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PubMed2000

Evaluation of a tobacco and alcohol use prevention program for Hispanic migrant adolescents: promoting the protective factor of parent-child communication.

BACKGROUND: Interventions designed to prevent tobacco and alcohol use targeting high-risk adolescents are limited. In addition, few studies have attempted to improve parent-child communication skills as a way of improving and maintaining healthy youth decision-making. METHODS: A total of 660 Hispanic migrant families participated in a randomized pre-post control group study that was utilized to determine the impact of the intervention on parent-child communication. Both treatment and attention-control groups of youth were exposed to an eight-session culturally sensitive program presented by bilingual/bicultural college students. Parents jointly attended three of the eight sessions and participated in helping their child complete homework assignments supporting the content of each session. The content of the treatment intervention included (1) information about tobacco and alcohol effects, (2) social skills training (i.e., refusal skills), and (3) the specific development of parent-child communication skills to support healthy youth decisions. RESULTS: Significant intervention by household size interactions for both parent and youth perceptions of communication were found indicating that the treatment was effective in increasing communication in families with fewer children. Based on the effect size and the previously established relationship between communication and susceptibility to tobacco and alcohol use, it was determined that the intervention effect could be translated into a future 5 to 10% decrease in susceptibility for these smaller families. CONCLUSIONS: A culturally sensitive family-based intervention for migrant Hispanic youth was found to be effective in increasing perceived parent-child communication in families with fewer children. It is expected that increases in this important protective factor will lead to later observed decreases in tobacco and alcohol use.

Adolescent↗
PubMed2002

Physician communication skills training: a review of theoretical backgrounds, objectives and skills.

CONTEXT: Significant shortcomings have been noted in the literature in communication skills training for practising doctors. Given the importance of competent communication to the doctor-patient relationship and health care in general, these shortcomings should be addressed in future research. OBJECTIVE: Research into physician communication skills training is examined with respect to the communication objectives and behaviours that are addressed. METHODS: A Medline search of literature from 1990 to the present was conducted. RESULTS: A total of 26 studies of doctor communication skills training were found. The majority of studies included insufficient information about the communication behaviours taught to participants. In several studies, there was a mismatch between stated behaviours and instruments or procedures used to assess them. CONCLUSION: Three recommendations are suggested. Firstly, future researchers should take greater care in matching assessment instruments with stated communication skills. Secondly, researchers should provide and use a theoretical framework for selecting communication skills to address in interventions, and thirdly, the timing of communication skills within the interview context should be part of the instruction in interventions.

Communication↗
PubMed1997

Communication after laryngectomy. An assessment of patient satisfaction.

OBJECTIVES: To determine the satisfaction of patients with their current method of alaryngeal communication. To focus primarily on the patients' perception of their own speech. DESIGN: A retrospective review of patients who underwent total laryngectomy for malignancy identified 4 groups of patients. A survey using a mailed questionnaire was used to compare groups. SETTING: Tertiary care university hospital, University of Texas Medical Branch at Galveston. PATIENTS: Forty-seven patients underwent total laryngectomy for cancer and survived. Thirty-one of the 47 patients responded to the survey. Patients were divided into 4 groups by their current method of communication: (1) tablet writers; (2) esophageal speech; (3) electrolarynx; and (4) tracheoesophageal speech. MAIN OUTCOME MEASURES: Satisfaction with communication, satisfaction with speech quality, ability to communicate over telephone, limitation of interaction with others, and satisfaction with quality of life. RESULTS: Patients in group 4 were significantly more satisfied with their speech (P < .001), perceived their speech to be of better quality (P < .001), had improved ability to communicate over the telephone (P < .001), and had less limitation of their interactions with others (P < .004). Patients in group 4 also rated their overall quality of life higher (P = .23). CONCLUSION: Although many studies in the past have demonstrated the objective superiority of tracheoesophageal speech compared with other methods of alaryngeal communication, most studies have focused on the intelligibility of speech judged by listeners. This study demonstrates that patients who use tracheoesophageal speech rate their own speech significantly higher than patients who use other methods and most likely have an overall superior quality of life.

Adult↗
PubMed1997

Adolescent-parent communication in self-harm.

