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PubMedDate not supplied

Communication from individuals with advanced DAT: can it provide clues to their sense of self-awareness and well-being?

Often communication from people with advanced dementia of the Alzheimer type (DAT) is regarded as incoherent and meaningless. However, with careful listening and observation, such communication often becomes more understandable. To better understand DAT communication, the investigators designed an exploratory qualitative study to videotape and critically analyze conversations between a clinical nurse specialist and 15 subjects with DAT ranging from mild to severe. One of the findings was that, even in later stages, indications were given that subjects had self-awareness of their cognitive decline. The investigators further examined the communication of the five most cognitively impaired subjects for other indications of self-awareness and well-being. To demonstrate this premise of awareness of cognitive decline and self in the later stages of DAT, excerpts from communication received from five subjects with advanced cognitive impairment are presented.

Aged↗
PubMed2000

Bilingual health communicators: role delineation issues.

Managers of health care services are seeking new opportunities to improve communication with clients who have limited English proficiency. An increase in bilingual health staff and the frequent use of their language skills in patient encounters provides opportunities but also brings with it confusion surrounding the role of interpreters and bilingual health staff. Secondary analysis of transcripts from 18 focus groups with monolingual and bilingual health staff has provided a method of distinguishing the roles of these complementary communicators. This paper clarifies the roles of interpreters and bilingual communication facilitators using seven key features: scope of language, language proficiency, nature of communication/interaction, nature of the contact and relationship, client responsibilities, and relationship with other health care providers. We discuss differences in how bilingual health staff use language when providing care, and alternative types of interactions interpreters could adopt to extend their current role. A collaborative group of communicators located within a health team is proposed, that is able to identify need and select the best communicator for the task.

Communication↗
PubMed1982

Gap junctional communication compartments in the Drosophila wing disk.

We have examined the gap junctional communication properties of cells in the wing imaginal disk of Drosophila, using intracellular injection of the fluorescent dye tracer Lucifer Yellow. The cell-to-cell passage of Lucifer Yellow is restricted at a boundary line that divides the wing disk into halves. We refer to each half as a "communication compartment" because there is a high level of gap junctional exchange within a compartment and much lower exchange between compartments. Comparison of the positions of the compartments with developmental fate maps suggests that cells in one communication compartment give rise to cuticular structures in the anterior half of the adult dorsal mesothorax, and cells in the other compartment contribute to posterior structures. This communication-restriction line appears to be coincident with the line between the anterior and posterior developmental compartments observed in studies of cell lineage. We propose that gap junctional communication restrictions may play a general role in generating or maintaining developmental compartments.

Animals↗
PubMed1991

Seismic communication in a blind subterranean mammal: a major somatosensory mechanism in adaptive evolution underground.

Seismic communication, through low-frequency and patterned substrate-borne vibrations that are generated by head thumping, and which travel long distances underground, is important in the nonvisual communication of subterranean mole rats of the Spalax ehrenbergi superspecies (2n = 52, 54, 58, and 60) in Israel. This importance pertains both intraspecifically in adaptation and interspecifically in speciation. Neurophysiologic, behavioral, and anatomic findings in this study suggest that the mechanism of long-distance seismic communication is basically somatosensory and is independent of the auditory mechanism. Seismic communication thus appears to be a channel of communication important in the evolution of subterranean mammals that display major adaptation to life underground.

Acoustic Stimulation↗
PubMed2002

Retroviral delivery of connexin genes to human breast tumor cells inhibits in vivo tumor growth by a mechanism that is independent of significant gap junctional intercellular communication.

The mechanism by which gap junction proteins, connexins, act as potent tumor suppressors remains poorly understood. In this study human breast tumor cells were found to exhibit diverse gap junction phenotypes including (a) undetectable Cx43 and no intercellular communication (HBL100); (b) low levels of Cx43 and sparse intercellular communication (MDA-MB-231); and (c) significant levels of Cx43 and moderate intercellular communication (Hs578T). Although retroviral delivery of Cx43 and Cx26 cDNAs to MDA-MB-231 cells did not achieve an expected substantial rescue of intercellular communication, overexpression of connexin genes did result in a dramatic suppression of tumor growth when connexin-expressing MDA-MB-231 cells were implanted into the mammary fat pad of nude mice. Subsequent immunolocalization studies on xenograph sections revealed only cytoplasmic stores of Cx43 and no detectable gap junctions. Moreover, DNA array and Western blot analysis demonstrated that overexpression of Cx43 or Cx26 in MDA-MB-231 cells down-regulated fibroblast growth factor receptor-3. Surprisingly, these results suggest that Cx43 and Cx26 induce their tumor-suppressing properties by a mechanism that is independent of significant gap junctional intercellular communication and possibly through the down-regulation of key genes involved in tumor growth. Moreover, our studies show that retroviruses are effective vehicles for delivering connexins to human breast tumor cells, facilitating potential gene therapy applications.

Animals↗
PubMed1978

The reinforcing effects of the recommendation in the threatening communication.

