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PubMed1975

Doctor-patient communication and outcomes among diabetic patients.

This study reports on 242 diabetic patients from the practices of 42 physicians. Communication from physician to patient was studied to determine the effect of communication on subsequent patient outcomes. Patients and physicians were questioned on instructions provided for diabetic management and self-care. The average level of effective communication for all patients in the study was 67 percent. Insulin-dependent diabetics had the best communication scores, those controlled on diet alone the poorest, while oral medication patients were intermediate. Although overall communication scores showed no significant correlation with diabetic control status, patient satisfaction, compliance in taking prescribed medication, or frequency of hospitalization, specific communication items were highly correlated with corresponding behavioral outcomes.

Administration, Oral↗
PubMed1996

Multiple method validation study of facilitated communication: II. Individual differences and subgroup results.

Potential individual variations in the effectiveness of a shared communication method, facilitated communication (FC), were examined among 20 students with autism and related disorders. To minimize the limits or disadvantages of a single method, we used multiple methods, including auditory or visual input, and simple pointing responses to pictures or words, as well as typing. Data were collected after 6 weeks of FC, and follow-up data up to 7 months later. Findings differed across methods, but there was little clear support for the validity of FC in enhancing communication over communication that students produced independently. Significant facilitator influence of responses was found, but was far less extensive than in other studies. However, an "abdication" pattern of responding was found for some students, in which high performance observed with independent responding was lessened on trials when FC was introduced. That is, these students may become more passive communicators when FC is used. The complex detected and undetected influences in the process of communication through facilitation are discussed, as well as risk factors in the use of FC.

Adolescent↗
PubMed1996

Biochemical systematics of Japanese fireflies of the subfamily Luciolinae and their flash communication systems.

Japanese fireflies of the subfamily Luciolinae are biochemically analyzed using 13 allozymes, and the phylogenetic relationships obtained from this analysis are compared with their flash communication systems. As a result, the Japanese Luciolinae can be divided into three groups. Hotaria parvula and H. tsushimana together with Luciola yayeyamana and L. kuroiwae form the first group, and they use the same communication system. L. lateralis, Curtos okinawana, and C. costipennis make up the second group, and their communication systems are also the same. L. cruciata makes up the last one, and its communication system is different from the other fireflies of Luciolinae. Therefore, their taxonomical arrangement and communication systems are not congruent. However, the genetic similarity deduced by allozymic analysis of the members of the Japanese Luciolinae is highly consistent with their flash communication systems.

Animal Communication↗
PubMed1989

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed2005

Is staff well-being and communication enhanced by multidisciplinary work shift evaluations?

OBJECTIVE: To study the implementation of multidisciplinary structured work shift evaluations at a pediatric intensive care unit (PICU) to enhance team communication. DESIGN AND SETTING: Prospective, repeated measurements design, comparison of pre/post measurements and process measures in a Dutch tertiary care, university-affiliated PICU. PARTICIPANTS: All 61 PICU staff members. INTERVENTIONS: Implementing multidisciplinary structured work shift evaluations. Before the implementation phase the PICU team received feedback training and eight participants (four physicians, four nurses) were trained as "work shift evaluation leader." MEASUREMENTS AND RESULTS: Outcome measures covered: (a) quality and process of the implementation through prestructured checklists during the 3 months of implementation, (b) a subjective evaluation of a feedback training on team communication as anticipated action and on the level of communication (about patients and with colleagues), and (c) emotional exhaustion complaints and work-related fatigue. The interdisciplinary structured work shift evaluations were implemented successfully as planned during the work shift; all staff were trained ahead, and the process was followed almost completely. Almost two-thirds (62%) of the staff felt a positive influence on team communication. Almost all staff members (92%) were satisfied regarding communication with their colleagues after the intervention, compared to 76% before. Emotional exhaustion in the PICU team decreased significantly after the implementation, but no differences in work-related fatigue levels were found. CONCLUSIONS: As organizational change the implementation of a multidisciplinary structured work shift evaluation at a PICU was successful and team communication improved. Emotional exhaustion decreased during the study period.