PURPOSE: To examine the association between communication with parents and self-harm in 14-19-year-old adolescents. METHODS: A total of 36 female and 16 male adolescents presenting to the accident and emergency department of a general hospital; 52 hospital-based controls were interviewed and studied using the following scales: Parent-Adolescent Communication Scale, Family Adaptability and Cohesion Evaluation Scale, Adolescent-Family Inventory of Life Events and Changes Scale, Children's Depression Index, and Nowicki-Strickland Locus of Control Scale. RESULTS: The absence of a family confidant was very strongly associated with adolescent self-harm. Despite controlling for a wide range of possible causal factors, poorer parent-adolescent communication remained strongly associated with self-harm. The effect of poorer communication on self-harm was strongest in the group with and internal locus of control. CONCLUSIONS: Impairment of communication between adolescents and their parents may be important in the origins of adolescent self-harm.

Adolescent↗
PubMed2003

Comparison of information about the quality of apparel in three retail formats.

Multiple options are available for selection and purchase of apparel including in-store, catalogue, and Internet. The present purpose was to compare information about quality available to consumers in three retail formats. Students studying quality of apparel selected a product which could be purchased in each of the three formats, completed an evaluation from both a consumer's and preprofessional perspective, and made recommendations for improving information on quality. A total of 413 recommendations were categorized and tested for independence. Students had similar expectations for cues of quality across Internet, catalogue, and in-store formats including fiber content, country of origin, 3-dimensional information about fit, color accuracy, size charts, and strong customer service. Students expected a uniform array of information on quality regardless of the shopping format. Merchandisers must be aware of the total image across formats and be prepared to explore methods for improving communication of information on quality in each.

Adult↗
PubMed1993

[Use of a modified "antigen-capture" enzyme immunoassay for the identification of virus persistence in cattle infected with bovine virus diarrhea (BVD)].

Bovine viral diarrhoea (BVD)/mucosal disease (MD) is an economically important infectious disease of cattle, and persistently infected animals are of central epidemiological significance. The identification of these animals is a prerequisite for further sanitary measures in affected herds. In order to process large numbers of samples an antigen capture enzyme immunoassay (AC-ELISA) for the detection of bovine viral diarrhoea viral antigen in peripheral blood leukocytes of cattle of all ages has been developed. In this communication an improved method for the preparation of samples is described. A total of 563 blood samples was tested using the AC-ELISA and a routine virus isolation procedure on susceptible bovine cells. When compared to virus isolation in cell culture, the sensitivity of the AC-ELISA was 97%. From the samples that were virus negative in cell culture, 99.1% were also negative in the AC-ELISA. There is some evidence that the AC-ELISA discriminated between transiently and persistently infected animals.

Animals↗
PubMed2004

Postoperative pain communication skills for older adults.

This study tested the effect of a preoperative pain communication intervention on older adults' ability to obtain pain relief after a total knee arthroplasty. A posttest-only experimental design was used to compare older adults randomly assigned to (a) view a pain management and pain communication film, (b) view the pain management film only, or (c) receive standard care only. Initial method adjustments decreased potential error in the study. Adjustments included testing only total knee arthroplasty patients receiving standard physical therapy and omitting unreliable measures from the analyses. Recruitment of the standard care group was halted when differences emerged between the remaining groups. Older adults in the communication group reported significantly less sensory pain on postoperative Day 1 than older adults in the pain management only group. Teaching older adults both pain communication skills and pain management information before surgery might result in greater pain relief during the early postoperative period.

Aged↗
PubMed2002

Stereological length estimation using spherical probes.

Lineal structures in biological tissue support a wide variety of physiological functions, including membrane stabilization, vascular perfusion, and cell-to-cell communication. In 1953, Smith and Guttman demonstrated a stereological method to estimate the total length density (Lv) of linear objects based on random intersections with a two-dimensional sampling probe. Several methods have been developed to ensure the required isotropy of object-probe intersections, including isotropic-uniform-random (IUR) sections, vertical-uniform-random (VUR) slices, and isotropic virtual planes. The disadvantages of these methods are the requirements for inconvenient section orientations (IUR, VUR) or complex counting rules at multiple focal planes (isotropic virtual planes). To overcome these limitations we report a convenient and straightforward approach to estimate Lv and total length, L, for linear objects on tissue sections cut at any arbitrary orientation. The approach presented here uses spherical probes that are inherently isotropic, combined with unbiased fractionator sampling, to demonstrate total L estimation for thin nerve fibres in dorsal hippocampus of the mouse brain.

