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PubMed1994

Wireless communication technology applied to disaster response.

Communication during disasters is frequently inadequate. In addition to having competent communication skills, medical responders must have access to adequate, effective, and reliable communications equipment. Wireless communication technologies are rapidly evolving. The medical community needs a basic understanding of existing and emerging technologies to fully exploit these new resources. Wireless communication technologies for disaster response include radio pagers, radios, cellular telephones, satellite communications, and personal communication services. This article explores concepts of each of these technologies, basic descriptions of current and future equipment, applications of the equipment to medical disaster response, and advantages and disadvantages of each technology.

Disasters↗
PubMed1994

Effect of Alzheimer's disease on communication function.

Dementia has a significant impact on communication abilities. The profile of communication skills in dementia differ from the profiles of developmental aging and focal organic disorders. Normal elders may have some episodic memory losses and slower reaction times as aging progresses. Focal language disorders (aphasia and right hemisphere disorders) will affect specific language functions without affecting intellect and memory. Communication in the presence of dementia progresses through three stages. The first stage deficits are primarily in the content area of lexical access and subtle conversational skills. The second stage reveals increased difficulty in content areas including concept formation, lexical access diminished graphic abilities, reliance on syntactic abilities and reduced memory function. The third stage of dementia may involve all of the above to a more severe degree, with severe memory and intellectual deficits. Assessment batteries have been developed to evaluate the deficit areas frequently associated with communication in dementia. Clinical evaluation and standardized assessment can differentiate the language profile of dementia from other neurological disorders. Therapeutic intervention in communication focuses on maintaining the patient's communication and providing educational information for caregivers for more effective communication strategies.

Alzheimer Disease↗
PubMed1993

[Improvement of communication behavior of laryngectomized and voice-rehabilitated patients by a psychological training program].

An important goal of laryngectomee rehabilitation is achieving the best possible result in voice restoration. In addition to good voice quality, efficient intelligibility in daily conversation requires specific communication skills, which are very often neglected in speech therapy. In this study 51 male laryngectomees were randomized to an intervention group or an attention control group. After hospital discharge the intervention group participated in a psychological training program aimed at improving the communication behavior of the laryngectomees. This training was part of a comprehensive rehabilitation program (lasting over six months) and consisted of four modules: Improvement of communication over the disability; Discrimination of factors affecting intelligibility; Development of behavioral strategies for improving intelligibility in daily conversation; Transferring the strategies to daily live. The effectiveness of training was evaluated by a questionnaire which covered three important aspects of communication behavior. As a result of the intervention the patients influenced more effectively their own communication behavior and also influenced more adequately the behavior of typical communication partners. Present finding with the psychological training program demonstrated that the communication behavior of laryngectomees can be significantly improved.

Adaptation, Psychological↗
PubMed1996

The peer relations of preschool children with communication disorders.

The peer-related social interactions of preschool-age children with communication disorders were compared to those of normally developing chronological age-mates. All children were previously unacquainted with one another and participated in a series of short-term play groups. Differences between the 2 groups emerged primarily in terms of overall social activity, as children with communication disorders engaged in fewer positive social interactions and conversed with peers less often during non-play activities. Children with communication disorders also were less successful in their social bids and appeared to be less directive with their peers. However, both groups of children exhibited similar patterns of socially competent interactions including the ability to sustain play (group play), to minimize conflict, to join others in ongoing activities, and to respond appropriately to the social bids of others. Based on peer sociometric ratings, both groups of children were equally accepted. These general patterns of similarities and differences were found in settings in which play groups consisted of all children with communication disorders (specialized settings) as well as in settings in which the play groups included both children with communication disorders and normally developing children (mainstreamed settings). However, even during the relatively brief acquaintanceship process, an analysis of peer preference patterns revealed that children with communication disorders in mainstreamed settings were less socially integrated in the play groups than normally developing children. The potential for additional difficulties in peer interactions for children with communication disorders when children become more familiar with one another and play becomes more intricate was discussed in light of interaction patterns formed during the short-term play groups.

Analysis of Variance↗
PubMed1979

Developing a new perspective for biomedical Communications.

