical practice, this narrative review identifies some main gaps in research on medical communication skills training and presents insights from theories on learning

  9. Learning in context: identifying gaps in research on the transfer of medical communication skills to the clinical workplace

    NARCIS (Netherlands)

    Eertwegh, V. van den; Dulmen, S. van; Dalen, J. Van; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der

    2013-01-01

    OBJECTIVE: In order to reduce the inconsistencies of findings and the apparent low transfer of communication skills from training to medical practice, this narrative review identifies some main gaps in research on medical communication skills training and presents insights from theories on learning

  10. Communicating bad news: an integrative review of the nursing literature.

    Science.gov (United States)

    Fontes, Cassiana Mendes Bertoncello; Menezes, Daniele Vieira de; Borgato, Maria Helena; Luiz, Marcos Roberto

    2017-01-01

    describe how the process of breaking bad news is established and identify how nurses approach the task of giving bad news. integrative review of the literature for articles in Portuguese and English published between 1993-2014, in the databases: Bireme, PubMed, Scopus, Web of Science, CINAHL and Embase. Nine articles were included using the selection flow chart. A digital form was completed for each article according to the Consolidated Criteria for Reporting Qualitative Research checklist and the level of scientific evidence was determined. Of the 99 articles in identified, nine were included after applying the selection flowchart. breaking bad news is frequent in the area of oncology and palliative care, with a strong cultural influence on the autonomy of nurses in this process. the approach and skills of the nurse during this task influences the patient's reaction to the message. The theme is scarce in the literature and merits further investigation. Descrever como se estabelece o processo de comunicação de más notícias e identificar como o enfermeiro pratica a comunicação de más notícias. Revisão integrativa da literatura com artigos em português e inglês referente ao período 1993-2014 nas bases de dados Bireme, PubMed, Scopus, Web of Science, CINAHL e Embase. Elegeram-se nove artigos pelo fluxograma de seleção. Para cada artigo foi preenchida uma ficha eletrônica, elaborado um checklist do Consolidated Criteria for Reporting Qualitative Research e verificado o nível de evidência científica. Foram identificados 99 artigos e incluídos nove pelo fluxograma de seleção. Transmitir más notícias é frequente nas áreas de oncologia e cuidados paliativos, com forte influência cultural na autonomia do enfermeiro nesse processo. O modo e a habilidade do enfermeiro durante a ação influenciarão a reação do paciente acerca da mensagem. O tema é escasso na literatura, necessitando ser explorado.

  11. Use of simulated patients to assess the clinical and communication skills of community pharmacists.

    Science.gov (United States)

    Weiss, Marjorie C; Booth, Anneka; Jones, Bethan; Ramjeet, Sarah; Wong, Eva

    2010-06-01

    To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Community pharmacies in the southwest of England during 2007. Two simulated patient ('mystery shopper') scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John's Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.

  12. Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

    Science.gov (United States)

    Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

    2016-06-10

    International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory

  13. A Systematic Review of the Use of Social Media for Food Safety Risk Communication.

    Science.gov (United States)

    Overbey, Katie N; Jaykus, Lee-Ann; Chapman, Benjamin J

    2017-09-01

    This article covers the current published literature related to the use of social media in food safety and infectious disease communication. The aim was to analyze literature recommendations and draw conclusions about how best to utilize social media for food safety risk communication going forward. A systematic literature review was conducted, and 24 articles were included for analysis. The inclusion criteria were (i) original peer-reviewed articles and (ii) primary focus on communication through social media about food safety and/or infectious diseases. Studies were coded for themes about social media applications, benefits, limitations, and best practices. Trust and personal beliefs were important drivers of social media use. The wide reach, immediacy, and information gathering capacities of social media were frequently cited benefits. Suggestions for social media best practices were inconsistent among studies, and study designs were highly variable. More evidence-based suggestions are needed to better establish guidelines for social media use in food safety and infectious disease risk communication. The information gleaned from this review can be used to create effective messages for shaping food safety behaviors.

  14. Language and communication development in preschool children with visual impairment: A systematic review

    Directory of Open Access Journals (Sweden)

    Renata Mosca

    2015-10-01

    Full Text Available Background: Language and communication difficulties of young children with visual impairment (VI are ascribed to intellectual disability, multiple disabilities and autism spectrum disorder (ASD rather than their sensory impairment. Consequently, the communication difficulties of children with VI may have been underestimated and undertreated. Objectives: This report aims to critically appraise recent peer reviewed literature relating to communication and language development in children with VI. Method: A systematic search of the literature (2003–2013 was completed using the PRISMA guidelines, and primary and secondary search phrases. Nine publications were reviewed in terms of the strength of recent evidence. Thematic analysis was used to describe the early language and communication characteristics of children with VI. Results: All the selected articles (n = 9 were from developed countries and participants from seven of the studies had congenital VI. Five of the studies received an evidence level rating of III while four articles were rated as IIb. Two main themes emerged from the studies: early intervention, and multiple disabilities and ASD. Language and communication development is affected by VI, especially in the early stages of development. Speech-language therapists should therefore be included in early intervention for children with VI. Conclusion: Recent evidence on the early language and communication difficulties of children with VI exists, but children in developing countries with acquired VI appear to not be investigated. The identified language and communication developmental characteristics may assist speech-language therapists to build a knowledge base for participation in early intervention for young children with VI and their families.

  15. Clinical subtypes of delirium and their relevance for daily clinical practice: a systematic review

    NARCIS (Netherlands)

    de Rooij, S. E.; Schuurmans, M. J.; van der Mast, R. C.; Levi, M. [=Marcel M.

    2005-01-01

    Background Delirium is a disorder that besides four essential features consists of different combinations of symptoms. We reviewed the clinical classification of clusters of symptoms in two or three delirium subtypes. The possible implications of this subtype classification may be several. The

  16. Clinical applications of nuclear magnetic resonance spectroscopy: a review

    International Nuclear Information System (INIS)

    Newman, R.J.

    1984-01-01

    The advantages and present limitations of the clinical applications of nuclear magnetic resonance spectroscopy are reviewed in outline, with passing references to skeletal muscular studies, in particular a group of children with advanced Duchenne dystrophy, and the applications to the study of cerebral metabolism of neonates, excised kidneys, biopsy studies of breast and axillary lymph node samples, and NMR spectroscopy performed during chemotherapy of a secondary rhabdomyosarcoma in the skin. (U.K.)

  17. Clinical applications of nuclear magnetic resonance spectroscopy: a review

    Energy Technology Data Exchange (ETDEWEB)

    Newman, R.J. (Glasgow Western Infirmary (UK))

    1984-09-01

    The advantages and present limitations of the clinical applications of nuclear magnetic resonance spectroscopy are reviewed in outline, with passing references to skeletal muscular studies, in particular a group of children with advanced Duchenne dystrophy, and the applications to the study of cerebral metabolism of neonates, excised kidneys, biopsy studies of breast and axillary lymph node samples, and NMR spectroscopy performed during chemotherapy of a secondary rhabdomyosarcoma in the skin.

  18. A systematic review of the quality of homeopathic clinical trials

    Science.gov (United States)

    Jonas, Wayne B; Anderson, Rachel L; Crawford, Cindy C; Lyons, John S

    2001-01-01

    Background While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature. Methods In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945–1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95. Results 59 studies met the inclusion criteria. Of these, 79% were from peer-reviewed journals, 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. The main validity problems were in measurement where 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. 17% of subjects dropped out in studies where this was reported. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies in homeopathy was worse and only slightly improved in more recent years. Conclusions Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. Many of these problems are correctable even within a "holistic" paradigm given sufficient research expertise, support and methods

  19. Conceptualizations of clinical leadership: a review of the literature

    Directory of Open Access Journals (Sweden)

    Mianda S

    2017-10-01

    Full Text Available Solange Mianda, Anna S Voce Department of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Introduction: Poor patient outcomes in South African maternal health settings have been associated with inadequately performing health care providers and poor clinical leadership at the point of care. While skill deficiencies among health care providers have been largely addressed, the provision of clinical leadership has been neglected. In order to develop and implement initiatives to ensure clinical leadership among frontline health care providers, a need was identified to understand the ways in which clinical leadership is conceptualized in the literature.Design: Using the systematic quantitative literature review, papers published between 2004 and 2016 were obtained from search engines (Google Scholar and EBSCOhost. Electronic databases (CINHAL, PubMed, Medline, Academic Search Complete, Health Source: Consumer, Health Source: Nursing/Academic, ScienceDirect and Ovid® and electronic journals (Contemporary Nurse, Journal of Research in Nursing, Australian Journal of Nursing and Midwifery, International Journal of Clinical Leadership were also searched.Results: Using preselected inclusion criteria, 7256 citations were identified. After screening 230 potentially relevant full-text papers for eligibility, 222 papers were excluded because they explored health care leadership or clinical leadership among health care providers other than frontline health care providers. Eight papers met the inclusion criteria for the review. Most studies were conducted in high-income settings. Conceptualizations of clinical leadership share similarities with the conceptualizations of service leadership but differ in focus, with the intent of improving direct patient care. Clinical leadership can be a shared responsibility, performed by every competent frontline health care provider