An instrumental escape conditioning paradigm was used to test the drive reducing effects of the recommendation in a threatening communication. Analogies were drawn between threatening communications and conditioning. Instrumental response speed was a monotonic decreasing function of delay of reinforcement: 0, 2, 6 sec (p less than .001). Each of the three delay groups acquired the instrumental response (p less than .001). Speed = 1/latency, automatically measured to .01 sec by a Lafayette digital stop clock. The Ss were 54 undergraduate males. A procedure was introduced to allow the separation and analysis of the drive inducing and reinforcing components of a threatening communication. Significant differences were detected between the reinforcing effects of communications (p less than .008). The results were interpreted in terms of the fear reduction model of persuasive communication.

Anxiety↗
PubMed1986

An exploratory study of parent-child communication about sex and the sexual attitudes of early, middle, and late adolescents.

In an attempt to examine the relationship between parent-child communication about sex and parent-adolescent attitudes about sex, 12- to 20-year-olds (N = 141) and their parents completed sexual communication and attitude questionnaires. The correlation between parents' and children's attitudes were high for all the early adolescents and low for all the middle adolescents. Only among the late adolescents was there a significant difference in the correlations between the sexual attitudes of parents and their children as a function of family communication level, with the attitudes of adolescents and parents in the high communication group being highly correlated and the attitudes of adolescents and parents in the low communication group not being significantly correlated. Middle adolescents had significantly more permissive sexual attitudes than early and late adolescents. Gender variables were also studied, but conclusions were limited due to the small number of participating fathers. All findings must be tempered with the recognition of the possible sampling bias introduced by the use of a convenience sample. It is suggested that the more responsible sexuality seen in adolescents who can talk to their parents about sex may be a function of the similarity in sexual attitudes between these late adolescents and their parents.

Adolescent↗
PubMed1989

Communication disturbances and hyperactive/conduct-disturbed behavior.

This study examines mother-child communication as one factor in the development of conduct-disturbed/hyperactive boys. Three groups of school-age children were compared: a group including conduct-disturbed/hyperactive boys who had a significant insult in their perinatal/developmental history; a group of conduct-disturbed/hyperactive boys in whom no insult could be found; and a group of normally active/non-conduct-disturbed/hyperactive boys. It was hypothesized that disturbed communication between mother and son would be found in boys who were conduct-disturbed/hyperactive, whether or not there was a probable organic cause for their dysfunction, and this hypothesis was confirmed. In addition, it was found that the communication patterns in children who had a probable organic etiology for their disturbance were different from those found in the group lacking an organic etiology. However, both of these groups exhibited communication patterns that were more disturbed than the communication from mother to son in the normally active, non-conduct-disturbed group.

Attention Deficit Disorder with Hyperactivity↗
PubMed1981

A comparison of sex therapy and communication therapy: couples complaining of orgasmic dysfunction.

Forty-eight couples who complained of female orgasmic dysfunction received one of two therapies: sex therapy and communication therapy. Each couple was treated by a team of one male and one female therapist. Pretherapeutic, posttherapeutic and follow-up measurements showed that female sexual satisfaction increased in both therapies, but that the increase came more quickly in sex therapy. Male sexual satisfaction increased in sex therapy, but diminished in communication therapy. A two-phase model of the sexual response was tested against the therapeutic results. The experience of sexual interaction and the orgasmic experience improved in males and females in sex therapy, and in females in communication therapy. The male experience of sexual interaction deteriorated in communication therapy, while the male orgasmic experience initially increased and subsequently diminished again. Satisfaction with the total relationship increased in the males in communication therapy, and in the females in sex therapy.

Adult↗
PubMed1983

Construct validity of the marital communication inventory.

The Marital Communication Inventory (MCI) is an extremely popular self-report measure of marital communication that has been used in over 65 dissertations and empirical articles since 1970, including several recent clinical reports that used the MCI as a principal outcome measure. However, contrary to its treatment in the clinical literature as a unidimensional, valid measure of treatment outcome, the MCI appears to be a multidimensional instrument, whose primary dimension may not be a specific style or method of communication. Using a canonical correlation analysis of data from over 200 midwestern wives, we compared MCI subscales with subscales from an abbreviated version of the Barrett-Lennard Relationship Inventory (RI). Results supported the hypothesis that the primary dimension of the MCI is more closely associated with positive regard than with the more specific communication dimensions of either empathy or congruence as measured by the RI. Future clinical research in the improvement of marital communication should use the MCI in a much more careful way in order to provide the most valid outcome data.

Adolescent↗
PubMed2005

Undergraduate students' attitudes to communication skills learning differ depending on year of study and gender.

The authors wished to assess medical students' attitudes towards communication skills learning, and to validate the use of the Communication Skills Attitude Scale (CSAS) in a different population. This cross-sectional study of Years 1-3 MBChB students, University of Aberdeen, in 2002-03 (overall response rate=86.2%) identified significant differences in attitudes to communication skills teaching by year of study and gender. PAS (positive attitudes scores) for Year 1 were significantly higher than those for Years 2 and 3. NAS (negative attitudes scores) for Year 1 were significantly lower than the scores for Year 2 but not Year 3. The scores for Years 2 and 3 were not significantly different. Female students had a significantly higher mean PAS score and lower mean NAS score than males, and were more likely to disagree that their communication and clinical skills were competent. While cohort effects may be present, it seems that attitudes towards communication skills learning are positive initially, becoming less so until students experience interacting with patients. Differences between male and female students reflect those seen in previous studies. The findings presented support the use of the CSAS as an appropriate tool to measure attitudes in a wide population of medical students.

