WorldWideScience

Sample records for providing fluid communication

  1. Communication in Pipes Using Acoustic Modems that Provide Minimal Obstruction to Fluid Flow

    Science.gov (United States)

    Bar-Cohen, Yoseph (Inventor); Archer, Eric D. (Inventor); Bao, Xiaoqi (Inventor); Sherrit, Stewart (Inventor)

    2016-01-01

    A plurality of phased array acoustic communication devices are used to communicate data along a tubulation, such as a well. The phased array acoustic communication devices employ phased arrays of acoustic transducers, such as piezoelectric transducers, to direct acoustic energy in desired directions along the tubulation. The system is controlled by a computer-based controller. Information, including data and commands, is communicated using digital signaling.

  2. Effective communication with primary care providers.

    Science.gov (United States)

    Smith, Karen

    2014-08-01

    Effective communication requires direct interaction between the hospitalist and the primary care provider using a standardized method of information exchange with the opportunity to ask questions and assign accountability for follow-up roles. The discharge summary is part of the process but does not provide the important aspects of handoff, such as closed loop communication and role assignments. Hospital discharge is a significant safety risk for patients, with more than half of discharged patients experiencing at least one error. Hospitalist and primary care providers need to collaborate to develop a standardized system to communicate about shared patients that meets handoff requirements. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Parent-provider communication during hospitalization.

    Science.gov (United States)

    Fisher, Mark J; Broome, Marion E

    2011-02-01

    Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. SPACEWAY: Providing affordable and versatile communication solutions

    Science.gov (United States)

    Fitzpatrick, E. J.

    1995-08-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  5. Effects of fluid communications between fluid volumes on the seismic behaviour of nuclear breeder reactor internals

    International Nuclear Information System (INIS)

    Durandet, E.; Gibert, R.J.

    1987-01-01

    The internal structures of a breeder reactor as SUPERPHENIX are mainly axisymmetrial shells separated by fluid volumes which are connected by small communications holes. These communications can destroy the axisymmetry of the problem and their effects on the inertial terms due to the fluid are important. An equivalent axisymmetrical element based on a local tridimensional solution in the vicinity of the fluid communication is defined. An axisymmetrical modelization using this type of element is built in order to calculate the horizontal seismic behaviour of the reactor internals. The effect due to three typical fluid communications are studied and compared. (orig.)

  6. Health Care Provider Accommodations for Patients with Communication Disorders

    Science.gov (United States)

    Burns, Michael I.; Baylor, Carolyn; Dudgeon, Brian J.; Starks, Helene; Yorkston, Kathryn

    2017-01-01

    Health care providers can experience increased diffculty communicating with adult patients during medical interactions when the patients have communication disorders. Meeting the communication needs of these patients can also create unique challenges for providers. The authors explore Communication Accommodation Theory (H. Giles, 1979) as a guide…

  7. Fluid structure interaction due to fluid communications between fluid volumes. Application to seismic behaviour of F.B.R. vessels

    International Nuclear Information System (INIS)

    Durandet, E.; Gibert, R.J.; Gantenbein, F.

    1988-01-01

    The internal structures of a pool-type breeder reactor are mainly axisymmetric shells separated by fluid volumes which are connected one to another by small communications. Unfortunately, the communications destroy the axisymmetry of the problem and a correct modelisation by finite element method generally need a lot of small elements compared to the size of the standard mesh of the fluid volumes. To overcome these difficulties, an equivalent axisymmetric element based on a local tridimensional solution in the vicinity of the fluid communication is defined and will be described in the paper. This special fluid element is characterized by an equivalent length and annular cross-section. The second part of the paper is devoted to the application to an horizontal seismic calculation of breeder reactor

  8. Standardizing communication from acute care providers to primary care providers on critically ill adults.

    Science.gov (United States)

    Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

    2015-11-01

    To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

  9. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

    2017-06-08

    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in

  10. Healthcare Providers' Responses to Narrative Communication About Racial Healthcare Disparities.

    Science.gov (United States)

    Burgess, Diana J; Bokhour, Barbara G; Cunningham, Brooke A; Do, Tam; Gordon, Howard S; Jones, Dina M; Pope, Charlene; Saha, Somnath; Gollust, Sarah E

    2017-10-25

    We used qualitative methods (semi-structured interviews with healthcare providers) to explore: 1) the role of narratives as a vehicle for raising awareness and engaging providers about the issue of healthcare disparities and 2) the extent to which different ways of framing issues of race within narratives might lead to message acceptance for providers' whose preexisting beliefs about causal attributions might predispose them to resist communication about racial healthcare disparities. Individual interviews were conducted with 53 providers who had completed a prior survey assessing beliefs about disparities. Participants were stratified by the degree to which they believed providers contributed to healthcare inequality: low provider attribution (LPA) versus high provider attribution (HPA). Each participant read and discussed two differently framed narratives about race in healthcare. All participants accepted the "Provider Success" narratives, in which interpersonal barriers involving a patient of color were successfully resolved by the provider narrator, through patient-centered communication. By contrast, "Persistent Racism" narratives, in which problems faced by the patient of color were more explicitly linked to racism and remained unresolved, were very polarizing, eliciting acceptance from HPA participants and resistance from LPA participants. This study provides a foundation for and raises questions about how to develop effective narrative communication strategies to engage providers in efforts to reduce healthcare disparities.

  11. Improving Interdisciplinary Provider Communication Through a Unified Paging System.

    Science.gov (United States)

    Heidemann, Lauren; Petrilli, Christopher; Gupta, Ashwin; Campbell, Ian; Thompson, Maureen; Cinti, Sandro; Stewart, David A

    2016-06-01

    Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported. House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project. House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%). Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

  12. Research and Practice Communications Between Oral Health Providers and Prenatal Health Providers: A Bibliometric Analysis.

    Science.gov (United States)

    Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika

    2016-08-01

    Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.

  13. Multicomponent reactions provide key molecules for secret communication.

    Science.gov (United States)

    Boukis, Andreas C; Reiter, Kevin; Frölich, Maximiliane; Hofheinz, Dennis; Meier, Michael A R

    2018-04-12

    A convenient and inherently more secure communication channel for encoding messages via specifically designed molecular keys is introduced by combining advanced encryption standard cryptography with molecular steganography. The necessary molecular keys require large structural diversity, thus suggesting the application of multicomponent reactions. Herein, the Ugi four-component reaction of perfluorinated acids is utilized to establish an exemplary database consisting of 130 commercially available components. Considering all permutations, this combinatorial approach can unambiguously provide 500,000 molecular keys in only one synthetic procedure per key. The molecular keys are transferred nondigitally and concealed by either adsorption onto paper, coffee, tea or sugar as well as by dissolution in a perfume or in blood. Re-isolation and purification from these disguises is simplified by the perfluorinated sidechains of the molecular keys. High resolution tandem mass spectrometry can unequivocally determine the molecular structure and thus the identity of the key for a subsequent decryption of an encoded message.

  14. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    Science.gov (United States)

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

  15. Science Communications: Providing a Return on Investment to the Taxpayer

    Science.gov (United States)

    Horack, John M.; Borchelt, Rick E.

    1999-01-01

    Nowhere is the disconnect between needing to better communicate science and technology and the skills and techniques used for that communication more evident than in the Federal research enterprise. As Federal research budgets stagnate or decline, and despite public clamor for more and better scientific information, communication of basic research results continues to rank among the lowest agency priorities, mortgaged against traditional public-relations activities to polish an agency's image or control negative information flow to the press and public. Alone among the Federal agencies, NASA articulates in its strategic plan the need "...to advance and communicate scientific knowledge and understanding..." These words emphasize the reality that if new knowledge is generated but not communicated, only half the job has been done. This is a reflection of the transition of NASA from primarily an engineering organization used to help win the Cold War to a producer of new knowledge and technology in the National interest for the 21st century.

  16. Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review.

    Science.gov (United States)

    Luu, Ngoc-Phuong; Pitts, Samantha; Petty, Brent; Sawyer, Melinda D; Dennison-Himmelfarb, Cheryl; Boonyasai, Romsai Tony; Maruthur, Nisa M

    2016-04-01

    Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care. We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool. Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26). The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.

  17. How the Ethnography of Communication Provides Resources for Design

    Science.gov (United States)

    Leighter, James L.; Rudnick, Lisa; Edmonds, Theresa J.

    2013-01-01

    Designing solutions to social problems requires some degree of interpretive accountability to the sociocultural systems in which design solutions must live. Our case studies show how ethnography of communication research generates distinctive resources for design. (Contains 5 notes.)

  18. Humor as a Communication Strategy in Provider-Patient Communication in a Chronic Care Setting.

    Science.gov (United States)

    Schöpf, Andrea C; Martin, Gillian S; Keating, Mary A

    2017-02-01

    Humor is a potential communication strategy to accomplish various and potentially conflicting consultation goals. We investigated humor use and its reception in diabetes consultations by analyzing how and why humor emerges and its impact on the interaction. We did this by using an interactional sociolinguistics approach. We recorded 50 consultations in an Irish diabetes setting. Analysis of the humor events drew on framework analysis and on concepts from Conversation Analysis and pragmatics. The study also comprised interviews using tape-assisted recall. We identified 10 humor functions and two umbrella functions. A key finding is that most humor is relationship-protecting humor initiated by patients, that is, they voice serious messages and deal with emotional issues through humor. Our findings imply that patients' and providers' awareness of indirect communication strategies needs to be increased. We also recommend that researchers employ varied methods to adequately capture the interactive nature of humor.

  19. Methodical Approaches to Communicative Providing of Retailer Branding

    Directory of Open Access Journals (Sweden)

    Andrey Kataev

    2017-07-01

    Full Text Available The thesis is devoted to the rationalization of methodical approaches for provision of branding of retail trade enterprises. The article considers the features of brand perception by retail consumers and clarifies the specifics of customer reviews of stores for the procedures accompanying brand management. It is proved that besides traditional communication mix, the most important tool of communicative influence on buyers is the store itself as a place for comfortable shopping. The shop should have a stimulating effect on all five human senses, including sight, smell, hearing, touch, and taste, which shall help maximize consumer integration into the buying process.

  20. FameLab provides competition and coaching on science communication

    Science.gov (United States)

    Scalice, Daniella; Weiss, Peter

    2012-10-01

    In today's media-intensive environment, the ability to convey science can reshape the face of scientific exploration and discovery. Many early-career scientists could benefit from training on how to communicate their work effectively to all stakeholders along their career paths, from deans and political representatives to neighbors and students, and perhaps even to public audiences through the lens of a camera or the voice of a blog.

  1. 30 seismic analysis of FBR vessels: Coupling between components and vessels, fluid communications, imperfections

    International Nuclear Information System (INIS)

    Gantenbein, F.; Gibert, R.J.; Aita, S.; Durandet, E.

    1988-01-01

    The internal structures of a loop type breeder reactors such as SUPERPHENIX are composed of axisymmetrical shells separated by fluid volumes. Seismic analysis is usually performed by axisymmetric finite element model taking into account fluid structure interaction but the geometry is in fact 3D due to components, small communications between fluid volumes and imperfections in the vessels. The methods to take this 3D behaviour into account are based on Fourier decomposition of the motion and substructuration. They are briefly described in the following chapters. The influence of components and of small communications on a block reactor similar to SPX1 will also be presented. 15 refs, 20 figs

  2. Providers' perceptions of communication with patients in primary healthcare in Rwanda.

    Science.gov (United States)

    Cubaka, Vincent Kalumire; Schriver, Michael; Cotton, Philip; Nyirazinyoye, Laetitia; Kallestrup, Per

    2018-01-01

    Delivery of effective healthcare is contingent on the quality of communication between the patient and the healthcare provider. Little is known about primary healthcare providers' perceptions of communication with patients in Rwanda. To explore providers' perceptions of patient-provider communication (PPC) and analyse the ways in which providers present and reflect on communication practice and problems. Qualitative, in-depth, semi structured interviews with nine primary health care providers. An abductive analysis supplemented by the framework method was applied. A narrative approach allowed the emergence of archetypical narratives on PPC. Providers shared rich reflections on the importance of proper communication with patients and appeared committed to making their interaction work optimally. Still, providers had difficulty critically analysing limitations of their communication in practice. Reported communication issues included lack of communication training as well as time and workload issues. Two archetypes of narratives on PPC issues and practice emerged and are discussed. While providers' narratives put patients at the centre of care, there were indications that patient-provider communication training and practice need further development. In-depth exploration of highlighted issues and adapted strategies to tackle communication drawbacks are prerequisites to improvement. This study contributes to the advancement of knowledge related to communication between the patient and the provider in a resource-limited setting.

  3. Sexual health communication between cancer survivors and providers: how frequently does it occur and which providers are preferred?

    Science.gov (United States)

    Sporn, Nora J; Smith, Kelly B; Pirl, William F; Lennes, Inga T; Hyland, Kelly A; Park, Elyse R

    2015-09-01

    Sexual health concerns in cancer survivors are often unaddressed by providers. Study objectives were to assess cancer survivors' reported rates of communication with oncology providers about sexual health, preference for such communication with their oncology or primary care providers (PCPs), and factors associated with these communication rates and preferences. Sixty-six patients attending a cancer survivorship clinic were asked how often their oncologist addressed and initiated discussion about sexual functioning and whether they wanted their oncologist or PCP to ask about their sexual health. We also assessed whether various sociodemographic characteristics and levels of depression, anxiety, and sexual satisfaction were associated with survivors' sexual health communication rates and preferences. 41% of patients wanted their oncologist to ask about sexual health and 58% of patients wanted their PCP to ask about sexual health. Over 90% of patients reported that their oncologist infrequently addressed sexual health concerns and that their oncologist was unlikely to initiate such discussions. Education level influenced whether patients wanted their oncologist to ask about sexual health. Age, education level, and insurance type influenced whether patients wanted their PCP to ask about sexual health. Levels of depression, anxiety, and sexual satisfaction were not associated with communication rates or preferences. Patients attending a survivorship clinic reported infrequent communication about sexual health with their oncology providers, despite wanting their providers to ask about sexual health concerns. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

    Science.gov (United States)

    Ulrey, K L; Amason, P

    2001-01-01

    Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication.

  5. Can risk communication provide assistance in nuclear energy disputes?

    International Nuclear Information System (INIS)

    Meadd, Ellen

    2001-01-01

    The continued use of nuclear technology in Canada appears to he limited by a lack of public acceptance of fuel waste disposal strategies. The outcome of the recent environmental assessment process conducted on the deep geological disposal concept bears-out this point. A brief review of transcripts from the he public hearing portion of this process indicates that public sentiment on the issue includes anti-nuclear attitudes and concern over equity, safety, and trust. This paper discusses Canadian sentiment on the issue and suggests that it is in line with public views on similar issues in other nations. The field of risk communication has played a significant role in understanding the root causes of public opposition. This paper suggests that the field is well-placed to play an expanded role in resolving the issues underlying public concerns, (e.g., lack of trust, public disenfranchisement with the decision making process); however, this is a supportive role. It is suggested that broad-based involvement, commitment, and collaboration among all stake holders in this dispute are necessary if improvement is to be achieved. (author)

  6. The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol.

    Science.gov (United States)

    Manojlovich, Milisa; Adler-Milstein, Julia; Harrod, Molly; Sales, Anne; Hofer, Timothy P; Saint, Sanjay; Krein, Sarah L

    2015-06-11

    Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. This 4-year study uses a sequential mixed-methods design, beginning with a

  7. MEDICARE: Improvements Needed in Provider Communications and Contracting Procedures

    National Research Council Canada - National Science Library

    Aronovitz, Leslie

    2001-01-01

    .... Under Medicare's fee-for-service system-which accounts for over 80 percent of program beneficiaries physicians, hospitals, and other providers submit claims to receive reimbursement for services...

  8. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research.

    Science.gov (United States)

    Hemsley, Bronwyn; Balandin, Susan

    2014-12-01

    Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.

  9. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.

    Science.gov (United States)

    Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C

    2013-11-04

    Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

  10. Understanding Family Caregiver Communication to Provide Family-Centered Cancer Care.

    Science.gov (United States)

    Wittenberg, Elaine; Buller, Haley; Ferrell, Betty; Koczywas, Marianna; Borneman, Tami

    2017-12-01

    To describe a family caregiver communication typology and demonstrate identifiable communication challenges among four caregiver types: Manager, Carrier, Partner, and Lone. Case studies based on interviews with oncology family caregivers. Each caregiver type demonstrates unique communication challenges that can be identified. Recognition of a specific caregiver type will help nurses to adapt their own communication to provide tailored support. Family-centered cancer care requires attention to the communication challenges faced by family caregivers. Understanding the challenges among four family caregiver communication types will enable nurses to better address caregiver burden and family conflict. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

    Science.gov (United States)

    2013-01-01

    Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff

  12. The influence of Hispanic ethnicity on parent-provider communication about asthma.

    Science.gov (United States)

    Carlin, Courtney; Yee, Alison B; Fagnano, Maria; Halterman, Jill S

    2014-04-01

    Research has shown that minority caregivers of children with asthma report poorer communication with health care providers than nonminority caregivers. Less is known about the specific influence of Hispanic ethnicity on parent-provider communication. Our objective was to evaluate the influence of Hispanic ethnicity on parent-provider communication regarding their child's asthma and on caregiver confidence in communicating with their child's provider at a primary care visit. Data were obtained from 166 caregivers of children (2-12 years) with persistent asthma. Caregiver perceptions of provider communication and confidence were evaluated. We found that Hispanic compared to non-Hispanic caregivers reported better communication with providers on several items. Hispanic caregivers also were more likely to indicate full confidence in their ability to communicate with providers. These findings suggest Hispanic caregivers may experience better parent-provider communication than non-Hispanics. Further investigation is needed to assess provider- and clinic-specific factors that may influence communication between minority caregivers and providers.

  13. Multidimensional proteomics analysis of amniotic fluid to provide insight into the mechanisms of idiopathic preterm birth.

    Directory of Open Access Journals (Sweden)

    Irina A Buhimschi

    2008-04-01

    Full Text Available Though recent advancement in proteomics has provided a novel perspective on several distinct pathogenetic mechanisms leading to preterm birth (inflammation, bleeding, the etiology of most preterm births still remains elusive. We conducted a multidimensional proteomic analysis of the amniotic fluid to identify pathways related to preterm birth in the absence of inflammation or bleeding.A proteomic fingerprint was generated from fresh amniotic fluid using surface-enhanced laser desorbtion ionization time of flight (SELDI-TOF mass spectrometry in a total of 286 consecutive samples retrieved from women who presented with signs or symptoms of preterm labor or preterm premature rupture of the membranes. Inflammation and/or bleeding proteomic patterns were detected in 32% (92/286 of the SELDI tracings. In the remaining tracings, a hierarchical algorithm was applied based on descriptors quantifying similarity/dissimilarity among proteomic fingerprints. This allowed identification of a novel profile (Q-profile based on the presence of 5 SELDI peaks in the 10-12.5 kDa mass area. Women displaying the Q-profile (mean+/-SD, gestational age: 25+/-4 weeks, n = 40 were more likely to deliver preterm despite expectant management in the context of intact membranes and normal amniotic fluid clinical results. Utilizing identification-centered proteomics techniques (fluorescence two-dimensional differential gel electrophoresis, robotic tryptic digestion and mass spectrometry coupled with Protein ANalysis THrough Evolutionary Relationships (PANTHER ontological classifications, we determined that in amniotic fluids with Q-profile the differentially expressed proteins are primarily involved in non-inflammatory biological processes such as protein metabolism, signal transduction and transport.Proteomic profiling of amniotic fluid coupled with non-hierarchical bioinformatics algorithms identified a subgroup of patients at risk for preterm birth in the absence of intra

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

    Science.gov (United States)

    Underhill, Meghan L.; Kiviniemi, Marc T.

    2012-01-01

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

  15. 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.

  16. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

    Science.gov (United States)

    Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

    2017-10-01

    Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

  17. Interprovider Communication Using a Scheduled Provider Alert-Response Communication System in 3 Inpatient Neurology Units.

    Science.gov (United States)

    Siegler, James E; Finegan, Dan; Kasner, Scott E; Price, Raymond S

    2017-10-01

    Nonemergent communications between nursing staff and residents often occur randomly throughout the workday at teaching institutions, resulting in inefficiency and interruptions of scheduled resident educational conferences or periods of overnight rest. The aim of this study was to determine whether a quality improvement communication strategy can reduce interruptive notifications during scheduled resident didactic sessions. We conducted a prospective, mixed-methods trial of a communication strategy between nurses and residents in 3 neurology units of an academic institution. We measured content and volume of notifications from nurses to residents during scheduled conferences and overnight and categorized these notifications according to levels of urgency. We implemented an intervention requiring multidisciplinary evening work rounds between the on-call resident and charge nurse and batching of nonemergent communications. Survey data were collected. The total census during the 6-month study period was 728 patients. Of the 704 resident-reported nursing notifications, 50% could be safely deferred until change of shift. After the intervention, there was a 52% decrement of notifications (0.52 vs 0.25 notifications per patient, P communication system reduced interruptive calls during educational conferences and overnight by half. This intervention was perceived as safe and effective and resulted in higher satisfaction among participants.

  18. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

    Science.gov (United States)

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

    2017-06-01

    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Communication strategies and accommodations utilized by health care providers with hearing loss: a pilot study.

    Science.gov (United States)

    Trotter, Alanna R; Matt, Susan B; Wojnara, Danuta

    2014-03-01

    Poor communication between health care providers and patients may negatively impact patient outcomes, and enhancing communication is one way to improve outcomes. Effective communication is particularly important for health care providers who have hearing loss. The authors found that a systematic survey of the communication strategies and experiences of health care providers with hearing loss had not yet been conducted. In this pilot study, 32 health care professionals with hearing loss were recruited via the Association of Medical Professionals With Hearing Losses and were asked to complete a 28-question survey. Health care providers with hearing loss already employ strategies that all health care providers are encouraged to use in order to enhance patient–provider communication, and survey participants have found the strategies to be effective. The communication techniques and assistive technologies used by individuals with hearing loss seem to be effective: All participants reported feeling able to communicate effectively with patients at least most of the time. More research is needed to determine if use of these communication techniques has similar results for health care providers without hearing loss.

  20. How electricity providers communicate price increases – A qualitative analysis of notification letters

    International Nuclear Information System (INIS)

    Pick, Doreén; Zielke, Stephan

    2015-01-01

    In several markets firms are required to explicitly announce price increases by sending customers notification letters. The purpose of this article is to analyze how electricity providers deal with such obligatory price increase communication and to provide a comprehensive overview of communicative arguments used by firms. Data is gathered through a content analysis of 97 price increase mailings. Findings show that electricity providers apply several price communication strategies while other promising strategies for customer retention are mostly ignored (i.e., those related to competitors, offerings and relationship benefits). Further, price increase communication differs between national and local firms. Local firms are more transparent in their price increase communication and refer even less often to offer and relationship benefits. Electricity firms have many options to improve the potential effects of price increase letters, such as referring to the future relationship. This is the first study which examines the content of price increase communication by firms. It structures price communication practices used by electricity providers, analyzes their empirical relevance, summarizes findings in five global propositions, and provides a detailed agenda for future research. Moreover, the study indicates several means for public policy organizations to offer regulations on the content of price increase notifications. - Highlights: • We examine 97 price increase letters from electricity providers in Germany. • We investigate the means how firms deal with price increase communications. • Electricity providers aim to hide price increases towards their customers. • Electricity providers only scarcely use benefit and relationship communication. • Price increase communication differs between types of providers as national firms are more professional.

  1. Communication Challenges: A Qualitative Look at the Relationship Between Pediatric Hospitalists and Primary Care Providers.

    Science.gov (United States)

    Solan, Lauren G; Sherman, Susan N; DeBlasio, Dominick; Simmons, Jeffrey M

    2016-07-01

    Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists. Using qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution. The open-ended, semistructured question guides included questions about communication experiences, patient care responsibilities, and suggestions for improvement. Using inductive thematic analysis, investigators coded the transcripts, and resolved differences through consensus. Six PCP (n = 27) and 3 hospitalist (n = 15) focus groups were held. Fifty-six percent of PCPs and 14% of hospitalists had been practicing for >10 years. Five major themes were identified: problematic aspects of communication, perceptions of provider roles, push-pull, postdischarge responsibilities/care, and proposed solutions. Aspects of communication included specific problem areas with verbal and written communication. Perceptions of provider roles highlighted the issue of PCPs feeling devalued. Push-pull described conflicting expectations about a counterpart's role and responsibilities. Postdischarge responsibilities/care addressed unclear responsibilities related to patient follow-up. Proposed solutions were suggested for ways to improve communication. Deficiencies in communication hinder successful collaboration and can cause tension between providers in inpatient and outpatient settings. Understanding specific issues that contribute to poor communication like perceptions about provider roles is critical to improving relationships and facilitating combined efforts to improve patient care

  2. Anti-Smoking Communication to Preadolescents with and without a Cancer Diagnosis: Parents and Healthcare Providers as Important Communicators

    OpenAIRE

    Throckmorton-Belzer, Leslee; Tyc, Vida L.; Robinson, Leslie A.; Klosky, James L.; Lensing, Shelly; Booth, Andrea K.

    2009-01-01

    A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt of anti-smoking messages from physicians and pa...

  3. Patient-provider communication and low-income adults: age, race, literacy, and optimism predict communication satisfaction.

    Science.gov (United States)

    Jensen, Jakob D; King, Andy J; Guntzviller, Lisa M; Davis, LaShara A

    2010-04-01

    To assess whether literacy, numeracy, and optimism are related to low-income adults' satisfaction with their healthcare provider's communication skills. Low-income adults (N=131) were recruited from seven counties in Indiana through University extension programs. To achieve research triangulation, participants were surveyed and interviewed about their communication satisfaction with health providers. Survey data revealed that four variables significantly predicted satisfaction: age, race, literacy, and optimism. Low-income adults in the current study were more critical of their healthcare provider's communication skills if they were younger, White, functionally literate, and pessimistic. Follow-up interviews confirmed this pattern and suggested it was a byproduct of patient activism. In low-income populations, communication satisfaction may be lower for groups that are traditionally active in doctor-patient interactions (e.g., younger patients, patients with higher literacy skills). Healthcare providers should be aware that older, non-White, optimistic, and literacy deficient patients report greater communication satisfaction than their younger, White, pessimistic, and functionally literate peers. Both groups may be coping with their situation, the former by withdrawing and the latter by actively pushing for a higher standard of care. Healthcare providers should continue to seek out ways to facilitate dialogue with these underserved groups. 2009 Elsevier Ireland Ltd. All rights reserved.

  4. Patients' Perspectives of Oral Healthcare Providers' Communication: Considering the Impact of Message Source and Content.

    Science.gov (United States)

    Fico, Ashley E; Lagoe, Carolyn

    2018-08-01

    This study explores patients' perceptions of positive and negative communication experiences with dentists and dental hygienists using a sample of 267 individuals who reported having a general dental provider. Patients' oral health literacy, dental mistrust, use of dental health services, anxiety, and provider satisfaction are examined on the basis of reported communication experiences in the dental context. When comparing participants who had or had not experienced positive communication with a dentist, individuals with positive experiences demonstrated significantly higher levels of oral health literacy and provider satisfaction, as well as lower levels of dental mistrust. Participants who had experienced negative communication with a dentist reported significantly higher levels of anxiety and dental mistrust, as well as greater likelihood of ever leaving a dental practice, as compared to those without negative communication experiences. By contrast, positive and negative communication experiences with hygienists had limited impact on patient outcomes. Information derived from this investigation can be used by dental providers to guide communicative actions with patients, as well as by scholars to enhance existing theoretical explanations of the function of communication in dentistry.

  5. 47 CFR 4.3 - Communications providers covered by the requirements of this part.

    Science.gov (United States)

    2010-10-01

    ..., paging service, and/or SS7 communications. (c) IXC or LEC tandem facilities refer to tandem switches (or... provide communications services directly to end users. (e) Signaling System 7 (SS7) is a signaling system... most paging services. For purposes of this rule part, SS7 refers to both the SS7 protocol and the...

  6. Exploring Health Care Providers' Views About Initiating End-of-Life Care Communication.

    Science.gov (United States)

    Nedjat-Haiem, Frances R; Carrion, Iraida V; Gonzalez, Krystana; Ell, Kathleen; Thompson, Beti; Mishra, Shiraz I

    2017-05-01

    Numerous factors impede effective and timely end-of-life (EOL) care communication. These factors include delays in communication until patients are seriously ill and/or close to death. Gaps in patient-provider communication negatively affect advance care planning and limit referrals to palliative and hospice care. Confusion about the roles of various health care providers also limits communication, especially when providers do not coordinate care with other health care providers in various disciplines. Although providers receive education regarding EOL communication and care coordination, little is known about the roles of all health care providers, including nonphysician support staff working with physicians to discuss the possibility of dying and help patients prepare for death. This study explores the perspectives of physicians, nurses, social workers, and chaplains on engaging seriously ill patients and families in EOL care communication. Qualitative data were from 79 (medical and nonmedical) providers practicing at 2 medical centers in Central Los Angeles. Three themes that describe providers' perceptions of their roles and responsibility in talking with seriously ill patients emerged: (1) providers' roles for engaging in EOL discussions, (2) responsibility of physicians for initiating and leading discussions, and (3) need for team co-management patient care. Providers highlighted the importance of beginning discussions early by having physicians lead them, specifically due to their medical training and need to clarify medical information regarding patients' prognosis. Although physicians are a vital part of leading EOL communication, and are at the center of communication of medical information, an interdisciplinary approach that involves nurses, social workers, and chaplains could significantly improve patient care.

  7. Pediatric primary care providers' perspectives regarding hospital discharge communication: a mixed methods analysis.

    Science.gov (United States)

    Leyenaar, JoAnna K; Bergert, Lora; Mallory, Leah A; Engel, Richard; Rassbach, Caroline; Shen, Mark; Woehrlen, Tess; Cooperberg, David; Coghlin, Daniel

    2015-01-01

    Effective communication between inpatient and outpatient providers may mitigate risks of adverse events associated with hospital discharge. However, there is an absence of pediatric literature defining effective discharge communication strategies at both freestanding children's hospitals and general hospitals. The objectives of this study were to assess associations between pediatric primary care providers' (PCPs) reported receipt of discharge communication and referral hospital type, and to describe PCPs' perspectives regarding effective discharge communication and areas for improvement. We administered a questionnaire to PCPs referring to 16 pediatric hospital medicine programs nationally. Multivariable models were developed to assess associations between referral hospital type and receipt and completeness of discharge communication. Open-ended questions asked respondents to describe effective strategies and areas requiring improvement regarding discharge communication. Conventional qualitative content analysis was performed to identify emergent themes. Responses were received from 201 PCPs, for a response rate of 63%. Although there were no differences between referral hospital type and PCP-reported receipt of discharge communication (relative risk 1.61, 95% confidence interval 0.97-2.67), PCPs referring to general hospitals more frequently reported completeness of discharge communication relative to those referring to freestanding children's hospitals (relative risk 1.78, 95% confidence interval 1.26-2.51). Analysis of free text responses yielded 4 major themes: 1) structured discharge communication, 2) direct personal communication, 3) reliability and timeliness of communication, and 4) communication for effective postdischarge care. This study highlights potential differences in the experiences of PCPs referring to general hospitals and freestanding children's hospitals, and presents valuable contextual data for future quality improvement initiatives

  8. "Are you still driving?" Metasynthesis of patient preferences for communication with health care providers.

    Science.gov (United States)

    Betz, Marian E; Scott, Kenneth; Jones, Jacqueline; Diguiseppi, Carolyn

    2016-05-18

    The aim of this study was to synthesize published qualitative studies to identify older adults' preferences for communication about driving with health care providers. Health care providers play a key role in addressing driving safety and driving retirement with older adults, but conversations about driving can be difficult. Guides exist for family members and providers, but to date less is known about the types of communication and messages older drivers want from their health care providers. A qualitative metasynthesis of studies published on or before October 10, 2014, in databases (PubMed, CINAHL, PsycINFO, and Web of Science) and grey literature was performed. Twenty-two published studies representing 518 older adult drivers met the following inclusion criteria: the study (1) was about driving; (2) involved older drivers; (3) was qualitative (rather than quantitative or mixed methods); and (4) contained information on older drivers' perspectives about communication with health care providers. We identified 5 major themes regarding older adults' communication preferences: (1) driving discussions are emotionally charged; (2) context matters; (3) providers are trusted and viewed as authority figures; (4) communication should occur over a period of time rather than suddenly; and (5) older adults desire agency in the decision to stop driving. Various stakeholders involved in older driver safety should consider older drivers' perspectives regarding discussions about driving. Health care providers can respect and empower older drivers-and support their family members-through tactful communication about driving safety and mobility transitions during the life course.

  9. Patient-provider communication over social media: perspectives of adolescents with psychiatric illness.

    Science.gov (United States)

    van Rensburg, Samuel H; Klingensmith, Katherine; McLaughlin, Paige; Qayyum, Zheala; van Schalkwyk, Gerrit I

    2016-02-01

    Social media is an increasingly dominant platform for communication, especially among adolescents. Statements from professional bodies and a growing body of empirical evidence support a role for social media in improving provider-patient interactions. In psychiatry, particular concerns exist about the suitability of this style of communication. Very limited data are available exploring how patients would like to incorporate social media into their communication with their psychiatric providers. We conducted a qualitative study with 20 adolescents attending the Yale Psychiatric Hospital Intensive Outpatient Programme. Interviews were analysed using inductive thematic analysis. Participants highlighted how social media could allow for constant access to a mental health provider, provide a less anxiety-provoking mode of communication, and allow for them to be monitored in a more on-going fashion. However, participants also identified many potential risks associated with these applications, including the potential for anxiety if a provider was not able to respond immediately, and a sense that online interactions would be less rich overall. Our findings suggest that adolescents are open to the idea of communicating with mental health providers over social media and are able to describe a number of instances where this could be of value. The risks participants described, as well as concerns raised by existing literature, indicate the need for further work and protocol development in order for social media to be a feasible tool for communication between providers and adolescents with psychiatric illness. © 2015 John Wiley & Sons Ltd.

  10. Communication practices about HPV testing among providers in Federally Qualified Health Centers

    Directory of Open Access Journals (Sweden)

    Lavinia Lin

    2015-01-01

    Conclusion: As HPV testing plays a more prominent role in cervical cancer screening, more attention should be given to communications between providers and patients about the benefits and harms of different screening options.

  11. Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems

    National Research Council Canada - National Science Library

    Zhao, Wei; Bettati, Riccardo; Vaidya, Nitin

    2005-01-01

    This document is the final report for Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems, a Texas A AND M project funded through the DARPA Fault Tolerant Networks Program...

  12. Self-contained miniature electronics transceiver provides voice communication in hazardous environment

    Science.gov (United States)

    Cribb, H. E.

    1970-01-01

    Two-way wireless voice communications system is automatic, provides freedom of movement, allows for complete awareness of the environment, and does not present any additional hazards such as activation of electromagnetic sensitive devices.

  13. Rheo-NMR - how nuclear magnetic resonance is providing new insight regarding complex fluid rheology

    International Nuclear Information System (INIS)

    Callaghan, P.T.

    2000-01-01

    Over the past five decades, NMR has revolutionised chemistry, and has found widespread application in condensed matter physics, in molecular biology, in medicine and in food technology. Most recently NMR has made a significant impact in chemical engineering, where it is being extensively used for the non-invasive study of dispersion and flow in porous media. One of the most recent applications of NMR in materials science concerns its use in the study of the mechanical properties of complex fluids. This particular aspect of NMR has been extensively developed in research carried out at Massey University in New Zealand. In this short article, some of the ideas behind this work and the applications which have resulted, will be described. These examples provide a glimpse of possible applications of Nuclear Magnetic Resonance to the study of complex fluid rheology. While this is a very new field of research in which only a handful of groups presently participate, the potential exists for a substantial increase in Rheo-NMR research activity. Systems studied to date include polymer melts and semi-dilute solutions, thermotropic and lyotropic liquid crystals and liquid crystalline polymers, micellar solutions, food materials and colloidal suspensions. Rheo-NMR suffers in a number of respects by comparison with optical methods. It is expensive, it is difficult to use, it suffers from poor signal-to-noise ratios and the effective interpretation of spectra often depends on familiarity with the nuclear spin Hamiltonian and the associated effects of spin dynamics. Nonetheless NMR offers some unique advantages, including the ability to work with opaque materials, the ability to combine velocimetry with localised spectroscopy, and the ability to access a wide range of molecular properties relating to organisation, orientation and dynamics. Rheo-NMR has been able to provide a direct window on a variety of behaviours, including slip, shear-thinning, shear banding, yield stress

  14. Emergent dynamics of Cucker-Smale particles under the effects of random communication and incompressible fluids

    Science.gov (United States)

    Ha, Seung-Yeal; Xiao, Qinghua; Zhang, Xiongtao

    2018-04-01

    We study the dynamics of infinitely many Cucker-Smale (C-S) flocking particles under the interplay of random communication and incompressible fluids. For the dynamics of an ensemble of flocking particles, we use the kinetic Cucker-Smale-Fokker-Planck (CS-FP) equation with a degenerate diffusion, whereas for the fluid component, we use the incompressible Navier-Stokes (N-S) equations. These two subsystems are coupled via the drag force. For this coupled model, we present the global existence of weak and strong solutions in Rd (d = 2 , 3). Under the extra regularity assumptions of the initial data, the unique solvability of strong solutions is also established in R2. In a large coupling regime and periodic spatial domain T2 : =R2 /Z2, we show that the velocities of C-S particles and fluids are asymptotically aligned to two constant velocities which may be different.

  15. Anti-Smoking Communication to Preadolescents with and without a Cancer Diagnosis: Parents and Healthcare Providers as Important Communicators.

    Science.gov (United States)

    Throckmorton-Belzer, Leslee; Tyc, Vida L; Robinson, Leslie A; Klosky, James L; Lensing, Shelly; Booth, Andrea K

    2009-10-01

    A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt of anti-smoking messages from physicians and parents, and recalled more messages >/= 4 months post-diagnosis as compared to 1-3 months. Should anti-tobacco communications prove to influence smoking outcomes, parents and physicians may be uniquely positioned to provide smoking prevention interventions to these patients.

  16. Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

    Science.gov (United States)

    Jesus, Tiago Silva; Silva, Isabel Lopes

    2016-04-01

    There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

  17. Influence of Provider Communication on Women's Delivery Expectations and Birth Experience Appraisal: A Qualitative Study.

    Science.gov (United States)

    Ledford, Christy J W; Canzona, Mollie Rose; Womack, Jasmyne J; Hodge, Joshua A

    2016-07-01

    Although current research suggests that patient-provider prenatal communication and expectation-setting affects women's outcomes, more needs to be understood about the kinds of communication experiences that shape women's expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. Mothers recognize providers' use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers' appraisals of the birth experience. Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.

  18. Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination.

    Science.gov (United States)

    Moss, Jennifer L; Gilkey, Melissa B; Rimer, Barbara K; Brewer, Noel T

    2016-06-02

    Healthcare providers may vary their communications with different patients, which could give rise to differences in vaccination coverage. We examined demographic disparities in parental report of collaborative provider communication and implications for human papillomavirus (HPV) vaccination. Participants were 4,124 parents who completed the National Immunization Survey-Teen about daughters ages 13-17. We analyzed disparities in collaborative communication (mutual information exchange, deliberation, and decision) and whether they mediated the relationship between demographic characteristics and HPV vaccine initiation. Half of parents (53%) in the survey reported collaborative communication. Poor, less educated, Spanish-speaking, Southern, and rural parents, and parents of non-privately insured and Hispanic adolescents, were least likely to report collaborative communication (all pcommunication accounted for geographic variation in HPV vaccination, specifically, the higher rates of uptake in the Northeast versus the South (mediation z=2.31, pcommunication showed widespread disparities, being least common among underserved groups. Collaborative communication helped account for differences-and lack of differences-in HPV vaccination among some subgroups of adolescent girls. Leveraging patient-provider communication, especially for underserved demographic groups, could improve HPV vaccination coverage.

  19. Provider Communication Regarding Psychosocial Factors Predicts Pain Beliefs in Parent and Child

    Science.gov (United States)

    Sood, Erica; Pinder, Wendy; Pendley, Jennifer S.; Fisher, Alicia O.; Wali, Prateek D.; del Rosario, Fernando

    2017-01-01

    Objective To examine the role of provider communication about psychosocial causes of abdominal pain and recommendations for psychosocial intervention during a gastroenterology clinic visit in predicting families’ causal beliefs and perceptions of treatment acceptability. Method Participants were 57 children with a diagnosed or suspected abdominal pain-related functional gastrointestinal disorder (FGID) presenting for an outpatient gastroenterology follow-up visit and their accompanying parent. Children and parents completed questionnaires assessing child anxiety and abdominal pain severity, recall of provider communication about causes of abdominal pain and recommendations for intervention, their own causal beliefs about pain, and perceived acceptability of cognitive behavioral therapy (CBT) and standard medical treatment (SMT) after reading descriptions of each treatment. Providers completed a questionnaire assessing their perceptions and communication about the causes of the child’s abdominal pain and perceived acceptability of CBT. Results Provider communication about psychosocial causes and interventions was reported infrequently by parents, children, and providers. Parents rated psychosocial causes for abdominal pain as less likely than physical causes, and children and parents rated CBT as less acceptable than SMT. Parents’ recall of provider communication about psychosocial causes was associated with their own causal beliefs about pain and their perceived acceptability of CBT. Children’s and parents’ recall of provider recommendations for psychosocial intervention was associated with their perceived acceptability of CBT. Conclusion Results highlight the importance of provider communication about psychosocial contributors to abdominal pain and psychosocial interventions for children with FGIDs. Medical and mental health providers can partner to deliver care to children with FGIDs using a biopsychosocial approach. PMID:27035693

  20. Measuring patient-provider communication skills in Rwanda: Selection, adaptation and assessment of psychometric properties of the Communication Assessment Tool.

    Science.gov (United States)

    Cubaka, Vincent Kalumire; Schriver, Michael; Vedsted, Peter; Makoul, Gregory; Kallestrup, Per

    2018-04-23

    To identify, adapt and validate a measure for providers' communication and interpersonal skills in Rwanda. After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed. Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted. Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients. Eleven providers and 291 patients were involved in the field-testing. Confirmatory factor analysis showed a good fit for the original one factor model. Test-retest reliability assessment revealed a mean quadratic weighted Kappa = 0.81 (range: 0.69-0.89, N = 57). The average proportion of excellent scores was 15.7% (SD: 24.7, range: 9.9-21.8%, N = 180). Differential item functioning was not observed except for item 1, which focuses on greetings, for age groups (p = 0.02, N = 180). The Kinyarwanda version of CAT (K-CAT) is a reliable and valid patient-reported measure of providers' communication and interpersonal skills. K-CAT was validated on nurses and its use on other types of providers may require further validation. K-CAT is expected to be a valuable feedback tool for providers in practice and in training. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing

    DEFF Research Database (Denmark)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-01-01

    Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In-depth int......Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In....... Results: Four themes emerged describing barriers to communication, from the HIV-positive women’s point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider’s emphasis on ‘scientific’ facts, (iv...

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives.

    Science.gov (United States)

    Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W

    2016-11-01

    Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Fluid resuscitation practices in cardiac surgery patients in the USA: a survey of health care providers

    Directory of Open Access Journals (Sweden)

    Solomon Aronson

    2017-10-01

    Full Text Available Abstract Background Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. Methods We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1 patients undergoing cardiopulmonary bypass (CPB without bleeding, (2 patients undergoing CPB with bleeding, (3 patients undergoing acute normovolemic hemodilution (ANH, (4 patients requiring extracorporeal membrane oxygenation (ECMO or use of a ventricular assist device (VAD, and (5 patients undergoing either off-pump coronary artery bypass graft (OPCABG surgery or transcatheter aortic valve replacement (TAVR. First-choice fluid used in fluid boluses for these five patient types was requested. Descriptive statistics were performed using Kruskal-Wallis test and follow-up tests, including t tests, to evaluate differences among respondent groups. Results The most commonly preferred indicators of volume status were blood pressure, urine output, cardiac output, central venous pressure, and heart rate. The first choice of fluid for patients needing volume expansion during CPB without bleeding was crystalloids, whereas 5% albumin was the most preferred first choice of fluid for bleeding patients. For volume expansion during ECMO or VAD, the respondents were equally likely to prefer 5% albumin or crystalloids as a first choice of IV fluid, with 5% albumin being the most frequently used adjunct fluid to crystalloids. Surgeons, as a group, more often chose starches as an adjunct fluid to crystalloids for patients needing volume expansion during CPB without bleeding. Surgeons

  5. Acculturation differences in communicating information about child mental health between Latino parents and primary care providers.

    Science.gov (United States)

    Lê Cook, Benjamin; Brown, Jonathan D; Loder, Stephen; Wissow, Larry

    2014-12-01

    Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents' communication with providers about youth mental health and the role of acculturation in influencing this communication. We estimated regression models to assess the association between time in the US and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Parent's length of time in the US was positively associated with their communication of: their child's psychosocial problems with their child's MA, stress in their own life with their child's MA, and their child's school problems with their child's doctor. These differences were especially apparent for parents living in the US for >10 years. Parent-child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness.

  6. Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management

    Directory of Open Access Journals (Sweden)

    Ayse Basak Cinar

    2014-01-01

    Full Text Available The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI, HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC or health education (HE. At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P>0.05. Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P=0.001. Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures.

