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PubMed1991

Anatomical and functional communications between the synovial sacs of the equine stifle joint.

The anatomical and functional communications of the synovial sacs of the equine stifle joint were evaluated in 50 stifle joints of 25 horses. Femoropatellar joint (FPJ) sacs were injected with 50 ml of gelatin-based dye and horses were then walked for 50 m. Horses were subsequently killed, the stifle joints dissected and the location of the dye recorded. Twenty-three horses (46 joints) had clinically normal stifle joints and in this group, anatomical communications of the stifle joints were bilaterally symmetrical in each horse. In 15 of these 23 horses (65 per cent), direct anatomical communication between the FPJ sac and the medial sac of the femorotibial joint (FTJ) was demonstrated. The FPJ sac communicated with both the medial and lateral sacs of the FTJ in four of these 23 horses (17.5 per cent). There were no anatomical communications between the FPJ sac and either sac of the FTJ in the remaining four horses (17.5 per cent). Functional communication, which was established by finding dye in the FTJ sacs were anatomical communication with the FPJ sac existed, was demonstrated in 14 of 19 horses (74 per cent). Two horses were affected with degenerative joint disease of one stifle joint. In both of these joints the FPJ sac communicated with both the medial and lateral FTJ sacs. This distribution was different from that of the contralateral joint. When performing intra-articular anaesthesia of equine stifle joints, each synovial sac needs to be injected separately to ensure that anaesthesia of the appropriate synovial sac is obtained.

Animals↗

PubMed1993

Communication of the ulnaris lateralis bursa with the equine elbow joint and evaluation of caudal arthrocentesis.

Elbows from cadaver limbs were evaluated to determine the presence of a communication between the ulnaris lateralis bursa (ULB) and the joint and the extent of the bursa. Thirty-two pairs of joints were studied: 12 pairs were frozen, then transversely sectioned and 20 pairs were injected with methyl methacrylate. The 12 frozen-section pairs revealed a communication between the ULB and the elbow joint in 9/24 joints (37.5%) and a true bursa (absence of communication) in 15/24 joints (62.5%). The mean bursal length in adult horses was 3.8 cm. There was no significant difference in the length of the bursa or presence of bursa-joint communication between the right and left limbs. In the acrylic specimens a communication between the ULB and the joint was found in 19/40 specimens (47.5%). There was no significant correlation between age or sex and frequency of communication. There was a significantly greater prevalence of communications present in Quarter Horse than in non-Quarter Horse (P < 0.05) joints. A communication between the ULB and the joint is not always present, and therefore injection of the elbow joint via the ULB may be unreliable.

Acrylic Resins↗

PubMed2003

Communication is the key.

All forms of communication between human beings have long been recognized as a requirement for reciprocal understanding, transfer of knowledge, and productive development of societies. This also applies to living cells who are organized in <<microsocietiest; that constantly adjust to their environment through a complex network of signaling pathways. The chemical communication which occurs at various levels results in an integrated exchange of information that is essential for coordinated responses.We wish to present a few features of Cell Communication and Signaling: an open access, peer-reviewed journal devoted to the publication of manuscripts covering all aspects of cell communication, with a particular focus on molecular processes that govern intercellular signaling and events that sustain cellular communication, both in normal and pathological conditions.The launching of Cell Communication and Signaling provides us the opportunity to present a brief overview of basic processes underlying cell communication and the signaling processes that take place within and between cells to permit an efficient communication.

Journal Article↗

PubMed1999

[Health communication as a curriculum at United States universities].

This article analyzes the state of development of communications related to health in universities of the United States of America. This specialty is essential for people's well-being, and it involves interpersonal, organizational, and mass communications. In the United States, communications for health promotion is an area of applied communications with social relevance and generally performed in interdisciplinary settings. A number of universities in the United States offer communications master's degree programs with an emphasis on health. However, so far, the only program with a formal graduate degree in health and communications is one jointly offered by the Emerson University Department of Communications and the Tufts School of Medicine. Developing and including this specialization in the schools of communications in Latin America is crucial to improving the quality of life of the peoples of the continent.

Curriculum↗

PubMed1991

Unidirectional joint communications in wrist arthrography: an evaluation of 250 cases.

