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PubMed1998

The role of information systems in IDS-physician relationships.

The success of integrated delivery systems (IDSs) depends on their ability to develop collaborative relationships with affiliated physician practices. As a long-term strategy, IDSs should develop sophisticated information systems that help their physician practices to effectively manage wellness and disease across the continuum of care. These information systems eventually should include a broad range of features, including systemwide access to communications technologies, such as e-mail and groupware, computer-based alerts and reminders to support wellness management, immediate access to hospital data from physician offices, and automated care guidelines. To address the immediate needs of affiliated physicians, however, IDSs should attempt to optimize the functionality of their existing communications systems, such as fax links and manual processes.

Computer Communication Networks↗
PubMed2003

Language perception activates the hand motor cortex: implications for motor theories of speech perception.

The precise mechanisms of how speech may have developed are still unknown to a large extent. Gestures have proven a powerful concept for explaining how planning and analysing of motor acts could have evolved into verbal communication. According to this concept, development of an action-perception network allowed for coding and decoding of communicative gestures. These were manual or manual/articulatory in the beginning and then became increasingly elaborate in the articulatory mode. The theory predicts that listening to the 'gestures' that compose spoken language should activate an extended articulatory and manual action-perception network. To examine this hypothesis, we assessed the effects of language on cortical excitability of the hand muscle representation by transcranial magnetic stimulation. We found the hand motor system to be activated by linguistic tasks, most notably pure linguistic perception, but not by auditory or visuospatial processing. The amount of motor system activation was comparable in both hemispheres. Our data support the theory that language may have evolved within a general and bilateral action-perception network.

Adult↗
PubMed1995

Obstetric complications and schizophrenia: a meta-analysis.

BACKGROUND: This systematic review of the association between schizophrenia and obstetric complications (OCs) was performed to assess the degree of heterogeneity between studies and to quantify the increased risk of schizophrenia in exposed subjects. METHOD: Twenty case-control, one prospective cohort and two historical cohort studies were identified using a MEDLINE search supplemented by a manual search and direct communication with other researchers. Individual odds ratios were calculated for each study and a pooled estimate produced. The effect of methodological variation between studies was further assessed by partitioning studies according to study characteristics. RESULTS: Overall, there was no significant heterogeneity of effect between studies, and the pooled odds ratio for the exposure to OCs on subsequent development of schizophrenia was 2.0 (95% CI 1.6-2.4). However, partitioning according to study design revealed significant heterogeneity (z = -2.60, P < 0.01) between the pooled estimate from the case-control studies and that from the historical cohort studies. There was a gap on the funnel plot in the region of small studies finding no effect. CONCLUSIONS: Although the result indicates that subjects exposed to OCs are twice as likely to develop schizophrenia, the analysis suggests that the observed association could be inflated by both selection and publication biases.

Case-Control Studies↗
PubMed1990

Developing hospital identity manuals: a reference tool for illustrators.

Because of an increase in hospital marketing efforts, medical illustrators may be asked to assist in developing and implementing hospital identity manuals, which specify the graphic standards for visual communications media. A checklist survey of existing identity manuals and a literature review were conducted by one of the authors, a medical illustrator, to help her to develop a manual for her hospital employer. This article documents the literature review, the study, and the identity manual development, and presents recommendations to help other medical illustrators who might become involved in similar assignments.

Hospitals↗
PubMed1977

The development of language-like communication without a language model.

Deaf children who are unable to acquire oral language naturally and who are not exposed to a standard manual language can spontaneously develop a structured sign system that has many of the properties of natural spoken language. This communication system appears to be largely the invention of the child himself rather than of the caretakers.

Child, Preschool↗
PubMedDate not supplied

Production and perception of final consonant voicing in speech during simultaneous communication.

Simultaneous communication combines both spoken and manual modes to produce each word of an utterance. This study investigated the potential influence of alterations in the temporal structure of speech produced during simultaneous communication on the perception of final consonant voicing. Experienced signers recorded words that differed only in the voicing characteristic of the final consonant under two conditions: (a) speech alone and (b) simultaneous communication. The words were digitally edited to remove the final consonant and played to 20 listeners who, in a forced-choice paradigm, circled the word they thought they heard. Results indicated that accurate perception of final consonant voicing was not impaired by changes in the temporal structure of speech that accompany simultaneous communication.

Communication↗
PubMed1977

Acquisition of modified American sign language by a mute autistic child.

An attempt was made to teach a modified version of American Sign Language to mute 5-year-old boy who had been diagnosed autistic and who had a Merrill-Palmer IQ of 65. Previous attempts to teach imitative spoken language had failed, and baseline data indicated that the child's signing vocabulary was also nonexistent. Data were collected during 20 structured sessions involving presentation of stimuli, prompting and manual guidance when necessary, and reinforcement. Continuous use of signs as communication in class and at home was emphasized. The child had mastered 12 signs at the end of the study. Spontaneous signing frequency as recorded by parents and teachers during several 48 hour periods rose from 15 to 42 emitted signs over the 3 months of the study. The child made 6 months' developmental progress during this time, as measured by a sign-language adaptation of the Alpern-Boll Communication Scale. However, the child made no apparent progress in acquiring spoken language.