  7. The "Hand-in" Project: Jump-starting Communication Between Inpatient and Outpatient Providers.

    Science.gov (United States)

    Holleck, Jürgen L; Gunderson, Craig G; Antony, Sheila M; Gupta, Shaili; Chang, John J; Merchant, Naseema; Lin, Shin; Federman, Daniel G

    2017-11-01

    Communication between hospitalists and primary care providers (PCPs) upon discharge has been much discussed, but the transition from outpatient to inpatient has received less attention. We questioned whether a brief, standardized e-mail from the hospitalist to the PCP upon admission could facilitate information exchange, increase communication, elucidate PCP preferences, and improve outcomes. This prospective single-center study with a preintervention-to-postintervention design involved 300 inpatient admissions from June 2015 through October 2015 in the Veterans Affairs Connecticut Healthcare System. Hospitalists e-mailed an encrypted notification of admission along with standardized questions to PCPs within 1 day of admission. Measurements included the number of communications between PCPs and hospitalists, length of stay (LOS), 30-day readmissions, 30-day emergency department (ED) utilization rates, PCP preferences with regard to communication, and follow-up. Preintervention data for 94 patients during a 6-week period revealed 0.11 communications per patient, an LOS of 4.18 days, 30-day readmissions of 28.7%, and 30-day ED visits of 32%. Postintervention data on 206 patients during the next 12 weeks showed statistically significant increased communications per patient (0.5), and a nonsignificant decrease in LOS (3.96 days), 30-day readmissions (22.3%), and 30-day ED visits (31%). P values were communication upon discharge (40%) to telephone (25%) or instant messaging (13%), and 39% wanted a follow-up appointment within 2 weeks, regardless of what transpired. A hospitalist-led transition-of-care intervention designed to improve communication and information exchange between PCPs and hospitalists at the time of admission demonstrated that encrypted e-mail could be used as a tool to obtain useful additional medical and psychosocial information and to better understand PCP attitudes and preferences. The increased level of communication did not yield statistically

  8. Associations between parents' satisfaction with provider communication and HPV vaccination behaviors.

    Science.gov (United States)

    Kornides, Melanie L; Fontenot, Holly B; McRee, Annie-Laurie; Panozzo, Catherine A; Gilkey, Melissa B

    2018-05-03

    Despite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents' decision-making. Healthcare providers can influence parents' HPV vaccination decision-making, but little is known about parents' perspectives on the counseling they receive. We sought to assess U.S. parents' satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors. Parents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression. Most parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38-0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15-2.55) and continuation (aOR = 2.05, 95% CI: 1.24-3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29-0.70, initiation aOR = 3.59, 95% CI: 2.23-5.78, and continuation aOR = 4.08, 95% CI: 2.38-7.01). Our study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item

  9. Disparities in perceived patient-provider communication quality in the United States: Trends and correlates.

    Science.gov (United States)

    Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J

    2016-05-01

    This study aimed to describe disparities and temporal trends in the level of perceived patient-provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ. A cross-sectional analysis was conducted using nationally-representative data from the 2011-2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations. PPPCQ scores, the composite measure of patients' ratings of communication quality, were positive overall (82.8; 95% CI: 82.1-83.5). However, less than half (42-46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors. Disparities in PPPCQ can be attributed to patients' age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health. These findings may inform educational and policy efforts which aim to improve patient-provider communication, enhance the quality of care, and reduce health disparities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. A Novel Dual Separate Paths (DSP) Algorithm Providing Fault-Tolerant Communication for Wireless Sensor Networks.

    Science.gov (United States)

    Tien, Nguyen Xuan; Kim, Semog; Rhee, Jong Myung; Park, Sang Yoon

    2017-07-25

    Fault tolerance has long been a major concern for sensor communications in fault-tolerant cyber physical systems (CPSs). Network failure problems often occur in wireless sensor networks (WSNs) due to various factors such as the insufficient power of sensor nodes, the dislocation of sensor nodes, the unstable state of wireless links, and unpredictable environmental interference. Fault tolerance is thus one of the key requirements for data communications in WSN applications. This paper proposes a novel path redundancy-based algorithm, called dual separate paths (DSP), that provides fault-tolerant communication with the improvement of the network traffic performance for WSN applications, such as fault-tolerant CPSs. The proposed DSP algorithm establishes two separate paths between a source and a destination in a network based on the network topology information. These paths are node-disjoint paths and have optimal path distances. Unicast frames are delivered from the source to the destination in the network through the dual paths, providing fault-tolerant communication and reducing redundant unicast traffic for the network. The DSP algorithm can be applied to wired and wireless networks, such as WSNs, to provide seamless fault-tolerant communication for mission-critical and life-critical applications such as fault-tolerant CPSs. The analyzed and simulated results show that the DSP-based approach not only provides fault-tolerant communication, but also improves network traffic performance. For the case study in this paper, when the DSP algorithm was applied to high-availability seamless redundancy (HSR) networks, the proposed DSP-based approach reduced the network traffic by 80% to 88% compared with the standard HSR protocol, thus improving network traffic performance.

  11. Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers.

    Science.gov (United States)

    Lederer, Swati; Fischer, Michael J; Gordon, Howard S; Wadhwa, Anuradha; Popli, Subhash; Gordon, Elisa J

    2015-12-01

    Many patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient-provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized. Adults with an estimated glomerular filtration rate (eGFR) of communication dynamics. Thirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30-59 mL/min/1.73 m(2); 34%), CKD-4 (eGFR 15-29 mL/min/1.73 m(2); 25%), CKD-5 (eGFR barriers to patient-provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a 'listener', reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient-provider relationship. Several barriers to patient-provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.

  12. A mobile communication device adapted to provide a dynamic display arrangement

    DEFF Research Database (Denmark)

    2011-01-01

    The invention relates to a mobile communication device comprising a light projector adapted to project a multi-coloured image onto a surface; a hinged mirror comprising a first mirror part adapted to be tilted around the hinge into the light path of the light projector; wherein the first mirror...... part comprises means for correcting a skew angle in the multi-coloured image projected onto a surface. Thereby is achieved that the mobile communication device is able to provide RGB full colour dynamic image projection which is preferred over monochromatic laser projection because it is a speckle free...... and eye-friendly projection....

  13. Amniotic fluid RNA gene expression profiling provides insights into the phenotype of Turner syndrome.

    Science.gov (United States)

    Massingham, Lauren J; Johnson, Kirby L; Scholl, Thomas M; Slonim, Donna K; Wick, Heather C; Bianchi, Diana W

    2014-09-01

    Turner syndrome is a sex chromosome aneuploidy with characteristic malformations. Amniotic fluid, a complex biological material, could contribute to the understanding of Turner syndrome pathogenesis. In this pilot study, global gene expression analysis of cell-free RNA in amniotic fluid supernatant was utilized to identify specific genes/organ systems that may play a role in Turner syndrome pathophysiology. Cell-free RNA from amniotic fluid of five mid-trimester Turner syndrome fetuses and five euploid female fetuses matched for gestational age was extracted, amplified, and hybridized onto Affymetrix(®) U133 Plus 2.0 arrays. Significantly differentially regulated genes were identified using paired t tests. Biological interpretation was performed using Ingenuity Pathway Analysis and BioGPS gene expression atlas. There were 470 statistically significantly differentially expressed genes identified. They were widely distributed across the genome. XIST was significantly down-regulated (p Turner syndrome transcriptome from other aneuploidies we previously studied. Manual curation of the differentially expressed gene list identified genes of possible pathologic significance, including NFATC3, IGFBP5, and LDLR. Transcriptomic differences in the amniotic fluid of Turner syndrome fetuses are due to genome-wide dysregulation. The hematologic/immune system differences may play a role in early-onset autoimmune dysfunction. Other genes identified with possible pathologic significance are associated with cardiac and skeletal systems, which are known to be affected in females with Turner syndrome. The discovery-driven approach described here may be useful in elucidating novel mechanisms of disease in Turner syndrome.

  14. Parent Preferences for Communicating With Their Adolescent's Provider Using New Technologies.

    Science.gov (United States)

    Rand, Cynthia M; Blumkin, Aaron; Vincelli, Phyllis; Katsetos, Viki; Szilagyi, Peter G

    2015-09-01

    Because adolescents make few health care visits, we assessed the views of parents of adolescents on various means to communicate with their adolescents' physicians about vaccine reminders and appointments, medication refills and test results-including phone, mail, e-mail, text messages, and personal health records (PHRs). We performed a cross-sectional survey of 400 parents of adolescents presenting to four pediatric offices (two urban, two suburban) in Rochester, NY in 2011 before vaccine reminders occurring in these practices. Roughly half of parents (60% urban, 52% suburban, p = .11) were accepting of teens receiving their own vaccine reminders. Urban parents preferred communicating with the provider via telephone, whereas suburban parents preferred e-mail for most issues and a PHR for receipt of test results. In adjusted analyses, being younger was associated with preferring text message vaccine reminders (41 to parent was associated with preferring e-mail reminders (aRR = 1.6, p parents are ready for electronic (text message, e-mail, PHR) communications for their adolescents' health care and that a parent age and socioeconomic divide exists. Providing options in the means in which parents communicate with an adolescent's provider is ideal. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues.

    Science.gov (United States)

    Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M

    2015-01-01

    Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

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

    Science.gov (United States)

    Leonard, M; Graham, S; Bonacum, D

    2004-10-01

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

  17. Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome.

    Science.gov (United States)

    Burton-Chase, A M; Hovick, S R; Sun, C C; Boyd-Rogers, S; Lynch, P M; Lu, K H; Peterson, S K

    2014-08-01

    We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75-80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome

    Science.gov (United States)

    Burton-Chase, AM; Hovick, SR; Sun, CC; Boyd-Rogers, S; Lynch, PM; Lu, KH; Peterson, SK

    2014-01-01

    We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75–80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. PMID:23906188

  19. Facilitating communication about sexual health between aging women and their health care providers.

    Science.gov (United States)

    Hughes, Anne K; Lewinson, Terri D W

    2015-04-01

    Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women's perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women's attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient-provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers. © The Author(s) 2014.

  20. Electronic cigarette use among patients with cancer: Reasons for use, beliefs, and patient-provider communication.

    Science.gov (United States)

    Correa, John B; Brandon, Karen O; Meltzer, Lauren R; Hoehn, Hannah J; Piñeiro, Bárbara; Brandon, Thomas H; Simmons, Vani N

    2018-04-19

    Smoking tobacco cigarettes after a cancer diagnosis increases risk for several serious adverse outcomes. Thus, patients can significantly benefit from quitting smoking. Electronic cigarettes are an increasingly popular cessation method. Providers routinely ask about combustible cigarette use, yet little is known about use and communication surrounding e-cigarettes among patients with cancer. This study aims to describe patterns, beliefs, and communication with oncology providers about e-cigarette use of patients with cancer. Patients with cancer (N = 121) who currently used e-cigarettes were surveyed in a cross-sectional study about their patterns and reasons for use, beliefs, and perceptions of risk for e-cigarettes, combustible cigarettes, and nicotine replacement therapies. Patient perspectives on provider communication regarding e-cigarettes were also assessed. Most participants identified smoking cessation as the reason for initiating (81%) and continuing (60%) e-cigarette use. However, 51% of patients reported current dual use of combustible cigarettes and e-cigarettes, and most patients reported never having discussed their use of e-cigarettes with their oncology provider (72%). Patients characterized e-cigarettes as less addictive, less expensive, less stigmatizing, and less likely to impact cancer treatment than combustible cigarettes (Ps < .05), and more satisfying, more useful for quitting smoking, and more effective at reducing cancer-related stress than nicotine replacement therapies (Ps < .05). Patients with cancer who use e-cigarettes have positive attitudes toward these devices and use them to aid in smoking cessation. This study also highlights the need for improved patient-provider communication on the safety and efficacy of e-cigarettes for smoking cessation. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Enhancing client welfare through better communication of private mental health data between rural service providers

    Directory of Open Access Journals (Sweden)

    Oliver Kisalay Burmeister

    2015-11-01

    Full Text Available Client welfare is detrimentally affected by poor communication of data between rural service providers, which in part is complicated by privacy legislation. A study of service provision involving interviews with mental health professionals, found challenges in communicative processes between agencies were exacerbated by the heavy workloads. Dependence on individual interpretations of legislation, and on manual handling, led to delays that detrimentally affected client welfare. The main recommendation arising from this article is the creation of an ehealth system that is able to negotiate differing levels of access to client data through centralised controls, where the administration of that system ensures that it stays current with changing legislative requirements. The main contribution of the proposed model is to combine two well-known concepts: data integration and generalisation. People with mental illness are amongst the most vulnerable members of society, and current ehealth systems that provide access to medical records inadequately cater to their needs.

  2. Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...

  3. Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement.

    Science.gov (United States)

    Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B

    2014-02-20

    Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.

  4. Reliance communications' flag telecom to provide ethernet link between CERN and TIFR

    CERN Multimedia

    2007-01-01

    "Flag Telecom Group Limited (Flag), the undersea cable network arm of Anil Ambani-le Reliance Communications, has announced a landmark deal with CERn (Conseil Européen pour la Recheche Nucléaire), the European organisation for nuclear research based in Geneva, Switzerland and the Tata institute of Fundamental Research (TIFR) in Mumbai to provide gigabit Ethernet connectivity between the two." (1 page)

  5. Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

    Science.gov (United States)

    Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

    2017-10-01

    Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

  6. Artificial intelligence and immediacy: designing health communication to personally engage consumers and providers.

    Science.gov (United States)

    Kreps, Gary L; Neuhauser, Linda

    2013-08-01

    We describe how ehealth communication programs can be improved by using artificial intelligence (AI) to increase immediacy. We analyzed major deficiencies in ehealth communication programs, illustrating how programs often fail to fully engage audiences and can even have negative consequences by undermining the effective delivery of information intended to guide health decision-making and influence adoption of health-promoting behaviors. We examined the use of AI in ehealth practices to promote immediacy and provided examples from the ChronologyMD project. Strategic use of AI is shown to help enhance immediacy in ehealth programs by making health communication more engaging, relevant, exciting, and actionable. AI can enhance the "immediacy" of ehealth by humanizing health promotion efforts, promoting physical and emotional closeness, increasing authenticity and enthusiasm in health promotion efforts, supporting personal involvement in communication interactions, increasing exposure to relevant messages, reducing demands on healthcare staff, improving program efficiency, and minimizing costs. User-centered AI approaches, such as the use of personally involving verbal and nonverbal cues, natural language translation, virtual coaches, and comfortable human-computer interfaces can promote active information processing and adoption of new ideas. Immediacy can improve information access, trust, sharing, motivation, and behavior changes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Health literacy in the "oral exchange": an important element of patient-provider communication.

    Science.gov (United States)

    Nouri, Sarah S; Rudd, Rima E

    2015-05-01

    Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange. A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included. The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand. This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field. Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Examination of Routine Use of Prenatal Weight Gain Charts as a Communication Tool for Providers.

    Science.gov (United States)

    Aguilera, Marijo; Sidebottom, Abbey C; McCool, Brigitte R

    2017-10-01

    Objectives In 2009 the IOM revised prenatal weight gain guidelines. The primary purpose of this pilot study was to assess if provider education and use of prenatal weight gain charts to track weight gain and counsel patients was associated with better patient and provider knowledge and communication about the guidelines. Methods A prospective non-randomized study conducted in four OB practices (two control, two intervention). Data sources included provider surveys (n = 16 intervention, 21 control), patient surveys (n = 332), and medical records. Intervention clinics received provider education on the IOM guidelines and used patient education materials and prenatal weight gain charts to track weight gain and as a counseling tool. Comparison clinics received no education and did not use the charts or patient education information. Results More patients at intervention clinics (92.3%) reported that a provider gave them advice about weight gain, compared to patients from comparison clinics (66.4%) (p gain (83.1 vs. 64.3%, p = 0.007). Intervention clinic patients were more likely to have knowledge of the guidelines indicated by 72.3% reporting a target weight gain amount within the guidelines versus 50.4% of comparison patients (p gain charts resulted in higher patient reported communication about weight gain from their provider, higher patient satisfaction with those discussions, and better knowledge of the appropriate target weight gain goals.

  9. Power Relations and Health Care Communication in Older Adulthood: Educating Recipients and Providers.

    Science.gov (United States)

    Eliassen, A Henry

    2016-12-01

    Unequal power relations lie just below the surface in much of today's discourse on health care communication with older adults. Focusing on pathologies or deficits tends to reinforce stereotypes of frailty and dependency, thus framing elders as a vulnerable group requiring special assistance. Implicit stereotyping frequently colors interactions of health care personnel with older clients and their families-interactions likely to affect elders' perceptions and health outcomes. Health care providers need to be attuned to the vast and growing diversity in today's older population, wherein many older adults are exemplars of what it takes to marshal resources and cope with multifaceted challenges. Thus, elders have the potential to teach medical personnel through narratives of resilience as well as tribulation. This potential can be fully realized, however, only in contexts where communication patterns characterized by paternalism, consumerism, and collaboration are mutually recognized and selectively challenged or implemented. Promising interventions to facilitate health care communication in older adulthood might well be directed toward (a) educating both recipients and providers to become more mindful of cues that evoke stereotypical thinking, (b) promoting an institutional culture that normalizes situationally appropriate assertive responses to stereotyping, and (c) formally ratifying older adults' life experience in the training of health care personnel. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

    Science.gov (United States)

    Clark, Phillip G

    2014-01-01

    Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

  11. 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.

  12. A mixed methods study of patient-provider communication about opioid analgesics.

    Science.gov (United States)

    Hughes, Helen Kinsman; Korthuis, Philip Todd; Saha, Somnath; Eggly, Susan; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Beach, Mary Catherine

    2015-04-01

    To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes toward patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers' attitudes toward patients. 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialog suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient's experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95% CI: 0.27-0.95) when opioids were discussed. Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients. Empathy and pain acknowledgment are tools that clinicians can use to facilitate productive discussions of pain management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Impacts of mobile tablet computing on provider productivity, communications, and the process of care.

    Science.gov (United States)

    Schooley, Benjamin; Walczak, Steven; Hikmet, Neset; Patel, Nitin

    2016-04-01

    Health information technology investments continue to increase while the value derived from their implementation and use is mixed. Mobile device adoption into practice is a recent trend that has increased dramatically and formal studies are needed to investigate consequent benefits and challenges. The objective of this study is to evaluate practitioner perceptions of improvements in productivity, provider-patient communications, care provision, technology usability and other outcomes following the adoption and use of a tablet computer connected to electronic health information resources. A pilot program was initiated in June 2013 to evaluate the effect of mobile tablet computers at one health provider organization in the southeast United States. Providers were asked to volunteer for the evaluation and were each given a mobile tablet computer. A total of 42 inpatient and outpatient providers were interviewed in 2015 using a survey style questionnaire that utilized yes/no, Likert-style, and open ended questions. Each had previously used an electronic health record (EHR) system a minimum of one year outside of residency, and were regular users of personal mobile devices. Each used a mobile tablet computer in the context of their practice connected to the health system EHR. The survey results indicate that more than half of providers perceive the use of the tablet device as having a positive effect on patient communications, patient education, patient's perception of the provider, time spent interacting with patients, provider productivity, process of care, satisfaction with EHR when used together with the device, and care provision. Providers also reported feeling comfortable using the device (82.9%), would recommend the device to colleagues (69.2%), did not experience increased information security and privacy concerns (95%), and noted significant reductions in EHR login times (64.1%). Less than 25% of participants reported negative impacts on any of these areas as

  14. Patient-provider communication and hormonal therapy side effects in breast cancer survivors.

    Science.gov (United States)

    Lin, Jenny J; Chao, Jennifer; Bickell, Nina A; Wisnivesky, Juan P

    2017-09-01

    Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients' reporting of side effects is unknown. We undertook this study to assess factors associated with women's reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01-69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence.

  15. Communication Between Middle SES Black Women and Healthcare Providers About HIV Testing.

    Science.gov (United States)

    Fray, Niasha A; Caldwell, Kia Lilly

    2017-01-01

    This article explores the impact of patient and healthcare provider communication (PPC) on the HIV testing behaviors of middle socioeconomic status (SES) Black women in North Carolina. We explore how PPC about STIs and HIV (or the lack thereof) affects the provision of STI/HIV testing by either confirming the need for middle SES Black women to test routinely or potentially deterring women from feeling they need to be tested. After conducting 15 qualitative interviews with middle SES Black women between 25 and 45 years of age, we uncovered the role of patient self-advocacy in promoting HIV testing among middle SES Black women when they communicate with their healthcare providers. We discuss the importance of healthcare providers engaging their middle SES Black female patients in routine discussions about sexual health and sexual risk reduction, regardless of providers' perceptions of their potential STI/HIV risk. We recommend including SES as a variable in data collection and research in order to better understand how social class, race, and gender affect sexual health behavior and the provision of STI and HIV/AIDS prevention to diverse populations. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

  16. Implementation of physiological fluids to provide insight into the characterization, fate, and biological interactions of silver nanoparticles

    Science.gov (United States)

    Breitner, Emily K.; Burns, Katherine E.; Hussain, Saber M.; Comfort, Kristen K.

    2018-06-01

    Silver nanoparticles (AgNPs) are being increasingly utilized in consumer and medical applications. However, there remains conflicting reports on their safety, which are evaluated through a combination of in vitro and in vivo exposure models. These discrepancies may arise, in part, due to the inherent differences between cell-based and animal systems. It is well established that nanotoxicological effects are highly dependent on the unique physicochemical properties and behavior of the particle set, including size, surface chemistry, agglomeration, and ionic dissolution. However, recent studies have identified that these properties vary as a function of exposure environment; providing a rationale for the contradictory results between in vitro and in vivo assessments. Artificial physiological fluids are emerging as a powerful tool as they allow for the characterization of NPs in an environment which they would likely encounter in vivo, in addition to having the experimental advantages of flexibility and consistency. Here, we demonstrated that the utilization of artificial fluids provided a mechanism to assess AgNP behavior and induced bioresponses in environments that they would likely encounter in vivo. AgNPs were introduced within an alveolar-based exposure model, which included alveolar epithelial (A549) cells incubated within artificial alveolar fluid (AF). Additionally, the particles underwent extensive characterization within both AF and lysosomal fluid, which the AgNPs would encounter following cellular internalization. Following incubation in physiological environments AgNP properties were significantly modified versus a traditional media environment, including alterations to both extent of agglomeration and rate of ionic dissolution. Moreover, when A549s were exposed to AgNPs in AF, the cells displayed lower cytotoxicity and stress rates, corresponding to a fluid-dependent drop in silver ion production. This work highlights the need for enhanced in vitro

  17. The Agr communication system provides a benefit to the populations of Listeria monocytogenes in soil.

    Science.gov (United States)

    Vivant, Anne-Laure; Garmyn, Dominique; Gal, Laurent; Piveteau, Pascal

    2014-01-01

    In this study, we investigated whether the Agr communication system of the pathogenic bacterium Listeria monocytogenes was involved in adaptation and competitiveness in soil. Alteration of the ability to communicate, either by deletion of the gene coding the response regulator AgrA (response-negative mutant) or the signal pro-peptide AgrD (signal-negative mutant), did not affect population dynamics in soil that had been sterilized but survival was altered in biotic soil suggesting that the Agr system of L. monocytogenes was involved to face the complex soil biotic environment. This was confirmed by a set of co-incubation experiments. The fitness of the response-negative mutant was lower either in the presence or absence of the parental strain but the fitness of the signal-negative mutant depended on the strain with which it was co-incubated. The survival of the signal-negative mutant was higher when co-cultured with the parental strain than when co-cultured with the response-negative mutant. These results showed that the ability to respond to Agr communication provided a benefit to listerial cells to compete. These results might also indicate that in soil, the Agr system controls private goods rather than public goods.

  18. Fluid mechanics in dentinal microtubules provides mechanistic insights into the difference between hot and cold dental pain.

    Science.gov (United States)

    Lin, Min; Luo, Zheng Yuan; Bai, Bo Feng; Xu, Feng; Lu, Tian Jian

    2011-03-23

    Dental thermal pain is a significant health problem in daily life and dentistry. There is a long-standing question regarding the phenomenon that cold stimulation evokes sharper and more shooting pain sensations than hot stimulation. This phenomenon, however, outlives the well-known hydrodynamic theory used to explain dental thermal pain mechanism. Here, we present a mathematical model based on the hypothesis that hot or cold stimulation-induced different directions of dentinal fluid flow and the corresponding odontoblast movements in dentinal microtubules contribute to different dental pain responses. We coupled a computational fluid dynamics model, describing the fluid mechanics in dentinal microtubules, with a modified Hodgkin-Huxley model, describing the discharge behavior of intradental neuron. The simulated results agreed well with existing experimental measurements. We thence demonstrated theoretically that intradental mechano-sensitive nociceptors are not "equally sensitive" to inward (into the pulp) and outward (away from the pulp) fluid flows, providing mechanistic insights into the difference between hot and cold dental pain. The model developed here could enable better diagnosis in endodontics which requires an understanding of pulpal histology, neurology and physiology, as well as their dynamic response to the thermal stimulation used in dental practices.

  19. Influence of English proficiency on patient-provider communication and shared decision-making.

    Science.gov (United States)

    Paredes, Anghela Z; Idrees, Jay J; Beal, Eliza W; Chen, Qinyu; Cerier, Emily; Okunrintemi, Victor; Olsen, Griffin; Sun, Steven; Cloyd, Jordan M; Pawlik, Timothy M

    2018-06-01

    The number of patients in the United States (US) who speak a language other than English is increasing. We evaluated the impact of English proficiency on self-reported patient-provider communication and shared decision-making. The 2013-2014 Medical Expenditure Panel Survey database was utilized to identify respondents who spoke a language other than English. Patient-provider communication (PPC) and shared decision-making (SDM) scores from 4-12 were categorized as "poor" (4-7), "average" (8-11), and "optimal." The relationship between PPC, SDM, and English proficiency was analyzed. Among 13,880 respondents, most were white (n = 10,281, 75%), age 18-39 (n = 6,677, 48%), male (n = 7,275, 52%), middle income (n = 4,125, 30%), and born outside of the US (n = 9,125, 65%). English proficiency was rated as "very well" (n = 7,221, 52%), "well" (n = 2,378, 17%), "not well" (n = 2,820, 20%), or "not at all" (n = 1,463, 10%). On multivariable analysis, patients who rated their English as "well" (OR 1.73, 95% CI 1.37-2.18) or "not well" (OR 1.53, 95% CI 1.10-2.14) were more likely to report "poor" PPC (both P English proficiency as "not well" (OR 1.31, 95% CI 1.04-1.65, P = .02). Decreased English proficiency was associated with worse self-reported patient-provider communication and shared decision-making. Attention to patients' language needs is critical to patient satisfaction and improved perception of care. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Provider communication behaviors that predict motivation to change in black adolescents with obesity.

    Science.gov (United States)

    Carcone, April Idalski; Naar-King, Sylvie; Brogan, Kathryn E; Albrecht, Terrance; Barton, Ellen; Foster, Tanina; Martin, Tim; Marshall, Sharon

    2013-10-01

    The goal of this research was to identify communication behaviors used by weight loss counselors that mostly strongly predicted black adolescents' motivational statements. Three types of motivational statements were of interest: change talk (CT; statements describing their own desires, abilities, reasons, and need for adhering to weight loss recommendations), commitment language (CML; statements about their intentions or plans for adhering), and counterchange talk (CCT; amotivational statements against change and commitment). Thirty-seven black adolescents with obesity received a single motivational interviewing session targeting weight-related behaviors. The video-recorded transcribed sessions were coded using the Minority Youth Sequential Coding for Observing Process Exchanges generating a sequential chain of communication. Data were then subjected to sequential analysis to determine causal relationships between counselor and adolescent communication. Asking open-ended questions to elicit adolescent CT and emphasizing adolescents' autonomy most often led to CT. Open-ended questions to elicit CML, reflecting adolescent CML, and emphasizing autonomy most often led to CML. In contrast, open-ended questions to elicit CCT, reflecting CCT, reflecting ambivalence, and neutral open-ended questions about the target behavior led to CCT. This study provides clinicians with insight into the most effective way to communicate with black adolescents with obesity about weight loss. Specifically, reflective statements and open questions focusing on their own desires, abilities, reasons, need, and commitment to weight loss recommendations are more likely to increase motivational statements, whereas other types of reflections and questions may be counterproductive. Finally, because adolescents have a strong need for autonomous decision making, emphasizing their autonomy may be particularly effective in evoking motivational statements.

  1. Communicating the benefits of combination vaccines to parents and health care providers.

    Science.gov (United States)

    Koslap-Petraco, Mary Beth; Parsons, Tamra

    2003-01-01

    Infants may receive as many as 5 separate injections at an office visit in order to comply with the 2002 childhood immunization schedule. Many parents and healthcare providers disagree with administering 4 or 5 injections at one visit, and therefore may delay some injections until another visit. This practice may lead to decreased compliance and can increase costs for the parent. New combination vaccines will help to simplify the immunization schedule, and health care providers will need to be able to address parental concerns regarding these vaccines. Nurses are often responsible for administering vaccines in the office setting, and therefore are also influential in deciding which vaccines should be ordered. The purpose of this article is to educate nurses on communicating the benefits of combination vaccines to parents and other healthcare providers.

  2. New mission requirements methodologies for services provided by the Office of Space Communications

    Science.gov (United States)

    Holmes, Dwight P.; Hall, J. R.; Macoughtry, William; Spearing, Robert

    1993-01-01

    The Office of Space Communications, NASA Headquarters, has recently revised its methodology for receiving, accepting and responding to customer requests for use of that office's tracking and communications capabilities. This revision is the result of a process which has become over-burdened by the size of the currently active and proposed missions set, requirements reviews that focus on single missions rather than on mission sets, and negotiations most often not completed early enough to effect needed additions to capacity or capability prior to launch. The requirements-coverage methodology described is more responsive to project/program needs and provides integrated input into the NASA budget process early enough to effect change, and describes the mechanisms and tools in place to insure a value-added process which will benefit both NASA and its customers. Key features of the requirements methodology include the establishment of a mechanism for early identification of and systems trades with new customers, and delegates the review and approval of requirements documents to NASA centers in lieu of Headquarters, thus empowering the system design teams to establish and negotiate the detailed requirements with the user. A Mission Requirements Request (MRR) is introduced to facilitate early customer interaction. The expected result is that the time to achieve an approved set of implementation requirements which meet the customer's needs can be greatly reduced. Finally, by increasing the discipline in requirements management, through the use of base lining procedures, a tighter coupling between customer requirements and the budget is provided. A twice-yearly projection of customer requirements accommodation, designated as the Capacity Projection Plan (CPP), provides customer feedback allowing the entire mission set to be serviced.

  3. Communication and cultural issues in providing reproductive health care to immigrant women: health care providers' experiences in meeting the needs of [corrected] Somali women living in Finland.

    Science.gov (United States)

    Degni, Filio; Suominen, Sakari; Essén, Birgitta; El Ansari, Walid; Vehviläinen-Julkunen, Katri

    2012-04-01

    Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

  4. Diffusion-Weighted Magnetic Resonance Imaging of Cerebrospinal Fluid in Patients with and without Communicating Hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Nasel, C.; Gentzsch, S.; Heimberger, K. [Cerebrovascular Imaging Workgroup of the Div. of Neuroradiology, Dept. of Radiology, Medical Univ. Vienna, Vienna (Austria)

    2007-09-15

    Background: Recent concepts about cerebrospinal fluid (CSF) circulation in communicating hydrocephalus (CoHy), which is also termed 'restricted arterial pulsation hydrocephalus,' suggest reduced arterial pulsations of subarachnoid vessels with a smaller amount of CSF shifted in subarachnoid spaces during the early systole. The postulated restriction of subarachnoid arterial pulsations in CoHy should induce a smaller motion artifact and reduced local stream effects in CSF in magnetic resonance (MR) diffusion-weighted imaging (DWI). Purpose: To investigate the maximum diffusivity in CSF in patients with and without CoHy using DWI. Material and Methods: 12 patients without CSF circulation disturbances and six cases with proven CoHy were assessed. Diffusion was measured in six non collinear directions without triggering the arterial pulse wave (scan time 6:45 min, voxel size 2x2x2 mm). Due to expected artifacts, the calculated maximum diffusivity was called apparent diffusivity. Regional high and low apparent diffusivity was assessed in CSF spaces on newly created 3D CSF motion maps. Results: Patients with regular CSF circulation exhibited high apparent diffusivity in CSF in basal subarachnoid spaces, whereas apparent diffusivity was low there in patients with CoHy. Conclusion: DWI opens a feasible approach to study CSF motion in the neurocranium. Restricted arterial pulsations seem to be involved in CoHy.

  5. Diffusion-Weighted Magnetic Resonance Imaging of Cerebrospinal Fluid in Patients with and without Communicating Hydrocephalus

    International Nuclear Information System (INIS)

    Nasel, C.; Gentzsch, S.; Heimberger, K.

    2007-01-01

    Background: Recent concepts about cerebrospinal fluid (CSF) circulation in communicating hydrocephalus (CoHy), which is also termed 'restricted arterial pulsation hydrocephalus,' suggest reduced arterial pulsations of subarachnoid vessels with a smaller amount of CSF shifted in subarachnoid spaces during the early systole. The postulated restriction of subarachnoid arterial pulsations in CoHy should induce a smaller motion artifact and reduced local stream effects in CSF in magnetic resonance (MR) diffusion-weighted imaging (DWI). Purpose: To investigate the maximum diffusivity in CSF in patients with and without CoHy using DWI. Material and Methods: 12 patients without CSF circulation disturbances and six cases with proven CoHy were assessed. Diffusion was measured in six non collinear directions without triggering the arterial pulse wave (scan time 6:45 min, voxel size 2x2x2 mm). Due to expected artifacts, the calculated maximum diffusivity was called apparent diffusivity. Regional high and low apparent diffusivity was assessed in CSF spaces on newly created 3D CSF motion maps. Results: Patients with regular CSF circulation exhibited high apparent diffusivity in CSF in basal subarachnoid spaces, whereas apparent diffusivity was low there in patients with CoHy. Conclusion: DWI opens a feasible approach to study CSF motion in the neurocranium. Restricted arterial pulsations seem to be involved in CoHy

  6. Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

    Science.gov (United States)

    Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander; Ben-David, Boaz M.; Saragosa, Marianne; Boscart, Veronique M.; Wilson, Rozanne; Galimidi-Epstein, Karmit K.

    2016-01-01

    Background: Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care. Purpose: To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden. Method: The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study. Results: The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden. Conclusion: The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden. PMID:27899433

  7. 49 CFR 1102.2 - Ex parte communications prohibited; penalties provided.

    Science.gov (United States)

    2010-10-01

    ... communication by means of the news media that in the ordinary course of business of the publisher is intended to... of the Board of such ex parte communications sent to the Section Chief. The Designated Agency Ethics... Ethics Official. The Chairman may require that any communication be placed in the correspondence section...

  8. THE INFORMATION TECHNOLOGY AND COMMUNICATION USED BY LOGISTICS SERVICE PROVIDERS: LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Carolina Luisa dos Santos Vieira

    2012-10-01

    Full Text Available With the growth in the supply of logistics services, and the increase of competition, the use of information and communication technologies (ICT is now considered by logistics service providers (LSP, a source of competitive advantage. Through a literature review, this paper seeks to identify which technologies have been used by the PSL. Analyzing 47 articles on the subject, published in international journal that has the largest number of works on PSL, applications of technologies by PSL were analyzed according to a taxonomy suggested based on literature - software, hardware and networks. Among the results highlight the technologies cited by categories and greater scientific interest, such as EDI, RFID, TTS, WMS and Internet.

  9. A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

    Science.gov (United States)

    Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

    2015-03-15

    Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

  10. Improving sexual health communication between older women and their providers: how the integrative model of behavioral prediction can help.

    Science.gov (United States)

    Hughes, Anne K; Rostant, Ola S; Curran, Paul G

    2014-07-01

    Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.

  11. Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

    Science.gov (United States)

    Riggie, Jennifer

    2013-01-01

    The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

  12. Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

    Science.gov (United States)

    Gálvez, Patricia; Valencia, Alejandra; Palomino, Ana M; Cataldo, Marjorie; Schwingel, Andiara

    2015-01-01

    Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

  13. The efficacy of online communication platforms for plastic surgeons providing extended disaster relief.

    Science.gov (United States)

    Fan, Kenneth L; Avashia, Yash J; Dayicioglu, Deniz; DeGennaro, Vincent A; Thaller, Seth R

    2014-04-01

    Immediately after the January 2010 earthquake in Haiti, plastic surgeons provided disaster relief services through the University of Miami Miller School of Medicine for 5 months. To improve surgical care and promote awareness of plastic surgery's role in humanitarian assistance, an online communication platform (OCP) was initiated. An OCP is a Web-based application combining Web blogging, picture uploading, news posting, and private messaging systems into a single platform. The purpose of this study was to analyze the use of OCP during disaster relief. Surgeries performed during the period from January 13 to May 28, 2010, were documented. The OCP was established with 4 priorities: ease of use, multimedia integration, organization capabilities, and security. Web traffic was documented. A 17-question survey was administered to 18 plastic surgeons who used the OCP after 1 year to assess their attitudes and perceptions. From January 13 to May 28, 2010, 413 operations were performed at the field hospital. Of the overall number of procedures, 46.9% were performed by plastic surgery teams. In a year, beginning from January 12, 2011, the OCP had 1117 visits with 530 absolute unique visitors. Of 17 plastic surgeons, 71% responded that the OCP improved follow-up and continuity of care by debriefing rotating plastic surgery teams. One hundred percent claimed that the OCP conveyed the role of plastic surgeons with the public. Results demonstrate the necessity of OCP during disaster relief. Online communication platform permitted secure exchange of surgical management details, follow-up, photos, and miscellaneous necessary recommendations. Posted experiences and field hospital progress assisted in generating substantial awareness regarding the significant role and contribution played by plastic surgeons in disaster relief.

  14. The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

    Science.gov (United States)

    Hou, Jiran; Shim, Minsun

    2010-01-01

    Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.

  15. We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record.

    Science.gov (United States)

    Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant; Wu, Ethel

    2015-05-01

    Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement. Seventy-five of 124 (60%) clinicians completed the survey. Although most PCPs reported receiving automated discharge notifications (71%), only 39% felt that notifications plus discharge summaries were adequate for safe transitions of care. PCPs expressed that complex hospitalizations necessitated additional communication via e-mail or telephone; only 31% reported receiving such communication. The content most important in additional communication included medication changes, follow-up actions, and active medical issues. Despite optimized access to information provided by a shared EMR, only 52% of PCPs were satisfied with current discharge communication. PCPs express a continued need for high-touch communication for safe transitions of care. Further standardization of discharge communication practices is necessary. © 2015 Society of Hospital Medicine.

  16. [Communication strategies used by health care professionals in providing palliative care to patients].

    Science.gov (United States)

    Trovo de Araújo, Monica Martins; da Silva, Maria Júlia Paes

    2012-06-01

    The objective of this study is to verify the relevance and utilization of communication strategies in palliative care. This is a multicenter qualitative study using a questionnaire, performed from August of 2008 to July of 2009 with 303 health care professionals who worked with patients receiving palliative care. Data were subjected to descriptive statistical analysis. Most participants (57.7%) were unable to state at least one verbal communication strategy, and only 15.2% were able to describe five signs or non-verbal communication strategies. The verbal strategies most commonly mentioned were those related to answering questions about the disease/treatment. Among the non-verbal strategies used, the most common were affective touch, looking, smiling, physical proximity, and careful listening. Though professionals have assigned a high degree of importance to communication in palliative care, they showed poor knowledge regarding communication strategies. Final considerations include the necessity of training professionals to communicate effectively in palliative care.

  17. Communication about Sexuality and Intimacy in Couples Affected by Lung Cancer and their Clinical Care Providers

    Science.gov (United States)

    Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R.

    2012-01-01

    OBJECTIVE Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health care provider, patient, and partner perspectives on: 1) the effects of lung cancer on physical and emotional intimacy, 2) the ways in which intimacy affects the experience of living with lung cancer, and 3) communication about intimacy and sexuality in the context of lung cancer. METHODS Qualitative, in-depth interviews with 8 cancer care providers and 13 married couples (ages 43–79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. RESULTS Most cancer care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. CONCLUSIONS Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. PMID:20540168

  18. Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

    Science.gov (United States)

    Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

    2016-01-01

    Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

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

    OpenAIRE

    Leonard, M; Graham, S; Bonacum, D

    2004-01-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

  20. Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer.

    Science.gov (United States)

    Nyrop, Kirsten A; Deal, Allison M; Williams, Grant R; Guerard, Emily J; Pergolotti, Mackenzi; Muss, Hyman B

    2016-02-01

    National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about physical activity during routine clinic visits with patients with early-stage breast, colon, or prostate cancer. This study used a retrospective chart review for documentation of inquiries or recommendations pertaining to physical activity in clinician notes and after-visit patient summaries. In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early-stage cancer patients. Thirty-five percent of these encounters included a provider communication about "physical activity," "exercise," or "activity." Encounters with a medical oncologist resulted in a physical activity communication 55% of the time, whereas encounters with other clinician specialties did so 20% of the time (P communication increased with patient age (P communications was significantly higher (46%, 37%, and 58%, respectively) than the rate when the visit was during radiation treatment or surgery (6% and 19%, respectively; P communications during routine clinic visits; however, the frequency of physical activity communications varies among providers. Interventions are needed to remind and encourage all oncology providers to encourage their patients with early-stage cancer to be physically active. . © 2015 American Cancer Society.

  1. Impact of audit and feedback and pay-for-performance interventions on pediatric hospitalist discharge communication with primary care providers.

    Science.gov (United States)

    Tejedor-Sojo, Javier; Creek, Tracy; Leong, Traci

    2015-01-01

    The study team sought to improve hospitalist communication with primary care providers (PCPs) at discharge through interventions consisting of (a) audit and feedback and (b) inclusion of a discharge communication measure in the incentive compensation for pediatric hospitalists. The setting was a 16-physician pediatric hospitalist group within a tertiary pediatric hospital. Discharge summaries were selected randomly for documentation of communication with PCPs. At baseline, 57% of charts had documented communication with PCPs, increasing to 84% during the audit and feedback period. Following the addition of a financial incentive, documentation of communication with PCPs increased to 93% and was sustained during the combined intervention period. The number of physicians meeting the study's performance goal increased from 1 to 14 by the end of the study period. A financial incentive coupled with an audit and feedback tool was effective at modifying physician behavior, achieving focused, measurable quality improvement gains. © 2014 by the American College of Medical Quality.

  2. DC microgrids providing frequency regulation in electrical power system - imperfect communication issues

    DEFF Research Database (Denmark)

    Bašić, Hrvoje; Dragicevic, Tomislav; Pandžić, Hrvoje

    2017-01-01

    This paper presents a model of multiple DC microgrids with battery energy storage systems and demand response capability, taking part in primary frequency regulation of electrical power system. Although DC microgrids can contribute to stability and efficiency of frequency regulation, these complex...... systems may cause serious stability issues due to the imperfect communication. This work presents possible scenarios of unstable primary frequency regulation in a simplified model of electrical power system with DC microgrids, which are controlled through communication network....

  3. 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.

  4. Patients’ Perception of Patient–Provider Communication in Fertility Preservation Decision Making Among Young Women With Cancer

    Directory of Open Access Journals (Sweden)

    Aakrati Mathur

    2013-09-01

    Full Text Available Fertility preservation (FP for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to be directive when referring to the fertility clinic. Later in the process, they expect a supportive style of communication from providers. Patient-accessible language, supportive and reassuring styles of communication, and an existing relationship with providers may enhance well-being of the patients.

  5. Patient-Provider Communication: Experiences of Low-Wage-Earning Breast Cancer Survivors in Managing Cancer and Work.

    Science.gov (United States)

    Nichols, Helen M; Swanberg, Jennifer E; Vanderpool, Robin C

    2018-02-26

    In 2017, there will be more than 250,000 new diagnoses of invasive breast cancer; most cases will occur in working-age women. The goal of this qualitative study was to explore low-wage-earning breast cancer survivors' experiences communicating with their oncology team about cancer and employment issues. Twenty-four low-wage-earning breast cancer survivors in the USA were interviewed in 2012 using a structured interview protocol. Sociodemographic data, cancer history, and patient-provider communication experiences regarding the management of cancer and work were collected. Interviews were analyzed using grounded theory strategy of constant comparative analysis. Low-wage-earning breast cancer survivors' experiences communicating with their oncology team about employment and cancer focused on three dimensions of patient-provider communication: extent, quality, and content. Over 70% of respondents reported no communication or only routine communication with their providers regarding work; three quarters of women reported poor or standard communication quality, and content of work-related communication covered scheduling issues, work absences, continuing to work during treatment, and financial concerns. Communication between oncology care teams and low-wage-earning cancer patients is critical to the successful management of treatment and work responsibilities given the vulnerable employment situation of these women. There is a need for education of oncology team members about how cancer and its treatment can impact employment for all workers, but especially for low-wage workers, thereby allowing the care team to address these issues proactively and help patients successfully manage both cancer treatment and work responsibilities.