Communication↗
PubMed2004

RADPED: an approach to teaching communication skills to radiology residents.

BACKGROUND: The Accreditation Council for Graduate Medical Education mandates that radiology residency programs teach communication skills to residents. OBJECTIVE: The purpose of this paper is to present a mnemonic, RADPED, that can be used to enhance communication in the radiology setting. It reminds the resident of the salient points to address during an imaging encounter with pediatric patients and their families for the purpose of enhancing communication. MATERIALS AND METHODS: Recent history and research in medical communication are reviewed. Various communication guides used by primary care physicians, such as SEGUE, and the Kalamazoo consensus statement are discussed. This methodology was adapted into a format that could be used to teach communication skills to radiology residents in the context of an imaging encounter. RESULTS: RADPED reminds the resident to establish rapport with the patient, ask questions as to why the patient and family are presenting for the study, discuss the exam, perform the procedure, use exam distractions, and discuss the results with the referring physician and family when appropriate. SUMMARY: This simple memory aid promotes the key points necessary to optimize the radiology resident's encounter with pediatric patients and their families.

Adolescent↗
PubMed2006

Communicative aspects of environmental management by objectives: examples from the Swedish context.

Management by objectives (MBO) is a technique for integrating ecological concerns into national political and administrative structures. Politicians determine environmental objectives and interim targets to be implemented and assessed by civil servants in national, regional, and local contexts. Well-developed organizational communication is a prerequisite for MBO. However, communication-related obstacles can arise when using MBO in public environmental management. We examine communicative aspects of environmental MBO, looking specifically at the implementation, administration, and assessment of Swedish environmental quality objectives. Our argument is illustrated by quotations from individual and focus group interviews. We conclude that communicative problems may arise, because different actors interpret messages from different perspectives, depending on their agendas, prior knowledge and experience, and positions in the administrative system. It is crucial to recognize the dialogic aspects of communication, by involving the receiver of a message in a process of response. In addition, the different time frames underlying different arguments could contribute to misunderstandings between actors involved in handling environmental issues. In assessing the achievement of environmental objectives, indicators are used as communicative tools. It is important to investigate whether and how these indicators contribute to the de- and recontextualization of environmental objectives.

Communication↗
PubMed2005

Decreased gap junctional communication in neurobiotin microinjected lens epithelial cells after taxol treatment.

The aim of the study was to examine gap-junction-mediated intercellular communication after experimentally induced aggregations of microtubules in cultured bovine lens epithelial cells. Intercellular communication between lens cells appears to be crucial for normal lens homeostasis. However, investigations on the maintenance of direct ion and metabolite exchange via gap junctions and its quantified dependency of cytoskeletal microtubules have not been available under conditions leading to bundling of microtubules. Thus, metabolic coupling of neighboring lens epithelial cells was quantified following microinjections of neurobiotin into single cells under various conditions. In controls, intensive gap-junction-mediated intercellular communication could be documented by dye-spreading of microinjected neurobiotin. In contrast, taxol treatment for 1-3 days impaired, but did not completely block gap-junction-mediated intercellular communication. After depletion of taxol, a complete recovery of intercellular communication was achieved. In addition, confocal laser scanning microscopy and rapid-freeze deep-etch electron microscopy revealed a displacement of actin-filaments from the perinuclear cytoplasm, accompanied by an abnormal aggregation of microtubules after taxol treatment, including impeded translocation of connexin 43 from the cytoplasm into the plasma membrane. Incubation of cells with nocodazole destroyed the microtubule network, accompanied by a clear reduction of plasma-membrane-integrated connexin 43 and significant impairment of dye spreading. Thus, in lens epithelial cells intercellular communication at gap junctions made by connexin 43 depends on the integrity of the microtubule network through the translocation of connexins to the plasma membrane.

