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. 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.

  4. 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…

  5. Patient-Provider Communication: the Rise of Patient Engagement.

    Science.gov (United States)

    Jenerette, Coretta M; Mayer, Deborah K

    2016-05-01

    To describe the changing dynamics of patient-provider communication with proposals for optimizing this important relationship. Current research, national programs and guidelines from the National Cancer Institute, the Commission on Cancer, the Institute of Medicine, and the Oncology Nursing Society. There are important opportunities to apply evidence-based strategies to optimize patient-provider communication that will result in improved health outcomes. Oncology nurses across all areas of practice, including clinical care, research, and education, can play a significant role in achieving the goal of positive health outcomes by addressing challenges that inhibit effective patient-provider communication. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management.

    Science.gov (United States)

    Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

    2017-04-01

    Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.

  7. Provider communication effects medication adherence in hypertensive African Americans

    Science.gov (United States)

    Schoenthaler, Antoinette; Chaplin, William F.; Allegrante, John P.; Fernandez, Senaida; Diaz-Gloster, Marleny; Tobin, Jonathan N.; Ogedegbe, Gbenga

    2009-01-01

    Objective To evaluate the effect of patients’ perceptions of providers’ communication on medication adherence in hypertensive African Americans. Methods Cross-sectional study of 439 patients with poorly-controlled hypertension followed in community-based healthcare practices in the New York metropolitan area. Patients’ rating of their providers’ communication was assessed with a perceived communication style questionnaire,while medication adherence was assessed with the Morisky self-report measure. Results Majority of participants were female, low-income, and had high school level educations, with mean age of 58 years. Fifty-five percent reported being nonadherent with their medications; and 51% rated their provider’s communication to be non-collaborative. In multivariate analysis adjusted for patient demographics and covariates (depressive symptoms, provider degree), communication rated as collaborative was associated with better medication adherence (β = -.11, p = .03). Other significant correlates of medication adherence independent of perceived communication were age (β = .13, p = .02) and depressive symptoms (β = -.18, p = .001). Conclusion Provider communication rated as more collaborative was associated with better adherence to antihypertensive medications in a sample of low-income hypertensive African-American patients. Practice Implications The quality of patient-provider communication is a potentially modifiable element of the medical relationship that may affect health outcomes in this high-risk patient population. PMID:19013740

  8. 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 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 facilitating communication, as

  9. Provider communication quality: influence of patients' weight and race.

    Science.gov (United States)

    Wong, Michelle S; Gudzune, Kimberly A; Bleich, Sara N

    2015-04-01

    To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Parents' perceptions of provider communication regarding adolescent vaccines.

    Science.gov (United States)

    Dempsey, Amanda F; Pyrzanowski, Jennifer; Lockhart, Steven; Campagna, Elizabeth; Barnard, Juliana; O'Leary, Sean T

    2016-06-02

    Strong provider recommendations for adolescent vaccines are critical for achieving high vaccination levels.  However, little is known about parents' preferred provider communication strategies for adolescent vaccines in general, and for human papillomavirus (HPV) vaccines specifically. We performed a cross-sectional survey of 800 parents of 9-14 year olds in April 2014 to assess current adolescent vaccine communication practices by providers, parents' preferred HPV vaccine-specific communication strategies, and the association of these two outcomes with experiential, attitudinal and demographic characteristics.  Among the 356 parents in the study (response rate 48%), HPV vaccines were reported as less likely to have been "very strongly" recommended by their adolescent's provider (39%) than other adolescent-targeted vaccines (45%-59%, parents (87%) reported that, if available, they would use a website providing personalized HPV vaccine-related materials before their adolescent's next check-up, and other technology-based communications were also endorsed by the majority of parents.   From these data we conclude that parents received weaker recommendations for HPV vaccines than other adolescent vaccines, and that most parents want additional HPV vaccine-related materials, preferably delivered using a variety of technology-based modalities which is not their providers' current practice.

  11. Parents’ perceptions of provider communication regarding adolescent vaccines

    Science.gov (United States)

    Dempsey, Amanda F.; Pyrzanowski, Jennifer; Lockhart, Steven; Campagna, Elizabeth; Barnard, Juliana; O'Leary, Sean T.

    2016-01-01

    ABSTRACT Strong provider recommendations for adolescent vaccines are critical for achieving high vaccination levels.  However, little is known about parents’ preferred provider communication strategies for adolescent vaccines in general, and for human papillomavirus (HPV) vaccines specifically. We performed a cross-sectional survey of 800 parents of 9-14 year olds in April 2014 to assess current adolescent vaccine communication practices by providers, parents’ preferred HPV vaccine-specific communication strategies, and the association of these two outcomes with experiential, attitudinal and demographic characteristics.  Among the 356 parents in the study (response rate 48%), HPV vaccines were reported as less likely to have been “very strongly” recommended by their adolescent’s provider (39%) than other adolescent-targeted vaccines (45%-59%, HPV vaccines was associated with a higher likelihood of vaccine receipt (71% versus 39%, pvaccinated, increased likelihood of positive vaccination intentions (82% vs. 60%, p = 0.015).  Nearly all parents (87%) reported that, if available, they would use a website providing personalized HPV vaccine-related materials before their adolescent’s next check-up, and other technology-based communications were also endorsed by the majority of parents.   From these data we conclude that parents received weaker recommendations for HPV vaccines than other adolescent vaccines, and that most parents want additional HPV vaccine-related materials, preferably delivered using a variety of technology-based modalities which is not their providers’ current practice. PMID:27078515

  12. Patient provider communication about the health effects of obesity

    NARCIS (Netherlands)

    Durant, Nefertiti H.; Bartman, Barbara; Person, Sharina D.; Collins, Felicia; Austin, S. Bryn

    Objective: We assessed the influence of race/ethnicity and provider Communication oil overweight and obese patients' perceptions of the damage weight causes to their health. Methods: The-study included 1071 overweight and obese patients who completed the 2002 Community Health Center (CHC) User

  13. Control and Communication in Provider-Patient Relationships.

    Science.gov (United States)

    Northouse, Peter G.

    Noting that loss of control is a major concern confronting patients experiencing an illness, this paper critically analyzes the research literature on control and clarifies the implications of this research for provider-patient communication. The paper first defines control, noting that the most frequently cited definition is the "locus of…

  14. Open communication: Recommendations for enhancing communication among primary care and mental health providers, services, and systems.

    Science.gov (United States)

    Wong, Shale L; Talmi, Ayelet

    2015-06-01

    Comments on the article "Please break the silence: Parents' views on communication between pediatric primary care and mental health providers" by Greene et al. (see record 2015-14521-001). The article highlights the need to improve communication between primary care and mental health care providers to better serve children and families. The report reaffirms that parents understand the value and necessity of collaborative care, as evidenced by the identification of gaps in consistency of bidirectional communication between providers in traditional and separate practice settings and the desire for improved care coordination. (c) 2015 APA, all rights reserved).

  15. 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.

  16. 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.

  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. 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.

  1. 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.

  2. 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

  3. A Metasynthesis of Patient-Provider Communication in Hospital for Patients with Severe Communication Disabilities: Informing New Translational Research

    Science.gov (United States)

    Balandin, Susan

    2014-01-01

    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. PMID:25229213

  4. 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.

  5. Providing information communication technology-based support to ...

    African Journals Online (AJOL)

    Student support is a major factor in distance education. This study was concerned with the use of ICT as a medium for providing student support at the University of Zambia. It was necessary to study the factors that would affect the application of ICT, in order to inform policy makers and managers of distance education which ...

  6. How does patient-provider communication influence adherence to asthma medications?

    Science.gov (United States)

    Young, Henry N; Len-Rios, Maria E; Brown, Roger; Moreno, Megan M; Cox, Elizabeth

    2017-04-01

    To assess hypothesized pathways through which patient-provider communication impacts asthma medication adherence. A national sample of 452 adults with asthma reported assessments of patient-provider communication, proximal outcomes (understanding of asthma self-management, patient-provider agreement, trust in the clinician, involvement in care, motivation), and adherence to asthma medications. Structural equation modeling was used to examine hypothesized pathways. Significantly positive direct pathways were found between patient-provider communication and all proximal outcomes. Only positive indirect pathways, operating through trust and motivation, were found between patient-provider communication and medication adherence. Patient-provider communication influences many desirable proximal outcomes, but only influences adherence through trust and motivation. To promote better adherence to asthma medication regimens and, ultimately positive asthma outcomes, healthcare providers can focus on implementing communication strategies that strengthen patients' trust and increase patient motivation to use asthma medications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. 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

  8. Communications: Mechanical Deformation of Dendrites by Fluid Flow

    Science.gov (United States)

    Pilling, J.; Hellawell, A.

    1996-01-01

    It is generally accepted that liquid agitation during alloy solidification assists in crystal multiplication, as in dendrite fragmentation and the detachment of side arms in the mushy region of a casting. Even without deliberate stirring by electromagnetic or mechanical means, there is often vigorous interdendritic fluid flow promoted by natural thermosolutal convection. In this analysis, we shall estimate the stress at the root of a secondary dendrite arm of aluminum arising from the action of a flow of molten metal past the dendrite arm.

  9. Communication: Fundamental measure theory for hard disks: fluid and solid.

    Science.gov (United States)

    Roth, Roland; Mecke, Klaus; Oettel, Martin

    2012-02-28

    Two-dimensional hard-particle systems are rather easy to simulate but surprisingly difficult to treat by theory. Despite their importance from both theoretical and experimental points of view, theoretical approaches are usually qualitative or at best semi-quantitative. Here, we present a density functional theory based on the ideas of fundamental measure theory for two-dimensional hard-disk mixtures, which allows for the first time an accurate description of the structure of the dense fluid and the equation of state for the solid phase within the framework of density functional theory. The properties of the solid phase are obtained by freely minimizing the functional.

  10. Provider communication and HPV vaccination: The impact of recommendation quality

    Science.gov (United States)

    Gilkey, Melissa B.; Calo, William A.; Moss, Jennifer L.; Shah, Parth D.; Marciniak, Macary W.; Brewer, Noel T.

    2016-01-01

    Background Receiving a healthcare provider’s recommendation is a strong predictor of HPV vaccination, but little is known empirically about which types of recommendation are most influential. Thus, we sought to investigate the relationship between recommendation quality and HPV vaccination among U.S. adolescents. Methods In 2014, we conducted a national, online survey of 1,495 parents of 11- to 17-year-old adolescents. Parents reported whether providers endorsed HPV vaccination strongly, encouraged same-day vaccination, and discussed cancer prevention. Using an index of these quality indicators, we categorized parents as having received no, low-quality, or high-quality recommendations for HPV vaccination. Separate multivariable logistic regression models assessed associations between recommendation quality and HPV vaccine initiation (≥1 dose), follow through (3 doses, among initiators), refusal, and delay. Results Almost half (48%) of parents reported no provider recommendation for HPV vaccination, while 16% received low-quality recommendations and 36% received high-quality recommendations. Compared to no recommendation, high-quality recommendations were associated with over nine times the odds of HPV vaccine initiation (23% vs. 74%, OR=9.31, 95% CI, 7.10–12.22) and over three times the odds of follow through (17% vs. 44%, OR=3.82, 95% CI, 2.39–6.11). Low-quality recommendations were more modestly associated with initiation (OR=4.13, 95% CI, 2.99–5.70), but not follow through. Parents who received high-versus low-quality recommendations less often reported HPV vaccine refusal or delay. Conclusions High-quality recommendations were strongly associated with HPV vaccination behavior, but only about one-third of parents received them. Interventions are needed to improve not only whether, but how providers recommend HPV vaccination for adolescents. PMID:26812078

  11. 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…

  12. 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

    2017-04-27

    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.

  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. Improving parent satisfaction: an intervention to increase neonatal parent?provider communication

    OpenAIRE

    Weiss, S; Goldlust, E; Vaucher, Y E

    2009-01-01

    Objective: The objective of the study was to assess whether a targeted intervention improved the satisfaction of neonatal parents with primary medical provider communication. Study Design: The study design was a survey assessment of parents in a neonatal intensive care unit regarding their satisfaction with physician and nurse practitioner communication. Serial cohorts were surveyed before and after an intervention, including educating providers about family communication, distributing contac...

  15. Race/Ethnicity and Health Care Communication: Does Patient-Provider Concordance Matter?

    Science.gov (United States)

    Sweeney, Casey F; Zinner, Darren; Rust, George; Fryer, George E

    2016-11-01

    Although many minority patients would prefer a provider of their own race/ethnicity, the influence of this relationship on patient-provider communication remains unknown. This analysis examined the effect of patient-provider race/ethnicity concordance on patient-reported provider communication quality using data from the Medical Expenditure Panel Survey years 2002-2012. Ordinary least squares regressions were executed on communication rating, measured by the Consumer Assessment of Health Providers and Systems. Only 13.8% of black, non-Hispanic patients reported their usual source of care provider matched their race/ethnicity, compared with 94.4% of white, non-Hispanic patients and 43.8% of Hispanic patients. Differences in communication ratings were driven by patient race, rather than provider race. Although black, non-Hispanic patients rate their communication significantly higher than their counterparts overall, there was no significant influence of patient-provider racial concordance on ratings of communication when controlling for other sociodemographic variables. Minorities may seek the services of minority providers, but they are not more satisfied with patient-provider communication experience than when in race-discordant provider arrangements.

  16. 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.

  17. Provider Difficulties With Spiritual and Forgiveness Communication at the End of Life.

    Science.gov (United States)

    Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Buller, Haley

    2016-11-01

    Due to an absence of communication training, provider responses to patient/family spiritual distress are highly variable. Assessing spiritual and forgiveness concerns are important to ensuring quality holistic care. Cross-sectional survey data were collected from providers attending 1 of 2 continuing education courses. The survey measured the frequency and initiation of communication about spirituality and forgiveness with patients/families, the perceived difficulty in communication across topics, and preparation and resources for these discussions. Most participants (n = 124) were nurses followed by social workers with over half of providers having 10 years or more of clinical experience. Participants reported the highest level of difficulty in spiritual communication when talking with family after the death of a patient, followed by conducting a spiritual history with a patient. Facilitating forgiveness communication between parent and adult child, followed by facilitating forgiveness between partners was most difficult for all participants. Social workers reported much lower difficulty than nurses on all items of spiritual and forgiveness communication. The majority of participants indicated they were involved in spiritual and forgiveness communication. The most difficult communication included talking with family after death and facilitating forgiveness between patients and families. These findings support the importance of spiritual communication in clinical practice, and the need for clinician training in communicating about spirituality and forgiveness with patients and families. © The Author(s) 2015.

  18. Patient–provider communication data: linking process and outcomes in oncology care

    Directory of Open Access Journals (Sweden)

    Kennedy Sheldon L

    2011-11-01

    Full Text Available Lisa Kennedy Sheldon1,2, Fangxin Hong3,4, Donna Berry4,51University of Massachusetts Boston, Boston, MA, USA; 2St Joseph Hospital, Nashua, NH, USA; 3Dana-Farber Cancer Institute, Department of Biostatistics and Computational Biology, Boston, MA, USA; 4Dana-Farber Cancer Institute, Phyllis F Cantor Center for Research in Nursing and Patient Care Services, Boston, MA, USA; 5Harvard Medical School, Boston, MA, USAOverview: Patient–provider communication is vital to quality patient care in oncology settings and impacts health outcomes. Newer communication datasets contain patient symptom reports, real-time audiofiles of visits, coded communication data, and visit outcomes. The purpose of this paper is to: (1 review the complex communication processes during patient–provider interaction during oncology care; (2 describe methods of gathering and coding communication data; (3 suggest logical approaches to analyses; and (4 describe one new dataset that allows linking of patient symptoms and communication processes with visit outcomes.Challenges: Patient–provider communication research is complex due to numerous issues, including human subjects’ concerns, methods of data collection, numerous coding schemes, and varying analytic techniques.Data collection and coding: Coding of communication data is determined by the research question(s and variables of interest. Subsequent coding and timestamping the behaviors provides categorical data and determines the interval between and patterns of behaviors.Analytic approaches: Sequential analyses move from descriptive statistics to explanatory analyses to direct analyses and conditional probabilities. In the final stage, explanatory modeling is used to predict outcomes from communication elements. Examples of patient and provider communication in the ambulatory oncology setting are provided from the new Electronic Self Report Assessment-Cancer II dataset.Summary: More complex communication data sets provide

  19. 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.

  20. 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.

  1. Providing Alternative Reinforcers to Facilitate Tolerance to Delayed Reinforcement Following Functional Communication Training

    Science.gov (United States)

    Austin, Jillian E.; Tiger, Jeffrey H.

    2015-01-01

    The earliest stages of functional communication training (FCT) involve providing immediate and continuous reinforcement for a communicative response (FCR) that is functionally equivalent to the targeted problem behavior. However, maintaining immediate reinforcement is not practical, and the introduction of delays is associated with increased…

  2. E-mail in patient–provider communication: A systematic review

    Science.gov (United States)

    Ye, Jiali; Rust, George; Fry-Johnson, Yvonne; Strothers, Harry

    2014-01-01

    Objective To review systematically the role of e-mails in patient–provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care. Methods A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008. Results A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed. Conclusion The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool. Practice implications It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication. PMID:19914022

  3. E-mail in patient-provider communication: a systematic review.

    Science.gov (United States)

    Ye, Jiali; Rust, George; Fry-Johnson, Yvonne; Strothers, Harry

    2010-08-01

    To review systematically the role of e-mails in patient-provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care. A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008. A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed. The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool. It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  4. 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.

  5. 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

  6. 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.

  7. "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.

  8. 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.

  9. Patients' and providers' perceptions of the impact of health literacy on communication in pulmonary rehabilitation.

    Science.gov (United States)

    Sadeghi, Shiva; Brooks, Dina; Goldstein, Roger S

    2013-05-01

    Chronic obstructive pulmonary disease (COPD) is the most prevalent form of chronic respiratory diseases worldwide. Pulmonary rehabilitation, including self-management education, highlights the importance of good patient-provider communication in establishing optimal care. There is a growing awareness of the potential impact of health literacy (HL) on the patients' access to and understanding of medical information. This study was designed to explore the patients' and health care professionals' (HCPs) perceptions of the role of HL in health communication. Semi-structured interviews and focus groups were conducted with 12 patients and 20 HCPs at a Pulmonary Rehabilitation Center in Metropolitan Toronto. Although the term health literacy was not familiar to many patients, the contribution of knowledge to patient well-being was consistently identified by patients and HCPs. Barriers to communication included provider time constraints and the use of medical jargon. For providers they also included patient characteristics, language, culture and awareness of health resources. Approaches that might improve communication incorporated family support, peer support, better print and visual teaching material and a trusting empathic patient-provider relationship. The findings provide an increased understanding of patients' and providers' perceptions of HL as a barrier to effective communication of medical information to patients with COPD as well as approaches that might improve this communication.

  10. Physicians' Preferences for Communication of Pharmacist-Provided Medication Therapy Management in Community Pharmacy.

    Science.gov (United States)

    Guthrie, Kendall D; Stoner, Steven C; Hartwig, D Matthew; May, Justin R; Nicolaus, Sara E; Schramm, Andrew M; DiDonato, Kristen L

    2017-02-01

    (1) To identify physicians' preferences in regard to pharmacist-provided medication therapy management (MTM) communication in the community pharmacy setting; (2) to identify physicians' perceived barriers to communicating with a pharmacist regarding MTM; and (3) to determine whether Missouri physicians feel MTM is beneficial for their patients. A cross-sectional prospective survey study of 2021 family and general practice physicians registered with MO HealthNet, Missouri's Medicaid program. The majority (52.8%) of physicians preferred MTM data to be communicated via fax. Most physicians who provided care to patients in long-term care (LTC) facilities (81.0%) preferred to be contacted at their practice location as opposed to the LTC facility. The greatest barriers to communication were lack of time and inefficient communication practices. Improved/enhanced communication was the most common suggestion for improvement in the MTM process. Approximately 67% of respondents reported MTM as beneficial or somewhat beneficial for their patients. Survey respondents saw value in the MTM services offered by pharmacists. However, pharmacists should use the identified preferences and barriers to improve their currently utilized communication practices in hopes of increasing acceptance of recommendations. Ultimately, this may assist MTM providers in working collaboratively with patients' physicians.

  11. 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.

  12. Culturally competent patient–provider communication in the management of cancer: An integrative literature review

    Directory of Open Access Journals (Sweden)

    Ottilia Brown

    2016-11-01

    Full Text Available Background: Managing cancer in a multicultural environment poses several challenges, which include the communication between the patient and the healthcare provider. Culture is an important consideration in clinical care as it contributes to shaping patients’ health-related values, beliefs, and behaviours. This integrative literature review gathered evidence on how culturally competent patient–provider communication should be delivered to patients diagnosed with cancer. Design: Whittemore and Knafl's approach to conducting an integrative literature review was used. A number of databases were systematically searched and a manual search was also conducted. Specific inclusion and exclusion criteria were set and documents were critically appraised independently by two reviewers. Thirty-five documents were included following these processes. Data extraction and synthesis followed and were also independently verified. Results: Various strategies and personal characteristics and attitudes for culturally competent communication were identified. The importance of culturally competent healthcare systems and models for culturally competent communication were also emphasised. The findings related to all themes should be treated with caution as the results are based mostly on low-level evidence (Level VII. Conclusions: More rigorous research yielding higher levels of evidence is needed in the field of culturally competent patient–provider communication in the management of cancer. Most of the available literature was classified as non-research evidence. The themes that emerged do, however, provide some insight into how culturally competent patient–provider communication may be delivered in order to improve treatment outcomes in patients diagnosed with cancer.

  13. Provider communication and patient understanding of life-limiting illness and their relationship to patient communication of treatment preferences.

    Science.gov (United States)

    Wagner, Glenn J; Riopelle, Deborah; Steckart, Jillisa; Lorenz, Karl A; Rosenfeld, Kenneth E

    2010-03-01

    Medical decision making in the context of serious illness ideally involves a patient who understands his or her condition and prognosis and can effectively formulate and communicate his or her care preferences. To understand the relationships among these care processes, we analyzed baseline interview data from veterans enrolled in a randomized controlled trial of a palliative care intervention. Participants were 400 inpatient veterans admitted with a physician-estimated risk of one-year mortality more than 25%; 260 (65%) had cancer as the primary diagnosis. Patients who believed that they had a life-limiting illness (89% of sample) reported that their provider had communicated this to them more frequently than those who did not share that belief (78% vs. 22%, Pcommunication with patients regarding prognosis. Because functional decline may prompt physicians to discuss prognosis with patients, patients with relatively preserved function may particularly need such communication. (c) 2010 U.S. Cancer Pain Relief Committee. All rights reserved.

  14. Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns.

    Science.gov (United States)

    Douglas, Susan R; Vides de Andrade, Ana Regina; Boyd, Stephanie; Leslie, Melanie; Webb, Lynn; Davis, Lauren; Fraine, Melissa; Frazer, Nicole L; Hargraves, Ryan; Bickman, Leonard

    2016-07-01

    To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology. Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate). All Soldiers were eligible to participate and were blinded to provider training status. Immediately after screening encounters, providers reported on their identification of mental health concerns and Soldiers reported on provider communication behaviors resulting in 1,400 matched pairs. Electronic health records were also available for 26,005 Soldiers. The workshop was found to increase (1) providers' patient-centered communication behaviors as evaluated by Soldiers; (2) provider identification of Soldier mental health concerns; and (3), related health outcomes including provision of education and referral to a confidential counseling resource. Results are promising, but with small effect sizes and study limitations, further research is warranted. A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. New methods to provide exact solutions for some unidirectional motions of rate type fluids

    Directory of Open Access Journals (Sweden)

    Fetecau Corina

    2016-01-01

    Full Text Available Based on three immediate consequences of the governing equations corresponding to some unidirectional motions of rate type fluids, new motion problems are tackled for exact solutions. For generality purposes, exact solutions are developed for shear stress boundary value problems of generalized Burgers fluids. Such solutions, for which the shear stress instead of its differential expressions is given on the boundary, are lack in the literature for such fluids. Consequently, the first exact solutions for motions of rate type fluids induced by an infinite plate or a circular cylinder that applies a constant shear f or an oscillating shear f sin(ωt to the fluid are here presented. In addition, all steady-state solutions can easily be reduced to known solutions for second grade and Newtonian fluids.

  16. Optical devices having flakes suspended in a host fluid to provide a flake/fluid system providing flakes with angularly dependent optical properties in response to an alternating current electric field due to the dielectric properties of the system

    Science.gov (United States)

    Kosc, Tanya Z [Rochester, NY; Marshall, Kenneth L [Rochester, NY; Jacobs, Stephen D [Pittsford, NY

    2006-05-09

    Optical devices utilizing flakes (also called platelets) suspended in a host fluid have optical characteristics, such as reflective properties, which are angular dependent in response to an AC field. The reflectivity may be Bragg-like, and the characteristics are obtained through the use of flakes of liquid crystal material, such as polymer liquid crystal (PLC) materials including polymer cholesteric liquid crystal (PCLC) and polymer nematic liquid crystal (PNLC) material or birefringent polymers (BP). The host fluid may be propylene carbonate, poly(ethylene glycol) or other fluids or fluid mixtures having fluid conductivity to support conductivity in the flake/host system. AC field dependent rotation of 90.degree. can be obtained at rates and field intensities dependent upon the frequency and magnitude of the AC field. The devices are useful in providing displays, polarizers, filters, spatial light modulators and wherever switchable polarizing, reflecting, and transmission properties are desired.

  17. 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...

  18. 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

  19. 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.

  20. Patient-Centred Communication and Provider Avoidance: Does Body Mass Index Modify the Relationship?

    Science.gov (United States)

    Phibbs, Sandi Cleveland; Faith, Jennifer; Thorburn, Sheryl

    2017-01-01

    Objective: Poor quality communication with healthcare providers has been associated with provider avoidance. Because obesity is stigmatised in healthcare settings, this association may differ for patients who are overweight or obese compared to patients who are normal weight. Our objective was to determine if associations between patient-centred…

  1. Please break the silence: Parents' views on communication between pediatric primary care and mental health providers.

    Science.gov (United States)

    Greene, Carolyn A; Ford, Julian D; Ward-Zimmerman, Barbara; Foster, Dana

    2015-06-01

    The purpose of this study was to gain a better understanding of parents' preferences regarding the sharing of information between their children's primary care and mental health providers. Fifty-five parents with a child who was actively engaged in mental health treatment completed an anonymous survey while accompanying their child to either a primary care or mental health clinic appointment. This brief measure elicited parents' experiences with and preferences for treatment coordination across their children's primary care and mental health providers, with a focus on communication practices. Parents consistently described communication among their children's primary care and mental health providers as important, yet frequently reported that such communication was not currently taking place. Further, parents reported that they were often called upon to act as "communication bridges" between professionals caring for their children. Implications for the collaborative pediatric and mental health care of children as well as recommendations for improving communication between mental health and pediatric providers are discussed. (c) 2015 APA, all rights reserved).

  2. Please break the silence: Parents’ views on communication between pediatric primary care and mental health providers

    Science.gov (United States)

    Greene, Carolyn A.; Ford, Julian D.; Ward-Zimmerman, Barbara; Foster, Dana

    2015-01-01

    Introduction The purpose of this study was to gain a better understanding of parents’ preferences regarding the sharing of information between their children's primary care and mental health providers. Methods Fifty-five parents with a child who was actively engaged in mental health treatment completed an anonymous survey while accompanying their child to either a primary care or mental health clinic appointment. This brief measure elicited parents’ experiences with and preferences for treatment coordination across their children's primary care and mental health providers, with a focus on communication practices. Results Parents consistently described communication amongst their children's primary care and mental health providers as important, yet frequently reported that such communication was not currently taking place. Further, parents reported that they were often called upon to act as “communication bridges” between professionals caring for their children. Discussion Implications for the collaborative pediatric and mental health care of children as well as recommendations for improving communication between mental health and pediatric providers are discussed. PMID:25844776

  3. 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.

  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. How live online communication can facilitate collaborative learning by providing a space for shared knowledge construction

    DEFF Research Database (Denmark)

    Kjær, Christopher

    2009-01-01

    to the oral and written communication channels of the system, leaving the students with only the possibility to listen. It is a somewhat limiting view that leads to a superficial use of the system. Furthermore, this view brings with it a very narrow definition of the learning process which becomes an exchange......Fast net connections are rapidly becoming available to people and organizations around the world. At the same time, prices on computers and related equipment is dropping. This has paved the way for web conference systems that provide users with easy access to live online communication but that also...... limited to physical class rooms, but can go global via virtual class rooms that can be created in the available web conference system. Most web conference systems provide presentation functions enabling users to show slides, share files and engage in oral and visual communication with the other...

  6. 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.

  7. Discharge communication practices and healthcare provider and patient preferences, satisfaction and comprehension: A systematic review.