Animals↗
PubMed2026

Family communication patterns and adolescent depressive symptoms: sequential mediating effects of hedonic capacity and anger expression.

OBJECTIVE: Depression is increasingly prevalent among adolescents, highlighting the need to explore its underlying developmental mechanisms to inform effective prevention. This study examined how different family communication patterns longitudinally impact adolescent depressive symptoms, with a focus on the mediating roles of diminished hedonic capacity and anger expression. METHOD: A total of 729 Chinese adolescents from five high schools participated in this two-wave longitudinal study over a six-month period. Participants completed the Family Communication Patterns Scale (FCPS), the Children's Depression Inventory (CDI), the Anhedonia Scale for Adolescents (ASA), and the Children's Inventory of Anger (ChIA). Mediation analyses were conducted using Hayes' PROCESS macro, alongside cross-lagged panel analyses to explore longitudinal effect. RESULTS: Cross-sectional analyses indicated that diminished hedonic capacity and anger experience sequentially mediated the relationship between family communication patterns and adolescent depressive symptoms. Specifically, this mediating effect existed for conversation orientation in junior high school students and female senior high school students, as well as for conformity orientation among female junior and senior high school students. In addition, longitudinal analyses revealed that diminished hedonic capacity mediated the associations at Wave 2. CONCLUSION: Our findings suggest that enhanced hedonic capacity and reduced anger expression may play a key role in the relationship between family communication patterns and adolescent depression, and hedonic capacity should be prioritized in practical interventions. These results support the potential value of interventions that promote positive family communication patterns as a means of mitigating adolescent depression, particularly for families with daughters.

anger expression↗
PubMed2002

The relationship between medical students' attitudes towards communication skills learning and their demographic and education-related characteristics.

INTRODUCTION: The General Medical Council (GMC) has stressed the importance of medical students' attitudes towards learning. However, few studies have explored medical students' attitudes towards communication skills learning. This study explores the relationship between the attitudes of medical students at two different schools and their demographic and education-related characteristics. METHODS: A total of 490 medical students from the Universities of Nottingham (Years 1 and 2) and Leicester (Year 1) completed the 26-item Communication Skills Attitude Scale (CSAS) and a personal details questionnaire satisfactorily. The relationships between students' attitudes and their demographic and education-related characteristics were analysed separately for Nottingham and Leicester students using both univariate and multivariate statistics. RESULTS: The attitudes of Nottingham and Leicester medical students towards communication skills learning were significantly associated with a number of demographic and education-related characteristics. Both Nottingham and Leicester students with more positive attitudes towards communication skills learning tended to be female, tended to think their communication skills needed improving and tended not to have parents who were doctors. Both Nottingham and Leicester students with more negative attitudes towards communication skills learning tended to think their communication skills did not need improving. DISCUSSION: The results indicate that medical students' attitudes towards communication skills learning are associated with their demographic and education-related characteristics. These findings have a number of implications for educational practice and further research and these are discussed in this paper.

Adult↗
PubMed2006

Validation of the critical-care pain observation tool in adult patients.

BACKGROUND: Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally. OBJECTIVE: To validate the Critical-Care Pain Observation Tool. METHODS: A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada, participated in the study. Following surgery, 33 of the 105 were evaluated while unconscious and intubated and 99 while conscious and intubated; all 105 were evaluated after extubation. For each of the 3 testing periods, patients were evaluated by using the Critical-Care Pain Observation Tool at rest, during a nociceptive procedure (positioning), and 20 minutes after the procedure, for a total of 9 assessments. Each patient's self-report of pain was obtained while the patient was conscious and intubated and after extubation. RESULTS: The reliability and validity of the Critical-Care Pain Observation Tool were acceptable. Interrater reliability was supported by moderate to high weighted kappa coefficients. For criterion validity, significant associations were found between the patients' self-reports of pain and the scores on the Critical-Care Pain Observation Tool. Discriminant validity was supported by higher scores during positioning (a nociceptive procedure) versus at rest. CONCLUSIONS: The Critical-Care Pain Observation Tool showed that no matter their level of consciousness, critically ill adult patients react to a noxious stimulus by expressing different behaviors that may be associated with pain. Therefore, the tool could be used to assess the effect of various measures for the management of pain.

Cardiac Surgical Procedures↗
PubMed2006

A colorectal cancer patient focus group develops an information package.