  6. Co-cultures provide a new tool to probe communication between adult sensory neurons and urothelium.

    Science.gov (United States)

    O'Mullane, Lauren M; Keast, Janet R; Osborne, Peregrine B

    2013-08-01

    Recent evidence suggests that the urothelium functions as a sensory transducer of chemical, mechanical or thermal stimuli and signals to nerve terminals and other cells in the bladder wall. The cellular and molecular basis of neuro-urothelial communication is not easily studied in the intact bladder. This led us to establish a method of co-culturing dorsal root ganglion sensory neurons and bladder urothelial cells. Sensory neurons and urothelial cells obtained from dorsal root ganglia and bladders dissected from adult female Sprague-Dawley® rats were isolated by enzyme treatment and mechanical dissociation. They were plated together or separately on collagen coated substrate and cultured in keratinocyte medium for 48 to 72 hours. Retrograde tracer labeling was performed to identify bladder afferents used for functional testing. Neurite growth and complexity in neurons co-cultured with urothelial cells was increased relative to that in neuronal monocultures. The growth promoting effect of urothelial cells was reduced by the tyrosine kinase inhibitor K252a but upstream inhibition of nerve growth factor signaling with TrkA-Fc had no effect. Fura-2 calcium imaging of urothelial cells showed responses to adenosine triphosphate (100 μM) and activation of TRPV4 (4α-PDD, 10 μM) but not TRPV1 (capsaicin, 1 μM), TRPV3 (farnesyl pyrophosphate, 1 μM) or TRPA1 (mustard oil, 100 μM). In contrast, co-cultured neurons were activated by all agonists except farnesyl pyrophosphate. Co-culturing provides a new methodology for investigating neuro-urothelial interactions in animal models of urological conditions. Results suggest that neuronal properties are maintained in the presence of urothelium and neurite growth is potentiated by a nerve growth factor independent mechanism. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

    Science.gov (United States)

    Klarica, Marijan; Radoš, Milan; Erceg, Gorislav; Petošić, Antonio; Jurjević, Ivana; Orešković, Darko

    2014-01-01

    Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF) pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

  8. The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

    Directory of Open Access Journals (Sweden)

    Marijan Klarica

    Full Text Available Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

  9. Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

    Science.gov (United States)

    Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

    2017-01-01

    Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

  10. Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda.

    Directory of Open Access Journals (Sweden)

    Jolly Beyeza-Kashesya

    Full Text Available Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.75% of the sample was female; 61% were on antiretroviral therapy; and 61% had HIV-negative or unknown status partners. Nearly all (98% reported the desire to discuss childbearing intentions with their HIV provider; however, only 44% reported such discussions, the minority (28% of which was initiated by the provider. Issues discussed with HIV providers included: HIV transmission risk to partner (30%, HIV transmission risk to child (30%, and how to prevent transmission to the child (27%; only 8% discussed safer conception methods. Regression analysis showed that those who had communicated with providers about childbearing were more likely to have been diagnosed with HIV for a longer period [OR (95% CI = 1.09 (1.03, 1.15], while greater internalized childbearing stigma was associated with lower odds of this communication [OR (95% CI = 0.70 (0.49, 0.99], after controlling for all bivariate correlates and basic demographics.Communication between HIV clients and providers about childbearing needs is poor and associated with stigma. Innovations to mitigate stigma among clients as well as training to improve health worker communication and skills related to safer conception counseling is needed.

  11. Student-Run Communications Agencies: Providing Students with Real-World Experiences That Impact Their Careers

    Science.gov (United States)

    Bush, Lee; Haygood, Daniel; Vincent, Harold

    2017-01-01

    While several studies have examined the learning outcomes of student-run communications agencies, these studies have mostly been from the perspective of faculty advisors. Through in-depth interviews with student agency graduates, this study examined how current industry professionals perceive the benefits of their student agency experiences and…

  12. Providing a Flexible Course in Multicultural, International Communications within a Traditional University School of Business.

    Science.gov (United States)

    Joy, Robert O.

    1990-01-01

    Describes a summer course designed for students interested in business, workers in business, and entrepreneurs to improve their skills in multicultural international business communication. Notes that students' comments and teacher evaluations suggest that the experience with the class was generally positive. (RS)

  13. Effectiveness of a training program in supervisors' ability to provide feedback on residents' communication skills

    NARCIS (Netherlands)

    Junod Perron, N.; Nendaz, M.; Louis-Simonet, M.; Sommer, J.; Gut, A.; Baroffio, A.; Dolmans, D.; Vleuten, C.P.M. van der

    2013-01-01

    Teaching communication skills (CS) to residents during clinical practice remains problematic. Direct observation followed by feedback is a powerful way to teach CS in clinical practice. However, little is known about the effect of training on feedback skills in this field. Controlled studies are

  14. Patients' perspective of the design of provider-patients electronic communication services.

    Science.gov (United States)

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

    2014-06-12

    Information Delivery is one the most important tasks in healthcare practice. This article discusses patient's tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design.

  15. Gender differences in health care provider-patient communication: are they due to style, stereotypes, or accommodation?

    Science.gov (United States)

    Street, Richard L

    2002-12-01

    This article examines gender differences in health care provider-patient communication within the framework of an ecological model of communication in the medical encounter. The ecological perspective posits that, although health care provider-patient interactions are situated within a number of contexts (e.g. organizational, political, cultural), the interpersonal domain is the primary context within which these interactions unfold. Hence, gender may influence provider-patient interaction to the extent that it can be linked to the interactants' goals, skills, perceptions, emotions, and the way the participants adapt to their partner's communication. The evidence reviewed in this essay indicates that gender differences in medical encounters may come from several sources including differences in men's and women's communicative styles, perceptions of their partners, and in the way they accommodate their partner's behavior during the interaction. However, because gender is but one of many personal and partner variables (e.g. age, ethnicity, personal experiences) that can influence these processes, gender differences are often quite modest (if apparent at all) when examined across a population of health care providers and patients. Implications for future research and communicative skill training are discussed.

  16. Barriers to Office-Based Mental Health Care and Interest in E-Communication With Providers: A Survey Study.

    Science.gov (United States)

    Rai, Minnie; Vigod, Simone N; Hensel, Jennifer M

    2016-08-01

    With rising availability and use of Internet and mobile technology in society, the demand and need for its integration into health care is growing. Despite great potential within mental health care and growing uptake, there is still little evidence to guide how these tools should be integrated into traditional care, and for whom. To examine factors that might inform how e-communication should be implemented in our local outpatient mental health program, including barriers to traditional office-based care, patient preferences, and patient concerns. We conducted a survey in the waiting room of our outpatient mental health program located in an urban, academic ambulatory hospital. The survey assessed (1) age, mobile phone ownership, and general e-communication usage, (2) barriers to attending office-based appointments, (3) preferences for, and interest in, e-communication for mental health care, and (4) concerns about e-communication use for mental health care. We analyzed the data descriptively and examined associations between the presence of barriers, identifying as a social media user, and interest level in e-communication. Respondents (N=68) were predominantly in the age range of 25-54 years. The rate of mobile phone ownership was 91% (62/68), and 59% (40/68) of respondents identified as social media users. There was very low existing use of e-communication between providers and patients, with high levels of interest endorsed by survey respondents. Respondents expressed an interest in using e-communication with their provider to share updates and get feedback, coordinate care, and get general information. In regression analysis, both a barrier to care and identifying as a social media user were significantly associated with e-communication interest (P=.03 and P=.003, respectively). E-communication interest was highest among people who both had a barrier to office-based care and were a social media user. Despite high interest, there were also many concerns

  17. A Framework to Improve Communication and Reliability Between Cloud Consumer and Provider in the Cloud

    OpenAIRE

    Vivek Sridhar

    2014-01-01

    Cloud services consumers demand reliable methods for choosing appropriate cloud service provider for their requirements. Number of cloud consumer is increasing day by day and so cloud providers, hence requirement for a common platform for interacting between cloud provider and cloud consumer is also on the raise. This paper introduces Cloud Providers Market Platform Dashboard. This will act as not only just cloud provider discoverability but also provide timely report to consumer on cloud ser...

  18. An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal

    OpenAIRE

    Clarke, M; Mars, M

    2014-01-01

    This article has been made available through the Brunel Open Access Publishing Fund. Abstract Background: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. Materials and Methods: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access...

  19. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.

    Science.gov (United States)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-05-01

    In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV. Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'. Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Critical care providers refer to information tools less during communication tasks after a critical care clinical information system introduction.

    Science.gov (United States)

    Ballermann, Mark; Shaw, Nicola T; Mayes, Damon C; Gibney, R T Noel

    2011-01-01

    Electronic documentation methods may assist critical care providers with information management tasks in Intensive Care Units (ICUs). We conducted a quasi-experimental observational study to investigate patterns of information tool use by ICU physicians, nurses, and respiratory therapists during verbal communication tasks. Critical care providers used tools less at 3 months after the CCIS introduction. At 12 months, care providers referred to paper and permanent records, especially during shift changes. The results suggest potential areas of improvement for clinical information systems in assisting critical care providers in ensuring informational continuity around their patients.

  1. Web-Based Tools for Text-Based Patient-Provider Communication in Chronic Conditions: Scoping Review.

    Science.gov (United States)

    Voruganti, Teja; Grunfeld, Eva; Makuwaza, Tutsirai; Bender, Jacqueline L

    2017-10-27

    Patients with chronic conditions require ongoing care which not only necessitates support from health care providers outside appointments but also self-management. Web-based tools for text-based patient-provider communication, such as secure messaging, allow for sharing of contextual information and personal narrative in a simple accessible medium, empowering patients and enabling their providers to address emerging care needs. The objectives of this study were to (1) conduct a systematic search of the published literature and the Internet for Web-based tools for text-based communication between patients and providers; (2) map tool characteristics, their intended use, contexts in which they were used, and by whom; (3) describe the nature of their evaluation; and (4) understand the terminology used to describe the tools. We conducted a scoping review using the MEDLINE (Medical Literature Analysis and Retrieval System Online) and EMBASE (Excerpta Medica Database) databases. We summarized information on the characteristics of the tools (structure, functions, and communication paradigm), intended use, context and users, evaluation (study design and outcomes), and terminology. We performed a parallel search of the Internet to compare with tools identified in the published literature. We identified 54 papers describing 47 unique tools from 13 countries studied in the context of 68 chronic health conditions. The majority of tools (77%, 36/47) had functions in addition to communication (eg, viewable care plan, symptom diary, or tracker). Eight tools (17%, 8/47) were described as allowing patients to communicate with the team or multiple health care providers. Most of the tools were intended to support communication regarding symptom reporting (49%, 23/47), and lifestyle or behavior modification (36%, 17/47). The type of health care providers who used tools to communicate with patients were predominantly allied health professionals of various disciplines (30%, 14

  2. Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential.

    Science.gov (United States)

    McBride, Deborah L; LeVasseur, Sandra A

    2017-04-13

    Coincident with the proliferation of employer-provided mobile communication devices, personal communication devices, including basic and enhanced mobile phones (smartphones) and tablet computers that are owned by the user, have become ubiquitous among registered nurses working in hospitals. While there are numerous benefits of personal communication device use by nurses at work, little is known about the impact of these devices on in-patient care. Our aim was to examine how hospital-registered nurses use their personal communication devices while doing both work-related and non‒work-related activities and to assess the impact of these devices on in-patient care. A previously validated survey was emailed to 14,797 members of two national nursing organizations. Participants were asked about personal communication device use and their opinions about the impact of these devices on their own and their colleagues' work. Of the 1268 respondents (8.57% response rate), only 5.65% (70/1237) never used their personal communication device at work (excluding lunch and breaks). Respondents self-reported using their personal communication devices at work for work-related activities including checking or sending text messages or emails to health care team members (29.02%, 363/1251), as a calculator (25.34%, 316/1247), and to access work-related medical information (20.13%, 251/1247). Fewer nurses reported using their devices for non‒work-related activities including checking or sending text messages or emails to friends and family (18.75%, 235/1253), shopping (5.14%, 64/1244), or playing games (2.73%, 34/1249). A minority of respondents believe that their personal device use at work had a positive effect on their work including reducing stress (29.88%, 369/1235), benefiting patient care (28.74%, 357/1242), improving coordination of patient care among the health care team (25.34%, 315/1243), or increasing unit teamwork (17.70%, 220/1243). A majority (69.06%, 848/1228) of

  3. Fluid Centrality: A Social Network Analysis of Social-Technical Relations in Computer-Mediated Communication

    Science.gov (United States)

    Enriquez, Judith Guevarra

    2010-01-01

    In this article, centrality is explored as a measure of computer-mediated communication (CMC) in networked learning. Centrality measure is quite common in performing social network analysis (SNA) and in analysing social cohesion, strength of ties and influence in CMC, and computer-supported collaborative learning research. It argues that measuring…

  4. Mixing students and performance artists to provide innovative ways of communicating scientific research

    Science.gov (United States)

    van Manen, S. M.

    2007-12-01

    In May 2007 the Open University (U.K.) in conjunction with the MK (Milton Keynes) Gallery invited performance artists Noble and Silver to work with a group of students to design innovative methods of disseminating their research to a general audience. The students created a multitude of well-received live and multimedia performances based on their research. Students found they greatly benefited from the artists' and each others' different viewpoints and backgrounds, resulting in improved communication skills and varying interpretations of their own topic of interest. This work focuses on research aimed at identifying precursory activity at volcanoes using temperature, earthquake and ground movement data, to aid improvement of early warning systems. For this project an aspect of the research relevant to the public was chosen: the importance of appropriately timed warnings regarding the possibility of an eruption. If a warning is issued too early it may cause complacency and apathy towards the situation, whereas issuing a warning too late may endanger lives and property. An interactive DVD was produced which leads the user through the events preceding a volcanic eruption. The goal is to warn the public about the impending eruption at the most appropriate time. Data is presented in short film clips, after which questions are posed. Based on the player's answers the consequences or follow-up events of the choices are explored. We aim to improve and expand upon this concept in the near future, as well as making the DVD available to schools for educational purposes.

  5. Assistance dogs provide a useful behavioral model to enrich communicative skills of assistance robots.

    Science.gov (United States)

    Gácsi, Márta; Szakadát, Sára; Miklósi, Adám

    2013-01-01

    These studies are part of a project aiming to reveal relevant aspects of human-dog interactions, which could serve as a model to design successful human-robot interactions. Presently there are no successfully commercialized assistance robots, however, assistance dogs work efficiently as partners for persons with disabilities. In Study 1, we analyzed the cooperation of 32 assistance dog-owner dyads performing a carrying task. We revealed typical behavior sequences and also differences depending on the dyads' experiences and on whether the owner was a wheelchair user. In Study 2, we investigated dogs' responses to unforeseen difficulties during a retrieving task in two contexts. Dogs displayed specific communicative and displacement behaviors, and a strong commitment to execute the insoluble task. Questionnaire data from Study 3 confirmed that these behaviors could successfully attenuate owners' disappointment. Although owners anticipated the technical competence of future assistance robots to be moderate/high, they could not imagine robots as emotional companions, which negatively affected their acceptance ratings of future robotic assistants. We propose that assistance dogs' cooperative behaviors and problem solving strategies should inspire the development of the relevant functions and social behaviors of assistance robots with limited manual and verbal skills.

  6. An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers.

    Science.gov (United States)

    Doorenbos, Ardith Z; Levy, Wayne C; Curtis, J Randall; Dougherty, Cynthia M

    2016-09-01

    Heart failure patients contend with a markedly impaired quality of life, experiencing emotional distress and severe physical discomfort that increases in frequency in the last months of life. Improving communication between patients and providers about goals of care has the potential to improve patient-provider communication and patient outcomes. To determine the effects of a goals-of-care (GoC) intervention compared to usual care on the number of GoC conversations, quality of communication between patients and providers, referrals to palliative care services and completion of advance care directives. A two-group randomized study (n = 40/group) compared a GoC intervention to usual care, conducted in an academic heart failure (HF) clinic. The GoC intervention was a previsit patient activation-education, telephone-based intervention delivered by a nurse. The primary outcome of the study was number of GoC conversations between HF patients and HF providers. Secondary outcomes were quality of communication, number of referrals to palliative care, and completion of advance directives. Patients averaged 58.15 ± 11.26 years of age, with mean left ventricular ejection fraction = 30.31 ± 9.72% and Seattle Heart Failure Model scores = 95.1 ± 1.60. There was a significant increase in goals-of-care conversations (58% vs. 2.6%, P communication (P = 0.03) in the GoC group compared to usual care after the intervention. There were no differences between groups on the other outcomes. The GoC intervention resulted in more GoC conversations and higher quality communication between HF patients and providers without increased anxiety or depression. Further studies are needed to assess impact on longer term quality of care and patient outcomes. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Short communication: Pseudomonas azotoformans causes gray discoloration in HTST fluid milk.

    Science.gov (United States)

    Evanowski, Rachel L; Reichler, Samuel J; Kent, David J; Martin, Nicole H; Boor, Kathryn J; Wiedmann, Martin

    2017-10-01

    Pseudomonas species are well recognized as dairy product spoilage organisms, particularly due to their ability to grow at refrigeration temperatures. Although Pseudomonas-related spoilage usually manifests itself in flavor, odor, and texture defects, which are typically due to production of bacterial enzymes, Pseudomonas is also reported to cause color defects. Because of consumer complaints, a commercial dairy company shipped 4 samples of high temperature, short time (HTST)-pasteurized milk with distinctly gray colors to our laboratory. Bacterial isolates from all 4 samples were identified as Pseudomonas azotoformans. All isolates shared the same partial 16S rDNA sequence and showed black pigmentation on Dichloran Rose Bengal Chloramphenicol agar. Inoculation of one pigment-producing P. azotoformans isolate into HTST-pasteurized fluid milk led to development of gray milk after 14 d of storage at 6°C, but only in containers that had half of the total volume filled with milk (∼500 mL of milk in ∼1,000-mL bottles). We conclusively demonstrate that Pseudomonas can cause a color defect in fluid milk that manifests in gray discoloration, adding to the palette of color defects known to be caused by Pseudomonas. This information is of considerable interest to the dairy industry, because dairy processors and others may not typically associate black or gray colors in fluid milk with the presence of microbial contaminants but rather with product tampering (e.g., addition of ink) or other inadvertent chemical contamination. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  8. Elements of patient-health-care provider communication related to cardiovascular rehabilitation referral.

    Science.gov (United States)

    Pourhabib, Sanam; Chessex, Caroline; Murray, Judy; Grace, Sherry L

    2016-04-01

    Cardiovascular rehabilitation has been designed to decrease the burden of cardiovascular disease. This study described (1) patient-health-care provider interactions regarding cardiovascular rehabilitation and (2) which discussion elements were related to patient referral. This was a prospective study of cardiovascular patients and their health-care providers. Discussion utterances were coded using the Roter Interaction Analysis System. Discussion between 26 health-care providers and 50 patients were recorded. Cardiovascular rehabilitation referral was related to greater health-care provider interactivity (odds ratio = 2.82, 95% confidence interval = 1.01-7.86) and less patient concern and worry (odds ratio = 0.64, 95% confidence interval = 0.45-0.89). Taking time for reciprocal discussion and allaying patient anxiety may promote greater referral. © The Author(s) 2014.

  9. Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr).

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S

    2015-08-01

    This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'scommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    OpenAIRE

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...

  11. The Synthetic Biology Open Language (SBOL) provides a community standard for communicating designs in synthetic biology.

    Science.gov (United States)

    Galdzicki, Michal; Clancy, Kevin P; Oberortner, Ernst; Pocock, Matthew; Quinn, Jacqueline Y; Rodriguez, Cesar A; Roehner, Nicholas; Wilson, Mandy L; Adam, Laura; Anderson, J Christopher; Bartley, Bryan A; Beal, Jacob; Chandran, Deepak; Chen, Joanna; Densmore, Douglas; Endy, Drew; Grünberg, Raik; Hallinan, Jennifer; Hillson, Nathan J; Johnson, Jeffrey D; Kuchinsky, Allan; Lux, Matthew; Misirli, Goksel; Peccoud, Jean; Plahar, Hector A; Sirin, Evren; Stan, Guy-Bart; Villalobos, Alan; Wipat, Anil; Gennari, John H; Myers, Chris J; Sauro, Herbert M

    2014-06-01

    The re-use of previously validated designs is critical to the evolution of synthetic biology from a research discipline to an engineering practice. Here we describe the Synthetic Biology Open Language (SBOL), a proposed data standard for exchanging designs within the synthetic biology community. SBOL represents synthetic biology designs in a community-driven, formalized format for exchange between software tools, research groups and commercial service providers. The SBOL Developers Group has implemented SBOL as an XML/RDF serialization and provides software libraries and specification documentation to help developers implement SBOL in their own software. We describe early successes, including a demonstration of the utility of SBOL for information exchange between several different software tools and repositories from both academic and industrial partners. As a community-driven standard, SBOL will be updated as synthetic biology evolves to provide specific capabilities for different aspects of the synthetic biology workflow.

  12. Validation of King's transaction process for healthcare provider-patient communication in pharmaceutical context: One cross-sectional study.

    Science.gov (United States)

    Wang, Dan; Liu, Chenxi; Zhang, Zinan; Ye, Liping; Zhang, Xinping

    2018-03-27

    With the impressive advantages of patient-pharmacist communication being advocated and poor pharmacist-patient communication in different settings, it is of great significance and urgency to explore the mechanism of the pharmacist-patient communicative relationship. The King's theory of goal attainment is proposed as one of the most promising models to be applied, because it takes into consideration both improving the patient-pharmacist relationship and attaining patients' health outcomes. This study aimed to validate the King's transaction process and build the linkage between the transaction process and patient satisfaction in a pharmaceutical context. A cross-sectional study was conducted in four tertiary hospitals in two provincial cities (Wuhan and Shanghai) in central and east China in July 2017. Patients over 18 were investigated in the pharmacies of the hospitals. The instrument for the transaction process was revised and tested. Path analysis was conducted for the King's transaction process and its relationship with patient satisfaction. Five hundred eighty-nine participants were investigated for main study. Prior to the addition of covariates, the hypothesised model of the King's transaction process was validated, in which all paths of the transaction process were statistically significant (p process had direct effects on patient satisfaction (p process was established as one valid theoretical framework of healthcare provider-patient communication in a pharmaceutical context. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

    Science.gov (United States)

    Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

    2012-01-01

    Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

  14. The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

    Science.gov (United States)

    Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

    2012-08-01

    This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

  15. Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.

    Science.gov (United States)

    Agénor, Madina; Bailey, Zinzi; Krieger, Nancy; Austin, S Bryn; Gottlieb, Barbara R

    2015-01-01

    Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.

  16. Communication between cochlear perilymph and cerebrospinal fluid through the cochlear modiolus visualized after intratympanic administration of Gd-DTPA

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Satake, Hiroko; Iwano, Shingo; Sone, Michihiko; Nakashima, Tsutomu

    2008-01-01

    Intratympanic injection of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) has been reported as a procedure to visualize endolymphatic hydrops of Meniere's disease. We frequently noted that cerebrospinal fluid (CSF) in the internal auditory canal (IAC) was also enhanced after this procedure. The purpose of this study was to evaluate how frequently this occurs and to investigate the specific features of patients who lack this communication. A total of 25 patients with clinically suspected endolymphatic hydrops underwent the procedure. After 24 h, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and 3D constructive interference in steady state (3D-CISS) were performed. The presence of contrast enhancement in the CSF space of the fundus of the IAC was evaluated. The contrast ratio between CSF of the IAC fundus and cerebellar white matter on the injected side was 1.49±0.65, and that of the noninjected side was 0.32±0.16 (P<0.01). Enhancement of the CSF space in the IAC fundus was seen in all but two subjects: one had enlarged endolymphatic duct and sac syndrome (EEDS), and the other had cochlear nerve agenesis. In these two patients, the cochlear modiolus seemed to be normal. Intratympanic Gd-DTPA administration can reveal permeability of the modiolus and might facilitate evaluation of functional abnormalities of the modiolus not detected by conventional imaging tests. (author)

  17. Providing Fast Discovery in D2D Communication with Full Duplex Technology

    DEFF Research Database (Denmark)

    Gatnau, Marta; Berardinelli, Gilberto; Mahmood, Nurul Huda

    2016-01-01

    technology to provide D2D fast discovery. Such framework provides an algorithm to estimate the number of neighbor devices and to dynamically decide the transmission probability, for adapting to network changes and meeting the 10 milliseconds target. Finally, a signaling scheme is proposed to reduce......In Direct Device-to-Device (D2D), the device awareness procedure known as the discovery phase is required prior to the exchange of data. This work considers autonomous devices where the infrastructure is not involved in the discovery procedure. Commonly, the transmission of the discovery message...... the network interference. Results show that our framework performs better than a static approach, reducing the time it takes to complete the discovery phase. In addition, supporting full duplex allows to further reduce the discovery time compared to half duplex transmission mode....

  18. 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.

  19. Colorectal cancer screening at US community health centers: Examination of sociodemographic disparities and association with patient-provider communication.

    Science.gov (United States)

    Lin, Sue C; McKinley, Duane; Sripipatana, Alek; Makaroff, Laura

    2017-11-01

    Colorectal cancer (CRC) screening rates are low among underserved populations. High-quality patient-physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient-provider communication on the receipt of CRC screening among HC patients. Using 2014 Health Center Patient Survey data, bivariate and multivariate analyses examined the association of sociodemographic variables (sex, race/ethnicity, age, geography, preferred language, household income, insurance, and employment status) and patient-provider communication with the receipt of CRC screening. Patients between the ages of 65 and 75 years (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.33-4.64) and patients not in the labor force (aOR, 2.32; 95% CI, 1.37-3.94) had higher odds of receiving CRC screening, whereas patients who were uninsured (aOR, 0.33; 95% CI, 0.18-0.61) and patients who were non-English-speaking (aOR, 0.42; 95% CI, 0.18-0.99) had lower odds. Patient-provider communication was not associated with the receipt of CRC screening. The CRC screening rate for HC patients was 57.9%, whereas the rate was 65.1% according to the 2012 Behavioral Risk Factor Surveillance System and 58.2% according to the 2013 National Health Interview Survey. The high ratings of patient-provider communication, regardless of the screening status, suggest strides toward a patient-centered medical home practice transformation that will assist in a positive patient experience. Addressing the lack of insurance, making culturally and linguistically appropriate patient education materials available, and training clinicians and care teams in cultural competency are critical for increasing future CRC screening rates. Cancer 2017

  20. Patient-provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Malta, Monica; Todd, Catherine S; Stibich, Mark A; Garcia, Thais; Pacheco, Diego; Bastos, Francisco I

    2010-12-01

    To qualitatively assess the influence of patient-provider communication on contraceptive choice among HIV-positive women in the context of universal antiretroviral therapy (ART) access. Focus group discussions (FGD; n=3), in-depth (IDI; n=15) and freelist interviews (FLI; n=36) were conducted with HIV-positive women aged 18-40 years recruited from public health units in Rio de Janeiro/Brazil. Of 70 participants, 49 used ART and the median time since HIV diagnosis was 6 years (range: 1-18). The majority of participants (71.4%) reported some degree of dissatisfaction with their health providers (usually lack of open dialogue) and a few reported experiences of stigma/prejudice during appointments. Intra, interpersonal and social factors modulated behaviors and reproductive health decisions, and those issues were rarely addressed by providers during HIV clinical care. Despite dramatic increases in survival and life quality after universal ART implementation in Brazil, reproductive health issues are neglected by multiple cadres of HIV health providers. Communication on reproductive health issues remains fragmented and potentially contradictory, compromising care in these settings. Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Patient-provider communication about medication use at the community pharmacy counter.

    Science.gov (United States)

    van Dijk, Marloes; Blom, Lyda; Koopman, Laura; Philbert, Daphne; Koster, Ellen; Bouvy, Marcel; van Dijk, Liset

    2016-02-01

    The objectives of this study were to, first, describe the information exchanged between pharmacy staff and patients about prescribed medication at the community pharmacy counter, and second, to investigate to what extent this met professional medication counselling guidelines. Pharmaceutical encounters were videotaped in four community pharmacies in the Netherlands. Patients were included if they collected a prescription for their own use. An observation protocol, including the MEDICODE checklist, was used to analyse the video recordings. A distinction was made between first and repeat prescriptions. One hundred fifty-three encounters were videotaped. When dispensing first prescriptions, pharmacy staff provided most information on instructions how to use the medication (83.3%), form of the medication (71.4%) and treatment duration (42.9%). Topics for repeat prescriptions (such as the effects of the medication and the incidence of observed adverse effects) were rarely discussed. Pharmacy staff rarely encouraged patients to ask questions. Pharmacy staff members provided little medication-related information at the counter, especially for repeat prescriptions, did not encourage active patient participation, and thereby did not adhere to the guidelines of their professional organisation. Further research is needed to understand the reasons for this. © 2015 Royal Pharmaceutical Society.

  2. Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India.

    Science.gov (United States)

    Lindquist, Benjamin; Strehlow, Matthew C; Rao, G V Ramana; Newberry, Jennifer A

    2016-07-08

    Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care. We sought to identify obstacles in the cellular communication process among GVK Emergency Management and Research Institute (GVK EMRI) EMTs in Gujarat, India. A convenience sample of practicing EMTs in Gujarat, India were surveyed regarding the barriers to call initiation and completion. 108 EMTs completed the survey. Overall, ninety-seven (89.8%) EMTs responded that the most common reason they did not initiate a call with the call center physician was insufficient time. Forty-six (42%) EMTs reported that they were unable to call the physician one or more times during a typical workweek (approximately 5-6 twelve-hour shifts/week) due to their hands being occupied performing direct patient care. Fifty-eight (54%) EMTs reported that they were unable to reach the call center physician, despite attempts, at least once a week. This study identified multiple barriers to communication, including insufficient time to call for advice and inability to reach call center physicians. Identification of simple interventions and best practices may improve communication and ensure timely and appropriate prehospital care.

  3. Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.

    Science.gov (United States)

    Porter, Laura S; Pollak, Kathryn I; Farrell, David; Cooper, Meredith; Arnold, Robert M; Jeffreys, Amy S; Tulsky, James A

    2015-10-01

    Patients often struggle to express their emotional concerns to their oncology providers and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers. The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study. The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients' expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47 to 64 %. This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.

  4. Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

    Science.gov (United States)

    Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

    2015-02-01

    When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

  5. "Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

    Science.gov (United States)

    Geist-Martin, Patricia; Bell, Keely K

    2009-10-01

    Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

  6. Impact of Family History Assessment on Communication with Family Members and Health Care Providers: A report from the Family Healthware™ Impact Trial (FHITr)

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.

    2015-01-01

    Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (psfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453

  7. Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

    Science.gov (United States)

    Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

    2013-11-01

    This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (Pcommunication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Variation in patient-provider communication by patient's race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey.

    Science.gov (United States)

    Aseltine, Robert H; Sabina, Alyse; Barclay, Gillian; Graham, Garth

    2016-01-01

    The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient's race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient-provider communication. We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents conducted between June 2012 and February 2013. Eight measures of patient-provider communication were analyzed using weighted general linear and logistic regression models. Patients' assessments of the quality of communication with their health care providers were generally positive. Hispanic patients, those who received care in a clinic or hospital setting, and those who did not consistently see the same provider reported significantly poorer communication with their providers. Our data suggest that improving patient-provider communication for Hispanic patients may be a critical step in achieving health equity. However, increased access to health care delivered outside of physician offices where there may not be consistency in providers across encounters may pose challenges to effective health communication.

  9. Variation in patient–provider communication by patient’s race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey

    Directory of Open Access Journals (Sweden)

    Robert H Aseltine

    2016-01-01

    Full Text Available Objectives: The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient’s race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient–provider communication. Methods: We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents conducted between June 2012 and February 2013. Eight measures of patient–provider communication were analyzed using weighted general linear and logistic regression models. Results: Patients’ assessments of the quality of communication with their health care providers were generally positive. Hispanic patients, those who received care in a clinic or hospital setting, and those who did not consistently see the same provider reported significantly poorer communication with their providers. Conclusion: Our data suggest that improving patient–provider communication for Hispanic patients may be a critical step in achieving health equity. However, increased access to health care delivered outside of physician offices where there may not be consistency in providers across encounters may pose challenges to effective health communication.

  10. Provider interaction with the electronic health record: the effects on patient-centered communication in medical encounters.

    Science.gov (United States)

    Street, Richard L; Liu, Lin; Farber, Neil J; Chen, Yunan; Calvitti, Alan; Zuest, Danielle; Gabuzda, Mark T; Bell, Kristin; Gray, Barbara; Rick, Steven; Ashfaq, Shazia; Agha, Zia

    2014-09-01

    The computer with the electronic health record (EHR) is an additional 'interactant' in the medical consultation, as clinicians must simultaneously or in alternation engage patient and computer to provide medical care. Few studies have examined how clinicians' EHR workflow (e.g., gaze, keyboard activity, and silence) influences the quality of their communication, the patient's involvement in the encounter, and conversational control of the visit. Twenty-three primary care providers (PCPs) from USA Veterans Administration (VA) primary care clinics participated in the study. Up to 6 patients per PCP were recruited. The proportion of time PCPs spent gazing at the computer was captured in real time via video-recording. Mouse click/scrolling activity was captured through Morae, a usability software that logs mouse clicks and scrolling activity. Conversational silence was coded as the proportion of time in the visit when PCP and patient were not talking. After the visit, patients completed patient satisfaction measures. Trained coders independently viewed videos of the interactions and rated the degree to which PCPs were patient-centered (informative, supportive, partnering) and patients were involved in the consultation. Conversational control was measured as the proportion of time the PCP held the floor compared to the patient. The final sample included 125 consultations. PCPs who spent more time in the consultation gazing at the computer and whose visits had more conversational silence were rated lower in patient-centeredness. PCPs controlled more of the talk time in the visits that also had longer periods of mutual silence. PCPs were rated as having less effective communication when they spent more time looking at the computer and when there was more periods of silence in the consultation. Because PCPs increasingly are using the EHR in their consultations, more research is needed to determine effective ways that they can verbally engage patients while simultaneously

  11. Metal-rich fluid inclusions provide new insights into unconformity-related U deposits (Athabasca Basin and Basement, Canada)

    Science.gov (United States)

    Richard, Antonin; Cathelineau, Michel; Boiron, Marie-Christine; Mercadier, Julien; Banks, David A.; Cuney, Michel

    2016-02-01

    The Paleoproterozoic Athabasca Basin (Canada) hosts numerous giant unconformity-related uranium deposits. The scope of this study is to establish the pressure, temperature, and composition (P-T-X conditions) of the brines that circulated at the base of the Athabasca Basin and in its crystalline basement before, during and after UO2 deposition. These brines are commonly sampled as fluid inclusions in quartz- and dolomite-cementing veins and breccias associated with alteration and U mineralization. Microthermometry and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) data from five deposits (Rabbit Lake, P-Patch, Eagle Point, Millennium, and Shea Creek) complement previously published data for the McArthur River deposit. In all of the deposits investigated, fluid inclusion salinity is between 25 and 40 wt.% NaCl equiv., with compositions displaying a continuum between a "NaCl-rich brine" end-member (Cl > Na > Ca > Mg > K) and a "CaCl2-rich brine" end-member (Cl > Ca ≈ Mg > Na > K). The CaCl2-rich brine has the highest salinity and shows evidence for halite saturation at the time of trapping. The continuum of compositions between the NaCl-rich brine and the CaCl2-rich brine end-members combined with P-T reconstructions suggest anisothermal mixing of the two brines (NaCl-rich brine, 180 ± 30 °C and 800 ± 400 bars; CaCl2-rich brine, 120 ± 30 °C and 600 ± 300 bars) that occurred under fluctuating pressure conditions (hydrostatic to supra-hydrostatic). However, because the two brines were U bearing and therefore oxidized, brine mixing was probably not the driving force for UO2 deposition. Several scenarios are put forward to account for the Cl-Na-Ca-Mg-K composition of the brines, involving combinations of seawater evaporation, halite dissolution, mixing with a halite-dissolution brine, Mg/Ca exchange by dolomitization, Na/Ca exchange by albitization of plagioclase, Na/K exchange by albitization of K-feldspar, and Mg loss by Mg

  12. A systematic mapping review of effective interventions for communicating with, supporting and providing information to parents of preterm infants.

    Science.gov (United States)

    Brett, Jo; Staniszewska, Sophie; Newburn, Mary; Jones, Nicola; Taylor, Lesley

    2011-06-02

    Background and objective The birth of a preterm infant can be an overwhelming experience of guilt, fear and helplessness for parents. Provision of interventions to support and engage parents in the care of their infant may improve outcomes for both the parents and the infant. The objective of this systematic review is to identify and map out effective interventions for communication with, supporting and providing information for parents of preterm infants. Design Systematic searches were conducted in the electronic databases Medline, Embase, PsychINFO, the Cochrane library, the Cumulative Index to Nursing and Allied Health Literature, Midwives Information and Resource Service, Health Management Information Consortium, and Health Management and Information Service. Hand-searching of reference lists and journals was conducted. Studies were included if they provided parent-reported outcomes of interventions relating to information, communication and/or support for parents of preterm infants prior to the birth, during care at the neonatal intensive care unit and after going home with their preterm infant. Titles and abstracts were read for relevance, and papers judged to meet inclusion criteria were included. Papers were data-extracted, their quality was assessed, and a narrative summary was conducted in line with the York Centre for Reviews and Dissemination guidelines. Studies reviewed Of the 72 papers identified, 19 papers were randomised controlled trials, 16 were cohort or quasi-experimental studies, and 37 were non-intervention studies. Results Interventions for supporting, communicating with, and providing information to parents that have had a premature infant are reported. Parents report feeling supported through individualised developmental and behavioural care programmes, through being taught behavioural assessment scales, and through breastfeeding, kangaroo-care and baby-massage programmes. Parents also felt supported through organised support groups and

  13. Mobile-based patient-provider communication in cancer survivors: The roles of health literacy and patient activation.

    Science.gov (United States)

    Jiang, Shaohai; Hong, Y Alicia

    2018-03-01

    Thanks to rapid penetration of mobile tools, more and more cancer survivors have adopted mobile-based patient-provider communication (MBPPC). The relationship between MBPPC and patients' health outcomes, however, remains unclear; how health literacy and patient activation interact with such relationship is unexplored. Data were drawn from National Cancer Institute's Health Information National Trends Survey 4 Cycle 3. A sample of 459 cancer survivors were included in the analysis. Based on the 3-stage model of health promotion using interactive media, this study empirically tested a moderated mediation model. MBPPC (eg, patient use of email, text message, mobile app, and social media to communicate with providers) had no direct effect on cancer survivors' emotional health. Instead, health literacy completely mediated this path. Patient activation positively moderated the effect of health literacy on emotional health and further increased the indirect effect of MBPPC on emotional health. MBPPC alone does not directly result in better emotional health outcomes; health literacy is the key to realize its health benefits; patient activation significantly strengthens the effects of MBPPC. As we embrace the mHealth movement, innovative programs are needed to promote MBPPC, and improve health literacy and activation of cancer survivors, particularly in underserved communities, to reduce health disparities. Copyright © 2017 John Wiley & Sons, Ltd.

  14. An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal.

    Science.gov (United States)

    Clarke, Malcolm; Mars, Maurice

    2015-02-01

    We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable

  15. Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: a scoping review.

    Science.gov (United States)

    Gentles, Stephen James; Lokker, Cynthia; McKibbon, K Ann

    2010-06-18

    Pediatric patients with health conditions requiring follow-up typically depend on a caregiver to mediate at least part of the necessary two-way communication with health care providers on their behalf. Health information technology (HIT) and its subset, information communication technology (ICT), are increasingly being applied to facilitate communication between health care provider and caregiver in these situations. Awareness of the extent and nature of published research involving HIT interventions used in this way is currently lacking. This scoping review was designed to map the health literature about HIT used to facilitate communication involving health care providers and caregivers (who are usually family members) of pediatric patients with health conditions requiring follow-up. Terms relating to care delivery, information technology, and pediatrics were combined to search MEDLINE, EMBASE, and CINAHL for the years 1996 to 2008. Eligible studies were selected after three rounds of duplicate screening in which all authors participated. Data regarding patient, caregiver, health care provider, HIT intervention, outcomes studied, and study design were extracted and maintained in a Microsoft Access database. Stage of research was categorized using the UK's Medical Research Council (MRC) framework for developing and evaluating complex interventions. Quantitative and qualitative descriptive summaries are presented. We included 104 eligible studies (112 articles) conducted in 17 different countries and representing 30 different health conditions. The most common conditions were asthma, type 1 diabetes, special needs, and psychiatric disorder. Most studies (88, 85%) included children 2 to 12 years of age, and 73 (71%) involved home care settings. Health care providers operated in hospital settings in 96 (92%) of the studies. Interventions featured 12 modes of communication (eg, Internet, intranets, telephone, video conferencing, email, short message service [SMS], and

  16. Enhancing the relationship and improving communication between adolescents and their health care providers: a school based intervention by medical students.

    Science.gov (United States)

    Towle, Angela; Godolphin, William; Van Staalduinen, Samantha

    2006-08-01

    To develop, implement and evaluate a workshop to help adolescents develop independent and active relationships with their physicians. A needs-assessment survey informed the development of a workshop delivered by medical student volunteers and incorporated into the career and personal planning curriculum of high schools in Vancouver, Canada. Over a 6-year period, 64 workshops were delivered by 181 medical students to 1651 high school students in six schools. The workshop is acceptable, do-able, effective and sustainable, characteristics that arise from the mutual benefits to all the groups involved: the medical school, the school board, the medical students, the high school teachers and students. The workshop provides a model for providing health care education to adolescents in the community. Teaching adolescents the importance of good doctor-patient communication encourages them to take ongoing responsibility for their health care and is an alternative route to direct health care education.

  17. Comprehensive Quantitative Profiling of Tau and Phosphorylated Tau Peptides in Cerebrospinal Fluid by Mass Spectrometry Provides New Biomarker Candidates.

    Science.gov (United States)

    Russell, Claire L; Mitra, Vikram; Hansson, Karl; Blennow, Kaj; Gobom, Johan; Zetterberg, Henrik; Hiltunen, Mikko; Ward, Malcolm; Pike, Ian

    2017-01-01

    Aberrant tau phosphorylation is a hallmark in Alzheimer's disease (AD), believed to promote formation of paired helical filaments, the main constituent of neurofibrillary tangles in the brain. While cerebrospinal fluid (CSF) levels of total tau and tau phosphorylated at threonine residue 181 (pThr181) are established core biomarkers for AD, the value of alternative phosphorylation sites, which may have more direct relevance to pathology, for early diagnosis is not yet known, largely due to their low levels in CSF and lack of standardized detection methods. To overcome sensitivity limitations for analysis of phosphorylated tau in CSF, we have applied an innovative mass spectrometry (MS) workflow, TMTcalibratortrademark, to enrich and enhance the detection of phosphoproteome components of AD brain tissue in CSF, and enable the quantitation of these analytes. We aimed to identify which tau species present in the AD brain are also detectable in CSF and which, if any, are differentially regulated with disease. Over 75% coverage of full-length (2N4R) tau was detected in the CSF with 47 phosphopeptides covering 31 different phosphorylation sites. Of these, 11 phosphopeptides were upregulated by at least 40%, along with an overall increase in tau levels in the CSF of AD patients relative to controls. Use of the TMTcalibratortrademark workflow dramatically improved our ability to detect tau-derived peptides that are directly related to human AD pathology. Further validation of regulated tau peptides as early biomarkers of AD is warranted and is currently being undertaken.

  18. Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

    Science.gov (United States)

    Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

    2016-02-01

    To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

  19. Multisoliton solutions in terms of double Wronskian determinant for a generalized variable-coefficient nonlinear Schroedinger equation from plasma physics, arterial mechanics, fluid dynamics and optical communications

    International Nuclear Information System (INIS)

    Lue Xing; Zhu Hongwu; Yao Zhenzhi; Meng Xianghua; Zhang Cheng; Zhang Chunyi; Tian Bo

    2008-01-01

    In this paper, the multisoliton solutions in terms of double Wronskian determinant are presented for a generalized variable-coefficient nonlinear Schroedinger equation, which appears in space and laboratory plasmas, arterial mechanics, fluid dynamics, optical communications and so on. By means of the particularly nice properties of Wronskian determinant, the solutions are testified through direct substitution into the bilinear equations. Furthermore, it can be proved that the bilinear Baecklund transformation transforms between (N - 1)- and N-soliton solutions

  20. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Directory of Open Access Journals (Sweden)

    Heather E Douglas

    2017-04-01

    Full Text Available Introduction: There is limited evidence of the benefits of information and communication technology (ICT to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  1. The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.

    Science.gov (United States)

    Lown, Beth A; Manning, Colleen F

    2010-06-01

    To assess the impact of Schwartz Center Rounds, an interdisciplinary forum where attendees discuss psychosocial and emotional aspects of patient care. The authors investigated changes in attendees' self-reported behaviors and beliefs about patient care, sense of teamwork, stress, and personal support. In 2006-2007, researchers conducted retrospective surveys of attendees at six sites offering Schwartz Center Rounds ("the Rounds") for > or =3 years and prospective surveys of attendees at 10 new Rounds sites that have held > or =7 Rounds. Most of the retrospective survey respondents indicated that attending Rounds enhanced their likelihood of attending to psychosocial and emotional aspects of care and enhanced their beliefs about the importance of empathy. Respondents reported better teamwork, including heightened appreciation of the roles and contributions of colleagues. There were significant decreases in perceived stress (P teamwork (both: P communication, teamwork, and provider support. The impact on measured outcomes increased with the number of Rounds attended. The Rounds represent an effective strategy for providing support to health care professionals and for enhancing relationships among them and with their patients.

  2. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  3. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  4. Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers.

    Science.gov (United States)

    Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R

    2011-02-01

    Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health-care provider, patient, and partner perspectives on: (1) the effects of lung cancer on physical and emotional intimacy, (2) the ways in which intimacy affects the experience of living with lung cancer, and (3) communication about intimacy and sexuality in the context of lung cancer. Qualitative, in-depth interviews with eight cancer-care providers and 13 married couples (ages 43-79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. Most cancer-care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. Copyright © 2010 John Wiley & Sons, Ltd.