  20. Augmentative and alternative communication in children with Down's syndrome: a systematic review.

    Science.gov (United States)

    Barbosa, Renata Thaís de Almeida; de Oliveira, Acary Souza Bulle; de Lima Antão, Jennifer Yohanna Ferreira; Crocetta, Tânia Brusque; Guarnieri, Regiani; Antunes, Thaiany Pedrozo Campos; Arab, Claudia; Massetti, Thaís; Bezerra, Italla Maria Pinheiro; de Mello Monteiro, Carlos Bandeira; de Abreu, Luiz Carlos

    2018-05-11

    The use of technology to assist in the communication, socialization, language, and motor skills of children with Down's syndrome (DS) is required. The aim of this study was to analyse research findings regarding the different instruments of 'augmentative and alternative communication' used in children with Down's syndrome. This is a systematic review of published articles available on PubMed, Web of Science, PsycInfo, and BVS using the following descriptors: assistive technology AND syndrome, assistive technology AND down syndrome, down syndrome AND augmentative and alternative communication. Studies published in English were selected if they met the following inclusion criteria: (1) study of children with a diagnosis of DS, and (2) assistive technology and/or augmentative and alternative communication analysis in this population. A total of 1087 articles were identified. Thirteen articles met the inclusion criteria. The instruments most used by the studies were speech-generating devices (SGDs) and the Picture Exchange Communication System (PECS). Twelve instruments that provided significant aid to the process of communication and socialization of children with DS were identified. These instruments increase the interaction between individuals among this population and their peers, contributing to their quality of life and self-esteem.

  1. Electronic mail communication between physicians and patients: a review of challenges and opportunities.

    Science.gov (United States)

    Antoun, Jumana

    2016-04-01

    Although promising benefits hold for email communication between physicians and patients in terms of lowering the costs of health care while maintaining or improving the quality of disease management and health promotion, physician use of email with patients is still low and lags behind the willingness of patients to communicate with their physicians through email. There is also a discrepancy between physicians' willingness and actual practice of email communication. Several factors may explain these discrepancies. They include physicians differ in their experience and attitude towards information technology; some may not be convinced that patients appreciate, need and can communicate by email with their doctors; others are still waiting for robust evidence on service performance and efficiency in addition to patient satisfaction and outcome that support such practice; and many are reluctant to do so because of perceived barriers. This report is a review of the literature on the readiness for and adoption of physician-patient email communication, and how can challenges be or have been addressed. The need for Governmental support and directives for email communication to move forward is iterated, and opportunities for future research are pointed out. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

    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.

  3. Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses

    Science.gov (United States)

    2016-01-01

    The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. “Assimilating to the hierarchical culture” emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses’ perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members’ satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression. PMID:27253389

  4. A trust-wide review of clinical nurse specialists' productivity.

    Science.gov (United States)

    Balsdon, Helen; Wilkinson, Susan

    2014-04-01

    The contribution made by clinical nurse specialists (CNSs) to patient care needs to be understood fully to provide assurance of effective use of resources. However, CNS roles are often poorly understood and not easily articulated. Due to the diversity of these roles, robust reviews of performance and economic benefits can be regarded as time consuming and resource intense, and many organisations enlist external agencies to clarify the contribution to care made by their CNSs. This article gives an overview of a Cambridge University Hospitals NHS Foundation Trust internal review of CNS roles without the support of an external agency. The review provided assurance that this group of nurses is being used effectively and identified opportunities to use the role in different ways to increase effectiveness.

  5. Applicability of the Calgary-Cambridge Guide to Dog and Cat Owners for Teaching Veterinary Clinical Communications.

    Science.gov (United States)

    Englar, Ryane E; Williams, Melanie; Weingand, Kurt

    2016-01-01

    Effective communication in health care benefits patients. Medical and veterinary schools not only have a responsibility to teach communication skills, the American Veterinary Medical Association (AVMA) Council on Education (COE) requires that communication be taught in all accredited colleges of veterinary medicine. However, the best strategy for designing a communications curriculum is unclear. The Calgary-Cambridge Guide (CCG) is one of many models developed in human medicine as an evidence-based approach to structuring the clinical consultation through 71 communication skills. The model has been revised by Radford et al. (2006) for use in veterinary curricula; however, the best approach for veterinary educators to teach communication remains to be determined. This qualitative study investigated if one adaptation of the CCG currently taught at Midwestern University College of Veterinary Medicine (MWU CVM) fulfills client expectations of what constitutes clinically effective communication. Two focus groups (cat owners and dog owners) were conducted with a total of 13 participants to identify common themes in veterinary communication. Participants compared communication skills they valued to those taught by MWU CVM. The results indicated that while the CCG skills that MWU CVM adopted are applicable to cat and dog owners, they are not comprehensive. Participants expressed the need to expand the skillset to include compassionate transparency and unconditional positive regard. Participants also expressed different communication needs that were attributed to the species of companion animal owned.

  6. Clinical assessment of early language development: a simplified short form of the Mandarin communicative development inventory.

    Science.gov (United States)

    Soli, Sigfrid D; Zheng, Yun; Meng, Zhaoli; Li, Gang

    2012-09-01

    The purpose of this study was to develop a practical mean for clinical evaluation of early pediatric language development by establishing developmental trajectories for receptive and expressive vocabulary growth in children between 6 and 32 months of age using a simple, time-efficient assessment tool. Simplified short form versions of the Words and Gestures and Words and Sentences vocabulary inventories in the Mandarin Communicative Development Inventory [1] were developed and used to assess early language development in developmentally normal children from 6 to 32 months of age during routine health checks. Developmental trajectories characterizing the rate of receptive and expressive vocabulary growth between 6 and 32 months of age are reported. These trajectories allow the equivalent age corresponding to a score to be determined after a brief structured interview with the child's parents that can be conducted in a busy clinical setting. The simplified short forms of the Mandarin Communicative Development Inventories can serve as a clinically useful tool to assess early child language development, providing a practical mean of objectively assessing early language development following early interventions to treat young children with hearing impairment as well as speech and language delays. Objective evidence of language development is essential for achievement of effective (re)habilitation outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection.

    Science.gov (United States)

    Dobler, Claudia C; Bosnic-Anticevich, Sinthia; Armour, Carol L

    2018-01-01

    The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk-benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

  8. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

    Directory of Open Access Journals (Sweden)

    Claudia C. Dobler

    2018-03-01

    Full Text Available The aim of the study was to explore the views of tuberculosis (TB physicians on treatment of latent TB infection (LTBI, focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk–benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

  9. Demonstrating the financial impact of clinical libraries: a systematic review.

    Science.gov (United States)

    Madden, Anne; Collins, Pamela; McGowan, Sondhaya; Stevenson, Paul; Castelli, David; Hyde, Loree; DeSanto, Kristen; O'Brien, Nancy; Purdon, Michelle; Delgado, Diana

    2016-09-01

    The purpose of this review is to evaluate the tools used to measure the financial value of libraries in a clinical setting. Searches were carried out on ten databases for the years 2003-2013, with a final search before completion to identify any recent papers. Eleven papers met the final inclusion criteria. There was no evidence of a single 'best practice', and many metrics used to measure financial impact of clinical libraries were developed on an ad hoc basis locally. The most common measures of financial impact were value of time saved, value of resource collection against cost of alternative sources, cost avoidance and revenue generated through assistance on grant submissions. Few papers provided an insight into the longer term impact on the library service resulting from submitting return on investment (ROI) or other financial impact statements. There are limited examples of metrics which clinical libraries can use to measure explicit financial impact. The methods highlighted in this literature review are generally implicit in the measures used and lack robustness. There is a need for future research to develop standardised, validated tools that clinical libraries can use to demonstrate their financial impact. © 2016 Health Libraries Group.

  10. A systematic review of clinical supervision evaluation studies in nursing.

    Science.gov (United States)

    Cutcliffe, John R; Sloan, Graham; Bashaw, Marie

    2018-02-15

    According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee. © 2018 Australian College of Mental Health Nurses Inc.