    Science.gov (United States)

    Newnham, Harvey; Barker, Anna; Ritchie, Edward; Hitchcock, Karen; Gibbs, Harry; Holton, Sara

    2017-09-07

    To systematically review the available evidence about hospital discharge communication practices and identify which practices were preferred by patients and healthcare providers, improved patient and provider satisfaction, and increased patients' understanding of their medical condition. OVID Medline, Web of Science, ProQuest, PubMed and CINAHL plus. Databases were searched for peer-reviewed, English-language papers, published to August 2016, of empirical research using quantitative or qualitative methods. Reference lists in the papers meeting inclusion criteria were searched to identify further papers. Of the 3489 articles identified, 30 met inclusion criteria and were reviewed. Much research to date has focused on the use of printed material and person-based discharge communication methods including verbal instructions (either in person or via telephone calls). Several studies have examined the use of information technology (IT) such as computer-generated and video-based discharge communication practices. Utilizing technology to deliver discharge information is preferred by healthcare providers and patients, and improves patients' understanding of their medical condition and discharge instructions. Well-designed IT solutions may improve communication, coordination and retention of information, and lead to improved outcomes for patients, their families, caregivers and primary healthcare providers as well as expediting the task for hospital staff.

  8. Brief Training on Patient Anger Increases Oncology Providers' Self-Efficacy in Communicating With Angry Patients.

    Science.gov (United States)

    Gerhart, James I; Sanchez Varela, Veronica; Burns, John W

    2017-09-01

    Anger is a common reaction to pain and life-limiting and life-threatening illness, is linked to higher levels of pain, and may disrupt communication with medical providers. Anger is understudied compared with other emotions in mental health and health care contexts, and many providers have limited formal training in addressing anger. The objective of this study was to assess if a brief provider training program is a feasible method for increasing providers' self-efficacy in responding to patient anger. Providers working in stem cell transplant and oncology units attending a brief training session on responding to patient anger. The program was informed by cognitive behavioral models of anger and included didactics, discussion, and experiential training on communication and stress management. Provider-rated self-efficacy was significantly higher for nine of 10 skill outcomes (P didactics, and experiential exercises can support provider awareness of anger, shape adaptive communication, and foster stress management skills. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  9. 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....

  10. 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.

  11. Internet use and e-mail communications between patients and providers: a survey of rheumatology outpatients.

    Science.gov (United States)

    Siva, Chokkalingam; Smarr, Karen L; Hanson, Kathleen Donovan; Parikh, Meghal; Lawlor, Kenneth; Ge, Bin

    2008-12-01

    As health care costs rise in the United States and elsewhere, adopting health information technology is being advocated to reduce costs and improve efficiency. Physician e-mail communication is a frequently proposed tool in this strategy. We examined the interest of rheumatology outpatients in using E-mail for communication with their rheumatologist. We sought to identify their privacy and cost concerns on this issue, and examine the patients' demographics, internet usage, and preferences. An anonymous survey was given to 150 consecutive patients. Patients responded to questions on demographics, rheumatic diseases, comorbidities, computer/internet access, E-mail use, privacy concerns, payment issues, and preferences regarding communication with their rheumatologist. Statistical analyses on the relationships between demographics and patient preferences on communications with their rheumatologist were conducted. There were 145 respondents; the mean age was 52.3 years, mean education level was 13.6 years. The sample tended to be women (74%), retired/disabled (46%) or employed full time (35%). Most had internet access (74.5%). Differences were found based on gender, age, education, and income levels. Younger adults were more likely to desire E-mail communication with their rheumatologists, especially if paid by insurance. More men than women had concerns about privacy; persons with higher income levels were more willing to self-pay for E-mail. As a significant number of patients with rheumatic diseases express interest in E-mail communication with their providers, rheumatologists need to be cognizant of patients' preferences. To deliver patient-centered care, rheumatology practices might consider incorporating E-mail communication into their practices.

  12. Interventions to improve child-parent-medical provider communication: A systematic review.

    Science.gov (United States)

    Kodjebacheva, Gergana Damianova; Sabo, Tina; Xiong, Janet

    2016-10-01

    Research related to effective communication between children/parents and medical providers is limited. To review interventions seeking to improve communication between children/parents and medical providers. The inclusion criteria were interventions in peer-reviewed articles and dissertations in English. Because of the limited availability of pediatric communication research, no restrictions were placed on the year, design, and length of follow-up of the interventions. Out of 4163 articles in the CINAHL, Cochrane, EMBASE, ERIC, MEDLINE, and PsycINFO databases, 34 met the inclusion criteria. The design, strategies, measurement tools, results, and conflicts of interest of the interventions were reviewed. Most interventions were conducted in the United States, had a small sample size, and used a pre-posttest design. Fifteen were randomized controlled trials (RCTs). The most frequent intervention strategies were role-playing sessions and seminars for medical providers. Standardized children (i.e., fictitious child patients) were frequently used to help train physicians. Most interventions improved providers' interpersonal, patient-centered interviewing skills. Interventions that targeted parents involved booklets and role-playing to encourage questions. They improved parents' satisfaction and communication. An intervention that targeted youth used a video portraying how children can communicate better with physicians. Once the children aged 5-15 years watched the video, they wrote questions for their physicians prior to the medical visit. The experimental group of children had better rapport with physicians and could recall recommendations about medications more often than the control group. More RCTs involving children as active participants are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Using Publicly Available Data to Characterize Consumers Use of Email to Communicate with Healthcare Providers.

    Science.gov (United States)

    Sandefer, Ryan H; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

    2015-01-01

    The use of patient focused technology has been proclaimed as a means to improve patient satisfaction and improve care outcomes. The Center for Medicaid/Medicare Services, through its EHR Incentive Program, has required eligible hospitals and professionals to send and receive secure messages from patients in order to receive financial incentives and avoid reimbursement penalties. Secure messaging between providers and patients has the potential to improve communication and care outcomes. The purpose of this study was to use National Health Interview Series (NHIS) data to identify the patient characteristics associated with communicating with healthcare providers via email. Individual patient characteristics were analyzed to determine the likelihood of emailing healthcare providers. The use of email for this purpose is associated with educational attainment, having a usual place of receiving healthcare, income, and geography. Publicly available data such as the NHIS may be used to better understand trends in adoption and use of consumer health information technologies.

  14. Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow.

    Science.gov (United States)

    Przybylo, Jennifer A; Wang, Ange; Loftus, Pooja; Evans, Kambria H; Chu, Isabella; Shieh, Lisa

    2014-09-01

    Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure. To determine if augmenting one-way pagers with Medigram, a secure, HIPAA-compliant group messaging (HCGM) application for smartphones, could improve hospital team communication. Eight-week prospective, cluster-randomized, controlled trial Stanford Hospital Three inpatient medicine teams used the HCGM application in addition to paging, while two inpatient medicine teams used paging only for intra-team communication. Baseline and post-study surveys were collected from 22 control and 41 HCGM team members. When compared with paging, HCGM was rated significantly (P applications improve provider perception of in-hospital communication, while providing the information security that paging and commercial cellular networks do not. © 2014 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.

  15. Low income parents' reports of communication problems with health care providers: effects of language and insurance.

    Science.gov (United States)

    Clemans-Cope, Lisa; Kenney, Genevieve

    2007-01-01

    This study examines how parental reports of communication problems with health providers vary over a wider range of characteristics of low income children than considered in previous studies. Data were drawn from the 1999 and 2002 National Survey of America's Families. Communication problems, insurance type, socioeconomic characteristics, health factors, and provider type were examined. Data were analyzed using bivariate and multivariate techniques. Bivariate analysis identified that the parents of 24.4% of low income children and 36.4% of publicly covered low income children with a Spanish interview reported poor communication with health providers. Coefficients from regression analysis suggest that, controlling for covariates, foreign-born parents with a Spanish interview were 11.8 percentage points (pcommunication problems than U.S.-born parents with an English interview. Among low income publicly covered children with a Spanish interview, regression analysis suggests that parents of children who used clinics or hospital outpatient departments as their usual source of care were 9.5 percentage points (pcommunication problems compared with those whose usual source of care was a doctor's or HMO office. Implementing policies to improve communication barriers for low income children, particularly those with foreign-born parents whose native language is not English, may be necessary to reduce health disparities relative to higher income children across a variety of health domains including utilization, satisfaction, and outcomes. Focusing attention on the availability of professional translation services in clinics or hospital outpatient departments may be a cost-effective strategy for reducing communication problems for publicly insured children.

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

    Science.gov (United States)

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

    2017-04-01

    The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. 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.

  18. 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)

  19. 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.

  20. Enhancing patient-provider communication for long-term post-stroke spasticity management.

    Science.gov (United States)

    Sunnerhagen, K S; Francisco, G E

    2013-11-01

    Stroke is a major public health concern, with estimated 16 million people worldwide experiencing first-time strokes each year, a number that is expected to rise. Two-thirds of those experiencing a stroke are younger than 70 years of age. Stroke is a leading cause of disability in adults as a result of major sequelae that include spasticity, cognitive impairment, paresis, and depression. Disabling spasticity, defined as spasticity severe enough to require intervention, occurs in 4% of stroke survivors within 1 year of first-time stroke. The aim of this report is to focus instead on a discussion of patient-provider communication, and its role in post-stroke spasticity (PSS) rehabilitation within the context of patient-centered health care. A discussion based on a review of the literature, mainly since 2000. Problems within communication are identified and suggestion to enhance communication are proposed thus improving patient-centered goal setting/goal achievement for the effective management of spasticity rehabilitation. These are as follows: (i) involving family members, (ii) educating patients and family members on stroke and rehabilitation, and (iii) establishing a common definition for long-term goals. Increased communication among physicians, patients, and payers may bridge some of the gaps and increase the effectiveness of PSS rehabilitation and management. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Communication latencies of wireless devices suitable for time-critical messaging to anesthesia providers.

    Science.gov (United States)

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

    2013-04-01

    Rapid and reliable methods of text communication to mobile anesthesia care providers are important to patient care and to efficient operating room management. Anesthesia departments are implementing automated methods to send text messages to mobile devices for abnormal vital signs, clinical recommendations, quality of care, and compliance or billing issues. The most time-critical communications determine maximum acceptable latencies. We studied the reliability of several alphanumeric messaging systems to identify an appropriate technology for such use. Latencies between message initiation and delivery to 3 alphanumeric paging devices were measured over weeks. Two devices used Internet pathways outside the hospital's local network with an external paging vendor (SkyTel). The third device used only the internal hospital network (Zetron). Sequential cell phone text page latencies were examined for lag-1 autocorrelation using the runs test, with results binned by hour and by day. Message latencies subsequently were batched in successive 1-week bins for calculation of the mean and 99th percentiles of latencies. We defined acceptance criteria as a mean latency communication systems need to measure latencies of proposed communication pathways and devices used to deliver urgent messages to mobile users. Similar evaluation is relevant for text pagers used on an ad hoc basis for delivery of time-critical notifications. Testing over a period of hours to days is adequate only for disqualification of a candidate paging system, because acceptable results are not necessarily indicative of long-term performance. Rather, weeks of testing are required, with appropriate batching of pages for analysis.

  2. 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.

  3. Patient-provider communication in nephrology care for adolescents and young adults.

    Science.gov (United States)

    Coburn, S S; Eakin, M N; Roter, D; Pruette, C; Brady, T; Mendley, S; Tuchman, S; Fivush, B; Riekert, K A

    2017-09-01

    To compare the relative quantity of talk between providers, caregivers, and adolescents and young adults (AYAs) with chronic kidney disease (CKD) and how communication differs by age. During nephrology clinic visits, conversations between AYAs with CKD (N=99, ages 11-20, median=15), their caregivers, and providers (N=19) were audiotaped and coded using the Roter Interaction Analysis System. Linear mixed models tested AYA age differences in talk frequency by AYAs, caregivers, and providers. Post-hoc analyses tested differences in talk using AYA age groups. During clinic visits, providers spoke the most (63.7%), and caregivers spoke more (22.6%) than AYAs (13.7%). Overall talk differed by AYA age in AYAs (p<0.001) and caregivers (p<0.05), but not providers. Higher AYA age was associated with more AYA talk (biomedical information-giving, partnering, rapport-oriented) and less caregiver biomedical information-giving (ps<0.001-0.05). In post-hoc analyses, young adults talked more than adolescents; caregiver talk decreased in the middle-adolescent group. Increases in AYA talk occur primarily in young adulthood, whereas caregiver talk decreases in middle adolescence. This may indicate an appropriate developmental shift but raises concerns about conversational gaps during middle-adolescence. During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication. Copyright © 2017. Published by Elsevier B.V.

  4. Rapid paediatric fluid resuscitation: a randomised controlled trial comparing the efficiency of two provider-endorsed manual paediatric fluid resuscitation techniques in a simulated setting.

    Science.gov (United States)

    Cole, Evan T; Harvey, Greg; Urbanski, Sara; Foster, Gary; Thabane, Lehana; Parker, Melissa J

    2014-07-03

    Manual techniques of intravascular fluid administration are commonly used during paediatric resuscitation, although it is unclear which technique is most efficient in the hands of typical healthcare providers. We compared the rate of fluid administration achieved with the disconnect-reconnect and push-pull manual syringe techniques for paediatric fluid resuscitation in a simulated setting. This study utilised a randomised crossover trial design and enrolled 16 consenting healthcare provider participants from a Canadian paediatric tertiary care centre. The study was conducted in a non-clinical setting using a model simulating a 15 kg child in decompensated shock. Participants administered 900 mL (60 mL/kg) of normal saline to the simulated patient using each of the two techniques under study. The primary outcome was the rate of fluid administration, as determined by two blinded independent video reviewers. We also collected participant demographic data and evaluated other secondary outcomes including total volume administered, number of catheter dislodgements, number of technical errors, and subjective and objective measures of provider fatigue. All 16 participants completed the trial. The mean (SD) rate of fluid administration (mL/s) was greater for the disconnect-reconnect technique at 1.77 (0.145) than it was for the push-pull technique at 1.62 (0.226), with a mean difference of 0.15 (95% CI 0.055 to 0.251; p=0.005). There was no difference in mean volume administered (p=0.778) or participant self-reported fatigue (p=0.736) between techniques. No catheter dislodgement events occurred. The disconnect-reconnect technique allowed for the fastest rate of fluid administration, suggesting that use of this technique may be preferable in situations requiring rapid resuscitation. These findings may help to inform future iterations of paediatric resuscitation guidelines. This trial was registered at ClinicalTrials.gov [NCT01774214] prior to enrolling the first

  5. 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.

  6. 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.

  7. 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.

  8. 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.

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

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    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...... of the written materials found the juxtaposition of biomedical and patient empowerment discourses; these findings form the backdrop to the interviews, which are currently being undertaken. Conclusions: This study not only presents empirical findings on a relatively new, but increasingly used, setting for client...

  10. 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

  11. Real-World Verbal Communication Performance of Children Provided With Cochlear Implants or Hearing Aids.

    Science.gov (United States)

    Meister, Hartmut; Keilmann, Annerose; Leonhard, Katharina; Streicher, Barbara; Müller, Linda; Lang-Roth, Ruth

    2015-07-01

    To compare the real-world verbal communication performance of children provided with cochlear implants (CIs) with their peers with hearing aids (HAs). Cross-sectional study in university tertiary referral centers and at hearing aid dispensers. Verbal communication performance was assessed by the Functioning after Pediatric Cochlear Implantation (FAPCI) instrument. The FAPCI was administered to 38 parents of children using CIs and 62 parents of children with HAs. According to the WHO classification, children with HAs were categorized into three groups (mild-moderate-severe hearing loss). Analysis of variance (ANOVA) was performed on the FAPCI scores, with study group, hearing age (i.e., device experience), and age at hearing intervention as sources of variation. ANOVA showed that hearing age and study group significantly contribute to the FAPCI outcome. In all study groups except the children with mild hearing loss, FAPCI scores increased alongside growing experience with the devices. Children with mild hearing loss using HAs showed higher scores than those with severe hearing loss or implanted children. There were no significant differences between the children with CIs and the children with moderate or severe hearing loss using HAs. Real-world verbal communication abilities of children with CIs are similar to those of children with moderate-to-severe hearing loss using amplification. Because hearing age significantly influences performance, children with moderate-to-severe hearing loss using HAs and implanted children catch up with children with mild hearing loss at a hearing age of approximately 3 years.

  12. eHealth patient-provider communication in the United States: interest, inequalities, and predictors.

    Science.gov (United States)

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

    2017-04-01

    Health-related Internet use and eHealth technologies, including online patient-provider communication (PPC), are continually being integrated into health care environments. This study aimed to describe sociodemographic and health- and Internet-related correlates that influence adult patients' interest in and electronic exchange of medical information with health care providers in the United States. Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey ( N  = 3677) were analyzed. Descriptive statistics and multivariable regression analyses were performed to examine associations between patient-level characteristics and online PPC behavior and interests. Most respondents were Internet users (82.8%), and 61.5% of information seekers designated the Internet as their first source for health information. Younger respondents (Internet users (odds ratio, OR = 2.87, 95% CI, 1.35-6.08), college graduates (OR = 2.92, 95% CI, 1.42-5.99), and those with frequent provider visits (OR = 1.94, 95% CI, 1.02-3.71) had a higher likelihood of online PPC via email or fax, while Hispanics and those from higher-income households were 2-3 times more likely to communicate via text messaging or phone/mobile apps. Patients' interest in and display of online PPC-related behaviors vary by age, race/ethnicity, education, income, Internet access/behaviors, and information type. These findings can inform efforts aimed at improving the use and adoption of eHealth technologies, which may contribute to a reduction in communication inequalities and health care disparities.

  13. 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

    2018-02-23

    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.

  14. Factors Shaping Women's Pre-abortion Communication with Their Regular Gynecologic Care Providers.

    Science.gov (United States)

    Chor, Julie; Tusken, Megan; Lyman, Phoebe; Gilliam, Melissa

    2016-01-01

    To understand women's experiences communicating with their regular gynecologic care provider about abortion decision making before obtaining an abortion at a dedicated abortion clinic. Semistructured interviews were conducted with women presenting for first-trimester surgical abortion at a high-volume, hospital-based abortion clinic. Women were asked whether and why they did or did not discuss their abortion decision with their gynecologic care provider. Interviews were transcribed and computer-assisted content analysis was performed; salient themes are presented. Thirty women who obtained an abortion were interviewed. A majority of the 24 women who had a regular gynecologic care provider did not discuss their decision with that provider. Themes associated with not discussing their decision included: 1) perceiving that the discussion would not be beneficial, 2) expecting that gynecologic care providers do not perform abortions, 3) anticipating or experiencing logistical barriers, and 4) worrying about disrupting the patient-provider relationship. Women who did discuss their decision primarily did so because the pregnancy was diagnosed at the time of a previously scheduled appointment and generally did not believe that their provider performed abortions. For many women, seeking counsel from a regular gynecologic provider before seeking an abortion may not afford a significant benefit. However, some women express concerns with regard to seeking abortion counselling from their regular provider. These concerns underscore the need for gynecologic providers to foster patient-provider relationships that allow women to feel comfortable discussing all aspects of their reproductive health. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Min Lin

    Full Text Available 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.

  16. 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.

  17. Communication during patient-provider encounters regarding diabetes self-management.

    Science.gov (United States)

    Kruse, Robin L; Olsberg, Joshua E; Shigaki, Cheryl L; Parker Oliver, Debra R; Vetter-Smith, Molly J; Day, Tamara M; LeMaster, Joseph W

    2013-01-01

    Diabetes is a common chronic illness with potentially severe complications. The risk of complications is reduced through controlling blood sugar, lipids, and blood pressure. While medical intervention is important, substantial self-management on the part of patients is required to achieve good control. Patients often find self-management difficult, particularly diet and exercise modification. Clinicians face barriers as well, including lack of time, poor reimbursement, and difficulty changing their clinical practice patterns. We hypothesized that a strong focus on readily measured disease indicators competes with patients' agendas relating to symptoms and their day-to-day social context. We recorded clinical encounters to study communication about self-management in context. Recordings were transcribed verbatim and analyzed, primarily using a grounded theory approach. We found that clinicians often focused their communication on quantitative measures such as blood pressure and glycosylated hemoglobin but that patients found it difficult to relate these measures to how they were feeling physically. Patients' social contexts influenced their self-management activities, in particular heavy caregiving responsibilities and work schedules. Supporting self-management of patients with diabetes requires providers to link clinical measurements to patients' symptoms and likely outcomes. It is difficult for providers to know what support or assistance their patients need without knowledge of patients' social contexts.

  18. Relationship between ventricular morphology and aqueductal cerebrospinal fluid flow in healthy and communicating hydrocephalus.

    Science.gov (United States)

    Chiang, William W; Takoudis, Christos G; Lee, Sang H; Weis-McNulty, Annette; Glick, Roberta; Alperin, Noam

    2009-04-01

    Differences in the magnitude of cerebrospinal fluid (CSF) volumetric flow through the cerebral aqueduct between healthy and hydrocephalic patients have been previously reported. However it is not clear whether this is directly related to the pathophysiology or secondary to altered ventricular morphology and hydrodynamics. This work aims to determine the role of anatomic and hydrodynamic factors in modulating the magnitude of CSF flow through the aqueduct. Twenty subjects (10 healthy and 10 patients with communicating hydrocephalus of different causes) were studied by MRI. Scans included T1-weighted 3D anatomic imaging and velocity-encoded cine phase-contrast scans of transcranial blood and CSF flows as well as CSF flow through the aqueduct. Anatomic MR data were used for quantitation of ventricular volumes, third ventricular width, and gray and white brain tissue volumes. Velocity-encoded imaging was used for quantitation of aqueductal and cervical CSF stroke volumes (SV), aqueductal lumen area, and systolic maximal intracranial volume change. Because data from normal and hydrocephalic patients were aggregated, a battery of statistical methods that accounted for the group effects were used. Partial correlation was used to determine which of these parameters were most significantly associated with aqueductal stroke volume (ASV). Multiple linear regression analyses were employed to identify anatomic and hydrodynamic models with the least amount of variables that are significant predictors of ASV. Finally, the association between the magnitude of ASV and the aqueductal lumen area, and its implication on the CSF flow dynamic characteristics and aqueductal pressure difference was established. Using partial correlations, 5 of the 6 anatomic parameters and none of the hydrodynamic parameters and brain tissue volume were found to be statistically significant. The highest partial correlations were with the total ventricular volume (r = 0.838) and third ventricle width (r

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

    National Research Council Canada - National Science Library

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

    2015-01-01

    ...), 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...

  20. 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

  1. Increasing Patient / Provider Communications about Colorectal Cancer Screening In Rural Primary Care Practices

    Science.gov (United States)

    Geller, Berta M.; Skelly, Joan M.; Dorwaldt, Anne L.; Howe, Kathleen D.; Dana, Greg S.; Flynn, Brian S.

    2009-01-01

    Background Rural populations as well as less educated people in the U.S. are less likely to receive colorectal cancer (CRC) screening than people living in urban areas and more educated people. Methods We tested a computer tablet, Patient/Provider Communication Assistant (PPCA), which collected data, educated patients, and printed personalized notes to patients and providers encouraging conversation about CRC screening. Mixed model analyses using a pre-post quasi-experimental design compared patient results during the comparison and intervention periods in 5 rural primary care practices on provider discussion about CRC screening, provider recommendation, and patient intention to be screened. Models including age, education and literacy measures as covariates were examined. Results Providers talked with patients about CRC screening in general, and colonoscopy specifically more frequently after the PPCA than with the comparison group (p values =.04 and .01, respectively). Providers recommended CRC screening more often to patients in the intervention group than to the comparison group (p=.02). Patients planned to be screened and specifically with colonoscopy more frequently following the intervention than in the comparison group (p=.003). There were no interactions between group and any of the covariates. Ninety-five percent of the patients regardless of age or education found the PPCA easy to use. Conclusion Results indicated increased provider discussion and recommendation, and patients' intentions to obtain CRC screening, and in particular colonoscopy, for patients exposed to the intervention, regardless of the patients' age or literacy levels. The PPCA is a promising intervention method that is acceptable to rural patients. PMID:18725831

  2. 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.

  3. If You Could Read My Mind: The Role of Healthcare Providers' Empathic and Communicative Competencies in Clients' Satisfaction with Consultations.

    Science.gov (United States)

    Schrooten, Iete; de Jong, Menno D T

    2017-01-01

    This article investigates the relationship between healthcare providers' empathic and communicative competencies and clients' overall satisfaction with consultations. Two aspects of empathy were included: empathic attitude (sensitivity to the clients' perspective) and empathic skills (ability to estimate clients' evaluations). Communicative competencies were narrowed down to the clarity of the information provided. In the context of work disability examinations, 90 healthcare providers (44% physicians, 56% vocational experts) participated. For each provider, up to 20 dyads with clients were investigated. Within every dyad, clients rated their experiences and healthcare providers estimated clients' scores. The results show that both aspects of empathy and clarity of information significantly contribute to clients' overall satisfaction and as such confirm the importance of empathy and communication in medical consultations. Specifically, healthcare providers' empathic dispositions, in addition to their overt communicative behavior, appear to contribute to clients' overall satisfaction. Of the two aspects of empathy, only empathic attitude is significantly related to the clarity of information.

  4. 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.…

  5. The determinants and outcomes of good provider communication: a cross-sectional study in seven African countries.

    Science.gov (United States)

    Larson, Elysia; Leslie, Hannah H; Kruk, Margaret E

    2017-07-02

    To determine the extent of provider communication, predictors of good communication and the association between provider communication and patient outcomes, such as patient satisfaction, in seven sub-Saharan African countries. Cross-sectional, multicountry study. Data from recent Service Provision Assessment (SPA) surveys from seven countries in sub-Saharan Africa. SPA surveys include assessment of facility inputs and processes as well as interviews with caretakers of sick children. These data included 3898 facilities and 4627 providers. 16 352 caregivers visiting the facility for their sick children. We developed an index of four recommended provider communication items for a sick child assessment based on WHO guidelines. We assessed potential predictors of provider communication and considered whether better provider communication was associated with intent to return to the facility for care. The average score of the composite indicator of provider communication was low, at 35% (SD 26.9). Fifty-four per cent of caregivers reported that they were told the child's diagnosis, and only 10% reported that they were counselled on feeding for the child. Caregivers' educational attainment and provider preservice education and training in integrated management of childhood illness were associated with better communication. Private facilities and facilities with better infrastructure received higher communication scores. Caretakers reporting better communication were significantly more likely to state intent to return to the facility (relative risk: 1.19, 95% CI 1.16 to 1.22). There are major deficiencies in communication during sick child visits. These are associated with lower provider education as well as less well-equipped facilities. Poor communication, in turn, is linked to lower satisfaction and intention to return to facility among caregivers of sick children. Countries should test strategies for enhancing quality of communication in their efforts to improve

  6. 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.

  7. A Mixed Methods Examination of Communication between Oncologists and Primary Care Providers among Primary Care Physicians in Underserved Communities

    Science.gov (United States)

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

    2014-01-01

    Background 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. Methods A mixed methods approach was utilized 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 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, to be contacted via telephone or email, and saw their role as crucial in providing supportive care for their patients. Conclusions Although PCPs recognize that they play a critical, pro-active role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding post-referral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of post-referral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients’ quality of care, particularly in minority communities. PMID:25377382

  8. 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. PMID:25661846

  9. Intravehicular, Short- and Long-Range Communication Information Fusion for Providing Safe Speed Warnings

    Science.gov (United States)

    Jiménez, Felipe; Naranjo, Jose Eugenio; Serradilla, Francisco; Pérez, Elisa; Hernández, María Jose; Ruiz, Trinidad; Anaya, José Javier; Díaz, Alberto

    2016-01-01

    Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers’ behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior. PMID:26805839

  10. Intravehicular, Short- and Long-Range Communication Information Fusion for Providing Safe Speed Warnings

    Directory of Open Access Journals (Sweden)

    Felipe Jiménez

    2016-01-01

    Full Text Available Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS, access to intravehicular information from onboard sensors through the Controller Area Network (CAN bus, vehicle data entry by the driver, access to roadside information (short-range communications and access to a centralized server with information about the road in the current and following sections of the route (long-range communications. Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers’ behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior.

  11. Intravehicular, Short- and Long-Range Communication Information Fusion for Providing Safe Speed Warnings.

    Science.gov (United States)

    Jiménez, Felipe; Naranjo, Jose Eugenio; Serradilla, Francisco; Pérez, Elisa; Hernández, María Jose; Ruiz, Trinidad; Anaya, José Javier; Díaz, Alberto

    2016-01-21

    Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers' behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior.

  12. 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.

  13. [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.

  14. Communication Between Low Income Hispanic Patients and Their Healthcare Providers Regarding Physical Activity and Healthy Eating.