  5. Examining the effects of enhanced provider-patient communication on postoperative tonsillectomy pain: protocol of a randomised controlled trial performed by nurses in daily clinical care

    NARCIS (Netherlands)

    Vliet, L.M. van; Dulmen, S. van; Thiel, B.; Deelen, G.W. van; Immerzeel, S.; Godfried, M.B.; Bensing, J.M.

    2017-01-01

    INTRODUCTION: Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider's communication. So far, effects have

  6. Bringing the Digital World to Students: Partnering with the University Communications Office to Provide Social Media Experiential Learning Projects

    Science.gov (United States)

    Childers, Courtney C.; Levenshus, Abbey B.

    2016-01-01

    The Accrediting Council on Education in Journalism and Mass Communications recognizes the importance of a curriculum that prepares students "to apply current tools and technologies appropriate for the communications professions in which they work, and to understand the digital world" (ACEJMC, n.d.). Infusing experiential learning into…

  7. Feasibility of a patient-driven approach to recruiting older adults, caregivers, and clinicians for provider-patient communication research.

    Science.gov (United States)

    Lingler, Jennifer H; Martire, Lynn M; Hunsaker, Amanda E; Greene, Michele G; Dew, Mary Amanda; Schulz, Richard

    2009-07-01

    This report describes the implementation of a novel, patient-driven approach to recruitment for a study of interpersonal communication in a primary care setting involving persons with Alzheimer's disease (AD), their family caregivers, and their primary care providers (PCPs). Patients and caregivers were centrally recruited from a university-based memory clinic, followed by the recruitment of patient's individual PCPs. Recruitment tracking, naturalistic observation, and survey methods were used to evaluate recruitment success. About half of the patients and caregivers (n = 54; 51%) and most of the PCPs (n = 31; 76%) who we approached agreed to an audiorecording of the patient's next PCP visit. Characteristics of patient, caregiver, and PCP participants were compared to those of nonparticipants. Patient characteristics did not differ by participation status. Caregivers who volunteered for the study were more likely to be female and married than were those who declined to participate. Compared to nonparticipants, PCPs who agreed to the study were appraised slightly more favorably by patients' caregivers on a measure of satisfaction with care on the day of the visit. The vast majority of participating PCPs (95%) reported that the study had little or no impact on the flow of routine clinical operations. Findings support the feasibility of a patient-driven approach to recruitment for studies involving multiple linked participants. Our discussion highlights possible advantages of such an approach, including the potential to empower patient participants while achieving maximum variability within the pool of clinician participants.

  8. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

    Science.gov (United States)

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

  9. Self lubricating fluid bearings

    International Nuclear Information System (INIS)

    Kapich, D.D.

    1980-01-01

    The invention concerns self lubricating fluid bearings, which are used in a shaft sealed system extending two regions. These regions contain fluids, which have to be isolated. A first seal is fluid tight for the first region between the carter shaft and the shaft. The second seal is fluid tight between the carter and the shaft, it communicates with the second region. The first fluid region is the environment surrounding the shaft carter. The second fluid region is a part of a nuclear reactor which contains the cooling fluid. The shaft is conceived to drive a reactor circulating and cooling fluid [fr

  10. Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training.

    Science.gov (United States)

    O'Sullivan, Patricia; Chao, Serena; Russell, Matthew; Levine, Sharon; Fabiny, Anne

    2008-09-01

    Teaching and assessment of communication and interpersonal skills, one of the American Council for Graduate Medical Education-designated core competencies, is an important but difficult task in the training of physicians. Assessment of trainees offers an opportunity to provide explicit feedback on their skills and encourages learning. This article describes a pilot study in which clinician-educators affiliated with the geriatrics training programs at Beth Israel Deaconess Medical Center and Boston University Medical Center designed and piloted a novel Objective Structured Clinical Examination (OSCE) to assess the communication and interpersonal skills of medical, dental, and geriatric psychiatry fellows. The OSCE consisted of three stations where geriatricians and standardized patients evaluated candidates using specifically designed checklists and an abbreviated version of the Master Interview Rating Scale. Communication skills were assessed through performance of specific "real life" clinical tasks, such as obtaining a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions, and counseling. Interpersonal skills were assessed through the effect of the communication between doctor and standardized patient on fostering trust, relieving anxiety, and establishing a therapeutic relationship. This pilot study demonstrated that the OSCE format of assessment provides a valid means of evaluating the communication and interpersonal skills of interdisciplinary geriatric trainees and provides a valuable forum for formative assessment and feedback. Given that geriatricians and non geriatricians involved in elder care both need communication and interpersonal skills, this novel OSCE can be used for assessment of these skills in trainees in diverse healthcare subspecialties.

  11. The association between parent-reported provider communication quality and child obesity status: Variation by parent obesity and child race/ethnicity.

    Science.gov (United States)

    Wong, Michelle S; Showell, Nakiya N; Bleich, Sara N; Gudzune, Kimberly A; Chan, Kitty S

    2017-08-01

    To examine the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. We conducted a cross-sectional secondary data analysis with the 2011-2013 Medical Expenditures Panel Survey of parents with children ages 6-12 (n=5390). We used multivariable logistic regression to examine the association of parent-reported healthcare provider communication quality (explaining well, listening carefully, showing respect, and spending enough time) with child obesity status, and effect modification by parent obesity and child race/ethnicity. Parents of obese children were more likely to report that their child's healthcare provider listened carefully (OR=1.41, p=0.002) and spent enough time (OR=1.33, p=0.022) than parents of non-obese children. Non-obese parents of obese children experienced better communication in the domains of listening carefully (pobese non-Hispanic Asian children and non-Hispanic Black children were more likely to report that providers explained things well (p=0.043) and listened carefully (p=0.012), respectively. Parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian. Healthcare providers should ensure effective communication with obese parents of obese children. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Fluids engineering

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Fluids engineering has played an important role in many applications, from ancient flood control to the design of high-speed compact turbomachinery. New applications of fluids engineering, such as in high-technology materials processing, biotechnology, and advanced combustion systems, have kept up unwaining interest in the subject. More accurate and sophisticated computational and measurement techniques are also constantly being developed and refined. On a more fundamental level, nonlinear dynamics and chaotic behavior of fluid flow are no longer an intellectual curiosity and fluid engineers are increasingly interested in finding practical applications for these emerging sciences. Applications of fluid technology to new areas, as well as the need to improve the design and to enhance the flexibility and reliability of flow-related machines and devices will continue to spur interest in fluids engineering. The objectives of the present seminar were: to exchange current information on arts, science, and technology of fluids engineering; to promote scientific cooperation between the fluids engineering communities of both nations, and to provide an opportunity for the participants and their colleagues to explore possible joint research programs in topics of high priority and mutual interest to both countries. The Seminar provided an excellent forum for reviewing the current state and future needs of fluids engineering for the two nations. With the Seminar ear-marking the first formal scientific exchange between Korea and the United States in the area of fluids engineering, the scope was deliberately left broad and general

  13. Use of Information and Communication Technologies in India's First Open University: Experience and Perceptions of Learners and Learner Support Providers

    Science.gov (United States)

    Satyanarayana, P.; Meduri, Emmanuel D. K.

    2015-01-01

    Dr. B. R. Ambedkar Open University (BRAOU), the first distance teaching university in India, was a great educational event. It started a new chapter in the history of India's distance higher education. The general objects this research studies are: (1) to identify the information and communication technologies used in open distance education…

  14. Effectiveness of a Training Program in Supervisors' Ability to Provide Feedback on Residents' Communication Skills

    Science.gov (United States)

    Junod Perron, Noelle; Nendaz, Mathieu; Louis-Simonet, Martine; Sommer, Johanna; Gut, Anne; Baroffio, Anne; Dolmans, Diana; van der Vleuten, Cees

    2013-01-01

    Teaching communication skills (CS) to residents during clinical practice remains problematic. Direct observation followed by feedback is a powerful way to teach CS in clinical practice. However, little is known about the effect of training on feedback skills in this field. Controlled studies are scarce as well as studies that go beyond…

  15. The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

    Science.gov (United States)

    de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

    2014-01-16

    In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of

  16. Use of communication systems based on e-technologies by a RWM organisation: the experience of an information provider

    International Nuclear Information System (INIS)

    Hamilton, W.

    2006-01-01

    The Nuclear Decommissioning Authority (NDA) is responsible for the UK civil public sector nuclear legacy, which concerns sites and facilities built from the 1940.s onwards. The web strategy is to maintain the NDA's site as a primary vehicle for communication with stakeholders. The intranet and web-site are managed by a communication manager. A dedicated software allows for approval process and alerts to needs of revision. The web-site was developed specifically for recruitment, enabling candidates to apply online and ensuring a consistent format of applications for short listing candidates. It is now also a tool for stakeholder communication, recognising different audiences, namely, local stakeholder sites, contractors, employees, Non Governmental Organisations, politicians, and press/media. The web-site also serves as an electronic record and library of PDFs of all corporate information. As a news channel, the site runs a news alert service to stakeholders, who can subscribe online, and be reached by e-mail and access press releases and the NDA newsletter issued in PDF. The web-site also aims at offering a community platform in various ways. A web chat offers another means of engaging stakeholders, with an NDA panel responding to stakeholder questions online in real time. Independent site stakeholder groups are able to publish information on the NDA site, or to establish links to it. Audits of stakeholder connections to the NDA site, both quantitative and qualitative are performed regularly and statistics are produced

  17. Race, Income, and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training

    Science.gov (United States)

    Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall

    2014-01-01

    Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958

  18. Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.

    Science.gov (United States)

    Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall

    2014-04-01

    Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

  19. 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...

  20. 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...

  1. Short or Long End of the Lever? Associations between Provider Communication of the "Asthma-Action Plan" and Outpatient Revisits for Pediatric Asthma.

    Science.gov (United States)

    Rangachari, Pavani; Mehta, Renuka; Rethemeyer, R Karl; Ferrang, Carole; Dennis, Clifton; Redd, Vickie

    2015-10-01

    At the Children's Hospital of Georgia (CHOG), we found that outpatient revisits for pediatric asthma were significantly above national norms. According to the NIH, costly hospital revisits for asthma can be prevented through guidelines-based self-management of asthma, central to which, is the use of a written Asthma-Action Plan (AAP). The asthma services literature has emphasized the role of the healthcare provider in promoting asthma self-management using the AAP, to prevent hospital revisits. On the other hand, the asthma policy literature has emphasized the need for community-based interventions to promote asthma self-management. A gap remains in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma, through effective communication of AAP in the outpatient setting. Our study sought to address this gap. We conducted a 6-month intervention to implement "patient-and-family-centered communication of the AAP" in CHOG outpatient clinics, based on the "change-management" theoretical framework. Provider communication of AAP was assessed through a survey of "Parent Understanding of the Child's AAP." A quasi-experimental approach was used to measure outpatient revisits for pediatric asthma, pre- and post-intervention. Survey results showed that provider communication of the AAP was unanimously perceived highly positively by parents of pediatric asthma patients, across various metrics of patient-centered care. However, there were no statistically significant differences in outpatient "revisit behavior" for pediatric asthma between pre- and post-intervention periods after controlling for several demographic variables. Additionally, revisits remained significantly above national norms. Results suggest limited potential of "effective provider communication of AAP," in reducing outpatient revisits for pediatric asthma; and indicate need for broader community-based interventions to address patient life variables

  2. Patient’s expectation on communication performances community of Dental Health Services providers located in urban and rural area

    Directory of Open Access Journals (Sweden)

    Taufan Bramantoro

    2013-03-01

    Full Text Available Background: The quality of dentist’s communication skills is considered as one of important aspects on the quality of dental health services assessment. During the initial interview conducted at Ketabang, Dupak, and Kepadangan community dental health services at Surabaya and Sidoarjo, Indonesia, it appeared that eighty percent of initial respondents were not satisfied with the communication aspect. Community Dental Health Services (CDHS need to assess the communication performances based on community characteristics in effort to promote the quality and effectiveness of the denta health services. Purpose: The objective of this study was to analyze patient’s expectation values priorities on dentists' communication performances in CDHS that located in urban and rural area. Methods: The study was conducted in Ketabang Surabaya, Dupak Surabaya and Kepadangan Sidoarjo CDHSs. The participants were 400 patients above 18 years old. Participants were assessed their expectation value using the communication performances of dental health services questionnaire. Results: Patients in urban CDHS appeared that there were two priority aspects which had high values, namely the clarity of instructions and the dentist’s ability of active listening to the patient, while patients in rural CDHS revealed that the clarity of instructions and dentist-patient relationship were the aspects with high values. Conclusion: Patients in CDHS that located in rural area expect more dentist-patient interpersonal relationship performance than patients in CDHS located in urban area. This finding becomes a valuable information for CDHS to develop communication strategies based on community characteristics.Latar belakang: Kualitas komunikasi dari dokter gigi merupakan salah satu aspek penting dalam penilaian kualitas layanan suatu sarana pelayanan kesehatan. Pada wawancara pendahuluan yang dilaksanakan di puskesmas Ketabang, Dupak dan Kepadangan di Surabaya dan Sidoarjo

  3. "Are You Done?" Child Care Providers' Verbal Communication at Mealtimes that Reinforce or Hinder Children's Internal Cues of Hunger and Satiation

    Science.gov (United States)

    Ramsay, Samantha A.; Branen, Laurel J.; Fletcher, Janice; Price, Elizabeth; Johnson, Susan L.; Sigman-Grant, Madeleine

    2010-01-01

    Objective: To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Methods: Video observation transcripts of Head Start staff (n=29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Results: Adults' verbal…

  4. A Discourse of Disconnect: Young People from the Eastern Cape Talk about the Failure of Adult Communications to Provide Habitable Sexual Subject Positions

    Science.gov (United States)

    Jearey-Graham, Nicola; Macleod, Catriona

    2015-01-01

    Face-to-face adult communication with young people about sexuality is, for the most part, assigned to two main groups of people: educators tasked with teaching school-based sexuality education that is provided as part of the compulsory Life Orientation (LO) learning area, and parents. In this paper, we report on a study conducted with Further…

  5. ListeningTime; participatory development of a web-based preparatory communication tool for elderly cancer patients and their healthcare providers.

    NARCIS (Netherlands)

    Noordman, J.; Driesenaar, J.A.; Bruinessen, I.R. van; Dulmen, S. van

    2017-01-01

    Objective: This paper outlines the participatory development process of a web-based preparatory communication tool for elderly cancer patients and their oncological healthcare providers (HCPs). This tool aims to support them to (better) prepare their encounters. An overarching aim of the project is

  6. How you provide corrective feedback makes a difference: the motivating role of communicating in an autonomy-supporting way.

    Science.gov (United States)

    Mouratidis, Athanasios; Lens, Willy; Vansteenkiste, Maarten

    2010-10-01

    We relied on self-determination theory (SDT; Deci & Ryan, 2000) to investigate to what extent autonomy-supporting corrective feedback (i.e., feedback that coaches communicate to their athletes after poor performance or mistakes) is associated with athletes' optimal motivation and well-being. To test this hypothesis, we conducted a cross-sectional study with 337 (67.1% males) Greek adolescent athletes (age M = 15.59, SD = 2.37) from various sports. Aligned with SDT, we found through path analysis that an autonomy-supporting versus controlling communication style was positively related to future intentions to persist and well-being and negatively related to ill-being. These relations were partially mediated by the perceived legitimacy of the corrective feedback (i.e., the degree of acceptance of corrective feedback), and, in turn, by intrinsic motivation, identified regulation, and external regulation for doing sports. Results indicate that autonomy-supporting feedback can be still motivating even in cases in which such feedback conveys messages of still too low competence.

  7. [Access to health care in Dakar (Senegal): frequency, type of provider, and non-communicable chronic diseases].

    Science.gov (United States)

    Duboz, P; Gueye, L; Boetsch, G; Macia, E

    2015-01-01

    (1) To describe access to health care in the population of Dakar; (2) to analyze the influence of socioeconomic and demographic characteristics on access to health care; (3) and to describe the fraction of consultations accounted for by chronic non-communicable diseases. These data come from a 2009 survey of 600 individuals aged 20 years and over. Socioeconomic and demographic characteristics and information about access to health care were collected. Chi-square tests and binary logistic regressions were used for the statistical analyses. Men, people with no schooling, and poor people were underrepresented among users of health care services. Moreover, the majority of Dakar residents who sought health care during the year preceding the survey went to see a doctor (as opposed to a traditional healer, pharmacist, nurse, midwife, or dentist). Finally, chronic diseases accounted for the smallest fraction of reasons for medical consultations; they were mentioned most often by those aged 50 years or older who consult more than 5 times a year. Dakar residents have an access to health care similar to that of people in other African countries, but this conclusion hides major inequalities. Moreover, at the same time that Senegal is undergoing an epidemiological transition, chronic non-communicable diseases are not a major reason for consultations. The epidemiological projections made for Africa for the next 15 years indicate that the development of strategies to avert the development of these diseases in Senegal must be a priority objective.

  8. Determining Threshold Distance Providing Less Interference for Wireless Medical Implant Communication Systems in Coexisting Environments under Shadow Fading Conditions

    Directory of Open Access Journals (Sweden)

    Selman KULAÇ

    2017-08-01

    Full Text Available Important interference problems will be able to be encountered especially close areas to the hospitals where wireless implantable medical systems' communication traffic occurs heavily in near future. It is possible that these interferences could cause wireless implant devices to malfunction and harmful effects on patients. In this study, it is proposed to determine threshold distance in order to get less interference for wireless implantable medical systems under shadow fading conditions where MICS band and MetAids band users coexist intensely simultaneously. In this method, threshold power according to the \\cite{FCC} is pulled down by adding extra distance margin in order to minimize the interference effects to the MICS systems using confidence interval calculations. Because received signal strength just below the monitoring threshold power according to the \\cite{FCC} brings about much more interferences for the MICS systems even if listen-before-talk technique is applied.

  9. 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.

  10. Swab2know: An HIV-Testing Strategy Using Oral Fluid Samples and Online Communication of Test Results for Men Who Have Sex With Men in Belgium.

    Science.gov (United States)

    Platteau, Tom; Fransen, Katrien; Apers, Ludwig; Kenyon, Chris; Albers, Laura; Vermoesen, Tine; Loos, Jasna; Florence, Eric

    2015-09-01

    As HIV remains a public health concern, increased testing among those at risk for HIV acquisition is important. Men who have sex with men (MSM) are the most important group for targeted HIV testing in Europe. Several new strategies have been developed and implemented to increase HIV-testing uptake in this group, among them the Swab2know project. In this project, we aim to assess the acceptability and feasibility of outreach and online HIV testing using oral fluid samples as well as Web-based delivery of test results. Sample collection happened between December 2012 and April 2014 via outreach and online sampling among MSM. Test results were communicated through a secured website. HIV tests were executed in the laboratory. Each reactive sample needed to be confirmed using state-of-the-art confirmation procedures on a blood sample. Close follow-up of participants who did not pick up their results, and those with reactive results, was included in the protocol. Participants were asked to provide feedback on the methodology using a short survey. During 17 months, 1071 tests were conducted on samples collected from 898 men. Over half of the samples (553/1071, 51.63%) were collected during 23 outreach sessions. During an 8-month period, 430 samples out of 1071 (40.15%) were collected from online sampling. Additionally, 88 samples out of 1071 (8.22%) were collected by two partner organizations during face-to-face consultations with MSM and male sex workers. Results of 983 out of 1071 tests (91.78%) had been collected from the website. The pickup rate was higher among participants who ordered their kit online (421/430, 97.9%) compared to those participating during outreach activities (559/641, 87.2%; Ponline participants were more likely to have never been tested before (17.3% vs 10.0%; P=.001) and reported more sexual partners in the 6 months prior to participation in the project (mean 7.18 vs 3.23; Ponline counseling tool), and in studying the cost effectiveness of the

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

    Science.gov (United States)

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

    2017-09-01

    End-of-life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Although many training programs now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarize the findings. From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were of low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n = 7), and most were taught using a mixture of didactics (n = 123), reflection and discussion (n = 105), and role play (n = 86). Evaluation designs were weak: communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings, we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  12. Barriers to Communication With a Healthcare Provider and Health Literacy About Incontinence Among Informal Caregivers of Individuals With Dementia.

    Science.gov (United States)

    Mullins, Jean; Bliss, Donna Z; Rolnick, Sharon; Henre, Casey Arntson; Jackson, Jody

    2016-01-01

    The purpose of this study was to examine barriers to communicating with healthcare professionals and health literacy about incontinence among different types of informal caregivers of individuals with Alzheimer disease (AD). Descriptive secondary analysis. The sample included 48 family/friend adult caregivers of individuals who had AD. Seventy-five percent were female; their mean age was 64 ± 14 years (mean ± SD). Caregivers were spouses (44%), daughters (31%), or extended family members/friends (25%). Nearly half (48%) of caregivers had a racially or ethnically diverse background; 58% of their care recipients had incontinence. Data were collected via focus groups, interviews, and written surveys. Verbal responses were audiotaped, transcribed, and analyzed for themes by caregiver type using content analysis. Caregivers of persons with AD described role-related barriers to improving health literacy about incontinence and its management. Main themes of barriers emerged for each type of role that were emotive in nature for daughters, experiential for both spouse caregivers, system related for husbands, and relational (being perceived as an outsider) for extended family/friends. Nurse continence specialists have an important role in raising health literacy about incontinence and its management for informal caregivers of individual with AD. Results inform the development of interventions that are tailored to the type of caregiver as recommended by national health literacy initiatives with the aim of improving outcomes such as incontinence of care recipients.

  13. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

    Science.gov (United States)

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

    2016-01-01

    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  14. Who's talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda.

    Science.gov (United States)

    Langlois-Klassen, Deanne; Kipp, Walter; Rubaale, Tom

    2008-07-01

    Communication between patients and physicians about herbal medicine is valuable, enabling physicians to address issues of potential herb-drug interactions and ensuring appropriate medical care. As seemingly harmless herbal remedies may have detrimental interactions with various HIV antiretroviral drugs, the importance of communication is intensified, but often stifled around the use of herbal medicine in the treatment of HIV/AIDS. In western Uganda, 137 HIV-infected adults attending conventional HIV/AIDS treatment programmes (67 of whom were receiving antiretroviral therapy) shared their experiences and perceptions about traditional herbal medicine and related patient-physician communication issues through interviews and focus group discussions. Although close to 64% of respondents reported using herbal medicine after being diagnosed with HIV, only 16% of these respondents had informed their conventional medical practitioners about using these herbs. Furthermore, only 13% of antiretroviral therapy recipients had inquired about concurrent herb-antiretroviral drug use with their HIV/AIDS treatment providers, largely because they perceived a low acceptance and support for herbal medicine by conventional medical practitioners. Importantly however, almost 68% of HIV-infected adults indicated they would be willing to discuss herbal medicine use if directly asked by a conventional medical practitioner, and the overwhelming majority (91%) said they were amenable to following physician advice about herbal medicine. As such, improved patient-physician communication about herbal medicine is needed, and we recommend that herbal medicine histories be completed when patient histories are taken. Also, HIV/AIDS treatment programmes should be encouraged to develop specific patient-physician communication standards and best practice guidelines to ensure that patients can make informed decisions about herb and pharmaceutical drug co-therapy based on known risks, particularly in the

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

    Science.gov (United States)

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

    2014-12-20

    We examined racial and ethnic disparities in patient-provider communication (PPC), perceived care quality, and patient activation among long-term cancer survivors. In 2005 to 2006, survivors of breast, prostate, colorectal, ovarian, and endometrial cancers completed a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic white (white) survivors who had seen a physician for follow-up care in the past 2 years (n = 1,196) composed the analytic sample. We conducted linear and logistic regression analyses to identify racial and ethnic differences in PPC (overall communication and medical test communication), perceived care quality, and patient activation in clinical care (self-efficacy in medical decisions and perceived control). We further examined the potential contribution of PPC to racial and ethnic differences in perceived care quality and patient activation. Compared with white survivors (mean score, 85.16), Hispanic (mean score, 79.95) and Asian (mean score, 76.55) survivors reported poorer overall communication (P = .04 and P Asian survivors (mean score, 79.97) reported poorer medical test communication (P = .001). Asian survivors were less likely to report high care quality (odds ratio, 0.47; 95% CI, 0.30 to 0.72) and reported lower self-efficacy in medical decisions (mean score, 74.71; P Asian disparities remained significant. Asian survivors report poorer follow-up care communication and care quality. More research is needed to identify contributing factors beyond PPC, such as cultural influences and medical system factors. © 2014 by American Society of Clinical Oncology.

  16. Communication: A method to compute the transport coefficient of pure fluids diffusing through planar interfaces from equilibrium molecular dynamics simulations.

    Science.gov (United States)

    Vermorel, Romain; Oulebsir, Fouad; Galliero, Guillaume

    2017-09-14

    The computation of diffusion coefficients in molecular systems ranks among the most useful applications of equilibrium molecular dynamics simulations. However, when dealing with the problem of fluid diffusion through vanishingly thin interfaces, classical techniques are not applicable. This is because the volume of space in which molecules diffuse is ill-defined. In such conditions, non-equilibrium techniques allow for the computation of transport coefficients per unit interface width, but their weak point lies in their inability to isolate the contribution of the different physical mechanisms prone to impact the flux of permeating molecules. In this work, we propose a simple and accurate method to compute the diffusional transport coefficient of a pure fluid through a planar interface from equilibrium molecular dynamics simulations, in the form of a diffusion coefficient per unit interface width. In order to demonstrate its validity and accuracy, we apply our method to the case study of a dilute gas diffusing through a smoothly repulsive single-layer porous solid. We believe this complementary technique can benefit to the interpretation of the results obtained on single-layer membranes by means of complex non-equilibrium methods.

  17. Communication

    DEFF Research Database (Denmark)

    Hecksher, Tina

    2016-01-01

    This work provides the first direct evidence that the puzzling dielectric Debye process observed in mono-alcohols is coupled to density fluctuations. The results open up for an explanation of the Debye process within the framework of conventional liquid-statetheory. The spectral shape of the dyna...

  18. Patient-provider communication and trust in relation to use of an online patient portal among diabetes patients: The Diabetes and Aging Study.

    Science.gov (United States)

    Lyles, Courtney R; Sarkar, Urmimala; Ralston, James D; Adler, Nancy; Schillinger, Dean; Moffet, Howard H; Huang, Elbert S; Karter, Andrew J

    2013-01-01

    Patient-provider relationships influence diabetes care; less is known about their impact on online patient portal use. Diabetes patients rated provider communication and trust. In this study, we linked responses to electronic medical record data on being a registered portal user and using secure messaging (SM). We specified regression models to evaluate main effects on portal use, and subgroup analyses by race/ethnicity and age. 52% of subjects were registered users; among those, 36% used SM. Those reporting greater trust were more likely to be registered users (relative  risk (RR)=1.14) or SM users (RR=1.29). In subgroup analyses, increased trust was associated with being a registered user among white, Latino, and older patients, as well as SM use among white patients. Better communication ratings were also related to being a registered user among older patients. Since increased trust and communication were associated with portal use within subgroups, this suggests that patient-provider relationships encourage portal engagement.

  19. Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care.

    Science.gov (United States)

    Banerjee, Smita C; Walters, Chasity B; Staley, Jessica M; Alexander, Koshy; Parker, Patricia A

    2018-01-01

    Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.

  20. Short or Long End of the Lever? Associations between Provider Communication of the “Asthma-Action Plan” and Outpatient Revisits for Pediatric Asthma

    Science.gov (United States)

    Rangachari, Pavani; Mehta, Renuka; Rethemeyer, R. Karl; Ferrang, Carole; Dennis, Clifton; Redd, Vickie

    2017-01-01

    Background At the Children’s Hospital of Georgia (CHOG), we found that outpatient revisits for pediatric asthma were significantly above national norms. According to the NIH, costly hospital revisits for asthma can be prevented through guidelines-based self-management of asthma, central to which, is the use of a written Asthma-Action Plan (AAP). Purpose The asthma services literature has emphasized the role of the healthcare provider in promoting asthma self-management using the AAP, to prevent hospital revisits. On the other hand, the asthma policy literature has emphasized the need for community-based interventions to promote asthma self-management. A gap remains in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma, through effective communication of AAP in the outpatient setting. Our study sought to address this gap. Methods We conducted a 6-month intervention to implement “patient-and-family-centered communication of the AAP” in CHOG outpatient clinics, based on the “change-management” theoretical framework. Provider communication of AAP was assessed through a survey of “Parent Understanding of the Child’s AAP.” A quasi-experimental approach was used to measure outpatient revisits for pediatric asthma, pre- and post-intervention. Results Survey results showed that provider communication of the AAP was unanimously perceived highly positively by parents of pediatric asthma patients, across various metrics of patient-centered care. However, there were no statistically significant differences in outpatient “revisit behavior” for pediatric asthma between pre- and post-intervention periods after controlling for several demographic variables. Additionally, revisits remained significantly above national norms. Conclusions Results suggest limited potential of “effective provider communication of AAP,” in reducing outpatient revisits for pediatric asthma; and indicate need for

  1. Polar Bears or People?: How Framing Can Provide a Useful Analytic Tool to Understand & Improve Climate Change Communication in Classrooms

    Science.gov (United States)

    Busch, K. C.

    2014-12-01

    study indicates that framing may be a useful theory for investigating how climate change is taught and learned in classrooms. In addition, suggestions are made for how to develop effective professional development for teachers to improve their communication of climate change.

  2. Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E; Musial, Frauke; Salamonsen, Anita

    2016-09-08

    Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with

  3. "Are you done?" Child care providers' verbal communication at mealtimes that reinforce or hinder children's internal cues of hunger and satiation.

    Science.gov (United States)

    Ramsay, Samantha A; Branen, Laurel J; Fletcher, Janice; Price, Elizabeth; Johnson, Susan L; Sigman-Grant, Madeleine

    2010-01-01

    To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Video observation transcripts of Head Start staff (n=29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Adults' verbal communication with children at mealtimes emphasized non-internal cues: (1) cueing children to amounts without referencing children's internal cues; (2) meal termination time; (3) asking children if they wanted more without referencing their internal cues; (4) asking children if they were done without referencing their internal cues; (5) telling children to take, try, eat, or finish food; (6) praising children for eating; and (7) telling children about food being good for you. Adults demonstrated an overriding effort to get children to eat. Training needs to be developed that gives specifics on verbally cueing young children to their internal hunger and satiation cues. Published by Elsevier Inc.

  4. Modern fluid dynamics

    CERN Document Server

    Kleinstreuer, Clement

    2018-01-01

    Modern Fluid Dynamics, Second Edition provides up-to-date coverage of intermediate and advanced fluids topics. The text emphasizes fundamentals and applications, supported by worked examples and case studies. Scale analysis, non-Newtonian fluid flow, surface coating, convection heat transfer, lubrication, fluid-particle dynamics, microfluidics, entropy generation, and fluid-structure interactions are among the topics covered. Part A presents fluids principles, and prepares readers for the applications of fluid dynamics covered in Part B, which includes computer simulations and project writing. A review of the engineering math needed for fluid dynamics is included in an appendix.

  5. Communication latencies of Apple push notification messages relevant for delivery of time-critical information to anesthesia providers.

    Science.gov (United States)

    Rothman, Brian S; Dexter, Franklin; Epstein, Richard H

    2013-08-01

    Tablet computers and smart phones have gained popularity in anesthesia departments for educational and patient care purposes. VigiVU(™) is an iOS application developed at Vanderbilt University for remote viewing of perioperative information, including text message notifications delivered via the Apple Push Notification (APN) service. In this study, we assessed the reliability of the APN service. Custom software was written to send a message every minute to iOS devices (iPad(®), iPod Touch(®), and iPhone(®)) via wireless local area network (WLAN) and cellular pathways 24 hours a day over a 4-month period. Transmission and receipt times were recorded and batched by days, with latencies calculated as their differences. The mean, SEM, and the exact 95% upper confidence limits for the percent of days with ≥1 prolonged (>100 seconds) latency were calculated. Acceptable performance was defined as mean latency 100 seconds. Testing conditions included fixed locations of devices in high signal strength locations. Mean latencies were 173,000 iPad and iPod latencies, none were >100 seconds. For iPhone latencies, 0.03% ± 0.01% were >100 seconds. The 95% upper confidence limits of days with ≥1 prolonged latency were 42% (iPhone) and 5% to 8% (iPad, iPod). The APN service was reliable for all studied devices over WLAN and cellular pathways, and performance was better than third party paging systems using Internet connections previously investigated using the same criteria. However, since our study was a best-case assessment, testing is required at individual sites considering use of this technology for critical messaging. Furthermore, since the APN service may fail due to Internet or service provider disruptions, a backup paging system is recommended if the APN service were to be used for critical messaging.

  6. Fluid dynamics

    CERN Document Server

    Bernard, Peter S

    2015-01-01

    This book presents a focused, readable account of the principal physical and mathematical ideas at the heart of fluid dynamics. Graduate students in engineering, applied math, and physics who are taking their first graduate course in fluids will find this book invaluable in providing the background in physics and mathematics necessary to pursue advanced study. The book includes a detailed derivation of the Navier-Stokes and energy equations, followed by many examples of their use in studying the dynamics of fluid flows. Modern tensor analysis is used to simplify the mathematical derivations, thus allowing a clearer view of the physics. Peter Bernard also covers the motivation behind many fundamental concepts such as Bernoulli's equation and the stream function. Many exercises are designed with a view toward using MATLAB or its equivalent to simplify and extend the analysis of fluid motion including developing flow simulations based on techniques described in the book.

  7. A fuzzy multi-objective model for capacity allocation and pricing policy of provider in data communication service with different QoS levels

    Science.gov (United States)

    Pan, Wei; Wang, Xianjia; Zhong, Yong-guang; Yu, Lean; Jie, Cao; Ran, Lun; Qiao, Han; Wang, Shouyang; Xu, Xianhao

    2012-06-01

    Data communication service has an important influence on e-commerce. The key challenge for the users is, ultimately, to select a suitable provider. However, in this article, we do not focus on this aspect but the viewpoint and decision-making of providers for order allocation and pricing policy when orders exceed service capacity. It is a multiple criteria decision-making problem such as profit and cancellation ratio. Meanwhile, we know realistic situations in which much of the input information is uncertain. Thus, it becomes very complex in a real-life environment. In this situation, fuzzy sets theory is the best tool for solving this problem. Our fuzzy model is formulated in such a way as to simultaneously consider the imprecision of information, price sensitive demand, stochastic variables, cancellation fee and the general membership function. For solving the problem, a new fuzzy programming is developed. Finally, a numerical example is presented to illustrate the proposed method. The results show that it is effective for determining the suitable order set and pricing policy of provider in data communication service with different quality of service (QoS) levels.

  8. Survey mode matters: adults' self-reported statistical confidence, ability to obtain health information, and perceptions of patient-health-care provider communication.

    Science.gov (United States)

    Wallace, Lorraine S; Chisolm, Deena J; Abdel-Rasoul, Mahmoud; DeVoe, Jennifer E

    2013-08-01

    This study examined adults' self-reported understanding and formatting preferences of medical statistics, confidence in self-care and ability to obtain health advice or information, and perceptions of patient-health-care provider communication measured through dual survey modes (random digital dial and mail). Even while controlling for sociodemographic characteristics, significant differences in regard to adults' responses to survey variables emerged as a function of survey mode. While the analyses do not allow us to pinpoint the underlying causes of the differences observed, they do suggest that mode of administration should be carefully adjusted for and considered.

  9. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

    Directory of Open Access Journals (Sweden)

    Noortgate Nele

    2009-12-01

    Full Text Available Abstract Background The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. Methods A cross-sectional mail survey was sent to all acute hospitals (67 main campuses in Flanders (Belgium. The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. Results The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%. While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%. More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Conclusions Most Flemish acute hospitals have developed a policy on end-of-life practices

  10. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

    Science.gov (United States)

    D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

    2009-12-30

    The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care

  11. The Effect of Communication Skills Training for Generalist Palliative Care Providers on Patient-Reported Outcomes and Clinician Behaviors: A Systematic Review and Meta-analysis.

    Science.gov (United States)

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

    2017-09-01

    As most end-of-life care is provided by health care providers who are generalists rather than specialists in palliative care, effective communication skills training for generalists is essential. To determine the effect of communication training interventions for generalist palliative care providers on patient-reported outcomes and trainee behaviors. Systematic review from searches of 10 databases to December 2015 (MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, CENTRAL, Web of Science, ICTRP, CORDIS, and OpenGrey) plus hand searching. Randomized controlled trials of training interventions intended to enhance generalists' communication skills in end-of-life care were included. Two authors independently assessed eligibility after screening, extracted data, and graded quality. Data were pooled for meta-analysis using a random-effects model. PRISMA guidelines were followed. Nineteen of 11,441 articles were eligible, representing 14 trials. Eleven were included in meta-analyses (patients n = 3144, trainees n = 791). Meta-analysis showed no effect on patient outcomes (standardized mean difference [SMD] = 0.10, 95% CI -0.05 to 0.24) and high levels of heterogeneity (chi-square = 21.32, degrees of freedom [df] = 7, P = 0.003; I 2  = 67%). The effect on trainee behaviors in simulated interactions (SMD = 0.50, 95% CI 0.19-0.81) was greater than in real patient interactions (SMD = 0.21, 95% CI -0.01 to 0.43) with moderate heterogeneity (chi-square = 8.90, df = 5, P = 0.11; I 2  = 44%; chi-square = 5.96, df = 3, P = 0.11; I 2  = 50%, respectively). Two interventions with medium effects on showing empathy in real patient interactions included personalized feedback on recorded interactions. The effect of communication skills training for generalists on patient-reported outcomes remains unclear. Training can improve clinicians' ability to show empathy and discuss emotions, at least in simulated consultations. Personalized feedback on recorded patient

  12. Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

    Science.gov (United States)

    Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

    2017-01-01

    mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

  13. High pregnancy intentions and missed opportunities for patient-provider communication about fertility in a South African cohort of HIV-positive women on antiretroviral therapy.

    Science.gov (United States)

    Schwartz, Sheree R; Mehta, Shruti H; Taha, Taha E; Rees, Helen V; Venter, Francois; Black, Vivian

    2012-01-01

    High fertility intentions amongst HIV-positive women have been reported elsewhere. Less is known about how clinical and HIV treatment characteristics correlate with fertility intentions. We use cross-sectional baseline data from a prospective cohort study to assess pregnancy intentions and patient-provider communication around fertility. Non-pregnant, HIV-positive women aged 18-35 on ART were recruited through convenience sampling at Johannesburg antiretroviral (ART) treatment facilities. Among the 850 women in this analysis, those on efavirenz had similar fertility intentions over the next year as women on nevirapine-based regimens (33% vs. 38%). In multivariate analysis, recent ART initiation was associated with higher current fertility intentions; there was no association with CD4 cell count. Forty-one percent of women had communicated with providers about future pregnancy options. Women on ART may choose to conceive at times that are sub-optimal for maternal, child and partner health outcomes and should be routinely counseled around safer pregnancy options.

  14. Acoustic concentration of particles in fluid flow

    Science.gov (United States)

    Ward, Michael D.; Kaduchak, Gregory

    2010-11-23

    An apparatus for acoustic concentration of particles in a fluid flow includes a substantially acoustically transparent membrane and a vibration generator that define a fluid flow path therebetween. The fluid flow path is in fluid communication with a fluid source and a fluid outlet and the vibration generator is disposed adjacent the fluid flow path and is capable of producing an acoustic field in the fluid flow path. The acoustic field produces at least one pressure minima in the fluid flow path at a predetermined location within the fluid flow path and forces predetermined particles in the fluid flow path to the at least one pressure minima.

  15. Acoustic concentration of particles in fluid flow

    Science.gov (United States)

    Ward, Michael W.; Kaduchak, Gregory

    2017-08-15

    Disclosed herein is a acoustic concentration of particles in a fluid flow that includes a substantially acoustically transparent membrane and a vibration generator that define a fluid flow path therebetween. The fluid flow path is in fluid communication with a fluid source and a fluid outlet and the vibration generator is disposed adjacent the fluid flow path and is capable of producing an acoustic field in the fluid flow path. The acoustic field produces at least one pressure minima in the fluid flow path at a predetermined location within the fluid flow path and forces predetermined particles in the fluid flow path to the at least one pressure minima.

  16. Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

    Science.gov (United States)

    Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-01-01

    Background Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users’ experiences in using secure email messaging. Objective To quantitatively assess veteran patients’ experiences in using secure email messaging in a large patient sample. Methods A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations’ Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. Results The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy

  17. Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.

    Science.gov (United States)

    Haun, Jolie N; Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-12-21

    Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users' experiences in using secure email messaging. To quantitatively assess veteran patients' experiences in using secure email messaging in a large patient sample. A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations' Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared

  18. Patient–Provider Communication and Counseling about Gestational Weight Gain and Physical Activity: A Qualitative Study of the Perceptions and Experiences of Latinas Pregnant with their First Child

    Directory of Open Access Journals (Sweden)

    Ana Cristina Lindsay

    2017-11-01

    Full Text Available Latina women in the United States (U.S. are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and receive preventive services, education, nutritional support, and other social services to improve pregnancy outcomes. Excessive gestational weight gain (GWG has numerous negative short- and long-term consequences for both the mother and newborn. We explored nulliparous Latina women’s perceptions about their experiences communicating with their primary healthcare provider about GWG and physical activity (PA to identify possible intervention targets using in-depth, semi-structured interviews. Bilingual, trained research staff conducted 23 interviews with first-time pregnant Latinas between 22 and 36 weeks of gestation. Interviews were transcribed verbatim and analyzed using content analysis. Salient text passages were extracted, shortened, coded, and grouped into categories. Women, including those who self-identified as being overweight or obese prior to pregnancy, reported receiving limited or no advice from their healthcare providers about GWG or PA. Additionally, analysis revealed that although participants value information received from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program counselors, they would like to receive more information from their primary healthcare providers about adequate GWG. Furthermore, study findings indicate that some participants received conflicting information regarding PA during pregnancy. Study findings suggest the need for increased integration of communication and counseling about GWG and PA into prenatal care services to promote healthy weight gain and PA among low-income Latina women.

  19. Oral health-related concerns, behavior, and communication with health care providers of patients with breast cancer: impact of different treatments.

    Science.gov (United States)

    Taichman, L Susan; Van Poznak, Catherine H; Inglehart, Marita R

    2018-01-01

    The objectives are to compare responses of breast cancer (BCa) treatment groups (chemotherapy, tamoxifen, and aromatase inhibitors (AIs) to each other and a control regarding (a) subjective oral health, (b) oral health-related behaviors, (c) oral health-related concerns, and (d) communication with health care providers. Survey data were collected from 140 postmenopausal BCa patients and 41 healthy postmenopausal control respondents. BCa patients reported on average more frequent mouth sores/mucositis (5-point scale with 1 = never: 1.63 vs. 1.14; p oral health than patients on tamoxifen/AI (93% vs. 55%/56%; p oral health-related effects of cancer treatment than by dentists. Oncologists/nurses were more likely to communicate about oral health-related treatment effects with patients undergoing chemotherapy than patients on tamoxifen or AIs. Few BCa patients perceived dentists as knowledgeable about cancer treatment-related oral concerns and trusted them less than oncologists. BCa treatments impact oral health. Low percentages of BCa patients had received specific information about impacts of BCa treatments on oral health from their dentists. © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.

  20. Providing full point-to-point communications among compute nodes of an operational group in a global combining network of a parallel computer

    Energy Technology Data Exchange (ETDEWEB)

    Archer, Charles J.; Faraj, Daniel A.; Inglett, Todd A.; Ratterman, Joseph D.

    2018-01-30

    Methods, apparatus, and products are disclosed for providing full point-to-point communications among compute nodes of an operational group in a global combining network of a parallel computer, each compute node connected to each adjacent compute node in the global combining network through a link, that include: receiving a network packet in a compute node, the network packet specifying a destination compute node; selecting, in dependence upon the destination compute node, at least one of the links for the compute node along which to forward the network packet toward the destination compute node; and forwarding the network packet along the selected link to the adjacent compute node connected to the compute node through the selected link.

  1. Examining the effects of enhanced provider-patient communication on postoperative tonsillectomy pain: protocol of a randomised controlled trial performed by nurses in daily clinical care.