  11. E-textiles in Clinical Rehabilitation: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Amanda Fleury

    2015-02-01

    Full Text Available Electronic textiles have potential for many practical uses in clinical rehabilitation. This scoping review appraises recent and emerging developments of textile-based sensors with applications to rehabilitation. Contributions published from 2009 to 2013 are appraised with a specific focus on the measured physiological or biomechanical phenomenon, current measurement practices, textile innovations, and their merits and limitations. While fabric-based signal quality and sensor integration have advanced considerably, overall system integration (including circuitry and power has not been fully realized. Validation against clinical gold standards is inconsistent at best, and feasibility with clinical populations remains to be demonstrated. The overwhelming focus of research and development has been on remote sensing but the opportunity for textile-mediated feedback to the wearer remains unexplored. Recommendations for future research are provided.

  12. Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics.

    Science.gov (United States)

    Rand, Cynthia M; Schaffer, Stanley J; Dhepyasuwan, Nui; Blumkin, Aaron; Albertin, Christina; Serwint, Janet R; Darden, Paul M; Humiston, Sharon G; Mann, Keith J; Stratbucker, William; Szilagyi, Peter G

    2018-04-01

    Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. Staff and providers in 8 resident clinics participated in a 12-month QI study. The intervention included training to strengthen provider communication about the HPV vaccine. Clinics also implemented provider prompts, received monthly performance feedback, and participated in learning collaborative calls. The primary outcome measure was eligible visits with vaccination divided by vaccine-eligible visits (captured HPV vaccination opportunities). Practices performed chart audits that were fed into monthly performance feedback on captured HPV vaccination opportunities. We used conditional logistic regression (conditioning on practice) to assess captured vaccination opportunities, with the time period of the study (before and after the QI intervention) as the independent variable. Overall, captured opportunities for HPV vaccination increased by 16.4 percentage points, from 46.9% to 63.3%. Special cause was demonstrated by centerline shift, with 8 consecutive points above the preintervention mean. On adjusted analyses, patients were more likely to receive a vaccine during, versus before, the intervention (odds ratio: 1.87; 95% confidence interval: 1.54-2.28). Captured HPV vaccination rates improved at both well-child and other visits (by 11.7 and 13.0 percentage points, respectively). A bundled intervention of provider prompts and training in communication skills plus performance feedback increased captured opportunities for HPV vaccination. Copyright © 2018 by the American Academy of Pediatrics.

  13. Who's talking? Communication and the casual/part-time nurse: a literature review.

    Science.gov (United States)

    Batch, Mary; Barnard, Alan; Windsor, Carol

    2009-08-01

    The rapidly evolving nursing working environment has seen the increased use of flexible non standard employment, including part-time, casual and itinerate workers. Evidence suggests that the nursing workforce has been at the forefront of the flexibility push which has seen the appearance of a dual workforce and marginalization of part-time and casual workers by their full-time peers and managers. The resulting fragmentation has meant that effective communication management has become difficult. Additionally, it is likely that poor organisational communication exacerbated by the increased use of non standard staff, is a factor underlying current discontent in the nursing industry and may impact on both recruitment and retention problems as well as patient outcomes. This literature review explores the relationship between the increasing casualisation of the nursing workforce and, among other things, the communication practices of nurses within healthcare organisations.

  14. Communication technologies to improve HPV vaccination initiation and completion: A systematic review.

    Science.gov (United States)

    Francis, Diane B; Cates, Joan R; Wagner, Kyla P Garrett; Zola, Tracey; Fitter, Jenny E; Coyne-Beasley, Tamera

    2017-07-01

    This systematic review examines the effectiveness of communication technology interventions on HPV vaccination initiation and completion. A comprehensive search strategy was used to identify existing randomized controlled trials testing the impact of computer-, mobile- or internet-based interventions on receipt of any dose of the HPV vaccine. Twelve relevant studies were identified with a total of 38,945 participants. The interventions were delivered using several different methods, including electronic health record (i.e. recall/reminder) prompts, text messaging, automated phone calls, interactive computer videos, and email. Vaccine initiation and completion was greater for technology-based studies relative to their control conditions. There is evidence that interventions utilizing communication technologies as their sole or primary mode for HPV vaccination intervention delivery may increase vaccination coverage. Communication technologies hold much promise for the future of HPV vaccination efforts, especially initiatives in practice-based settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Assessing patient-centred communication in teaching: a systematic review of instruments.

    Science.gov (United States)

    Brouwers, Marianne; Rasenberg, Ellemieke; van Weel, Chris; Laan, Roland; van Weel-Baumgarten, Evelyn

    2017-11-01

    Patient-centred communication is a key component of patient centredness in medical care. Therefore, adequate education in and assessment of patient-centred communication skills are necessary. In general, feedback on communication skills is most effective when it is provided directly and is systematic. This calls for adequate measurement instruments. The aim of this study was to provide a systematic review of existing instruments that measure patient centredness in doctor-patient communication and can be used to provide direct feedback. A systematic review was conducted using an extensive validated search strategy for measurement instruments in PubMed, EMBASE, PsycINFO and CINAHL. The databases were searched from their inception to 1 July 2016. Articles describing the development or evaluation of the measurement properties of instruments that measure patient centredness (by applying three or more of the six dimensions of a published definition of patient centredness) in doctor-patient communication and that can be used for the provision of direct feedback were included. The methodological quality of measurement properties was evaluated using the COSMIN checklist. Thirteen articles describing 14 instruments measuring patient centredness in doctor-patient communication were identified. These studies cover a wide range of settings and patient populations, and vary in the dimensions of patient centredness applied and in methodological quality on aspects of reliability and validity. This review gives a comprehensive overview of all instruments available for the measurement of patient centredness in doctor-patient communication that can be used for the provision of direct feedback and are described in the literature. Despite the widely felt need for valid and reliable instruments for the measurement of patient-centred communication, most of the instruments currently available have not been thoroughly investigated. Therefore, we recommend further research into and

  16. Physician gender and patient-centered communication: a critical review of empirical research.

    Science.gov (United States)

    Roter, Debra L; Hall, Judith A

    2004-01-01

    Physician gender has stimulated a good deal of interest as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians are more patient-centered in their communication with patients. Our objective is to synthesize the results of two meta-analytic reviews the effects of physician gender on communication in medical visits within a communication framework that reflects patient-centeredness and the functions of the medical visit. We performed online database searches of English-language abstracts for the years 1967 to 2001 (MEDLINE, AIDSLINE, PsycINFO, and BIOETHICS), and a hand search was conducted of reprint files and the reference sections of review articles and other publications. Studies using a communication data source such as audiotape, videotape, or direct observation were identified through bibliographic and computerized searches. Medical visits with female physicians were, on average, two minutes (10%) longer than those of male physicians. During this time, female physicians engaged in significantly more communication that can be considered patient-centered. They engaged in more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk. Moreover, the patients of female physicians spoke more overall, disclosed more biomedical and psychosocial information, and made more positive statements to their physicians than did the patients of male physicians. Obstetrics and gynecology may present a pattern different from that of primary care: Male physicians demonstrated higher levels of emotionally focused talk than their female colleagues. Female primary care physicians and their patients engaged in more communication that can be considered patient-centered and had longer visits than did their male colleagues. Limited studies exist outside of primary care, and gender-related practice patterns might differ in some subspecialties from

  17. Clinical Governance in Primary Care; Principles, Prerequisites and Barriers: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jaafar Sadeq Tabrizi

    2013-07-01

    Full Text Available Introduction: Primary care organizations are the entities through which clinical governance is developed at local level. To implement clinical governance in primary care, awareness about principles, prerequisites and barriers of this quality improvement paradigm is necessary. The aim of this study is to pool evidence about implementing clinical governance in primary care organizations. Data sources: The literature search was conducted in July 2012. PubMed, Web of Science, Emerald, Springerlink, and MD Consult were searched using the following MESH keywords; “clinical governance” and “primary care” Study selection: The search was limited to English language journals with no time limitation. Articles that were either quantitative or qualitative on concepts of implementing clinical governance in primary care were eligible for this study. Data extraction: From selected articles, data on principles, prerequisites and barriers of clinical governance in primary health care were extracted and classified in the extraction tables. Results: We classified our findings about principles of clinical governance in primary care in four groups; general principles, principles related to staff, patient and communication. Prerequisites were categorized in eight clusters; same as the seven dimensions of National Health System (NHS models of clinical governance. Barriers were sorted out in five categories as structure and organizing, cultural, resource, theoretical and logistical. Conclusion: Primary care organizations must provide budget holding, incentivized programs, data feedback, peer review, education, human relations, health information technology (HIT support, and resources. Key elements include; enrolled populations, an interdisciplinary team approach, HIT interoperability and access between all providers as well as patients, devolution of hospital based services into the community, inter-sectorial integration, blended payments, and a balance of