Actin Cytoskeleton↗
PubMed2005

Chimpanzee (Pan troglodytes) intentional communication is not contingent upon food.

Studies of great apes have revealed that they use manual gestures and other signals to communicate about distal objects. There is also evidence that chimpanzees modify the types of communicative signals they use depending on the attentional state of a human communicative partner. The majority of previous studies have involved chimpanzees requesting food items from a human experimenter. Here, these same communicative behaviors are reported in chimpanzees requesting a tool from a human observer. In this study, captive chimpanzees were found to gesture, vocalize, and display more often when the experimenter had a tool than when she did not. It was also found that chimpanzees responded differentially based on the attentional state of a human experimenter, and when given the wrong tool persisted in their communicative efforts. Implications for the referential and intentional nature of chimpanzee communicative signaling are discussed.

Animal Communication↗
PubMed2006

Perceptions and congruence of symptoms and communication among second-generation Cambodian youth and parents: a matched-control design.

This study examined the relationship between perception of communication and report of symptoms among second-generation Cambodian children and their parents using a matched-control design of clinic and community children. Children reported significantly higher symptoms than parents in both samples. Clinic parents reported more symptoms than community parents, but no differences were observed between children, and the mean level of child-reported symptoms was similar to past studies examining clinic populations. Parents reported better communication than children, and community respondents reported better communication than their clinic counterparts. Same-informant communication predicted symptom report. These data suggest that communication is a key factor in understanding symptoms in this group, provide evidence that child perception of communication is particularly important, and that the use of a matched control design might reveal high symptom levels in community samples that are otherwise undetected.

Adolescent↗
PubMed2006

The role of maternal communication patterns about interparental disputes in associations between interparental conflict and child psychological maladjustment.

The present study examined the role of mothers' communication with children about interparental disputes in associations between interparental conflict and child psychological maladjustment in a sample of 227 children and their parents followed over a one-year span. Most of the time (i.e., 79.8%) mothers reported that they would communicate with their children following interparental disputes, with the vast majority of those communications containing relatively constructive depictions of interparental conflict. Post-conflict communications were not associated with children's adjustment above and beyond the impact of interparental conflict. However, maternal communications underscoring family cohesion and warmth, emphasizing remorse for engaging in the interparental disagreement, and denying the occurrence of the dispute each moderated associations between interparental conflict and child externalizing symptoms in distinct, complex ways. The findings in general suggest that not all positive communications have the beneficial impact on children that parents may have intended.

Adjustment Disorders↗
PubMed2005

Intergenerational communication beliefs across the lifespan: comparative data from Ghana and South Africa.

This paper examines (for the first time) young adult American, Ghanaian, and Black South Africans' perceptions of communication and aging. Irrespective of cultural background, as age of target increased, so did trait attributions of benevolence, norms of politeness and deference, and communicative respect and avoidance; however, attributions of personal vitality and communication satisfaction decreased linearly. Young adults' reported avoidant communication with older people negatively predicted their conversational satisfaction and enjoyment of it. In addition, communicative respect was more strongly predictive of Africans' satisfaction while certain age stereotypes had contrastive effects for the Ghanaian and South Africans' enjoyment of intergenerational communication.

Adult↗
PubMed1995

Pregnancy among Hispanic teenagers: is good parental communication a deterrent?