    Science.gov (United States)

    van Vliet, Liesbeth M; van Dulmen, Sandra; Thiel, Bram; van Deelen, Gerard W; Immerzeel, Stephanie; Godfried, Marc B; Bensing, Jozien M

    2017-11-03

    Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider's communication. So far, effects have primarily been shown in laboratory settings. The aim of this study is to determine the separate and combined effects of expectancy manipulation and empathy manipulation during preoperative and postoperative tonsillectomy analgesia care on clinical adult patients' outcomes. Using a two-by-two randomised controlled trial, 128 adult tonsillectomy patients will be randomly assigned to one out of four conditions differing in the level of expectancy manipulation (standard vs enhanced) and empathy manipulation (standard vs enhanced). Day care ward nurses are trained to deliver the intervention, while patients are treated via the standard analgesia protocol and hospital routines. The primary outcome, perceived pain, is measured via hospital routine by a Numeric Rating Scale, and additional prehospitalisation, perihospitalisation and posthospitalisation questionnaires are completed (until day 3, ie, 2 days after the operation). The manipulation is checked using audio recordings of nurse-patient interactions. Although communication is manipulated, the manipulations do not cross norms or values of acceptable behaviour. Standard medical care is provided. The ethical committee of the UMC Utrecht and the local OLVG hospital committee approved the study. Results will be published via (inter)national peer-reviewed journals and a lay publication. NTR5994; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Patient-provider communication styles in HIV treatment programs in Bamako, Mali: A mixed-methods study to define dimensions and measure patient preferences

    Directory of Open Access Journals (Sweden)

    Emily A. Hurley

    2017-12-01

    Full Text Available Effective patient-provider communication (PPC promotes patient adherence and retention in long-term care. Sub-Saharan Africa faces unprecedented demand for chronic care for HIV patients on antiretroviral therapy (ART, yet adherence and retention remain challenging. In high-income countries, research describing patient preferences for different PPC styles has guided interventions to improve PPC and patient outcomes. However, research on PPC preferences in sub-Saharan Africa is limited. We sought to define PPC dimensions relevant to ART programs in Bamako, Mali through recordings of clinical interactions, in-depth interviews and focus-group discussions with 69 patients and 17 providers. To assess preferences toward contrasting PPC styles within dimensions, we conducted a vignette-based survey with 141 patients across five ART facilities. Qualitative analysis revealed two PPC dimensions similar to those described in the literature on patient-centered communication (level of psychosocial regard, balance of power, and one unique dimension that emerged from the data (guiding patient behavior: easy/tough/sharp. Significantly more survey participants chose the vignette demonstrating high psychosocial regard (52.2% compared to a biomedical style (22.5% (p<0.001. Within balance of power, a statistically similar proportion of participants chose the vignette demonstrating shared power (40.2% compared to a provider-dominated style (35.8%. In guiding patient behavior, a similar proportion of participants preferred the vignette depicting the “easy” (38.4% and/or “tough” style (40.6%, but significantly fewer preferred the “sharp” style (14.5% (p<0.001. Highly educated participants chose biomedical and shared power styles more frequently, while less educated participants more frequently indicated “no preference”. Working to understand, develop, and tailor PPC styles to patients in chronic care may help support patient retention and ultimately

  3. Improving communication when seeking informed consent: a randomised controlled study of a computer-based method for providing information to prospective clinical trial participants.

    Science.gov (United States)

    Karunaratne, Asuntha S; Korenman, Stanley G; Thomas, Samantha L; Myles, Paul S; Komesaroff, Paul A

    2010-04-05

    To assess the efficacy, with respect to participant understanding of information, of a computer-based approach to communication about complex, technical issues that commonly arise when seeking informed consent for clinical research trials. An open, randomised controlled study of 60 patients with diabetes mellitus, aged 27-70 years, recruited between August 2006 and October 2007 from the Department of Diabetes and Endocrinology at the Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne. Participants were asked to read information about a mock study via a computer-based presentation (n = 30) or a conventional paper-based information statement (n = 30). The computer-based presentation contained visual aids, including diagrams, video, hyperlinks and quiz pages. Understanding of information as assessed by quantitative and qualitative means. Assessment scores used to measure level of understanding were significantly higher in the group that completed the computer-based task than the group that completed the paper-based task (82% v 73%; P = 0.005). More participants in the group that completed the computer-based task expressed interest in taking part in the mock study (23 v 17 participants; P = 0.01). Most participants from both groups preferred the idea of a computer-based presentation to the paper-based statement (21 in the computer-based task group, 18 in the paper-based task group). A computer-based method of providing information may help overcome existing deficiencies in communication about clinical research, and may reduce costs and improve efficiency in recruiting participants for clinical trials.

  4. Electronic medication complete communication strategy for opioid prescriptions in the emergency department: Rationale and design for a three-arm provider randomized trial.

    Science.gov (United States)

    McCarthy, Danielle M; Courtney, D Mark; Lank, Patrick M; Cameron, Kenzie A; Russell, Andrea M; Curtis, Laura M; Kim, Kwang-Youn A; Walton, Surrey M; Montague, Enid; Lyden, Abbie L; Gravenor, Stephanie J; Wolf, Michael S

    2017-08-01

    Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC 2 ) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. The ED EMC 2 Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions. This strategy will be assessed both with and without the addition of text messages via a three-arm randomized trial. The study will take place at an urban academic ED (annual volume>85,000) in Chicago, IL. Patients being discharged with a new prescription for hydrocodone-acetaminophen will be enrolled and randomized (based on their prescribing physician). The primary outcome of the study is medication safe use as measured by a demonstrated dosing task. Additionally actual safe use, patient knowledge and provider counseling will be measured. Implementation fidelity as well as costs will be reported. The ED EMC 2 Opioid Strategy embeds a risk communication strategy into the electronic health record and promotes medication counseling with minimal workflow disruption. This trial will evaluate the strategy's effectiveness and implementation fidelity as compared to usual care. This trial is registered on clinicaltrials.gov with identifier NCT02431793. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Use of information and communication technology to provide health information: what do older migrants know, and what do they need to know?

    Science.gov (United States)

    Goodall, Ken; Ward, Paul; Newman, Lareen

    2010-01-01

    print media from Australia and their home countries, family and acquaintances, government departments or service providers. Many expressed a preference for receiving information as printed material or directly from another person. Governments or primary healthcare organisations planning to make health information solely available via ICT should be aware that doing so may lead to an increase in 'information exclusion' and the formation of functional knowledge deficits for older migrants. At the moment at least, our participants do not perceive any functional knowledge deficits as they engage multiple sources to access the information they need for everyday life. We recommend that governments and healthcare organisations evaluate the appropriateness of using ICT to directly provide information to older migrants and consider non-digital means or the engagement of 'information brokers' when communicating with groups identified as low or non-users of ICT.

  6. Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control.

    Science.gov (United States)

    Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio

    2014-01-29

    Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when

  7. Adoption and Use of Internet Technologies in Health Communication: Examining Disparities in Diffusion Patterns, Health Information Sources, and Patient-Provider Encounters

    Science.gov (United States)

    Massey, Philip Minter

    2013-01-01

    This dissertation examines the impact of internet technologies on the field of health communication. Access and use of health communication technologies has and will continue to become increasingly important to manage and treat chronic conditions and other ailments, particularly in the context of health care reform that promotes improved quality…

  8. Fluid inclusion geothermometry

    Science.gov (United States)

    Cunningham, C.G.

    1977-01-01

    Fluid inclusions trapped within crystals either during growth or at a later time provide many clues to the histories of rocks and ores. Estimates of fluid-inclusion homogenization temperature and density can be obtained using a petrographic microscope with thin sections, and they can be refined using heating and freezing stages. Fluid inclusion studies, used in conjunction with paragenetic studies, can provide direct data on the time and space variations of parameters such as temperature, pressure, density, and composition of fluids in geologic environments. Changes in these parameters directly affect the fugacity, composition, and pH of fluids, thus directly influencing localization of ore metals. ?? 1977 Ferdinand Enke Verlag Stuttgart.

  9. Using multimedia information and communication technology (ICT) to provide added value to reminiscence therapy for people with dementia : Lessons learned from three field studies.

    Science.gov (United States)

    Bejan, Alexander; Gündogdu, Ramazan; Butz, Katherina; Müller, Nadine; Kunze, Christophe; König, Peter

    2018-01-01

    In the care of people with dementia (PwD), occupational therapies and activities aiming at maintaining the quality of life of PwD, such as reminiscence therapy (RT), are taking on a more and more important role. Information and communication technology (ICT) has the potential to improve and to facilitate RT by facilitating access to and selection of biographical information and related contents or by providing novel multimodal interaction forms to trigger memories; however, interactive multimedia technology is barely used in practice. This article presents three exploratory field studies that evaluated different aspects of RT technology use for PwD in care homes, including the utilization of online movie databases, interactive surface touch computers as well as natural user interfaces allowing gestures and haptic interaction. In these studies, the usage of prototype systems was observed in occupational sessions by 5, 12 and 16 PwD. The results indicate positive effects of technology use, e. g. in the form of verbally elicited reminiscence statements, expressed joy and playful interaction. Lessons learned for the design of technology-based RT interventions are presented and discussed.

  10. A hospital-wide picture archiving and communication system (PACS): the views of users and providers of the radiology service at Hammersmith Hospital

    International Nuclear Information System (INIS)

    Watkins, Jessamy

    1999-01-01

    Objective: To obtain users' views of the new picture archiving and communication system (PACS) from clinical and radiological staff at Hammersmith Hospital, UK. Methods: Semi-structured interviews were used to ascertain the views of staff, following an interview schedule which covered aspects of: (1) their use of PACS, (2) facilities available, (3) the perceived quality of images, (4) reporting, (5) image availability, (6) image accessibility, (7) training, and (8) ease of use of PACS. Results: Interviews were carried out with 34 key users and providers of the radiological service at Hammersmith Hospital. Overall, staff were very satisfied with PACS particularly in terms of image availability. All staff said that they preferred PACS to the previous, conventional radiology service. Conclusions: The key implications of issues raised by staff were: the impact of 'down-time' and the importance of an efficient back-up system, the requirement for sufficient short-term storage to prevent images being off-line during clinical situations, the usefulness of the folder system for management of the images, the need to access images for teaching purposes, the advantage of having a default display protocol to facilitate radiological reporting, and the requirement for flexible, yet effective, training to ensure that the system is utilised to its full potential by users

  11. The functional response of bioactive titania-modified three-dimensional Ti-6Al-4V mesh structure toward providing a favorable pathway for intercellular communication and osteoincorporation.

    Science.gov (United States)

    Nune, K C; Misra, R D K; Li, S J; Hao, Y L; Zhang, W

    2016-10-01

    The objective of the study is to fundamentally elucidate the biological response of 3D printed mesh structures subjected to plasma electrolytic oxidation process through the study of osteoblast functions. The cellular activity of plasma electrolytic-oxidized mesh structure was explored in terms of cell-to-cell communication involving proliferation, synthesis of extracellular and intracellular proteins, and mineralization. Upon plasma electrolytic oxidation of the mesh structure, a thin layer of bioactive titania with pore size 1-3 µm was nucleated on the surface. The combination of microporous bioactive titania and interconnected porous architecture provided the desired pathway for supply of nutrients and oxygen to cells and tissue and a favorable osteogenic microenvironment for tissue on-growth and in-growth, in relation to the unmodified mesh structure. The formation of a confluent layer as envisaged via electron microscopy and quantitative assessment of the expression level of proteins (actin, vinculin, and fibronectin) point toward the determining role of surface-modified mesh structure in modulating osteoblasts functions. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2488-2501, 2016. © 2016 Wiley Periodicals, Inc.

  12. Disappearing fluid?

    International Nuclear Information System (INIS)

    Graney, K.; Chu, J.; Lin, P.C.

    2002-01-01

    Full text: A 78-year old male in end stage renal failure (ESRF) with a background of NIDDM retinopathy, nephropathy, and undergoing continuous ambulatory peritoneal dialysis (CAPD) presented with anorexia, clinically unwell, decreased mobility and right scrotal swelling. There was no difficulty during CAPD exchange except there was a positive fluid balance Peritoneal dialysates remained clear A CAPD peritoneal study was requested. 100Mbq 99mTc Sulphur Colloid was injected into a standard dialysate bag containing dialysate. Anterior dynamic images were acquired over the abdomen pelvis while the dialysate was infused Static images with anatomical markers were performed 20 mins post infusion, before and after patient ambulation and then after drainage. The study demonstrated communication between the peritoneal cavity and the right scrotal sac. Patient underwent right inguinal herniaplasty with a marlex mesh. A repeat CAPD flow study was performed as follow up and no abnormal connection between the peritoneal cavity and the right scrotal sac was demonstrated post operatively. This case study shows that CAPD flow studies can be undertaken as a simple, minimally invasive method to evaluate abnormal peritoneal fluid flow dynamics in patients undergoing CAPD, and have an impact on dialysis management. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Qualitative evaluation of primary care providers experiences of a training programme to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa.

    Science.gov (United States)

    Malan, Zelra; Mash, Robert; Everett-Murphy, Katherine

    2015-08-19

    The global epidemic of non-communicable disease (NCDs) has been linked with four modifiable risky lifestyle behaviours, namely smoking, unhealthy diet, physical inactivity and alcohol abuse. Primary care providers (PCPs) can play an important role in changing patient's risky behaviours. It is recommended that PCPs provide individual brief behaviour change counselling (BBCC) as part of everyday primary care. This study is part of a larger project that re-designed the current training for PCPs in South Africa, to offer a standardized approach to BBCC based on the 5 As and a guiding style. This article reports on a qualitative sub-study, which explored whether the training intervention changed PCPs perception of their confidence in their ability to offer BBCC, whether they believed that the new approach could overcome the barriers to implementation in clinical practice and be sustained, and their recommendations on future training and integration of BBCC into curricula and clinical practice. This was a qualitative study that used verbal feedback from participants at the beginning and end of the training course, and twelve individual in-depth interviews with participants once they had returned to their clinical practice. Although PCP's confidence in their ability to counselling improved, and some thought that time constraints could be overcome, they still reported that understaffing, lack of support from within the facility and poor continuity of care were barriers to counselling. However, the current organisational culture was not congruent with the patient-centred guiding style of BBCC. Training should be incorporated into undergraduate curricula of PCPs for both nurses and doctors, to ensure that counselling skills are embedded from the start. Existing PCPs should be offered training as part of continued professional development programmes. This study showed that although training changed PCPs perception of their ability to offer BBCC, and increased their confidence

  14. Human papillomavirus vaccine awareness, uptake, and parental and health care provider communication among 11- to 18-year-old adolescents in a rural Appalachian Ohio county in the United States.

    Science.gov (United States)

    Bhatta, Madhav P; Phillips, Lynette

    2015-01-01

    This study examined human papillomavirus (HPV) vaccine awareness and uptake, and communication with a parent and/or a health care provider among 11- to 18-year-old male and female adolescents in an Appalachian Ohio county. Five questions regarding the HPV vaccine were added to the 2012 Youth Risk Behavior Surveillance System (YRBSS) surveys administered to middle and high school students in the county. The YRBSS surveys are school-based, anonymous, and voluntary. The questions added were about vaccine awareness and uptake, and communication with a parent or health care provider about the vaccine. Of the 1,299 participants, 51.9% were male and 90.3% were white. Overall, 49.2%, 23.5%, 19.2%, and 24.6%, respectively, reported vaccine awareness, uptake of at least 1 dose of the HPV vaccine, communication with a parent, and communication with a health care provider. Females and adolescents ≥ 15 years were significantly more likely to report awareness, uptake, and parental and provider communication than males and adolescents ≤ 14 years. Adolescents receiving any dose of the vaccine were significantly more likely to have had a parent (OR: 3.74; 95% CI: 2.30-6.06) or a health care provider (OR: 10.91; 95% CI: 6.42-18.6) discuss the vaccine than those who had not received any dose. Despite the strong link between parental and health care provider communication and HPV vaccine uptake, the levels of communication remain low in this Appalachian population. These findings suggest the need for public health education programs targeting the health care providers, the parents, and the adolescents to improve awareness, knowledge, and HPV vaccine uptake. © 2014 National Rural Health Association.

  15. Installations having pressurised fluid circuits

    International Nuclear Information System (INIS)

    Rigg, S.; Grant, J.

    1977-01-01

    Reference is made to nuclear installations having pressurised coolant flow circuits. Breaches in such circuits may quickly result in much damage to the plant. Devices such as non-return valves, orifice plates, and automatically operated shut-off valves have been provided to prevent or reduce fluid flow through a breached pipe line, but such devices have several disadvantages; they may present large restrictions to normal flow of coolant, and may depend on the operation of ancillary equipment, with consequent delay in bringing them into operation in an emergency. Other expedients that have been adopted to prevent or reduce reverse flow through an upstream breach comprise various forms of hydraulic counter flow brakes. The arrangement described has at least one variable fluid brake comprising a fluidic device connected into a duct in the pressurised circuit, the device having an inlet, an outlet, a vortex chamber between the inlet and outlet, a control jet for introducing fluid into the vortex chamber, connections communicating the inlet and the outlet into one part of the circuit and the control jet into another region at a complementary pressure so that, in the event of a breach in the circuit in one region, fluid passes from the other region to enter the vortex chamber to stimulate pressure to create a flow restricting vortex in the chamber that reduces flow through the breach. The system finds particular application to stream generating pressure tube reactors, such as the steam generating heavy water reactor at UKAEA, Winfrith. (U.K.)

  16. Fluid and particle mechanics

    CERN Document Server

    Michell, S J

    2013-01-01

    Fluid and Particle Mechanics provides information pertinent to hydraulics or fluid mechanics. This book discusses the properties and behavior of liquids and gases in motion and at rest. Organized into nine chapters, this book begins with an overview of the science of fluid mechanics that is subdivided accordingly into two main branches, namely, fluid statics and fluid dynamics. This text then examines the flowmeter devices used for the measurement of flow of liquids and gases. Other chapters consider the principle of resistance in open channel flow, which is based on improper application of th

  17. Effectiveness of the Lunch is in the Bag program on communication between the parent, child and child-care provider around fruits, vegetables and whole grain foods: A group-randomized controlled trial.

    Science.gov (United States)

    Sharma, Shreela V; Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cynthia; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M

    2015-12-01

    To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at pparent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β=0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β=0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Communication Speaks

    Science.gov (United States)

    Kinman, Robin Lynn

    2010-01-01

    When the author recently turned her attention to the National Council of Teachers of Mathematics (NCTM) "Principles and Standards," she was startled to see communication as key. She adjusted her teaching to meet the NCTM Communication Standard and promote communication in her classroom by providing a safe environment, developing discourse and…

  19. Ripple Communication.

    Science.gov (United States)

    Wilcox, R. Stimson

    1980-01-01

    Discusses how surface-dwelling animals use the water surface as a mode of communication by making ripple signals while they swim about. Provides information about surfaces and surface waves, ripple communication in water striders, ripple signal characteristics, sensing and orienting, other modes of communication, and evolution of ripple…

  20. An Initiative to Standardize the Identification of and Acute Response to Postoperative Lower-Extremity Neurological Deficits: Effects on Provider Knowledge, Confidence, and Communication Skills.

    Science.gov (United States)

    Derman, Peter B; Iyer, Sravisht; Garner, Matthew; Orr, Steven; Felix, Karla J; Goldberg, Allison; Ologhobo, Titilayo; Wu, Minlun; Robbins, Laura; Cornell, Charles

    2016-12-07

    Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty. An educational curriculum composed of online learning modules and an in-person "boot camp" featuring simulations with standardized patients was developed, along with assessments of clinician knowledge, confidence levels, and communication skills. Nurses, physical therapists, physician assistants, residents, fellows, and attending surgeons were encouraged to participate. The intervention spanned a 5-month period in 2015 with a mean time of 18.4 weeks between baseline assessments and the time of the latest follow-up. Online modules were completed by 322 individuals, boot camp was completed by 70 individuals, and latest assessments were completed by 38 individuals. The percentage correct on the knowledge assessment increased from 74.5% before the learning modules to 89.5% immediately after (p communication skills assessment showed a significant mean increase (p = 0.02) over the course of the intervention from 30.32 to 32.50, and the mean self-assessed confidence survey scores increased by 16.7%, from 7.2 to 8.4 (p confidence and communication skills appear to be more long-lasting.

  1. Right-to-try laws and individual patient "compassionate use" of experimental oncology medications: A call for improved provider-patient communication.

    Science.gov (United States)

    Hoerger, Michael

    2016-01-01

    The U.S. Food and Drug Administration's Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, "Compassionate Use"). Sixteen U.S. states recently passed "right-to-try" legislation aimed at promoting Expanded Access. Acknowledging popular support, Expanded Access could undermine clinical trials that benefit public health. Moreover, existing norms in oncologic care, for example, often lead patients to pursue intense treatments near the end of life, at the expense of palliation, and improved communication about the risks and benefits of Expanded Access would more often discourage its use.

  2. Fluid Mechanics.

    Science.gov (United States)

    Drazin, Philip

    1987-01-01

    Outlines the contents of Volume II of "Principia" by Sir Isaac Newton. Reviews the contributions of subsequent scientists to the physics of fluid dynamics. Discusses the treatment of fluid mechanics in physics curricula. Highlights a few of the problems of modern research in fluid dynamics. Shows that problems still remain. (CW)

  3. Buffer fluid

    Energy Technology Data Exchange (ETDEWEB)

    Mirzadzhanzade, A Kh; Dedusanko, G Ya; Dinaburg, L S; Markov, Yu M; Rasizade, Ya N; Rozov, V N; Sherstnev, N M

    1979-08-30

    A drilling fluid is suggested for separating the drilling and plugging fluids which contains as the base increased solution of polyacrylamide and additive. In order to increase the viscoelastic properties of the liquid with simultaneous decrease in the periods of its fabrication, the solution contains as an additive dry bentonite clay. In cases of the use of a buffer fluid under conditions of negative temperatures, it is necessary to add to it table salt or ethylene glycol.

  4. Fluid mechanics fundamentals and applications

    CERN Document Server

    Cengel, Yunus

    2013-01-01

    Cengel and Cimbala's Fluid Mechanics Fundamentals and Applications, communicates directly with tomorrow's engineers in a simple yet precise manner. The text covers the basic principles and equations of fluid mechanics in the context of numerous and diverse real-world engineering examples. The text helps students develop an intuitive understanding of fluid mechanics by emphasizing the physics, using figures, numerous photographs and visual aids to reinforce the physics. The highly visual approach enhances the learning of Fluid mechanics by students. This text distinguishes itself from others by the way the material is presented - in a progressive order from simple to more difficult, building each chapter upon foundations laid down in previous chapters. In this way, even the traditionally challenging aspects of fluid mechanics can be learned effectively. McGraw-Hill is also proud to offer ConnectPlus powered by Maple with the third edition of Cengel/Cimbabla, Fluid Mechanics. This innovative and powerful new sy...

  5. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Schroedinger fluid

    International Nuclear Information System (INIS)

    Kan, K.K.

    1983-01-01

    The relationship of nuclear internal flow and collective inertia, the difference of this flow from that of a classical fluid, and the approach of this flow to rigid flow in independent-particle model rotation are elucidated by reviewing the theory of Schroedinger fluid and its implications for collective vibration and rotation. (author)

  7. Reflections of Homeless Women and Women with Mental Health Challenges on Breast and Cervical Cancer Screening Decisions: Power, Trust, and Communication with Care Providers

    Directory of Open Access Journals (Sweden)

    Catherine Claire Moravac

    2018-02-01

    Full Text Available This study conducted in Toronto, Canada, explored the perceptions of women living in homeless shelters and women with severe mental health challenges about the factors influencing their decision-making processes regarding breast and cervical cancer screening. Twenty-six in-depth qualitative interviews were conducted. The objectives of this research were (i to provide new insights about women’s decision-making processes, (ii to describe the barriers to and facilitators for breast and cervical cancer screening, and (iii to offer recommendations for future outreach, education, and screening initiatives developed specifically for under/never-screened marginalized women living in urban centers. This exploratory study utilized thematic analysis to broaden our understanding about women’s decision-making processes. A constructed ontology1 was used in an attempt to understand and describe participants’ constructed realities. The epistemological framework was subjective and reflected co-created knowledge. The approach was hegemonic, values-based, and context-specific. The aim of the analysis was to focus on meanings and actions with a broader view to identify the interplay between participants’ narratives and social structures, medical praxis, and policy implications. Results from 26 qualitative interviews conducted in 2013–2014 provided insights on both positive and negative prior cancer screening experiences, the role of power and trust in women’s decision-making, and areas for improvement in health care provider/patient interactions. Outcomes of this investigation contribute to the future development of appropriately designed intervention programs for marginalized women, as well as for sensitivity training for health care providers. Tailored and effective health promotion strategies leading to life-long cancer screening behaviors among marginalized women may improve clinical outcomes, decrease treatment costs, and save lives.

  8. MR imaging of cerebrospinal fluid dynamics in health and disease. On the vascular pathogenesis of communicating hydrocephalus and benign intracranial hypertension

    International Nuclear Information System (INIS)

    Greitz, D.; Hannerz, J.; Raehn, T.; Bolander, H.; Ericsson, A.

    1994-01-01

    The CSF flows in the aqueduct and at the foramen magnum were examined in 5 patients with communicating hydrocephalus (HC) and in 10 with benign intracranial hypertension (BIH) as well as in 5 healthy volunteers. As compared to normal individuals, the aqueductal flow in HC was about 10 times larger and the cervical flow was half as large. In BIH the CSF flows were not different from those of normal volunteers. The decreased arterial expansion as reflected in the reduced cervical flow in HC may be due to pathologic changes in the arteries and paravascular spaces. The large aqueductal flow in HC reflects a large brain expansion, causing increased transcerebral mantle pressure gradient and ventricular dilatation. In BIH there is a normal brain expansion (aqueductal flow) and consequently no ventricular dilatation. It is argued that BIH be caused by an obstruction on the venous side, as opposed to the vascular alterations in HC, which are on the arterial side. (orig.)

  9. A Review of Verbal and Non-Verbal Human-Robot Interactive Communication

    OpenAIRE

    Mavridis, Nikolaos

    2014-01-01

    In this paper, an overview of human-robot interactive communication is presented, covering verbal as well as non-verbal aspects of human-robot interaction. Following a historical introduction, and motivation towards fluid human-robot communication, ten desiderata are proposed, which provide an organizational axis both of recent as well as of future research on human-robot communication. Then, the ten desiderata are examined in detail, culminating to a unifying discussion, and a forward-lookin...

  10. Short communication: Intestinal digestibility of amino acids in fluid- and particle-associated rumen bacteria determined using a precision-fed cecectomized rooster bioassay.

    Science.gov (United States)

    Fonseca, A C; Fredin, S M; Ferraretto, L F; Parsons, C M; Utterback, P L; Shaver, R D

    2014-01-01

    Microbial protein represents the majority of metabolizable protein absorbed by ruminant animals. Enhanced understanding of the AA digestibility of rumen microbes will improve estimates of metabolizable protein. The objective of this experiment was to determine the digestibility of AA in fluid- (FAB) and particle-associated bacteria (PAB) using the precision-fed cecectomized rooster bioassay. Bacteria were isolated from 4 ruminally cannulated lactating Holstein cows by differential centrifugation, including particle suspension in 0.1% Tween-80 for increased removal of PAB from ruminal digesta. Samples of FAB and PAB were fed to 9 cecectomized roosters to determine standardized digestibility of AA. Total AA digestibility was 76.8 and 75.5% for FAB and PAB, respectively, but did not differ. Differences existed in AA digestibilities within bacterial type when compared with the mean essential AA digestibility value. Compared with previous literature estimates of AA digestibility in microbes (mean = 76%; range = 57-87%) and relative to National Research Council estimates of total AA from rumen bacteria (80%), the precision-fed cecectomized rooster assay is an acceptable in vivo model to determine AA digestibility of rumen bacteria. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  11. Communication: Studies of the Lennard-Jones fluid in 2, 3, and 4 dimensions highlight the need for a liquid-state 1/d expansion

    International Nuclear Information System (INIS)

    Costigliola, Lorenzo; Schrøder, Thomas B.; Dyre, Jeppe C.

    2016-01-01

    The recent theoretical prediction by Maimbourg and Kurchan [e-print http://arxiv.org/abs/1603.05023 (2016)] that for regular pair-potential systems the virial potential-energy correlation coefficient increases towards unity as the dimension d goes to infinity is investigated for the standard 12-6 Lennard-Jones fluid. This is done by computer simulations for d = 2, 3, 4 going from the critical point along the critical isotherm/isochore to higher density/temperature. In both cases the virial potential-energy correlation coefficient increases significantly. For a given density and temperature relative to the critical point, with increasing number of dimension the Lennard-Jones system conforms better to the hidden-scale-invariance property characterized by high virial potential-energy correlations (a property that leads to the existence of isomorphs in the thermodynamic phase diagram, implying that it becomes effectively one-dimensional in regard to structure and dynamics). The present paper also gives the first numerical demonstration of isomorph invariance of structure and dynamics in four dimensions. Our findings emphasize the need for a universally applicable 1/d expansion in liquid-state theory; we conjecture that the systems known to obey hidden scale invariance in three dimensions are those for which the yet-to-be-developed 1/d expansion converges rapidly.

  12. FRACTURING FLUID CHARACTERIZATION FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    Subhash Shah

    2000-08-01

    Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

  13. Fluid-cooled heat sink for use in cooling various devices

    Science.gov (United States)

    Bharathan, Desikan; Bennion, Kevin; Kelly, Kenneth; Narumanchi, Sreekant

    2017-09-12

    The disclosure provides a fluid-cooled heat sink having a heat transfer base, a shroud, and a plurality of heat transfer fins in thermal communication with the heat transfer base and the shroud, where the heat transfer base, heat transfer fins, and the shroud form a central fluid channel through which a forced or free cooling fluid may flow. The heat transfer pins are arranged around the central fluid channel with a flow space provided between adjacent pins, allowing for some portion of the central fluid channel flow to divert through the flow space. The arrangement reduces the pressure drop of the flow through the fins, optimizes average heat transfer coefficients, reduces contact and fin-pin resistances, and reduces the physical footprint of the heat sink in an operating environment.

  14. Insertable fluid flow passage bridgepiece and method

    Science.gov (United States)

    Jones, Daniel O.

    2000-01-01

    A fluid flow passage bridgepiece for insertion into an open-face fluid flow channel of a fluid flow plate is provided. The bridgepiece provides a sealed passage from a columnar fluid flow manifold to the flow channel, thereby preventing undesirable leakage into and out of the columnar fluid flow manifold. When deployed in the various fluid flow plates that are used in a Proton Exchange Membrane (PEM) fuel cell, bridgepieces of this invention prevent mixing of reactant gases, leakage of coolant or humidification water, and occlusion of the fluid flow channel by gasket material. The invention also provides a fluid flow plate assembly including an insertable bridgepiece, a fluid flow plate adapted for use with an insertable bridgepiece, and a method of manufacturing a fluid flow plate with an insertable fluid flow passage bridgepiece.

  15. Conductor for a fluid-cooled winding

    Science.gov (United States)

    Kenney, Walter J.

    1983-01-01

    A conductor and method of making the conductor are provided for use in winding electrical coils which are cooled by a fluid communicating with the conductor. The conductor is cold worked through twisting and reshaping steps to form a generally rectangular cross section conductor having a plurality of helical cooling grooves extending axially of the conductor. The conductor configuration makes it suitable for a wide variety of winding applications and permits the use of simple strip insulation between turns and perforated sheet insulation between layers of the winding.

  16. Fluid Dynamics for Physicists

    Science.gov (United States)

    Faber, T. E.

    1995-08-01

    This textbook provides an accessible and comprehensive account of fluid dynamics that emphasizes fundamental physical principles and stresses connections with other branches of physics. Beginning with a basic introduction, the book goes on to cover many topics not typically treated in texts, such as compressible flow and shock waves, sound attenuation and bulk viscosity, solitary waves and ship waves, thermal convection, instabilities, turbulence, and the behavior of anisotropic, non-Newtonian and quantum fluids. Undergraduate or graduate students in physics or engineering who are taking courses in fluid dynamics will find this book invaluable.

  17. Microgravity Fluids for Biology, Workshop

    Science.gov (United States)

    Griffin, DeVon; Kohl, Fred; Massa, Gioia D.; Motil, Brian; Parsons-Wingerter, Patricia; Quincy, Charles; Sato, Kevin; Singh, Bhim; Smith, Jeffrey D.; Wheeler, Raymond M.

    2013-01-01

    Microgravity Fluids for Biology represents an intersection of biology and fluid physics that present exciting research challenges to the Space Life and Physical Sciences Division. Solving and managing the transport processes and fluid mechanics in physiological and biological systems and processes are essential for future space exploration and colonization of space by humans. Adequate understanding of the underlying fluid physics and transport mechanisms will provide new, necessary insights and technologies for analyzing and designing biological systems critical to NASAs mission. To enable this mission, the fluid physics discipline needs to work to enhance the understanding of the influence of gravity on the scales and types of fluids (i.e., non-Newtonian) important to biology and life sciences. In turn, biomimetic, bio-inspired and synthetic biology applications based on physiology and biology can enrich the fluid mechanics and transport phenomena capabilities of the microgravity fluid physics community.

  18. The powerline technology has been developed to market maturity (energy supply companies as 'dark cable' communication service and access providers). A member of Ascom Powerline Communications AG explains the system; Das Powerline-System ist marktreif (EVU als 'Dark-Cable-Anbieter' und 'Access-Provider'). Powerline aus der Sicht des Entwicklungsunternehmens

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, D. [Ascom Powerline Communications AG, Bern (Switzerland)

    2001-03-12

    Combining communication processes and power transmission on one means of transport, - a fascinating idea, and not at all far-fetched but rather simple, actually. The article explains the basic ideas underlying the development of the powerline communication technology and the first commercially available service offered by Ascom Powerline Communications AG. (orig./CB) [German] Kommunikationssignale und Strom in einen Transportweg zusammenzufassen - eine faszinierende wie nahe liegende Idee. So nahe liegend wie die naechste Steckdose. Im Outdoor-Bereich wird in der jeweiligen Ortsnetzstation beides auf das Stromnetz gekoppelt. Von dort aus gelangt der 'Daten-Strom' dann ueber das Niederspannungsnetz zum Endverbraucher (Letzte Meile). Innerhalb des Hauses, im Indoor-Bereich, sind lediglich Adapter noetig, um Strom und Kommunikation wieder voneinander zu trennen und ihren individuellen Anwendungen zuzufuehren. Die Notwendigkeit einer separaten Telefon- oder Datenverkabelung entfaellt, da die Steckdose nun weit mehr ist als ein Elektrizitaetsanschluss: Sie wird zu einer leistungsfaehigen Kommunikationsschnittstelle - sei es zur Ueberbrueckung der 'Letzten Meile' fuer den Highspeed-Internet-Zugang oder zur Vernetzung innerhalb des Hauses. Die Vorteile fuer private Nutzer wie fuer Unternehmen sind enorm. (orig.)

  19. Fluid sampling tool

    Science.gov (United States)

    Garcia, A.R.; Johnston, R.G.; Martinez, R.K.

    1999-05-25

    A fluid sampling tool is described for sampling fluid from a container. The tool has a fluid collecting portion which is drilled into the container wall, thereby affixing it to the wall. The tool may have a fluid extracting section which withdraws fluid collected by the fluid collecting section. The fluid collecting section has a fluted shank with an end configured to drill a hole into a container wall. The shank has a threaded portion for tapping the borehole. The shank is threadably engaged to a cylindrical housing having an inner axial passageway sealed at one end by a septum. A flexible member having a cylindrical portion and a bulbous portion is provided. The housing can be slid into an inner axial passageway in the cylindrical portion and sealed to the flexible member. The bulbous portion has an outer lip defining an opening. The housing is clamped into the chuck of a drill, the lip of the bulbous section is pressed against a container wall until the shank touches the wall, and the user operates the drill. Wall shavings (kerf) are confined in a chamber formed in the bulbous section as it folds when the shank advances inside the container. After sufficient advancement of the shank, an o-ring makes a seal with the container wall. 6 figs.

  20. Fluid sampling tool

    Science.gov (United States)

    Garcia, Anthony R.; Johnston, Roger G.; Martinez, Ronald K.

    1999-05-25

    A fluid sampling tool for sampling fluid from a container. The tool has a fluid collecting portion which is drilled into the container wall, thereby affixing it to the wall. The tool may have a fluid extracting section which withdraws fluid collected by the fluid collecting section. The fluid collecting section has a fluted shank with an end configured to drill a hole into a container wall. The shank has a threaded portion for tapping the borehole. The shank is threadably engaged to a cylindrical housing having an inner axial passageway sealed at one end by a septum. A flexible member having a cylindrical portion and a bulbous portion is provided. The housing can be slid into an inner axial passageway in the cylindrical portion and sealed to the flexible member. The bulbous portion has an outer lip defining an opening. The housing is clamped into the chuck of a drill, the lip of the bulbous section is pressed against a container wall until the shank touches the wall, and the user operates the drill. Wall shavings (kerf) are confined in a chamber formed in the bulbous section as it folds when the shank advances inside the container. After sufficient advancement of the shank, an o-ring makes a seal with the container wall.

  1. Personalised fluid resuscitation in the ICU: still a fluid concept?

    Science.gov (United States)

    van Haren, Frank

    2017-12-28

    The administration of intravenous fluid to critically ill patients is one of the most common, but also one of the most fiercely debated, interventions in intensive care medicine. Even though many thousands of patients have been enrolled in large trials of alternative fluid strategies, consensus remains elusive and practice is widely variable. Critically ill patients are significantly heterogeneous, making a one size fits all approach unlikely to be successful.New data from basic, animal, and clinical research suggest that fluid resuscitation could be associated with significant harm. There are several important limitations and concerns regarding fluid bolus therapy as it is currently being used in clinical practice. These include, but are not limited to: the lack of an agreed definition; limited and short-lived physiological effects; no evidence of an effect on relevant patient outcomes; and the potential to contribute to fluid overload, specifically when fluid responsiveness is not assessed and when targets and safety limits are not used.Fluid administration in critically ill patients requires clinicians to integrate abnormal physiological parameters into a clinical decision-making model that also incorporates the likely diagnosis and the likely risk or benefit in the specific patient's context. Personalised fluid resuscitation requires careful attention to the mnemonic CIT TAIT: context, indication, targets, timing, amount of fluid, infusion strategy, and type of fluid.The research agenda should focus on experimental and clinical studies to: improve our understanding of the physiological effects of fluid infusion, e.g. on the glycocalyx; evaluate new types of fluids; evaluate novel fluid minimisation protocols; study the effects of a no-fluid strategy for selected patients and scenarios; and compare fluid therapy with other interventions. The adaptive platform trial design may provide us with the tools to evaluate these types of interventions in the intrinsically

  2. Police Communications

    Science.gov (United States)

    1981-01-01

    Oklahoma City Police Department developed a computerized communications system, based on Johnson Space Center's (JSC's) 1960-mission control knowledge. JSC furnished information on lighting and other fatigue reducing measures, and provided specifications for equipment and design layouts. JSC also advised OCPD how to avoid communications bottlenecks associated with simultaneous handling of telephone, radio and inner-office transmissions. Oklahoma City saved money in reduced design and engineering costs by utilizing the already developed NASA technology.

  3. Antifragile Communications

    OpenAIRE

    Lichtman, Marc Louis

    2016-01-01

    Jamming is an ongoing threat that plagues wireless communications in contested areas. Unfortunately, jamming complexity and sophistication will continue to increase over time. The traditional approach to addressing the jamming threat is to harden radios, such that they sacrifice communications performance for more advanced jamming protection. To provide an escape from this trend, we investigate the previously unexplored area of jammer exploitation. This dissertation develops the concep...

  4. Magnetic power piston fluid compressor

    Science.gov (United States)

    Gasser, Max G. (Inventor)

    1994-01-01

    A compressor with no moving parts in the traditional sense having a housing having an inlet end allowing a low pressure fluid to enter and an outlet end allowing a high pressure fluid to exit is described. Within the compressor housing is at least one compression stage to increase the pressure of the fluid within the housing. The compression stage has a quantity of magnetic powder within the housing, is supported by a screen that allows passage of the fluid, and a coil for selectively providing a magnetic field across the magnetic powder such that when the magnetic field is not present the individual particles of the powder are separated allowing the fluid to flow through the powder and when the magnetic field is present the individual particles of the powder pack together causing the powder mass to expand preventing the fluid from flowing through the powder and causing a pressure pulse to compress the fluid.

  5. The coupling of fluids, dynamics, and controls on advanced architecture computers

    Science.gov (United States)

    Atwood, Christopher

    1995-01-01

    This grant provided for the demonstration of coupled controls, body dynamics, and fluids computations in a workstation cluster environment; and an investigation of the impact of peer-peer communication on flow solver performance and robustness. The findings of these investigations were documented in the conference articles.The attached publication, 'Towards Distributed Fluids/Controls Simulations', documents the solution and scaling of the coupled Navier-Stokes, Euler rigid-body dynamics, and state feedback control equations for a two-dimensional canard-wing. The poor scaling shown was due to serialized grid connectivity computation and Ethernet bandwidth limits. The scaling of a peer-to-peer communication flow code on an IBM SP-2 was also shown. The scaling of the code on the switched fabric-linked nodes was good, with a 2.4 percent loss due to communication of intergrid boundary point information. The code performance on 30 worker nodes was 1.7 (mu)s/point/iteration, or a factor of three over a Cray C-90 head. The attached paper, 'Nonlinear Fluid Computations in a Distributed Environment', documents the effect of several computational rate enhancing methods on convergence. For the cases shown, the highest throughput was achieved using boundary updates at each step, with the manager process performing communication tasks only. Constrained domain decomposition of the implicit fluid equations did not degrade the convergence rate or final solution. The scaling of a coupled body/fluid dynamics problem on an Ethernet-linked cluster was also shown.

  6. Fluid Shifts

    Science.gov (United States)

    Stenger, M. B.; Hargens, A. R.; Dulchavsky, S. A.; Arbeille, P.; Danielson, R. W.; Ebert, D. J.; Garcia, K. M.; Johnston, S. L.; Laurie, S. S.; Lee, S. M. C.; hide

    2017-01-01

    Introduction. NASA's Human Research Program is focused on addressing health risks associated with long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight and to determine if a relation exists with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. Methods. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid

  7. Supercritical fluid reverse micelle separation

    Science.gov (United States)

    Fulton, J.L.; Smith, R.D.

    1993-11-30

    A method of separating solute material from a polar fluid in a first polar fluid phase is provided. The method comprises combining a polar fluid, a second fluid that is a gas at standard temperature and pressure and has a critical density, and a surfactant. The solute material is dissolved in the polar fluid to define the first polar fluid phase. The combined polar and second fluids, surfactant, and solute material dissolved in the polar fluid is maintained under near critical or supercritical temperature and pressure conditions such that the density of the second fluid exceeds the critical density thereof. In this way, a reverse micelle system defining a reverse micelle solvent is formed which comprises a continuous phase in the second fluid and a plurality of reverse micelles dispersed in the continuous phase. The solute material is dissolved in the polar fluid and is in chemical equilibrium with the reverse micelles. The first polar fluid phase and the continuous phase are immiscible. The reverse micelles each comprise a dynamic aggregate of surfactant molecules surrounding a core of the polar fluid. The reverse micelle solvent has a polar fluid-to-surfactant molar ratio W, which can vary over a range having a maximum ratio W[sub o] that determines the maximum size of the reverse micelles. The maximum ratio W[sub o] of the reverse micelle solvent is then varied, and the solute material from the first polar fluid phase is transported into the reverse micelles in the continuous phase at an extraction efficiency determined by the critical or supercritical conditions. 27 figures.

  8. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  9. Fluid mechanics

    International Nuclear Information System (INIS)

    Granger, R.A.

    1985-01-01

    This text offers the most comprehensive approach available to fluid mechanics. The author takes great care to insure a physical understanding of concepts grounded in applied mathematics. The presentation of theory is followed by engineering applications, helping students develop problem-solving skills from the perspective of a professional engineer. Extensive use of detailed examples reinforces the understanding of theoretical concepts

  10. Communications device identification methods, communications methods, wireless communications readers, wireless communications systems, and articles of manufacture

    Science.gov (United States)

    Steele, Kerry D [Kennewick, WA; Anderson, Gordon A [Benton City, WA; Gilbert, Ronald W [Morgan Hill, CA

    2011-02-01

    Communications device identification methods, communications methods, wireless communications readers, wireless communications systems, and articles of manufacture are described. In one aspect, a communications device identification method includes providing identification information regarding a group of wireless identification devices within a wireless communications range of a reader, using the provided identification information, selecting one of a plurality of different search procedures for identifying unidentified ones of the wireless identification devices within the wireless communications range, and identifying at least some of the unidentified ones of the wireless identification devices using the selected one of the search procedures.

  11. Providing affinity

    DEFF Research Database (Denmark)

    Guglielmi, Michel; Johannesen, Hl

    2004-01-01

    , Essex, Hertfordshire, Norfolk and Suffolk. Research found that there was a lack of identity or sense of belonging and nothing anchoring people to the region as a whole. Common affinity is somehow forced to the people of East England and thereby we came to the conclusion that a single landmark...... and potential situations but also virtual events that calls for an undeterminated process of resolution. This process is activated by the user who co-produces the actualisation as an answer to a virtual reality that we defined at the first place. The potential situations or the possible it is a fantomatic real....... The possible is like the real. It is determinated and it only lakes existence. While the possible is already made, the virtual is like a problematic which needs to be resolved and actualized. Our installations are based on high tech interactivity where we use sensors and remote communication to offer a sense...

  12. Racial and ethnic differences in the relationship between antenatal stressful life events and postpartum depression among women in the United States: does provider communication on perinatal depression minimize the risk?