    Science.gov (United States)

    Gauri, Aliyah; Rodriguez, Xeniamaria; Gaona, Patricia; Maestri, Stephanie; Dietz, Noella; Stoutenberg, Mark

    2017-05-20

    U.S. Hispanics disproportionately show health burdens that may be decreased by discussing physical activity (PA) and healthy eating with their healthcare providers (HCPs). We examined the perceptions of both HCPs and low-income Hispanic patients regarding the dynamics of these communications. We surveyed 295 low-income Hispanic patients and interviewed 14 HCPs at three community health clinics. Patients were asked about their comfort level with HCPs, how often their HCP discussed PA and healthy eating, and the likelihood of following advice on PA and healthy eating. HCPs were asked about their delivery (frequency/duration) and perceived effectiveness in providing such advice. Patients reported feeling "most comfortable" with their physicians (57%) with a lower proportion (19%) feeling "most comfortable" with nurses. Nearly all patients (95%) reported being very likely to follow the advice of their physician. On average, HCPs (physicians and nurses) reported discussing PA and healthy eating with 85% and 80% of their patients, respectively. In contrast, a fewer proportion of patients (65.8%) reported that their physician discussed PA and healthy eating "some" or "a lot" of the time. Overall, physicians reported discussing PA and healthy eating for an average of 5 and 6 min, respectively; whereas nurses reported discussing PA and healthy eating for an average of 12 and 19 min, respectively. Further study on the content and delivery of conversations between HCPs and their low-income Hispanic patients regarding PA and healthy eating could be vital to optimally impact health behaviors.

  15. 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 < .001 and r = 0.543, P < .001). The remaining clinics were not significantly correlated but demonstrated a weak positive correlation (r = 0.098, P = .560 and r = 0.069, P = .671). Implementation and increased use of 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.

  16. The absent discourse of communication: understanding ethics of provider-patient relationship in six hospitals in urban India.

    Science.gov (United States)

    Ghoshal, Rakhi; Madhiwalla, Neha; Jesani, Amar; Samant, Padmaja; Badhwar, Vijaya; Surve, Sweta

    2013-01-01

    Understanding the complexities of a provider-patient relationship is considered to be of critical importance especially in medical ethics. It is important to understand this relation from the perspectives of all stakeholders. This article derives from a qualitative study conducted across six obstetric care providing institutions in the cities of Mumbai and Navi Mumbai, India, over a period of 10 months. Thirty obstetricians were interviewed in-depth to understand what they perceived as the most important aspect in developing a good provider-patient relationship. The study found that while most providers highlighted the point of communication as the most critical part of the provider-patient relationship, they admitted that they could not engage in communication with the patients for various reasons. Obstetric consultants and residents said that they were too overburdened to spend time communicating with patients; providers working in public hospitals added that the lack of education of their patients posed a hindrance in effective communication. However, providers practicing in private institutions explained that they faced a challenge in communicating with patients because their patients came from educated families who tended to trust the provider less and were generally more critical of the provider's clinical judgement. The article shows how provider-patient communication exists as an idea among medical providers but is absent in daily clinical practice. This gives rise to a discourse shaped around an absence. The authors conclude by decoding the term 'communication' - they read the word against the context of its use in the interviews, and argue that for the providers 'communication' was not intended to be a trope towards setting up a dialogue-based, egalitarian provider-patient relationship. Providers used the word in lieu of 'counselling', 'guiding', 'talking to'. It concludes that, despite the providers' insisting on the significance of communication and

  17. Patient-Provider Communication About Prostate Cancer Screening and Treatment: New Evidence From the Health Information National Trends Survey.

    Science.gov (United States)

    Bhuyan, Soumitra S; Chandak, Aastha; Gupta, Niodita; Isharwal, Sudhir; LaGrange, Chad; Mahmood, Asos; Gentry, Dan

    2015-11-26

    The American Urological Association, American Cancer Society, and American College of Physicians recommend that patients and providers make a shared decision with respect to prostate-specific antigen (PSA) testing for prostate cancer (PCa). The goal of this study is to determine the extent of patient-provider communication for PSA testing and treatment of PCa and to examine the patient specific factors associated with this communication. Using recent data from the Health Information National Trends Survey, this study examined the association of patient characteristics with four domains of patient-provider communication regarding PSA test and PCa treatment: (1) expert opinion of PSA test, (2) accuracy of PSA test, (3) side effects of PCa treatment, and (4) treatment need of PCa. The current results suggested low level of communication for PSA testing and treatment of PCa across four domains. Less than 10% of the respondents report having communication about all four domains. Patient characteristics like recent medical check-up, regular healthcare provider, global health status, age group, marital status, race, annual household income, and already having undergone a PSA test are associated with patient-provider communication. There are few discussions about PSA testing and PCa treatment options between healthcare providers and their patients, which limits the shared decision-making process for PCa screening and treatment as recommended by the current best practice guidelines. This study helps identify implications for changes in physician practice to adhere with the PSA screening guidelines. © The Author(s) 2015.

  18. Health care provider communicator style and patient comprehension of oral contraceptive use.

    Science.gov (United States)

    Schrader, E L; Schrader, D C

    2001-02-01

    To explore reasons for the incorrect usage of oral contraceptive pills (OCPs) by examining the relationship between patients' abilities to comprehend and/or recall information presented to them by nurse practitioners (NPs) and the communicator style of their NP. A convenience sample of 46 OCP users completed an instrument designed to test their comprehension of OCP use and an instrument designed to measure the communicator style of their NP. A multiple stepwise regression revealed that attentive and friendly communicator styles were positive predictors and the communicator image and dramatic styles were negative predictors of comprehension. Unwanted pregnancies that result from non-compliance with OCP regimens can have significant social and financial effects. A lack of understanding of proper OCP use may depend on the style of communication a NP uses to convey crucial information regarding the regimen.

  19. Professional e-mail communication among health care providers: proposing evidence-based guidelines.

    Science.gov (United States)

    Malka, S Terez; Kessler, Chad S; Abraham, John; Emmet, Thomas W; Wilbur, Lee

    2015-01-01

    E-mail is now a primary method of correspondence in health care, and proficiency with professional e-mail use is a vital skill for physicians. Fundamentals of e-mail courtesy can be derived from lay literature, but there is a dearth of scientific literature that addresses the use of e-mail between physicians. E-mail communication between providers is generally more familiar and casual than other professional interactions, which can promote unprofessional behavior or misunderstanding. Not only e-mail content but also wording, format, and tone may influence clinical recommendations and perceptions of the e-mail sender. In addition, there are serious legal and ethical implications when unprofessional or unsecured e-mails related to patient-identifying information are exchanged or included within an electronic medical record. The authors believe that the appropriate use of e-mail is a vital skill for physicians, with serious legal and ethical ramifications and the potential to affect professional development and patient care. In this article, the authors analyze a comprehensive literature search, explore several facets of e-mail use between physicians, and offer specific recommendations for professional e-mail use.

  20. 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.

  1. Communication architecture for AAL. Supporting patient care by health care providers in AAL-enhanced living quarters.

    Science.gov (United States)

    Nitzsche, T; Thiele, S; Häber, A; Winter, A

    2014-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Concepts of Ambient Assisted Living (AAL) support a long-term health monitoring and further medical and other services for multi-morbid patients with chronic diseases. In Germany many AAL and telemedical applications exist. Synergy effects by common agreements for essential application components and standards are not achieved. It is necessary to define a communication architecture which is based on common definitions of communication scenarios, application components and communication standards. The development of a communication architecture requires different steps. To gain a reference model for the problem area different AAL and telemedicine projects were compared and relevant data elements were generalized. The derived reference model defines standardized communication links. As a result the authors present an approach towards a reference architecture for AAL-communication. The focus of the architecture lays on the communication layer. The necessary application components are identified and a communication based on standards and their extensions is highlighted. The exchange of patient individual events supported by an event classification model, raw and aggregated data from the personal home area over a telemedicine center to health care providers is possible.

  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. 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 oncology providers to have physical activity 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.

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

    Science.gov (United States)

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

    2017-01-01

    Background 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. Objective 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. Methods 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. Results 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

  6. 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…

  7. Strategic Frame Analysis: Providing the "Evidence" for Evidence-Based Communications

    Science.gov (United States)

    Manuel, Tiffany; Davey, Lynn

    2009-01-01

    This article describes the five major phases of research associated with Strategic Frame Analysis, an approach to communications research and practice that advances new ways of pursuing social change of entrenched and complex social problems. This multimethod approach is characterized by multidisciplinary and iterative research techniques that…

  8. 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…

  9. 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

  10. Development of a Web-based educational intervention to improve cross-cultural communication among hospice providers.

    Science.gov (United States)

    Doorenbos, Ardith Z; Lindhorst, Taryn; Schim, Stephanie Myers; Van Schaik, Eileen; Demiris, George; Wechkin, Hope A; Curtis, J Randall

    2010-01-01

    In this article, the authors describe the theoretical foundation, development, and content of a Web-based educational intervention to improve cross-cultural communication about end-of-life concerns and report on the preliminary evaluation of this intervention using a qualitative study design. The data were collected with non-structured questions in a convenience sample of 21 hospice providers. Participants reported that they found the training appropriate and useful. Participants also reported finding the online delivery convenient and the interactive format valuable. Improving the quality of cross-cultural patient-provider communication can contribute to reducing disparities at end-of-life.

  11. 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

  12. A survey of scientific literacy to provide a foundation for designing science communication in Japan.

    Science.gov (United States)

    Kawamoto, Shishin; Nakayama, Minoru; Saijo, Miki

    2013-08-01

    There are various definitions and survey methods for scientific literacy. Taking into consideration the contemporary significance of scientific literacy, we have defined it with an emphasis on its social aspects. To acquire the insights needed to design a form of science communication that will enhance the scientific literacy of each individual, we conducted a large-scale random survey within Japan of individuals older than 18 years, using a printed questionnaire. The data thus acquired were analyzed using factor analysis and cluster analysis to create a 3-factor/4-cluster model of people's interest and attitude toward science, technology and society and their resulting tendencies. Differences were found among the four clusters in terms of the three factors: scientific factor, social factor, and science-appreciating factor. We propose a plan for designing a form of science communication that is appropriate to this current status of scientific literacy in Japan.

  13. Nurses as information providers: facilitating understanding and communication of statistical information.

    Science.gov (United States)

    Hanoch, Yaniv; Pachur, Thorsten

    2004-04-01

    Nurses are increasingly being called upon to be the conveyers of important statistical information to patients. This trend is particularly evident in the domains of genetics and cancer screening. These new roles, however, demand new competencies, such as the ability to solve statistical problems, and the skill to communicate the answers effectively, as effective communication is an important ingredient in shared decision making. Genetic testing, perhaps more than other medical domains, relies heavily on the use of statistics. Being able to convey statistical information effectively is vital. In this paper, we illustrate the problems health care professionals have had in tackling and communicating statistical information. We introduce the natural frequencies method of solving Bayesian inference problems and review empirical evidence that shows the superiority of this format. Being able to transform probabilities into natural frequencies facilitates correct Bayesian inferences. It is argued that the conventional approach to educating nurses in Bayesian problem solving should be reconsidered and their statistical curriculum should be supplemented with instruction in using the natural frequency format.

  14. 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.

  15. Frequency of high-quality communication behaviors used by primary care providers of heterozygous infants after newborn screening.

    Science.gov (United States)

    Farrell, Michael H; Christopher, Stephanie A

    2013-02-01

    To examine the quality of communication likely to be experienced by parents when being first informed about how newborn screening identified heterozygous "carrier" status for cystic fibrosis or sickle cell disease. Primary care providers (PCPs) of infants found to have carrier status were telephoned over a 48-month period, and asked to rehearse with a standardized patient how they would inform the infants' parent(s). 214 rehearsal transcripts were abstracted using explicit criteria methods to measure the frequency of five categories of high-quality communication behaviors. Overall, PCPs used large amounts of jargon and failed to use high quality communication behaviors. On average, PCPs used 18.6 total jargon words (8.7 unique words), but explained 2.4 jargon words. The most frequent assessment of understanding was the close-ended version, although it was only seen in 129 of 214 transcripts. The most common organizing behavior was importance emphasis (121/214). Precautionary empathy was rare; the most frequent behavior was "instruction about emotion" (33/214). The limited use of high-quality communication behaviors in rehearsals raises concern about parental understanding, decision-making, and psychosocial outcomes after newborn screening. Measurement of specific behaviors may help PCPs to improve communication, and thereby improve the patient experience. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. 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

    2013-12-01

    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 self-reported data. The aim of the study was to develop and assess the effectiveness of a training program for clinical supervisors on how to give feedback on residents' CS in clinical practice. The authors designed a pretest-posttest controlled study in which clinical supervisors working in two different medical services were invited to attend a sequenced and multifaceted program in teaching CS over a period of 6-9 months. Outcome measures were self-perceived and observed feedback skills collected during questionnaires and three videotaped objective structured teaching encounters. The videotaped feedbacks made by the supervisors were analysed using a 20-item feedback rating instrument. Forty-eight clinical supervisors participated (28 in the intervention, 20 in the control group). After training, a higher percentage of trained participants self-reported and demonstrated statistically significant improvement in making residents more active by exploring residents' needs, stimulating self-assessment, and using role playing to test strategies and checking understanding, with effect sizes ranging from 0.93 to 4.94. A training program on how to give feedback on residents' communication skills was successful in improving clinical supervisors' feedback skills and in helping them operate a shift from a teacher-centered to a more learner-centered approach.

  17. 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

  18. Characterizing providers' immunization communication practices during health supervision visits with vaccine-hesitant parents: a pilot study.

    Science.gov (United States)

    Opel, Douglas J; Robinson, Jeffrey D; Heritage, John; Korfiatis, Carolyn; Taylor, James A; Mangione-Smith, Rita

    2012-02-08

    To determine the feasibility of using direct observation of provider-parent immunization discussions and to characterize provider communication practices with vaccine-hesitant parents. Over a 6 month period in 2010, we videotaped immunization discussions between pediatric providers and vaccine-hesitant parents during health supervision visits involving children 2-15 months old (N=24) in the Seattle area, Washington, USA. Videotapes were analyzed using the qualitative method of conversation analysis. We approached 96 parents seen by 9 different providers. Of those who were eligible (N=56), we enrolled 43% (N=24). Four videotaped visits were excluded from analysis for failure to obtain parental HIPAA authorization. Of the remaining 20 visits, there were ≥2 visits each that involved children aged 2, 4, 6, 9, 12, and 15 months, and all videotaped visits contained at least a brief immunization discussion. We identified 6 communication practices and several behavior types within each practice relevant to immunization: Practice 1, providers' initiations of the topic of vaccination; Types: participatory or presumptive format; Practice 2, parents' responses to providers' topic initiations; Types: strong or weak acceptance or resistance; Practice 3, providers' follow-ups to parent's responses; Types: no, immediate, or delayed pursuit; Practice 4, parents' vaccine-related questions or statements; Types: fact- or concern-based; Practice 5, providers' explicit solicitations of parent's questions/concerns; Types: designed to discourage or encourage discussion; and Practice 6, parents' responses to providers' solicitations of questions/concerns; Types: no question or fact- or concern-based inquiry. Direct observation of immunization discussions in the primary care pediatric setting is feasible and yields insight into several provider-parent immunization communication practices that are worthy of further study to determine which are effective at improving parental acceptance of

  19. The morphology and biochemistry of nanostructures provide evidence for synthesis and signaling functions in human cerebrospinal fluid

    Directory of Open Access Journals (Sweden)

    Chavez Jesus N

    2009-09-01

    Full Text Available Abstract Background Cerebrospinal fluid (CSF contacts many brain regions and may mediate humoral signaling distinct from synaptic neurotransmission. However, synthesis and transport mechanisms for such signaling are not defined. The purpose of this study was to investigate whether human CSF contains discrete structures that may enable the regulation of humoral transmission. Methods Lumbar CSF was collected prospectively from 17 participants: with no neurological or psychiatric disease, with Alzheimer's disease, multiple sclerosis, or migraine; and ventricular CSF from two cognitively healthy participants with long-standing shunts for congenital hydrocephalus. Cell-free CSF was subjected to ultracentrifugation to yield supernatants and pellets that were examined by transmission electron microscopy, shotgun protein sequencing, electrophoresis, western blotting, lipid analysis, enzymatic activity assay, and immuno-electron microscopy. Results Over 3,600 CSF proteins were identified from repeated shotgun sequencing of cell-free CSF from two individuals with Alzheimer's disease: 25% of these proteins are normally present in membranes. Abundant nanometer-scaled structures were observed in ultracentrifuged pellets of CSF from all 16 participants examined. The most common structures included synaptic vesicle and exosome components in 30-200 nm spheres and irregular blobs. Much less abundant nanostructures were present that derived from cellular debris. Nanostructure fractions had a unique composition compared to CSF supernatant, richer in omega-3 and phosphoinositide lipids, active prostanoid enzymes, and fibronectin. Conclusion Unique morphology and biochemistry features of abundant and discrete membrane-bound CSF nanostructures are described. Prostaglandin H synthase activity, essential for prostanoid production and previously unknown in CSF, is localized to nanospheres. Considering CSF bulk flow and its circulatory dynamics, we propose that these

  20. Infilling Direction and Fluid Communication in the E2.0 Reservoir of ...

    African Journals Online (AJOL)

    In addition, the use of the interparaffins from the GC fingerprints for correlating the oils indicates a significant degree of communication between the oils thereby ruling out any significant in-reservoir barrier. ... Keywords: Kolo Creek, reservoir geochemistry, reservoir continuity, Niger Delta, petroleum migration, biomarkers.

  1. 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.

  2. 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.

  3. Evaluation of the flow of cerebrospinal fluid as well as gender and age characteristics in patients with communicating hydrocephalus, using phase-contrast magnetic resonance imaging.

    Science.gov (United States)

    Bogomyakova, Olga; Stankevich, Yu; Mesropyan, N; Shaybman, L; Tulupov, A

    2016-12-01

    To determine the difference in the velocity parameters of cerebrospinal fluid flow in patients with varying severity of communicating hydrocephalus compared to a group of healthy volunteers without hydrodynamic disorders. The study involved 35 subjects with communicating hydrocephalus (25 subjects with Evans index of 0.31; 10 subject with Evans index of 0.46) and 62 healthy volunteers. The mean, volume, and peak flow velocities were determined at the different intracranial levels. Also were made an assessment of gender and age differences. Analysis of the differences between the mean values showed the progressive inhibition of cerebrospinal fluid outflow from the cranial cavity [in moderate communicating hydrocephalus-at 1.5 times (p fluid flow (F = 5.3303, p = 0.0003, for mean velocity).

  4. 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.

  5. 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 (pscommunicating 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. 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

  6. Reducing Disaster Exacerbated Non-Communicable Diseases Through Public Health Infrastructure Resilience: Perspectives of Australian Disaster Service Providers.

    Science.gov (United States)

    Ryan, Benjamin J; Franklin, Richard C; Burkle, Frederick M; Aitken, Peter; Smith, Erin; Watt, Kerrianne; Leggat, Peter

    2016-12-21

    The exposure of people and infrastructure to flood and storm related disasters across the world is increasing faster than vulnerability is decreasing. For people with non-communicable diseases this presents a significant risk as traditionally the focus of disaster management systems has been on immediate trauma and communicable diseases. This focus must now be expanded to include the management of non-communicable diseases because these conditions are generating the bulk of ill health, disability and premature death around the globe. When public health service infrastructure is destroyed or damaged access to treatment and care is severely jeopardised, resulting in an increased risk of non-communicable disease exacerbation or even death. This research proposes disaster responders, coordinators and government officials are vital assets to mitigate and eventually prevent these problems from being exacerbated during a disaster. This is due to their role in supporting the public health service infrastructure required to maximise treatment and care for people with non-communicable diseases. By focusing on the disaster cycle as a template, and on mitigation and prevention phases in particular, these actions and activities performed by disaster service responders will lead to overall improved preparedness, response, recovery and rehabilitation phases. Data were collected via 32 interviews and one focus group (eight participants) between March 2014 and August 2015 (total of 40 participants). The research was conducted in the State of Queensland, Australia, with disaster service providers. The analysis included the phases of: organizing data; data description; data classification; and interpretation. The research found a relationship between the impact of a disaster on public health service infrastructure, and increased health risks for people with non-communicable diseases. Mitigation strategies were described for all phases of the disaster cycle impacting public health

  7. Use of Healthcare Services by Patients with Non-Communicable Diseases in Nepal: A Qualitative Study with Healthcare Providers.

    Science.gov (United States)

    Khanal, Saval; Veerman, Lennert; Nissen, Lisa; Hollingworth, Samantha

    2017-06-01

    The healthcare systems in many Low-and Middle-Income Countries (LMICs) like Nepal have long focused on preventing and treating infectious diseases. Little is known about their preparedness to address the increasing prevalence of Non-Communicable Diseases (NCDs). This study aimed to investigate the use of healthcare services by patients with NCDs in Nepal. Nine healthcare providers (including health assistants, pharmacy assistants, nurse, specialised nurse, practicing pharmacists, chief hospital pharmacist, doctors and specialised doctor) from Pokhara, Nepal, were recruited using purposive sampling. In depth interviews about the magnitude of NCDs, first point of care, screening and diagnosis, prevention and management, follow-up, and healthcare system responses to NCD burden were conducted. Data were thematically analysed with a deductive approach. Although the healthcare system in Nepal is still primarily focused on communicable infectious diseases, healthcare providers are aware of the increasing burden of NCDs and NCD risk factors. The first points of care for patients with NCDs are government primary healthcare facilities and private pharmacies. NCDs are often diagnosed late and opportunistically. NCD prevention and treatment is unaffordable for many people. There are no government sponsored NCD screening programs. There are problems associated with screening, diagnosis, treatment and follow-up of patients with NCDs in Nepal. Healthcare providers believe that the current healthcare system in Nepal is inadequate to address the growing problem of NCDs. The health system of Nepal will face challenges to incorporate programs to prevent and treat NCDs in addition to the pre-existing communicable diseases.

  8. Communication

    NARCIS (Netherlands)

    Sigafoos, J.; Lancioni, G.E.; O’Reilly, M.F.; Lang, R.; Singh, N.N.; Didden, H.C.M.; Green, V.A.; Marschik, P.B.

    2016-01-01

    Communication disorders are common among people with intellectual disabilities. Consequently, enhancing the communication skills of such individuals is a major intervention priority. This chapter reviews the nature and prevalence of the speech, language, and communication problems associated with

  9. Cancer as a problem to be solved: internet use and provider communication by men with cancer.

    Science.gov (United States)

    Dickerson, Suzanne S; Reinhart, Amber; Boemhke, Marcia; Akhu-Zaheya, Laila

    2011-07-01

    Increasingly, cancer-related Web sites have been developed to provide information for patients. More needs to be done to understand the experience of men with cancer using the Internet. Heideggerian hermeneutics is the interpretive approach used to guide this study. Fifteen men with cancer who used the Internet were recruited through a prostate cancer support group and snowball sampling. Participants were individually interviewed and asked to tell stories of Internet use and practices. Transcribed interviews provided data for interpretive analysis. The overall constitutive pattern describing the men's experience is "cancer diagnosis as a problem to be solved." Five related themes included (1) seeking disease and treatments information from the Internet for decision making, to become comfortable with treatment plan; (2) organizing information to facilitate provider encounters and to monitor for reoccurrence; (3) evaluating Web information by credibility and usability with trust in the physician influencing the end decision point; (4) symptom management by knowing possibilities by hearing patient stories; and (5) navigating through the healthcare system politics and power. Men with cancer are incorporating Internet use into their cancer journey. They perceive changing provider-patient relationships when they participate in treatment decisions and monitor for reoccurrence.

  10. Maintaining Long-Distance Friendships: Communication Practices for Seeking and Providing Social Support across Geographic Divides

    Science.gov (United States)

    Lobburi, Patipan

    2012-01-01

    People seek and provide support through their personal social network, especially when they must cope with stress, deal with an emergency, or need help. Coping with a new culture or new environment is a stressful situation that sojourner students must face. Support through friendship plays an important role in facing such new situations. Focusing…

  11. Real-time video communication improves provider performance in a simulated neonatal resuscitation.

    Science.gov (United States)

    Fang, Jennifer L; Carey, William A; Lang, Tara R; Lohse, Christine M; Colby, Christopher E

    2014-11-01

    To determine if a real-time audiovisual link with a neonatologist, termed video-assisted resuscitation or VAR, improves provider performance during a simulated neonatal resuscitation scenario. Using high-fidelity simulation, 46 study participants were presented with a neonatal resuscitation scenario. The control group performed independently, while the intervention group utilized VAR. Time to effective ventilation was compared using Wilcoxon rank sum tests. Providers' use of the corrective steps for ineffective ventilation per the NRP algorithm was compared using Cochran-Armitage trend tests. The time needed to establish effective ventilation was significantly reduced in the intervention group when compared to the control group (mean time 2 min 42 s versus 4 min 11 s, presuscitation scenario significantly reduces the time to establish effective ventilation and improves provider adherence to NRP guidelines. This technology may be a means for regional centers to support local providers during a neonatal emergency to improve patient safety and improve neonatal outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. 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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    is done according to a fixed probability. However, this configuration may be not appropriate to meet the 10 milliseconds control plane latency target defined for the next 5th generation (5G) system. In this work, we propose a distributed radio resource management framework supporting full duplex...... 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...... 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....

  14. Atypical birdsong and artificial languages provide insights into how communication systems are shaped by learning, use, and transmission.

    Science.gov (United States)

    Fehér, Olga

    2017-02-01

    In this article, I argue that a comparative approach focusing on the cognitive capacities and behavioral mechanisms that underlie vocal learning in songbirds and humans can provide valuable insights into the evolutionary origins of language. The experimental approaches I discuss use abnormal song and atypical linguistic input to study the processes of individual learning, social interaction, and cultural transmission. Atypical input places increased learning and communicative pressure on learners, so exploring how they respond to this type of input provides a particularly clear picture of the biases and constraints at work during learning and use. Furthermore, simulating the cultural transmission of these unnatural communication systems in the laboratory informs us about how learning and social biases influence the structure of communication systems in the long run. Findings based on these methods suggest fundamental similarities in the basic social-cognitive mechanisms underlying vocal learning in birds and humans, and continuing research promises insights into the uniquely human mechanisms and into how human cognition and social behavior interact, and ultimately impact on the evolution of language.

  15. Examining the association between patient-centered communication and provider avoidance, CAM use, and CAM-use disclosure.

    Science.gov (United States)

    Faith, Jennifer; Thorburn, Sheryl; Tippens, Kimberly M

    2015-01-01

    Patients' perceptions of the quality of their relationships with health care providers may influence their health care-seeking behaviors and future interactions with providers, including use of conventional health care, use of complementary and alternative medicine (CAM), and disclosure of CAM use. The study examined the associations between perceived patient-centered communication and provider avoidance, CAM use, and CAM-use disclosure. This study used cross-sectional survey data from the Health Information National Trends Survey (HINTS) 3, a nationally representative survey of US adults collected between January 2008 and May 2008. Two questions asked about CAM use and CAM-use disclosure, and another asked about avoidance of doctors. For the independent variable, responses from 6 questions on patient-centered communication were averaged to create a scale score ranging from 1-4. The research team conducted multiple logistic regressions of the 3 primary outcome measures, adjusting for sociodemographic characteristics, presence or absence of a regular source of care, insurance status, frequency of visits to providers, and health status. All analyses were weighted to make the results representative of the US population aged ≥18 y. Approximately one-third of respondents (36%) had avoided seeing their doctors within the 12 mo prior to the survey. Approximately 24% had used CAM within the prior 12 mo, and 51.7% of CAM users had discussed their CAM use with their doctors. Higher levels of patient-centered communication were significantly associated with lower odds of provider avoidance (AOR=0.63; 95% CI=0.52, 0.76) and CAM use (AOR=0.60; 95% CI=0.46, 0.78) but were not associated with CAM-use disclosure. Findings suggest that patients may be more likely to avoid seeing their doctors and more likely to use CAM when they perceive low levels of patient-centered communication. Further research to understand the role of the characteristics of patient-provider relationships

  16. 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.

  17. MicroRNAs transported by exosomes in body fluids as mediators of intercellular communication in cancer

    Directory of Open Access Journals (Sweden)

    Salido-Guadarrama I

    2014-07-01

    Full Text Available Iván Salido-Guadarrama,1 Sandra Romero-Cordoba,1 Oscar Peralta-Zaragoza,2 Alfredo Hidalgo-Miranda,1 Mauricio Rodríguez-Dorantes1 1Oncogenomics Laboratory, National Institute of Genomics Medicine, Mexico City, Mexico; 2Direction of Chronic Infections and Cancer, Research Center in Infectious Diseases, National Institute of Public Health, Cuernavaca, Morelos, Mexico Abstract: Cancer-cell communication is an important and complex process, achieved through a diversity of mechanisms that allows tumor cells to mold and influence their environment. In recent years, evidence has accumulated indicating that cells communicate via the release and delivery of microRNAs (miRNAs packed into tumor-released (TR exosomes. Understanding the role and mode of action of miRNAs from TR exosomes is of paramount importance in the field of cancer biomarker discovery and for the development of new biomedical applications for cancer therapeutics. In this review, we focus on miRNAs secreted via TR exosomes, which by acting in a paracrine or endocrine manner, facilitate a diversity of signaling mechanisms between cancer cells. We address their contribution as signaling molecules, to the establishment, maintenance, and enhancement of the tumor microenvironment and the metastatic niche in cancer. Finally, we address the potential role of these molecules as biomarkers in cancer diagnosis and prognosis and their impact as a biomedical tool in cancer therapeutics. Keywords: tumor cells, multivesicular bodies, interference RNA, biomarkers and therapeutics

  18. 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'sfamily 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.