Although arthrographically demonstrable communications between various compartments of the wrist occur in older persons without symptoms, similar communications in younger persons may indicate clinically significant posttraumatic ligament tears and other pathologic processes. However, detection of communications varies depending on the arthrographic technique used. It has been claimed that if triple-compartment arthrography is not used in all patients, clinically significant unidirectional ligament tears may be overlooked. We determined the frequency and distribution of unidirectional intercompartmental communications, using a modification of techniques described in the literature. Separate injections of contrast material were made in sequence into the midcarpal, distal radioulnar, and radiocarpal joints of 250 consecutive patients. We found 38 unidirectional communications (17 lunotriquetral, nine scapholunate, three radial capsular, one ulnar capsular, six combined sites, and two indeterminate sites) between the midcarpal and radiocarpal joints. Nine unidirectional communications between the radiocarpal and distal radioulnar joints were found. Comparison of these results with the frequency and direction of unidirectional communications reported by others suggests that demonstration of communications depends on specific technical factors, such as which joint is injected first, the amount of contrast material used, and the delay between injections. This dependence on technical factors raises questions about the value of routine three-compartment wrist arthrography.

Adult↗

PubMed2005

[Three-dimensional imaging of the optic nerve using magnetic resonance angiography--application to anterior communicating artery aneurysm and craniopharingioma].

The purpose of this investigation was to analyze three-dimensional images of the optic nerve obtained by magnetic resonance angiography (MRA) in cases of anterior communicating artery aneurysm and craniopharingioma. Four ruptured anterior communicating artery aneurysms, five non-ruptured anterior communicating artery aneurysms and two craniopharingiomas were examined. The images were taken using MR/i Hispeed Plus 1.5T Infinity version, and analyzed by Advantage Work station AW4.1. The routine MR imaging parameters are shown in Table. The imaging time was about 10 minutes. Analysis was made by reformation of images parallel to the optic nerve obtained from the original MRA images. The optic nerve and brain tumor were traced with paintbrush from one sheet to another of the reformed images after subtraction of the blood vessels around the anterior communicating artery in these reformed images, and then three-dimensional images were constructed. Three-dimensional images of the blood vessels were reconstructed from MIP (maximum intensity projection) images using the threshold method. The optic nerve and anterior communicating arterial aneurysm or brain tumor were both observed in the overlapped 3D-SSD (shaded surface display) images. The analysis time was about 15 minutes. Three-dimensional images of the optic nerve and anterior communicating artery aneurysm or brain tumor were able to be made in all cases. As a preoperative investigation for anterior communicating artery aneurysm or suprasellar brain tumor, we considered that three-dimensional imaging of the optic nerve is useful in the operative approach because the optic nerve acts as a merkmal for the anterior communicating aneurysm or brain tumor.

Adult↗

PubMed2006

[Reexamination of the communicating branch between the sural and tibial nerves].

Reexamination of communicating branches between the sural and tibial nerves ventral to the calcanean tendon was carried out on 52 legs of 26 Japanese cadavers which were used for ordinary dissection practices at the Niigata University School of Medicine. Communicating branches were found in 7 out of 52 dissections (13.5% of cases). In three of the 7 specimens, the communicating branch, the sural nerve and the tibial nerve with the deep crural fascia were removed from the legs and demonstrated by a modified Sihler's staining technique. Three types of communicating branches, Y, U and N, were distinguished on the basis of their shapes. In type Y, a medial branch from the sural nerve and a branch from the tibial nerve joined in Y-shape and become one terminal branch. In type U, the both branches formed a loop between the sural and tibial nerves. The type N communicating branch ran obliquely and medially to reach the tibial nerve distally. Only the Y type appeared in 5 specimens. Both the Y and U type and the Y and N types occurred in one specimen each. We assume that the communicating branch of the N type contains motor fibers which are derived from the sural nerve and innervate some plantar muscles, because this type is correspond to the communication type of some animals in which motor fibers have been demonstrated. Therefore, if the sural nerve biopsy is performed to examine a pure sensory nerve, removal of the more distal part of the sural nerve than a diverging point of a communicating branch is recommended. This study also indicated that the modified Sihler's staining technique is useful to examine distributions of cadaveric peripheral nerves after medical students' dissection course.