A three-dimensional model is utilized in an attempt to develop a complete picture of the many facets of biomedical communications. This model provides a suitable visual structure from which to explore the complex interactions of individuals, institutions, and activities in defining the field of biomedical communications. The first dimension of the model was developed through a historical overview of the environment of the biomedical communicator and suggests that changing organization goals, client needs, technology, and resources have influenced the evolution of different types of biomedical communicators. The second dimension of the model identifies five major work roles that may be performed by the biomedical communicator of today. The final dimension of the model is developed by a consideration of the major communication methods (illustration, photography, cinematography, television, audiovisual, and computer) of the biomedical communicator.

Administrative Personnel↗
PubMedDate not supplied

Spouse abuse, patient-physician communication, and patient satisfaction.

INTRODUCTION: This study examines differences in physician communication and patient satisfaction with physician care, contrasting women who have and have not been abused by spouses or intimate partners. METHODS: A nationally representative sample of women participated in a telephone survey including questions on spouse abuse, health status, satisfaction with physicians, and communication with physicians. This article uses data from the survey describing 1,082 married or cohabitating respondents 18-64 years of age who had a regular physician and made at least one doctor visit in 1992. RESULTS: Overall, 7.3% of respondents reported being physically abused by a spouse during the previous year. Abused women were much more likely than other women to report both poor communication and dissatisfaction with physicians. Only 9.7% of the abused women had discussed the abuse with a physician. Controlling for socio-demographic and health-related factors in logistic regression analysis, we found that spouse abuse more than doubled respondents' odds of being dissatisfied with physician care. When the quality of patient-physician communication was added to the model, the influence of spouse abuse became insignificant. Instead, women reporting poor communication with physicians were four times more likely than others to be dissatisfied with physician care. CONCLUSIONS: Spouse abuse creates barriers to patient-physician communication, and poor communication contributes to lower satisfaction with care. Careful interviewing by trained clinicians is essential to identify and address abusive situations and to prevent further damage to women's physical and mental health.

Adolescent↗
PubMed1997

The biological conditions of assessment of ethylene glycol-induced inhibition of gap junctional intercellular communication by metabolic cooperation assay.

Ethylene glycol (EG) has been previously shown to inhibit gap junctional intercellular communication. In this paper we examine conditions under which the effect of EG on gap junctional communication is assessed by metabolic cooperation assay. The later, after the start of metabolic cooperation assay, EG was added, the lower its inhibitory effect was. If treatment with EG began 12 h or even later after plating of cells, no significant effect on gap junctional communication was observed. Short EG treatments (2-8 h) induced a reversible inhibition of cell-to-cell communication, provided that the cells could communicate freely after the drug was removed. However, if further cell-to-cell communication was excluded, the effect of short exposures was irreversible. Using Scrape loading method we observed that after a 60 min exposure to EG the standard gap junctional intercellular communication was completely restored in a few hours.

Animals↗
PubMed1997

[Communication with patients].

A survey on patients' opinions about and needs for communication is reported. Most patients consider communication as an important part of nursing and recovery. Not only information is demanded, but also a discussion of problems and distress. Nurses are well requested to play a part herein. While most patients indicate that their communication demands are well cared for, there are also deficits. A considerable minority of patients has notable problems with solitude and lack of communication, they want personal help to cope with disease and help for better social integration. Special demands for more communication are indicated by younger patients and by women. Patients who feel severely ill and patients who suffer from pain, depression or fright say they need more communication about their feelings and fears. Frequent, long-term or immobile patients are less convinced that doctors and nurses know what is good for them. Patients with reduced mobility tend to express less interest in communication. A field for improvement may also be found within clinics: Quality of relationships between nurses and patients differ between clinics with a clear impact on quality of nursing and wellbeing of the patients.

Adaptation, Psychological↗
PubMed1997

Perspectives on AAC systems by the users and by their communication partners.

The study examined the perspectives of augmentative and alternative communication (AAC) users and their 'formal' and 'informal' communication partners in relation to two areas of relevance to AAC: firstly, communication strategies, and secondly, advantages and disadvantages of AAC systems. With respect to communication strategies, it was found that formal communication partners thought that more vocabulary for communicating social purposes was actually available to AAC users and they were less aware of daily routines within day and residential environments. With respect to advantages and disadvantages, three main areas of concern emerged: the effect of the AAC system on the users' communication; features of AAC systems; and the effect of AAC on the users' quality of life. Both high- and low-technology AAC systems were seen as having advantages and disadvantages. This study demonstrates the important contribution to be made by AAC users in the provision of a new set of priorities based on their user experiences.