  19. 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

  20. 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

  1. 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

    2015-01-01

    Objective 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. Methods 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. Results 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 inpatient-centeredness. PCPs controlled more of the talk time in the visits that also had longer periods of mutual silence. Conclusions 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

  2. Patients' reported reasons for non-use of an internet-based patient-provider communication service: qualitative interview study.

    Science.gov (United States)

    Varsi, Cecilie; Gammon, Deede; Wibe, Torunn; Ruland, Cornelia M

    2013-11-11

    The adoption of Internet-based patient-provider communication services (IPPC) in health care has been slow. Patients want electronic communication, and the quality of health care can be improved by offering such IPPCs. However, the rate of enrollment in such services remains low, and the reasons for this are unclear. Knowledge about the barriers to use is valuable during implementation of IPPCs in the health care services, and it can help timing, targeting, and tailoring IPPCs to different groups of patients. The goal of our study was to investigate patients' views of an IPPC that they could use from home to pose questions to nurses and physicians at their treatment facility, and their reported reasons for non-use of the service. This qualitative study was based on individual interviews with 22 patients who signed up for, but did not use, the IPPC. Patients appreciated the availability and the possibility of using the IPPC as needed, even if they did not use it. Their reported reasons for not using the IPPC fell into three main categories: (1) they felt that they did not need the IPPC and had sufficient access to information elsewhere, (2) they preferred other types of communication such as telephone or face-to-face contact, or (3) they were hindered by IPPC attributes such as login problems. Patients were satisfied with having the opportunity to send messages to health care providers through an IPPC, even if they did not use the service. IPPCs should be offered to the patients at an appropriate time in the illness trajectory, both when they need the service and when they are receptive to information about the service. A live demonstration of the IPPC at the point of enrollment might have increased its use. ClinicalTrials.gov NCT00971139; http://clinicaltrial.gov/ct2/show/NCT00971139 (Archived by WebCite at http://www.webcitation.org/6KlOiYJrW).

  3. 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

    2017-11-28

    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.

  4. Health care provider communication training in rural Tanzania empowers HIV-infected patients on antiretroviral therapy to discuss adherence problems.

    Science.gov (United States)

    Erb, S; Letang, E; Glass, T R; Natamatungiro, A; Mnzava, D; Mapesi, H; Haschke, M; Duthaler, U; Berger, B; Muri, L; Bader, J; Marzolini, C; Elzi, L; Klimkait, T; Langewitz, W; Battegay, M

    2017-10-01

    Self-reported adherence assessment in HIV-infected patients on antiretroviral therapy (ART) is challenging and may overestimate adherence. The aim of this study was to improve the ability of health care providers to elicit patients' reports of nonadherence using a "patient-centred" approach in a rural sub-Saharan African setting. A prospective interventional cohort study of HIV-infected patients on ART for ≥ 6 months attending an HIV clinic in rural Tanzania was carried out. The intervention consisted of a 2-day workshop for health care providers on patient-centred communication and the provision of an adherence assessment checklist for use in the consultations. Patients' self-reports of nonadherence (≥ 1 missed ART dose/4 weeks), subtherapeutic plasma ART concentrations (communication can successfully be implemented with a simple intervention in rural Africa. It increases the likelihood of HIV-infected patients reporting problems with adherence to ART; however, sustainability remains a challenge. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  5. 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

  6. 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

  7. Physicians cite hurdles ranging from lack of coverage to poor communication in providing high-quality care to latinos.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Chen, Jie

    2011-10-01

    We surveyed physicians about their ability to provide high-quality care to patients from diverse ethnic backgrounds. Primarily, we wanted to explore the challenges faced by physicians treating Latino patients compared to physicians whose patients were primarily white and non-Latino. We found that physicians treating Latinos, particularly those who worked in primary care in comparison to specialists, were less likely than physicians treating primarily white patients to believe in their ability to provide high-quality care. They cited problems of inadequate time with patients, patients' ability to pay, patients' nonadherence to recommended treatment, difficulties communicating with patients, relative lack of specialist availability, and lack of timely transmission of reports among physicians. Insurance expansions and complementary reforms mandated by the Affordable Care Act of 2010 and other recent legislation should aid physicians in closing some of these gaps in quality.

  8. Communication.

    Science.gov (United States)

    Hancock, Alan

    An informal introduction to the study of communication deals with the major topics in the field. It presents basic theories of communication and language, reviews how language takes on meaning, explains the stimulus-response and Piaget theories of learning, and presents major theories dealing with communications and society. These theories include…

  9. 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

  10. The Hispanic Clinic for Pediatric Surgery: A model to improve parent-provider communication for Hispanic pediatric surgery patients.

    Science.gov (United States)

    Jaramillo, Joshua; Snyder, Elizabeth; Dunlap, Jonathan L; Wright, Robert; Mendoza, Fernando; Bruzoni, Matias

    2016-04-01

    26 million Americans have limited English proficiency (LEP). It is well established that language barriers adversely affect health and health care. Despite growing awareness of language barriers, there is essentially a void in the medical literature regarding the influence of language disparity on pediatric surgery patients. This study was designed to assess the impact of patient-provider language concordance on question-asking behavior and patient satisfaction for pediatric surgery patients. Participants included families of patients in a General Pediatric Surgery Clinic categorized into 3 groups by patient-provider language concordance: concordant English-speaking, LEP concordant Spanish-speaking, and LEP discordant Spanish-speaking using an interpreter. Clinical visits were audio recorded and the number of patient-initiated questions and the length of clinical encounter were measured. Families were administered a surgery-specific, 5-point Likert scale questionnaire modeled after validated surveys concerning communication, trust, perceived discrimination and patient-provider language concordance. Regression models were performed to analyze associations between language concordance and patient's question-asking behavior and between language concordance and survey results. A total of 156 participants were enrolled including 57 concordant-English, 52 LEP concordant-Spanish and 47 LEP-discordant-Spanish. There was significant variation in the mean number of patient-initiated questions among the groups (p=0.002). Both the English and Spanish concordant groups asked a similar number of questions (p=0.9), and they both asked more questions compared to the Spanish-discordant participants (p=0.002 and p=0.001). Language discordance was associated with fewer questions asked after adjustment for socioeconomic status. Language concordant participants rated higher scores of communication. Both Spanish-concordant and Spanish-discordant patients reported significantly increased

  11. Impact of a health education tool on enhancing communication between health providers and parents of neonates in intensive care in Egypt

    Directory of Open Access Journals (Sweden)

    Mohamed S. Hesham

    2016-07-01

    Conclusion: Providing sufficient information and increasing awareness of parents about the NICU in the form of a written guide is an effective way of improving communication between healthcare providers and parents.

  12. Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

    Science.gov (United States)

    Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H

    2013-01-01

    Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide

  13. Provider connectedness and communication patterns: extending continuity of care in the context of the circle of care.

    Science.gov (United States)

    Price, Morgan; Lau, Francis Y

    2013-08-14

    Continuity is an important aspect of quality of care, especially for complex patients in the community. We explored provider perceptions of continuity through a system's lens. The circle of care was used as the system. Soft systems methodology was used to understand and improve continuity for end of life patients in two communities. Physicians, nurses, pharmacists in two communities in British Columbia, involved in end of life care. Two debates/discussion groups were completed after the interviews and initial analysis to confirm findings. Interview recordings were qualitatively analyzed to extract components and enablers of continuity. 32 provider interviews were completed. Findings from this study support the three types of continuity described by Haggerty and Reid (information, management, and relationship continuity). This work extends their model by adding features of the circle of care that influence and enable continuity: Provider Connectedness the sense of knowing and trust between providers who share care of a patient; a set of ten communication patterns that are used to support continuity across the circle of care; and environmental factors outside the circle that can indirectly influence continuity. We present an extended model of continuity of care. The components in the model can support health planners consider how health care is organized to promote continuity and by researchers when considering future continuity research.

  14. Providers caring for adolescents with perinatally-acquired HIV: Current practices and barriers to communication about sexual and reproductive health.

    Science.gov (United States)

    Albright, Jamie N; Fair, Cynthia D

    2014-11-01

    The population of adolescents and young adults (AYA) with perinatally-acquired HIV (PHIV) present challenges to HIV healthcare providers (HHCPs). Originally not expected to survive childhood, they are now living well into young adulthood. Little is known about the type of sexual and reproductive (SRH) information/services offered to AYA with PHIV by HHCPs. HHCPs (n=67) were recruited using snowball sampling, and completed an online survey. Providers' most frequently endorsed SRH topics discussed with both male and female patients included condom use (77.3%), STD prevention (73.1%), and screening (62.1%). Providers' reports indicated that females received significantly more education about SRH topics overall. The most frequently noted barriers to SRH communication included more pressing health concerns (53.0%), parent/guardian not receptive (43.9%), and lack of time during appointment (43.9%). Provider-reported SRH conversations with HHCPs were highly focused on horizontal transmission and pregnancy prevention. Salient social aspects of SRH promotion for AYAs with PHIV (e.g., managing disclosure and romantic relationships) were less commonly discussed, though such conversations may serve to reduce secondary transmission and enhance the overall well-being of AYA with PHIV. Findings indicated that further work must be done to identify strategies to address unmet SRH needs of the aging population of AYA with PHIV.

  15. Patients’ Reported Reasons for Non-Use of an Internet-Based Patient-Provider Communication Service: Qualitative Interview Study

    Science.gov (United States)

    Gammon, Deede; Wibe, Torunn; Ruland, Cornelia M

    2013-01-01

    Background The adoption of Internet-based patient–provider communication services (IPPC) in health care has been slow. Patients want electronic communication, and the quality of health care can be improved by offering such IPPCs. However, the rate of enrollment in such services remains low, and the reasons for this are unclear. Knowledge about the barriers to use is valuable during implementation of IPPCs in the health care services, and it can help timing, targeting, and tailoring IPPCs to different groups of patients. Objective The goal of our study was to investigate patients’ views of an IPPC that they could use from home to pose questions to nurses and physicians at their treatment facility, and their reported reasons for non-use of the service. Methods This qualitative study was based on individual interviews with 22 patients who signed up for, but did not use, the IPPC. Results Patients appreciated the availability and the possibility of using the IPPC as needed, even if they did not use it. Their reported reasons for not using the IPPC fell into three main categories: (1) they felt that they did not need the IPPC and had sufficient access to information elsewhere, (2) they preferred other types of communication such as telephone or face-to-face contact, or (3) they were hindered by IPPC attributes such as login problems. Conclusions Patients were satisfied with having the opportunity to send messages to health care providers through an IPPC, even if they did not use the service. IPPCs should be offered to the patients at an appropriate time in the illness trajectory, both when they need the service and when they are receptive to information about the service. A live demonstration of the IPPC at the point of enrollment might have increased its use. Trial Registration ClinicalTrials.gov NCT00971139; http://clinicaltrial.gov/ct2/show/NCT00971139 (Archived by WebCite at http://www.webcitation.org/6KlOiYJrW). PMID:24220233

  16. Communicating.

    Science.gov (United States)

    Coursen, David

    Chapter 8 in a volume on school leadership, this chapter is a revised version of "Communications in the Open Organization." It offers suggestions from a number of authorities for administrators who want to learn how to communicate more effectively with a variety of groups within and outside the school. It begins by explaining the human…

  17. Communication.

    Science.gov (United States)

    Online-Offline, 1998

    1998-01-01

    This theme issue on communication includes annotated listings of Web sites, CD-ROM and computer software, videos, books, and professional resources that deal with various methods of communication. Sidebars discuss mythology, photojournalism, sharing ideas on the Web, and songs of protest. Suggestions for class activities are also included. (LRW)

  18. 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

  19. Characterization ofTrichuris murissecreted proteins and extracellular vesicles provides new insights into host-parasite communication.

    Science.gov (United States)

    Eichenberger, Ramon M; Talukder, Md Hasanuzzaman; Field, Matthew A; Wangchuk, Phurpa; Giacomin, Paul; Loukas, Alex; Sotillo, Javier

    2018-01-01

    Whipworms are parasitic nematodes that live in the gut of more than 500 million people worldwide. Owing to the difficulty in obtaining parasite material, the mouse whipworm Trichuris muris has been extensively used as a model to study human whipworm infections. These nematodes secrete a multitude of compounds that interact with host tissues where they orchestrate a parasitic existence. Herein we provide the first comprehensive characterization of the excretory/secretory products of T. muris . We identify 148 proteins secreted by T. muris and show for the first time that the mouse whipworm secretes exosome-like extracellular vesicles (EVs) that can interact with host cells. We use an Optiprep® gradient to purify the EVs, highlighting the suitability of this method for purifying EVs secreted by a parasitic nematode. We also characterize the proteomic and genomic content of the EVs, identifying >350 proteins, 56 miRNAs (22 novel) and 475 full-length mRNA transcripts mapping to T. muris gene models. Many of the miRNAs putatively mapped to mouse genes are involved in regulation of inflammation, implying a role in parasite-driven immunomodulation. In addition, for the first time to our knowledge, colonic organoids have been used to demonstrate the internalization of parasite EVs by host cells. Understanding how parasites interact with their host is crucial to develop new control measures. This first characterization of the proteins and EVs secreted by T. muris provides important information on whipworm-host communication and forms the basis for future studies.

  20. 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.

  1. Patients' Perception of Chronic-Pain-Related Patient-Provider Communication in Relation to Sociodemographic and Pain-Related Variables: A Cross-Sectional Nationwide Study.

    Science.gov (United States)

    Jonsdottir, Thorbjorg; Gunnarsdottir, Sigridur; Oskarsson, Gudmundur K; Jonsdottir, Helga

    2016-10-01

    Pain is a personal experience and patient-provider communication therefore an essential part of diagnosis and treatment where the patient's perspective needs to be central. The aim of this descriptive cross-sectional study was to investigate chronic-pain-related patient-provider communication in the context of sociodemographic variables, pain variables, perceived outcome of care, and satisfaction with health care providers. A postal questionnaire measuring socio-demographic variables, pain characteristics, pain-related health care utilization and patient-provider communication was sent to a sample of 4,500 individuals randomly drawn from the national population of Iceland. A subsample reporting chronic pain and having visited a health care provider for pain the previous six months (n = 401) was analyzed. Relationships between patient-provider communication and other measured variables were tested using bivariate and multivariate statistics. The more chronic pain impaired health-related quality of life, the more provider control the patients perceived in the patient-provider communication. There was also a strong negative relationship between patients' perception of providers' support and openness to discussing symptoms, and satisfaction with health care provider. Patients' perception of their own control in patient-provider communication and involvement in decisions regarding care was related to sociodemographic variables (specifically, education and residence) but not to pain related variables. This study highlights the importance of assessing chronic pain in a broad spectrum, listening, and giving patients time and support to communicate chronic pain and how it affects their life situation. The more interfering the pain is, the more important this is. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  2. Communications

    Indian Academy of Sciences (India)

    Popular mediums : Paper postal service, newspapers. Air (Wireless) person to person communication, mobile phones, satellite systems. Copper Wire ( Land - line) POTS based telephone system; Other mediums optical fiber, water etc.

  3. 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…

  4. Communications

    OpenAIRE

    anonymous

    1982-01-01

    Communications are read for interest in issues that have importance for all who practice and use management science. They are not refereed for technical correctness, as are articles and Notes that appear in Management Science. The reader is therefore cautioned that the publication of any Communication implies neither scientific standing nor acceptance per se on the part of either Management Science or TIMS. Centers Within Universities: Management and Evaluation by James G. Taaffe, On a Common...

  5. Numerical fluid-dynamic optimization of microchannel-provided porous scaffolds for the co-culture of adherent and non-adherent cells.

    Science.gov (United States)

    Cantini, Marco; Fiore, Gianfranco B; Redaelli, Alberto; Soncini, Monica

    2009-03-01

    Computational fluid dynamic (CFD) techniques were used to optimize the microenvironment inside scaffolds for hematopoietic stem cell (HSC) culture in a perfusion bioreactor. These matrices are meant to be seeded with adherent bone marrow stromal cells and then co-cultivated with HSCs; the scaffold micro-architecture and the fluid-dynamic conditions have to be optimized to avoid non-adherent stem cells being dragged away while ensuring adequate nutrient supply. The insertion of longitudinal microchannels was tested as a tool to improve perfusion in a homogeneous porous scaffold. Models of microchannel-provided scaffolds, characterized by different values of geometric parameters concerning pores and channels, were built, and numerical fluid-dynamic and oxygen-transfer analyses were carried out. The results of the computations indicated that the microchannels created preferential paths for culture medium flow, causing low shear stresses and drag forces within the pores; meanwhile, they improved oxygen delivery by forcing its penetration into the scaffold bulk. In particular, an 85% porous, 3-mm-thick scaffold with 175-microm-diameter pores was considered; at a constant average drag force guaranteeing stem cell suspension inside this porous bulk, the addition of approximately 260-microm-diameter, 700-microm-spaced channels resulted in 34% higher oxygen partial pressure at the exit (approximately 135 vs 101 mmHg), maintaining a wall shear stress median value of approximately 0.14 mPa. The present work demonstrates the capacity of microchannel-provided scaffolds to ensure suitable conditions for HSC culture and shows that CFD methods are a valuable tool to retrieve significant clues for the design of the culture environment.

  6. Smartphone applications for communicating avalanche risk information - a study on how they are developed and evaluated by their providers

    Science.gov (United States)

    Charrière, Marie K. M.; Bogaard, Thom A.

    2016-05-01

    Every year, people are victims of avalanches. It is commonly assumed that one way to decrease those losses is to inform about danger levels. This paper presents a study on current practices in the development and evaluation of smartphones applications that are dedicated to avalanche risk communication. The analysis based on semi-structured interviews with developers of six smartphone apps highlights the context of their development, how choices of content and visualization were made and how their effectiveness is evaluated by the developers themselves. It appears that all these communicators agree on the message to disseminate and the general representation concepts (i.e., use of the international avalanche danger scale and of a tiered approach). However, the specific ways this message is presented (e.g., maps, icons) is not uniform. Moreover, only simple evaluation processes (e.g., usage monitoring) are conducted by the developers. However, they are well aware that further efforts need to be made in order to thoroughly analyze the effectiveness of the smartphone apps in terms of their real impact (e.g., increase in awareness or change in behavior). This work also highlighted that the smartphone applications are in transition from being one-way communication tools to becoming two-way communication platforms, with the possibility for non-experts users to report on snow and avalanche conditions. This paper indicates challenges that avalanche risk communication is facing, although it is indisputably the most advanced and standardized practice compared to communication tools for other natural hazards. In addition to being relevant for the avalanche risk communication community, this research is therefore of interest for scientists and practitioners working on risk communication related to natural hazards.

  7. Device useful as a borehole fluid sampler

    Energy Technology Data Exchange (ETDEWEB)

    Freifeld, Barry M.

    2018-01-09

    The present invention provides a device comprising: (a) a proximal end of the device comprises an inner first conduit within the lumen of an outer second conduit, (b) a distal end of the device comprises the outer second conduit in fluid communication with a third conduit and a fourth conduit through a Y-shaped, T-shaped or U-shaped junction, (c) the third conduit terminates in a triggering mechanism, and (d) the fourth conduit is in fluid communication through a one-way valve, wherein fluid can only convey in a direction from the fourth conduit towards the second outer conduit, with an aperture.

  8. 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.

  9. 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…

  10. 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…

  11. 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

  12. Intrathecal gadolinium (gadopentetate dimeglumine) - enhanced MR cisternography used to determine potential communication between the cerebrospinal fluid pathways and intracranial arachnoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Tali, E. Turgut; Ercan, Nil [Gazi University School of Medicine, Department of Radiology, Division of Neuroradiology, Ankara (Turkey); Kaymaz, Memduh; Pasaoglu, Aydin [Gazi University School of Medicine, Department of Neurosurgery, Ankara (Turkey); Jinkins, J. Randy [Drexel University, Medical College of Pennsylvania-Hahnemann Hospitals, Department of Radiologic Sciences, Philadelphia, Pennsylvania (United States)

    2004-09-01

    This study was designed to assess the feasibility of intrathecal gadolinium-enhanced magnetic resonance cisternography (MRC) for the evaluation of the presence or absence of communication of cranial arachnoid cysts with the cerebrospinal fluid (CSF) pathways of the central nervous system (CNS). This prospective study included 20 patients (12 males and 8 females) with a mean age of 37 years, who had, as a group, 22 intracranial arachnoid cysts identified on prior CT and/or MR examinations. Routine pre-contrast cranial MR imaging was followed by the intrathecal administration of 0.5 cc gadopentetate dimeglumine (GD) (Magnevist, Schering, Germany). Immediate and delayed (24 h) MR cisternography was then carried out. Eleven of 22 arachnoid cysts showed immediate CSF communication by the demonstration GD-contrast enhancement of the cyst fluid on the immediate post-injection scan. Contrast enhancement of the cyst was observed only on delayed MRC in six patients. MR imaging in five patients demonstrated no contrast enhancement of the arachnoid cysts on either immediate or delayed imaging. Six patients had mild transient post-procedure headache that was relieved by oral analgesics within 24 h. No serious immediate or chronic adverse effects or complications relating to the intrathecal contrast administration were observed. This study showed the relative safety, feasibility and reliability of low-dose intrathecal GD MR imaging in the demonstration of the communication or non-communication of intracranial arachnoid cysts with the CSF pathways of the CNS. In the future, this may have bearing on the selection for surgery of patients with intracranial arachnoid cysts presenting with clinical signs and symptoms potentially related to the location and mass effect of the cyst. (orig.)

  13. 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...

  14. 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...

  15. 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.

  16. "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…

  17. 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

  18. Simulated Conversations With Virtual Humans to Improve Patient-Provider Communication and Reduce Unnecessary Prescriptions for Antibiotics: A Repeated Measure Pilot Study.

    Science.gov (United States)

    Schoenthaler, Antoinette; Albright, Glenn; Hibbard, Judith; Goldman, Ron

    2017-04-19

    Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics. However, most patients and providers do not feel prepared to engage in such challenging conversations. The aim of this pilot study was to assess the ability of a brief 15-min simulated role-play conversation with virtual humans to serve as a preliminary step to help health care providers and patients practice, and learn how to engage in effective conversations about antibiotics overuse. A total of 69 participants (35 providers and 34 patients) completed the simulation once in one sitting. A pre-post repeated measures design was used to assess changes in patients' and providers' self-reported communication behaviors, activation, and preparedness, intention, and confidence to effectively communicate in the patient-provider encounter. Changes in patients' knowledge and beliefs regarding antibiotic use were also evaluated. Patients experienced a short-term positive improvement in beliefs about appropriate antibiotic use for infection (F1,30=14.10, P=.001). Knowledge scores regarding the correct uses of antibiotics improved immediately postsimulation, but decreased at the 1-month follow-up (F1,30=31.16, Pchange in patient activation and shared decision-making (SDM) scores in the total sample of patients (P>.10) Patients with lower levels of activation exhibited positive, short-term benefits in increased intent and confidence to discuss their needs

  19. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review.

    Science.gov (United States)

    Gorman, Jessica R; Standridge, Daniel; Lyons, Karen S; Elliot, Diane L; Winters-Stone, Kerri; Julian, Anne K; Weprin, Jennifer; Storksdieck, Martin; Hayes-Lattin, Brandon

    2017-09-01

    To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Study of fluid dynamics reveals direct communications between lymphatic vessels and venous blood vessels at lymph nodes of mice.

    Science.gov (United States)

    Takeda, Kazu; Mori, Shiro; Kodama, Tetsuya

    2017-06-01

    Cancer cells metastasize to lymph nodes, with distant metastasis resulting in poor prognosis. The role of lymph node metastasis (LNM) in the spread of cancer to distant organs remain incompletely characterized. The visualization of flow dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice, which develop systemic swelling of lymph nodes up to 10mm in diameter, has revealed that lymph nodes have the potential to be a direct source of systemic metastasis. However, it is not known whether these fluid dynamics characteristics are universal phenomena present in other strains of laboratory mice. Here we show that the fluid dynamics observed in MXH10/Mo-lpr/lpr mice are the same as those observed in C57BL/6J, BALB/cAJcl and NOD/ShiJic-scidJcl mice. Furthermore, when fluorescent solution was injected into a tumor-bearing lymph node, the flow dynamics observed in the efferent lymphatic vessels and thoracoepigastric vein depended on the type of tumor cell. Our results indicate that fluid dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice are generalized phenomena seen in conventional laboratory mice. We anticipate our results can facilitate studies of the progression of lymphatic metastasis to hematogenous metastasis via lymph nodes and the early diagnosis and treatment of LNM. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Impact of a health education tool on enhancing communication between health providers and parents of neonates in intensive care in Egypt.

    Science.gov (United States)

    Hesham, Mohamed S; Mansi, Yasmin; Abdelhamid, Tamer A; Saleh, Rehan M

    2016-07-01

    Admission of an infant to the neonatal intensive care unit (NICU) is a stressful experience for parents. Parents' education improves knowledge and satisfaction. The purpose of this study was to evaluate the influence of using a family information guide about the NICU as a communication intervention between the healthcare providers and parents having their infants in the unit. An interventional study was conducted among 100 fathers with their neonates inside the NICU-Kasr Al Ainy Teaching Hospital, Cairo, Egypt. The study passed through three stages: pre-intervention, intervention using a family information guide, and post-intervention. After using the guide, fathers showed significant improvement in their knowledge, with a change in their feelings towards the admission of their neonates to the NICU. Providing sufficient information and increasing awareness of parents about the NICU in the form of a written guide is an effective way of improving communication between healthcare providers and parents. Copyright © 2016. Published by Elsevier Taiwan LLC.

  2. 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...

  3. Patients' perceptions of how healthcare providers communicate with them and their families following a diagnosis of colorectal cancer and undergoing chemotherapy treatment.

    Science.gov (United States)

    McCarthy, Bridie

    2014-10-01

    Chemotherapy can result in many unpredictable and often debilitating side-effects hence patients undergoing chemotherapy treatment may have to rely on their loved ones to support them through this most challenging period. In view of this possibility then good communication skills between patients, healthcare providers and family members is of paramount importance for effective patient outcomes. The aim of this study therefore, was to explore patients' perceptions of how healthcare providers communicate with them and their family members whilst undergoing chemotherapy treatment for cancer. Using a qualitative methodology and a descriptive design, data were collected using unstructured interviews with patients undergoing chemotherapy (n = 14) and analysed by content analysis. Participants expressed that both they and their family members were treated with compassion, kindness, empathy and understanding. They appreciated the time given to them and their family members to listen and answer their questions before, during and/or after treatment. In addition they commented positively on the warm and cheerful environment and the selective use of appropriate humour by oncology healthcare providers in the chemotherapy units. The data highlights in particular the positive communication encounters between patients with cancer and their healthcare providers and family members. Oncology nurses were identified as being particularly supportive to both patients and their family members. Despite chemotherapy units being a difficult place to be a part of, this study highlights that healthcare providers can help make this a less daunting place for patients and their family members through their appropriate use of professional communication. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. HIV provider-patient communication regarding cardiovascular risk: results from the AIDS Treatment for Life International Survey.

    Science.gov (United States)

    Sherer, Renslow; Solomon, Suniti; Schechter, Mauro; Nachega, Jean B; Rockstroh, Jurgen; Zuniga, José M

    2014-01-01

    Few global studies have assessed HIV clinician-patient communication regarding cardiovascular disease (CVD) risks. We conducted a multicountry, comparative, cross-sectional survey of HIV-infected individuals in 12 countries on 5 continents in 2010, with 100 to 200 enrollees per country. HIV-infected adults >17 years and on antiretroviral therapy were recruited in clinics and community organizations and surveyed via direct interview, telephone encounter, or online. Chi-square analyses were performed with an 80% power to detect a difference of >20%. Of 2035 participants, 37% were women. Prevalence of self-reported CVD risk factors was 28% overall, and greater CVD risk was present in 55% of patients in North America, 12% in Africa, and 26% to 28% on other continents. Only 19% of patients ever discussed CVD with their physician, and 31% had ever discussed hypertension, hypercholesterolemia, family history of CVD, or smoking; these findings were true for HIV clinicians in all regions of the world. Forty-four percent of smokers reported never discussing smoking with their HIV clinician. We found that HIV clinicians worldwide are not sufficiently addressing CVD risk factors with their patients. Expanded training and education for HIV clinicians should include effective approaches to the mitigation of CV risk factors.