INTRODUCTION: In order to deliver high quality care and empower cancer patients in decision-making, good quality information and communication are essential. We describe the development of an information booklet. PATIENTS AND METHODS: A total of 22 colorectal cancer patients (12 male; median age, 72 years, range, 40-86 years) met on 3 occasions. Patients were asked to define their information needs and score them (1-4) according to importance. The information document was written. The second meeting involved feedback on the booklet. The modified booklet was reviewed/approved by the group before submission for local ethics committee approval prior to its distribution to other patients. RESULTS: All participants felt the project a good idea. Essential information included the surgeon's individual morbidity, mortality, survival, recurrence data and details of adjuvant therapies (score = 4). Also important were type of surgery, complications and postoperative recovery (score = 3). Simple anatomical drawings were also considered important. CONCLUSIONS: The booklet is now used to personalise information for all our patients and serves, in part, as a record of the key issues discussed during the consultation. The booklet has been evaluated in a randomised trial.

Adult↗
PubMed2004

Control of a two-dimensional movement signal by a noninvasive brain-computer interface in humans.

Brain-computer interfaces (BCIs) can provide communication and control to people who are totally paralyzed. BCIs can use noninvasive or invasive methods for recording the brain signals that convey the user's commands. Whereas noninvasive BCIs are already in use for simple applications, it has been widely assumed that only invasive BCIs, which use electrodes implanted in the brain, can provide multidimensional movement control of a robotic arm or a neuroprosthesis. We now show that a noninvasive BCI that uses scalp-recorded electroencephalographic activity and an adaptive algorithm can provide humans, including people with spinal cord injuries, with multidimensional point-to-point movement control that falls within the range of that reported with invasive methods in monkeys. In movement time, precision, and accuracy, the results are comparable to those with invasive BCIs. The adaptive algorithm used in this noninvasive BCI identifies and focuses on the electroencephalographic features that the person is best able to control and encourages further improvement in that control. The results suggest that people with severe motor disabilities could use brain signals to operate a robotic arm or a neuroprosthesis without needing to have electrodes implanted in their brains.

Adult↗
PubMedDate not supplied

Clinical and experimental investigation of pseudoaneurysm in the anterior communicating artery area on 3-dimensional time-of-flight cerebral magnetic resonance angiography.

OBJECTIVE: To investigate the hemodynamic mechanism of pseudoaneurysm in the anterior communicating artery (AcoA) area in magnetic resonance (MR) angiography. METHODS: For the clinical study, a total of 62 patients who undertook digital subtraction angiography (DSA) because of the rupture of an aneurysm originating from a location other than the AcoA area were examined with MR angiography. The relation between signal defect at the AcoA in MR angiography and anatomic variation of the anterior cerebral artery (ACA) was evaluated. For the experimental study, MR angiography and DSA were performed on elastic silicon vascular phantoms with 2 different bifurcation angles (70 degrees and 140 degrees). Hemodynamic factors producing signal defects were evaluated, and the results were compared by computational fluid dynamics (CFD). RESULTS: In a clinical study, 21 of 62 patients had a hypogenetic A1 segment on either side of the ACA. Their MR angiography showed signal defects in the axilla area of the bifurcated AcoA complex in 14 patients, 7 of which could make the residual normal vessel seem to be an aneurysm. All the cases with an intact AcoA complex showed no signal defect. In an experimental study, MR angiography of vascular phantoms with broad-angle bifurcation (140 degrees) showed signal defects at the axilla areas of bifurcation, and these were shown as turbulent flow in DSA and CFD. Phantoms with narrow-angle bifurcation (70 degrees) did not show a significant signal defect, however. CONCLUSIONS: A hypoplastic A1 segment accompanying a broad bifurcation angle of the contralateral A1 segment may cause a pseudoaneurysm in MR angiography because of signal defect in the AcoA area.

Adolescent↗
PubMedDate not supplied

Quality of life in male tracheoesophageal (TE) speakers.

For this study, we determined the quality of life (QOL) in individuals who had undergone total laryngectomy (TL) and who used tracheoesophageal (TE) speech as their primary method of postlaryngectomy communication. We also descriptively compared present QOL outcomes with those found in an extension of the Department of Veterans Affairs' (VA) Laryngeal Cancer Study. Thirty laryngectomized men with TE speech as their primary mode of communication were recruited for participation in the investigation. Participants completed a general information form as well as the University of Michigan Head and Neck Quality of Life (HNQOL) instrument. Results revealed a high level of self-perceived QOL in the domains of communication, eating, pain, and emotion that was empirically better than results found in a previous study involving individuals who had undergone TL and who were treated in VA hospitals. Possible reasons for the improved self-reported QOL among individuals in the present group include use of TE speech for postlaryngectomy communication, a higher level of education, and membership in a support group. The results suggest to us that these factors should be considered in postlaryngectomy care in the veteran population to optimize rehabilitation outcomes.