Adolescent↗
PubMedDate not supplied

Family communication about sex: what are parents saying and are their adolescents listening?

CONTEXT: Communication between parents and adolescents about sex, particularly in minority families, has been understudied; more information is needed both on which sex-related topics are discussed and on how their content is transmitted. METHODS: Parent-adolescent communication about 10 sex-related topics was examined in a sample of 907 Hispanic and black 14-16-year-olds. Chi-square analyses were performed to test for significant differences across the 10 topics in discussions reported by the adolescents (with either parent) and by the mothers. The openness of communication, parent-adolescent agreement about communication of topics and differences by gender and ethnicity were also examined. RESULTS: Significantly higher proportions of mothers and adolescents reported discussions of HIV or AIDS (92% by mothers and 71% by adolescents, respectively) and STDs (85% and 70%, respectively) than of issues surrounding sexual behavior, contraceptive use and physical development (27-74% for these other eight topics as reported by mothers vs. 15-66% as reported by adolescents). The gender of the adolescent and of the parent holding the discussion, but not the family's ethnicity, significantly influenced findings, with adolescents of both sexes more likely to report discussions with mothers than with fathers, and with parents more likely to discuss any of the 10 topics with an adolescent of the same gender than of the opposite gender. The likelihood of a topic being discussed and of mother-adolescent agreement that a topic was discussed both increased with an increasing degree of openness in the communication process. CONCLUSIONS: Consistent with research among white samples, mothers of black and Hispanic adolescents are the primary parental communicators about sexual topics. To facilitate communication, educational programs for parents should cover not only what is discussed, but how the information is conveyed.

Adolescent↗
PubMed1996

When the diagnosis is cancer: patient communication experiences and preferences.

BACKGROUND: Discrepancies exist between reported experiences of patients when they have been given a diagnosis of cancer, published guidelines for telling a diagnosis, and patterns of communication patients rate as favorable. Several studies have identified what happened and what is important to cancer patients when told their diagnosis, but no studies have addressed subsequent communications concerning the implications of the diagnosis and treatment choices. This study extended previous research by investigating the experiences and preferences for communication about diagnosis, prognosis, and treatment of patients diagnosed with breast cancer or melanoma. METHODS: A self-report questionnaire was designed for this study based on previous research and qualitative data generated from focus groups. Patients with breast cancer or melanoma answered questions about their experiences with communication at the time of diagnosis and concerning prognosis, treatment and related issues. Comparisons were made between patient experiences, preferences and published guidelines. Differences between the experiences of breast cancer and melanoma patients were tested and the relationship between communication and subsequent psychological adjustment to cancer was assessed. RESULTS: Patient preferences for communication during diagnostic consultation were not always consistent with published guidelines. Type of cancer did not significantly affect patient preferences. Psychological adjustment was related to patient ratings of the quality of doctor discussion about treatment options, but not about the diagnosis of cancer and its implications. Patients who wanted more emotional support at the time of diagnosis subsequently experienced poorer psychological adjustment. CONCLUSIONS: The differences in patient preferences show that a list of prescriptions for how to disclose a cancer diagnosis is too simplistic. Guidelines for clinicians should be derived from patient-based data rather than be limited only to clinical opinion. Guidelines concerning communication at the time of diagnosis also need to address discussions concerning the implications of the diagnosis and making treatment decisions.

Adult↗
PubMed1996

The communicating branch of the lateral plantar nerve: a descriptive anatomic study.

Since the communicating branch of the lateral plantar nerve has been implicated as a factor in the etiology of Morton's neuroma, a painful perineurofibrosis of a common plantar digital nerve, this project was designed to investigate the anatomy of this communicating branch. Both feet of 40 embalmed human cadavers were dissected to show the frequency of occurrence and anatomical variation of the communicating branch. The communicating branch was present in 66.2% of the feet we studied with no large gender-based differences. Branches occurred bilaterally in 52.5% of cadavers, while 27.5% had branches unilaterally. The occurrence of this branch does not correlate well with the likelihood of development of Morton's neuroma. Differences in diameter of the communicating branch ranged from less than 0.5 mm to as large as the common plantar digital nerves themselves, about 2 mm. The presence or absence of the communicating branch made no qualitative difference in the diameters of the common plantar digital nerves. There were 60.4% of the communicating branches in this study that had a typically-described orientation, arising more proximally in the foot from the fourth common plantar digital nerve, while 39.6% of the branches had a reversed orientation, arising more proximally from the third common plantar digital nerve. These reversed branches had a more oblique orientation when compared to the classic branches. Other anatomical variations were noted, including accessory branches that attached to deeper structures in the foot. These data form a basis for further research into the etiology of Morton's neuroma and improved surgical techniques for correcting this condition.