  5. 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.

  6. When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved in Your Care

    Science.gov (United States)

    ... Can I have another person pick up my prescription drugs, medical supplies, or X-rays? Yes. HIPAA allows health care providers (such as pharmacists) to give prescription drugs, medical supplies, X-rays, and other health care items ...

  7. How acceptable is it for HIV positive African, Caribbean and Black women to provide breast milk/fluid samples for research purposes?

    Science.gov (United States)

    Kapiriri, L; Tharao, W; Muchenje, M; Khatundi, I M; Ongoiba, F

    2017-01-03

    The African, Caribbean and Black communities have been found to be reluctant to participate in health research in North America. This is partly attributed to historical experiences as well as their cultural beliefs. Cultural beliefs about the uses of breast milk/fluids could further hinder the participation of African, Caribbean, and Black communities in research involving the collection of breast milk/fluids samples. We conducted 17 in-depth interviews and three group interviews (n = 10) with HIV+ African, Caribbean and Black women living in Ontario, Canada to explore their cultural beliefs about breast milk/fluids and their acceptance of participating in research that involves the provision of breast fluid samples. Qualitative study involving in-depth interviews. Our respondents believed that breast milk/fluids should be used for infant feeding and for curative purposes for a variety of children's health ailments as well as ailments experienced by other family members. The cultural belief that breast milk/fluids could be used to bewitch the baby and mother and the perception that it is intrusive (equating breast milk/fluids research to DNA testing), could prevent African, Caribbean and Black women from participating in research involving the collection of breast milk/fluids. Despite these fears, some respondents expressed that they would participate if the research results would benefit them directly, for example, by finding a cure for HIV, enabling HIV+ mothers to breastfeed, or contributing to developing new drugs or vaccines for HIV. Women's recommendations to facilitate successful recruitment included giving incentives to participants, and employing a recruiter who was trustworthy, informed, and culturally sensitive. Cultural beliefs could present barriers to recruitment and participation of Africa, Caribbean and Black communities in health research involving breast milk/fluid samples. Successful recruitment for future studies would necessitate researchers

  8. Impact of a health education tool on enhancing communication between health providers and parents of neonates in intensive care in Egypt

    OpenAIRE

    Hesham, Mohamed S.; Mansi, Yasmin; Abdelhamid, Tamer A.; Saleh, Rehan M.

    2016-01-01

    Background: Admission of an infant to the neonatal intensive care unit (NICU) is a stressful experience for parents. Parents' education improves knowledge and satisfaction. The purpose of this study was to evaluate the influence of using a family information guide about the NICU as a communication intervention between the healthcare providers and parents having their infants in the unit. Methods: An interventional study was conducted among 100 fathers with their neonates inside the NICU-Ka...

  9. E-Mail Communication Practices and Preferences Among Patients and Providers in a Large Comprehensive Cancer Center.

    Science.gov (United States)

    Cook, Natalie; Maganti, Manjula; Dobriyal, Aditi; Sheinis, Michal; Wei, Alice C; Ringash, Jolie; Krzyzanowska, Monika K

    2016-07-01

    Little is known about how electronic mail (e-mail) is currently used in oncology practice to facilitate patient care. The objective of our study was to understand the current e-mail practices and preferences of patients and physicians in a large comprehensive cancer center. Separate cross-sectional surveys were administered to patients and physicians (staff physicians and clinical fellows) at the Princess Margaret Cancer Centre. Logistic regression was used to identify factors associated with current e-mail use. Record review was performed to assess the impact of e-mail communication on care. The survey was completed by 833 patients. E-mail contact with a member of the health care team was reported by 41% of respondents. The team members contacted included administrative assistants (52%), nurses (45%), specialist physicians (36%), and family physicians (18%). Patient factors associated with a higher likelihood of e-mail contact with the health care team included younger age, higher education, higher income, enrollment in a clinical trial, and receipt of multiple treatments. Eighty percent of physicians (n = 63 of 79) reported previous contact with a patient via e-mail. Physician factors associated with a greater likelihood of e-mail contact with patients included older age, more senior clinical position, and higher patient volume. Nine hundred sixty-two patient records were reviewed, with e-mail correspondence documented in only 9% of cases. E-mail is commonly used for patient care but is poorly documented. The use of e-mail in this setting can be developed with appropriate guidance; however, there may be concerns about widening the gap between certain groups of patients. Copyright © 2016 by American Society of Clinical Oncology.

  10. 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.

  11. Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening

    Science.gov (United States)

    Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.

    2009-01-01

    Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

  12. 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

  13. 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: 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.

  14. Tell Us™: A Web-Based Tool for Improving Communication Among Patients, Families, and Providers in Hospice and Palliative Care Through Systematic Data Specification, Collection, and Use

    Science.gov (United States)

    Dy, Sydney M.; Roy, Jayashree; Ott, Geoffrey E.; McHale, Michael; Kennedy, Christine; Kutner, Jean S.; Tien, Allen

    2015-01-01

    Context Routine electronic patient-reported outcome collection in patients with advanced disease could improve communication among patients, caregivers and providers and improve the timeliness of identifying problems and effectiveness of follow-up. Objective To develop a web-based tool to collect symptoms and need data and provide feedback to hospice and palliative care patients, caregivers and providers. Methods We developed Tell Us™ based on an existing pure web technology platform, the Medical Decision Logic, Inc. (“mdlogix”) Health Science Process Framework (HSPF™). The software development process included eliciting information on systems and needs and mapping care processes with three diverse hospices, and soliciting ideas for the software from clinicians and researchers. We developed a prototype software product, incorporated the hospices’ processes, assessment questions, and educational materials, and refined the product with feedback from other hospice and palliative care professionals. Results Tell Us includes modules for authoring and deploying clinical queries and completion schedules; for enrolling clinical sites and patients for patients and/or families to complete assigned assessments on a scheduled basis; and for providers to view patient-reported data. Tell Us provides customizable automated provider e-mail alerts based on patient responses (such as uncontrolled symptoms or need for medication refills) and provides educational materials targeted to patient needs. Conclusions This web-based toolset may be useful for improving communication between hospice and palliative care patients, caregivers, and providers and proactive patient management. Future research will involve integrating the software into care and evaluating its feasibility and use for data collection, patient education, and improving outcomes. PMID:21458214

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. Acoustic concentration of particles in fluid flow

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Postoperative fluid management

    OpenAIRE

    Kayilioglu, Selami Ilgaz; Dinc, Tolga; Sozen, Isa; Bostanoglu, Akin; Cete, Mukerrem; Coskun, Faruk

    2015-01-01

    Postoperative care units are run by an anesthesiologist or a surgeon, or a team formed of both. Management of postoperative fluid therapy should be done considering both patients’ status and intraoperative events. Types of the fluids, amount of the fluid given and timing of the administration are the main topics that determine the fluid management strategy. The main goal of fluid resuscitation is to provide adequate tissue perfusion without harming the patient. The endothelial glycocalyx dysf...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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…

  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. Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes.

    Science.gov (United States)

    Burns, Clare L; Ward, Elizabeth C; Hill, Anne J; Kularatna, Sanjeewa; Byrnes, Joshua; Kenny, Lizbeth M

    2017-05-01

    The purpose of this study was to present our evaluation of a new speech pathology telepractice service supporting the swallowing and communication management of patients with head and neck cancer. A multicenter randomized controlled trial was conducted within a large public cancer service. Referrals from speech pathologists at 3 regional sites (spoke sites) were managed by a specialist clinician from a cancer center (hub site) either via standard care (phone/email support/appointments at the hub site) or a newly established telepractice service (online consultation between the hub site and spoke site). Eighty-two referrals (39 for standard care and 43 for telepractice care) were managed. Service efficiency favoring the telepractice model was reported with a significant reduction in the number (p = .004) and duration (p = .024) of contact events required to manage the referrals. Higher consumer and clinician satisfaction was also reported for the telepractice service. A speech pathology telepractice service benefits both the patient and health provider through higher service efficiency and treatment satisfaction. © 2017 Wiley Periodicals, Inc. Head Neck 39: 932-939, 2017. © 2017 Wiley Periodicals, Inc.

  11. 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...... and less on the plan to communicate. Against the backdrop of the comprehensive changes to communication in and about organizations brought about by the rise of digital communication technologies and related contextual developments, Strategizing Communication provides better and more up to date tools...

  12. 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.

  13. Patient-Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States: Medical Expenditure Panel Survey 2010 to 2013.

    Science.gov (United States)

    Okunrintemi, Victor; Spatz, Erica S; Di Capua, Paul; Salami, Joseph A; Valero-Elizondo, Javier; Warraich, Haider; Virani, Salim S; Blaha, Michael J; Blankstein, Ron; Butt, Adeel A; Borden, William B; Dharmarajan, Kumar; Ting, Henry; Krumholz, Harlan M; Nasir, Khurram

    2017-04-01

    Consumer-reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative US adult population with established atherosclerotic cardiovascular disease. The study population consisted of a nationally representative sample of 6810 individuals (aged ≥18 years), representing 18.3 million adults with established atherosclerotic cardiovascular disease (self-reported or International Classification of Diseases, Ninth Edition diagnosis) reporting a usual source of care in the 2010 to 2013 pooled Medical Expenditure Panel Survey cohort. Participants responded to questions from Consumer Assessment of Health Plans Survey that assessed PPC, and we developed a weighted PPC composite score using their responses, categorized as 1 (poor), 2 (average), and 3 (optimal). Outcomes of interest were (1) patient-reported outcomes: 12-item Short Form physical/mental health status, (2) quality of care measures: statin and ASA use, (3) healthcare resource utilization: emergency room visits and hospital stays, and (4) total annual and out-of-pocket healthcare expenditures. Atherosclerotic cardiovascular disease patients reporting poor versus optimal were over 2-fold more likely to report poor outcomes; 52% and 26% more likely to report that they are not on statin and aspirin, respectively, had a significantly greater utilization of health resources (odds ratio≥2 emergency room visit, 1.41 [95% confidence interval, 1.09-1.81]; odds ratio≥2 hospitalization, 1.36 [95% confidence interval, 1.04-1.79]), as well as an estimated $1243 ($127-$2359) higher annual healthcare expenditure. This study reveals a strong relationship between PPC and patient-reported outcomes, utilization of

  14. Amniotic fluid

    Science.gov (United States)

    ... or movements Too much amniotic fluid is called polyhydramnios . This condition can occur with multiple pregnancies (twins ... development of the fetus. Images Amniocentesis Amniotic fluid Polyhydramnios Amniotic fluid References Burton GJ, Sibley CP, Jauniaux ...

  15. Communication: Generalizing Rosenfeld's excess-entropy scaling to predict long-time diffusivity in dense fluids of Brownian particles: from hard to ultrasoft interactions.

    Science.gov (United States)

    Pond, Mark J; Errington, Jeffrey R; Truskett, Thomas M

    2011-02-28

    Computer simulations are used to test whether a recently introduced generalization of Rosenfeld's excess-entropy scaling method for estimating transport coefficients in systems obeying molecular dynamics can be extended to predict long-time diffusivities in fluids of particles undergoing Brownian dynamics in the absence of interparticle hydrodynamic forces. Model fluids with inverse-power-law, Gaussian-core, and Hertzian pair interactions are considered. Within the generalized Rosenfeld scaling method, long-time diffusivities of ultrasoft Gaussian-core and Hertzian particle fluids, which display anomalous trends with increasing density, are predicted (to within 20%) based on knowledge of interparticle interactions, excess entropy, and scaling behavior of simpler inverse-power-law fluids.

  16. Communication path for extreme environments

    Science.gov (United States)

    Jorgensen, Charles C. (Inventor); Betts, Bradley J. (Inventor)

    2010-01-01

    Methods and systems for using one or more radio frequency identification devices (RFIDs), or other suitable signal transmitters and/or receivers, to provide a sensor information communication path, to provide location and/or spatial orientation information for an emergency service worker (ESW), to provide an ESW escape route, to indicate a direction from an ESW to an ES appliance, to provide updated information on a region or structure that presents an extreme environment (fire, hazardous fluid leak, underwater, nuclear, etc.) in which an ESW works, and to provide accumulated thermal load or thermal breakdown information on one or more locations in the region.

  17. 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

  18. A framework for community ownership of a text messaging programme to improve adherence to antiretroviral therapy and client-provider communication: a mixed methods study.

    Science.gov (United States)

    Mbuagbaw, Lawrence; Bonono-Momnougui, Renee-Cecile; Thabane, Lehana; Kouanfack, Charles; Smieja, Marek; Ongolo-Zogo, Pierre

    2014-09-26

    Mobile phone text messaging has been shown to improve adherence to antiretroviral therapy and to improve communication between patients and health care workers. It is unclear which strategies are most appropriate for scaling up text messaging programmes. We sought to investigate acceptability and readiness for ownership (community members designing, sending and receiving text messages) of a text message programme among a community of clients living with human immunodeficiency virus (HIV) in Yaoundé, Cameroon and to develop a framework for implementation. We used the mixed-methods sequential exploratory design. In the qualitative strand we conducted 7 focus group discussions (57 participants) to elicit themes related to acceptability and readiness. In the quantitative strand we explored the generalizability of these themes in a survey of 420 clients. Qualitative and quantitative data were merged to generate meta-inferences. Both qualitative and quantitative strands showed high levels of acceptability and readiness despite low rates of participation in other community-led projects. In the qualitative strand, compared to the quantitative strand, more potential service users were willing to pay for a text messaging service, preferred participation of health personnel in managing the project and preferred that the project be based in the hospital rather than in the community. Some of the limitations identified to implementing a community-owned project were lack of management skills in the community, financial, technical and literacy challenges. Participants who were willing to pay were more likely to find the project acceptable and expressed positive feelings about community readiness to own a text messaging project. Community ownership of a text messaging programme is acceptable to the community of clients at the Yaoundé Central Hospital. Our framework for implementation includes components for community members who take on roles as services users (demonstrating

  19. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    not determine the success of strategic communication. Rather, contextual factors such as competition, technological developments, global cultural trends and local traditions as well as employees’ skills and attitudes will determine the organization’s communicative success. This holds true regardless...... and less on the plan to communicate. Against the backdrop of the comprehensive changes to communication in and about organizations brought about by the rise of digital communication technologies and related contextual developments, Strategizing Communication provides better and more up to date tools......Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...

  20. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    and less on the plan to communicate. Against the backdrop of the comprehensive changes to communication in and about organizations brought about by the rise of digital communication technologies and related contextual developments, Strategizing Communication provides better and more up to date tools......Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...... when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...

  1. Communication: The application of the global isomorphism to the study of liquid-vapor equilibrium in two and three-dimensional Lennard-Jones fluids

    Science.gov (United States)

    Kulinskii, V. L.

    2010-10-01

    We analyze the interrelation between the coexistence curve of the Lennard-Jones fluid and the Ising model in two and three dimensions within the global isomorphism approach proposed earlier [V. L. Kulinskii, J. Phys. Chem. B 114, 2852 (2010)]. In case of two dimensions, we use the exact Onsager result to construct the binodal of the corresponding Lennard-Jones fluid and compare it with the results of the simulations. In the three-dimensional case, we use available numerical results for the Ising model for the corresponding mapping. The possibility to observe the singularity of the binodal diameter is discussed.

  2. Engineering fluid mechanics

    CERN Document Server

    Yamaguchi, Hiroshi

    2008-01-01

    This book is intended to serve as a unique and comprehensive textbook for scientists and engineers as well as advanced students in thermo-fluid courses. It provides an intensive monograph essential for understanding dynamics of ideal fluid, Newtonian fluid, non-Newtonian fluid and magnetic fluid. These distinct, yet intertwined subjects are addressed in an integrated manner. It starts with coherent treatment of fundamental continuum mechanics, with an emphasis on the intrinsic angular momentum, by which the concepts of ferrohydrodynamics are progressively built up, and serve as a foundation for later development. Flows of ideal and Newtonian fluids are followed by a detailed presentation of basic continuum equations for applications of fluid engineering, which cover the design and operations of various turbomachines, heat exchangers and flow elements. The study of the deformation and flow of matter, namely rheology, is discussed primarily with regard to the stresses generated during the flow of complex materi...

  3. [Better communication between surgery and anesthesia may provide safer surgery. The exchange of information has been mapped within the framework of "Safe abdominal surgery"].

    Science.gov (United States)

    Göransson, Katarina; Lundberg, Johan; Ljungqvist, Olle; Ohlsson, Elisabet; Sandblom, Gabriel

    2015-09-01

    Poor communication between surgical and anesthesia unit personnel may jeopardize patient safety.  Review reports from a national survey on patient safety performed at 17 units 2011-2013 were analyzed in order to identify strategies to reduce risks related to the interaction between surgery and anesthesia. The reports were reviewed in this study by an independent group in order to extract findings related to communication between anesthesia and surgical unit personnel. Suggested strategies to improve patient safety included: uniform national health declaration forms; consistent use of admission notes; uniform systems for documenting medical information; multidisciplinary forum for evaluation of high-risk patients; weekly and daily scheduling of surgical programs; application of the WHO check list; open dialog during surgery; oral and written reports from the surgeon to the postoperative unit; and combined mortality and morbidity conferences.

  4. 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)

  5. Fluid Interfaces

    DEFF Research Database (Denmark)

    Hansen, Klaus Marius

    2001-01-01

    Fluid interaction, interaction by the user with the system that causes few breakdowns, is essential to many user interfaces. We present two concrete software systems that try to support fluid interaction for different work practices. Furthermore, we present specificity, generality, and minimality...... as design goals for fluid interfaces....

  6. Organizatonal Communication Issues in Italian Multinational Corporations.

    Science.gov (United States)

    Cesaria, Ruggero

    2000-01-01

    Provides a brief historical reconstruction of management communication in Italian companies. Suggests that dealing with communication technologies, communication professionals, and intercultural communication represent three future challenges. (NH)

  7. Selective peptide inhibitors of bifunctional thymidylate synthase-dihydrofolate reductase from Toxoplasma gondii provide insights into domain-domain communication and allosteric regulation.

    Science.gov (United States)

    Landau, Mark J; Sharma, Hitesh; Anderson, Karen S

    2013-09-01

    The bifunctional enzyme thymidylate synthase-dihydrofolate reductase (TS-DHFR) plays an essential role in DNA synthesis and is unique to several species of pathogenic protozoans, including the parasite Toxoplasma gondii. Infection by T. gondii causes the prevalent disease toxoplasmosis, for which TS-DHFR is a major therapeutic target. Here, we design peptides that target the dimer interface between the TS domains of bifunctional T. gondii TS-DHFR by mimicking β-strands at the interface, revealing a previously unknown allosteric target. The current study shows that these β-strand mimetic peptides bind to the apo-enzyme in a species-selective manner to inhibit both the TS and distal DHFR. Fluorescence spectroscopy was used to monitor conformational switching of the TS domain and demonstrate that these peptides induce a conformational change in the enzyme. Using structure-guided mutagenesis, nonconserved residues in the linker between TS and DHFR were identified that play a key role in domain-domain communication and in peptide inhibition of the DHFR domain. These studies validate allosteric inhibition of apo-TS, specifically at the TS-TS interface, as a potential target for novel, species-specific therapeutics for treating T. gondii parasitic infections and overcoming drug resistance. © 2013 The Protein Society.

  8. Interracial Communication

    Science.gov (United States)

    Harris, Tina M.

    2004-01-01

    This course explores the inextricable and multidimensional relationships among race, culture, and communication by providing students with an extensive theoretical framework to enhance their understanding of interracial communication. Specific attention is geared toward the construction of one's own racial and ethnic identity as well as those of…

  9. 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.

  10. The Integration of Speech Therapy Techniques with Those of Movement, Music, and Sensory Integrative Therapies in Order to Provide Communication Systems for Severely Emotionally Disturbed Children.

    Science.gov (United States)

    LeShay, Debra N.

    Project LINK at the Developmental Center for Autistic Children in Philadelphia provides therapy to emotionally disturbed children and training and consultation for teachers and mental health professionals. Each child is evaluated by treatment team members through repeated observations and informal assessments. The primary goal of treatment is the…

  11. 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...

  12. Fluid Dynamics

    DEFF Research Database (Denmark)

    Brorsen, Michael

    These lecture notes are intended mainly for the 7th semester course "Fluid Dynamics" offered by the Study Committee on Civil Engineering, Aalborg University.......These lecture notes are intended mainly for the 7th semester course "Fluid Dynamics" offered by the Study Committee on Civil Engineering, Aalborg University....

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

    Energy Technology Data Exchange (ETDEWEB)

    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. 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.

  15. A point-of-sale communications campaign to provide consumers safety information on drug-dietary supplement interactions: a pilot study.

    Science.gov (United States)

    Perlman, Adam I; Lebow, David G; Raphael, Karen; Ali, Ather; Simmons, Leigh Ann

    2013-01-01

    Concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals has become increasingly common, and with this trend, so has the incidence of adverse drug-supplement interactions. In the current market, consumers have no way to distinguish between safe and potentially harmful supplements. Thus, the primary objective of this study was to test the hypothesis that messages designed to increase consumers' awareness of potential health risks of concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals would promote further consideration and action, as evidenced by (a) seeking additional information from an authoritative source or qualified health care professional and (b) changing dietary supplement usage patterns. To test this hypothesis, an innovative consumer information delivery system, referred to as the Buyer Information Network (BuyIN), was utilized. BuyIN uses currently available, Web-enabled point-of-sale (POS) technology to provide up-to-date, evidence-based, health- and safety-related messages to consumers at the retail checkout counter. Results showed that more than one-fourth (27.1%) of consumers (n = 199) who purchased targeted items reported they were aware of the messages. Of this subgroup of aware consumers, 11.2% reported that they sought additional information from a physician or pharmacist, 11.5% reported that they visited the website listed on the coupon, and 10.5% indicated that they changed their dietary supplement usage patterns as a result of the messages. Future research should include a large-scale study of a fully implemented and capable system at multiple test sites around the country, including investigating the utility of BuyIN in different retail settings.

  16. 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.

  17. Fluid dynamics of dilatant fluid

    DEFF Research Database (Denmark)

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

    2012-01-01

    A dense mixture of granules and liquid often shows a severe shear thickening and is called a dilatant fluid. We construct a fluid dynamics model for the dilatant fluid by introducing a phenomenological state variable for a local state of dispersed particles. With simple assumptions for an equation...... 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...... reveals that the shear thickening fluid shows an instability in a shear flow for some regime and exhibits the shear thickening oscillation (i.e., the oscillatory shear flow alternating between the thickened and the relaxed states). The results of numerical simulations are presented for one- and two...

  18. Wireless Communications

    Science.gov (United States)

    1991-01-01

    A technology utilization project led to the commercial adaptation of a Space Shuttle Orbiter wireless infrared voice communications system. The technology was adapted to a LAN system by Wilton Industries, one of the participants. Because the system is cable-free, installation charges are saved, and it can be used where cable is impractical. Resultant products include the IRplex 6000. Transceivers can be located anywhere and can include mobile receivers. The system provides wireless LAN coverage up to 44,000 square feet. applications include stock exchange communications, trade shows, emergency communications, etc.

  19. 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...... into the regulatory mechanisms and functions of secretion-related processes in tumor development. Secondly, the anomalous secretion of molecules that is innate to tumors and the tumor microenvironment, being associated with cancer progression, offers a valuable source for biomarker discovery and possible targets...... for therapeutic intervention. Here we provide an overview of the features of tumor-associated interstitial fluids, based on recent and updated information obtained mainly from our studies of breast cancer. Data from the study of interstitial fluids recovered from several other types of cancer are also discussed...

  20. 7 CFR 2902.41 - Metalworking fluids.

    Science.gov (United States)

    2010-01-01

    ... operations such as cutting, drilling, grinding, machining, and tapping. (2) Metalworking fluids for which... 7 Agriculture 15 2010-01-01 2010-01-01 false Metalworking fluids. 2902.41 Section 2902.41... Items § 2902.41 Metalworking fluids. (a) Definition. (1) Fluids that are designed to provide cooling...

  1. 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.

  2. 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 ...

  3. 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...... chapters represent review articles covering the most relevant areas of the field. They are written with the goal of providing students with comprehensive introductions. Further they offer a supply of numerous references to the relevant literature. Besides its usefulness as a textbook, this will make...... 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...

  4. 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...

  5. 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.

  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. Fluid Fascinations

    NARCIS (Netherlands)

    Bokhove, Onno; Zwart, Valerie; Haveman, Martha J.

    De Art & Science show “Fluid Fascinations��? omvat een presentatie over de wetenschappelijke context, inclusief een live experiment (ontworpen samen met kunstenaar/designer Wout Zweers); en, gemengde media en olieverfschilderijen, en digitale fotowerken van kunstenares Valerie Zwart. De show is

  8. 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

  9. 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.

  10. Intravenous Fluid Generation System

    Science.gov (United States)

    McQuillen, John; McKay, Terri; Brown, Daniel; Zoldak, John

    2013-01-01

    The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in

  11. Animal communication.

    Science.gov (United States)

    Kaplan, Gisela

    2014-11-01

    Animal communication is first and foremost about signal transmission and aims to understand how communication occurs. It is a field that has contributed to and been inspired by other fields, from information technology to neuroscience, in finding ever better methods to eavesdrop on the actual 'message' that forms the basis of communication. Much of this review deals with vocal communication as an example of the questions that research on communication has tried to answer and it provides an historical overview of the theoretical arguments proposed. Topics covered include signal transmission in different environments and different species, referential signaling, and intentionality. The contention is that animal communication may reveal significant thought processes that enable some individuals in a small number of species so far investigated to anticipate what conspecifics might do, although some researchers think of such behavior as adaptive or worth dismissing as anthropomorphizing. The review further points out that some species are more likely than others to develop more complex communication patterns. It is a matter of asking how animals categorize their world and which concepts require cognitive processes and which are adaptive. The review concludes with questions of life history, social learning, and decision making, all criteria that have remained relatively unexplored in communication research. Long-lived, cooperative social animals have so far offered especially exciting prospects for investigation. There are ample opportunities and now very advanced technologies as well to tap further into expressions of memory of signals, be they vocal or expressed in other modalities. WIREs Cogn Sci 2014, 5:661-677. doi: 10.1002/wcs.1321 For further resources related to this article, please visit the WIREs website. The author has declared no conflicts of interest for this article. © 2014 John Wiley & Sons, Ltd.

  12. 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.

  13. Magnetostatic communication

    Science.gov (United States)

    Daily, William D [Livermore, CA

    2008-02-26

    A system for providing communication of information by modulating a magnetostatic field with a magnetostatic transmitter that modulates said magnetostatic field to contain the information and detecting the information in the modulated field at a distance with a magnetostatic detector that detects the modulated magnetic field containing the information.

  14. Fluid Mechanics

    Science.gov (United States)

    Pnueli, David; Gutfinger, Chaim

    1997-01-01

    This text is intended for the study of fluid mechanics at an intermediate level. The presentation starts with basic concepts, in order to form a sound conceptual structure that can support engineering applications and encourage further learning. The presentation is exact, incorporating both the mathematics involved and the physics needed to understand the various phenomena in fluid mechanics. Where a didactical choice must be made between the two, the physics prevails. Throughout the book the authors have tried to reach a balance between exact presentation, intuitive grasp of new ideas, and creative applications of concepts. This approach is reflected in the examples presented in the text and in the exercises given at the end of each chapter. Subjects treated are hydrostatics, viscous flow, similitude and order of magnitude, creeping flow, potential flow, boundary layer flow, turbulent flow, compressible flow, and non-Newtonian flows. This book is ideal for advanced undergraduate students in mechanical, chemical, aerospace, and civil engineering. Solutions manual available.

  15. 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.

  16. 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...

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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...

  2. 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).

  3. 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

  4. 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...

  5. Multiple vertebral fluid-fluid levels

    Energy Technology Data Exchange (ETDEWEB)

    Bladt, O.; Demaerel, P.; Catry, F.; Breuseghem, I. Van [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Ballaux, F. [University Hospitals Gasthuisberg, Department of Pathology, Leuven (Belgium); Samson, I. [University Hospitals Gasthuisberg, Department of Orthopedic Surgery, Leuven (Belgium)

    2004-11-01

    We present a case of multiple vertebral metastases, with multiple fluid-fluid levels, from a moderately to poorly differentiated carcinoma of unknown origin. We suggest that fluid-fluid levels in multiple vertebral lesions are highly suggestive of bone metastases. (orig.)

  6. 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.

  7. COMMUNICATIONS GROUP

    CERN Document Server

    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...

  8. 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...