Autistic Disorder↗
PubMed1989

Communication skills in an aphasic deaf adult.

A case study is presented of a 64-year-old, right-handed, congenitally deaf man who suffered a single, unilateral, left CVA resulting in a right hemiplegia and moderate aphasia. The relationship between his verbal (reading and writing), manual, and pantomimic performances is examined in two ways. First, a comparison of the three modes of communication shows whether or not these systems can be dissociated by pathology. Second, the extent to which one mode recovers more fully than the others indicates whether the three modes function independently. Results of testing conducted at six weeks and at 18 months postonset revealed that this individual's manual, verbal, and pantomimic communication skills were all similarly impaired as a result of his CVA. Furthermore, at 18 months no single mode had recovered more rapidly or to a greater extent than any other. These results support the notion that aphasia in the deaf and hearing population is similar, and is consistent with the view that aphasia is the result of a central symbolic/cognitive process which manifests itself in parallel dysfunctions of verbal, manual, and pantomimic communication.

Aphasia↗
PubMedDate not supplied

Production and perception of final consonant voicing in speech produced by inexperienced signers during simultaneous communication.

Simultaneous communications combines both spoken and manual modes to produce each word of an utterance. This study investigated the potential influence of alterations in the temporal structure of speech produced by inexperienced signers during simultaneous communication on the perception of final consonant voicing. Inexperienced signers recorded words that differed only in the voicing characteristic of the final consonant under two conditions: (1) speech alone and (2) simultaneous communication. The words were subsequently digitally edited to remove the final consonant and played to 20 listeners who, in a forced-choice paradigm, circled the word they thought they heard. Results indicated that accurate perception of final consonant voicing was not impaired by changes in the temporal structure of speech that accompanied the inexperienced signers' simultaneous communication.

Female↗
PubMed2000

Caring for the nursing home resident on dialysis: a search for solutions.

The need for nursing home placement of dialysis patients continues to escalate. Creative solutions are necessary to insure placement availability and optimal care of residents on dialysis once admitted. Communication between the nursing home and dialysis unit staff is key to reducing barriers to placement. The National Kidney Foundation of Michigan is currently intervening through the Nursing Home Manual to enhance training and communication.

Communication↗
PubMed1999

Communication between hospitals and isolated aboriginal community health clinics.

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

Australia↗
PubMed1977

Sign language and multisensory input training of children with communication and related developmental disorders.

This report deals with the preliminary findings of a research project on simultaneous communication and multisensory input in the treatment of six autistic and communication disordered children. The children, aged 5 to 12, were taught manually signed English and speech using a multisensory-intrusion approach. The hypothesis was that such a technique would serve to alleviate the children's difficulties in information processing, organization of experience, and affect. The dependent measures were behavioral ratings derived from both structured (teaching) and unstructured (free play) sessions. The results indicate that the children manifested a consistent acquisition of sign lanuage, which in some cases transferred into verbal communication skills. Moreover, statistical analyses of some of the observed socioaffective behaviors (i.e., nonsolitary play, interaction with peers and adults, exploration, and detachment) revealed tendencies supportive of the hypothesis. The variability of the data preclude any categorical statement in relation to the hypothesis. However, the preliminary results strongly support the continuation of the study.

Auditory Perception↗
PubMedDate not supplied

Diagnostic factors bearing on the use of cued speech with hearing-impaired children.

Cued Speech is a system which utilizes eight hand configurations and four locations of either hand for supplementing the visible manifestations of normal speech in such a way as to effectively eliminate the ambiguities of lipreading. Its effects upon language development and oral communication skills, supported by research data, suggest that it is a useful technique for inclusion in the array of tools available for use with young, hearing-impaired children. Use of diagnostic teaching, in addition to audiometric and other evaluations, is recommended for evaluation of conditions which suggest or discourage the choice of Cued Speech as a communication modality. Children are exposed to diagnostic teaching sequences in a progression which begins with auditory-only, then auditory/oral, then auditory/oral/cued speech, and finally (in some cases), manually coded English. In each stage, data should be collected on significant reactions and behavior for use in recommending a choice of communication mode.

Child↗
PubMed1999

How effective is tailored print communication?

This article reviews the "first generation" of tailored print communications studies in the published literature, describing the purpose, theoretical framework, sample, research design, message type and source, outcomes measured, and findings of each. Eight studies compared tailored versus similar nontailored print; one compared tailored print versus an alternate intervention, and three included tailored print as one of several intervention components. Although studies varied by behavioral topic, type of tailoring, and measurement of behavioral outcomes, several themes persist. Compared to their nontailored counterparts, tailored print communications have been consistently better remembered, read, and perceived as relevant and/or credible. There is also evidence that tailored print communications are more effective for influencing health behaviors. Six of the eight tailored/nontailored comparisons found more behavior change among tailored than nontailored recipients. Tailored print communications have also demonstrated effectiveness as an adjunct to other intervention components such as self-help smoking cessation manuals. However, studies comparing tailored print communications with tailoring via other media such as telephone counseling have shown mixed results. Additional research is needed to assess whether the behavioral topic itself may make a difference in whether tailoring is appropriate and effective.

Health Behavior↗