Calcaneus↗

PubMed2005

Factors related to the development of communication in CHARGE syndrome.

Parents of 28 children and a young adult with CHARGE syndrome participated in a survey on factors related to communication development. Information was obtained using a questionnaire and a follow-up interview. Parents were asked to (1) specify their child's primary mode of communication, (2) judge the significance of the effects of physical disorders, sensory deficits, and behavior on development and communication, (3) provide lists of their child's conditions and disorders, and (4) provide information about intervention related to communication and education. Thirty-nine percent of the participants (11/28) did not use symbolic language to communicate. The results suggest that factors affecting the majority of participants--physical disorders, vision loss, and hearing loss--may adversely affect communication ability. However, these factors did not preclude the development of symbolic language. Factors that were related to the development of symbolic language were success in the treatment of hearing loss with amplification, the ability to walk independently, and communication training initiated by 3 years of age. Other factors that may be related to the development of symbolic language are also discussed.

Abnormalities, Multiple↗

PubMed2006

The importance of communication in secondary fragility fracture treatment and prevention.

INTRODUCTION: We report on a Canadian longitudinal qualitative case study of midlife women with fragility fractures, their treating orthopaedic surgeons and family physicians. METHODS: Women and their treating physicians were followed for an average of one year post fracture to investigate the health outcomes and what, if any, follow-up occurred aimed at secondary fracture prevention. The final dataset includes 223 interviews gathered from women aged 40 to 65 with fragility fractures, orthopaedic surgeons and family physicians. RESULTS: The circle of care for those with fragility fractures is disrupted at vital communication junctures: (1) the inconsistent flow of information between acute care institutions and family physicians; (2) unidirectional and inconsistent communication from orthopaedic surgeons to family physicians; and (3) competing demands of the cast clinic environment and patient expectations. It is not the lack of will that is undermining the consistent and detailed communication among patients, physicians and institutions. It is the episodic nature of fracture care that makes communication among involved parties difficult, if not impossible. CONCLUSIONS: Communication about events, acuity and clear expectations around roles and follow-up is urgently needed to improve communication throughout the circle of care to support secondary fracture prevention. Fractures from a standing height or similar trauma in women aged 40 to 65 should be treated as suspicious fractures and followed-up to investigate the underlying bone condition. This article reports on challenges and barriers to clear communication among women, their orthopaedic surgeons and family physicians that is necessary for follow-up and prevention of future fractures.

Adult↗

PubMed2001

Assessment of a measure of relational communication for doctor-patient interactions.

This research analyzes the psychometric properties of a 34-item doctor-patient relational communication scale adapted from its survey research form [Commun Monogr 1987;54:307] for use as an observational instrument to rate doctor-patient interaction. Relational communication determines the affective "tone" of interpersonal communication, and is handled mostly through nonverbal channels. Relational communication provides the framework in which the content of a doctor-patient exchange, such as symptom reports by the patient, is interpreted and acted upon. The relational communication scale was adapted for use by three trained observers each of whom rated 20 videotaped interactions between medical students and standardized patients. Results indicate fair to excellent internal consistency, inter-rater reliability, inter-rater agreement, and construct validity for four of the six relational communication subscales. The scale is practical to administer and would lend itself for use in formative evaluation of medical student and physician communication skills.

Clinical Competence↗

PubMedDate not supplied

Shared care for diabetes: supporting communication between primary and secondary care.