  9. 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

  10. Synovial fluid analysis.

    Science.gov (United States)

    Pascual, Eliseo; Jovaní, Vega

    2005-06-01

    Synovial fluid (SF) accumulates in the joint cavity in different conditions; this review outlines the data from those analyses that help in their differential and definitive diagnosis. The gross appearance of the fluid can provide a quick bedside orientation with regard to the amount of inflammation present in the joint: totally transparent SF originates in non-inflammatory conditions--of which osteoarthritis is the most common--and the amount of turbidity grossly relates to the amount of inflammation. Most turbid to purulent fluids usually come from infected joints, but exceptions are not uncommon. The white cell count offers quantitative information, but the boundaries between non-inflammatory and inflammatory SF and between this and septic fluid are very hazy and figures have to be interpreted in the clinical setting. Detection and identification of monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals allow a precise diagnosis of gout and CPPD crystal-related arthropathy. Only one in five CPPD crystals have sufficient birefringence for easy detection and they are easily missed if searched for only using a polarised microscope. Instructions for beginners are given. Proper microbiological studies of the SF is the key to the diagnosis of infectious conditions.

  11. 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....

  12. Thermophysical Properties of Fluids and Fluid Mixtures

    Energy Technology Data Exchange (ETDEWEB)

    Sengers, Jan V.; Anisimov, Mikhail A.

    2004-05-03

    The major goal of the project was to study the effect of critical fluctuations on the thermophysical properties and phase behavior of fluids and fluid mixtures. Long-range fluctuations appear because of the presence of critical phase transitions. A global theory of critical fluctuations was developed and applied to represent thermodynamic properties and transport properties of molecular fluids and fluid mixtures. In the second phase of the project, the theory was extended to deal with critical fluctuations in complex fluids such as polymer solutions and electrolyte solutions. The theoretical predictions have been confirmed by computer simulations and by light-scattering experiments. Fluctuations in fluids in nonequilibrium states have also been investigated.

  13. Automatic fluid dispenser

    Science.gov (United States)

    Sakellaris, P. C. (Inventor)

    1977-01-01

    Fluid automatically flows to individual dispensing units at predetermined times from a fluid supply and is available only for a predetermined interval of time after which an automatic control causes the fluid to drain from the individual dispensing units. Fluid deprivation continues until the beginning of a new cycle when the fluid is once again automatically made available at the individual dispensing units.

  14. Hydrodynamic instabilities in miscible fluids

    Science.gov (United States)

    Truzzolillo, Domenico; Cipelletti, Luca

    2018-01-01

    Hydrodynamic instabilities in miscible fluids are ubiquitous, from natural phenomena up to geological scales, to industrial and technological applications, where they represent the only way to control and promote mixing at low Reynolds numbers, well below the transition from laminar to turbulent flow. As for immiscible fluids, the onset of hydrodynamic instabilities in miscible fluids is directly related to the physics of their interfaces. The focus of this review is therefore on the general mechanisms driving the growth of disturbances at the boundary between miscible fluids, under a variety of forcing conditions. In the absence of a regularizing mechanism, these disturbances would grow indefinitely. For immiscible fluids, interfacial tension provides such a regularizing mechanism, because of the energy cost associated to the creation of new interface by a growing disturbance. For miscible fluids, however, the very existence of interfacial stresses that mimic an effective surface tension is debated. Other mechanisms, however, may also be relevant, such as viscous dissipation. We shall review the stabilizing mechanisms that control the most common hydrodynamic instabilities, highlighting those cases for which the lack of an effective interfacial tension poses deep conceptual problems in the mathematical formulation of a linear stability analysis. Finally, we provide a short overview on the ongoing research on the effective, out of equilibrium interfacial tension between miscible fluids.

  15. Supercritical Fluids: Nanotechnology and Select Emerging Applications

    Science.gov (United States)

    2006-01-01

    cholesterol from food products, Mohamad and Mansoori (2002), and pollution remediation using environmentally friendly supercritical fluids Ekhtera et...material needs in energy, health, communication, transportation, food , water, etc.’’ WHAT IS A SUPERCRITICAL FLUID? For a pure material, a supercritical...Technology Council (NSTC). WTEC, Loyola College, Maryland, MD. Hu, X. and Lesser, A.J. (2004) Enhanced crystallization of bisphenol -A poly- carbonate

  16. DEVELOPING INTERCULTURAL COMMUNICATION COMPETENCE THROUGH INTERCULTURAL COMMUNICATION

    Directory of Open Access Journals (Sweden)

    Діана Терещук

    2015-09-01

    Full Text Available In the article the author analyses how intercultural competency can provide realization of the main purpose of foreign language education, namely developing intercultural communication competence. The author concretizes the content of intercultural communication competence, its components, and frames the educational potential of intercultural communication in the development of this competence. The principal ways of through which educators can foster students to take part in intercultural communication were defined. In particular, the paper delves into study abroad programmes, study trips, exchange projects, cultural mobility, as well as ways of students` involvement in intercultural communication by means of modern technologies and in the home country environment. The discussed key approach to foreign language education with the aim to develop intercultural communication competence is experiential learning approach.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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 ...

  2. 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.

  3. La gramatica comunicativa (Communicative Grammar).

    Science.gov (United States)

    Zierer, Ernesto

    This paper explains the main concepts of communicative grammar and provides a detailed view of how communicative grammar analyses language at various levels. Language is discussed in terms of communication; the central elements in the analysis are those that carry information. Communicative grammar seeks to describe the process of the linguistic…

  4. Communicators' perspective on snow avalanche risk communication

    Science.gov (United States)

    Charriere, M. K. M.; Bogaard, T.; Mostert, E.

    2014-12-01

    Among all the natural hazards, snow avalanches are the only ones for which a public danger scale is globally used. It consists of 5 levels of danger displayed with a given number and colour and for each of them, behavioural advices are provided. Even though this is standardized in most of the countries affected by this natural hazard, the tools (usually websites or smartphone applications) with which the information is disseminated to the general pubic differs, particularly in terms of target audience and level of details. This study aims at gathering the perspectives of several communicators that are responsible for these communication practices. The survey was created to assess how and why choices were made in the design process of the communication tools and to determine how their effectiveness is evaluated. Along with a review of existing avalanche risk communication tools, this study provides guidelines for communication and the evaluation of its effectiveness.

  5. Pulsatile cerebrospinal fluid dynamics in the human brain.

    Science.gov (United States)

    Linninger, Andreas A; Tsakiris, Cristian; Zhu, David C; Xenos, Michalis; Roycewicz, Peter; Danziger, Zachary; Penn, Richard

    2005-04-01

    Disturbances of the cerebrospinal fluid (CSF) flow in the brain can lead to hydrocephalus, a condition affecting thousands of people annually in the US. Considerable controversy exists about fluid and pressure dynamics, and about how the brain responds to changes in flow patterns and compression in hydrocephalus. This paper presents a new model based on the first principles of fluid mechanics. This model of fluid-structure interactions predicts flows and pressures throughout the brain's ventricular pathways consistent with both animal intracranial pressure (ICP) measurements and human CINE phase-contrast magnetic resonance imaging data. The computations provide approximations of the tissue deformations of the brain parenchyma. The model also quantifies the pulsatile CSF motion including flow reversal in the aqueduct as well as the changes in ICPs due to brain tissue compression. It does not require the existence of large transmural pressure differences as the force for ventricular expansion. Finally, the new model gives an explanation of communicating hydrocephalus and the phenomenon of asymmetric hydrocephalus.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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...

  11. Supercritical fluids cleaning

    Energy Technology Data Exchange (ETDEWEB)

    Butner, S.; Hjeresen, D.; Silva, L.; Spall, D.; Stephenson, R.

    1991-01-01

    This paper discusses a proposed multi-party research and development program which seeks to develop supercritical fluid cleaning technology as an alternative to existing solvent cleaning applications. While SCF extraction technology has been in commercial use for several years, the use of these fluids as cleaning agents poses several new technical challenges. Problems inherent in the commercialization of SCF technology include: the cleaning efficacy and compatibility of supercritical working fluids with the parts to be cleaned must be assessed for a variety of materials and components; process parameters and equipment design Have been optimized for extractive applications and must be reconsidered for application to cleaning; and co-solvents and entrainers must be identified to facilitate the removal of polar inorganic and organic contaminants, which are often not well solvated in supercritical systems. The proposed research and development program would address these issues and lead to the development and commercialization of viable SCF-based technology for precision cleaning applications. This paper provides the technical background, program scope, and delineates the responsibilities of each principal participant in the program.

  12. 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...

  13. 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.

  14. The mixing of fluids

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. 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...

  16. 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...... experiences document that participatory communication adds value to a development project or program? Many communication practitioners and development workers face obstacles and challenges in their practical work. A participatory communication strategy offers a very specific perspective on how to articulate......, 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....

  17. System and method for confining an object to a region of fluid flow having a stagnation point

    Science.gov (United States)

    Schroeder, Charles M. (Inventor); Shaqfeh, Eric S. G. (Inventor); Babcock, Hazen P. (Inventor); Chu, Steven (Inventor)

    2006-01-01

    A device for confining an object to a region proximate to a fluid flow stagnation point includes one or more inlets for carrying the fluid into the region, one or more outlets for carrying the fluid out of the region, and a controller, in fluidic communication with the inlets and outlets, for adjusting the motion of the fluid to produce a stagnation point in the region, thereby confining the object to the region. Applications include, for example, prolonged observation of the object, manipulation of the object, etc. The device optionally may employ a feedback control mechanism, a sensing apparatus (e.g., for imaging), and a storage medium for storing, and a computer for analyzing and manipulating, data acquired from observing the object. The invention further provides methods of using such a device and system in a number of fields, including biology, chemistry, physics, material science, and medical science.

  18. 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.

  19. 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.

  20. Ethyl Pyruvate Provides Therapeutic Benefits to Resuscitation Fluids

    Science.gov (United States)

    2009-02-01

    Dentistry of New Jersey Newark, NJ 07101 REPORT DATE: February 2009 TYPE OF REPORT: Final PREPARED FOR: U.S. Army...PERFORMING ORGANIZATION REPORT NUMBER University of Medicine and Dentistry of New Jersey...pleiotropic cytokine and therapeutic target. Annu Rev Med, 1994. 45: p. 491-503. 7. Xu, J., et al., Trauma and hemorrhage-induced acute hepatic insulin

  1. 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....

  2. 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...... be chosen. The fabrication of a prototype flow meter and experimental verification of the analytical data were reported. The fabricated prototype is able to measure the velocity of the water in an open channel....... and with measuring its travel time between two different positions, its velocity could be calculated. Given the velocity of the auxiliary fluid, the velocity of the main fluid could be calculated. Using this technique, it is possible to measure the velocity of any kind of fluids, if an appropriate auxiliary fluid...

  3. 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

  4. Communication with patients and colleagues

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte

    2012-01-01

    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......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...

  5. High Performance Computing and Communications Act of 1991. Hearing Before the Subcommittee on Science, Technology, and Space of the Committee on Commerce, Science, and Transportation. One Hundred Second Congress, First Session on S. 272 To Provide for a Coordinated Federal Research Program To Ensure Continued United States Leadership in High-Performance Computing.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Commerce, Science, and Transportation.

    This hearing before the Senate Subcommittee on Science, Technology, and Space focuses on S. 272, the High-Performance Computing and Communications Act of 1991, a bill that provides for a coordinated federal research and development program to ensure continued U.S. leadership in this area. Performance computing is defined as representing the…

  6. 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...

  7. 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.

  8. 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...

  9. Language Communication and Communicative Competence: A View from Contemporary Classrooms

    Science.gov (United States)

    Leung, Constant; Lewkowicz, Jo

    2013-01-01

    In this paper, we examine some of the tenets of the current conceptualisations of communicative competence. Drawing on the empirical data collected in linguistically diverse university classrooms, we show that meaning-making in social interaction is considerably more complex and fluid than is envisaged in theoretical models of communicative…

  10. CSR communication

    DEFF Research Database (Denmark)

    Golob, Ursa; Podnar, Klement; Elving, Wim

    2013-01-01

    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...... 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...

  11. 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.

  12. 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.

  13. Ways Animals Communicate

    Science.gov (United States)

    Curry, Kristen; Sumrall, William J.; Moore, Jerilou; Daniels, Anniece

    2008-01-01

    The authors describe a set of upper-elementary activities that focuses on how animals communicate. The activities describe procedures that students working in groups can use to investigate the topic of animal communication. An initial information sheet, resource list, and grading rubric are provided. The lesson plan was field-tested in an…

  14. Fluid control structures in microfluidic devices

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Electrorheological (ER) Fluids: A Research Needs Assessment

    Science.gov (United States)

    1993-05-01

    arising from charges on the particles and modified by the presence and distribution of free ions. Magnetorheological (MR) fluids undergo strong...separate control of cab and trailer motions is probably the way to go. Other automotive uses that may come in the near future include vibration dampers ...this work used very simple fluids offering less than optimum performance, but provided some useful guidelines to damper and clutch design using ER fluids

  16. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...... when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...... 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...

  17. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    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......Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...... when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...

  18. Data communications

    Energy Technology Data Exchange (ETDEWEB)

    Preckshot, G.G. [Lawrence Livermore National Lab., CA (United States)

    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.

  19. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...... not determine the success of strategic communication. Rather, contextual factors such as competition, technological developments, global cultural trends and local traditions as well as employees’ skills and attitudes will determine the organization’s communicative success. This holds true regardless...... 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...

  20. PREFACE: XXI Fluid Mechanics Conference

    Science.gov (United States)

    Szmyd, Janusz S.; Fornalik-Wajs, Elzbieta; Jaszczur, Marek

    2014-08-01

    This Conference Volume contains the papers presented at the 21st Fluid Mechanics Conference (XXI FMC) held at AGH - University of Science and Technology in Krakow, Poland, 15-18 June 2014, and accepted for Proceedings published in the Journal of Physics: Conference Series. The Fluid Mechanics Conferences have been taking place every two years since 1974, a total of forty years. The 21st Fluid Mechanics Conference (XXI FMC) is being organized under the auspices of the Polish Academy of Sciences, Committee of Mechanics. The goal of this conference is to provide a forum for the exposure and exchange of ideas, methods and results in fluid mechanics. Conference topics include, but are not limited to Aerodynamics, Atmospheric Science, Bio-Fluids, Combustion and Reacting Flows, Computational Fluid Dynamics, Experimental Fluid Mechanics, Flow Machinery, General Fluid Dynamics, Hydromechanics, Heat and Fluid Flow, Measurement Techniques, Micro- and Nano- Flow, Multi-Phase Flow, Non-Newtonian Fluids, Rotating and Stratified Flows, Turbulence. Within the general subjects of this conference, the Professor Janusz W. Elsner Competition for the best fluid mechanics paper presented during the Conference is organized. Authors holding a M.Sc. or a Ph.D. degree and who are not older than 35 years of age may enter the Competition. Authors with a Ph.D. degree must present individual papers; authors with a M.Sc. degree may present papers with their supervisor as coauthor, including original results of experimental, numerical or analytic research. Six state-of-the-art keynote papers were delivered by world leading experts. All contributed papers were peer reviewed. Recommendations were received from the International Scientific Committee, reviewers and the advisory board. Accordingly, of the 163 eligible extended abstracts submitted, after a review process by the International Scientific Committee, 137 papers were selected for presentation at the 21st Fluid Mechanics Conference, 68

  1. Existential Communication.

    Science.gov (United States)

    Self, Charles C.

    Focusing on the seminal work "Being and Nothingness," this paper explores the implications of the ideas of Jean-Paul Sartre for the study of communication in society. The paper redefines communication from an existential point of view, explores some implications of this redefinition for the study of communication within the social…

  2. Communication Complexity

    Indian Academy of Sciences (India)

    Jaikumar Radhakrishnan

    Communication complexity. Strategy I. Alice x ∈ {0, 1}n. ⇒. ⇐. Bob y ∈ {0, 1}n. Naive strategy. Alice sends x to Bob. Bob tells Alice if x = y. Cost. Requires n + 1 bits of communication. Jaikumar Radhakrishnan. Communication Complexity ...

  3. 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...

  4. Amniotic fluid embolism

    National Research Council Canada - National Science Library

    Kaur, Kiranpreet; Bhardwaj, Mamta; Kumar, Prashant; Singhal, Suresh; Singh, Tarandeep; Hooda, Sarla

    2016-01-01

    Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse...

  5. 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.

  6. 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.

  7. Communicating with Professionals

    Medline Plus

    Full Text Available ... what you need – over the phone, at the hospital or during office visits. Good communication skills help you get better results from the time you spend with all your healthcare providers, not ...

  8. 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

  9. 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...... for understanding and managing strategic communication processes.......Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...

  10. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...... 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...... for understanding and managing strategic communication processes....

  11. 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....

  12. Communication Acoustics

    DEFF Research Database (Denmark)

    Blauert, Jens

    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......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......: acoustics, cognitive science, speech science, and communication technology....

  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......: acoustics, cognitive science, speech science, and communication technology....... 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...

  14. Measurement of interleukins in vitreous infusion fluid.

    Science.gov (United States)

    Kase, Satoru; Yokoi, Masahiko; Ishida, Susumu; Kase, Manabu

    2015-11-01

    Measurements of interleukin (IL)-6 and -10 concentrations in the vitreous can be used to differentiate intraocular lymphoma (IOL) from uveitis. This is the first study reporting the IL-6 and -10 concentrations in the undiluted vitreous fluid and vitreous infusion fluid, which were simultaneously examined in the patients. A total of 2 females presented with intraocular inflammation, and underwent pars plana vitrectomy. Undiluted anterior vitreous and vitreous infusion fluid were collected simultaneously. IL concentrations were determined by enzyme-linked immunosorbent assay systems. Vitreous infusion fluid of 20 ml was eventually collected following completion of core vitrectomy in the two patients. IL-6 concentrations of the first patient were 513 and 106 pg/ml in the undiluted vitreous and the infusion fluid, respectively, while those of the second patient were 263 and 29 pg/ml. By contrast, IL-10 was under the detectable levels in all the fluids. The IL-10/-6 ratio was vitreous fluid. The two patients were eventually diagnosed with uveitis. Measurements of IL concentrations in the vitreous infusion fluid provided significant evidence on the differential diagnosis between IOL and uveitis, when considering how vitreous infusion fluid was diluted. The present study highlighted a novel application of cytokine analyses using the vitreous infusion fluid, which may contribute to the development of future translational researches on uveitis/IOL patients.

  15. 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 chapt......: acoustics, cognitive science, speech science, and communication technology.......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...

  16. Amniotic fluid water dynamics

    NARCIS (Netherlands)

    Beall, M. H.; van den Wijngaard, J. P. H. M.; van Gemert, M. J. C.; Ross, M. G.

    2007-01-01

    Water arrives in the mammalian gestation from the maternal circulation across the placenta. It then circulates between the fetal water compartments, including the fetal body compartments, the placenta and the amniotic fluid. Amniotic fluid is created by the flow of fluid from the fetal lung and

  17. Fluid Statics and Archimedes

    Indian Academy of Sciences (India)

    In this article we derive equations for variation of pressure in a static fluid or in one that is moving as a rigid body. Also, we show that surfaces of constant pressure and constant density should coincide. Various types of instabilities related to submerged bodies and multi layerd fluids are briefly discussed. Pressure in Fluids.

  18. Legitimacy and Strategic Communication in Globalization

    DEFF Research Database (Denmark)

    Holmstrøm, Susanne Maria; Falkheimer, Jesper; Gade Nielsen, Astrid

    2010-01-01

    for strategic communication. As globalizing organizations increasingly face conflicting perceptions of legitimacy, new challenges to strategic communication arise. Different types of societal constitution breed different legitimating corporate settings. Taking as the empirical example the transnational...... Scandinavian dairy group Arla Foods, three fundamentally different legitimacy conflicts and their interplay with strategic communication are analyzed: between Western and Middle-East values; between former and present ideals as society changes from solid to fluid modernity; and between the neighboring...

  19. Fluid to fluid contact heat exchanger

    Science.gov (United States)

    Clark, W. E.

    1986-01-01

    Heat transfer and pressure drop test results for a fluid to fluid contact heat exchanger are reported. The heat exchanger, fabricated and tested to demonstrate one method of transferring heat between structures in space, had a total contact area of 0.18 sq m. It utilized contact surfaces which were flexible and conformed to the mating contact surfaces upon pressurization of the fluid circulating within the heat exchanger. During proof-of-concept performance tests, the heat exchanger was operated in a typical earth environment. It demonstrated a contact conductance of 3.8 kW/sq m C at contact pressures in the 15 to 70 kPa range.

  20. 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.

  1. 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.

  2. New trends in fluid mechanics research. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, F.G. [China Aerospace Corporation, Beijing (China). Science and Technology Council; Li, J.C. (eds.) [Chinese Academy of Science, Beijing (China). Inst. of Mechanics

    2008-07-01

    This volume is the proceedings of the Fifth International Conference on Fluid Mechanics (ICFM-V), the primary forum for the presentation of technological advances and research results in the fields of theoretical, experimental, and computational Fluid Mechanics. Following the previous conferences in Beijing (1987, 1993 and 1998) and Dalian (2004) organized by the Chinese Society of Theoretical and Applied Mechanics, the Scientific Committee for ICFM presents ICFM-V to provide a forum for researchers to exchange original ideas and recent advances in Fluid Mechanics and relevant interdisciplinary subjects. Topics include: flow instability and turbulence, aerodynamics and gas dynamics, hydrodynamics, industrial and environmental fluid mechanics, biofluid mechanics, geophysical fluid mechanics, plasma and magneto-hydrodynamics, multiphase flows, non-Newtonian flows and flows in porous media, flow of reacting fluid, microscale flow and others.The CD-ROM includes all papers presented at the conference in PDF format, including those that were not selected for the book. (orig.)

  3. Drug testing in oral fluid.

    Science.gov (United States)

    Drummer, Olaf H

    2006-08-01

    Over the last decade there have been considerable developments in the use of oral fluid (saliva) for drug testing. Oral fluid can provide a quick and non-invasive specimen for drug testing. However, its collection may be thwarted by lack of available fluid due to a range of physiological factors, including drug use itself. Food and techniques designed to stimulate production of oral fluid can also affect the concentration of drugs. Current applications are mainly focused on drugs of abuse testing in employees at workplaces where drug use has safety implications, in drivers of vehicles at the roadside and in other situations where drug impairment is suspected. Testing has included alcohol (ethanol) and a range of clinical tests eg antibodies to HIV, therapeutic drugs and steroids. Its main application has been for testing for drugs of abuse such as the amphetamines, cocaine and metabolites, opioids such as morphine, methadone and heroin, and for cannabis. Oral fluid concentrations of basic drugs such as the amphetamines, cocaine and some opioids are similar or higher than those in plasma. Tetrahydrocannabinol (THC), the major species present from cannabis use, displays similar concentrations in oral fluid compared to blood in the elimination phase. However, there is significant local absorption of the drug in the oral cavity which increases the concentrations for a period after use of drug. Depot effects occur for other drugs introduced into the body that allow local absorption, such as smoking of tobacco (nicotine), cocaine, amphetamines, or use of sub-lingual buprenorphine. Screening techniques are usually an adaptation of those used in other specimens, with an emphasis on the parent drug since this is usually the dominant species present in oral fluid. Confirmatory techniques are largely based on mass spectrometry (MS) with an emphasis on Liquid Chromatography-Mass Spectrometry (LC-MS), due to low sample volumes and the low detection limits required. Drug testing

  4. Supercritical Fluid Facilitated Growth of Copper and Aluminum Oxide Nanoparticles

    Science.gov (United States)

    Williams, Geoffrey L.; Vohs, Jason K.; Brege, Jonathan J.; Fahlman, Bradley D.

    2005-01-01

    Supercritical fluids (SCFs) possess properties that are intermediate between liquids and gases. The combination of supercritical fluid technology with advanced characterization techniques such as electron microscopy provided a practical and rewarding undergraduate laboratory experiment.

  5. 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...

  6. Fluid-Structure Interaction of Channel Driven Cavity Flow

    Science.gov (United States)

    2016-06-01

    study the fluid- structure interaction and provide benchmark data for validation of numerical fluid-structure interaction models. The channel driven...driven cavity flow in order to study the fluid-structure interaction and provide benchmark data for validation of numerical fluid-structure interaction...Finally, I would like to thank Mom and Dad for ensuring I received the best education possible while I lived at home. xiv THIS PAGE INTENTIONALLY

  7. Spinning fluids reactor

    Science.gov (United States)

    Miller, Jan D; Hupka, Jan; Aranowski, Robert

    2012-11-20

    A spinning fluids reactor, includes a reactor body (24) having a circular cross-section and a fluid contactor screen (26) within the reactor body (24). The fluid contactor screen (26) having a plurality of apertures and a circular cross-section concentric with the reactor body (24) for a length thus forming an inner volume (28) bound by the fluid contactor screen (26) and an outer volume (30) bound by the reactor body (24) and the fluid contactor screen (26). A primary inlet (20) can be operatively connected to the reactor body (24) and can be configured to produce flow-through first spinning flow of a first fluid within the inner volume (28). A secondary inlet (22) can similarly be operatively connected to the reactor body (24) and can be configured to produce a second flow of a second fluid within the outer volume (30) which is optionally spinning.

  8. Celebrity endorsement in marketing communications

    OpenAIRE

    Aspa, Jukka Kimmo Antero

    2009-01-01

    This master thesis will discuss elements of using celebrity in marketing communication. Theory will cover basic communication process, Elaboration Likelihood Model, and meaning transfer model but main focus will be in discussing various celebrity selection theories, identifying different risks involved in using celebrities in marketing communication and investigating ways how to utilize celebrities to enhance the communication. Several examples are included to provide connection to real life ...

  9. 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...

  10. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...... when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...... 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...

  11. Strategizing Communication

    DEFF Research Database (Denmark)

    Gulbrandsen, Ib Tunby; Just, Sine Nørholm

    not determine the success of strategic communication. Rather, contextual factors such as competition, technological developments, global cultural trends and local traditions as well as employees’ skills and attitudes will determine the organization’s communicative success. This holds true regardless......Strategizing Communication offers a unique perspective on the theory and practice of strategic communication. Written for students and practitioners interested in learning about and acquiring tools for dealing with the technological, environmental and managerial challenges, which organizations face...... when communicating in today’s mediascape, this book presents an array of theories, concepts and models through which we can understand and practice communication strategically. The core of the argument is in the title: strategizing – meaning the act of making something strategic. This entails looking...

  12. MANAGERIAL COMMUNICATION

    OpenAIRE

    Stefanescu, Camelia; Popa, Laura

    2008-01-01

    The new spirit of business must be marked by efficient managerial communication. To build, to develop and to run business means, first of all, to communicate, to transmit information, opinions and decisions and, at the same time, to receive answers to such. In practice, the manager is required to have certain qualities that are indispensable for the managerial activity, and the ability to communicate efficiently is one of them. Under the pressure of the changes occurring in the business envir...

  13. [Verbal communication].

    Science.gov (United States)

    Fiorini, Fulvio; Panini, Roberta; Ameri, Cinzia

    2014-01-01

    The communication is an action that occupies a lot of part of the life of every individual and understands a whole activity that the purpose has to reach a preset goal: the communication obligatorily foresees the presence of a recipient/receiving.During communication we used both the word, but also the gesture and the way of do/say. The oral communication represents the most complete system however, evolved, end and thin to communicate, able to also express concepts and thoughts and not only behaviors: with it he can also lie and to supply misinformation. The oral communication also possesses an important temporal value, in how much you/he/she can define him now, the before and the then, but also the ability to determine the human relationships, because it participates in to define the different roles in which broadcasting station and receiver are found at that time. The truest power of the words is that to create, to maintain, to modify other people's behaviors; a natural correlation exists that is between communication and behavior. The final objective of the communication results therefore that to create or to modify the relationships and the human behaviors; in other terms we can be affirmed that the words can determine the reality. The true ragion to be to communicate is the purpose however, that who speaks he/she wants to reach: it is a voluntary, both mental and physical effort, that originates from a need both explicit and implicit of whom sends forth the message.

  14. Intercultural Communication

    National Research Council Canada - National Science Library

    Georgeta Modiga

    2014-01-01

    .... Meanwhile, conjunction and theoretical approaches we witness interference, under the imperative of interdisciplinary vision lead us, often up to a damaging confusion between communication and culture...

  15. 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.

  16. Metalworking fluids: oil mist and beyond.

    Science.gov (United States)

    Gauthier, Stephen L

    2003-11-01

    This article is based upon my own experiences with metalworking fluids and the adverse health effects and medical conditions associated with exposure to metalworking fluids. I have researched and witnessed the benefits that can be achieved when metalworking fluids are properly maintained and managed. My experiences have provided insight into how a shop operates, including comprehension of the equipment used, processes, mist generating points, engineering controls currently being adopted, and procedures that are used to maintain metalworking fluids. I have been able to share my personal experiences with the country's leading experts in the field of metalworking fluids. I have presented my insights on the topic in Washington, D.C., to the Standard Advisory Committee of OSHA, as well as at many other conferences nationwide. I have provided awareness training for a number of union and nonunion workers. Being a part of developing successful metal removal fluid programs, I realize the importance of transferring and sharing information. Many times an organization is not fully aware of certain conditions and how to combat them. My mission and intent is to properly educate those who are exposed to the harm that metalworking fluids can invoke and to inform those involved of the possible methods of reducing long- and short-term risk. One thing that must be kept in mind is the way we view these fluids. Many shops categorize the fluids as a type of "operating expense" when they should actually be seen as a sort of investment. Just as performing a scheduled maintenance on a machine promises the best possible longevity of that machine, the upkeep of metalworking fluid also provides longer "tool life." Monitoring and maintaining the fluids also provides for more effective and efficient productivity. If we fail to consider that proper management of the fluids can cut cost dramatically, then we will miss out on the financial impact they can have on a company. Try looking at the

  17. 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…

  18. 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.

