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PubMed1988

Concentration/response effect of 2,2', 4,4', 5,5'-hexabromobiphenyl on cell-cell communication in vitro: assessment by fluorescence redistribution after photobleaching ("FRAP").

Inhibition of gap junction-mediated cell-cell communication might be a mechanism for several types of cellular dysfunctions, including tumor promotion. Although many different assays have been designed to measure gap junction-mediated intercellular communication, we applied a new technique, termed Fluorescence Redistribution After Photobleaching ("FRAP"), to assess the ability of a known tumor promoter, 2,2', 4,4', 5,5'-hexabromobiphenyl (245-HBB), to inhibit cell-cell communication in a concentration-dependent manner. WB-F344 (rat epithelial) cells were plated at low density, exposed to noncytotoxic concentrations of 1, 5, or 20 micrograms 245-HBB/ml medium, and stained with 6-carboxyfluorescein diacetate. Single cells in pairs or clusters of touching cells in each exposure group were examined with FRAP. The results revealed an inverse correlation between the degree of fluorescence redistribution in photobleached cells and the concentration of 245-HBB. Therefore, FRAP appears to be a sensitive and rapid technique for determining complete or partial inhibition of chemically induced intercellular communication in vitro. These results also provide further evidence for the ability of 245-HBB to inhibit gap junction-mediated cell-cell communication in a concentration-dependent manner.

Cell Communication↗
PubMed1994

Modulation of gap junction-mediated intercellular communication in embryonic chick mesenchyme during tissue remodeling in vitro.

Gap junction-mediated intercellular communication was analyzed in a model system in which tissue necrosis and remodeling could be modulated. This in vitro system, previously used for analysis of epithelial-mesenchymal tissue interaction, was modified to permit analysis of the presence and extent of intercellular communication by monitoring intercellular transfer of the microinjected fluorescent dye, Lucifer Yellow. Light and transmission electronmicroscopy were employed to correlate the presence and degree of gap junctional communication (coupling) with tissue morphology. Digital image analysis was used to determine cell density and mitotic indices within the outgrowths of explants. Our results indicated that cell communication in outgrowths adjacent to necrotic foci within an explant was minimal or absent. Cell-coupling in outgrowths adjacent to a compartment of viable mesenchyme was significantly higher - equivalent to unseparated control cultures. A time-course study demonstrated correlation of increased levels of cell-coupling in outgrowths with the level of tissue remodeling within an explant. Our conclusions from these studies are that embryonic mesenchymal cell populations may be selectively uncoupled as a result of alterations in the microenvironment produced by a proximate impaired cell population. It is proposed that endogenous factors in the microenvironment ("wound signals"), emanating from impaired cell populations, regulate gap junction-mediated intercellular communication in adjacent viable tissue. Normal, unimpaired populations of cells surrounding an area of injury are thereby isolated from the effects of a potentially toxic environment. This could serve as a protective function in development and may represent, in a more general sense, part of the repertoire of events associated with tissue repair and remodeling.

Animals↗
PubMed1986

Structure and dynamics of human communication at the beginning of life.

Although the beginning of postpartum social integration and communication has been long viewed as relevant to psychiatric theories, early parent-infant communication has become a matter of scientific investigation only recently. The present survey explains the significance of an approach based upon the general systems theory and explores to what extent the early parent-infant interaction can function as a didactic system to support the development of thought and speech. Evidence of this function has been found in those forms of parental behavior that escape the parent's conscious awareness and control, as exemplified in the vocal communication with presyllabic infants. Parents unknowingly adjust the structure and dynamics of speech to the constraints of infant capacities, detach prosodic musicality from lexical structure, and use it in particularly expressive forms for the delivery of the first prototypical messages. In this and other similar ways, parents offer an abundance of learning situations in which infants can try out various integrative operations. A biological rather than cultural provenience of the support of communicative development indicates a potential relevance for the interpretation of speech evolution. In addition to qualities of the vocal tract and to complex symbolic capacities in humans, the early intuitive support of communicative development and its playful character are suggested as species-specific determinants of speech evolution. Implications for clinical research are suggested.

Communication↗
PubMed1981

Peer popularity and peer communication patterns: hyperactive versus active but normal boys.

Classroom peer perceptions of 18 teacher-nominated hyperactive and 18 teacher-nominated active but normal elementary school-age boys, as revealed in two sociometric measures (Bower's Class Play, like-dislike nomination), were compared. Results indicated that hyperactives were significantly different from actives on all sociometric measures in that they were perceived more negatively. Peer communication patterns also were assessed. The communicative content, communicative quality, and attention to task instructions of hyperactive boys were compared to those of comparison boys. Limited support was found for the earlier finding that hyperactive boys were less likely than comparison boys to modulate behavior in response to changing external cues and to respond to subtle social learning opportunities. The communication task was found to be highly engaging for both groups of boys, and results suggest that hyperactive children may not lack the interpersonal skills necessary for referential communication, although they may be unable to use them consistently in all settings. The need to continue the study of peer relations of hyperactive children in naturalistic settings is stressed.