    Science.gov (United States)

    Mukherjee, Soumyadeep; Fennie, Kristopher; Coxe, Stefany; Madhivanan, Purnima; Trepka, Mary Jo

    2018-07-01

    Multi-state population-based studies exploring the racial/ethnic differences in the prevalence and correlates of postpartum depression (PPD), which affects 10-20% of women in the US, are rare. The aim of this study was to examine the racial/ethnic disparities in the relationship between antenatal stressful life events and PPD among US women and to explore whether antenatal health care provider communication on perinatal depression was associated with a lower risk. Data from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS) were used. For each racial/ethnic group, the distribution of PPD was compared according to different levels of the stressors and socio-demographic, pre-pregnancy, antenatal, delivery, and neonatal characteristics. Multivariable logistic regression analyses were performed with PPD as the outcome and all variables that were significant in bivariate analyses as predictors. Eleven percent of 87,565 women met the criteria for PPD with the prevalence ranging from 7.9% among Asian/Pacific Islanders to 14% among American Indian/Alaska Natives. Irrespective of race/ethnicity, having many bills to pay and having more than usual arguments with husband/partner were risk factors for PPD. Among non-Hispanic black (NHB) women, having a husband/partner who did not want the pregnancy was associated with PPD (adjusted odds ratio [aOR]: 1.47; 95% confidence interval [CI]: 1.14, 1.90), and among non-Hispanic whites (NHWs), drug/drinking problems of someone close was associated with PPD (aOR: 1.37; 95% CI: 1.21, 1.55). Provider communication was inversely associated with PPD among NHWs (aOR: 0.77; 95% CI: 0.69, 0.85) and NHBs (aOR: 0.74; 95% CI: 0.60, 0.93). The protective effect of provider communication on PPD suggests the benefit of a simple conversation about perinatal depression during antenatal care. Furthermore, risk factors for PPD varied by race/ethnicity suggesting that these vulnerabilities should be taken into consideration in identifying

  13. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2011-01-01

    The CMS Communications Group, established at the start of 2010, has been busy in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure There are now 55 CMS Centres worldwide that are well used by physicists working on remote CMS shifts, Computing operations, data quality monitoring, data analysis and outreach. The CMS Centre@CERN in Meyrin, is the centre of the CMS offline and computing operations, hosting dedicated analysis efforts such as during the CMS Heavy Ion lead-lead running. With a majority of CMS sub-detectors now operating in a “shifterless” mode, many monitoring operations are now routinely performed from there, rather than in the main Control Room at P5. The CMS Communications Group, CERN IT and the EVO team are providing excellent videoconferencing support for the rapidly-increasing number of CMS meetings. In parallel, CERN IT and ...

  14. Fluid dynamics of dilatant fluid

    DEFF Research Database (Denmark)

    Nakanishi, Hiizu; Nagahiro, Shin-ichiro; Mitarai, Namiko

    2012-01-01

    of the state variable, we demonstrate that the model can describe basic features of the dilatant fluid such as the stress-shear rate curve that represents discontinuous severe shear thickening, hysteresis upon changing shear rate, and instantaneous hardening upon external impact. An analysis of the model...

  15. Editorial Special Issue on Fluid Mechanics and Fluid Power (FMFP ...

    Indian Academy of Sciences (India)

    a shark is more efficient than a propeller; the notoriously complicated and nonlinear Navier–. Stokes equations governing fluid motion provide fertile ground for research to both applied and pure mathematicians. There is the phenomenon of turbulence in fluid flows. A statement in 1932, attributed to Horace Lamb, author of ...

  16. Fluid-cooled heat sink with improved fin areas and efficiencies for use in cooling various devices

    Science.gov (United States)

    Bharathan, Desikan; Bennion, Kevin; Kelly, Kenneth; Narumanchi, Sreekant

    2015-04-21

    The disclosure provides a fluid-cooled heat sink having a heat transfer base and a plurality of heat transfer fins in thermal communication with the heat transfer base, where the heat transfer base and the heat transfer fins form a central fluid channel through which a forced or free cooling fluid may flow. The heat transfer pins are arranged around the central fluid channel with a flow space provided between adjacent pins, allowing for some portion of the central fluid channel flow to divert through the flow space. The arrangement reduces the pressure drop of the flow through the fins, optimizes average heat transfer coefficients, reduces contact and fin-pin resistances, and reduces the physical footprint of the heat sink in an operating environment.

  17. Fluid dynamics

    CERN Document Server

    Ruban, Anatoly I

    This is the first book in a four-part series designed to give a comprehensive and coherent description of Fluid Dynamics, starting with chapters on classical theory suitable for an introductory undergraduate lecture course, and then progressing through more advanced material up to the level of modern research in the field. The present Part 1 consists of four chapters. Chapter 1 begins with a discussion of Continuum Hypothesis, which is followed by an introduction to macroscopic functions, the velocity vector, pressure, density, and enthalpy. We then analyse the forces acting inside a fluid, and deduce the Navier-Stokes equations for incompressible and compressible fluids in Cartesian and curvilinear coordinates. In Chapter 2 we study the properties of a number of flows that are presented by the so-called exact solutions of the Navier-Stokes equations, including the Couette flow between two parallel plates, Hagen-Poiseuille flow through a pipe, and Karman flow above an infinite rotating disk. Chapter 3 is d...

  18. A Customized Quantitative PCR MicroRNA Panel Provides a Technically Robust Context for Studying Neurodegenerative Disease Biomarkers and Indicates a High Correlation Between Cerebrospinal Fluid and Choroid Plexus MicroRNA Expression.

    Science.gov (United States)

    Wang, Wang-Xia; Fardo, David W; Jicha, Gregory A; Nelson, Peter T

    2017-12-01

    MicroRNA (miRNA) expression varies in association with different tissue types and in diseases. Having been found in body fluids including blood and cerebrospinal fluid (CSF), miRNAs constitute potential biomarkers. CSF miRNAs have been proposed as biomarkers for neurodegenerative diseases; however, there is a lack of consensus about the best candidate miRNA biomarkers and there has been variability in results from different research centers, perhaps due to technical factors. Here, we sought to optimize technical parameters for CSF miRNA studies. We examined different RNA isolation methods and performed miRNA expression profiling with TaqMan® miRNA Arrays. More specifically, we developed a customized CSF-miRNA low-density array (TLDA) panel that contains 47 targets: miRNAs shown previously to be relevant to neurodegenerative disease, miRNAs that are abundant in CSF, data normalizers, and controls for potential blood and tissue contamination. The advantages of using this CSF-miRNA TLDA panel include specificity, sensitivity, fast processing and data analysis, and cost effectiveness. We optimized technical parameters for this assay. Further, the TLDA panel can be tailored to other specific purposes. We tested whether the profile of miRNAs in the CSF resembled miRNAs isolated from brain tissue (hippocampus or cerebellum), blood, or the choroid plexus. We found that the CSF miRNA expression profile most closely resembles that of choroid plexus tissue, underscoring the potential importance of choroid plexus-derived signaling through CSF miRNAs. In summary, the TLDA miRNA array panel will enable evaluation and discovery of CSF miRNA biomarkers and can potentially be utilized in clinical diagnosis and disease stage monitoring.

  19. The fluid dynamics of climate

    CERN Document Server

    Palazzi, Elisa; Fraedrich, Klaus

    2016-01-01

    This volume provides an overview of the fluid aspects of the climate system, focusing on basic aspects as well as recent research developments. It will bring together contributions from diverse fields of the physical, mathematical and engineering sciences. The volume will be useful to doctorate students, postdocs and researchers working on different aspects of atmospheric, oceanic and environmental fluid dynamics. It will also be of interest to researchers interested in quantitatively understanding how fluid dynamics can be applied to the climate system, and to climate scientists willing to gain a deeper insight into the fluid mechanics underlying climate processes.

  20. Clusters in simple fluids

    International Nuclear Information System (INIS)

    Sator, N.

    2003-01-01

    This article concerns the correspondence between thermodynamics and the morphology of simple fluids in terms of clusters. Definitions of clusters providing a geometric interpretation of the liquid-gas phase transition are reviewed with an eye to establishing their physical relevance. The author emphasizes their main features and basic hypotheses, and shows how these definitions lead to a recent approach based on self-bound clusters. Although theoretical, this tutorial review is also addressed to readers interested in experimental aspects of clustering in simple fluids

  1. Supercritical fluid analytical methods

    International Nuclear Information System (INIS)

    Smith, R.D.; Kalinoski, H.T.; Wright, B.W.; Udseth, H.R.

    1988-01-01

    Supercritical fluids are providing the basis for new and improved methods across a range of analytical technologies. New methods are being developed to allow the detection and measurement of compounds that are incompatible with conventional analytical methodologies. Characterization of process and effluent streams for synfuel plants requires instruments capable of detecting and measuring high-molecular-weight compounds, polar compounds, or other materials that are generally difficult to analyze. The purpose of this program is to develop and apply new supercritical fluid techniques for extraction, separation, and analysis. These new technologies will be applied to previously intractable synfuel process materials and to complex mixtures resulting from their interaction with environmental and biological systems

  2. Newnes communications technology handbook

    CERN Document Server

    Lewis, Geoff

    1994-01-01

    Newnes Communications Technology Handbook provides a discussion on different topics relevant to communications technology. The book is comprised of 39 chapters that tackle a wide variety of concern in communications technology. The coverage of the text includes technologies, such as analog digital communications systems, radio frequency receiver, and satellite systems. The book also discusses some methods and techniques used in communications technology, including mixer signal processing, modulation and demodulation, and spread spectrum techniques. The text will be of great use to engineers, t

  3. Fluid simulation for computer graphics

    CERN Document Server

    Bridson, Robert

    2008-01-01

    Animating fluids like water, smoke, and fire using physics-based simulation is increasingly important in visual effects, in particular in movies, like The Day After Tomorrow, and in computer games. This book provides a practical introduction to fluid simulation for graphics. The focus is on animating fully three-dimensional incompressible flow, from understanding the math and the algorithms to the actual implementation.

  4. Introduction to mathematical fluid dynamics

    CERN Document Server

    Meyer, Richard E

    2010-01-01

    An introduction to the behavior of liquids and gases, this volume provides excellent coverage of kinematics, momentum principle, Newtonian fluid, rotating fluids, compressibility, and more. It is geared toward advanced undergraduate and graduate students of mathematics and general science, and it requires a background in calculus and vector analysis. 1971 edition.

  5. Communication without communication

    Directory of Open Access Journals (Sweden)

    Bratina Boris R.

    2017-01-01

    Full Text Available This paper analyses the necessary conditions for successful communication. It is well known that post-modernity, described as an era of control, produces only decentralized, imploded subjectivities, who are neither able to question their own being nor to relate one with another in authentic bonds of communication. Today, virtual communication has become an ultimate model of every possible communication whatsoever. The authors, therefore, pose the question of conditions for possibility of subjectivities who would be able and apt for authentic communication, wherein faith, fidelity, truth, and capability of keeping one's word occupy the central place.

  6. Cryogenic Fluid Management Facility

    Science.gov (United States)

    Eberhardt, R. N.; Bailey, W. J.

    1985-01-01

    The Cryogenic Fluid Management Facility is a reusable test bed which is designed to be carried within the Shuttle cargo bay to investigate the systems and technologies associated with the efficient management of cryogens in space. Cryogenic fluid management consists of the systems and technologies for: (1) liquid storage and supply, including capillary acquisition/expulsion systems which provide single-phase liquid to the user system, (2) both passive and active thermal control systems, and (3) fluid transfer/resupply systems, including transfer lines and receiver tanks. The facility contains a storage and supply tank, a transfer line and a receiver tank, configured to provide low-g verification of fluid and thermal models of cryogenic storage and transfer processes. The facility will provide design data and criteria for future subcritical cryogenic storage and transfer system applications, such as Space Station life support, attitude control, power and fuel depot supply, resupply tankers, external tank (ET) propellant scavenging, and ground-based and space-based orbit transfer vehicles (OTV).

  7. Adaptação sócio-comunicativa no espectro autístico: dados obtidos com pais e terapeutas Social communicative adaptation in the autistic spectrum: data provided by parents and therapists

    Directory of Open Access Journals (Sweden)

    Priscilla Faria Sousa-Morato

    2009-01-01

    information sources, in this case, parents and therapists, is effective to identify individual differences in children of the autistic spectrum. METHODS: Subjects were 48 children, with ages ranging from three to 11 years and ten months, with psychiatric diagnosis included in the autistic spectrum. The parents of those children (46 mothers and two fathers and 15 speech therapists, who were, respectively, legal caregivers and responsible for their speech-language therapy for at least 12 months, were also subjects of the study. They answered a questionnaire regarding each child's social relation performance. RESULTS: Generically, it is possible to say that the answers obtained from different sources (parents and therapists were similar. However, the analysis of raw data showed that parents consistently presented higher number of positive answers when compared to therapists, in questions regarding social performance. CONCLUSION: The determination of data about social-communicative adaptation could characterize these subjects, demonstrating that this protocol can be used with different information sources; the answers provided by parents and therapists were homogeneous, confirming data reliability despite of significant differences in the comparison among social-communicative stages and levels. The application of the questionnaire and the social communicative protocol to different information sources can provided homogeneous results, allowing a reliable characterization of these children's social abilities.

  8. Communication Theory.

    Science.gov (United States)

    Penland, Patrick R.

    Three papers are presented which delineate the foundation of theory and principles which underlie the research and instructional approach to communications at the Graduate School of Library and Information Science, University of Pittsburgh. Cybernetic principles provide the integration, and validation is based in part on a situation-producing…

  9. Fluid mechanics

    International Nuclear Information System (INIS)

    Paraschivoiu, I.; Prud'homme, M.; Robillard, L.; Vasseur, P.

    2003-01-01

    This book constitutes at the same time theoretical and practical base relating to the phenomena associated with fluid mechanics. The concept of continuum is at the base of the approach developed in this work. The general advance proceeds of simple balances of forces as into hydrostatic to more complex situations or inertias, the internal stresses and the constraints of Reynolds are taken into account. This advance is not only theoretical but contains many applications in the form of solved problems, each chapter ending in a series of suggested problems. The major part of the applications relates to the incompressible flows

  10. Principles of fluid mechanics

    International Nuclear Information System (INIS)

    Kreider, J.F.

    1985-01-01

    This book is an introduction on fluid mechanics incorporating computer applications. Topics covered are as follows: brief history; what is a fluid; two classes of fluids: liquids and gases; the continuum model of a fluid; methods of analyzing fluid flows; important characteristics of fluids; fundamentals and equations of motion; fluid statics; dimensional analysis and the similarity principle; laminar internal flows; ideal flow; external laminar and channel flows; turbulent flow; compressible flow; fluid flow measurements

  11. Constructive communication

    CERN Document Server

    Ellis, Richard

    2012-01-01

    Richard Ellis is a consultant in communications and the successful author of 'Communication for Engineers'. In each chapter he highlights key points and situations, and provides exercises to consolidate what has already been learnt. The book ends with a 'toolbox' of useful information on subjects such as writing letters, spelling, punctuation, using abbreviations, studying for exams, using libraries and training.Written in clear, informative English, with the emphasis on the practical, this book is essential reading for both students and professionals in the con

  12. Auxillary Fluid Flowmeter

    DEFF Research Database (Denmark)

    RezaNejad Gatabi, Javad; Forouzbakhsh, Farshid; Ebrahimi Darkhaneh, Hadi

    2010-01-01

    The Auxiliary Fluid Flow meter is proposed to measure the fluid flow of any kind in both pipes and open channels. In this kind of flow measurement, the flow of an auxiliary fluid is measured Instead of direct measurement of the main fluid flow. The auxiliary fluid is injected into the main fluid ...

  13. Interlimb communication

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas

    A continual coordination between the two legs is necessary for maintaining a symmetric walking pattern and adapting to changes in the external environment. Recent evidence in animals and humans suggests that spinal interneuronal circuits under supraspinal control may mediate communication between...... the lower limbs. The overall objective of the present thesis was to further investigate and elucidate neural pathways underlying interlimb communication in humans, focusing primarily on the possible interlimb connections to the biceps femoris muscle. The major aims were 1) to investigate whether interlimb...... walking (Study IV). The results of the this thesis provide new insights into the neural mechanisms underlying human interlimb communication, as well as their functional relevance to human locomotion. Although it is difficult to propose the exact neural pathways mediating interlimb reflexes...

  14. Fluid-driven reciprocating apparatus and valving for controlling same

    Science.gov (United States)

    Whitehead, John C.; Toews, Hans G.

    1993-01-01

    A control valve assembly for alternately actuating a pair of fluid-driven free-piston devices by using fluid pressure communication therebetween. Each control valve is switched by a pressure signal depending on the state of its counterpart's piston. The communication logic is arranged to provide overlap of the forward strokes of the pistons, so that at least one of the pair will always be pressurized. Thus, uninterrupted pumping of liquid is made possible from a pair of free-piston pumps. In addition, the speed and frequency of piston stroking is entirely dependent on the mechanical power load applied. In the case of a pair of pumps, this enables liquid delivery at a substantially constant pressure over the full range of flow rates, from zero to maximum flow. One embodiment of the invention utilized two pairs of fluid-driven free-piston devices whereby a bipropellant liquid propulsion system may be operated, so as to provide continuous flow of both fuel and oxidizer liquids when used in rocket applications, for example.

  15. Nuclear reactor core support incorporating also a cooling fluid flow system

    International Nuclear Information System (INIS)

    Pennell, W.E.

    1975-01-01

    A description is given of a core bearing plate with several modular intake units having cooling fluid intake openings on their lower extensions, and on their upper ends located above the bearing plate, at least one fuel assembly which is thus in communication with the area under the bearing plate through the modular intake unit. The means for introducing the cooling fluid into the reactor vessel area are located under the bearing plate. The lower ends of the modular intake have ribs arranged essentially on a plane and join together with openings provided between the seals, in such a manner that the ribs form a barrier. The cooling fluid intake openings are located above this barrier, so that the cooling fluid is compelled to cross it before penetrating into the modular intake units [fr

  16. Digital communication communication, multimedia, security

    CERN Document Server

    Meinel, Christoph

    2014-01-01

    The authors give a detailed summary about the fundamentals and the historical background of digital communication. This includes an overview of the encoding principles and algorithms of textual information, audio information, as well as images, graphics, and video in the Internet. Furthermore the fundamentals of computer networking, digital security and cryptography are covered. Thus, the book provides a well-founded access to communication technology of computer networks, the internet and the WWW. Numerous pictures and images, a subject-index and a detailed list of historical personalities in

  17. Gyroelastic fluids

    Energy Technology Data Exchange (ETDEWEB)

    Kerbel, G.D.

    1981-01-20

    A study is made of a scale model in three dimensions of a guiding center plasma within the purview of gyroelastic (also known as finite gyroradius-near theta pinch) magnetohydrodynamics. The (nonlinear) system sustains a particular symmetry called isorrhopy which permits the decoupling of fluid modes from drift modes. Isorrhopic equilibria are analyzed within the framework of geometrical optics resulting in (local) dispersion relations and ray constants. A general scheme is developed to evolve an arbitrary linear perturbation of a screwpinch equilibrium as an invertible integral transform (over the complete set of generalized eigenfunctions defined naturally by the equilibrium). Details of the structure of the function space and the associated spectra are elucidated. Features of the (global) dispersion relation owing to the presence of gyroelastic stabilization are revealed. An energy principle is developed to study the stability of the tubular screwpinch.

  18. Gyroelastic fluids

    International Nuclear Information System (INIS)

    Kerbel, G.D.

    1981-01-01

    A study is made of a scale model in three dimensions of a guiding center plasma within the purview of gyroelastic (also known as finite gyroradius-near theta pinch) magnetohydrodynamics. The (nonlinear) system sustains a particular symmetry called isorrhopy which permits the decoupling of fluid modes from drift modes. Isorrhopic equilibria are analyzed within the framework of geometrical optics resulting in (local) dispersion relations and ray constants. A general scheme is developed to evolve an arbitrary linear perturbation of a screwpinch equilibrium as an invertible integral transform (over the complete set of generalized eigenfunctions defined naturally by the equilibrium). Details of the structure of the function space and the associated spectra are elucidated. Features of the (global) dispersion relation owing to the presence of gyroelastic stabilization are revealed. An energy principle is developed to study the stability of the tubular screwpinch

  19. Self-lubricating fluid bearing assembly

    International Nuclear Information System (INIS)

    Kapich, D.D.

    1981-01-01

    A sealed self-lubricating fluid bearing assembly is described for circulating fluid in the form of a gas coolant in a nuclear reactor, the power for the circulator being provided by a shaft located within the primary containment vessel. In such a system the reactor coolant is isolated from the fluid region at the far end of the drive shaft. (U.K.)

  20. Quantum communications

    CERN Document Server

    Cariolaro, Gianfranco

    2015-01-01

    This book demonstrates that a quantum communication system using the coherent light of a laser can achieve performance orders of magnitude superior to classical optical communications Quantum Communications provides the Masters and PhD signals or communications student with a complete basics-to-applications course in using the principles of quantum mechanics to provide cutting-edge telecommunications. Assuming only knowledge of elementary probability, complex analysis and optics, the book guides its reader through the fundamentals of vector and Hilbert spaces and the necessary quantum-mechanical ideas, simply formulated in four postulates. A turn to practical matters begins with and is then developed by: ·         development of the concept of quantum decision, emphasizing the optimization of measurements to extract useful information from a quantum system; ·         general formulation of a transmitter–receiver system ·         particular treatment of the most popular quantum co...

  1. Providing x-rays

    International Nuclear Information System (INIS)

    Mallozzi, P.J.; Epstein, H.M.

    1985-01-01

    This invention provides an apparatus for providing x-rays to an object that may be in an ordinary environment such as air at approximately atmospheric pressure. The apparatus comprises: means (typically a laser beam) for directing energy onto a target to produce x-rays of a selected spectrum and intensity at the target; a fluid-tight enclosure around the target; means for maintaining the pressure in the first enclosure substantially below atmospheric pressure; a fluid-tight second enclosure adjoining the first enclosure, the common wall portion having an opening large enough to permit x-rays to pass through but small enough to allow the pressure reducing means to evacuate gas from the first enclosure at least as fast as it enters through the opening; the second enclosure filled with a gas that is highly transparent to x-rays; the wall of the second enclosure to which the x-rays travel having a portion that is highly transparent to x-rays (usually a beryllium or plastic foil), so that the object to which the x-rays are to be provided may be located outside the second enclosure and adjacent thereto and thus receive the x-rays substantially unimpeded by air or other intervening matter. The apparatus is particularly suited to obtaining EXAFS (extended x-ray fine structure spectroscopy) data on a material

  2. Fluid Annotations in a Open World

    DEFF Research Database (Denmark)

    Zellweger, Polle Trescott; Bouvin, Niels Olof; Jehøj, Henning

    2001-01-01

    Fluid Documents use animated typographical changes to provide a novel and appealing user experience for hypertext browsing and for viewing document annotations in context. This paper describes an effort to broaden the utility of Fluid Documents by using the open hypermedia Arakne Environment to l...... to layer fluid annotations and links on top of abitrary HTML pages on the World Wide Web. Changes to both Fluid Documents and Arakne are required....

  3. Cerebrospinal fluid cisternography

    International Nuclear Information System (INIS)

    Sandler, M.P.; Price, A.C.; Partain, C.L.; James, A.E.; Runge, V.M.

    1988-01-01

    The evaluation of CSF dynamics has been discussed utilizing nuclear medicine, computed tomography, and magnetic resonance imaging. Cerebrospinal fluid leaks are readily diagnosed by both CT and nuclear scintigraphy. The major advantage of CT is the exact anatomic localization of the site of CSF leakage. Contrast toxicity, as well as complex and costly technology, often limit the wide applicability of CT in the diagnosis of CSF leaks. Nuclear scintigraphy, on the other hand, offers nonexact localization of CSF leaks, but is often more readily available than Ct. Magnetic resonance resolution is presently insufficient for diagnosis of CSF leaks. The anatomic diagnosis of hydrocephalus is more readily established with CT and MRI as compared to nuclear scintigraphy. However, none of the imaging modalities discussed are clearly superior in differentiating communicating from obstructive hydrocephalus. Nuclear scintigraphy remains the imaging modality of choice in the quantitative evaluation of CSF shunts and their patency

  4. Improving Pathologists' Communication Skills.

    Science.gov (United States)

    Dintzis, Suzanne

    2016-08-01

    The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

  5. Communication theory

    CERN Document Server

    Goldie, Charles M

    1991-01-01

    This book is an introduction, for mathematics students, to the theories of information and codes. They are usually treated separately but, as both address the problem of communication through noisy channels (albeit from different directions), the authors have been able to exploit the connection to give a reasonably self-contained treatment, relating the probabilistic and algebraic viewpoints. The style is discursive and, as befits the subject, plenty of examples and exercises are provided. Some examples and exercises are provided. Some examples of computer codes are given to provide concrete illustrations of abstract ideas.

  6. Fluid jet electric discharge source

    Science.gov (United States)

    Bender, Howard A [Ripon, CA

    2006-04-25

    A fluid jet or filament source and a pair of coaxial high voltage electrodes, in combination, comprise an electrical discharge system to produce radiation and, in particular, EUV radiation. The fluid jet source is composed of at least two serially connected reservoirs, a first reservoir into which a fluid, that can be either a liquid or a gas, can be fed at some pressure higher than atmospheric and a second reservoir maintained at a lower pressure than the first. The fluid is allowed to expand through an aperture into a high vacuum region between a pair of coaxial electrodes. This second expansion produces a narrow well-directed fluid jet whose size is dependent on the size and configuration of the apertures and the pressure used in the reservoir. At some time during the flow of the fluid filament, a high voltage pulse is applied to the electrodes to excite the fluid to form a plasma which provides the desired radiation; the wavelength of the radiation being determined by the composition of the fluid.

  7. Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study.

    Science.gov (United States)

    Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede; Ruland, Cornelia M

    2015-11-18

    Although there is growing evidence of the positive effects of Internet-based patient-provider communication (IPPC) services for both patients and health care providers, their implementation into clinical practice continues to be a challenge. The 3 aims of this study were to (1) identify and compare barriers and facilitators influencing the implementation of an IPPC service in 5 hospital units using the Consolidated Framework for Implementation Research (CFIR), (2) assess the ability of the different constructs of CFIR to distinguish between high and low implementation success, and (3) compare our findings with those from other studies that used the CFIR to discriminate between high and low implementation success. This study was based on individual interviews with 10 nurses, 6 physicians, and 1 nutritionist who had used the IPPC to answer messages from patients. Of the 36 CFIR constructs, 28 were addressed in the interviews, of which 12 distinguished between high and low implementation units. Most of the distinguishing constructs were related to the inner setting domain of CFIR, indicating that institutional factors were particularly important for successful implementation. Health care providers' beliefs in the intervention as useful for themselves and their patients as well as the implementation process itself were also important. A comparison of constructs across ours and 2 other studies that also used the CFIR to discriminate between high and low implementation success showed that 24 CFIR constructs distinguished between high and low implementation units in at least 1 study; 11 constructs distinguished in 2 studies. However, only 2 constructs (patient need and resources and available resources) distinguished consistently between high and low implementation units in all 3 studies. The CFIR is a helpful framework for illuminating barriers and facilitators influencing IPPC implementation. However, CFIR's strength of being broad and comprehensive also limits its

  8. Astronomy Communication

    Science.gov (United States)

    Heck, A.; Madsen, C.

    2003-07-01

    Astronomers communicate all the time, with colleagues of course, but also with managers and administrators, with decision makers and takers, with social representatives, with the news media, and with the society at large. Education is naturally part of the process. Astronomy communication must take into account several specificities: the astronomy community is rather compact and well organized world-wide; astronomy has penetrated the general public remarkably well with an extensive network of associations and organizations of aficionados all over the world. Also, as a result of the huge amount of data accumulated and by necessity for their extensive international collaborations, astronomers have pioneered the development of distributed resources, electronic communications and networks coupled to advanced methodologies and technologies, often much before they become of common world-wide usage. This book is filling up a gap in the astronomy-related literature by providing a set of chapters not only of direct interest to astronomy communication, but also well beyond it. The experts contributing to this book have done their best to write in a way understandable to readers not necessarily hyperspecialized in astronomy nor in communication techniques while providing specific detailed information, as well as plenty of pointers and bibliographic elements. This book will be very useful for researchers, teachers, editors, publishers, librarians, computer scientists, sociologists of science, research planners and strategists, project managers, public-relations officers, plus those in charge of astronomy-related organizations, as well as for students aiming at a career in astronomy or related space science. Link: http://www.wkap.nl/prod/b/1-4020-1345-0

  9. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2010-01-01

    The recently established CMS Communications Group, led by Lucas Taylor, has been busy in all three of its main are areas of responsibility: Communications Infrastructure, Information Systems, and Outreach and Education Communications Infrastructure The damage caused by the flooding of the CMS Centre@CERN on 21st December has been completely repaired and all systems are back in operation. Major repairs were made to the roofs, ceilings and one third of the floor had to be completely replaced. Throughout these works, the CMS Centre was kept operating and even hosted a major press event for first 7 TeV collisions, as described below. Incremental work behind the scenes is steadily improving the quality of the CMS communications infrastructure, particularly Webcasting, video conferencing, and meeting rooms at CERN. CERN/IT is also deploying a pilot service of a new videoconference tool called Vidyo, to assess whether it might provide an enhanced service at a lower cost, compared to the EVO tool currently in w...

  10. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2011-01-01

    The CMS Communications Group has been busy in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure The 55 CMS Centres worldwide are well used by physicists working on remote CMS shifts, Computing operations, data quality monitoring, data analysis and outreach. The CMS Centre@CERN in Meyrin, is the centre of the CMS Offline and Computing operations, and a number of subdetector shifts can now take place there, rather than in the main Control Room at P5. A new CMS meeting room has been equipped for videoconferencing in building 42, next to building 40. Our building 28 meeting room and the facilities at P5 will be refurbished soon and plans are underway to steadily upgrade the ageing equipment in all 15 CMS meeting rooms at CERN. The CMS evaluation of the Vidyo tool indicates that it is not yet ready to be considered as a potential replacement for EVO. The Communications Group provides the CMS-TV (web) cha...

  11. Wave Interactions and Fluid Flows

    Science.gov (United States)

    Craik, Alex D. D.

    1988-07-01

    This up-to-date and comprehensive account of theory and experiment on wave-interaction phenomena covers fluids both at rest and in their shear flows. It includes, on the one hand, water waves, internal waves, and their evolution, interaction, and associated wave-driven means flow and, on the other hand, phenomena on nonlinear hydrodynamic stability, especially those leading to the onset of turbulence. This study provide a particularly valuable bridge between these two similar, yet different, classes of phenomena. It will be of value to oceanographers, meteorologists, and those working in fluid mechanics, atmospheric and planetary physics, plasma physics, aeronautics, and geophysical and astrophysical fluid dynamics.

  12. Fluid intelligence: A brief history.

    Science.gov (United States)

    Kent, Phillip

    2017-01-01

    The concept of fluid and crystallized intelligence was introduced to the psychological community approximately 75 years ago by Raymond B. Cattell, and it continues to be an area of active research and controversy. The purpose of this paper is to provide a brief overview of the origin of the concept, early efforts to define intelligence and uses of intelligence tests to address pressing social issues, and the ongoing controversies associated with fluid intelligence and the structure of intelligence. The putative neuropsychological underpinnings and neurological substrates of fluid intelligence are discussed.

  13. Advances in Environmental Fluid Mechanics

    CERN Document Server

    Mihailovic, Dragutin T

    2010-01-01

    Environmental fluid mechanics (EFM) is the scientific study of transport, dispersion and transformation processes in natural fluid flows on our planet Earth, from the microscale to the planetary scale. This book brings together scientists and engineers working in research institutions, universities and academia, who engage in the study of theoretical, modeling, measuring and software aspects in environmental fluid mechanics. It provides a forum for the participants, and exchanges new ideas and expertise through the presentations of up-to-date and recent overall achievements in this field.

  14. Standardization of Thermo-Fluid Modeling in Modelica.Fluid

    Energy Technology Data Exchange (ETDEWEB)

    Franke, Rudiger; Casella, Francesco; Sielemann, Michael; Proelss, Katrin; Otter, Martin; Wetter, Michael

    2009-09-01

    This article discusses the Modelica.Fluid library that has been included in the Modelica Standard Library 3.1. Modelica.Fluid provides interfaces and basic components for the device-oriented modeling of onedimensional thermo-fluid flow in networks containing vessels, pipes, fluid machines, valves and fittings. A unique feature of Modelica.Fluid is that the component equations and the media models as well as pressure loss and heat transfer correlations are decoupled from each other. All components are implemented such that they can be used for media from the Modelica.Media library. This means that an incompressible or compressible medium, a single or a multiple substance medium with one or more phases might be used with one and the same model as long as the modeling assumptions made hold. Furthermore, trace substances are supported. Modeling assumptions can be configured globally in an outer System object. This covers in particular the initialization, uni- or bi-directional flow, and dynamic or steady-state formulation of mass, energy, and momentum balance. All assumptions can be locally refined for every component. While Modelica.Fluid contains a reasonable set of component models, the goal of the library is not to provide a comprehensive set of models, but rather to provide interfaces and best practices for the treatment of issues such as connector design and implementation of energy, mass and momentum balances. Applications from various domains are presented.

  15. Synovial fluid analysis

    Science.gov (United States)

    Joint fluid analysis; Joint fluid aspiration ... El-Gabalawy HS. Synovial fluid analysis, synovial biopsy, and synovial pathology. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly's Textbook of ...

  16. Endoscopic Management of Peri-Pancreatic Fluid Collections.

    Science.gov (United States)

    Yip, Hon Chi; Teoh, Anthony Yuen Bun

    2017-09-15

    In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.

  17. Fluid dynamics an introduction

    CERN Document Server

    Rieutord, Michel

    2015-01-01

    This book is dedicated to readers who want to learn fluid dynamics from the beginning. It assumes a basic level of mathematics knowledge that would correspond to that of most second-year undergraduate physics students and examines fluid dynamics from a physicist’s perspective. As such, the examples used primarily come from our environment on Earth and, where possible, from astrophysics. The text is arranged in a progressive and educational format, aimed at leading readers from the simplest basics to more complex matters like turbulence and magnetohydrodynamics. Exercises at the end of each chapter help readers to test their understanding of the subject (solutions are provided at the end of the book), and a special chapter is devoted to introducing selected aspects of mathematics that beginners may not be familiar with, so as to make the book self-contained.

  18. Optimal composition of fluid-replacement beverages.

    Science.gov (United States)

    Baker, Lindsay B; Jeukendrup, Asker E

    2014-04-01

    The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences.

  19. Unified communications

    OpenAIRE

    Kravos, Urban

    2011-01-01

    In the modern business world, communication are becoming more and more complex. As a solution to this problem unified communications occurred. Using a single communication approach unified communications are the integration of various communication technologies (eg, telephony, unified messaging, audio, video and web conferencing and collaboration tools). Unified Messaging, which represents only part of the unified communications means the integration of different non real time communication t...

  20. Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives.

    Science.gov (United States)

    Litchfield, Ian; Bentham, Louise; Hill, Ann; McManus, Richard J; Lilford, Richard; Greenfield, Sheila

    2015-11-01

    The testing and result communication process in primary care is complex. Its successful completion relies on the coordinated efforts of a range of staff in primary care and external settings working together with patients. Despite the importance of diagnostic testing in provision of care, this complexity renders the process vulnerable in the face of increasing demand, stretched resources and a lack of supporting guidance. We conducted a series of focus groups with patients and staff across four primary care practices using process-improvement strategies to identify and understand areas where either unnecessary delay is introduced, or the process may fail entirely. We then worked with both patients and staff to arrive at practical strategies to improve the current system. A total of six areas across the process were identified where improvements could be introduced. These were: (1) delay in phlebotomy, (2) lack of a fail-safe to ensure blood tests are returned to practices and patients, (3) difficulties in accessing results by telephone, (4) role of non-clinical staff in communicating results, (5) routine communication of normal results and (6) lack of a protocol for result communication. A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data. There remains an urgent need for further work to test these and other potential solutions. 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.

  1. Karl Marx & Communication @ 200: Towards a Marxian Theory of Communication

    Directory of Open Access Journals (Sweden)

    Christian Fuchs

    2018-05-01

    Full Text Available This contribution takes Marx’s bicentenary as occasion for reflecting on foundations of a Marxian theory of communication. It aims to show that Marx provides a consistent account as foundation for a critical, dialectical theory of communication. The article first discusses the relationship of communication and materialism in order to ground a communicative materialism that avoids the dualist assumption that communication is a superstructure erected on a material base. Second, the paper provides an overview of how Marx’s approach helps us to understand the role of the means of communication and communicative labour in capitalism. Third, it conceives of ideology as a form of fetishised communication and fetishism as ideological communication. Given that communicative capitalism is a significant dimension of contemporary society, it is about time to develop a Marxian theory of communication.

  2. Extension of Generalized Fluid System Simulation Program's Fluid Property Database

    Science.gov (United States)

    Patel, Kishan

    2011-01-01

    This internship focused on the development of additional capabilities for the General Fluid Systems Simulation Program (GFSSP). GFSSP is a thermo-fluid code used to evaluate system performance by a finite volume-based network analysis method. The program was developed primarily to analyze the complex internal flow of propulsion systems and is capable of solving many problems related to thermodynamics and fluid mechanics. GFSSP is integrated with thermodynamic programs that provide fluid properties for sub-cooled, superheated, and saturation states. For fluids that are not included in the thermodynamic property program, look-up property tables can be provided. The look-up property tables of the current release version can only handle sub-cooled and superheated states. The primary purpose of the internship was to extend the look-up tables to handle saturated states. This involves a) generation of a property table using REFPROP, a thermodynamic property program that is widely used, and b) modifications of the Fortran source code to read in an additional property table containing saturation data for both saturated liquid and saturated vapor states. Also, a method was implemented to calculate the thermodynamic properties of user-fluids within the saturation region, given values of pressure and enthalpy. These additions required new code to be written, and older code had to be adjusted to accommodate the new capabilities. Ultimately, the changes will lead to the incorporation of this new capability in future versions of GFSSP. This paper describes the development and validation of the new capability.

  3. Communicative Musicality

    DEFF Research Database (Denmark)

    Holck, Ulla

    2010-01-01

    university, Stephen Malloch listened to tapes of mothers and their babies ‘chatting’ with each other, recorded by Trevarthen in the 70’s. One of the first tapes was the vocal interaction of Laura and her mother. “As I listened, intrigued by the fluid give and take of the communication, and the lilting speech...... of the mother as she chatted with her baby, I began to tap my foot. I am, by training, a musician, so I was very used to automatically feeling the beat as I listened to musical sounds.… I replaced the tape, and again, I could sense a distinct rhythmicity and melodious give and take to the gentle prompting...... therapy as purely protomusic. But with Malloch & Trevarthen’s focus on musicality as the innate human abilities that make music production and appreciation possible, this discussion can easily move on. These and many other essential discussions await us – thanks to this comprehensive – and demanding...

  4. Geophysical fluid dynamics

    CERN Document Server

    Pedlosky, Joseph

    1982-01-01

    The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which land my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same tim...

  5. Microfluidics with fluid walls.

    Science.gov (United States)

    Walsh, Edmond J; Feuerborn, Alexander; Wheeler, James H R; Tan, Ann Na; Durham, William M; Foster, Kevin R; Cook, Peter R

    2017-10-10

    Microfluidics has great potential, but the complexity of fabricating and operating devices has limited its use. Here we describe a method - Freestyle Fluidics - that overcomes many key limitations. In this method, liquids are confined by fluid (not solid) walls. Aqueous circuits with any 2D shape are printed in seconds on plastic or glass Petri dishes; then, interfacial forces pin liquids to substrates, and overlaying an immiscible liquid prevents evaporation. Confining fluid walls are pliant and resilient; they self-heal when liquids are pipetted through them. We drive flow through a wide range of circuits passively by manipulating surface tension and hydrostatic pressure, and actively using external pumps. Finally, we validate the technology with two challenging applications - triggering an inflammatory response in human cells and chemotaxis in bacterial biofilms. This approach provides a powerful and versatile alternative to traditional microfluidics.The complexity of fabricating and operating microfluidic devices limits their use. Walsh et al. describe a method in which circuits are printed as quickly and simply as writing with a pen, and liquids in them are confined by fluid instead of solid walls.

  6. Geophysical fluid dynamics

    CERN Document Server

    Pedlosky, Joseph

    1979-01-01

    The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which I and my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same ti...

  7. Object-oriented communications

    International Nuclear Information System (INIS)

    Chapman, L.J.

    1989-01-01

    OOC is a high-level communications protocol based on the object-oriented paradigm. OOC's syntax, semantics, and pragmatics balance simplicity and expressivity for controls environments. While natural languages are too complex, computer protocols are often insufficiently expressive. An object-oriented communications philosophy provides a base for building the necessary high-level communications primitives like I don't understand and the current value of X is K. OOC is sufficiently flexible to express data acquisition, control requests, alarm messages, and error messages in a straightforward generic way. It can be used in networks, for inter-task communication, and even for intra-task communication

  8. Communications article

    KAUST Repository

    Fariborzi, Hossein

    2017-01-01

    Seamless, covert communications using a communications system integrated or incorporated within an article of clothing is described. In one embodiment, the communications system is integrated or incorporated into a shoe insole and includes a haptic

  9. Bone Conduction: Anatomy, Physiology, and Communication

    National Research Council Canada - National Science Library

    Henry, Paula; Letowski, Tomasz R

    2007-01-01

    ... conduction transmission, and the use of the bone conduction pathway for communication. Bone conduction for the transmission of communication is effective and feasible for Soldiers because it provides a means of providing radio communication in combination with hearing protection devices.

  10. The mixing of fluids

    International Nuclear Information System (INIS)

    Ottino, J.M.

    1989-01-01

    What do the eruption of Krakatau, the manufacture of puff pastry and the brightness of stars have in common? Each involves some aspect of mixing. Mixing also plays a critical role in modern technology. Chemical engineers rely on mixing to ensure that substances react properly, to produce polymer blends that exhibit unique properties and to disperse drag-reducing agents in pipelines. Yet in spite of its of its ubiquity in nature and industry, mixing is only imperfectly under-stood. Indeed, investigators cannot even settle on a common terminology: mixing is often referred to as stirring by oceanographers and geophysicists, as blending by polymer engineers and as agitation by process engineers. Regardless of what the process is called, there is little doubt that it is exceedingly complex and is found in a great variety of systems. In constructing a theory of fluid mixing, for example, one has to take into account fluids that can be miscible or partially miscible and reactive or inert, and flows that are slow and orderly or very fast and turbulent. It is therefore not surprising that no single theory can explain all aspect of mixing in fluids and that straightforward computations usually fail to capture all the important details. Still, both physical experiments and computer simulations can provide insight into the mixing process. Over the past several years the authors and his colleague have taken both approaches in an effort to increase understanding of various aspect of the process-particularly of mixing involving slow flows and viscous fluids such as oils

  11. Thermodynamic properties of cryogenic fluids

    CERN Document Server

    Leachman, Jacob; Lemmon, Eric; Penoncello, Steven

    2017-01-01

    This update to a classic reference text provides practising engineers and scientists with accurate thermophysical property data for cryogenic fluids. The equations for fifteen important cryogenic fluids are presented in a basic format, accompanied by pressure-enthalpy and temperature-entropy charts and tables of thermodynamic properties. It begins with a chapter introducing the thermodynamic relations and functional forms for equations of state, and goes on to describe the requirements for thermodynamic property formulations, needed for the complete definition of the thermodynamic properties of a fluid. The core of the book comprises extensive data tables and charts for the most commonly-encountered cryogenic fluids. This new edition sees significant updates to the data presented for air, argon, carbon monoxide, deuterium, ethane, helium, hydrogen, krypton, nitrogen and xenon. The book supports and complements NIST’s REFPROP - an interactive database and tool for the calculation of thermodynamic propertie...

  12. Fluid mechanics in fluids at rest.

    Science.gov (United States)

    Brenner, Howard

    2012-07-01

    Using readily available experimental thermophoretic particle-velocity data it is shown, contrary to current teachings, that for the case of compressible flows independent dye- and particle-tracer velocity measurements of the local fluid velocity at a point in a flowing fluid do not generally result in the same fluid velocity measure. Rather, tracer-velocity equality holds only for incompressible flows. For compressible fluids, each type of tracer is shown to monitor a fundamentally different fluid velocity, with (i) a dye (or any other such molecular-tagging scheme) measuring the fluid's mass velocity v appearing in the continuity equation and (ii) a small, physicochemically and thermally inert, macroscopic (i.e., non-Brownian), solid particle measuring the fluid's volume velocity v(v). The term "compressibility" as used here includes not only pressure effects on density, but also temperature effects thereon. (For example, owing to a liquid's generally nonzero isobaric coefficient of thermal expansion, nonisothermal liquid flows are to be regarded as compressible despite the general perception of liquids as being incompressible.) Recognition of the fact that two independent fluid velocities, mass- and volume-based, are formally required to model continuum fluid behavior impacts on the foundations of contemporary (monovelocity) fluid mechanics. Included therein are the Navier-Stokes-Fourier equations, which are now seen to apply only to incompressible fluids (a fact well-known, empirically, to experimental gas kineticists). The findings of a difference in tracer velocities heralds the introduction into fluid mechanics of a general bipartite theory of fluid mechanics, bivelocity hydrodynamics [Brenner, Int. J. Eng. Sci. 54, 67 (2012)], differing from conventional hydrodynamics in situations entailing compressible flows and reducing to conventional hydrodynamics when the flow is incompressible, while being applicable to both liquids and gases.

  13. Reduced abrasion drilling fluid

    NARCIS (Netherlands)

    2010-01-01

    A reduced abrasion drilling fluid system and method of drilling a borehole by circulating the reduced abrasion drilling fluid through the borehole is disclosed. The reduced abrasion drilling fluid comprises a drilling fluid, a first additive and a weighting agent, wherein the weighting agent has a

  14. Reduced abrasion drilling fluid

    NARCIS (Netherlands)

    2012-01-01

    A reduced abrasion drilling fluid system and method of drilling a borehole by circulating the reduced abrasion drilling fluid through the borehole is disclosed. The reduced abrasion drilling fluid comprises a drilling fluid, a first additive and a weighting agent, wherein the weighting agent has a

  15. Process fluid cooling system

    International Nuclear Information System (INIS)

    Farquhar, N.G.; Schwab, J.A.