  19. 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.

  20. Method and apparatus for fluid dispersion

    Energy Technology Data Exchange (ETDEWEB)

    Stone, Howard A; Anna, Shelley L; Bontoux, Nathalie; Link, Darren Roy; Weitz, David A; Gitlin, Irina; Kumacheva, Eugenia; Garstecki, Piotr; Diluzio, Willow R; Whitesides, George M

    2015-03-24

    A microfluidic method and device for focusing and/or forming discontinuous sections of similar or dissimilar size in a fluid is provided. The device can be fabricated simply from readily-available, inexpensive material using simple techniques.

  1. Fluid Management in Patients with Trauma: Restrictive Versus Liberal Approach.

    Science.gov (United States)

    Palmer, Lee

    2017-03-01

    Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival. This article discusses the current evidence regarding liberal and restrictive fluid strategies for trauma. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 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.

  3. 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

  4. Mediatization and Government Communication

    DEFF Research Database (Denmark)

    Laursen, Bo; Valentini, Chiara

    2015-01-01

    in the light of mediatization and government communication theories. Without one pan-European public sphere, the European Parliament, like the other European Union (EU) institutions, competes with national actors for the news media’s attention in the EU’s twenty-eight national public spheres, where EU affairs......” in their communication efforts, and that they face a daily professional challenge as they attempt to promote the European Parliament and its activities to the news media in a way that will not compromise their credibility as government sources. The study provides new insights into communicative aspects of EU governance...

  5. 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....

  6. Communicating Information

    Indian Academy of Sciences (India)

    There was a mathematical theory of information and communication even prior to Shannon. Shannon's land- mark contribution is in his use of probability theory to quantify information communicated across a chan- nel and in the operational significance of his definitions and theorems. Further, his definitions turned out to.

  7. Communicating up

    Science.gov (United States)

    Lum, Lydia

    2013-01-01

    Chief communicators at many U.S. institutions are interested in forging closer ties with governing boards. Proponents say such relationships can increase board trust and confidence in communicators before a crisis occurs, making it easier to manage the institution's reputation and limit negative publicity when one does. At some institutions, such…

  8. 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'

  9. 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…

  10. 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.

  11. DENSO Technical Communication Education

    Science.gov (United States)

    Isogai, Emiko; Suzuki, Takamasa

    We developed technical communication education from beginning to managerial levels to enhance communication skills necessary for engineers. The courses in this program progressed from theory to hands-on training and discussion, providing an opportunity for fact-finding and problem-solving. After the courses were completed, the engineers applied what they had learned on the job. The courses proved to be useful, satisfying participating engineers.

  12. 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.

  13. 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

  14. Communications for Wearable Devices

    OpenAIRE

    Tabibu, Shivram

    2017-01-01

    Wearable devices are transforming computing and the human-computer interaction and they are a primary means for motion recognition of reflexive systems. We review basic wearable deployments and their open wireless communications. An algorithm that uses accelerometer data to provide a control and communication signal is described. Challenges in the further deployment of wearable device in the field of body area network and biometric verification are discussed.

  15. Communications for ROV operation

    Energy Technology Data Exchange (ETDEWEB)

    1985-09-01

    This paper discusses the use of fiber optics for ROV communications; greatly improving the quality and depth capabilities of these vehicles. It discusses the design of the new fiber optic cables which were engineered to provide the minimum drag from sea currents and weight problems associated with heavier metal cable communication systems. It discusses the design and use of these cables in actual underwater operations and compares the reliability of data transmission.

  16. 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

  17. Communicating health.

    Science.gov (United States)

    Chatterjee, A

    1995-01-01

    Routine production of communication materials without paying attention to utilization, field test, and impact analysis is ineffective. The concept of information, education, and communication (IEC) should encompass voluntary activity of health education in a tradition of innovation. One seminal factor may be the communication technologies developed by the National Technology Missions. The missions were participatory by seeking solutions among communities and analyzing health issues from the perspective of those directly involved, rather than from the top down. The prime focus of the national drinking water mission was convenience, hence messages concentrating on health advantages were ignored. At this juncture, influencing health behavior required decentralization reflecting local cultures. Thus community-based partners became the foundation of a strategy of communicating safe water. As national strategies emerged in each of the technology missions, communication addressed advocacy of the need for political will, dissemination of technical information, and influencing patterns of behavior. Despite learning a new understanding, the danger exists that IEC remains just another label of mass communication with posters, advertisements, brochures, radio, and television. Decisions on contraceptive choice and use requires more than just accurate information; it requires the power to make such a decision. A new approach demands a priority for communication skills taking into account people's aspirations. The HIV-AIDS crisis underlines the urgency with which communication has to respond to health challenges. A series of experiments facilitated by the World Conservation Union helped build communication capabilities among environmental groups working in Latin America, Africa, and India. The International Reference Center on Water and Sanitation initiated pilot communication projects in West Africa for community health.

  18. Sources of variability in human communicative skills.

    Science.gov (United States)

    Volman, Inge; Noordzij, Matthijs L; Toni, Ivan

    2012-01-01

    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 complex collaborative activity.

  19. Thermodynamics of Fluid Polyamorphism

    Science.gov (United States)

    Anisimov, Mikhail A.; Duška, Michal; Caupin, Frédéric; Amrhein, Lauren E.; Rosenbaum, Amanda; Sadus, Richard J.

    2018-01-01

    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.

  20. 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

  1. Sphere based fluid systems

    Science.gov (United States)

    Elleman, Daniel D. (Inventor); Wang, Taylor G. (Inventor)

    1989-01-01

    Systems are described for using multiple closely-packed spheres. In one system for passing fluid, a multiplicity of spheres lie within a container, with all of the spheres having the same outside diameter and with the spheres being closely nested in one another to create multiple interstitial passages of a known size and configuration and smooth walls. The container has an inlet and outlet for passing fluid through the interstitial passages formed between the nested spheres. The small interstitial passages can be used to filter out material, especially biological material such as cells in a fluid, where the cells can be easily destroyed if passed across sharp edges. The outer surface of the spheres can contain a material that absorbs a constitutent in the flowing fluid, such as a particular contamination gas, or can contain a catalyst to chemically react the fluid passing therethrough, the use of multiple small spheres assuring a large area of contact of these surfaces of the spheres with the fluid. In a system for storing and releasing a fluid such as hydrogen as a fuel, the spheres can include a hollow shell containing the fluid to be stored, and located within a compressable container that can be compressed to break the shells and release the stored fluid.

  2. DIORAMA Communications

    Energy Technology Data Exchange (ETDEWEB)

    Galassi, Mark C. [Los Alamos National Laboratory

    2016-05-24

    Diorama is written as a collection of modules that can run in separate threads or in separate processes. This defines a clear interface between the modules and also allows concurrent processing of different parts of the pipeline. The pipeline is determined by a description in a scenario file[Norman and Tornga, 2012, Tornga and Norman, 2014]. The scenario manager parses the XML scenario and sets up the sequence of modules which will generate an event, propagate the signal to a set of sensors, and then run processing modules on the results provided by those sensor simulations. During a run a variety of “observer” and “processor” modules can be invoked to do interim analysis of results. Observers do not modify the simulation results, while processors may affect the final result. At the end of a run results are collated and final reports are put out. A detailed description of the scenario file and how it puts together a simulation are given in [Tornga and Norman, 2014]. The processing pipeline and how to program it with the Diorama API is described in Tornga et al. [2015] and Tornga and Wakeford [2015]. In this report I describe the communications infrastructure that is used.

  3. 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.

  4. 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.

  5. External Suction and Fluid Output in Chest Drains After Lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Neckelmann, Kirsten; Licht, Peter B

    2017-01-01

    was delegated to staff nurses: air leakage less than 20 mL/min for 6 hours regardless of fluid output, provided it was serous. The primary end point was fluid output after 24 and 48 hours. RESULTS: Mean fluid output was significantly higher with high suction after both 24 (338 ± 265 mL versus 523 ± 215 m...

  6. Intercultural Communication

    Directory of Open Access Journals (Sweden)

    Georgeta Modiga

    2014-05-01

    Full Text Available The concept of culture has become one of strategic importance for all disciplines studying human and social universe, being invested today with multiple explanatory connotations. Meanwhile, conjunction and theoretical approaches we witness interference, under the imperative of interdisciplinary vision lead us, often up to a damaging confusion between communication and culture. Distinction between symbolic and instrumental, of culture and civilization are necessary to not confuse the contents of symbolic culture media of communication technology. An inventory of issues and social transformations that have acquired an indisputable relevance in contemporary development equation surgery is necessary but difficult. It should be mentioned two of them, given their global significance: the rediscovery of culture as a defining factor of the social and importance that have acquired communication processes in living societies. In fact, between the two aspects there is a relationship of inherent and consubstantiality, validated by actual historical experience. Culture and Communication is now a binomial with terms interchangeably, the two processes intertwined in a single block. Welding of the two dimensions was otherwise devoted to the vocabulary of social sciences and humanities through the concepts of culture media and intercultural communication. If we examine the paradigm shift in the theoretical space of the last century, the most surprising phenomena that we observe is that theories concerning communication space literally invaded the area that was traditionally reserved for theories about culture. For theorists today, communication is a structural constituent and all definitions, descriptions and characterizations that build on contemporary culture.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Damping of a fluid-conveying pipe surrounded by a viscous annulus fluid

    Science.gov (United States)

    Kjolsing, Eric J.; Todd, Michael D.

    2017-04-01

    To further the development of a downhole vibration based energy harvester, this study explores how fluid velocity affects damping in a fluid-conveying pipe stemming from a viscous annulus fluid. A linearized equation of motion is formed which employs a hydrodynamic forcing function to model the annulus fluid. The system is solved in the frequency domain through the use of the spectral element method. The three independent variables investigated are the conveyed fluid velocity, the rotational stiffness of the boundary (using elastic springs), and the annulus fluid viscosity. It was found that, due to the hydrodynamic functions frequency-dependence, increasing the conveyed fluid velocity increases the systems damping ratio. It was also noted that stiffer systems saw the damping ratio increase at a slower rate when compared to flexible systems as the conveyed fluid velocity was increased. The results indicate that overestimating the stiffness of a system can lead to underestimated damping ratios and that this error is made worse if the produced fluid velocity or annulus fluid viscosity is underestimated. A numeric example was provided to graphically illustrate these errors. Approved for publication, LA-UR-15-28006.

  12. 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...

  13. 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

  14. Polio communication.

    Science.gov (United States)

    Galaway, Michael

    2005-12-01

    Substantial investments are being made in the area of communication and social mobilisation to interrupt transmission of wild poliovirus. A number of organisations with active support from the Government of India and various state governments are implementing activities to raise awareness and encourage all families to immunise their children. A mass media campaign is the most recognised health promotion effort on media. Mass media efforts are being backed by intensive social mobilisation and interpersonal communication efforts in polio-endemic states. Advocacy and editorial media environment are key elements of the overall communication approach, creating a conducive environment for the polio programme.

  15. Fluid Mechanics and Fluid Power (FMFP)

    Indian Academy of Sciences (India)

    Amitabh Bhattacharya

    engineers to efficiently simulate turbulent flows, was in fact first devised by Joseph Smagorinsky, a researcher in atmo- spheric science. ... Over the last few decades, mainly due to the rapid improvement in computational efficiency, cameras, optics and instrumentation, both ... towards design of fluid power systems. Asim and ...

  16. Dynamics of Complex Fluid-Fluid Interfaces

    NARCIS (Netherlands)

    Sagis, L.M.C.

    2016-01-01

    This chapter presents an overview of recent progress in modelling the behaviour of complex fluid–fluid interfaces with non-equilibrium thermodynamics. We will limit ourselves to frameworks employing the Gibbs dividing surface model, and start with a general discussion of the surface excess

  17. 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...

  18. Deep Mantle Fluids Bottled Up in Diamonds

    Science.gov (United States)

    Weiss, Y.; Pearson, D. G.

    2015-12-01

    Many mantle xenoliths and mineral inclusions in diamonds reflect refertilisation and enrichment by mantle metasomatism, a key mechanism for controlling abrupt changes in the chemical and physical properties of the continental lithospheric mantle (CLM) globally. However, the nature of the fluids involved can normally only be constrained indirectly from geochemical proxies or calculated using mineral/melt partition coefficients. Direct samples of mantle metasomatic fluids, shielded from any late stage alteration, are encased as microinclusions in fast-growing diamonds - "fibrous diamonds". These trapped high-density fluids (HDFs) provide a unique chemical and physical record for tracing the sources of deep mantle fluids and constraining the processes that shape their nature.Diamond HDFs vary between four major compositional types: saline, silicic and high-Mg plus low-Mg carbonatitic. A strong connection has been established between high-Mg carbonatitic HDFs and a carbonated peridotite source. In addition, the silicic and low-Mg carbonatitic HDFs have been related to hydrous eclogite (±carbonate). However, the compositionally extreme saline fluid endmember remained enigmatic and its source in the deep lithosphere has remained ambiguous. Our new data on fluid-rich diamonds show the geochemical fingerprints of a subducting slab as the source of deep mantle fluids of saline composition. In addition, for the first time, we show that these deep saline fluids are parental, via fluid rock interaction, to in-situ forming carbonatitic and silicic melts in the lithosphere. This model provides a strong platform for resolving the effects of the compositional spectrum of mantle fluids, which alter the deep lithosphere globally and play key roles in diamond formation.

  19. Fluid Statics and Archimedes

    Indian Academy of Sciences (India)

    Fluid Statics and Archimedes. Jaywant H Arakeri C Dharuman. General Article Volume 11 Issue 10 October 2006 pp 28- ... Keywords. Fluid statics; buoyancy; stratification; instability. Author Affiliations. Jaywant H Arakeri1 C Dharuman1. Department of Mechanical Engineering, Indian Institute of Science, Bangalore 560012 ...

  20. 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 ...

  1. Fluid loading responsiveness

    NARCIS (Netherlands)

    Geerts, Bart

    2011-01-01

    Patients in the intensive care unit (ICU) and in the peri-operative phase are dependent on physicians and nurses for their fluid intake. Volume status optimization is required to maximize oxygen delivery to vital organs. Unnecessary fluid administration can, however, lead to general and pulmonary

  2. Research in Technical Communication. A Bibliographic Sourcebook.

    Science.gov (United States)

    Moran, Michael G., Ed.; Journet, Debra, Ed.

    The essays in this volume enunciate the pressing need for a theoretical framework for the study of technical communication. The first part of the volume provides an overview of extensive ways to study technical communication. Subsequent chapters discuss humanistic approaches to technical communication, the history of technical communication,…

  3. Group Communication in Amoeba and its Applications

    NARCIS (Netherlands)

    Kaashoek, M.F.; Tanenbaum, A.S.; Verstoep, C.

    1993-01-01

    Unlike many other operating systems, Amoeba is a distributed operating system that provides group communication (i.e. one-to-many communication). The authors discuss design issues for group communication, Amoeba's group system calls, and the protocols to implement group communication. To demonstrate

  4. 49 CFR 193.2519 - Communication systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Communication systems. 193.2519 Section 193.2519...: 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...

  5. Aesthetic Communication

    DEFF Research Database (Denmark)

    Thyssen, Ole

    2012-01-01

    Based on Niklas Luhmann's systems theory, aesthetics is defined as a manner of reinforcing the connectivity, or Anschlusswert, of communication. Without changing the content, a message can be made more attractive, strengthening the receiver's willingness to be attentive and accepting....... As communication inevitably makes use of a sensuous medium, such as light or sound, all communication has an aesthetic dimension. In the 19th Century, an important distinction was made between pure and applied art, following Immanuel Kant's separation of theory of knowledge, moral theory and aesthetic theory....... Whereas pure art is produced in order to be observed, applied art has to fulfill practical purposes as well. Modern organizations, defined as systems of communication, may use art works to embellish and define themselves. But they inevitably use applied art as a practical tool in their normal...

  6. 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.

  7. Simulation Of Cell Signaling Communications

    OpenAIRE

    Huertas González, Daniel

    2014-01-01

    Simulation of cell signaling communications using the Omnet ++ Simulation Framework and molecular dynamics algorithms. [ANGLÈS] Cells, whether they be unicellular organisms or belong to a multicellular organism, are able to encode and transmit information to each other by means of signaling molecules and the diffusion processes in the extracellular fluid. The aim of this project is to develop an Event Driven Molecular Dynamics (EDMD) simulator using the Omnet++ Simulation Framework in orde...

  8. Climate change communication: what can we learn from communication theory?

    DEFF Research Database (Denmark)

    Ballantyne, Anne Gammelgaard

    2016-01-01

    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...... 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......The literature on climate change communication addresses a range of issues relevant to the communication of climate change and climate science to lay audiences or publics. In doing so, it approaches this particular challenge from a variety of different perspectives and theoretical frameworks...

  9. Accessing Thermodynamic Fluid Properties in LabVIEW

    CERN Document Server

    Grohmann, S

    2001-01-01

    LabVIEW users that are experimenting with fluid circuits and want to have an online evaluation of measuring data need to import thermodynamic properties of the working fluid. This document describes how CRYODATA's software package GASPAK can be accessed from LabVIEW via ActiveX Automation. An interface server has been developed to enable inter-application communication. The installation of the server is explained and its function calls are demonstrated in a set of example VIs.

  10. Hamiltonian description of the ideal fluid

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. 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.

  12. Maintenance Fluid Therapy: Isotonic Versus Hypotonic Solutions.

    Science.gov (United States)

    Hansen, Bernie; Vigani, Alessio

    2017-03-01

    The goal of maintenance fluid therapy in small animals is to replace normal ongoing losses of water and salts when oral intake is withheld. Hospitalized dogs and cats may have multiple stimuli for antidiuretic hormone release that disrupt normal osmoregulation and predispose to water retention. Severe illness promotes retention of both sodium and water as edema. Commercially available fluids have electrolyte concentrations that are very different from dietary maintenance requirements, and potential consequences include development of hypoosmolality, edema, or both when excesses of water or sodium are administered. Suggestions for tailoring fluid administration toward specific goals are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Patient-doctor communication.

    Science.gov (United States)

    Teutsch, Carol

    2003-09-01

    Communication is an important component of patient care. Traditionally, communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communicating per se. The reliability and consistency of this teaching method left gaps, which are currently getting increased attention from medical schools and accreditation organizations. There is also increased interest in researching patient-doctor communication and recognizing the need to teach and measure this specific clinical skill. In 1999, the Accreditation of Council for Graduate Medical Education implemented a requirement for accreditation for residency programs that focuses on "interpersonal and communications skills that result in effective information exchange and teaming with patients, their families, and other health professionals." The National Board of Medical Examiners, Federation of State Medical Boards. and the Educational Commission for Foreign Medical Graduates have proposed an examination between the. third and fourth year of medical school that "requires students to demonstrate they can gather information from patients, perform a physical examination, and communicate their findings to patients and colleagues" using standardized patients. One's efficiency and effectiveness in communication can be improved through training, but it is unlikely that any future advances will negate the need and value of compassionate and empathetic two-way communication between clinician and patient. The published literature also expresses belief in the essential role of communication. "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient communication can have beneficial effects on health outcomes". A systematic review of

  14. Bridging Corporate and Organizational Communication

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Cornelissen, Joep

    2011-01-01

    The theory and practice of corporate communication is usually driven by other disciplinary concerns than the field of organizational communication. However, its particular mind-set focusing on wholeness and consistency in corporate messages increasingly influence the domain of contemporary...... organizational communication as well. We provide a formative and critical review of research on corporate communication as a platform for highlighting crucial intersections with select research traditions in organizational communication to argue for a greater integration between these two areas of research....... Following this review, we relax the assumptions underlying traditional corporate communication research and show how these dimensions interact in organizational and communication analysis, thus, demonstrating the potential for a greater cross-fertilization between the two areas of research. This cross...

  15. Micromachined Fluid Inertial Sensors

    Directory of Open Access Journals (Sweden)

    Shiqiang Liu

    2017-02-01

    Full Text Available Micromachined fluid inertial sensors are an important class of inertial sensors, which mainly includes thermal accelerometers and fluid gyroscopes, which have now been developed since the end of the last century for about 20 years. Compared with conventional silicon or quartz inertial sensors, the fluid inertial sensors use a fluid instead of a solid proof mass as the moving and sensitive element, and thus offer advantages of simple structures, low cost, high shock resistance, and large measurement ranges while the sensitivity and bandwidth are not competitive. Many studies and various designs have been reported in the past two decades. This review firstly introduces the working principles of fluid inertial sensors, followed by the relevant research developments. The micromachined thermal accelerometers based on thermal convection have developed maturely and become commercialized. However, the micromachined fluid gyroscopes, which are based on jet flow or thermal flow, are less mature. The key issues and technologies of the thermal accelerometers, mainly including bandwidth, temperature compensation, monolithic integration of tri-axis accelerometers and strategies for high production yields are also summarized and discussed. For the micromachined fluid gyroscopes, improving integration and sensitivity, reducing thermal errors and cross coupling errors are the issues of most concern.

  16. Micromachined Fluid Inertial Sensors

    Science.gov (United States)

    Liu, Shiqiang; Zhu, Rong

    2017-01-01

    Micromachined fluid inertial sensors are an important class of inertial sensors, which mainly includes thermal accelerometers and fluid gyroscopes, which have now been developed since the end of the last century for about 20 years. Compared with conventional silicon or quartz inertial sensors, the fluid inertial sensors use a fluid instead of a solid proof mass as the moving and sensitive element, and thus offer advantages of simple structures, low cost, high shock resistance, and large measurement ranges while the sensitivity and bandwidth are not competitive. Many studies and various designs have been reported in the past two decades. This review firstly introduces the working principles of fluid inertial sensors, followed by the relevant research developments. The micromachined thermal accelerometers based on thermal convection have developed maturely and become commercialized. However, the micromachined fluid gyroscopes, which are based on jet flow or thermal flow, are less mature. The key issues and technologies of the thermal accelerometers, mainly including bandwidth, temperature compensation, monolithic integration of tri-axis accelerometers and strategies for high production yields are also summarized and discussed. For the micromachined fluid gyroscopes, improving integration and sensitivity, reducing thermal errors and cross coupling errors are the issues of most concern. PMID:28216569

  17. Communication Offline or Communication Online?

    National Research Council Canada - National Science Library

    Maria-Magdalena Lupu

    2014-01-01

      About the communication it has been said and wrote a lot of volumes and it seems that the subject is far to be exhausted, the specific problem of this domain instead of being restricted, it extends...

  18. Communicability testing for voice communications

    NARCIS (Netherlands)

    Wijngaarden, S.J. van; Tardelli, J.D.; Hassanein, H.; Ray, B.; Collura, J.S.

    2002-01-01

    Traditionally, the performance of low bit rate coders was measured by two performance characteristics, namely quality and intelligibility. However, those characteristics are not adequate for measuring the performance over a realistic communication link, where factors such as hannel conditions

  19. Interdisciplinary Analysis of Drought Communication Through Social Media Platforms and Risk Communication

    Science.gov (United States)

    Wygant, M.

    2015-12-01

    As droughts continue to impact businesses and communities throughout the United States, there needs to be a greater emphasis on drought communication through interdisciplinary approaches, risk communication, and digital platforms. The purpose of this research is to provide an overview of the current literature on communicating drought and suggests areas for further improvement. Specifically, this research focuses on communicating drought through social media platforms such as Facebook, Twitter, and Instagram. It also focuses on the conglomeration of theoretical frameworks within the realm of risk communication, to provide a strong foundation towards future drought communication. This research proposal provides a critical step to advocate for paradigmatic shifts within natural hazard communication.

  20. 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.

  1. Critical fluid light scattering

    Science.gov (United States)

    Gammon, Robert W.

    1988-01-01

    The objective is to measure the decay rates of critical density fluctuations in a simple fluid (xenon) very near its liquid-vapor critical point using laser light scattering and photon correlation spectroscopy. Such experiments were severely limited on Earth by the presence of gravity which causes large density gradients in the sample when the compressibility diverges approaching the critical point. The goal is to measure fluctuation decay rates at least two decades closer to the critical point than is possible on earth, with a resolution of 3 microK. This will require loading the sample to 0.1 percent of the critical density and taking data as close as 100 microK to the critical temperature. The minimum mission time of 100 hours will allow a complete range of temperature points to be covered, limited by the thermal response of the sample. Other technical problems have to be addressed such as multiple scattering and the effect of wetting layers. The experiment entails measurement of the scattering intensity fluctuation decay rate at two angles for each temperature and simultaneously recording the scattering intensities and sample turbidity (from the transmission). The analyzed intensity and turbidity data gives the correlation length at each temperature and locates the critical temperature. The fluctuation decay rate data from these measurements will provide a severe test of the generalized hydrodynamic theories of transport coefficients in the critical regions. When compared to equivalent data from binary liquid critical mixtures they will test the universality of critical dynamics.

  2. A discursive approach to organizational health communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Pors, Anja Svejgaard

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health...... communication, identifying three distinct types of communication ideas and tools: clinical communication, extra-clinical communication and corporate communication. In order to assess the wider implications of health communication, we elaborate a discursive perspective, illustrated by presenting exemplary...... analyses of a) the institutionalisation of communication ideals, b) the communicative management of meaning and c) communication tools as organising technologies. The discursive perspective highlights that organisations and individual healthcare providers should not only look for the desired outcomes...

  3. Communicating science and engineering data in the information age

    National Research Council Canada - National Science Library

    Panel on Communicating National Science Foundation Science and Engineering Information to Data Users; National Research Council

    2012-01-01

    ...) communicates its science and engineering (S&E) information to data users in a very fluid environment that is undergoing modernization at a pace at which data producer dissemination practices, protocols, and technologies, on one hand, and user...

  4. Cosmological perturbations for imperfect fluids

    CERN Document Server

    Giovannini, Massimo

    2005-01-01

    Interacting fluids, endowed with bulk viscous stresses, are discussed in a unified perspective with the aim of generalizing the treatment of cosmological perturbation theory to the case where both fluctuating decay rates and fluctuating bulk viscosity coefficients are simultaneously present in the relativistic plasma. A gauge-invariant treatment of the qualitatively new phenomena arising in this context is provided. In a complementary approach, faithful gauge-fixed descriptions of the gravitational and hydrodynamical fluctuations are developed and exploited. To deepen the interplay between bulk viscous stresses and fluctuating decay rates, illustrative examples are proposed and discussed both analytically and numerically. Particular attention is paid to the coupled evolution of curvature and entropy fluctuations when, in the relativistic plasma, at least one of the interacting fluids possesses a fluctuating bulk viscosity coefficient. It is argued that this class of models may be usefully employed as an effec...

  5. Validation of computational fluid dynamics

    Science.gov (United States)

    Sacher, P. W.; Bradley, R. G., Jr.; Schmidt, W.

    1989-05-01

    The Fluid Dynamics Panel AGARD Symposium entitled Validation of Computational Fluid Dynamics is reviewed and evaluated. The purpose of the Symposium was to assess the state of the art of Validation of Computer Codes and to ensure that the mathematical and numerical schemes employed in the codes correctly model the critical physics of the flow field under consideration. The evaluator addresses each of the papers presented separately and makes general comments on the seven major topic sessions. In addition, a Poster Session is reviewed in detail. It is evident that the new possibilities of CFD provide efficient tools for Analysis and Design in the Aeronautical Industry, but it is also evident that in spite of the existence of a number of excellent experimental databases, there is still a need for efforts in validating the computer programs both by experiment as well as by numerical exercises.

  6. Local empathy provides global minimization of congestion in communication networks

    Science.gov (United States)

    Meloni, Sandro; Gómez-Gardeñes, Jesús

    2010-11-01

    We present a mechanism to avoid congestion in complex networks based on a local knowledge of traffic conditions and the ability of routers to self-coordinate their dynamical behavior. In particular, routers make use of local information about traffic conditions to either reject or accept information packets from their neighbors. We show that when nodes are only aware of their own congestion state they self-organize into a hierarchical configuration that delays remarkably the onset of congestion although leading to a sharp first-order-like congestion transition. We also consider the case when nodes are aware of the congestion state of their neighbors. In this case, we show that empathy between nodes is strongly beneficial to the overall performance of the system and it is possible to achieve larger values for the critical load together with a smooth, second-order-like, transition. Finally, we show how local empathy minimize the impact of congestion as much as global minimization. Therefore, here we present an outstanding example of how local dynamical rules can optimize the system’s functioning up to the levels reached using global knowledge.