Effective communication between Hispanic parents and teens about sexual issues may deter adolescent pregnancy, yet little is known about the prevalence or impact of such communication. The study examined this potential relationship in a cohort of urban Hispanic adolescents. A questionnaire was administered to a non-random sample of pregnant and non-pregnant Hispanic women aged 12-18 years attending inner city schools in Los Angeles to obtain demographic, sexual activity and communication information. Logistic regression analysis was used to evaluate the independent contribution of risk factors to teenage pregnancy. Good communication with one's mother was inversely related to pregnancy; the adjusted odds ratio of pregnancy if the mother told the daughter about sex was 0.3 (95% CI 0.2-0.6). Friends' love was also inversely related to pregnancy (odds ratio 0.7; 95% CI 0.6-0.8). In order of increasing strength, alcohol and drug use, favorable attitude toward premarital sex, receipt of welfare, older age at menarche, and older age were all significantly related to pregnancy. Pregnant Hispanic teenagers have poorer communication with their parents than do other Hispanic teens. Efforts to reduce the incidence of adolescent pregnancy among Hispanics may need to address not only family communication but also issues outside the home such as alcohol and recreational drugs.

Adolescent↗
PubMed1987

Is a mosaic embryo also a mosaic of communication compartments?

We have studied the pathways of cell communication in embryos of the mollusc Lymnaea stagnalis in which the developmental fate of a cell or a group of cells is known from cell lineage studies. We iontophoretically injected Lucifer Yellow CH and followed the spread of fluorescence between cells interconnected via gap junctions. In early stages all blastomeres appear to be dye-coupled, but later on communication is restricted within compartments. The pattern of cell communication corresponds with the development of compartments with specific cell fates. Dye-spread is limited by communication boundaries which completely or mostly prevent the passage of dye to adjacent compartments with different developmental fates. These boundaries appear progressively during development. Our results suggest that, during the development of Lymnaea, the progressive changes in the pattern of dye spread correspond with the progressive restrictions of the developmental fates of individual cells or groups of cells. We conclude that changes in the pattern of cell communication and in the appearance of communication compartments are not exclusive features of regulative embryos.

Animals↗
PubMed1992

Cell-cell communication in the embryo of Caenorhabditis elegans.

We have investigated the pattern of cell-cell communication in embryos of the free-living soil nematode Caenorhabditis elegans. For this, we have established a method for microinjection of tracer dyes into individual blastomeres. After iontophoresis of fluorescent dyes of different molecular weights (Lucifer yellow, LY, M(r) 457; rhodamine-labeled dextran, RD, M(r) 4000), we can visualize intercellular communication pathways. The dye-spread of LY, indicating communication via gap junctions, becomes first visible in the late 2-cell stage. From the 4-cell stage onward all cells appear to be well coupled by communication channels, which allow the free diffusion of LY. In contrast, RD remains restricted to the injected cell and its descendants. After the primordial germcell P4 has been generated in the 24-cell stage, dye-spread of LY into this cell and its somatic sister D is delayed. However, the restricted dye-coupling of D is only temporary. After a brief period it joins the somatic compartment. With the beginning of the morphogenesis phase the two existing germline cells (the daughters of P4) are completely uncoupled from the soma, while the latter still forms a single dye-coupling compartment. Only during the second half of embryogenesis different separate somatic communication compartments are established. We followed the pattern of intercellular communication in the alimentary tract and found a progressive restriction into smaller dye-coupling units. Our data are compared to those found in other systems and discussed with respect to cellular determination and differentiation.

Animals↗
PubMed1987

Cell contact but not junctional communication (dye coupling) with biliary epithelial cells is required for hepatocytes to maintain differentiated functions.