  18. Implementing communication and decision-making interventions directed at goals of care: a theory-led scoping review.

    Science.gov (United States)

    Cummings, Amanda; Lund, Susi; Campling, Natasha; May, Carl R; Richardson, Alison; Myall, Michelle

    2017-10-06

    To identify the factors that promote and inhibit the implementation of interventions that improve communication and decision-making directed at goals of care in the event of acute clinical deterioration. A scoping review was undertaken based on the methodological framework of Arksey and O'Malley for conducting this type of review. Searches were carried out in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to identify peer-reviewed papers and in Google to identify grey literature. Searches were limited to those published in the English language from 2000 onwards. Inclusion and exclusion criteria were applied, and only papers that had a specific focus on implementation in practice were selected. Data extracted were treated as qualitative and subjected to directed content analysis. A theory-informed coding framework using Normalisation Process Theory (NPT) was applied to characterise and explain implementation processes. Searches identified 2619 citations, 43 of which met the inclusion criteria. Analysis generated six themes fundamental to successful implementation of goals of care interventions: (1) input into development; (2) key clinical proponents; (3) training and education; (4) intervention workability and functionality; (5) setting and context; and (6) perceived value and appraisal. A broad and diverse literature focusing on implementation of goals of care interventions was identified. Our review recognised these interventions as both complex and contentious in nature, making their incorporation into routine clinical practice dependent on a number of factors. Implementing such interventions presents challenges at individual, organisational and systems levels, which make them difficult to introduce and embed. We have identified a series of factors that influence successful implementation and our analysis has distilled key learning points, conceptualised as a set of propositions, we consider relevant to implementing other complex

  19. Adaptive design methods in clinical trials – a review

    Directory of Open Access Journals (Sweden)

    Chang Mark

    2008-05-01

    Full Text Available Abstract In recent years, the use of adaptive design methods in clinical research and development based on accrued data has become very popular due to its flexibility and efficiency. Based on adaptations applied, adaptive designs can be classified into three categories: prospective, concurrent (ad hoc, and retrospective adaptive designs. An adaptive design allows modifications made to trial and/or statistical procedures of ongoing clinical trials. However, it is a concern that the actual patient population after the adaptations could deviate from the originally target patient population and consequently the overall type I error (to erroneously claim efficacy for an infective drug rate may not be controlled. In addition, major adaptations of trial and/or statistical procedures of on-going trials may result in a totally different trial that is unable to address the scientific/medical questions the trial intends to answer. In this article, several commonly considered adaptive designs in clinical trials are reviewed. Impacts of ad hoc adaptations (protocol amendments, challenges in by design (prospective adaptations, and obstacles of retrospective adaptations are described. Strategies for the use of adaptive design in clinical development of rare diseases are discussed. Some examples concerning the development of Velcade intended for multiple myeloma and non-Hodgkin's lymphoma are given. Practical issues that are commonly encountered when implementing adaptive design methods in clinical trials are also discussed.

  20. COMMUNICATIONS

    CERN Multimedia

    L. Taylor and D. Barney

    2010-01-01

    CMS Centres, Outreach and the 7 TeV Media Event The new CMS Communications group is now established and is addressing three areas that are critical to CMS as it enters the physics operations phase: - Communications Infrastructure, including almost 50 CMS Centres Worldwide, videoconferencing systems, and CERN meeting rooms - Information systems, including the internal and external Web sites as well as the document preparation and management systems - Outreach and Education activities, including working with print, radio and TV media, visits to CMS, and exhibitions. The group has been active in many areas, with the highest priority being accorded to needs of CMS operations and preparations for the major media event planned for 7 TeV collisions. Unfortunately the CMS Centre@CERN suffered a major setback when, on 21st December, a cooling water pipe froze and burst on the floor above the CMS Centre main room. Water poured through the ceiling, flooding the floor and soaking some of the consoles, before e...

  1. COMMUNICATIONS

    CERN Multimedia

    A. Petrilli

    2013-01-01

    The organisation of the Open Days at the end of September was the single biggest effort of the CMS Communications Group this year. We would like to thank all volunteers for their hard work to show our Point 5 facilities and explain science and technology to the general public. During two days more than 5,000 people visited the CMS detector underground and profited from the surface activities, which included an exhibition on CMS, a workshop on superconductivity, and an activity for our younger visitors involving wooden Kapla blocks. The Communications Group took advantage of the preparations to produce new CMS posters that can be reused at other venues. Event display images have been produced not just for this occasion but also for other exhibits, education purposes, publications etc. During the Open Days, Gilles Jobin, 2012 winner of CERN Collide@CERN prize, performed his Quantum show in Point 5, with the light installation of German artist Julius von Bismarck. Image 3: CERN Open Days at CMS wel...

  2. The use of systematic reviews in clinical trials and narrative reviews in dermatology: is the best evidence being used?

    Science.gov (United States)

    Conde-Taboada, A; Aranegui, B; García-Doval, I; Dávila-Seijo, P; González-Castro, U

    2014-04-01

    Systematic reviews -the most comprehensive type of literature review-should be taken into account before a clinical trial or a narrative review on a topic is undertaken. The objective of this study was to describe the use of systematic reviews in clinical trials and narrative reviews in dermatology. This was a descriptive cross-sectional study. We selected randomized clinical trials and narrative reviews from the dermatological clinical research journals identified as most important (according to impact factor) and from Actas Dermosifiliográficas, and studied the bibliographies to ascertain whether the authors made reference to existing systematic reviews and Cochrane reviews. Of the 72 clinical trials for which a systematic review was available, 24 (33.3%) cited at least 1 review; reference was made to relevant Cochrane reviews in 15.6% of cases and to non-Cochrane reviews in 32%. In the case of the 24 narrative reviews for which a review was available, 10 (41.7%) cited at least 1 review; Cochrane reviews were cited in 20% and non-Cochrane reviews in 35.3%.In the case of Actas Dermosifiliográficas, very few clinical trials were found and the findings for narrative review articles were similar to those observed for the other journals. Systematic reviews are not often taken into account by the authors of clinical trials and narrative reviews and this may lead to redundant studies and publications. Authors appear to use Cochrane reviews even less than non-Cochrane reviews and are therefore ignoring one of the main sources of available evidence. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

  3. Dissecting aneurysms of posterior communicating artery itself: anatomical, diagnostic, clinical, and therapeutical considerations.

    Science.gov (United States)

    Kocak, Burak; Tureci, Ercan; Kizilkilic, Osman; Islak, Civan; Kocer, Naci

    2013-09-01

    Posterior communicating artery (PCoA) itself is an unusual location for intracranial aneurysms in that isolated dissections or dissecting aneurysms are extremely rare. In the way of correct diagnosis of dissecting aneurysms of PCoA itself, a proper understanding of (1) the anatomy of the PCoA and its perforator branches, (2) some particular diagnostic features, and (3) related clinical aspects is of significant importance. Although there are no established treatment strategies for this particular type of aneurysms, the endovascular approach might be considered as a plausible one. In this paper, our scope was to report five cases with dissecting aneurysm of the PCoA itself and to discuss this rare vascular pathology from anatomical, diagnostic, clinical, and therapeutical perspectives.

  4. Persuasiveness of eWOM Communications: Literature Review and Suggestions for Future Research

    OpenAIRE

    Ismagilova , Elvira; Slade , Emma; Williams , Michael

    2016-01-01

    Part 4: Information Sharing on Social Media; International audience; Electronic word-of-mouth (eWOM) plays an important part in consumer purchase decision. The way consumers perceive the persuasiveness of eWOM message can affect their attitude, and purchase intention, and hence sales. Thus, the topic of persuasiveness of eWOM communications has received much attention from scholars. The objective of this paper is to provide a brief review of the existing literature related to the effectivenes...

  5. Communicating hunger and satiation in the first 2?years of life: a systematic review

    OpenAIRE

    McNally, Janet; Hugh?Jones, Siobhan; Caton, Samantha; Vereijken, Carel; Weenen, Hugo; Hetherington, Marion

    2015-01-01

    Abstract Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore, the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these ...

  6. Communicating Hunger and Satiation in the First Two Years of Life: A Systematic Review

    OpenAIRE

    McNally, JE; Hugh-Jones, S; Caton, S; Vereijken, C; Weenen, H; Hetherington, M

    2016-01-01

    Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these states. A ...