OBJECTIVE: To assess the effects on information exchange of electronic communication between physicians co-treating diabetic patients. DESIGN: Comparison of traditional paper-based communication for reporting and electronic communication. SETTING: General practitioners and an internal medicine outpatient clinic of an urban public hospital. SUBJECTS: A total of 275 diabetic patients, and the 32 general practitioners and one internal medicine consultant who cared for them. INTERVENTION: An electronic communication network, linking up the computer-based patient records of the physicians, thus enabling electronic data interchange. MAIN OUTCOME MEASURES: Number of letters sent and received per year by the general practitioners, the number of diabetes-related parameters (e.g. results of laboratory tests) in the patient records, and HBA1C levels. RESULTS: INTERVENTION GPs received more messages per year (1.6 per patient) than control GPs (0.5 per patient, P<0.05). Significant higher availability (P<0.05) was achieved for data on HBA1C levels, fructosamine levels, blood pressure measurements, cholesterol levels, triglyceride levels and weight measurements. INTERVENTION patients showed a slight but significant decrease of HBA1C levels in the second semester of 1994 (from 7.0 to 6.8, P = 0.03), control patients also showed a slightly decreased group mean, but this change was not significant (from 6.6 to 6.5, P = 0.52). The magnitudes of these mean differences, however, were not significantly different (intervention group: 0.21; control group: 0.12, P = 0.68). CONCLUSIONS: The electronic communication network for exchanging consultation outcomes significantly increased frequency of communication and the availability of data to the general practitioner on diagnostic procedures performed in the hospital, thus providing more complete information about the care that patients are receiving. A large-scale experiment over a longer period of time is needed to assess the effects of improved communication on quality of care.

Adult↗

PubMed2004

Teaching VOCA use as a communicative repair strategy.

Students with developmental disabilities often rely on prelinguistic behavior (e.g., reaching, leading) to communicate. When listeners fail to attend to prelinguistic behaviors, students may benefit from responding with an alternative form of communication to repair the breakdown. In the present study, we taught two students with developmental disabilities to repair communicative breakdowns by using a voice-output communication aid (VOCA). Intervention occurred at morning snack time when the students had the opportunity to access preferred items through prelinguistic behavior (e.g., reaching, guiding). Breakdowns occurred when the listener failed to attend to the student's initial request. Effects of the intervention were evaluated in a multiple-baseline design across subjects. Both students learned to use the VOCA to repair communicative breakdowns. As VOCA use was acquired as a repair strategy, the students also began to use the device to initiate requests when there had been no breakdown in communication. The intervention appeared to be an effective approach for supplementing prelinguistic behaviors with an additional option for communicating a request.

Adolescent↗

PubMed1981

Perception of spoken communication by elderly chronically ill patients in an institutional setting.

The purpose of this research was to investigate the perception of elderly and chronically ill patients regarding the spoken communication that occurs in a long-term care institution. Twenty-four patients were given a focused semi-standardized interview to investigate their perception of how much they talked, their communication partners, where they talked, their topics, their desire and enjoyment in talking, factors affecting communication, and suggestions for improving the communication atmosphere in this setting. Results indicate that communication is limited in quantity and scope, though elderly patients desire communicative interaction. The results of the study are explained from two perspectives-how the patients themselves contribute to the limited communication and how institutional life restricts interaction. Implications for the speech pathologist are given.

Adult↗

PubMed2001

Complexity of staff communication and reported level of understanding skills in adults with intellectual disability.

Staff reports of the communication acts taking place with 22 adults with intellectual disability were compared with video observations of the communication acts used by staff with 12 of these service users. The interactions were coded in terms of the form of communication used, the function of the act and the level of complexity. The results show that staff tend to underestimate their own use of verbal communication and overestimate their use of non-verbal communication. The findings also indicate a mismatch between the reported level of understanding of the service user and the level of complexity of the language used. Staff appeared unable to adapt their communication to the skills of the service user and an average of 45% of communicative acts were outside the reported understanding skills of the individual. The implications of these findings are discussed and possible explanations for staff behaviour are suggested.

Adult↗

PubMed2002

Appraisal of communication skills and patients' satisfaction in cross-language encounters in oncology practice.