Attention Deficit Disorder with Hyperactivity↗
PubMed1993

The effects of electronic mail on communication in two health sciences institutions.

A study was done during 1991-1992 to determine the perceived impact of electronic mail (E-mail) relative to other forms of communication in health sciences institutions. E-mail subscribers at two major health sciences institutions were sent 2919 surveys, and 823 (28%) completed survey instruments were returned. A significant positive impact of E-mail was found relative to other forms of communication (e.g., paper, phone) with regard to E-mail messaging, response rates, influence, value, formality, perceptions, errors in communication, cost-effectiveness, communication style, and other factors. Areas where no differences were found between communication mechanisms were also revealing. Technical problems, maintenance, and confidentiality of E-mail messaging were not found to be significant problems. Trends, value, and impact of E-mail use in health sciences institutions are also discussed.

Academic Medical Centers↗
PubMed1994

Gap junctional intercellular communication of cultured rat liver parenchymal cells is stabilized by epithelial cells and their isolated plasma membranes.

The gap junctional intercellular communication (GJIC) determined by measuring dye coupling with Lucifer yellow, decreased within 3 d from 66% to 28% in monocultures of rat liver parenchymal cells. Coculturing of the parenchymal cells with a nonparenchymal epithelial cell line from rat liver resulted in increased and stabilized intercellular communication (83% after 3 d). The presence of isolated plasma membrane vesicles of the nonparenchymal epithelial cells also stabilized the intercellular communication between the liver parenchymal cells (70% after 3 d). When liver parenchymal cells were cocultured with a rat liver fibroblast cell line the gap junctional communication between the parenchymal cells was not stabilized (43% after 3 d), and isolated plasma membrane vesicles of the fibroblast were also unable to support the GJIC in parenchymal cells (35% after 3 d). It is concluded that plasma membrane constituents of the nonparenchymal epithelial cells were responsible for the stabilization of the GJIC between parenchymal cells. A heterotypic gap junctional communication between parenchymal and nonparenchymal cells was not observed.

Animals↗
PubMed1978

[Communication theory and health education].

Health Education can be understood as a communication process, in which a communicator gives a message to receivers through a certain channel with a specific destination. The application of the results of communication research to problems of Health Education is difficult since, on the one hand, communication research does not sufficiently relate to the problems of Health Education and, on the other, the Health Educators often ignore the results of empirical research. Moreover, it is inherent in communication theory to overstimate knowledge as a vehicle of behavior change. The norms, laws and institutions of society often limit the possibilities of Health Education. Another limitation consists in the lack of information concerning many of the factors which cause health damaging behavior. The consequences of these considerations are that efficient Health Education has to be carried out not only on the personal but also on the societal level and that knowledge about the causes of health-injuring behavior must be improved. A model of integrated Health Education is presented.

Communication↗
PubMed1996

A case study: follow-up assessment of facilitated communication.

A 6-month follow-up of an individual reported to engage in validated facilitated communication (FC) is presented. Three main issues are addressed: the current status of the individual's FC use, the effect of food reinforcers on his communicative ability, and a comparison of FC to the Picture Exchange Communication System (PECS). Results indicated that the individual did not engage in any validated FC, that performance was equivalent on food and nonfood trials, and that PECS was the preferred mode of communication, yielding 100% accuracy in a message-passing, object identification task. Implications of these findings are discussed in the context of an individual's right to communicate by objectively validated methods.

Adolescent↗
PubMed1999

Communication skills for anesthesiologists.

PURPOSE: To provide a simple, practical guide to communication skills which might be useful to practising anesthesiologists. SOURCE: Selected citations from the literature on patient-physician communication, and the personal observations of the authors based on their reading and experiences. PRINCIPAL FINDINGS: Basic communication skills are introduced, and then their application to clinical anesthesiology described. The possible benefits resulting from the enhancement of clinical communication are outlined. Strategies for tackling four commonly-encountered situations - handling others' feelings, imparting information, explaining complex concepts simply and breaking bad news - are presented. By taking a skills-oriented approach, we hope that readers will be encouraged to view this area of their work as one that can be improved upon with continued observation and practice. CONCLUSION: Communication skills can enhance medical practice and improve patient outcomes. We suggest that all anesthesiologists should give thought to their effectiveness in this area.

Anesthesiology↗
PubMed1999

Hypertension in multicultural and minority populations: linking communication to compliance.