Specific differentiated gene expression and the morphology of adult rat hepatocytes can be maintained for as long as 8 weeks in vitro only when they are cultured in the presence of biliary epithelial cells; when primary hepatocytes are cultured alone, they lose these functions within 2 to 3 days. We obtained evidence suggesting that contact between hepatocytes and biliary epithelial cells is necessary for maintaining hepatocyte functions. We examined whether junctional communication between and among hepatocytes and biliary epithelial cells is required for long-term maintenance of hepatocyte functions, using a dye-transfer method, in three co-cultures: (1) hepatocytes and biliary epithelial cells prepared from Sprague-Dawley rats; (2) hepatocytes from Sprague-Dawley rats and epithelial cells of the IAR 20 line, originally established from BDVI rats; and (3) hepatocytes from BDVI rats and IAR 20 epithelial cells. The established epithelial cell line (IAR 20) and early-passage cultures of biliary epithelial cells maintained hepatocyte-specific functions in culture for 40 and 70 days, respectively, but the latter induced more stable maintenance of albumin secretion. Hepatocytes cultured alone lost their characteristic morphology within 5 to 8 days, and almost no dye transfer was observed. In co-cultures, the capacity of biliary epithelial cells to communicate among themselves remained relatively high throughout the culture period, whereas hepatocytes showed almost no junctional communication at an early phase of culture and first began to communicate after 2 weeks, communication capacity increasing for at least the next 10 days of culture. The most notable finding was that there was no dye transfer between hepatocytes and biliary epithelial cells in any co-culture system. These results suggest that the maintenance of hepatocyte-specific functions requires intercellular contact but probably not gap-junctional communication between hepatocytes and biliary epithelial cells. This system is useful for studying heterotypic cell-cell interactions and the control of gene expression.

Albumins↗
PubMed1977

Accuracy of vocal emotional communications among children and adults and the power of negative emotions.

Two tapes of six emotions (anger, fear, sadness, contentment, happiness, love) recorded by child and adult speakers were played to child and adult listeners to determine whether (a) each group of listeners responds more accurately to positive or negative emotions; (b) each group of speakers communicates positive or negative emotions more accurately; (c-g) there were specific ways in which children adn adults differ in accuracy of perceiving and communicating the six emotions studied. Two hundred and ten white, male, middle-class Ss were used. It was found that (a) all listener groups perceived negative emotions more accurately; (b) all speaker groups communicated negative emotions more accurately; (c) there was a developmental trend in the ability to accurately perceive vocal communication; (d) children and adults did not differ significantly in the ability to express emotions; (e) adults perceived fear more accurately; (f) children communicated fear more accurately; (g) adults communicated sadness more accurately than children.

Age Factors↗
PubMed1995

Intercellular communication and carcinogenesis.

Two types of intercellular communication (humoral and cell contact-mediated) are involved in control of cellular function in multicellular organisms, both of them mediated by membrane-embedded proteins. Involvement of aberrant humoral communication in carcinogenesis has been well documented and genes coding for some growth factors and their receptors have been classified as oncogenes. More recently, cell contact-mediated communication has been found to have an important role in carcinogenesis, and some genes coding for proteins involved in this type of communication appear to form a family of tumor-suppressor genes. Both homologous (among normal or (pre-)cancerous cells) as well as heterologous (between normal and (pre)cancerous cells) communications appear to play important roles in cell growth control. Gap junctional intercellular communication (GJIC) is the only means by which multicellular organisms can exchange low molecular weight signals directly from within one cell to the interior of neighboring cells. GJIC is altered by many tumor-promoting agents and in many human and rodent tumors. We have recently shown that liver tumor-promoting agents inhibit GJIC in the rat liver in vivo. Molecular mechanisms which could lead to aberrant GJIC include: (1) mutation of connexin genes; (2) reduced and/or aberrant expression of connexin mRNA; (3) aberrant localization of connexin proteins, i.e., intracytoplasmic rather than in the cytoplasmic membrane; and (4) modulation of connexin functions by other proteins, such as those involved in extracellular matrix and cell adhesion. Whilst mutations of the cx 32 gene appear to be rare in tumors, cx 37 gene mutations have been reported in a mouse lung tumor cell line. Our results suggest that aberrant connexin localization is rather common in cancer cells and that possible molecular mechanisms include aberrant phosphorylation of connexin proteins and lack of cell adhesion molecules. Studies on transfection of connexin genes into tumor cells suggest that certain connexin genes (e.g., cx 26, cx 43 and cx 32) act as tumor-suppressor genes.

Animals↗