  7. Students' Perceptions of Communications and Course Motivation Provided by Faculty

    Science.gov (United States)

    Evert, Amanda; Blackwell, Cindy; Tilley, Daniel; Weckler, Paul; Holcomb, Rodney

    2013-01-01

    Because innovation is essential to the future of our society and because there is a need to prepare college students to succeed in business organizations, it has become increasingly important to investigate the factors that enhance or discourage creativity and innovation. College professors have a vital role in introducing students to the…

  8. 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.

  9. 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.

  10. Exploiting & sharing context : computer mediated nonverbal communication

    OpenAIRE

    Sahami Shirazi, Alireza

    2014-01-01

    Humans are social beings and need to communicate and share their emotions. Communication takes place by exchanging not only verbal information but also nonverbal information. With the development of human civilization, communication is undergoing a constant change. The advances in technologies have led to new communication mediums allowing non-colocated persons to communicate and exchange information. Further, the ubiquity of computers, such as mobile phones, has provided the possibility to u...

  11. Biosynthetic infochemical communication.

    Science.gov (United States)

    Olsson, S B; Challiss, R A J; Cole, M; Gardeniers, J G E; Gardner, J W; Guerrero, A; Hansson, B S; Pearce, T C

    2015-07-09

    There is an ever-increasing demand for data to be embedded in our environment at ever-decreasing temporal and spatial scales. Whilst current communication and storage technologies generally exploit the electromagnetic properties of media, chemistry offers us a new alternative for nanoscale signaling using molecules as messengers with high information content. Biological systems effectively overcome the challenges of chemical communication using highly specific biosynthetic pathways for signal generation together with specialized protein receptors and nervous systems. Here we consider a new approach for information transmission based upon nature's quintessential example of infochemical communication, the moth pheromone system. To approach the sensitivity, specificity and versatility of infochemical communication seen in nature, we describe an array of biologically-inspired technologies for the production, transmission, detection, and processing of molecular signals. We show how it is possible to implement each step of the moth pheromone pathway for biosynthesis, transmission, receptor protein binding/transduction, and antennal lobe processing of monomolecular and multimolecular signals. For each implemented step, we discuss the value, current limitations, and challenges for the future development and integration of infochemical communication technologies. Together, these building blocks provide a starting point for future technologies that can utilize programmable emission and detection of multimolecular information for a new and robust means of communicating chemical information.

  12. Management & Communication

    CERN Multimedia

    2006-01-01

    Calendar of courses for September to December 2006 Please check our Web site to find out the number of places available, which may vary. Management Curriculum 2nd semester 2006 Titles Dates Language Quality Management 18, 19 September Bilingual Managing Teams 19, 20, 21 September English Communicating Effectively - Residential 20, 21, 22 septembre Bilingual (Full) Personal Awareness & Impact 26, 27, 28 September Bilingual Introduction to Leadership 4, 5, 6 October Bilingue IProject Scheduling & Costing 12, 13 October English CDP-SL part 1 Several sessions Dates to be fixed English or French Personal Awareness & Impact 23, 24 October Bilingual Communicating to Convince 23, 24, 25 October Bilingual CDP-GL part 2 25, 26, 27 October English CDP-GL part 1 Dates to be fixed Bilingual Risk Management 20, 21 December Bilingual Communication curriculum 2nd semester 2006 Titles Dates Language Techniques d'exposé et de présentation 18, 19 sept...

  13. Communication & Management

    CERN Multimedia

    Nathalie Dumeaux

    2006-01-01

    Calendar of courses for September to December 2006 Please check our Web site to find out the number of places available, which may vary. Management Curriculum 2nd semester 2006 Titles Dates Language Quality Management 18, 19 September Bilingual Managing Teams 19, 20, 21 September English Communicating Effectively - Residential 20, 21, 22 septembre Bilingual (Full) Personal Awareness & Impact 26, 27, 28 September Bilingual Introduction to Leadership 4, 5, 6 October Bilingue IProject Scheduling & Costing 12, 13 October English CDP-SL part 1 Several sessions Dates to be fixed English or French Personal Awareness & Impact 23, 24 October Bilingual Communicating to Convince 23, 24, 25 October Bilingual CDP-GL part 2 25, 26, 27 October English CDP-GL part 1 Dates to be fixed Bilingual Risk Management 20, 21 December Bilingual Communication curriculum 2nd semester 2006 Titles Dates Language Techniques d'exposé et de présentation 18, 19 s...

  14. Communicative Musicality

    DEFF Research Database (Denmark)

    Holck, Ulla

    2010-01-01

    plots of the interactions of mother infant dyads, the theory of communicative musicality found precise formulation in terms of the parameters: pulse, quality and narrative. This was first reported in Malloch (1999/2000), in the Special Issue of Musicae Scientiae, known to many of NJMT’s readers...... of the hearing and production of our musicality? If musicality is an intrinsic aspect of being human, how does it express itself in our living, feeling, thinking and being? What is the basis for this in our psyche and biology? The proposed answers come from different scientific areas: evolutionary theory...... of meaning for a sexually abused child (Robarts), and fostering communication in children with autistic spectrum disorders or with Rett Syndrome (Wigram & Elefant). Communicative Musicality is also shown in dance therapy with a group of children, born partially deaf and blind with disabilities (Bond...

  15. NASA Fluid Lensing & MiDAR: Next-Generation Remote Sensing Technologies for Aquatic Remote Sensing

    Science.gov (United States)

    Chirayath, Ved

    2018-01-01

    We present two recent instrument technology developments at NASA, Fluid Lensing and MiDAR, and their application to remote sensing of Earth's aquatic systems. Fluid Lensing is the first remote sensing technology capable of imaging through ocean waves in 3D at sub-cm resolutions. MiDAR is a next-generation active hyperspectral remote sensing and optical communications instrument capable of active fluid lensing. Fluid Lensing has been used to provide 3D multispectral imagery of shallow marine systems from unmanned aerial vehicles (UAVs, or drones), including coral reefs in American Samoa and stromatolite reefs in Hamelin Pool, Western Australia. MiDAR is being deployed on aircraft and underwater remotely operated vehicles (ROVs) to enable a new method for remote sensing of living and nonliving structures in extreme environments. MiDAR images targets with high-intensity narrowband structured optical radiation to measure an objectâ€"TM"s non-linear spectral reflectance, image through fluid interfaces such as ocean waves with active fluid lensing, and simultaneously transmit high-bandwidth data. As an active instrument, MiDAR is capable of remotely sensing reflectance at the centimeter (cm) spatial scale with a signal-to-noise ratio (SNR) multiple orders of magnitude higher than passive airborne and spaceborne remote sensing systems with significantly reduced integration time. This allows for rapid video-frame-rate hyperspectral sensing into the far ultraviolet and VNIR wavelengths. Previously, MiDAR was developed into a TRL 2 laboratory instrument capable of imaging in thirty-two narrowband channels across the VNIR spectrum (400-950nm). Recently, MiDAR UV was raised to TRL4 and expanded to include five ultraviolet bands from 280-400nm, permitting UV remote sensing capabilities in UV A, B, and C bands and enabling mineral identification and stimulated fluorescence measurements of organic proteins and compounds, such as green fluorescent proteins in terrestrial and

  16. Amniotic Fluid Embolism

    Science.gov (United States)

    ... type, as well as a complete blood count (CBC) Electrocardiogram (ECG or EKG) to evaluate your heart's ... mayoclinic.org/diseases-conditions/amniotic-fluid-embolism/basics/definition/CON-20035462 . Mayo Clinic Footer Legal Conditions and ...

  17. Peritoneal Fluid Analysis

    Science.gov (United States)

    ... Analysis Kidney Stone Risk Panel KRAS Mutation Lactate Lactate Dehydrogenase (LD) Lactoferrin Lactose Tolerance Tests LDL Cholesterol LDL ... Peritoneal fluid glucose, amylase, tumor markers, bilirubin, creatinine, lactate dehydrogenase (LD) Microscopic examination – may be performed if infection ...

  18. Pleural Fluid Analysis Test

    Science.gov (United States)

    ... Analysis Kidney Stone Risk Panel KRAS Mutation Lactate Lactate Dehydrogenase (LD) Lactoferrin Lactose Tolerance Tests LDL Cholesterol LDL ... set of tests (cell count, protein, albumin, and lactate dehydrogenase (LD) level, and appearance of the fluid) to ...

  19. 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 ...

  20. Organizational values in managerial communication

    OpenAIRE

    Malbašić, Ivan; Brčić, Ruža

    2012-01-01

    Organizational values have recently been regaining importance, which is reflected in the fact that they are commonly referred to as organizational foundations. Indeed, practice has proved that those values provide the basis for decision-making at all levels of the organization – from senior management to the non-managerial employees. This paper addresses the issue of communicating organizational values in managerial communication. In particular, communicating organizational values to employee...

  1. Self-tracking as communication

    DEFF Research Database (Denmark)

    Lomborg, Stine; Frandsen, Kirsten

    2016-01-01

    that is predominantly about getting things done in ways that are possible, suitable and meaningful for the individual. To account for this, we propose to conceptualize self-tracking as a communicative phenomenon along three dimensions: communication with the system, the self and social networks of peers. We develop...... of an individual user who is situated in a broader web of everyday activities, and stimulated and augmented by communicative features provided by the technology....

  2. Amniotic fluid inflammatory cytokines

    DEFF Research Database (Denmark)

    Abdallah, Morsi; Larsen, Nanna; Grove, Jakob

    2013-01-01

    The aim of the study was to analyze cytokine profiles in amniotic fluid (AF) samples of children developing autism spectrum disorders (ASD) and controls, adjusting for maternal autoimmune disorders and maternal infections during pregnancy.......The aim of the study was to analyze cytokine profiles in amniotic fluid (AF) samples of children developing autism spectrum disorders (ASD) and controls, adjusting for maternal autoimmune disorders and maternal infections during pregnancy....

  3. [Diagnosis: synovial fluid analysis].

    Science.gov (United States)

    Gallo Vallejo, Francisco Javier; Giner Ruiz, Vicente

    2014-01-01

    Synovial fluid analysis in rheumatological diseases allows a more accurate diagnosis in some entities, mainly infectious and microcrystalline arthritis. Examination of synovial fluid in patients with osteoarthritis is useful if a differential diagnosis will be performed with other processes and to distinguish between inflammatory and non-inflammatory forms. Joint aspiration is a diagnostic and sometimes therapeutic procedure that is available to primary care physicians. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  4. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  5. Digital communication

    CERN Document Server

    Das, Apurba

    2010-01-01

    ""Digital Communications"" presents the theory and application of the philosophy of Digital Communication systems in a unique but lucid form. This book inserts equal importance to the theory and application aspect of the subject whereby the authors selected a wide class of problems. The Salient features of the book are: the foundation of Fourier series, Transform and wavelets are introduces in a unique way but in lucid language; the application area is rich and resemblance to the present trend of research, as we are attached with those areas professionally; a CD is included which contains code

  6. Communicating Transactions

    Science.gov (United States)

    de Vries, Edsko; Koutavas, Vasileios; Hennessy, Matthew

    We propose a novel language construct called communicating transactions, obtained by dropping the isolation requirement from classical transactions, which can be used to model automatic error recovery in distributed systems. We extend CCS with this construct and give a simple semantics for the extended calculus, called TransCCS. We develop a behavioural theory which is sound and complete with respect to the may-testing preorder, and use it to prove interesting laws and reason compositionally about example systems. Finally, we prove that communicating transactions do not increase the observational power of processes; thus CCS equivalences are preserved in the extended language.

  7. Fullerol ionic fluids

    KAUST Repository

    Fernandes, Nikhil

    2010-01-01

    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). © 2010 The Royal Society of Chemistry.

  8. Research in corporate communication: An overview of an emerging field

    NARCIS (Netherlands)

    C.B.M. van Riel (Cees)

    1997-01-01

    textabstractVan Riel provides an overview of research in corporate communication, focusing on achievements found in the international academic literature in both communication and business school disciplines.

  9. Communicating about Cutbacks: Straightforward Strategies for the Retrenchment Era.

    Science.gov (United States)

    Jacobson, Harvey K.

    1984-01-01

    Institutional advancement office needs a communication strategy for interpreting the retrenchment effects on the institution. Fourteen guidelines for communication about retrenchment are provided. (MLW)

  10. statistical fluid theory for associating fluids containing alternating ...

    Indian Academy of Sciences (India)

    Abstract. Statistical associating fluid theory of homonuclear dimerized chain fluids and homonuclear monomer-dimer mixture chain fluids are extended to fluids containing al- ternating heteronuclear chain molecules separately. The proposed models account for the appropriate site-site correlation functions at contact.

  11. The language of communication

    African Journals Online (AJOL)

    The language of communication. Speaking to a person in their own language provides an opportu nity to place that person at their ease, an essential requirement in medicine, and makes retrieving information from that person easier. An article in this edition discusses the conversion of an English uterovaginal pelvic organ ...

  12. THE ENVIRONMENTAL COMMUNICATION FORUM

    African Journals Online (AJOL)

    Arising out of these productive contacts it was agreed that an organization should be formed that could enable the more effective communication of envi:onmental ... department provide several 'natural' areas within the. Durban boundary and has compiled very informative booklets for self-guided nature trails, with pictures.

  13. Short Communication

    African Journals Online (AJOL)

    ... et al., 1999). The assay represents a rapid, inexpensive and simple bioassay for testing plant extracts bioactivity which in most cases correlates reasonably well with cytotoxic and anti-tumor properties. The brine shrimp lethality assay is based on the ability of the extract to show lethality in laboratory. Short Communication ...

  14. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2010-01-01

    The CMS Communications Group, established at the start of 2010, has been strengthening the activities in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure The Communications Group has invested a lot of effort to support the operations needs of CMS. Hence, the CMS Centres where physicists work on remote CMS shifts, Data Quality Monitoring, and Data Analysis are running very smoothly. There are now 55 CMS Centres worldwide, up from just 16 at the start of CMS data-taking. The latest to join are Imperial College London, the University of Iowa, and the Università di Napoli. The CMS Centre@CERN in Meyrin, which is now full repaired after the major flooding at the beginning of the year, has been at the centre of CMS offline and computing operations, most recently hosting a large fraction of the CMS Heavy Ion community during the lead-lead run. A number of sub-detector shifts can now take pla...

  15. Nonverbal Communication.

    Science.gov (United States)

    Overmier, Mary; Frank, Cheryl

    This booklet presents 10 activities that deal with nonverbal communication. Activities in the booklet involve nonverbal messages present in the style of lettering, design, and color in advertisements; comic strips; facial expressions; body movement; idioms (such as "to be all eyes"); personal space; handshakes; clothing; and nonverbal…

  16. SHORT COMMUNICATION

    African Journals Online (AJOL)

    Tanzania Health Research Bulletin (2005), Vol. 7, No. 2. SHORT COMMUNICATION. Palliative care in Tanzania: a needs assessment study of family caregivers in urban setting. T. NGOMA. Ocean Road Cancer Institute, PO. Box 3592 Dar es Salaam, Tanzania;. Email: ngoma@uccmail.co.tz. Tanzania, with a population of ...

  17. Short communications

    African Journals Online (AJOL)

    2015-05-23

    May 23, 2015 ... the majority of birds in one image (Fig. 2). Figure 2. Partial stack of 100+ Levant Sparrowhawks over the Mara North Conservancy, 23 February 2014. Photo: M. Mockler. Short communications. 33. Figure 1. Photographs confirming the identification of Levant Sparrowhawk. Accipiter brevipes. Photos: M.

  18. Brief communication

    Indian Academy of Sciences (India)

    2011-03-14

    Mar 14, 2011 ... Keywords. Cre-lox; inducible promoter; marker removal; site-specific recombination; transgenic rice. Brief communication ..... USA 88 10558–10562. Gidoni D, Srivastava V and Carmi N 2008 Site-specific excisional recombination strategies for elimination of undesirable transgenes from crop plants. In Vitro ...

  19. Brief communication

    Indian Academy of Sciences (India)

    2016-01-22

    Jan 22, 2016 ... Berberis lycium; large pollen sac; male function; pollination; staminal filament. Brief communication. Published online: 22 January .... 2006 Anther evolution: pollen presentation strategies when pol- linators differ. Am. J. Bot. 167 288–296. Cota-sanchez JH, Almeida OJG, Falconer DJ, Choi HJ and. Bevan L ...

  20. Brief communication

    Indian Academy of Sciences (India)

    2013-11-05

    Nov 5, 2013 ... Harrell FE 2001 Regression modeling strategies (New York: Springer). Hasson O 1991 Pursuit-deterrent signals: communication between prey and predator. Trends. Ecol. Evol. 6 325–329. Kramer DL and Bonenfant M 1997 Direction of predator approach and the decision to flee to a refuge. Anim. Behav.

  1. Short Communication

    African Journals Online (AJOL)

    Nigerian Journal of Basic and Applied Science (2011), 19(2): 304-307. ISSN 0794-5698. Short Communication. Lead and Cadmium Levels of Five Commonly and Widely Consumed Leafy Vegetables in. Kano State, Nigeria. *M.I. Mohammed and ... the agreed international requirements. This is particularly important for farm ...

  2. Short communication

    African Journals Online (AJOL)

    UPuser

    Short communication. Polymorphisms of the CAST gene in the Meishan and five other pig populations in China. Q.S. Wang. 1. , Y.C. Pan. 1#. , L.B. Sun. 2 and H. Meng. 1. 1 Department of Animal Science, School of Agriculture and Biology, Shanghai Jiaotong University, Shanghai. 201101, P.R. China. 2 Shanghai Institute of ...

  3. Health communication

    DEFF Research Database (Denmark)

    Sørensen, Mariann B.

    communication changes from information to conversation and negotiation of a chared understanding and challenges the concept of professionalism. The success of conversations depends on the interactions and the capacity to deal with several voices in a complex context. The study discusses the opportunity...

  4. Brief communication

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    specifically has one AciI restriction site, producing two fragments, and A supergroup Wolbachia has two AciI. Brief communication. Frequency of infection with A and B supergroup Wolbachia in insects and pests associated with mulberry and silkworm. B M PRAKASH and H P PUTTARAJU*. Laboratory of Seribiotechnology ...

  5. Brief communication

    Indian Academy of Sciences (India)

    Unknown

    Intercellular communication between the cells of the pigmented epithelium rapidly reduces as a result of inflammatory reactions. During the initial phase the condensed chromatin of the PEC nuclei becomes prog- ressively dispersed, the nuclear volume increases and melanosomes move towards the peripheral regions of ...

  6. Communication Planning.

    Science.gov (United States)

    Development Communication Report, 1978

    1978-01-01

    Communication planning in developing countries is discussed in individual articles on theory, knowledge production and utilization, planning at the regional level, software, and rural development. A nutrition education project and three experiments in developing educational materials with feedback from villagers in Africa are described in the…

  7. Communicating Information

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 2. Communicating Information. K Viswanath. General Article Volume 7 Issue 2 February 2002 pp 26-32. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/007/02/0026-0032. Keywords. Entropy ...

  8. Melvin Defleur's Information Communication Model: Its Application ...

    African Journals Online (AJOL)

    The paper discusses Melvin Defleur's information communication model and its application to archives administration. It provides relevant examples in which archives administration functions involve the communication process. Specific model elements and their application in archives administration are highlighted.

  9. Understanding communicative actions: A repetitive TMS study

    NARCIS (Netherlands)

    Stolk, Arjen; Noordzij, Matthijs Leendert; Volman, Inge; Verhagen, Lennart; Overeem, Sebastiaan; van Elswijk, Gijs; Bloem, Bas; Hagoort, Peter; Toni, Ivan

    2014-01-01

    Despite the ambiguity inherent in human communication, people are remarkably efficient in establishing mutual understanding. Studying how people communicate in novel settings provides a window into the mechanisms supporting the human competence to rapidly generate and understand novel shared

  10. Interculturalizing the Technical or Business Communications Course.

    Science.gov (United States)

    Tippens, Dora

    1993-01-01

    Claims that technical or business communications courses need to be interculturalized to prepare students for the global marketplace. Defines three problems: ethnocentrism, language barriers, and cultural differences. Provides strategies, assignments, and resources for implementing an interculturalized communications course. (HB)

  11. Animal Communication: What Do Animals Say?

    Science.gov (United States)

    Morton, Eugene S.

    1983-01-01

    Discusses the nature of animal communication, including possible relationships between the physical structure of vocalizations and their functions in communicating. Provides tables of mammalian and avian sounds (by species/family) used in hostile and friendly appeasing contexts. (JN)

  12. Communicating geological hazards: assisting geoscientists in communication skills

    Science.gov (United States)

    Liverman, D. G. E.

    2009-04-01

    Communication is important in all aspects of the geosciences but is more prominent in the area of geological hazards, as the main audience for scientific information often lacks a geoscience background; and because the implications of not communicating results effectively can be very serious. Geoscientists working in the hazards area face particular challenges in communicating the concepts of risk, probability and uncertainty. Barriers to effective communication of geoscience include the complex language used by geoscientists, restriction of dissemination of results to traditional scientific media, identification of the target audience, inability to tailor products to a variety of audiences, and lack of institutional support for communication efforts. Geoscientists who work in the area of natural hazards need training in risk communication, media relations, and communicating to non-technical audiences. Institutions need to support the efforts of geoscientists in communicating their results through providing communications training; ensuring access to communications professionals; rewarding efforts to engage the public; and devoting sufficient staff and budget to the effort of disseminating results. Geoscientists themselves have to make efforts to change attitudes towards social science, and to become involved in decision making at a community level. The International Union of Geological Sciences Commission for "Geoscience for Environmental Management" established a working group to deal with these issues. This group is holding workshops, publishing collections of papers, and is looking at other means to aid geoscientists in addressing these problems.

  13. Cosmological perturbations for imperfect fluids

    Energy Technology Data Exchange (ETDEWEB)

    Giovannini, Massimo [Centro ' Enrico Fermi' , Compendio del Viminale, Via Panisperna 89/A, 00184 Rome (Italy); Department of Physics, Theory Division, CERN, 1211 Geneva 23 (Switzerland)

    2005-12-21

    Interacting fluids, endowed with bulk viscous stresses, are discussed in a unified perspective with the aim of generalizing the treatment of cosmological perturbation theory to the case where both fluctuating decay rates and fluctuating bulk viscosity coefficients are simultaneously present in the relativistic plasma. A gauge-invariant treatment of the qualitatively new phenomena arising in this context is provided. In a complementary approach, faithful gauge-fixed descriptions of the gravitational and hydrodynamical fluctuations are developed and exploited. To deepen the interplay between bulk viscous stresses and fluctuating decay rates, illustrative examples are proposed and discussed both analytically and numerically. Particular attention is paid to the coupled evolution of curvature and entropy fluctuations when, in the relativistic plasma, at least one of the interacting fluids possesses a fluctuating bulk viscosity coefficient. It is argued that this class of models may be usefully employed as an effective description of the decay of the inflaton as well as of other phenomena involving imperfect relativistic fluids.

  14. Communicating Science

    Science.gov (United States)

    Russell, Nicholas

    2009-10-01

    Introduction: what this book is about and why you might want to read it; Prologue: three orphans share a common paternity: professional science communication, popular journalism, and literary fiction are not as separate as they seem; Part I. Professional Science Communication: 1. Spreading the word: the endless struggle to publish professional science; 2. Walk like an Egyptian: the alien feeling of professional science writing; 3. The future's bright? Professional science communication in the age of the internet; 4. Counting the horse's teeth: professional standards in science's barter economy; 5. Separating the wheat from the chaff: peer review on trial; Part II. Science for the Public: What Science Do People Need and How Might They Get It?: 6. The Public Understanding of Science (PUS) movement and its problems; 7. Public engagement with science and technology (PEST): fine principle, difficult practice; 8. Citizen scientists? Democratic input into science policy; 9. Teaching and learning science in schools: implications for popular science communication; Part III. Popular Science Communication: The Press and Broadcasting: 10. What every scientist should know about mass media; 11. What every scientist should know about journalists; 12. The influence of new media; 13. How the media represents science; 14. How should science journalists behave?; Part IV. The Origins of Science in Cultural Context: Five Historic Dramas: 15. A terrible storm in Wittenberg: natural knowledge through sorcery and evil; 16. A terrible storm in the Mediterranean: controlling nature with white magic and religion; 17. Thieving magpies: the subtle art of false projecting; 18. Foolish virtuosi: natural philosophy emerges as a distinct discipline but many cannot take it seriously; 19. Is scientific knowledge 'true' or should it just be 'truthfully' deployed?; Part V. Science in Literature: 20. Science and the Gothic: the three big nineteenth-century monster stories; 21. Science fiction: serious

  15. Optimizing intraoperative fluid therapy.

    Science.gov (United States)

    Stephens, Robert; Mythen, Monty

    2003-08-01

    Correcting the fluid status of the surgical patient is an integral part of good anaesthetic practice. There have been few areas in anaesthesia and perioperative medicine as controversial as fluid resuscitation. Uncertainties still exist as to what the best solution to give is, whether it be a colloid or a crystalloid, and how and when to give it. As well as increasing awareness of the different properties of various colloids, there has been interest in the nature of the carrier solutions, essentially a choice between saline or Ringer's lactate (compound sodium lactate or Hartmann's solution). In this article we review recent studies involving crystalloids, the 'new colloids', and on the amount and timing of fluid therapy. Saline based fluids (including most colloids) are associated with a hyperchloremic metabolic acidosis, and a hypocoagulable state, although these may not necessarily harm the patient. Saline may have deleterious effects on renal function. Colloids in solutions similar to Ringer's lactate ('balanced solutions') may avoid these effects although few are currently available. Several studies that have used fluids (along with other therapies) to improve organ perfusion around the time of surgery have been associated with a better outcome. Compared with Ringer's lactate, saline, and saline-based colloids are associated with a hyperchloremic metabolic acidosis, and a hypocoagulable state although they may not be associated with adverse patient outcomes. Increasing awareness of the 'Stewart hypothesis' has led to new ways of managing hyperchloremic metabolic acidosis. The 'crystalloid-colloid debate' continues, and has led to an awareness that these different fluids, along with their carrier solutions are drugs with different effects. Several studies, in which patients have received more fluid in the protocol group, have found better clinical outcomes in the 'optimized' patients.

  16. Communications Advisor | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... IDRC within Canada and internationally and communicate the research it supports. There is a strong focus on products that deliver on the IDRC's new strategic plan through the full range of communications products and channels, including media, social media, and the website. Provides editorial and linguistic advice to ...

  17. Communicating Geomorphology. JGHE Annual Lecture

    Science.gov (United States)

    Brierley, Gary

    2009-01-01

    Communication strategies emphasize concerns for "content" (what is said) and "process" (the way things are said). Scientists have a responsibility to communicate the findings of their research, enhancing prospects that their insights can meaningfully inform management practice. When used effectively, principles from geomorphology provide critical…

  18. Sustainable social change and communication

    NARCIS (Netherlands)

    Servaes, J.; Lie, R.

    2013-01-01

    The article provides a survey of the field of sustainable social change and communication in the global context. It discusses the history of development communication as well as related policy and rights issues. It reviews approaches such as modernization, globalization and localization,

  19. Energy performance indicator report: fluid milk plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    In Canada, the dairy sector consumes significant amounts of energy and is looking for new ways of saving energy. The aim of this study, performed by the Competitive Analysis Centre Inc., was to find novel energy savings ideas for fluid milk plants. For this purpose, the energy consumption of 17 fluid milk plants, which accounts for over 50% of total Canadian output, was analyzed; first, at the plant level, and then by 8 categories at the sub-plant level in order to develop benchmarks that could be applied at both these levels. The paper provides background information on Canada's fluid milk sector and outlines the methodology used to develop and apply energy efficiency measures in the sector; the study findings are also presented. This report found that the energy consumption of the Canadian fluid milk sector could be lowered by applying the energy saving proposals developed herein.

  20. Modern fluid dynamics for physics and astrophysics

    CERN Document Server

    Regev, Oded; Yecko, Philip A

    2016-01-01

    This book grew out of the need to provide students with a solid introduction to modern fluid dynamics. It offers a broad grounding in the underlying principles and techniques used, with some emphasis on applications in astrophysics and planetary science. The book comprehensively covers recent developments, methods and techniques, including, for example, new ideas on transitions to turbulence (via transiently growing stable linear modes), new approaches to turbulence (which remains the enigma of fluid dynamics), and the use of asymptotic approximation methods, which can give analytical or semi-analytical results and complement fully numerical treatments. The authors also briefly discuss some important considerations to be taken into account when developing a numerical code for computer simulation of fluid flows. Although the text is populated throughout with examples and problems from the field of astrophysics and planetary science, the text is eminently suitable as a general introduction to fluid dynamics. It...