Cardiovascular disease disproportionately affects minority populations, in part because of multiple sociocultural factors that directly affect compliance with antihypertensive medication regimens. Compliance is a complex health behavior determined by a variety of socioeconomic, individual, familial, and cultural factors. In general, provider-patient communication has been shown to be linked to patient satisfaction, compliance, and health outcomes. In multicultural and minority populations, the issue of communication may play an even larger role because of linguistic and contextual barriers that preclude effective provider-patient communication. These factors may further limit compliance. The ESFT Model for Communication and Compliance is an individual, patient-based communication tool that allows for screening for barriers to compliance and illustrates strategies for interventions that might improve outcomes for all hypertensive patients.

Communication Barriers↗
PubMed1998

Inhibition of cell-cell communication by methylsulfonyl metabolites of polychlorinated biphenyl congeners in rat liver epithelial IAR 20 cells.

The effects of three polychlorinated biphenyl (PCB) congeners and their six methylsulfonyl (MeSO2)-metabolites on cell communication have been investigated in the scrape-loading/dye-transfer assay in IAR 20 rat liver epithelial cells. The results demonstrated that at non-cytotoxic concentrations 2,2',4',5-tetrachlorobiphenyl, 2,2',4',5,5'-pentachlorobiphenyl (2,2',4',5,5'-pentaCB), 2,2',4',5,5',6-hexachlorobiphenyl (2,2',4',5,5', 6-hexaCB), and their 3- and 4-MeSO2 derivatives completely inhibited the cell communication within 1 h. 4-MeSO2-2,2',4',5,5'-pentaCB and 4-MeSO2-2,2',4',5, 5',6-hexaCB appeared to inhibit the cell communication at slightly lower concentration than their parental PCB congeners and 3-MeSO2 derivatives. The results show that 3- and 4-MeSO2 derivatives of the PCB congeners tested inhibit gap junction intercellular communication at about the same potency as their parental compounds. Since inhibition of cell communication is often observed after treatment with many tumor promoters, our findings suggest that the metabolites may also act as tumor promoters.

Alkanesulfonates↗
PubMed2000

Effects of continuing paediatric education in interpersonal communication skills.

UNLABELLED: Paediatric care places great demands on interpersonal communication skills, especially as regards the handling of psychosocial issues. Recent shifts in paediatric morbidity and increases in patient empowerment furthermore emphasize the need for continuing paediatric education in communication skills. It is, however, debatable, whether after residency paediatric education can influence paediatrician performance. This study evaluated the effects of a 5-day experiential communication training by means of a pretest/post-test control group design. A total of 21 consulting paediatricians (10 experimental, 11 control group paediatricians) videotaped two series of consecutive outpatient encounters. Compared with the untrained control group, trained paediatricians asked more psychosocial questions and looked at the patients and their parents more often. In addition, they gave patients and parents more room to talk. No difference was found in the length of the outpatient visits. CONCLUSION: Paediatric education after residency influences paediatricians' verbal and nonverbal communication skills positively, especially as regards handling psychosocial issues. On the basis of these findings, it appears worthwhile to encourage continuing paediatric education in interpersonal communication skills.

Adult↗
PubMed2001

Communicating prognosis to patients with metastatic disease: what do they really want to know?

Clinical audits suggest that prognosis is often not discussed with cancer patients, and cancer patients often over- or underestimate their prognosis. Doctors wish to convey information honestly and sensitively, but are often unsure how best to achieve this. An evidence base and guidelines in this area are lacking. This study aimed to obtain patient and health professional views on optimal ways of presenting prognosis to patients with metastatic breast cancer. Qualitative methods were used to generate participant views and experiences. Seventeen patients and 13 health professionals working in cancer care participated in structured interviews, which were audio-taped and transcribed. Sampling was discontinued when informational redundancy was achieved. The transcribed interviews were content analysed by a trained assessor using the constant-comparative method. Seven primary themes were identified, including: communication within a caring, trusting, long-term relationship; open and repeated negotiations for patient preferences for information; clear, straightforward presentation of prognosis where desired; strategies to ensure patient understanding; encouragement of hope and a sense of control; consistency of communication within the multi-disciplinary team; communication with other members of the family. Communication about prognosis in a metastatic setting requires considerable resources from both patients and doctors. Nevertheless, a number of useful strategies were identified. A quantitative study obtaining feedback from a large and representative sample of patients with metastatic cancer is now in progress, to confirm patient preferences for the communication styles identified in this qualitative study.

Adult↗
PubMed2005

Differences in individual approaches: communication in the familial breast cancer consultation and the effect on patient outcomes.

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p < or = 0.001); facilitating active involvement (p < or = 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p < or = 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patient's depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.