  7. A Systematic Literature Review and Research Agenda for Organ Donation Decision Communication.

    Science.gov (United States)

    Knox, Kathy; Parkinson, Joy; Pang, Bo; Fujihira, Haruka; David, Patricia; Rundle-Thiele, Sharyn

    2017-09-01

    This study systematically located and appraised peer-reviewed evidence for the efficacy of strategies to increase organ donation decision communication among adults including an assessment of study quality to guide future research in this field. There is little room to move in strengthening unanimously positive public attitudes toward organ donation. Consequently, researchers have called for a focus on organ donation decision communication to understand modifiable factors to increase organ donation rates. Multiple databases were searched during September 2015, and 44 studies were selected for inclusion. Data concerning participants, design, and outcomes were extracted. Studies were rated for quality and levels of evidence. Although not amenable to meta-analysis, the literature indicates that approximately 50% of adults who are willing to become an organ donor have discussed this decision with family. The majority of research was conducted in a Western context with an overrepresentation of students. Strategies to increase communication include education, motivation, input from lived experience, efforts to address salient audience beliefs, and scheduled reminders or prompts. Intentions and willingness to discuss organ donation were consistently positively related to discussion behavior; however, formative research and experimental studies testing theoretically driven interventions were scarce. There is mixed evidence for the role of demographic and attitudinal characteristics in the success of organ donation communication interventions. Additional theoretically based research is recommended to establish boundary conditions and validate strategies to increase organ donation decision communication among adults.

  8. Advancing Partner Notification Through Electronic Communication Technology: A Review of Acceptability and Utilization Research.

    Science.gov (United States)

    Pellowski, Jennifer; Mathews, Catherine; Kalichman, Moira O; Dewing, Sarah; Lurie, Mark N; Kalichman, Seth C

    2016-06-01

    A cornerstone of sexually transmitted infection (STI) prevention is the identification, tracing, and notification of sex partners of index patients. Although partner notification reduces disease burden and prevents new infections as well as reinfections, studies show that only a limited number of partners are ever notified. Electronic communication technologies, namely, the Internet, text messaging, and phone calls (i.e., e-notification), have the potential to expand partner services. We conducted a systematic review of studies that have investigated the acceptability and utility of e-notification. We identified 23 studies that met the following criteria: (a) 9 studies presented data on the acceptability of technology-based communications for contacting sex partner(s), and (b) 14 studies reported on the utilization of communication technologies for partner notification. Studies found high levels of interest in and acceptability of e-notification; however, there was little evidence for actual use of e-notification. Taken together, results suggest that electronic communications could have their greatest impact in notifying less committed partners who would otherwise be uninformed of their STI exposure. In addition, all studies to date have been conducted in resource-rich countries, although the low cost of e-notification may have its greatest impact in resource-constrained settings. Research is needed to determine the best practices for exploiting the opportunities afforded by electronic communications for expanding STI partner services.

  9. Reproducibility of clinical research in critical care: a scoping review.

    Science.gov (United States)

    Niven, Daniel J; McCormick, T Jared; Straus, Sharon E; Hemmelgarn, Brenda R; Jeffs, Lianne; Barnes, Tavish R M; Stelfox, Henry T

    2018-02-21

    The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. We used scoping review methods to examine reproducibility within a cohort of randomized trials examining clinical critical care research and published in the top general medical and critical care journals. To identify relevant clinical practices, we searched the New England Journal of Medicine, The Lancet, and JAMA for randomized trials published up to April 2016. To identify a comprehensive set of studies for these practices, included articles informed secondary searches within other high-impact medical and specialty journals. We included late-phase randomized controlled trials examining therapeutic clinical practices in adults admitted to general medical-surgical or specialty intensive care units (ICUs). Included articles were classified using a reproducibility framework. An original study was the first to evaluate a clinical practice. A reproduction attempt re-evaluated that practice in a new set of participants. Overall, 158 practices were examined in 275 included articles. A reproduction attempt was identified for 66 practices (42%, 95% CI 33-50%). Original studies reported larger effects than reproduction attempts (primary endpoint, risk difference 16.0%, 95% CI 11.6-20.5% vs. 8.4%, 95% CI 6.0-10.8%, P = 0.003). More than half of clinical practices with a reproduction attempt demonstrated effects that were inconsistent with the original study (56%, 95% CI 42-68%), among which a large number were reported to be efficacious in the original study and to lack efficacy in the reproduction attempt (34%, 95% CI 19-52%). Two practices reported to be efficacious in the original study were found to be harmful in the reproduction attempt. A minority of critical care practices with research published

  10. A microbiological and clinical review on Corynebacterium kroppenstedtii

    Directory of Open Access Journals (Sweden)

    Andreas Tauch

    2016-07-01

    Full Text Available The genus Corynebacterium represents a taxon of Gram-positive bacteria with a high G + C content in the genomic DNA. Corynebacterium kroppenstedtii is an unusual member of this taxon as it lacks the characteristic mycolic acids in the cell envelope. Genome sequence analysis of the C. kroppenstedtii type strain has revealed a lipophilic (lipid-requiring lifestyle and a remarkable repertoire of carbohydrate uptake and utilization systems. Clinical isolates of C. kroppenstedtii have been obtained almost exclusively from female patients and mainly from breast abscesses and cases of granulomatous mastitis. However, the role of C. kroppenstedtii in breast pathologies remains unclear. This review provides a comprehensive overview of the taxonomy, microbiology, and microbiological identification of C. kroppenstedtii, including polyphasic phenotypic approaches, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the use of 16S rRNA gene sequencing. A clinical review presents reported cases, various antimicrobial treatments, antibiotic susceptibility assays, and antibiotic resistance genes detected during genome sequencing. C. kroppenstedtii must be considered a potential opportunistic human pathogen and should be identified accurately in clinical laboratories.

  11. Review and classification of variability analysis techniques with clinical applications.

    Science.gov (United States)

    Bravi, Andrea; Longtin, André; Seely, Andrew J E

    2011-10-10

    Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis.

  12. Review and classification of variability analysis techniques with clinical applications

    Science.gov (United States)

    2011-01-01

    Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis. PMID:21985357

  13. Auditory and communicative abilities in the auditory neuropathy spectrum disorder and mutation in the Otoferlin gene: clinical cases study.

    Science.gov (United States)

    Costa, Nayara Thais de Oliveira; Martinho-Carvalho, Ana Claudia; Cunha, Maria Claudia; Lewis, Doris Ruthi

    2012-01-01

    This study had the aim to investigate the auditory and communicative abilities of children diagnosed with Auditory Neuropathy Spectrum Disorder due to mutation in the Otoferlin gene. It is a descriptive and qualitative study in which two siblings with this diagnosis were assessed. The procedures conducted were: speech perception tests for children with profound hearing loss, and assessment of communication abilities using the Behavioral Observation Protocol. Because they were siblings, the subjects in the study shared family and communicative context. However, they developed different communication abilities, especially regarding the use of oral language. The study showed that the Auditory Neuropathy Spectrum Disorder is a heterogeneous condition in all its aspects, and it is not possible to make generalizations or assume that cases with similar clinical features will develop similar auditory and communicative abilities, even when they are siblings. It is concluded that the acquisition of communicative abilities involves subjective factors, which should be investigated based on the uniqueness of each case.

  14. How can placebo effects best be applied in clinical practice? A narrative review

    Directory of Open Access Journals (Sweden)

    Bystad M

    2015-01-01

    Full Text Available Martin Bystad,1,2 Camilla Bystad,3 Rolf Wynn1,3 1Division of Addictions and Specialized Psychiatric Services, University Hospital of North Norway, 2Institute of Psychology, 3Institute of Clinical Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway Abstract: Placebo effects are documented in a number of clinical and experimental studies. It is possible to benefit from placebo effects in clinical practice by using them as effects additive to those of documented and effective treatments. The purpose of this paper is to discuss how doctors and other health workers may benefit from placebo effects within an ethical framework. A narrative review of the literature relating to placebo effects in clinical practice was performed. We searched PubMed and selected textbooks on placebo effects for articles and book chapters relating to placebo effects in clinical practice. By drawing on placebo effects, doctors may access patients’ self-healing potentials. In practice, doctors may best benefit from placebo effects by influencing the patient’s expectations through communication. An important principle is to give the patient information stating that a particular treatment is effective, as long as this is based on realistic optimism. A patient-centered style involving elements such as developing trust and respect, exploring the patient’s values, speaking positively about treatments, and providing reassurance and encouragement might aid in activating placebo effects. The total effect of a documented treatment will partly depend on how well the placebo effects have been activated. Thus, placebo effects can be understood as a form of supplemental treatment. Keywords: placebo effects, doctor-patient communication, expectations, biopsychosocial model

  15. Patients' poor communication with their doctors in the first visit of the gynecological endocrinology outpatient clinics.