Adult↗
PubMed1998

Classification of communications between the musculocutaneous and median nerves.

In 16 out of 79 cadavers 22 communications were found between the musculocutaneous and median nerves. In six subjects they were present bilaterally. There were three types, based on the sites of communication. Type I: The communication was proximal to the entrance of the musculocutaneous nerve into coracobrachialis (9/22); Type II: The communication was distal to the muscle (10/22); Type III: The nerve as well as the communicating branch did not pierce the muscle (3/22). Bilateral communications were not necessarily of the same type. The possible clinical implications of these communications (relating either to the surgical approach to the shoulder joint, or to entrapment syndromes) are discussed.

Brachial Plexus↗
PubMed1977

Morphology of the intrarenal lymphatic system. Capsular and hilar communications.

Recent functional evidence has indicated that ureteric obstruction for three or more days in dogs causes a diversion of renal lymph from the hilar to the capsular system. The present study was concerned with the structural correlate of this functional evidence, having special reference to communications between the two systems. Within three days of ureteric occlusion the capsular lymphatic system became dilated. On histological examination two types of tributaries were found. One (termed a perforating lymphatic) served as a primary pathway for superficial cortical lymph from the subcapsular plexus, and penetrated the capsule either alone or in company with a small vein. The other (termed a communicating lymphatic) was closely associated with the occasional penetrating interlobular blood vessel which traversed the capsule to ramify in the perirenal tissue. Approximately 60% of the penetrating arteries in eight dog kidneys had associated communicating lymphatics. On the renal surface the perforating and communicating lymphatics formed the primary collecting vessels of the capsular system. Within the renal substance the communicating lymphatics were directly continuous with lymphatics which surrounded the interlobular blood vessels and which have been shown to drain into the hilar network. Thus the communicating lymphatics formed direct connections between the hilar and capsular systems. It was concluded that these communications, although dilated by hydronephrosis, existed under control conditions. Functionally they are probably of importance only under special circumstances when intrarenal lymph may be diverted from one to the other system.

Animals↗
PubMedDate not supplied

MR imaging of ventriculomegaly--a qualitative and quantitative comparison of communicating hydrocephalus, central atrophy, and normal studies.

Both communicating hydrocephalus and central atrophy cause ventricular dilatation. However, patients with hydrocephalus may require treatment. The aim of this study was to assess qualitatively and quantitatively the efficacy of MR imaging in the differentiation of communicating hydrocephalus from central atrophy. The midsagittal T1-weighted MR images of 33 patients with communicating hydrocephalus, 31 patients with central atrophy, and 23 normal subjects were evaluated qualitatively and quantitatively. This included configuration of the aqueduct; area of the septum pellucidum, third ventricle, and fourth ventricle; and morphology of the corpus callosum. Distal dilatation of the aqueduct was detected in 33.3% of patients with communicating hydrocephalus and in none of those with central atrophy. The corpus callosum was elevated in patients with communicating hydrocephalus when compared with that in patients with central atrophy. In conclusion, an analysis of midsagittal T1-weighted images has identified useful qualitative and quantitative criteria in the differentiation of communicating hydrocephalus from central atrophy. The configuration of the aqueduct with funneling at the fourth ventricular end strongly suggests the presence of communicating hydrocephalus rather than central atrophy alone.

Aged↗
PubMed1999

Quantitative tools for comparing animal communication systems: information theory applied to bottlenose dolphin whistle repertoires.