Adaptation, Psychological↗
PubMed2002

Physicians want education about complementary and alternative medicine to enhance communication with their patients.

BACKGROUND: More than one third of patients in the United States use complementary and alternative medicine (CAM); most also visit conventional physicians. There is little information about how physicians and patients discuss CAM. We hypothesized that physicians frequently fielded questions about CAM treatments but felt uncomfortable discussing them owing to a lack of education. OBJECTIVES: To survey physicians to see how they discussed CAM with their patients and what factors influenced discussions and referrals. METHODS: A total of 751 physicians in the Denver, Colo, area were asked about their experience with CAM and communication about CAM with patients. Analyses were conducted using the SAS system (version 6, 1989; SAS Institute Inc, Cary, NC). RESULTS: Of the 705 deliverable surveys, 302 (43%) were returned: 76% of physicians reported having patients using CAM; 59% had been asked about specific CAM treatments; 48% had recommended CAM to a patient; and 24% had personally used CAM. Physician recommendation of CAM was most strongly associated with physician self-use (odds ratio, 6.98; P<.001). Few physicians felt comfortable discussing CAM with their patients, and the overwhelming majority (84%) thought they needed to learn more about CAM to adequately address patient concerns. CONCLUSIONS: Education about CAM modalities is a significant unmet need among Denver physicians, and education may help alleviate the discomfort physicians have when answering patients' questions about CAM. Physicians who use CAM treatments themselves are much more likely to recommend CAM for their patients than physicians who do not.

Adult↗
PubMed2003

Intentional communicative behaviours of Turkish-speaking children with normal and delayed language development.

BACKGROUND: Language profiles may predict whether children with slower language development will catch up to their peers by overcoming this transient phenomenon or will be at risk for persistent language disorders. The research of the last decade has focused on this topic. Some researchers have emphasized the significance of developing communicative intentions, which provide a potential predictor of later language competence. In Turkey, children with slower language development may not be diagnosed partly because of the lack of sufficient standardized assessment/evaluation tools, educational and therapeutic media, and qualified speech-language therapists. In devising appropriate evaluation instruments, it is necessary to examine cross-linguistic variation in early language acquisition. The purpose of this study therefore is to observe, describe and assess early communicative behaviours of 15-36 months old Turkish-speaking children by using a functional communicative approach. METHODS: The research was designed within a qualitative-descriptive paradigm, involving qualitative data collection, observation and data analysis procedures. A total of 16 children, eight typically developing and eight language delayed, served as subjects. The classification system used in this study for coding children's communicative intentions was mostly based upon a system used by Dore (1977). Each variable was referred to as one of three intentional categories: regulating behaviours (request for object, request for action and protest), social interaction (direct attention, greeting and acknowledgement) and joint attention (comment/statement, asking for information and responding). A non-parametric Mann-Whitney U-test was carried out to verify the descriptive measures in comparing the delayed and normal group performance. RESULTS: As expected, the mode of expressing communicative intentions varied as a function of age for both groups. Children with normal language development were observed to express intentions within the category of joint attention more frequently whereas the children with delayed language expressed intentions related to the variables of regulating behaviours and social interaction.

Age Factors↗
PubMed2003

The effect of communication on nursing student outcomes in a Web-based course.

This study compared the effectiveness of different instructional communication methods in a Web-based course on students' cognitive learning, satisfaction, and motivation to complete the course. A total of 174 undergraduate nursing students were selected randomly and assigned to experimental or control groups. Instruments included a demographic data form, two examinations on course material, a course satisfaction scale, and calculation of completion rates. All students received identical didactic Web-based instructional materials. However, type of communication varied among groups. No significant group differences were found for cognitive learning or motivation to complete the course. A significant group difference was found for student satisfaction with the course, indicating carefully planned communication strategies can improve satisfaction. A need for technical support also was evident. More research is needed to determine the best strategies to enhance student learning outcomes and decrease student attrition in Web-based courses.

Adult↗