    Science.gov (United States)

    Li, Xiao-Hong; Han, Zi-Yan; She, Wen-Jing; Lei, Hai-Ke

    2016-01-01

    To investigate patients' communication with their gynecologists in the first visit of the gynecological endocrinology outpatient clinics. We developed a questionnaire to evaluate 379 women' expectations of their first visit, information-giving about illness, and understanding of the consultation they encountered from April to August 2010. Descriptive statistics and multiple linear regression analysis were used to analyze the data. Before the first visit, 55% (208/379) of participants hoped to get the doctors' special attention, and 60% (227/379) of patients expected a very satisfying consultation. During the consultation, only 34% (129/379) of patients provided their case history clearly according to physicians' inquiry, 21% (81/379) of patients understood the examination and 28% (105/379) of patients understood the therapeutic regime after doctors' explanation. Correlation analysis showed that sociodemographic characteristics such as young age (under 20 years old), low level of education (primary school or less), and lack of medical knowledge affected patients' information-giving about illness and understanding of their first visit (all ps endocrinology outpatient clinics. They could not communicate well with their doctors, which was affected by age, education, and medical background.

  16. Summary of literature review of risk communication: Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    Byram, S.J.

    1991-05-01

    The Hanford Environmental Dose Reconstruction (HEDR) Project will estimate radiation exposures people may have received from radioactive materials released during past operations at the Department of Energy's Hanford Site near Richland, Washington. The project is being conducted by Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The Centers for Disease Control (CDC) will use HEDR dose estimates in studies to investigate a potential link between thyroid disease and historical Hanford emissions. The HEDR Project was initiated to address public concerns about the possible health impacts from past releases of radioactive materials from Hanford. The TSP recognized early in the project that special mechanisms would be required to communicate effectively to the many different concerned audiences. To identify and develop these mechanisms, the TSP issued Directive 89-7 to PNL in May 1989. The TSP directed PNL to examine methods to communicate the causes and effects of uncertainties in the dose estimates. A literature review was conducted as the first activity in response to the TSP's directive. This report presents the results of the literature review. The objective of the literature review was to identify ''key principles'' that could be applied to develop communications strategies for the project. 26 refs., 6 figs

  17. A systematic review of recruitment for older Chinese immigrants into clinical trials

    Directory of Open Access Journals (Sweden)

    Wen-Wen Li

    2016-07-01

    Full Text Available The purpose of this systematic review was to identify barriers and discuss strategies for recruitment of older Chinese immigrants into clinical research studies. A review was conducted using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA. PubMed, WEB of Science, CINAHL Plus, and the Cochrane Central Register of Controlled Trials were searched for articles published between 2001 and 2014. Empirical studies with Chinese immigrants aged 60 years or older were identified and analyzed. Numerical analysis, such as calculation of response rates as indexes for recruitment outcomes, was conducted. Content analyses for recruitment barriers were abstracted. Thirteen studies of 4,753 subjects were analyzed. Response rates ranged from 39% to 99%. Recruitment barriers included age (i.e., 60-70 years old, low health literacy, longer length of stay (LOS in the United States, limited English speaking ability, low acculturation, time constraints, inadequate transportation, social stigma about diseases, and mistrust of researchers. Recruitment can be facilitated by overcoming the aforementioned barriers, which included the following strategies: 1 using convenience sampling methods, particularly personal referral; 2 using special techniques to recruit a younger subgroup of Chinese elders, such as doing outreach on holidays or weekends; 3 communicating effectively using participants’ native language; 4 exercising cultural competency; 5 establishing relationships of trust with participants and community leaders; 6 answering misconceptions about clinical trials; 7 providing incentives for participation; and 8 proper selection of research and interview locations.

  18. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Science.gov (United States)

    Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

    2012-01-01

    Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first

  19. Cultural competency and communication skills of dental students: clinical supervisors' perceptions.

    Science.gov (United States)

    Mariño, R; Ghanim, A; Morgan, M; Barrow, S

    2017-11-01

    This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught. Semi-structured one-to-one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software. A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience. For most CS, cultural competence was an important part of the clinician-patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications.

    Science.gov (United States)

    Uljarević, Mirko; Katsos, Napoleon; Hudry, Kristelle; Gibson, Jenny L

    2016-11-01

    Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications. We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals. Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has

  1. Do U.S. family planning clinics encourage parent-child communication? Findings from an exploratory survey.

    Science.gov (United States)

    Jones, Rachel K

    2006-09-01

    Clinics that receive Title X funding have a mandate to encourage parent-child communication for minors seeking family planning services. Little is known about the programs and practices that clinics have adopted to achieve this goal, or whether clinics not receiving Title X funds encourage family participation. As part of a larger project examining parental engagement among adolescents using family planning clinics, 81 clinics that served 200 or more adolescent contraceptive clients in 2001 completed a questionnaire containing closed- and open-ended items. Topic areas included clinic counseling and policies regarding clients younger than 18, activities to improve parent-child communication and community relations. Frequency distributions were calculated for the prevalence of activities, and cross-tabulations were used to compare prevalence by clinic characteristics. Every clinic engaged in at least one activity to promote parent-child communication, and nine in 10 offered multiple activities. Most of the clinics used counseling sessions to talk to adolescent clients about the importance of discussing sexual health issues with parents (73-94%, depending on the reason for the visit). More than eight in 10 clinics (84%) distributed pamphlets on how to talk about these issues. A substantial minority (43%) offered or referred interested individuals to educational programs designed to improve communication. Some of these exploratory findings reflect the prevalence of activities among all U.S. family planning clinics that serve adolescent clients. Evaluation and expansion of clinic efforts to promote voluntary communication about sexual health issues between parents and children could help encourage family participation.

  2. Pouchitis: an evolving clinical enigma--a review.

    LENUS (Irish Health Repository)

    Coffey, John Calvin

    2009-01-01

    While the overall incidence of pouchitis is low, extensive research continues at clinical and experimental levels in attempts to unravel its etiology. The ileal pouch and pouchitis together represent a unique in vivo opportunity to study mucosal adaptation and inflammation in depth. In the recent past, molecular data relating to pouchitis has significantly expanded. These data provide invaluable insight into intracellular and extracellular events that underpin mucosal adaptation and inflammation. Advances in classification, risk factor evaluation, and prevention have meant that a review of this data, as well as its relationship to our current understanding of pouchitis, is both timely and warranted. Therefore, the aim of this review is to summarize recent data in the context of the established literature.

  3. Microcephalic Osteodysplastic Primordial Dwarfism, Type II: a Clinical Review.

    Science.gov (United States)

    Bober, Michael B; Jackson, Andrew P

    2017-04-01

    This review will provide an overview of the microcephalic primordial dwarfism (MPD) class of disorders and provide the reader comprehensive clinical review with suggested care guidelines for patients with microcephalic osteodysplastic primordial dwarfism, type II (MOPDII). Over the last 15 years, significant strides have been made in the diagnosis, natural history, and management of MOPDII. MOPDII is the most common and well described form of MPD. The classic features of the MPD group are severe pre- and postnatal growth retardation, with marked microcephaly. In addition to these features, individuals with MOPDII have characteristic facies, skeletal dysplasia, abnormal dentition, and an increased risk for cerebrovascular disease and insulin resistance. Biallelic loss-of-function mutations in the pericentrin gene cause MOPDII, which is inherited in an autosomal recessive manner.

  4. Fluid therapy in the perioperative setting-a clinical review

    DEFF Research Database (Denmark)

    Voldby, Anders Winther; Brandstrup, Birgitte

    2016-01-01

    BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review...... aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well...... for most patients. It is less expensive and simpler than the zero-balance GDT approach and therefore recommended in this review. In outpatient surgery, 1-2 L of balanced crystalloids reduces postoperative nausea and vomiting and improves well-being....

  5. Defibrotide: a review on clinical use and future development.

    Science.gov (United States)

    Larocca, A; Cavallo, F; Magarotto, V; Rossi, D; Patriarca, F; Boccadoro, M; Palumbo, A

    2008-08-01

    Defibrotide is a deoxyribonucleic acid derivative that has been developed for the treatment of different vascular disorders. The authors reviewed the literature to give due representation to the spectrum of pharmacological properties and clinical application of this drug, evaluating consolidate and innovative application. The authors used PubMed from November 1982 to December 2007 and meeting abstracts (form American Society of Hematology Annual Meeting) with updated data as the sources for this review and selecting the most relevant papers when two or more articles covered the same point of interest. Defibrotide has been used effectively in the treatment of endothelial complications of allogeneic stem cell transplantation and recent preclinical evidences suggest an antiangiogenic effect and an anticancer activity. Further in vivo and in vitro investigations are needed.