Adaptation, Psychological↗
PubMed2006

Exploring genetic counseling communication patterns: the role of teaching and counseling approaches.

The educational and counseling models are often touted as the two primary professional approaches to genetic counseling practice. Yet, research has not been conducted to examine how these approaches are used in practice. In the present study, we conducted quantitative communication analyses of BRCA1 genetic counseling sessions. We measured communication variables that represent content (e.g., a biomedical focus) and process (e.g., passive listening) to explore whether genetic counselor approaches are consistent with prevailing professional models. The Roter Interaction Analysis System (RIAS) was used to code 167 pre-test genetic counseling sessions of members of a large kindred with an identified BRCA1 mutation. Three experienced genetic counselors conducted the sessions. Creating composite categories from the RIAS codes, we found the sessions to be largely educational in nature with the counselors and clients devoting the majority of their dialogue to providing biomedical information (62 and 40%, respectively). We used cluster analytic techniques, entering the composite communication variables and identified four patterns of session communication: Client-focused psychosocial, biomedical question and answer, counselor-driven psychosocial, and client-focused biomedical. Moreover, we found that the counselors had unique styles in which they combined the use of education and counseling approaches. We discuss the importance of understanding the variation in counselor communication to advance the field and expand prevailing assumptions.

Adult↗
PubMed2006

The effectiveness of the installation of a mobile voice communication system in a university hospital.

In large hospitals, collaborative clinical practice is currently emphasized, with members of various departments expected to work as a team. The importance of accurate communication among the team members is of utmost importance. To improve such communication, the introduction of mobile voice communication systems has received much attention in Japan. Shimane University Hospital also introduced a Personal Handy-phone System (PHS) for doctors. In the traditional setting, much time was wasted searching for doctors through multiple calls on fixed-line telephones. In order to measure the effectiveness of our system, the change in the number of calls made on fixed-line telephones before and after PHS installation was compared. The total number of calls was reduced by more than 35%, and the number of calls to the wards on weekdays was reduced by half. Mobile telecommunication systems with small output power, such as PHS, are known to cause little interference with medical devices which makes it possible to use mobile voice communication safely in hospitals. The improvement in communication by this systems resulted in an improvement in labor efficiency.

Diffusion of Innovation↗
PubMed1989

Relationships among measures of communication, marital satisfaction and exposure during couples treatment of agoraphobia.

The goals of this study were to examine the relationships among measures of couples interactions (satisfaction and communication), and response to treatment within a group of agoraphobic clients and their partners. The treatment included the clients' partners in structured, graduated in vivo exposure practices. Twenty-two clients and their partners completed pre-, mid- and post-treatment assessments. Treatment responders rated themselves and their partners as more communicative regarding the client's fears, at pre- and mid-assessments in comparison to nonresponders; measures of communication related inversely to levels of anxiety reported during exposures, but marital satisfaction did not relate to any measure of exposure. In addition, level of anxiety during exposure differentiated responders from nonresponders; responders experienced a significant reduction in their levels of anxiety. Finally, ratings of frequency of communication at mid-assessment were highly predictive of treatment outcome at post-assessment. The implications from these findings for communication skills training for a subset of couples who enter couples treatment for agoraphobia are discussed.

Adult↗
PubMed1988

Calmodulin involvement in TPA and DDT induced inhibition of intercellular communication.

The organochlorine pesticide DDT is a liver tumour promoter and a potent inhibitor of intercellular communication. Present knowledge of the mechanism by which DDT inhibits intercellular communication is limited but it has been suggested that increased intracellular free calcium induced by DDT could be of importance. As the effects of calcium are closely associated with the multifunctional protein calmodulin (CaM) in most cells the potential binding of DDT to CaM and subsequent effects on CaM-stimulated Ca2+/Mg2+-ATPase activity were studied. DDT inhibited CaM-stimulated Ca2+/Mg2+-ATPase activity and bound to CaM in a manner similar to established CaM-inhibitors. Subsequently an in vitro assay for measuring inhibition of metabolic cooperation between 6-thioguanine (TG)-sensitive and TG-resistant Chinese hamster (V79) cells was used to investigate the possible involvement of CaM in the regulation of intercellular communication. Calmidazolium (CzM), a potent CaM inhibitor, was tested alone or in combination with the tumour promoters 12-O-tetradecanoyl phorbol-13-acetate (TPA) or DDT known inhibitors of intercellular communication. The results showed that CzM alone was without effect with regard to inhibition of metabolic cooperation but potentiated the response induced by TPA, an effect not noticed with DDT. These results suggest different mechanisms of action of TPA and DDT on metabolic cooperation and support the hypothesis that with calcium CaM may be of importance for drug-induced inhibition of intercellular communication and tumour promotion.

Animals↗