OBJECTIVE: Communication skills are the most important determinant of patients' satisfaction with care. Data about the adverse effects of cross-language encounters are scarce. This prospective study was designed to examine the association between the communication language and patients' satisfaction in oncology practice. PATIENTS AND METHODS: The Art of Medicine questionnaire was used to assess patients' perceptions of clinicians' communication behaviors and patients' global satisfaction. Mean scores of patients cared for by Arabic-speaking oncologists were compared with those of patients who had communications translated from English by interpreters. RESULTS: 255 patients were eligible. Patients' median age was 44 years (95% CI, 42.8-46.2). Communication was in Arabic and interpreted English for 136 (53%) and 119 (47%) patients, respectively. The two groups were comparable for various demographic and clinical variables. On a nine-point scale, mean scores for the eight questionnaire items ranged from 6.24 (95% CI, 5.91-6.56) to 8.24 (95% CI, 8.03-8.45). There was no significant difference in communication skills between Arabic- and English-speaking clinicians for any questionnaire item. Moreover, a multiple regression analysis failed to identify any variable that independently influenced overall patients' satisfaction with the delivered care. CONCLUSIONS: The findings do not support a disadvantageous effect on interpersonal skills and patients' satisfaction as a result of cross-language communication.

Adult↗

PubMed2004

Communication strategies of people with ALS and their partners.

There are wider issues relating to the communication difficulties experienced by people with amyotrophic lateral sclerosis (ALS) than simply the physical problems caused by diminished oral control. In addition, existing literature on ALS rarely considers communication to be a joint interaction which depends on the strategies adopted by both communication partners, nor does it present communication in real life settings. This paper presents some of the findings from a 3-year research project which investigated the communication of people with ALS and their partners in their own homes. It discusses the purpose of human communication, and through examination of conversations in people's own homes has identified a range of strategies and techniques that families with ALS employ. For some people with ALS, although speech may deteriorate, they are still able to communicate closely and in a way that is more focused on topics that are particularly important to them. The findings from this study will be of interest to those who work with people with ALS.

Aged↗

PubMed2003

Notifying emergency department patients of negative test results: pitfalls of passive communication.

OBJECTIVE: Many emergency departments that perform a high volume of group A Streptococcus throat cultures inform patients or parents that unless they are notified of a positive result they can assume that their throat culture result is negative. Thus, positive throat culture results are communicated actively and negative results are communicated passively. We sought to determine the effectiveness and safety of such a system. METHODS: Prospective cohort study of 301 consecutive patients who had group A Streptococcus throat cultures obtained between March 28, 2000, and May 10, 2000, in the emergency department of an urban, academic, tertiary-care children's hospital. Outcomes were determined by telephone surveys of patients or their parents or guardians. The primary outcome was whether respondents had accurate knowledge of the throat culture result. Secondary outcomes included receipt of appropriate treatment instructions, need for another telephone call to the emergency department or primary-care provider to clarify the result or treatment instructions, satisfaction with the communication process, and preference to receive both positive and negative results or just positive results. RESULTS: Fifty-three percent of respondents did not have accurate knowledge of the throat culture result, 5% received inappropriate treatment instructions, 13% sought further clarification, 29% were dissatisfied with the communication process, and 85% preferred to receive both positive and negative results. Parents of patients with positive results were more likely to have accurate knowledge of the result (odds ratio 6.9, 95% confidence interval 1.4-65.7) and to be satisfied with the communication process. CONCLUSIONS: Passive communication of negative throat culture results to patients seen in the emergency department can be unreliable. Active communication of both positive and negative results may improve patient knowledge and satisfaction and ensure appropriate therapy, but in the absence of automated notification systems, would be resource intensive.

Adolescent↗

PubMed2004

Computer-assisted communication for critically ill patients: a pilot study.

BACKGROUND: Critically ill nonverbal patients often have limited means of communication through eye-blinking, communication cards, and occasionally writing. We evaluated a novel computer communication device to determine its clinical utility as an alternative form of communication between patients and hospital staff. METHODS: We conducted a prospective pilot study to evaluate a communication system (LifeVoice) for intubated nonverbal trauma patients. Patients and hospital staff completed questionnaires regarding product satisfaction and utility on days 1, 3, and 7. RESULTS: Patients (n = 35) felt the system assisted them in obtaining their needs (>90%). Hospital staff (n = 42) felt the device improved patient care (96%) and comfort (91%). CONCLUSION: The system evaluated offers an effective alternative to traditional means of communication in the intensive care unit. Computer-assisted communication improves patient comfort and allows advanced patient participation in medical care. Further studies will determine whether this modality objectively improves patient care by promoting a higher degree of safety and reducing medical errors.

Adult↗