Comparative analysis of nonhuman animal communication systems and their complexity, particularly in comparison to human language, has been generally hampered by both a lack of sufficiently extensive data sets and appropriate analytic tools. Information theory measures provide an important quantitative tool for examining and comparing communication systems across species. In this paper we use the original application of information theory, that of statistical examination of a communication system's structure and organization. As an example of the utility of information theory to the analysis of animal communication systems, we applied a series of information theory statistics to a statistically categorized set of bottlenose dolphin Tursiops truncatus, whistle vocalizations. First, we use the first-order entropic relation in a Zipf-type diagram (Zipf 1949 Human Behavior and the Principle of Least Effort) to illustrate the application of temporal statistics as comparative indicators of repertoire complexity, and as possible predictive indicators of acquisition/learning in animal vocal repertoires. Second, we illustrate the need for more extensive temporal data sets when examining the higher entropic orders, indicative of higher levels of internal informational structure, of such vocalizations, which could begin to allow the statistical reconstruction of repertoire organization. Third, we propose using 'communication capacity' as a measure of the degree of temporal structure and complexity of statistical correlation, represented by the values of entropic order, as an objective tool for interspecies comparison of communication complexity. In doing so, we introduce a new comparative measure, the slope of Shannon entropies, and illustrate how it potentially can be used to compare the organizational complexity of vocal repertoires across a diversity of species. Finally, we illustrate the nature and predictive application of these higher-order entropies using a preliminary sample of dolphin whistle vocalizations. The purpose of this preliminary report is to re-examine the original application of information theory to the field of animal communication, illustrate its potential utility as a comparative tool for examining the internal informational structure of animal vocal repertoires and their development, and discuss its relationship to behavioural ecology and evolutionary theory. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2005

Bridging the communication gap in the operating room with medical team training.

BACKGROUND: In the operating room (OR), poor communication among the surgeons, anesthesiologists, and nurses may lead to adverse events that can compromise patient safety. A survey performed at our institution showed low communication ratings from surgeons, anesthesiologists, and OR nursing staff. Our objective was to determine if communication in the operating room could be improved through medical team training (MTT). METHODS: A dedicated training session (didactic instruction, interactive participation, role-play, training films, and clinical vignettes) was offered to the entire surgical service using crew resource management principles. Attendees also were instructed in the principles of change management. A change team was formed to drive the implementation of the principles reviewed through a preoperative briefing conducted among the surgeon, anesthesiologist, and OR nurse. A validated Likert scale survey with questions specific to effective communication was administered to the nurses, anesthesiologists, and surgeons 2 months after the MTT to determine the impact on communication. Data are presented as mean +/- SEM. RESULTS: There was a significant increase in the anesthesiologist and surgeon communication composite score after medical team training (anesthesia pre-MTT = 2.0 +/- .3, anesthesia post-MTT = 4.5 +/- .6, P <.0008; surgeons pre-MTT = 5.2 +/- .2, surgeons post-MTT = 6.6+/-.3, P <.0004; nurses pre-MTT = 4.3 +/- .3, nurses post-MTT = 4.2 +/- .4, P = .7). CONCLUSIONS: Medical team training using crew resource management principles can improve communication in the OR, ensuring a safer environment that leads to decreased adverse events.

Anesthesiology↗
PubMed2004

GSM-PKI solution enabling secure mobile communications.

Because of its wide distribution and ease of use, the mobile phone, as a reliable personal communications channel, offers an excellent basis for the provision of reliable electronic communications services. In Finland, ca. 75% of the citizens have a mobile phone and, at present and most likely also in the future, it is the most widely spread service channel allowing reliable electronic communications. Despite the restricted functions of the mobile phone, the citizens can use the phone also as a communications medium. In 2001, the Finns sent over 1 billion SMS messages. In Finland, TeliaSonera Finland Oyi and the Population Register Centre (PRC) have closed a co-operation agreement with the aim of creating a mobile phone service for the electronic identification of a person. The co-operation launched is a significant development project from the perspective of the citizens. As a result, the consumers will have a new alternative for reliable electronic communications and commerce in data networks in addition to the electronic identification card. In the future, it will be possible to use the services of both public administration and the private sector by means of a mobile phone more reliably than before, without a physical visit, e.g. to a health centre or to another provider of healthcare services. The possibility of identification and signature by a mobile phone allows an easier provision of versatile services irrespective of time and place, because, in addition to voice, text message, and WAP functions, the service can be utilised also in communications services through the Internet, in which case, the mobile phone acts like a card reader. From the perspective of reliable personal mobile communications, the healthcare sector is one of the most significant and challenging application areas.

Cell Phone↗