  6. Clinical nursing and midwifery research in Middle Eastern and North African Countries: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Malak Alashal Alhusaini

    2016-01-01

    Full Text Available The professions of nursing and midwifery currently face many challenges, such as an increasing number of patients with communicable and non-communicable diseases, which strains resources and requires nurses and midwives to develop their knowledge and skills to a higher level. This is also true in the Middle East, including the Mediterranean East and North African regions, which means it is vitally important that nurses and midwives have access to and use current research to inform their practice, with research targeting the most relevant issues, including complex humanitarian emergency situations that increase health issues and challenge health infrastructure. For this to be achieved, a scoping review of the indexed clinical nursing and midwifery literature in the Middle East was performed to identify gaps in clinical nursing and midwifery research and areas requiring focus. A search of PubMed, CINAHL/EBSCO, EMBASE, the Jordanian Database for Nursing Research resulted in 210/1398 articles which met the inclusion criteria: (1 original research, (2 conducted in Middle Eastern countries as defined by the World Health Organization, (3 had at least one nurse or midwife author (but not limited to nurses in Middle Eastern countries, (4 published in an indexed, peer-reviewed journal between January 1, 2000, and December 31, 2015, (5 included patient outcomes in the results, (6 written in English or Arabic and (7 included an abstract. Studies were found from 10 of the 22 countries; the majority (n = 199; 94.76% was conducted in three countries: Jordan, Iran and Lebanon. Most studies (n = 158, 75.24% used quantitative designs, primarily cross-sectional, descriptive studies (n = 106 and the most frequently researched topics were related to maternal child health and women′s health (n = 95, 48.5%. Strategies are needed to encourage collaboration between nursing and midwifery faculty members including clinicians to assure that clinical research is

  7. Addressing unwarranted clinical variation: A rapid review of current evidence.

    Science.gov (United States)

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  8. Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature

    International Nuclear Information System (INIS)

    Brunskill, Kelsey; Nguyen, Timothy K.; Boldt, R. Gabriel; Louie, Alexander V.; Warner, Andrew; Marks, Lawrence B.; Palma, David A.

    2017-01-01

    Purpose: Peer review is a recommended component of quality assurance in radiation oncology; however, it is resource-intensive and its effect on patient care is not well understood. We conducted a systematic review of the published data to assess the reported clinical impact of peer review on radiation treatment plans. Methods and Materials: A systematic review of published English studies was performed in accordance with the PRISMA guidelines using the MEDLINE and EMBASE databases and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, the studies were required to report the effect of peer review on ≥1 element of treatment planning (eg, target volume or organ-at-risk delineation, dose prescription or dosimetry). Results: The initial search strategy identified 882 potentially eligible studies, with 11 meeting the inclusion criteria for full-text review and final analysis. Across a total of 11,491 patient cases, peer review programs led to modifications in a weighted mean of 10.8% of radiation treatment plans. Five studies differentiated between major and minor changes and reported weighted mean rates of change of 1.8% and 7.3%, respectively. The most common changes were related to target volume delineation (45.2% of changed plans), dose prescription or written directives (24.4%), and non-target volume delineation or normal tissue sparing (7.5%). Conclusions: Our findings suggest that peer review leads to changes in clinical care in approximately 1 of every 9 cases overall. This is similar to the reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.

  9. Social Media and HIV: A Systematic Review of Uses of Social Media in HIV Communication.

    Science.gov (United States)

    Taggart, Tamara; Grewe, Mary Elisabeth; Conserve, Donaldson F; Gliwa, Catherine; Roman Isler, Malika

    2015-11-02

    Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread. The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment. This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs. The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and receive information about HIV was

  10. Social Media and HIV: A Systematic Review of Uses of Social Media in HIV Communication

    Science.gov (United States)

    Grewe, Mary Elisabeth; Conserve, Donaldson F; Gliwa, Catherine; Roman Isler, Malika

    2015-01-01

    Background Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread. Objective The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment. Methods This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs. Results The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and

  11. Transferring clinical communication skills from the classroom to the clinical environment: perceptions of a group of medical students in the United kingdom.

    Science.gov (United States)

    Brown, Jo

    2010-06-01

    To better understand the transfer of classroom-learned clinical communication skills (CCS) to the clinical environment of the hospital ward, where they are practiced and refined by students. The author first briefly presents the literature on clinical communication, provides an overview of the debates around the notion of transfer, and presents a sociocultural model of developmental transfer applied to CCS learning. Second, she describes a focus group and nine individual interviews carried out with 17 fourth-year medical students at one medical school in the United Kingdom in 2008. The goal was to elicit their views of CCS teaching, learning, and transfer of CCS to the clinical workplace. The findings are presented under the four main themes of transition, where students experienced the transition from the medical school to the hospital ward as a mixture of positive and negative impacts on transferring their CCS skills; the clinical culture, where senior doctors had the greatest impact on student learning and emergent clinical practice; clinical communication as a vehicle for professionalism and being a "good" doctor; and, finally, transfer mechanisms, where simulated practice with actors and the clinical history template were powerful learning tools. Findings indicate that more needs to be done to support, develop, and embed CCS into the professional practice of medical students in the clinical workplace. This may be achieved by greater collaboration of educators in the academic and clinical environments. Using the developmental transfer model applied to CCS learning may help foster this relationship.

  12. Skeletal Muscle Laminopathies: A Review of Clinical and Molecular Features

    Directory of Open Access Journals (Sweden)

    Lorenzo Maggi

    2016-08-01

    Full Text Available LMNA-related disorders are caused by mutations in the LMNA gene, which encodes for the nuclear envelope proteins, lamin A and C, via alternative splicing. Laminopathies are associated with a wide range of disease phenotypes, including neuromuscular, cardiac, metabolic disorders and premature aging syndromes. The most frequent diseases associated with mutations in the LMNA gene are characterized by skeletal and cardiac muscle involvement. This review will focus on genetics and clinical features of laminopathies affecting primarily skeletal muscle. Although only symptomatic treatment is available for these patients, many achievements have been made in clarifying the pathogenesis and improving the management of these diseases.

  13. Operating room use of hypertonic solutions: a clinical review

    Directory of Open Access Journals (Sweden)

    Gustavo Azoubel

    2008-01-01

    Full Text Available Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.

  14. Clinical uses of the medicinal leech: A practical review

    Directory of Open Access Journals (Sweden)

    B S Porshinsky

    2011-01-01

    Full Text Available The medicinal leech, Hirudo medicinalis, is an excellent example of the use of invertebrates in the treatment of human disease. Utilized for various medical indications since the ancient times, the medicinal leech is currently being used in a narrow range of well-defined and scientifically-grounded clinical applications. Hirudotherapy is most commonly used in the setting of venous congestion associated with soft tissue replantations and free flap-based reconstructive surgery. This is a comprehensive review of current clinical applications of hirudotherapy, featuring a comprehensive search of all major medical search engines (i.e. PubMed, Google Scholar, ScientificCommons and other cross-referenced sources. The authors focus on indications, contraindications, practical application/handling of the leech, and therapy-related complications.

  15. Teaching communication skills: beyond wishful thinking.

    Science.gov (United States)

    Junod Perron, Noelle; Sommer, Johanna; Louis-Simonet, Martine; Nendaz, Mathieu

    2015-01-01

    Communication skills tend to decline with time unless they are regularly recalled and practiced. However, most medical schools still deliver clinical communication training only during pre-clinical years although the clinical environment is considered to be ideal for acquiring and teaching clinical communication. The aim of this article is to review the barriers that prevent communication skills teaching and training from occurring in clinical practice and describe strategies that may help enhance such activities. Barriers occur at several levels: students, junior doctors and clinical supervisors sometimes have negative attitudes towards communication training; structured training in communication skills is often insufficient; clinical supervisors behave as poor role models and lack effective communication and teaching skills; finally, there are organisational constraints such as lack of time, competing priorities, weak hierarchy support and lack of positive incentives for using, training or teaching good communication skills in clinical practice. Given the difficulty of assessing transfer of communication skills in practice, only few studies describe successful educational interventions. In order to optimise communication skills learning in practice, there is need to: (1.) modify the climate and structure of the working environment so that that use, training and teaching of good communication skills in clinical practice becomes valued, supported and rewarded; (2.) extend communication skills training to any field of medicine; (3.) provide regular structured trainings and tailor them to trainees' needs. Practical implications of such findings are discussed at the end of this review.