    1977-01-01

    A system of heat exchangers is disclosed for cooling process fluids. The system is particularly applicable to cooling steam generator blowdown fluid in a nuclear plant prior to chemical purification of the fluid in which it minimizes the potential of boiling of the plant cooling water which cools the blowdown fluid

  16. Emergency Communication

    Science.gov (United States)

    : Environmental Documents, Reports LANL Home Calendar Search Contacts Resources » Emergency Communication Emergency Communication Stay informed of emergencies, weather delays, closures, other alerts. Find links to

  17. Tactile Communications

    Data.gov (United States)

    National Aeronautics and Space Administration — Communication with the crew is vital and must be maintained regardless of environmental conditions and crew activity. Current spacecraft communication systems depend...

  18. Short communication: Postpasteurization hold temperatures of 4 or 6°C, but not raw milk holding of 24 or 72 hours, affect bacterial outgrowth in pasteurized fluid milk.

    Science.gov (United States)

    Andrus, Alexis D; Campbell, Brynne; Boor, Kathryn J; Wiedmann, Martin; Martin, Nicole H

    2015-11-01

    As fluid milk processors continue to reduce microbial spoilage in fluid milk through improved control of postpasteurization contamination and psychrotolerant sporeformer outgrowth, it is necessary to identify strategies to further improve the quality and extend the shelf life of fluid milk products that are high-temperature, short-time pasteurized. Solutions that optimize product quality, and are economically feasible, are of particular interest to the dairy industry. To this end, this study examined the effects of raw milk holding time and temperature of pasteurized milk storage over shelf life on bacterial growth. In 3 independent replicates, raw milk was stored for 24 and 72 h before pasteurization at 76°C for 25s and then incubated at 3 different storage conditions: (1) 4°C for 21d; (2) 4°C for the first 48 h, then 6°C for the duration of the 21-d shelf life; or (3) 6°C for 21d. Total bacteria counts were assessed initially and on d 7, 14, and 21. No substantial difference in bacterial growth over shelf life was observed between samples processed from raw milk held for 24 versus 72 h. A significantly lower bacterial load was seen at d 21 after pasteurization in samples held at 4°C, versus 4°C for the first 48 h followed by 6°C for the duration of the 21-d shelf life and samples held at 6°C for 21d. This work demonstrates the importance of maintaining control of the fluid milk cold chain throughout postpasteurization, transportation, and retail storage on fluid milk microbial quality. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  19. Essential Computational Fluid Dynamics

    CERN Document Server

    Zikanov, Oleg

    2011-01-01

    This book serves as a complete and self-contained introduction to the principles of Computational Fluid Dynamic (CFD) analysis. It is deliberately short (at approximately 300 pages) and can be used as a text for the first part of the course of applied CFD followed by a software tutorial. The main objectives of this non-traditional format are: 1) To introduce and explain, using simple examples where possible, the principles and methods of CFD analysis and to demystify the `black box’ of a CFD software tool, and 2) To provide a basic understanding of how CFD problems are set and

  20. Communications article

    KAUST Repository

    Fariborzi, Hossein

    2017-07-20

    Seamless, covert communications using a communications system integrated or incorporated within an article of clothing is described. In one embodiment, the communications system is integrated or incorporated into a shoe insole and includes a haptic feedback mechanism, a communications module, a flexible pressure sensor, and a battery. The communications module includes a wireless communications module for wireless communications, a wired interface for wired communications, a microcontroller, and a battery charge controller. The flexible pressure sensor can be actuated by an individual\\'s toe, for example, and communication between two communications nodes can be achieved using coded signals sent by individuals using a combination of long and short presses on the pressure sensor. In response to the presses, wireless communications modules can transmit and receive coded signals based on the presses.

  1. Methods of conveying fluids and methods of sublimating solid particles

    Science.gov (United States)

    Turner, Terry D; Wilding, Bruce M

    2013-10-01

    A heat exchanger and associated methods for sublimating solid particles therein, for conveying fluids therethrough, or both. The heat exchanger includes a chamber and a porous member having a porous wall having pores in communication with the chamber and with an interior of the porous member. A first fluid is conveyed into the porous member while a second fluid is conveyed into the porous member through the porous wall. The second fluid may form a positive flow boundary layer along the porous wall to reduce or eliminate substantial contact between the first fluid and the interior of the porous wall. The combined first and second fluids are conveyed out of the porous member. Additionally, the first fluid and the second fluid may each be conveyed into the porous member at different temperatures and may exit the porous member at substantially the same temperature.

  2. Electronic Payments using Mobile Communication Devices

    NARCIS (Netherlands)

    Waaij, B.D. van der; Siljee, B.I.J.; Broekhuijsen, B.J.; Ponsioen, C.; Maas, A.; Aten, R.M.; Hoepman, J.H.; Loon, J.H. van; Smit, M.

    2009-01-01

    A method of making a payment uses a first mobile communication device (1) and a second mobile communication device (2), each mobile communication device being provided with a respective near field communication unit (11, 21) and at least one of the mobile communication devices being provided with an

  3. Communication, concepts and grounding.

    Science.gov (United States)

    van der Velde, Frank

    2015-02-01

    This article discusses the relation between communication and conceptual grounding. In the brain, neurons, circuits and brain areas are involved in the representation of a concept, grounding it in perception and action. In terms of grounding we can distinguish between communication within the brain and communication between humans or between humans and machines. In the first form of communication, a concept is activated by sensory input. Due to grounding, the information provided by this communication is not just determined by the sensory input but also by the outgoing connection structure of the conceptual representation, which is based on previous experiences and actions. The second form of communication, that between humans or between humans and machines, is influenced by the first form. In particular, a more successful interpersonal communication might require forms of situated cognition and interaction in which the entire representations of grounded concepts are involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Fluid Mechanics An Introduction to the Theory of Fluid Flows

    CERN Document Server

    Durst, Franz

    2008-01-01

    Advancements of fluid flow measuring techniques and of computational methods have led to new ways to treat laminar and turbulent flows. These methods are extensively used these days in research and engineering practise. This also requires new ways to teach the subject to students at higher educational institutions in an introductory manner. The book provides the knowledge to students in engineering and natural science needed to enter fluid mechanics applications in various fields. Analytical treatments are provided, based on the Navier-Stokes equations. Introductions are also given into numerical and experimental methods applied to flows. The main benefit the reader will derive from the book is a sound introduction into all aspects of fluid mechanics covering all relevant subfields.

  5. 10th International Symposium on Applications of Laser Techniques to Fluid Mechanics

    CERN Document Server

    Adrian, R J; Heitor, M V; Maeda, M; Tropea, C; Whitelaw, J H

    2002-01-01

    This volume includes revised and extended versions of selected papers presented at the Tenth International Symposium on Applications of Laser Techniques to Fluid Mechanics held at the Calouste Gulbenkian Foundation in Lisbon, during the period of July 10 to 13, 2000. The papers describe instrumentation developments for Velocity, Scalar and Multi-Phase Flows and results of measurements of Turbulent Flows, and Combustion and Engines. The papers demonstrate the continuing and healthy interest in the development of understanding of new methodologies and implementation in terms of new instrumentation. The prime objective of the Tenth Symposium was to provide a forum for the presentation of the most advanced research on laser techniques for flow measurements, and communicate significant results to fluid mechanics. The application of laser techniques to scientific and engineering fluid flow research was emphasized, but contributions to the theory and practice of laser methods were also considered where they facilita...

  6. Microfluidic device and method for focusing, segmenting, and dispensing of a fluid stream

    Science.gov (United States)

    Jacobson, Stephen C [Knoxville, TN; Ramsey, J Michael [Knoxville, TN

    2008-09-09

    A microfluidic device and method for forming and dispensing minute volume segments of a material are described. In accordance with the present invention, a microfluidic device and method are provided for spatially confining the material in a focusing element. The device is also adapted for segmenting the confined material into minute volume segments, and dispensing a volume segment to a waste or collection channel. The device further includes means for driving the respective streams of sample and focusing fluids through respective channels into a chamber, such that the focusing fluid streams spatially confine the sample material. The device may also include additional means for driving a minute volume segment of the spatially confined sample material into a collection channel in fluid communication with the waste reservoir.

  7. Evaluation of the Communication Between Arachnoid Cysts and Neighboring Cerebrospinal Fluid Spaces by T2W 3D-SPACE With Variant Flip-Angle Technique at 3 T.

    Science.gov (United States)

    Algin, Oktay

    2018-05-21

    Phase-contrast cine magnetic resonance imaging (PC-MRI) is a widely used technique for determination of possible communication of arachnoid cysts (ACs). Three-dimensional (3D) sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) technique is a relatively new method for 3D isotropic scanning of the entire cranium within a short time. In this research, the usage of the 3D-SPACE technique in differentiation of communicating or noncommunicating type ACs was evaluated. Thirty-five ACs in 34 patients were retrospectively examined. The 3D-SPACE, PC-MRI, and contrast material-enhanced cisternography (if present) images of the patients were analyzed. Each cyst was described according to cyst size/location, third ventricle diameter, Evans index, and presence of hydrocephalus. Communication was defined as absent (score 0), suspected (score 1), or present (score 2) on each sequence. Results of PC-MRI or cisternography (if available) examinations were used as criterion standard techniques to categorize all cysts as communicating or noncommunicating type. The results of 3D-SPACE were compared with criterion standard techniques. The comparisons between groups were performed using Mann-Whitney and Fisher exact tests. For demonstration of communication status of the cysts, criterion standard test results and 3D-SPACE findings were almost in perfect harmony (κ[95% confidence interval: 0.94]; P SPACE findings correlated with other final results at a rate of 97%. There is a positive correlation with third ventricular diameters and Evans index for all patients (r = 0.77, P SPACE technique is an easy, useful, and noninvasive alternative for the evaluation of morphology, topographical relationships, and communication status of ACs.

  8. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    beyond, but not past instrumental, rational plans in order to become better able to understand and manage the concrete, incremental practices and contexts in which communication becomes strategic. Thus, we argue that although strategic communicators do (and should) make plans, a plan in itself does...... of the specific communicative disciplines and practices employed by the organization and/or its individual members, be they marketing, public relations, corporate communication, branding, public affairs or social advocacy. In all cases, strategic communicators do well to focus more on the process of communicating...... for understanding and managing strategic communication processes....

  9. Feasible quantum communication complexity protocol

    International Nuclear Information System (INIS)

    Galvao, Ernesto F.

    2002-01-01

    I show that a simple multiparty communication task can be performed more efficiently with quantum communication than with classical communication, even with low detection efficiency η. The task is a communication complexity problem in which distant parties need to compute a function of the distributed inputs, while minimizing the amount of communication between them. A realistic quantum optical setup is suggested that can demonstrate a five-party quantum protocol with higher-than-classical performance, provided η>0.33

  10. Quantum cryptography communication technology

    International Nuclear Information System (INIS)

    Cho, Jai Wan; Choi, Young Soo; Lee, Jae Chul; Choi, Yu Rak; Jung, Gwang Il; Jung, Jong Eun; Hong, Seok Boong; Koo, In Soo

    2007-09-01

    Quantum cryptography communication based on quantum mechanics provides and unconditional security between two users. Even though huge advance has been done since the 1984, having a complete system is still far away. In the case of real quantum cryptography communication systems, an unconditional security level is lowered by the imperfection of the communication unit. It is important to investigate the unconditional security of quantum communication protocols based on these experimental results and implementation examples for the advanced spread all over the world. The Japanese report, titled, 'Investigation report on the worldwide trends of quantum cryptography communications systems' was translated and summarized in this report. An unconditional security theory of the quantum cryptography and real implementation examples in the domestic area are investigated also. The goal of the report is to make quantum cryptography communication more useful and reliable alternative telecommunication infrastructure as the one of the cyber security program of the class 1-E communication system of nuclear power plant. Also another goal of this report is to provide the quantitative decision basis on the quantum cryptography communication when this secure communication system will be used in class 1-E communication channel of the nuclear power plant

  11. Quantum cryptography communication technology

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jai Wan; Choi, Young Soo; Lee, Jae Chul; Choi, Yu Rak; Jung, Gwang Il; Jung, Jong Eun; Hong, Seok Boong; Koo, In Soo

    2007-09-15

    Quantum cryptography communication based on quantum mechanics provides and unconditional security between two users. Even though huge advance has been done since the 1984, having a complete system is still far away. In the case of real quantum cryptography communication systems, an unconditional security level is lowered by the imperfection of the communication unit. It is important to investigate the unconditional security of quantum communication protocols based on these experimental results and implementation examples for the advanced spread all over the world. The Japanese report, titled, 'Investigation report on the worldwide trends of quantum cryptography communications systems' was translated and summarized in this report. An unconditional security theory of the quantum cryptography and real implementation examples in the domestic area are investigated also. The goal of the report is to make quantum cryptography communication more useful and reliable alternative telecommunication infrastructure as the one of the cyber security program of the class 1-E communication system of nuclear power plant. Also another goal of this report is to provide the quantitative decision basis on the quantum cryptography communication when this secure communication system will be used in class 1-E communication channel of the nuclear power plant.

  12. Digital communication system

    International Nuclear Information System (INIS)

    Union, D.C.

    1980-01-01

    A digital communication system for communicating among two central consoles and a plurality of local controllers, e.g. in a radiation and monitoring system, provides communication between each of the consoles and all of the local controllers via dual paths. Each path is independent of the other and each extends from one of the consoles to all of the local controllers from opposite directions, thereby forming a unique non-continuous loop. (author)

  13. Communication, ethics and anthropoethics

    OpenAIRE

    Luiz Martins da Silva

    2009-01-01

    The purpose of this article is to dream of – in the sense ofestablishing – the utopian perspective of a scenario that remains utopian but which nonetheless provides the first indications that we may be entering a new paradigm, that of communication-ethics, that is to say, the ethical dimension of communication, which in this case is not restricted to technological advancements but concerns communication with ethics and as ethics, to conclude that without ethics, there is no commun...

  14. Corruption and Organizational Communication

    DEFF Research Database (Denmark)

    Krause Hansen, Hans

    2017-01-01

    , and societal levels, as well as how corruption is and can be responded to through public scandals and more elaborate communicative strategies of corruption control, or anti-corruption. A focus on corruption and corruption control provides organizational communication scholars with entry points to explore...... the powerful communicative dynamics playing out between the local organizational meanings of particular practices and externally imposed definitions of what constitutes appropriate organizational behavior....

  15. FOREWORD Fluid Mechanics and Fluid Power (FMFP)

    Indian Academy of Sciences (India)

    This section of the Special Issue carries selected articles from the Fluid Mechanics and Fluid. Power Conference held during 12–14 December 2013 at the National Institute of Technology,. Hamirpur (HP). The section includes three review articles and nine original research articles. These were selected on the basis of their ...

  16. Spreading dynamics of power-law fluid droplets

    International Nuclear Information System (INIS)

    Liang Zhanpeng; Peng Xiaofeng; Wang Xiaodong; Lee, D-J; Su Ay

    2009-01-01

    This paper aims at providing a summary of the theoretical models available for non-Newtonian fluid spreading dynamics. Experimental findings and model predictions for a Newtonian fluid spreading test are briefly reviewed. Then how the complete wetting and partial wetting power-law fluids spread over a solid substrate is examined. The possible extension of Newtonian fluid models to power-law fluids is also discussed.

  17. Fluid control structures in microfluidic devices

    Science.gov (United States)

    Mathies, Richard A.; Grover, William H.; Skelley, Alison; Lagally, Eric; Liu, Chung N.

    2017-05-09

    Methods and apparatus for implementing microfluidic analysis devices are provided. A monolithic elastomer membrane associated with an integrated pneumatic manifold allows the placement and actuation of a variety of fluid control structures, such as structures for pumping, isolating, mixing, routing, merging, splitting, preparing, and storing volumes of fluid. The fluid control structures can be used to implement a variety of sample introduction, preparation, processing, and storage techniques.

  18. 4-H NFPA Fluid Power Challenge

    OpenAIRE

    Bonnett, Erika D

    2016-01-01

    The 4-H NFPA Fluid Power Challenge partnered Purdue Polytechnic Institute and Indiana 4-H with the National Fluid Power Association and Center for Compact and Efficient Fluid Power to provide teams of Indiana youth in 6-8th grades with opportunity to learn about hydraulics, engineering design, and other STEM skills. This created an opportunity to give youth a learning experience with STEM through hands-on, experiential learning activities. Youth experienced a one day workshop in which they wo...

  19. Communication with patients and colleagues

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte

    2012-01-01

    Although patient-centred communication has provided a focus point in health care for many years, patient surveys continuously reveal serious communication problems as experienced by patients, due to poor communication. Likewise, poor inter-collegial communication can cause problems for both health...... care staff and patients. So, knowing that patient-centred communication and good inter-collegial communication is for the benefit of both health professionals and patients, the relevance of improving health care professionals' communication skills and investigating the effect on both professionals...

  20. Fluid-solid contact vessel having fluid distributors therein

    Science.gov (United States)

    Jones, Jr., John B.

    1980-09-09

    Rectangularly-shaped fluid distributors for large diameter, vertical vessels include reinforcers for high heat operation, vertical sides with gas distributing orifices and overhanging, sloped roofs. Devices are provided for cleaning the orifices from a buildup of solid deposits resulting from the reactions in the vessel.

  1. CSR communication

    DEFF Research Database (Denmark)

    Golob, Ursa; Podnar, Klement; Elving, Wim

    2013-01-01

    Purpose – 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 the state of CSR communication knowledge. Design/methodology/approach – The existing literature on CSR communication was approached via systematic review. with a combination of conventional and summative qualitative content analysis. The final dataset contained 90 papers from two main business...... communications. The most important outlets for CSR communication-related topics are Journal of Business Ethics and Corporate Communications: An International Journal. Originality/value – This paper represents the first attempt to perform a systematic and comprehensive overview of CSR communication papers...

  2. Lectures on fluid mechanics

    CERN Document Server

    Shinbrot, Marvin

    2012-01-01

    Readable and user-friendly, this high-level introduction explores the derivation of the equations of fluid motion from statistical mechanics, classical theory, and a portion of the modern mathematical theory of viscous, incompressible fluids. 1973 edition.

  3. Synovial Fluid Analysis

    Science.gov (United States)

    ... Plasma Free Metanephrines Platelet Count Platelet Function Tests Pleural Fluid Analysis PML-RARA Porphyrin Tests Potassium Prealbumin ... is being tested? Synovial fluid is a thick liquid that acts as a lubricant for the body's ...

  4. Electric fluid pump

    Science.gov (United States)

    Van Dam, Jeremy Daniel; Turnquist, Norman Arnold; Raminosoa, Tsarafidy; Shah, Manoj Ramprasad; Shen, Xiaochun

    2015-09-29

    An electric machine is presented. The electric machine includes a hollow rotor; and a stator disposed within the hollow rotor, the stator defining a flow channel. The hollow rotor includes a first end portion defining a fluid inlet, a second end portion defining a fluid outlet; the fluid inlet, the fluid outlet, and the flow channel of the stator being configured to allow passage of a fluid from the fluid inlet to the fluid outlet via the flow channel; and wherein the hollow rotor is characterized by a largest cross-sectional area of hollow rotor, and wherein the flow channel is characterized by a smallest cross-sectional area of the flow channel, wherein the smallest cross-sectional area of the flow channel is at least about 25% of the largest cross-sectional area of the hollow rotor. An electric fluid pump and a power generation system are also presented.

  5. Cerebrospinal fluid culture

    Science.gov (United States)

    ... Alternative Names Culture - CSF; Spinal fluid culture; CSF culture Images Pneumococci organism References Karcher DS, McPherson RA. Cerebrospinal, synovial, serous body fluids, and alternative specimens. In: McPherson RA, Pincus ...

  6. Cerebrospinal fluid leak (image)

    Science.gov (United States)

    ... brain and spinal cord by acting like a liquid cushion. The fluid allows the organs to be buoyant protecting them from blows or other trauma. Inside the skull the cerebrospinal fluid is contained by the dura which covers ...

  7. Inductive Communication System Design Summary

    Science.gov (United States)

    1978-09-01

    The report documents the experience obtained during the design and development of the Inductive Communications System used in the Morgantown People Mover. The Inductive Communications System is used to provide wayside-to-vehicle and vehicle-to-waysid...

  8. Scientific communication

    Directory of Open Access Journals (Sweden)

    Aleksander Kobylarek

    2017-09-01

    Full Text Available The article tackles the problem of models of communication in science. The formal division of communication processes into oral and written does not resolve the problem of attitude. The author defines successful communication as a win-win game, based on the respect and equality of the partners, regardless of their position in the world of science. The core characteristics of the process of scientific communication are indicated , such as openness, fairness, support, and creation. The task of creating the right atmosphere for science communication belongs to moderators, who should not allow privilege and differentiation of position to affect scientific communication processes.

  9. Computational Fluid Dynamics

    International Nuclear Information System (INIS)

    Myeong, Hyeon Guk

    1999-06-01

    This book deals with computational fluid dynamics with basic and history of numerical fluid dynamics, introduction of finite volume method using one-dimensional heat conduction equation, solution of two-dimensional heat conduction equation, solution of Navier-Stokes equation, fluid with heat transport, turbulent flow and turbulent model, Navier-Stokes solution by generalized coordinate system such as coordinate conversion, conversion of basic equation, program and example of calculation, application of abnormal problem and high speed solution of numerical fluid dynamics.

  10. Data communications pocket book

    CERN Document Server

    Tooley, Michael

    2014-01-01

    Data Communications Pocket Book, Second Edition presents information relevant to data communication. The book provides tabulated reference materials with a brief description and diagrams. The coverage of the text includes abbreviations, terminal control codes, and conversion tables. The text will be of great use to individuals involved in the interconnection of computer systems.

  11. Reinventing Corporate Communications.

    Science.gov (United States)

    Toth, Elizabeth L.; Trujillo, Nick

    1987-01-01

    Urges a "re-inventing" of corporate communications in today's organizations, and provides information about how corporations can change in new and positive ways during the current "information age." Discusses specific public relations and organizational communication concepts essential for a comprehensive understanding of…

  12. Comparative Political Communication Research

    NARCIS (Netherlands)

    de Vreese, C.H.; Kenski, K.; Jamieson, K.H.

    2017-01-01

    This chapter provides an overview of comparative political communication research (CPCR). CPCR is a growing field since there is wide acknowledgement that many questions are not answered satisfactorily with single case studies. The chapter explains why political communication researchers should care

  13. Fluid Statics and Archimedes

    Indian Academy of Sciences (India)

    librium of a vertical slice fluid (Figure Id) of height H and again using the fact .... same fluid having the same shape and same volume as the body. This fluid volume .... example, can be caused by the heating of air near the ground by the sun ...

  14. Fullerol ionic fluids

    KAUST Repository

    Fernandes, Nikhil; Dallas, Panagiotis; Rodriguez, Robert; Bourlinos, Athanasios B.; Georgakilas, Vasilios; Giannelis, Emmanuel P.

    2010-01-01

    ®). The ionic fluid was compared to a control synthesized by mixing the partially protonated form (sodium form) of the fullerols with the same oligomeric amine in the same ratio as in the ionic fluids (20 wt% fullerol). In the fullerol fluid the ionic bonding

  15. A Fluid Mechanics Hypercourse

    Science.gov (United States)

    Fay, James A.; Sonwalkar, Nishikant

    1996-05-01

    This CD-ROM is designed to accompany James Fay's Introduction to Fluid Mechanics. An enhanced hypermedia version of the textbook, it offers a number of ways to explore the fluid mechanics domain. These include a complete hypertext version of the original book, physical-experiment video clips, excerpts from external references, audio annotations, colored graphics, review questions, and progressive hints for solving problems. Throughout, the authors provide expert guidance in navigating the typed links so that students do not get lost in the learning process. System requirements: Macintosh with 68030 or greater processor and with at least 16 Mb of RAM. Operating System 6.0.4 or later for 680x0 processor and System 7.1.2 or later for Power-PC. CD-ROM drive with 256- color capability. Preferred display 14 inches or above (SuperVGA with 1 megabyte of VRAM). Additional system font software: Computer Modern postscript fonts (CM/PS Screen Fonts, CMBSY10, and CMTT10) and Adobe Type Manager (ATM 3.0 or later). James A. Fay is Professor Emeritus and Senior Lecturer in the Department of Mechanical Engineering at MIT.

  16. Valving for controlling a fluid-driven reciprocating apparatus

    Science.gov (United States)

    Whitehead, John C.

    1995-01-01

    A pair of control valve assemblies for alternately actuating a pair of fluid-driven free-piston devices by using fluid pressure communication therebetween. Each control valve assembly is switched by a pressure signal depending on the state of its counterpart's piston. The communication logic is arranged to provide overlap of the forward strokes of the pistons, so that at least one of the pair will always be pressurized. Thus, uninterrupted pumping of liquid is made possible from a pair of free-piston pumps. In addition, the speed and frequency of piston stroking is entirely dependent on the mechanical power load applied. In the case of a pair of pumps, this enables liquid delivery at a substantially constant pressure over the full range of flow rates, from zero to maximum flow. Each of the valve assemblies uses an intake-exhaust valve and a signal valve with the signal valve of one pump being connected to be pressure responsive to the piston of the opposite cylinder or pump.

  17. Gas powered fluid gun with recoil mitigation

    Science.gov (United States)

    Grubelich, Mark C; Yonas, Gerold

    2013-11-12

    A gas powered fluid gun for propelling a stream or slug of a fluid at high velocity toward a target. Recoil mitigation is provided that reduces or eliminates the associated recoil forces, with minimal or no backwash. By launching a quantity of water in the opposite direction, net momentum forces are reduced or eliminated. Examples of recoil mitigation devices include a cone for making a conical fluid sheet, a device forming multiple impinging streams of fluid, a cavitating venturi, one or more spinning vanes, or an annular tangential entry/exit.

  18. Communicating Your Science

    Science.gov (United States)

    Young, C. A.

    2016-12-01

    Effective science communication can open doors, accelerate your career and even make you a better scientist. Part of being an effective and productive scientist means being an effective science communicator. The scientist must communicate their work in talks, posters, peer-reviewed papers, internal reports, proposals as well as to the broader public (including law makers). Despite the importance of communication, it has traditionally not been part of our core training as scientists. Today's science students are beginning to have more opportunities to formally develop their science communication skills. Fortunately, new and even more established scientists have a range of tools and resources at their disposal. In this presentation, we will share some of these resources, share our own experiences utilizing them, and provide some practical tools to improve your own science communication skills.

  19. Relativistic fluid theories - Self organization

    International Nuclear Information System (INIS)

    Mahajan, S.M.; Hazeltine, R.D.; Yoshida, Z.

    2003-01-01

    Developments in two distinct but related subjects are reviewed: 1) Formulation and investigation of closed fluid theories which transcend the limitations of standard magnetohydrodynamics (MHD), in particular, theories which are valid in the long mean free path limit and in which pressure anisotropy, heat flow, and arbitrarily strong sheared flows are treated consistently, and 2) Exploitation of the two-fluid theories to derive new plasma configurations in which the flow-field is a co-determinant of the overall dynamics; some of these states belong to the category of self-organized relaxed states. Physical processes which may provide a route to self-organization and complexity are also explored. (author)

  20. Data communications

    International Nuclear Information System (INIS)

    Preckshot, G.G.

    1993-08-01

    The purpose of this paper is to recommend regulatory guidance for reviewers examining computer communication systems used in nuclear power plants. The recommendations cover three areas important to these communications systems: system design, communication protocols, and communication media. The first area, system design, considers three aspects of system design--questions about architecture, specific risky design elements or omissions to look for in designs being reviewed, and recommendations for multiplexed data communication systems used in safety systems. The second area reviews pertinent aspects of communication protocol design and makes recommendations for newly designed protocols or the selection of existing protocols for safety system, information display, and non-safety control system use. The third area covers communication media selection, which differs significantly from traditional wire and cable. The recommendations for communication media extend or enhance the concerns of published IEEE standards about three subjects: data rate, imported hazards and maintainability

  1. Communication, Communication, Communication! Growth through Laboratory Instructing

    Science.gov (United States)

    Peterson, Jamie J.; DeAngelo, Samantha; Mack, Nancy; Thompson, Claudia; Cooper, Jennifer; Sesma, Arturo, Jr.

    2014-01-01

    This study examined gains undergraduate students made in their communication and collaboration skills when they served as peer teachers, i.e., laboratory instructors (LIs), for a General Psychology laboratory. Self-ratings of communication and collaboration skills were completed before and after teaching the laboratory. When compared to before the…

  2. Participatory Communication

    DEFF Research Database (Denmark)

    Tufte, Thomas

    This user guide on participatory communication aims to answer the following questions: What do we mean when we say participatory communication? What are the practical implications of working with participatory communication strategies in development and social change processes? What practical exp......, tools, and experiences on how to implement participatory communications strategies. It is targeted toward government officials, World Bank staff, develompent workers in the field, and civil society....

  3. Ultrasonic techniques for fluids characterization

    CERN Document Server

    Povey, Malcolm J W

    1997-01-01

    This book is a comprehensive and practical guide to the use of ultrasonic techniques for the characterization of fluids. Focusing on ultrasonic velocimetry, the author covers the basic topics and techniques necessaryfor successful ultrasound measurements on emulsions, dispersions, multiphase media, and viscoelastic/viscoplastic materials. Advanced techniques such as scattering, particle sizing, and automation are also presented. As a handbook for industrial and scientific use, Ultrasonic Techniques for Fluids Characterization is an indispensable guide to chemists and chemical engineers using ultrasound for research or process monitoring in the chemical, food processing, pharmaceutical, cosmetic, biotechnology,and fuels industries. Key Features * Appeals to anyone using ultrasound to study fluids * Provides the first detailed description of the ultrasound profiling technique for dispersions * Describes new techniques for measuring phase transitions and nucleation, such as water/ice and oil/fat * Presents the l...

  4. Edge Fracture in Complex Fluids.

    Science.gov (United States)

    Hemingway, Ewan J; Kusumaatmaja, Halim; Fielding, Suzanne M

    2017-07-14

    We study theoretically the edge fracture instability in sheared complex fluids, by means of linear stability analysis and direct nonlinear simulations. We derive an exact analytical expression for the onset of edge fracture in terms of the shear-rate derivative of the fluid's second normal stress difference, the shear-rate derivative of the shear stress, the jump in shear stress across the interface between the fluid and the outside medium (usually air), the surface tension of that interface, and the rheometer gap size. We provide a full mechanistic understanding of the edge fracture instability, carefully validated against our simulations. These findings, which are robust with respect to choice of rheological constitutive model, also suggest a possible route to mitigating edge fracture, potentially allowing experimentalists to achieve and accurately measure flows stronger than hitherto possible.

  5. Fluid Mechanics and Fluid Power (FMFP)

    Indian Academy of Sciences (India)

    Amitabh Bhattacharya

    of renewable energy (e.g., via wind, hydrokinetic generators), creating low-cost healthcare ... multiphase flow, turbulence, bio-fluid dynamics, atmospheric flows, microfluidic flows, and ... study the challenging problem of entry of solids in water.

  6. Cultural Communications.

    Science.gov (United States)

    Armas, Jose

    It is too often taken for granted that the communication process with culturally different children takes place as readily as it might with children from Anglo cultures. Most teachers receive training in verbal and formal communication skills; children come to school with nonverbal and informal communication skills. This initially can create…

  7. Stereotypes Communication

    Science.gov (United States)

    Zhang, Shuli; Deng, Dongyuan

    2009-01-01

    We live in a world, which is becoming a Global Village in which information and communication attract people's attention more than ever before. Our desire to communicate with strangers and our relationships with them depend on the degree to which we are effective in communicating with them. There are so many factors restricting or improving…

  8. Heidegger, communication, and healthcare.

    Science.gov (United States)

    Rentmeester, Casey

    2018-01-12

    Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger's phenomenology and hermeneutics to provide guidance for medical professional-patient interactions. The phenomenological approach espoused emphasizes the particular, contextual nature of such interactions, and thus is opposed to abstract, theoretical principles. Heidegger's hermeneutics provides a philosophical approach to communication that may guide the back-and-forth interpretation that should happen between medical professionals and patients to achieve effective communication.

  9. Strategic Communication Institutionalized

    DEFF Research Database (Denmark)

    Kjeldsen, Anna Karina

    2013-01-01

    of institutionalization when strategic communication is not yet visible as organizational practice, and how can such detections provide explanation for the later outcome of the process? (2) How can studies of strategic communication benefit from an institutional perspective? How can the virus metaphor generate a deeper...... understanding of the mechanisms that interact from the time an organization is exposed to a new organizational idea such as strategic communication until it surfaces in the form of symptoms such as mission and vision statements, communication manuals and communication positions? The first part of the article...... focuses on a discussion of the virus metaphor as an alternative to the widespread fashion metaphor for processes of institutionalization. The second part of the article provides empirical examples of the virus metaphor employed, examples that are drawn from a study of the institutionalization of strategic...

  10. Fluid and Electrolyte Disturbances in Critically Ill Patients

    OpenAIRE

    Lee, Jay Wook

    2010-01-01

    Disturbances in fluid and electrolytes are among the most common clinical problems encountered in the intensive care unit (ICU). Recent studies have reported that fluid and electrolyte imbalances are associated with increased morbidity and mortality among critically ill patients. To provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Fluid resuscitation should be aimed at restoration of normal...

  11. Credentialed Secure Communication "Switchboards"

    National Research Council Canada - National Science Library

    Freudenthal, Eric; Port, Lawrence; Keenan, Edward; Pesin, Tracy; Karamcheti, Vijay

    2001-01-01

    ... with connection monitoring facilities. Switchboard extends the secure authenticated communication channel abstraction provided by standard interfaces such as SSL/TLS with mechanisms to support trust management, key sharing, service...

  12. Interdisciplinary Communication

    Directory of Open Access Journals (Sweden)

    Nagib Callaos

    2013-12-01

    research, and/or in the more general context of research methodology or philosophy. The purpose of this initial draft is 1 to foster informal conversations and possibly formal research, and 2 to give a very modest first step in this general context, making some reflections on the subject, reviewing some related literature and providing a very initial framework for the generation of more reflections and research on this important subject. We will try to achieve this purpose by means of presenting the most important characteristics of inter-disciplinary communication and contrasting them with intra-disciplinary communication. This essay is a short version of a larger one which will be completed in the future. Consequently, we will present a scheme summarizing the characteristics and the contrasts identified in this version of the essay and those which details are being worked out for an expanded version of this essay to be released in the near future. Our purpose in this first short version is to give a modest step in the direction of exploring the importance and the ways of inter-disciplinary communication, in order to foster more similar steps by other researchers, scholars or practitioners. This is an evolving working essay, where the process of writing it is as much a part of the object as the object, itself. ___________________ [1] Kolenda, N., 1997, "Introduction" in Flower, R.G., Gordon T.F., Kolenda, N. and Souder, L. (Eds., Overcoming the Language Barrier: Problems of Interdisciplinary Dialogue; Proceedings of an International Roundtable Meeting; May 14-17, 1997; Philadelphia: The Center for Frontier Sciences, Temple University; pp.1-4. [2] Moran, J, 2002, Interdisciplinarity; London and New York: Routledge, Taylor & Francis Group, p.184. (Emphasis added [3] Liu, A., 1989, "The Power of Formalism: The New Historicism", English Library History 56, 4 (Winter: pp. 721-71. (Quoted by Moran, 2002 [4] Dardick, I., 1997, "Monologues" in Flower, R.G., Gordon T.F., Kolenda

  13. Communication Acoustics

    DEFF Research Database (Denmark)

    Blauert, Jens

    Communication Acoustics deals with the fundamentals of those areas of acoustics which are related to modern communication technologies. Due to the advent of digital signal processing and recording in acoustics, these areas have enjoyed an enormous upswing during the last 4 decades. The book...... the book a source of valuable information for those who want to improve or refresh their knowledge in the field of communication acoustics - and to work their way deeper into it. Due to its interdisciplinary character Communication Acoustics is bound to attract readers from many different areas, such as......: acoustics, cognitive science, speech science, and communication technology....

  14. Data communications

    International Nuclear Information System (INIS)

    Ann, Byeong Ho; Baek, Jeong Hun

    1998-01-01

    The contents of this book are notion of data communications : summary on data communication, data transmission, data communications system, data transmission technology, data conversion, data link control and control over error of data transmission and exchange of data communications network in the first part, computer communications network architecture : data communications architecture, OSI model, lower layer of OSI model, upper layer of OSI model and distributed surroundings in the second part, data information networking : LAN, FDDI, 100 Base T, DQDB and Frame Relay in the third part, Public Network : PSDN, N-ISDN, B-ISDN in the fourth part, internet and PC communication : emulator program, Binary file, BBS, E-mail service and user on-line service in the last part.

  15. Digital communication system

    Science.gov (United States)

    Monford, L. G., Jr. (Inventor)

    1974-01-01

    A digital communication system is reported for parallel operation of 16 or more transceiver units with the use of only four interconnecting wires. A remote synchronization circuit produces unit address control words sequentially in data frames of 16 words. Means are provided in each transceiver unit to decode calling signals and to transmit calling and data signals. The transceivers communicate with each other over one data line. The synchronization unit communicates the address control information to the transceiver units over an address line and further provides the timing information over a clock line. A reference voltage level or ground line completes the interconnecting four wire hookup.

  16. The art of communication.

    Science.gov (United States)

    Warnecke, Emma

    2014-03-01

    Effective communication is an essential skill in general practice consultations. The art of communication is the development of effective skills and finding a style of communication that suits the clinician and produces benefits for both patient and doctor. This paper outlines the essential skills required for effective communication with a patient and suggests that clinicians consider this communication as an art that can be developed throughout a medical career. Good communication can improve outcomes for patients and doctors, and deserves equal importance as developing clinical knowledge and procedural skill. The importance of good communication is so critical that Australian guidelines list effective communication as part of the required conduct for all doctors. A therapeutic patient-doctor relationship uses the clinician as a therapeutic intervention and is part of the art of communication. Despite all the technological advances of recent decades, caring, compassionate, healing doctors remain the best therapeutic tool in medicine. The ability of a doctor to provide comfort through their presence and their words is a fundamental component of good medical care.

  17. The Impact of a Group Communication Course on Veterinary Medical Students' Perceptions of Communication Competence and Communication Apprehension.

    Science.gov (United States)

    Kedrowicz, April A

    2016-01-01

    This paper explores the impact of a group communication course on veterinary medical students' perceptions of communication competence and communication anxiety. Students enrolled in the Group Communication in Veterinary Medicine course completed the Personal Report of Communication Apprehension and the Communicative Competence Scale at the beginning (Time 1) and end (Time 2) of the semester. Results show that first-year veterinary students' self-perceptions of communication competence increased and their self-reported levels of communication apprehension decreased across multiple contexts from Time 1 to Time 2. This research provides support for experiential communication training fostering skill development and confidence.

  18. 75 FR 5335 - Risk Communication Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-02-02

    ...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... previously issued communications, emphasizing communications challenges. Examples, selected for illustrative...

  19. Fullerol ionic fluids

    Science.gov (United States)

    Fernandes, Nikhil; Dallas, Panagiotis; Rodriguez, Robert; Bourlinos, Athanasios B.; Georgakilas, Vasilios; Giannelis, Emmanuel P.

    2010-09-01

    We report for the first time an ionic fluid based on hydroxylated fullerenes (fullerols). The ionic fluid was synthesized by neutralizing the fully protonated fullerol with an amine terminated polyethylene/polypropylene oxide oligomer (Jeffamine®). The ionic fluid was compared to a control synthesized by mixing the partially protonated form (sodium form) of the fullerols with the same oligomeric amine in the same ratio as in the ionic fluids (20 wt% fullerol). In the fullerol fluid the ionic bonding significantly perturbs the thermal transitions and melting/crystallization behavior of the amine. In contrast, both the normalized heat of fusion and crystallization of the amine in the control are similar to those of the neat amine consistent with a physical mixture of the fullerols/amine with minimal interactions. In addition to differences in thermal behavior, the fullerol ionic fluid exhibits a complex viscoelastic behavior intermediate between the neat Jeffamine® (liquid-like) and the control (solid-like).

  20. Fiber optic fluid detector

    Science.gov (United States)

    Angel, S.M.

    1987-02-27

    Particular gases or liquids are detected with a fiber optic element having a cladding or coating of a material which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses. 10 figs.

  1. Fiber optic fluid detector

    Science.gov (United States)

    Angel, S. Michael

    1989-01-01

    Particular gases or liquids are detected with a fiber optic element (11, 11a to 11j) having a cladding or coating of a material (23, 23a to 23j) which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector (24, 24a to 24j) may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses.

  2. Extraperitoneal Fluid Collection due to Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Takeo Yasuda

    2013-08-01

    Full Text Available A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl was found to exist in the extraperitoneal space (over the peritoneum, but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

  3. Fluid Methods for Modeling Large, Heterogeneous Networks

    National Research Council Canada - National Science Library

    Towsley, Don; Gong, Weibo; Hollot, Kris; Liu, Yong; Misra, Vishal

    2005-01-01

    .... The resulting fluid models were used to develop novel active queue management mechanisms resulting in more stable TCP performance and novel rate controllers for the purpose of providing minimum rate...

  4. Reactive flash volatilization of fluid fuels

    Science.gov (United States)

    Schmidt, Lanny D.; Dauenhauer, Paul J.; Dreyer, Bradon J.; Salge, James R.

    2013-01-08

    The invention provides methods for the production of synthesis gas. More particularly, various embodiments of the invention relate to systems and methods for volatilizing fluid fuel to produce synthesis gas by using a metal catalyst on a solid support matrix.

  5. Metalworking and machining fluids

    Science.gov (United States)

    Erdemir, Ali; Sykora, Frank; Dorbeck, Mark

    2010-10-12

    Improved boron-based metal working and machining fluids. Boric acid and boron-based additives that, when mixed with certain carrier fluids, such as water, cellulose and/or cellulose derivatives, polyhydric alcohol, polyalkylene glycol, polyvinyl alcohol, starch, dextrin, in solid and/or solvated forms result in improved metalworking and machining of metallic work pieces. Fluids manufactured with boric acid or boron-based additives effectively reduce friction, prevent galling and severe wear problems on cutting and forming tools.

  6. Disposing of fluid wastes

    International Nuclear Information System (INIS)

    Bradley, J.S.

    1984-01-01

    Toxic liquid waste, eg liquid radioactive waste, is disposed of by locating a sub-surface stratum which, before removal of any fluid, has a fluid pressure in the pores thereof which is less than the hydrostatic pressure which is normal for a stratum at that depth in the chosen area, and then feeding the toxic liquid into the stratum at a rate such that the fluid pressure in the stratum never exceeds the said normal hydrostatic pressure. (author)

  7. Fluid dynamics transactions

    CERN Document Server

    Fiszdon, W

    1965-01-01

    Fluid Dynamics Transactions, Volume 2 compiles 46 papers on fluid dynamics, a subdiscipline of fluid mechanics that deals with fluid flow. The topics discussed in this book include developments in interference theory for aeronautical applications; diffusion from sources in a turbulent boundary layer; unsteady motion of a finite wing span in a compressible medium; and wall pressure covariance and comparison with experiment. The certain classes of non-stationary axially symmetric flows in magneto-gas-dynamics; description of the phenomenon of secondary flows in curved channels by means of co

  8. Electrorheological fluids and methods

    Science.gov (United States)

    Green, Peter F.; McIntyre, Ernest C.

    2015-06-02

    Electrorheological fluids and methods include changes in liquid-like materials that can flow like milk and subsequently form solid-like structures under applied electric fields; e.g., about 1 kV/mm. Such fluids can be used in various ways as smart suspensions, including uses in automotive, defense, and civil engineering applications. Electrorheological fluids and methods include one or more polar molecule substituted polyhedral silsesquioxanes (e.g., sulfonated polyhedral silsesquioxanes) and one or more oils (e.g., silicone oil), where the fluid can be subjected to an electric field.

  9. Plasmas and fluids

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    Plasma and fluid physics includes the fields of fusion research and space investigation. This book discusses the most important advances in these areas over the past decade and recommends a stronger commitment to basic research in plasma and fluid physics. The book recommends that plasma and fluid physics be included in physics curriculums because of their increasing importance in energy and defense. The book also lists recent accomplishments in the fields of general plasma physics, fusion plasma confinement and heating, space and astrophysical plasmas, and fluid physics and lists research opportunities in these areas. A funding summary explains how research monies are allocated and suggests ways to improve their effectiveness

  10. Theoretical Fluid Dynamics

    CERN Document Server

    Shivamoggi, Bhimsen K

    1998-01-01

    "Although there are many texts and monographs on fluid dynamics, I do not know of any which is as comprehensive as the present book. It surveys nearly the entire field of classical fluid dynamics in an advanced, compact, and clear manner, and discusses the various conceptual and analytical models of fluid flow." - Foundations of Physics on the first edition. Theoretical Fluid Dynamics functions equally well as a graduate-level text and a professional reference. Steering a middle course between the empiricism of engineering and the abstractions of pure mathematics, the author focuses

  11. Communication theory

    DEFF Research Database (Denmark)

    Stein, Irene F.; Stelter, Reinhard

    2011-01-01

    Communication theory covers a wide variety of theories related to the communication process (Littlejohn, 1999). Communication is not simply an exchange of information, in which we have a sender and a receiver. This very technical concept of communication is clearly outdated; a human being...... is not a data processing device. In this chapter, communication is understood as a process of shared meaning-making (Bruner, 1990). Human beings interpret their environment, other people, and themselves on the basis of their dynamic interaction with the surrounding world. Meaning is essential because people...... ascribe specific meanings to their experiences, their actions in life or work, and their interactions. Meaning is reshaped, adapted, and transformed in every communication encounter. Furthermore, meaning is cocreated in dialogues or in communities of practice, such as in teams at a workplace or in school...

  12. Communication, ethics and anthropoethics

    Directory of Open Access Journals (Sweden)

    Luiz Martins da Silva

    2009-12-01

    Full Text Available The purpose of this article is to dream of – in the sense of establishing – the utopian perspective of a scenario that remains utopian but which nonetheless provides the first indications that we may be entering a new paradigm, that of communication-ethics, that is to say, the ethical dimension of communication, which in this case is not restricted to technological advancements but concerns communication with ethics and as ethics, to conclude that without ethics, there is no communication and by extension, no genuine mankind nor genuine humanity. Communication and ethics therefore appear inseparable; one cannot exist without the other. The audacity of this ethical visionary lies in managing to perceive more than just technological marvels, but also to appreciate the paradigm of anthropoethics entering the realm of the concrete, that is to say, ethics for mankind and for humanity, as conceived of by Apel, Habermas and Morin.

  13. COMMUNICATION, ETHICS AND ANTHROPOETHICS

    Directory of Open Access Journals (Sweden)

    Luiz Martins da Silva

    2009-12-01

    Full Text Available The purpose of this article is to dream of – in the sense ofestablishing – the utopian perspective of a scenario that remains utopian but which nonetheless provides the first indications that we may be entering a new paradigm, that of communication-ethics, that is to say, the ethical dimension of communication, which in this case is not restricted to technological advancements but concerns communication with ethics and as ethics, to conclude that without ethics, there is no communication and by extension, no genuine mankind nor genuine humanity. Communication and ethics therefore appear inseparable; one cannot exist without the other. The audacity of this ethical visionary lies in managing to perceive more than just technological marvels, but also to appreciate the paradigm of anthropoethics entering the realm of the concrete, that is to say, ethics for mankind and for humanity, as conceived of by Apel, Habermas and Morin.

  14. Postcultural Communication?

    DEFF Research Database (Denmark)

    Jensen, Iben

    2015-01-01

    When we as scholars use the concept of intercultural communication in its classic definition, as communication between people with different cultural backgrounds, we perpetuate the notion that national differences influence communication more than other differences; in doing so, ethnic minorities...... is presented as a postcultural prism composed by practice theory (Schatzki 1996, Reckwitz 2002, Nicolini 2012, Kemmis 2012), Intersectionality (Brah, Phoenix, Collins Rahsack) and positioning theory (Harre & Langenhove 1998)....

  15. Microbial Metabolism in Serpentinite Fluids

    Science.gov (United States)

    Crespo-Medina, M.; Brazelton, W. J.; Twing, K. I.; Kubo, M.; Hoehler, T. M.; Schrenk, M. O.

    2013-12-01

    Serpentinization is the process in which ultramafic rocks, characteristic of the upper mantle, react with water liberating mantle carbon and reducing power to potenially support chemosynthetic microbial communities. These communities may be important mediators of carbon and energy exchange between the deep Earth and the surface biosphere. Our work focuses on the Coast Range Ophiolite Microbial Observatory (CROMO) in Northern California where subsurface fluids are accessible through a series of wells. Preliminary analyses indicate that the highly basic fluids (pH 9-12) have low microbial diversity, but there is limited knowledge about the metabolic capabilities of these communties. Metagenomic data from similar serpentine environments [1] have identified Betaproteobacteria belonging to the order Burkholderiales and Gram-positive bacteria from the order Clostridiales as key components of the serpentine microbiome. In an effort to better characterize the microbial community, metabolism, and geochemistry at CROMO, fluids from two representative wells (N08B and CSWold) were sampled during recent field campaigns. Geochemical characterization of the fluids includes measurements of dissolved gases (H2, CO, CH4), dissolved inorganic and organic carbon, volatile fatty acids, and nutrients. The wells selected can be differentiated in that N08B had higher pH (10-11), lower dissolved oxygen, and cell counts ranging from 105-106 cells mL-1 of fluid, with an abundance of the betaproteobacterium Hydrogenophaga. In contrast, fluids from CSWold have slightly lower pH (9-9.5), DO, and conductivity, as well as higher TDN and TDP. CSWold fluid is also characterized for having lower cell counts (~103 cells mL-1) and an abundance of Dethiobacter, a taxon within the phylum Clostridiales. Microcosm experiments were conducted with the purpose of monitoring carbon fixation, methanotrophy and metabolism of small organic compounds, such as acetate and formate, while tracing changes in fluid

  16. Numerical study of fluid motion in bioreactor with two mixers

    Energy Technology Data Exchange (ETDEWEB)

    Zheleva, I., E-mail: izheleva@uni-ruse.bg [Department of Heat Technology, Hydraulics and Ecology, Angel Kanchev University of Rousse, 8 Studentska str., 7017 Rousse (Bulgaria); Lecheva, A., E-mail: alecheva@uni-ruse.bg [Department of Mathematics, Angel Kanchev University of Rousse, 8 Studentska str., 7017 Rousse (Bulgaria)

    2015-10-28

    Numerical study of hydrodynamic laminar behavior of a viscous fluid in bioreactor with multiple mixers is provided in the present paper. The reactor is equipped with two disk impellers. The fluid motion is studied in stream function-vorticity formulation. The calculations are made by a computer program, written in MATLAB. The fluid structure is described and numerical results are graphically presented and commented.

  17. Space Station fluid management logistics

    Science.gov (United States)

    Dominick, Sam M.

    1990-01-01

    Viewgraphs and discussion on space station fluid management logistics are presented. Topics covered include: fluid management logistics - issues for Space Station Freedom evolution; current fluid logistics approach; evolution of Space Station Freedom fluid resupply; launch vehicle evolution; ELV logistics system approach; logistics carrier configuration; expendable fluid/propellant carrier description; fluid carrier design concept; logistics carrier orbital operations; carrier operations at space station; summary/status of orbital fluid transfer techniques; Soviet progress tanker system; and Soviet propellant resupply system observations.

  18. COMMUNICATION IN THE EMERGENCY SITUATIONS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ovidiu Aurel GHIUȚĂ

    2014-12-01

    Full Text Available This paper is talking about communication use in emergency situations management from a marketing perspective. We have analyzed if this communication is different from the communication of a company with her publics; the legislation which provides the framework for this type of communication in Romania, when is applicable and who is in charge. As methodology we have utilized documentary research. We mention similarities and differences between this type of communication and Integrated Marketing Communication (IMC.

  19. Single-particle Schroedinger fluid. I. Formulation

    International Nuclear Information System (INIS)

    Kan, K.K.; Griffin, J.J.

    1976-01-01

    The problem of a single quantal particle moving in a time-dependent external potential well is formulated specifically to emphasize and develop the fluid dynamical aspects of the matter flow. This idealized problem, the single-particle Schroedinger fluid, is shown to exhibit already a remarkably rich variety of fluid dynamical features, including compressible flow and line vortices. It provides also a sufficient framework to encompass simultaneously various simplified fluidic models for nuclei which have earlier been postulated on an ad hoc basis, and to illuminate their underlying restrictions. Explicit solutions of the single-particle Schroedinger fluid problem are studied in the adiabatic limit for their mathematical and physical implications (especially regarding the collective kinetic energy). The basic generalizations for extension of the treatment to the many-body Schroedinger fluid are set forth

  20. Fluid mechanics a geometrical point of view

    CERN Document Server

    Rajeev, S G

    2018-01-01

    Fluid Mechanics: A Geometrical Point of View emphasizes general principles of physics illustrated by simple examples in fluid mechanics. Advanced mathematics (e.g., Riemannian geometry and Lie groups) commonly used in other parts of theoretical physics (e.g. General Relativity or High Energy Physics) are explained and applied to fluid mechanics. This follows on from the author's book Advanced Mechanics (Oxford University Press, 2013). After introducing the fundamental equations (Euler and Navier-Stokes), the book provides particular cases: ideal and viscous flows, shocks, boundary layers, instabilities, and transients. A restrained look at integrable systems (KdV) leads into a formulation of an ideal fluid as a hamiltonian system. Arnold's deep idea, that the instability of a fluid can be understood using the curvature of the diffeomorphism group, will be explained. Leray's work on regularity of Navier-Stokes solutions, and the modern developments arising from it, will be explained in language for physicists...

  1. Teaching Paraeducators to Support the Communication of Young Children with Complex Communication Needs

    Science.gov (United States)

    Douglas, Sarah N.; Light, Janice C.; McNaughton, David B.

    2013-01-01

    Paraeducators are frequent communication partners for young children with complex communication needs (CCN) in early childhood settings. This study examined the impact of instruction to paraeducators in two communication interaction strategies (IPLAN [Identify activities for communication, Provide means for communication, Locate and provide…

  2. Optimizing drilling performance using a selected drilling fluid

    Science.gov (United States)

    Judzis, Arnis [Salt Lake City, UT; Black, Alan D [Coral Springs, FL; Green, Sidney J [Salt Lake City, UT; Robertson, Homer A [West Jordan, UT; Bland, Ronald G [Houston, TX; Curry, David Alexander [The Woodlands, TX; Ledgerwood, III, Leroy W.

    2011-04-19

    To improve drilling performance, a drilling fluid is selected based on one or more criteria and to have at least one target characteristic. Drilling equipment is used to drill a wellbore, and the selected drilling fluid is provided into the wellbore during drilling with the drilling equipment. The at least one target characteristic of the drilling fluid includes an ability of the drilling fluid to penetrate into formation cuttings during drilling to weaken the formation cuttings.

  3. NASA science communications strategy

    Science.gov (United States)

    1995-01-01

    In 1994, the Clinton Administration issued a report, 'Science in the National Interest', which identified new national science goals. Two of the five goals are related to science communications: produce the finest scientists and engineers for the 21st century, and raise scientific and technological literacy of all Americans. In addition to the guidance and goals set forth by the Administration, NASA has been mandated by Congress under the 1958 Space Act to 'provide for the widest practicable and appropriate dissemination concerning its activities and the results thereof'. In addition to addressing eight Goals and Plans which resulted from a January 1994 meeting between NASA and members of the broader scientific, education, and communications community on the Public Communication of NASA's Science, the Science Communications Working Group (SCWG) took a comprehensive look at the way the Agency communicates its science to ensure that any changes the Agency made were long-term improvements. The SCWG developed a Science Communications Strategy for NASA and a plan to implement the Strategy. This report outlines a strategy from which effective science communications programs can be developed and implemented across the agency. Guiding principles and strategic themes for the strategy are provided, with numerous recommendations for improvement discussed within the respective themes of leadership, coordination, integration, participation, leveraging, and evaluation.

  4. Compressible generalized Newtonian fluids

    Czech Academy of Sciences Publication Activity Database

    Málek, Josef; Rajagopal, K.R.

    2010-01-01

    Roč. 61, č. 6 (2010), s. 1097-1110 ISSN 0044-2275 Institutional research plan: CEZ:AV0Z20760514 Keywords : power law fluid * uniform temperature * compressible fluid Subject RIV: BJ - Thermodynamics Impact factor: 1.290, year: 2010

  5. Pleural fluid smear

    Science.gov (United States)

    ... into the space around the lungs, called the pleural space. As fluid drains into a collection bottle, you may cough a bit. This is because your lung re-expands to fill the space where fluid had been. This sensation lasts for a few hours after the test.

  6. Peritoneal fluid culture

    Science.gov (United States)

    Culture - peritoneal fluid ... sent to the laboratory for Gram stain and culture. The sample is checked to see if bacteria ... The peritoneal fluid culture may be negative, even if you have ... diagnosis of peritonitis is based on other factors, in addition ...

  7. Tumor interstitial fluid

    DEFF Research Database (Denmark)

    Gromov, Pavel; Gromova, Irina; Olsen, Charlotta J.

    2013-01-01

    Tumor interstitial fluid (TIF) is a proximal fluid that, in addition to the set of blood soluble phase-borne proteins, holds a subset of aberrantly externalized components, mainly proteins, released by tumor cells and tumor microenvironment through various mechanisms, which include classical...

  8. Fluid control valves

    International Nuclear Information System (INIS)

    Rankin, J.

    1980-01-01

    A fluid control valve is described in which it is not necessary to insert a hand or a tool into the housing to remove the valve seat. Such a valve is particularly suitable for the control of radioactive fluids since maintenance by remote control is possible. (UK)

  9. Time Independent Fluids

    Science.gov (United States)

    Collyer, A. A.

    1973-01-01

    Discusses theories underlying Newtonian and non-Newtonian fluids by explaining flow curves exhibited by plastic, shear-thining, and shear-thickening fluids and Bingham plastic materials. Indicates that the exact mechanism governing shear-thickening behaviors is a problem of further study. (CC)

  10. Cerebrospinal fluid flow. Pt. 3

    International Nuclear Information System (INIS)

    Schroth, G.; Klose, U.

    1992-01-01

    Cardiac- and respiration-related movements of the cerebrospinal fluid (CSF) were investigated by MRI in 71 patients. In most patients with arteriosclerotic occlusive vascular disease CSF pulsations are normal. Decreased pulsatile flow is detectable in those with arteriovenous malformations, intracranial air and following lumbar puncture and withdrawal of CSF. Increased pulsatile flow in the cerebral aqueduct was found in 2 patients with large aneurysms, idiopathic communicating syringomyelia and in most cases of normal pressure hydrocephalus (NPH). CSF flow in the cervical spinal canal is, however, reduced or normal in NPH, indicating reduction of the unfolding ability of the surface of the brain and/or inhibition of rapid CSF movements in the subrachnoid space over its convexity. (orig.)

  11. Championship Communication

    Science.gov (United States)

    VanDerveer, Beth; Butterick, Betsy

    2017-01-01

    This article discusses team development and focuses specifically on championship communication and team-building activities. Team development takes time and the process typically occurs in stages. Regardless of the sport or what the competitive field may look like, communication is an often overlooked, yet vital element in cultivating a…

  12. Effective communication

    International Nuclear Information System (INIS)

    Kuntz, B.S.

    1989-01-01

    At the Waste Isolation Pilot Plant (WIPP) the responsibilities assigned to public affairs (PA) include communications to two main groups: institutional representatives and the general public. Research data indicates that these two populations perceive risk in different fashions. This paper discusses these distinct perceptions and how the communication programs at WIPP have been designed to accommodate these two differences

  13. Satellite Communications

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Satellite Communications. Arthur C Clarke wrote a seminal paper in 1945 in wireless world. Use three satellites in geo-synchronous orbit to enable intercontinental communications. System could be realised in '50 to 100 years'

  14. Science Communication in Denmark

    DEFF Research Database (Denmark)

    Busch, Henrik

    2005-01-01

    This paper was presented during the author?s visit at the Faculty of Human Development of the University of Kobe . The paper is intended to provide the knowledge about science communication in the Nordic countries (in particular in Denmark). The focus in the paper is on (i) examples of new...... and innovative modes of science communication in Denmark and (ii) educational programs for science communicators. Furthermore, emphasis is on the pedagogical ideas behind the initiatives, rather than on thorough descriptions of structures, curricula and evaluations of the projects....

  15. Communications technology handbook

    CERN Document Server

    Lewis, Geoff

    2013-01-01

    This is the first point of reference for the communications industries. It offers an introduction to a wide range of topics and concepts encountered in the field of communications technology. Whether you are looking for a simple explanation, or need to go into a subject in more depth, the Communications Technology Handbook provides all the information you need in one single volume.This second edition has been updated to include the latest technology including: Video on DemandWire-less Distribution systemsHigh spee

  16. Customer Communication Document

    Science.gov (United States)

    2009-01-01

    This procedure communicates to the Customers of the Automation, Robotics and Simulation Division (AR&SD) Dynamics Systems Test Branch (DSTB) how to obtain services of the Six-Degrees-Of-Freedom Dynamic Test System (SDTS). The scope includes the major communication documents between the SDTS and its Customer. It established the initial communication and contact points as well as provides the initial documentation in electronic media for the customer. Contact the SDTS Manager (SM) for the names of numbers of the current contact points.

  17. The Impact of Solid Surface Features on Fluid-Fluid Interface Configuration

    Science.gov (United States)

    Araujo, J. B.; Brusseau, M. L. L.

    2017-12-01

    Pore-scale fluid processes in geological media are critical for a broad range of applications such as radioactive waste disposal, carbon sequestration, soil moisture distribution, subsurface pollution, land stability, and oil and gas recovery. The continued improvement of high-resolution image acquisition and processing have provided a means to test the usefulness of theoretical models developed to simulate pore-scale fluid processes, through the direct quantification of interfaces. High-resolution synchrotron X-ray microtomography is used in combination with advanced visualization tools to characterize fluid distributions in natural geologic media. The studies revealed the presence of fluid-fluid interface associated with macroscopic features on the surfaces of the solids such as pits and crevices. These features and respective fluid interfaces, which are not included in current theoretical or computational models, may have a significant impact on accurate simulation and understanding of multi-phase flow, energy, heat and mass transfer processes.

  18. Working fluid selection for organic Rankine cycles - Impact of uncertainty of fluid properties

    DEFF Research Database (Denmark)

    Frutiger, Jerome; Andreasen, Jesper Graa; Liu, Wei

    2016-01-01

    This study presents a generic methodology to select working fluids for ORC (Organic Rankine Cycles)taking into account property uncertainties of the working fluids. A Monte Carlo procedure is described as a tool to propagate the influence of the input uncertainty of the fluid parameters on the ORC...... modeloutput, and provides the 95%-confidence interval of the net power output with respect to the fluid property uncertainties. The methodology has been applied to a molecular design problem for an ORCusing a low-temperature heat source and consisted of the following four parts: 1) formulation...... of processmodels and constraints 2) selection of property models, i.e. Penge Robinson equation of state 3)screening of 1965 possible working fluid candidates including identification of optimal process parametersbased on Monte Carlo sampling 4) propagating uncertainty of fluid parameters to the ORC netpower output...

  19. Relativistic thermodynamics of fluids

    International Nuclear Information System (INIS)

    Souriau, J.-M.

    1977-05-01

    The relativistic covariant definition of a statistical equilibrium, applied to a perfect gas, involves a 'temperature four-vector', whose direction is the mean velocity of the fluid, and whose length is the reciprocal temperature. The hypothesis of this 'temperature four-vector' being a relevant variable for the description of the dissipative motions of a simple fluid is discussed. The kinematics is defined by using a vector field and measuring the number of molecules. Such a dissipative fluid is subject to motions involving null entropy generation; the 'temperature four-vector' is then a Killing vector; the equations of motion can be completely integrated. Perfect fluids can be studied by this way and the classical results of Lichnerowicz are obtained. In weakly dissipative motions two viscosity coefficient appear together with the heat conductibility coefficient. Two other coefficients perharps measurable on real fluids. Phase transitions and shock waves are described with using the model [fr

  20. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Science.gov (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  1. Adrenal hormones in human follicular fluid.

    Science.gov (United States)

    Jimena, P; Castilla, J A; Peran, F; Ramirez, J P; Vergara, F; Molina, R; Vergara, F; Herruzo, A

    1992-11-01

    Considerable evidence indicates that adrenal hormones may affect gonadal function. To assess the role of some adrenal hormones in human follicular fluid and their relationship with the ability of the oocyte to be fertilized and then to cleave in vitro, cortisol and dehydroepiandrosterone sulfate were measured in follicular fluid obtained at the time of oocyte recovery for in vitro fertilization from cycles stimulated by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin. Thirty-six follicular fluid containing mature oocyte-corona-cumulus complexes and free of visible blood contamination were included in this study. There was no significant difference in follicular fluid dehydroepiandrosterone sulfate concentration between follicles with oocytes which did or did not fertilize (5.1 +/- 1.1 vs 5.8 +/- 2.0 mumol/l). However, follicular fluid from follicles whose oocytes were not fertilized had levels of cortisol significantly higher than those in follicular fluid from follicles containing successfully fertilized oocytes (406.0 +/- 75.9 vs 339.2 +/- 37.0 nmol/l; p < 0.005). No significant correlations were found between rates of embryo cleavage and cortisol and dehydroepiandrosterone levels in follicular fluid. We conclude that cortisol levels in follicular fluid may provide an index of fertilization outcome, at least in stimulated cycles by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin.

  2. Application of ICT supported learning in fluid mechanics

    DEFF Research Database (Denmark)

    Brohus, Henrik; Svidt, Kjeld

    2004-01-01

    of tools for knowledge transfer facilitates deep understanding and increases learning efficiency. Air flow is by nature invisible and represents a further challenge in the effort of providing sufficient understanding of typical flow patterns and behaviour of room air flow. An example of visualisation......This paper focuses on the application of ICT, Information & Communication Technology, supported learning in the area of fluid mechanics education. Taking a starting point in a course in Ventilation Technology, including room air flow and contaminant distribution, it explains how ICT may be used...... actively in the learning environment to increase efficiency in the learning process. The paper comprises past experiences and lessons learnt as well as prospect for future development in the area. A model is presented that describes a high efficiency learning environment where ICT plays an important role...

  3. Risk communication basics

    International Nuclear Information System (INIS)

    Corrado, P.G.

    1995-01-01

    In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information

  4. Industrial communication technology handbook

    CERN Document Server

    Zurawski, Richard

    2014-01-01

    Featuring contributions from major technology vendors, industry consortia, and government and private research establishments, the Industrial Communication Technology Handbook, Second Edition provides comprehensive and authoritative coverage of wire- and wireless-based specialized communication networks used in plant and factory automation, automotive applications, avionics, building automation, energy and power systems, train applications, and more.New to the Second Edition:46 brand-new chapters and 21 substantially revised chaptersInclusion of the latest, most significant developments in spe

  5. Advanced digital optical communications

    CERN Document Server

    Binh, Le Nguyen

    2015-01-01

    This book provides a fundamental understanding of digital communication applications in optical communication technologies. Emphasizing operation principles versus mathematical analysis, the Second Edition includes new coverage of superchannel optical transmission systems, metropolitan and long-haul optical systems and networks, and Nyquist pulse shaping and high spectral efficiency of optical transmission systems, as well as new homework problems and examples. Featuring theoretical foundations as well as practical case studies, the text focuses on enhancements to digital technologies that are

  6. The SKI communication programme

    International Nuclear Information System (INIS)

    Carlberg, Susanne

    2000-01-01

    Sweden has, since many years, an ongoing debate on nuclear power in general and nuclear safety and nuclear waste in particular. SKI is not the only part who wants to communicate about these subjects. The nuclear power plants, other authorities, the anti-nuclear groups and the politicians are other parts on the communication scene. The role of SKI is to provide the Swedish public with objective and prompt information based on facts. (author)

  7. Risk communication basics

    Energy Technology Data Exchange (ETDEWEB)

    Corrado, P.G. [Lawrence Livermore National Laboratory, CA (United States)

    1995-12-31

    In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

  8. CARAVAN: Providing Location Privacy for VANET

    National Research Council Canada - National Science Library

    Sampigethaya, Krishna; Huang, Leping; Li, Mingyan; Poovendran, Radha; Matsuura, Kanta; Sezaki, Kaoru

    2005-01-01

    .... This type of tracking leads to threats on the location privacy of the vehicle's user. In this paper, we study the problem of providing location privacy in VANET by allowing vehicles to prevent tracking of their broadcast communications...

  9. Climate change communication: what can we learn from communication theory?

    DEFF Research Database (Denmark)

    Ballantyne, Anne Gammelgaard

    2016-01-01

    the field of communication theory are highlighted and discussed in the context of communicating climate change. Rooted in the interaction paradigm, the article proposes a meta‐theoretical framework that conceptualizes communication as a constitutive process of producing and reproducing shared meanings...... as a theoretical construct. In some instances, communication theory appears reduced to an ‘ad hoc’ toolbox, from which theories are randomly picked to provide studies with a fitting framework. Inspired by the paradigm shift from transmission to interaction within communication theory, potential lessons from...

  10. Communication skills in psychiatry training.

    Science.gov (United States)

    Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

    2015-08-01

    Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  11. Magnelok technology: a complement to magnetorheological fluids

    Science.gov (United States)

    Carlson, J. David

    2004-07-01

    Magnetorheological or MR fluids have been successfully used to enable highly effective semi-active control systems in automobile primary suspensions to control unwanted motions in civil engineering structures and to provide force-feedback in steer-by-wire systems. A key to the successful use of MR fluids is an appreciation and understanding of the balance and trade-off between the magnetically controlled on-state force and the ever-present off-state viscous force. In all MR fluid applications, one must deal with the fact that MR fluids never fully decouple or go to zero force in their off-state. Magnelok devices are a magnetically controlled compliment to traditional MR fluid devices that have been developed to enable a true force decoupling in the off-state. Magnelok devices may be embodied as linear or rotary dampers, brakes, lockable struts or position holding devices. They are particularly suitable for lock/un-lock applications. Unlike MR fluid devices they contain no fluid yet they do provide a variable level of friction damping that is controlled by the magnitude of the applied magnetic field. Magnelok devices are low cost as they easily accommodate relatively loose mechanical tolerances and require no seals or accumulator. A variety of controllable Magnelok devices and applications are described.

  12. Fluid mechanics. Vol. 2

    International Nuclear Information System (INIS)

    Truckenbrodt, E.

    1980-01-01

    The second volume contains the chapter 4 to 6. Whereas chapter 1 deals with the introduction into the mechanics of fluids and chapter 2 with the fundamental laws of fluid and thermal fluid dynamics, in chapter 3 elementary flow phenomena in fluids with constant density are treated. Chapter 4 directly continues chapter 3 and describes elementary flow phenomena in fluids with varying density. Fluid statics again is treated as a special case. If compared with the first edition the treatment of unsteady laminar flow and of pipe flow for a fluid with varying density were subject to a substantial extension. In chapter 5 rotation-free and rotating potential flows are presented together. By this means it is achieved to explain the behaviour of the multidimensional fictionless flow in closed form. A subchapter describes some related problems of potential theory like the flow along a free streamline and seepage flow through a porous medium. The boundary layer flows in chapter 6 are concerned with the flow and temperature boundary layer in laminar and turbulent flows at a fired wall. In it differential and integral methods are applied of subchapter reports on boundary layer flows without a fixed boundary, occurring e.g. in an open jet and in a wake flow. The problems of intermittence and of the Coanda effect are briefly mentioned. (orig./MH)

  13. Science communication as political communication

    Science.gov (United States)

    Scheufele, Dietram A.

    2014-01-01

    Scientific debates in modern societies often blur the lines between the science that is being debated and the political, moral, and legal implications that come with its societal applications. This manuscript traces the origins of this phenomenon to professional norms within the scientific discipline and to the nature and complexities of modern science and offers an expanded model of science communication that takes into account the political contexts in which science communication takes place. In a second step, it explores what we know from empirical work in political communication, public opinion research, and communication research about the dynamics that determine how issues are debated and attitudes are formed in political environments. Finally, it discusses how and why it will be increasingly important for science communicators to draw from these different literatures to ensure that the voice of the scientific community is heard in the broader societal debates surrounding science. PMID:25225389

  14. Science communication as political communication.

    Science.gov (United States)

    Scheufele, Dietram A

    2014-09-16

    Scientific debates in modern societies often blur the lines between the science that is being debated and the political, moral, and legal implications that come with its societal applications. This manuscript traces the origins of this phenomenon to professional norms within the scientific discipline and to the nature and complexities of modern science and offers an expanded model of science communication that takes into account the political contexts in which science communication takes place. In a second step, it explores what we know from empirical work in political communication, public opinion research, and communication research about the dynamics that determine how issues are debated and attitudes are formed in political environments. Finally, it discusses how and why it will be increasingly important for science communicators to draw from these different literatures to ensure that the voice of the scientific community is heard in the broader societal debates surrounding science.

  15. Thermodynamics of Fluid Polyamorphism

    Directory of Open Access Journals (Sweden)

    Mikhail A. Anisimov

    2018-01-01

    Full Text Available Fluid polyamorphism is the existence of different condensed amorphous states in a single-component fluid. It is either found or predicted, usually at extreme conditions, for a broad group of very different substances, including helium, carbon, silicon, phosphorous, sulfur, tellurium, cerium, hydrogen, and tin tetraiodide. This phenomenon is also hypothesized for metastable and deeply supercooled water, presumably located a few degrees below the experimental limit of homogeneous ice formation. We present a generic phenomenological approach to describe polyamorphism in a single-component fluid, which is completely independent of the molecular origin of the phenomenon. We show that fluid polyamorphism may occur either in the presence or in the absence of fluid phase separation depending on the symmetry of the order parameter. In the latter case, it is associated with a second-order transition, such as in liquid helium or liquid sulfur. To specify the phenomenology, we consider a fluid with thermodynamic equilibrium between two distinct interconvertible states or molecular structures. A fundamental signature of this concept is the identification of the equilibrium fraction of molecules involved in each of these alternative states. However, the existence of the alternative structures may result in polyamorphic fluid phase separation only if mixing of these structures is not ideal. The two-state thermodynamics unifies all the debated scenarios of fluid polyamorphism in different areas of condensed-matter physics, with or without phase separation, and even goes beyond the phenomenon of polyamorphism by generically describing the anomalous properties of fluids exhibiting interconversion of alternative molecular states.

  16. Hamiltonian description of the ideal fluid

    International Nuclear Information System (INIS)

    Morrison, P.J.

    1994-01-01

    Fluid mechanics is examined from a Hamiltonian perspective. The Hamiltonian point of view provides a unifying framework; by understanding the Hamiltonian perspective, one knows in advance (within bounds) what answers to expect and what kinds of procedures can be performed. The material is organized into five lectures, on the following topics: rudiments of few-degree-of-freedom Hamiltonian systems illustrated by passive advection in two-dimensional fluids; functional differentiation, two action principles of mechanics, and the action principle and canonical Hamiltonian description of the ideal fluid; noncanonical Hamiltonian dynamics with examples; tutorial on Lie groups and algebras, reduction-realization, and Clebsch variables; and stability and Hamiltonian systems

  17. Performance Comparison and Selection of Transformer Fluid

    Directory of Open Access Journals (Sweden)

    Lu Yang

    2016-01-01

    Full Text Available Transformer fluid directly affects the working state of the components and the cooling efficiency of transformer. There are three kinds of transformer fluid used for electric locomotive, EMU and suburban rail vehicles: mineral oil, silicone liquid and synthetic ester based insulating oil. In this paper, the three kinds of oil are compared from the fire safety, environmental protection, reliability and low maintenance. It provides a strong basis for the selection of transformer fluid. By comprehensive analysis, synthetic ester based insulating oil can completely replace mineral oil and silicone liquid. With rail transport safety and environmental protection standards improving, synthetic ester based insulating oil will be the best choice for transformer.

  18. Magnetic fluid seals for DWDM filter manufacturing

    International Nuclear Information System (INIS)

    Li Zhixin

    2002-01-01

    Performance requirements of rotary magnetic fluid seals for thin film dense wavelength division multiplexing filter manufacturing are discussed. High speed, large diameter, tight tolerance for rotating accuracy and motion control are some of the technical challenges in this application. Analytical methods for studying these technical issues and experimental data are presented. Innovative design approaches are also discussed. It is shown that using the most advanced magnetic fluid technology and seal design technology, magnetic fluid seals can provide satisfactory performance in this challenging new application

  19. Creating fluid injectivity in tar sands formations

    Science.gov (United States)

    Stegemeier, George Leo; Beer, Gary Lee; Zhang, Etuan

    2010-06-08

    Methods for treating a tar sands formation are described herein. Methods for treating a tar sands may include heating a portion of a hydrocarbon layer in the formation from one or more heaters located in the portion. The heat may be controlled to increase the permeability of at least part of the portion to create an injection zone in the portion with an average permeability sufficient to allow injection of a fluid through the injection zone. A drive fluid and/or an oxidizing fluid may be provided into the injection zone. At least some hydrocarbons are produced from the portion.

  20. Analysis of anisotropic shells containing flowing fluid

    International Nuclear Information System (INIS)

    Lakis, A.A.

    1983-01-01

    A general theory for the dynamic analysis of anisotropic thin cylindrical shells containing flowing fluid is presented. The shell may be uniform or non-uniform, provided it is geometrically axially symmetric. This is a finite- element theory, using cylindrical finite elements, but the displacement functions are determined by using classical shell theory. A new solution of the wave equation of the liquid finite element leads to an expression of the fluid pressure, p, as a function of the nodal displacements of the element and three operative forces (inertia, centrifugal and Coriolis) of the moving fluid. (Author) [pt

  1. Multidomain multiphase fluid mechanics

    International Nuclear Information System (INIS)

    Sha, W.T.; Soo, S.L.

    1976-10-01

    A set of multiphase field equations--conversion of mass, momentum and energy--based on multiphase mechanics is developed. Multiphase mechanics applies to mixtures of phases which are separated by interfaces and are mutually exclusive. Based on the multiphase mechanics formulation, additional terms appear in the field equations when the physical size of the dispersed phase (bubble or droplet) is many times larger than the inter-molecular spacing. These terms are the inertial coupling due to virtual mass and the additional viscous coupling due to unsteadiness of the flow field. The multiphase formulation given here takes into account the discreteness of particles of dispersed phases and, at the same time, the necessity of the distributive representation of field variables via space-time averaging when handling a large number of particles. The provision for multidomain transition further permits us to treat dispersed phases which are large compared to the characteristic dimension of the flow system via interdomain relations. The multidomain multiphase approach provides a framework for us to model the various flow regimes. Because some of the transport parameters associated with the system equations are not well known at the present time, an idealized two-domain two-phase solution approach is proposed as a first step. Finally, comparisons are made between the field equations formulated based on the multidomain-multiphase fluid mechanics and the pertinent existing models, and their relative significances are discussed. The desirability of consistent approximation and simplifications possible for dilute suspensions are discussed

  2. Satellite Communications

    CERN Document Server

    Pelton, Joseph N

    2012-01-01

    The field of satellite communications represents the world's largest space industry. Those who are interested in space need to understand the fundamentals of satellite communications, its technology, operation, business, economic, and regulatory aspects. This book explains all this along with key insights into the field's future growth trends and current strategic challenges. Fundamentals of Satellite Communications is a concise book that gives all of the key facts and figures as well as a strategic view of where this dynamic industry is going. Author Joseph N. Pelton, PhD, former Dean of the International Space University and former Director of Strategic Policy at Intelstat, presents a r

  3. Thermal Fluid Engineering

    International Nuclear Information System (INIS)

    Jang, Byeong Ju

    1984-01-01

    This book is made up of 5 chapters. They are fluid mechanics, fluid machines, Industrial thermodynamics, steam boiler and steam turbine. It introduces hydrostatics, basic theory of fluid movement and law of momentum. It also deals with centrifugal pump, axial flow pump, general hydraulic turbine, and all phenomena happening in the pump. It covers the law of thermodynamics, perfect gas, properties of steam, and flow of gas and steam and water tube boiler. Lastly it explains basic format, theory, loss and performance as well as principle part of steam turbine.

  4. Sources of variability in human communicative skills

    Directory of Open Access Journals (Sweden)

    Inge eVolman

    2012-11-01

    Full Text Available When established communication systems cannot be used, people rapidly create novel systems to modify the mental state of another agent according to their intentions. However, there are dramatic inter-individual differences in the implementation of this human competence for communicative innovation. Here we characterize psychological sources of inter-individual variability in the ability to build a shared communication system from scratch. We consider two potential sources of variability in communicative skills. Cognitive traits of two individuals could independently influence their joint ability to establish a communication system. Another possibility is that the overlap between those individual traits influences the communicative performance of a dyad. We assess these possibilities by quantifying the relationship between cognitive traits and behavior of communicating dyads. Cognitive traits were assessed with psychometric scores quantifying cooperative attitudes and fluid intelligence. Competence for implementing successful communicative innovations was assessed by using a non-verbal communicative task. Individual capacities influence communicative success when communicative innovations are generated. Dyadic similarities and individual traits modulate the type of communicative strategy chosen. The ability to establish novel communicative actions was influenced by a combination of the communicator’s ability to understand intentions and the addressee’s ability to recognize patterns. Communicative pairs with comparable systemizing abilities or behavioral inhibition were more likely to explore the search space of possible communicative strategies by systematically adding new communicative behaviors to those already available. No individual psychometric measure seemed predominantly responsible for communicative success. These findings support the notion that the human ability for fast communicative innovations represents a special type of

  5. 49 CFR 193.2519 - Communication systems.

    Science.gov (United States)

    2010-10-01

    ...: FEDERAL SAFETY STANDARDS Operations § 193.2519 Communication systems. (a) Each LNG plant must have a primary communication system that provides for verbal communications between all operating personnel at... 49 Transportation 3 2010-10-01 2010-10-01 false Communication systems. 193.2519 Section 193.2519...

  6. Short communication

    African Journals Online (AJOL)

    abp

    2017-09-04

    Sep 4, 2017 ... Face-to-face interviews were conducted using a standardized ... Short communication. Open Access ... clinic during the time of the study and were invited to participate in the study. .... consume them. This is another ...

  7. Brief communication

    Indian Academy of Sciences (India)

    2013-11-05

    Nov 5, 2013 ... Brief communication. Published ... showed longer FIDs in response to a human looking at them than to a human not looking at them (Burger et al. 1992). ..... Rivas JA and Burghardt GM 2001 Understanding sexual size dimor-.

  8. Brief communication

    Indian Academy of Sciences (India)

    2011-03-14

    Mar 14, 2011 ... 1Department of Crop, Soil and Environmental Sciences, 2Department of Horticulture, University of Arkansas, ... controlled by the soybean heat-shock promoter is an effective tool for conditional removal ... Brief communication ...

  9. PC communication

    International Nuclear Information System (INIS)

    Oh, Jae Cheol

    1992-03-01

    This text book is comprised of five charters, which is about PC communication for beginners who need to learn manners and how to use Ketel and PC serve. So it introduces first, conception of PC and precautions on using PC communication, second, preparation for PC communication with Modem, its program, install, kinds of protocol and how to use protocol, third directions of emulator of PC communication and super session, fourth, instruction of Ketel with join and access, basic command of Ketel, list of Ketel's menu, Ketel editor, service guide, directions of News service, Stock and bond service business and economic figures, exchange rate and interest rate, tax culture and leisure, Ketel BBS service and posting. The last part has a instruction of PC-serve about join, basic command of PC-serve, service guide and practical guideline.

  10. PC communication

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Cheol

    1992-03-15

    This text book is comprised of five charters, which is about PC communication for beginners who need to learn manners and how to use Ketel and PC serve. So it introduces first, conception of PC and precautions on using PC communication, second, preparation for PC communication with Modem, its program, install, kinds of protocol and how to use protocol, third directions of emulator of PC communication and super session, fourth, instruction of Ketel with join and access, basic command of Ketel, list of Ketel's menu, Ketel editor, service guide, directions of News service, Stock and bond service business and economic figures, exchange rate and interest rate, tax culture and leisure, Ketel BBS service and posting. The last part has a instruction of PC-serve about join, basic command of PC-serve, service guide and practical guideline.

  11. SHORT COMMUNICATION

    African Journals Online (AJOL)

    PROF P.T. KAYE

    . SHORT COMMUNICATION. Formation and Structural Analysis of Novel Dibornyl Ethers. Perry T. Kaye*, Andrew R. Duggan, Joseph M. Matjila, Warner E. Molema, and. Swarnam S. Ravindran. Department of Chemistry, Rhodes University, Grahamstown, ...

  12. Colour in visualisation for computational fluid dynamics

    OpenAIRE

    Kinnear, D; Atherton, MA; Collins, MW; Dokhan, J; Karayiannis, TG

    2006-01-01

    Colour is used in computational fluid dynamic (CFD) simulations in two key ways. First it is used to visualise the geometry and allow the engineers to be confident that the model constructed is a good representation of the engineering situation. Once an analysis has been completed, colour is used in post-processing the data from the simulations to illustrate the complex fluid mechanic phenomena under investigation. This paper describes these two uses of colour and provides some examples to il...

  13. Nanoparticle enhanced ionic liquid heat transfer fluids

    Science.gov (United States)

    Fox, Elise B.; Visser, Ann E.; Bridges, Nicholas J.; Gray, Joshua R.; Garcia-Diaz, Brenda L.

    2014-08-12

    A heat transfer fluid created from nanoparticles that are dispersed into an ionic liquid is provided. Small volumes of nanoparticles are created from e.g., metals or metal oxides and/or alloys of such materials are dispersed into ionic liquids to create a heat transfer fluid. The nanoparticles can be dispersed directly into the ionic liquid during nanoparticle formation or the nanoparticles can be formed and then, in a subsequent step, dispersed into the ionic liquid using e.g., agitation.

  14. Fluid reasoning and the developing brain

    Directory of Open Access Journals (Sweden)

    Emilio Ferrer

    2009-05-01

    Full Text Available Fluid reasoning is a cornerstone of human cognition, both during development and in adulthood. In spite of this, the neural mechanisms underlying the development of fluid reasoning are largely unknown. Here we provide an overview of this important cognitive ability, how it is measured, how it changes over childhood and adolescence, and what is known about its neurobiological underpinnings. We review important findings from the psychometric, cognitive, and neuroscientific literatures, and outline important future directions for this interdisciplinary research.

  15. MFC Communications Infrastructure Study

    Energy Technology Data Exchange (ETDEWEB)

    Michael Cannon; Terry Barney; Gary Cook; George Danklefsen, Jr.; Paul Fairbourn; Susan Gihring; Lisa Stearns

    2012-01-01

    Unprecedented growth of required telecommunications services and telecommunications applications change the way the INL does business today. High speed connectivity compiled with a high demand for telephony and network services requires a robust communications infrastructure.   The current state of the MFC communication infrastructure limits growth opportunities of current and future communication infrastructure services. This limitation is largely due to equipment capacity issues, aging cabling infrastructure (external/internal fiber and copper cable) and inadequate space for telecommunication equipment. While some communication infrastructure improvements have been implemented over time projects, it has been completed without a clear overall plan and technology standard.   This document identifies critical deficiencies with the current state of the communication infrastructure in operation at the MFC facilities and provides an analysis to identify needs and deficiencies to be addressed in order to achieve target architectural standards as defined in STD-170. The intent of STD-170 is to provide a robust, flexible, long-term solution to make communications capabilities align with the INL mission and fit the various programmatic growth and expansion needs.

  16. Molecular mechanics and structure of the fluid-solid interface in simple fluids

    Science.gov (United States)

    Wang, Gerald J.; Hadjiconstantinou, Nicolas G.

    2017-09-01

    Near a fluid-solid interface, the fluid spatial density profile is highly nonuniform at the molecular scale. This nonuniformity can have profound effects on the dynamical behavior of the fluid and has been shown to play an especially important role when modeling a wide variety of nanoscale heat and momentum transfer phenomena. We use molecular-mechanics arguments and molecular-dynamics (MD) simulations to develop a better understanding of the structure of the first fluid layer directly adjacent to the solid in the layering regime, as delineated by a nondimensional number that compares the effects of wall-fluid interaction to thermal energy. Using asymptotic analysis of the Nernst-Planck equation, we show that features of the fluid density profile close to the wall, such as the areal density of the first layer ΣFL (defined as the number of atoms in this layer per unit of fluid-solid interfacial area), can be expressed as polynomial functions of the fluid average density ρave. This is found to be in agreement with MD simulations, which also show that the width of the first layer hFL is a linear function of the average density and only a weak function of the temperature T . These results can be combined to show that, for system average densities corresponding to a dense fluid (ρave≥0.7 ), the ratio C ≡ΣFLρavehFL, representing a density enhancement with respect to the bulk fluid, depends only weakly on temperature and is essentially independent of density. Further MD simulations suggest that the above results, nominally valid for large systems (solid in contact with semi-infinite fluid), also describe fluid-solid interfaces under considerable nanoconfinement, provided ρave is appropriately defined.

  17. Windshield washer fluid

    Science.gov (United States)

    ... tests Chest x-ray CT (computerized tomography, or advanced imaging) scan EKG (electrocardiogram, or heart tracing) Fluids ... Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  18. COUPLED CHEMOTAXIS FLUID MODEL

    KAUST Repository

    LORZ, ALEXANDER

    2010-01-01

    We consider a model system for the collective behavior of oxygen-driven swimming bacteria in an aquatic fluid. In certain parameter regimes, such suspensions of bacteria feature large-scale convection patterns as a result of the hydrodynamic

  19. Phoresis in fluids.

    Science.gov (United States)

    Brenner, Howard

    2011-12-01

    This paper presents a unified theory of phoretic phenomena in single-component fluids. Simple formulas are given for the phoretic velocities of small inert force-free non-Brownian particles migrating through otherwise quiescent single-component gases and liquids and animated by a gradient in the fluid's temperature (thermophoresis), pressure (barophoresis), density (pycnophoresis), or any combination thereof. The ansatz builds upon a recent paper [Phys. Rev. E 84, 046309 (2011)] concerned with slip of the fluid's mass velocity at solid surfaces--that is, with phenomena arising from violations of the classical no-slip fluid-mechanical boundary condition. Experimental and other data are cited in support of the phoretic model developed herein.

  20. Peritoneal Fluid Analysis

    Science.gov (United States)

    ... Get Tested? To help diagnose the cause of peritonitis, an inflammation of the membrane lining the abdomen, ... fever and your healthcare practitioner suspects you have peritonitis or ascites Sample Required? A peritoneal fluid sample ...