  16. Urinary tract infections in older women: a clinical review.

    Science.gov (United States)

    Mody, Lona; Juthani-Mehta, Manisha

    2014-02-26

    Asymptomatic bacteriuria and symptomatic urinary tract infections (UTIs) in older women are commonly encountered in outpatient practice. To review management of asymptomatic bacteriuria and symptomatic UTI and review prevention of recurrent UTIs in older community-dwelling women. A search of Ovid (Medline, PsycINFO, Embase) for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. The clinical spectrum of UTIs ranges from asymptomatic bacteriuria, to symptomatic and recurrent UTIs, to sepsis associated with UTI requiring hospitalization. Recent evidence helps differentiate asymptomatic bacteriuria from symptomatic UTI. Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality. The diagnosis of symptomatic UTI is made when a patient has both clinical features and laboratory evidence of a urinary infection. Absent other causes, patients presenting with any 2 of the following meet the clinical diagnostic criteria for symptomatic UTI: fever, worsened urinary urgency or frequency, acute dysuria, suprapubic tenderness, or costovertebral angle pain or tenderness. A positive urine culture (≥105 CFU/mL) with no more than 2 uropathogens and pyuria confirms the diagnosis of UTI. Risk factors for recurrent symptomatic UTI include diabetes, functional disability, recent sexual intercourse, prior history of urogynecologic surgery, urinary retention, and urinary incontinence. Testing for UTI is easily performed in the clinic using dipstick tests. When there is a low pretest probability of UTI, a negative dipstick result for leukocyte esterase and nitrites excludes infection. Antibiotics are selected by identifying the uropathogen, knowing local resistance rates, and considering adverse effect profiles. Chronic suppressive antibiotics for 6 to 12 months and vaginal estrogen therapy effectively reduce

  17. Improving clinical communication of students with English as a second language (ESL) using online technology: a small scale evaluation study.

    Science.gov (United States)

    Rogan, Fran; San Miguel, Caroline

    2013-09-01

    Increasingly, students with English as a second language (ESL) are enrolled in nursing degrees in English speaking countries (Wang et al., 2008). However, they may be at risk of clinical practice failure due to communication difficulties associated with unfamiliar linguistic and cultural factors (Guhde, 2003). This paper describes and evaluates an innovation to assist ESL nursing students at an Australian university develop their clinical communication skills and practice readiness by providing online learning resources, using podcast and vodcast technology, that blend with classroom activities and facilitate flexible and independent learning. The innovation builds on an intensive clinical language workshop program called 'Clinically Speaking' which has evolved through a cyclical process of ongoing research to produce resources in response to students' learning needs. Whilst uptake of the resources was modest, students of ESL as well as English speaking backgrounds (ESB) found the resources improved their clinical preparation and confidence by increasing their understanding of expectations, clinical language and communication skills. The innovation, developed with a modest budget, shows potential in developing ESL and ESB students' readiness for clinical communication, enabling them to engage in clinical practice to develop competency standards required of nursing graduates and registration authorities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Management of language discordance in clinical nursing practice--A critical review.

    Science.gov (United States)

    Probst, Sebastian; Imhof, Lorenz

    2016-05-01

    Language plays an essential role in the provision of nursing care, since successful communication is a vital prerequisite to being able to provide appropriate nursing care efficiently and effectively. It is not known what kinds of interventions are effective in overcoming language discordance in nursing practice. This critical review aimed to examine the interventions that are most successfully used to overcome language discordance in nursing. A critical review of the literature was performed and 24 relevant research papers were included. A search was carried out between January 2004 and September 2014 in MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychinfo, Germanistic online, Pragmatis and Linguistic & Language Behaviour Abstracts (LLBA). Both authors independently screened the titles (n=299), abstracts and full texts to decide which articles should be chosen. The inclusion criteria were: (1) articles examine the problem of language discordance in various health care settings and (2) articles published in English, German, French or Italian. Articles were included irrespective of their design. Data were analysed using the Critical Appraisal Skills Program Tool (CASP). In total, 24 publications met the inclusion criteria. Most of the studies (n=20) were focused on the nursing intervention of using an interpreter and three were describing the nursing assessment. The study designs of the included studies were mainly non-experimental studies, qualitative studies or reviews. The only suggested intervention described in the articles is the use of ad-hoc or professional interpreters for communicating with patients who do not speak the local language. Health care institutions should provide more strategies for clinical practice to overcome language discordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Message Framing in Vaccine Communication: A Systematic Review of Published Literature.

    Science.gov (United States)

    Penţa, Marcela A; Băban, Adriana

    2018-03-01

    Suboptimal vaccination rates are a significant problem in many countries today, in spite of improved access to vaccine services. As a result, there has been a recent expansion of research on how best to communicate about vaccines. The purpose of the present article is to provide an updated review of published, peer-reviewed empirical studies that examined the effectiveness of gain versus loss framing (i.e., goal framing) in the context of vaccine communication. To locate studies, we examined the reference list from the previous meta-analytic review (O'Keefe & Nan, 2012), and we conducted systematic searches across multiple databases. We included 34 studies in the qualitative synthesis. The relative effectiveness of goal-framed vaccine messages was often shown to depend on characteristics of the message recipient, perceived risk, or situational factors, yet most effects were inconsistent across studies, or simply limited by an insufficient number of studies. Methodological characteristics and variations are noted and discussed. The review points to several directions concerning moderators and mediators of framing effects where additional rigorous studies would be needed.

  20. How is communication of vaccines in traditional media: a systematic review.

    Science.gov (United States)

    Catalan-Matamoros, Daniel; Peñafiel-Saiz, Carmen

    2018-06-01

    Taking into account that a key determinant in public approval of vaccinations is how the media constructs and frames messages about vaccination programmes, our aim is to review communication studies exploring media coverage of vaccines within traditional media venues. Using a registered protocol (PROSPERO: 42017072849), a systematic review was conducted that searched in three international electronic databases (PubMed, Scopus, and the International Bibliography of Social Science) for articles published between 2007 and 2017 following content-analysis methods. The characteristics and outcomes were systematically identified and described. The search yielded 24 eligible studies that were further analysed in the review. Media coverage of vaccines has been largely studied during the last decade. Findings revealed that 62% ( n = 15) of studies analysed the human papillomavirus vaccine, 87% ( n = 21) examined newspapers, and 62% ( n = 15) examined North American media. In relation to media content analyses, 75% found negative messages on vaccines and 83% identified a lack of accurate information. This systematic review suggests an agenda for further research. There is a significant need to analyse other types of traditional media beyond newspapers. Future studies should focus on other geographical areas such as low-income countries and on analysing visual materials and digital media. We found that negative messages and inaccurate information are common in media coverage on vaccines; therefore, further research focusing on these topics is needed. Officials in public health organizations should develop a close collaboration with the media to improve public communication on vaccines.

  1. Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review.

    Science.gov (United States)

    Alkureishi, Maria Alcocer; Lee, Wei Wei; Lyons, Maureen; Press, Valerie G; Imam, Sara; Nkansah-Amankra, Akua; Werner, Deb; Arora, Vineet M

    2016-05-01

    While Electronic Medical Record (EMR) use has increased dramatically, the EMR's impact on the patient-doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient-doctor relationships and communication. Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient-doctor communication. English language observational or interventional studies (1995-2015) were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes. Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure communication behaviors using video or direct observation and pre-post or cross-sectional surveys to examine patient perceptions (25). Objective studies reported EMR communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, communication or the patient-doctor relationship (n = 22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings. Despite objective evidence that EMR use may negatively impact patient-doctor communication, studies examining patient perceptions found no change in patient satisfaction or patient-doctor communication. Therefore, our findings should encourage providers to adopt the EMR as a communication tool. Future research is needed to better understand how

  2. Clinical TVA-based studies: a general review

    Directory of Open Access Journals (Sweden)

    Thomas eHabekost

    2015-03-01

    Full Text Available In combination with whole report and partial report tasks, the Theory of Visual Attention (TVA can be used to estimate individual differences in five basic attentional parameters: The visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top-down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a neglect and simultanagnosia, (b reading disturbances, (c aging and neurodegenerative diseases, and most recently (d neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method’s most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research.

  3. Clinical ethics and patient advocacy: the power of communication in health care.

    Science.gov (United States)

    Emrich, Inken Annegret; Fröhlich-Güzelsoy, Leyla; Bruns, Florian; Friedrich, Bernd; Frewer, Andreas

    2014-06-01

    In recent years, the rights of patients have assumed a more pivotal role in international discussion. Stricter laws on the protection of patients place greater priority on the perspective and the status of patients. The purpose of this study is to emphasize ethical aspects in communication, the role of patient advocates as contacts for the concerns and suggestions of patients, and how many problems of ethics disappear when communication is highlighted. We reviewed 680 documented cases of consultation in a 10-year period of patient advocates' activity at a big German university hospital with 1,300 beds. On the basis of this extensive material, the article will focus on the intersection of the advocate's work with the problems of patients in hospitals. Deficits in the level of communication between health care professionals and patients were frequently uncovered. Patients primarily complain about the lack of dialogue and empathy. Middle-aged patients consulted the patients' advocate disproportionately more often. Measured against this baseline, the group of 65 and older complained less frequently. Besides complaint