Adolescent↗
PubMedDate not supplied

Parent-adolescent communication and support for diabetes management as reported by adolescents with type 1 diabetes.

This study examined parental involvement in terms of communication and support and these variables in relationship to diabetes management responsibility and metabolic control from the perspective of adolescents. The sample consisted of 27 adolescents who were 12 to 19 years of age (M=15.0 years, SD=1.9) and had type 1 diabetes. Participants completed Independent Functioning, Independent Decision Making, Parent-Adolescent Communication, and Parental Support Checklists. Adolescents reported relatively high level of communication with parents and relatively low level of parental support. These adolescents reported more agreement than amount of communication with parents and reported more parental support received than sought. Although not significantly different, the means for amount of communication and agreement decreased from early to middle to late adolescence and the means for seeking and receiving support increased from early to middle and then decreased from middle to late adolescence. When working with parents and adolescents with type 1 diabetes, health care professionals need to be cognizant of adolescents' view of specific ways that parents are involved and the developmental influences on parent-adolescent relationships.

Adolescent↗
PubMed2004

Functional communication screening in individuals with traumatic brain injury.

The feasibility of a novel instrument, the Functional Communication Scale (FCS), was determined for individuals with moderate-to-mild cognitive-communication deficits secondary to traumatic brain injury (TBI). A group design including 30 adults with confirmed diagnosis and communication problems was utilized. Conversational samples with each participant were videotaped and rated for 13 FCS items. Three raters with diverse clinical experiences rated the elicited samples. Results identified significant and positive relationships between the cognitive-communication severities and the total FCS scores. Significant inter- and intra-rater reliability scores were found for the three raters. The FCS also determined significant differences between individuals with and without concurrent aphasia or dysarthria. No obvious differences were found between males and females nor between individuals with the primary diagnosis of TBI vs other neurological aetiologies. These findings have implications for assessing the adequacy of functional communication of individuals who are candidates for community re-entry.

Adult↗
PubMed2004

How do paediatricians communicate with children and parents?

AIM: The outpatient clinic visit is the major focus of the hospital medical process for most paediatricians, children and parents. The importance of children as active participants in this interaction has been recognized. Our study aims are to describe and assess the components of doctor-parent-child communication in the outpatient setting. METHODS: Fifty-one medical paediatric clinic consultations were recorded on audio cassette, and communication was analysed according to quantitative methods. Questionnaires assessed parents' and children's perceptions. RESULTS: Doctors contributed most to the conversation (61%), children only 4%. Behaviour: Doctors' communication was 84% instrumental (e.g. asking questions, giving information or instructions), 13% affective behaviour (expressing concerns and worries) and 3% social (small talk). Parents' communication included giving information (83%), seeking information (13%) and social (4%). The child asked less information (3%) and had more social conversation (19%). CONTROL: Doctors dominated in turn taking (52%). Children took 9% of all turns. Perception: There was no correlation between parents' and children's perception and the informative or affective behaviour of the doctor. CONCLUSION: Communication is mainly instrumental. Doctors tend to direct the interview. Children's contribution is small. The participation of children needs to be encouraged as part of a patient-centred approach.

Adult↗
PubMed2002

Communication and psychosocial consequences of sensory loss in older adults: overview and rehabilitation directions.

With increasing longevity among populations, age-related vision and hearing impairments are becoming prevalent conditions in the older adult populations. In combination dual sensory loss occurs. Dual sensory loss is becoming a more common condition seen by clinicians and previous research has shown that 6% of non-institutionalized older adults had a dual sensory impairment, whilst 70% of severely vision-impaired older adults also demonstrated a significant hearing loss. Decreased vision and/or hearing acuity interferes with reception of the spoken message and hence people with sensory loss frequently experience communication breakdown. Many personal, situational and environmental triggers are also responsible for communication breakdown. Limited ability to improve communication performance frequently results in poor psychosocial functioning. Older adults with sensory loss often experience difficulty adjusting to their sensory loss. Depression, anxiety, lethargy and social dissatisfaction are often reported. Sensory loss, decreased communication performance and psychosocial functioning impacts on one's quality of life and feelings of well-being. Rehabilitation services for older adults with age-related sensory loss need to accommodate these difficulties. Improved staff education and rehabilitation programmes providing clients and carers with strategies to overcome communication breakdown is required. A multidisciplinary perspective to the assessment and remediation of older adults is recommended.

Activities of Daily Living↗
PubMedDate not supplied

Facilitating communication in children with multiple disabilities: three case studies of girls with Rett syndrome.

PURPOSE: To investigate the effect of cueing on communicative responses of children with multiple disabilities in an educational setting. It was hypothesized that differences would exist in teacher interactional styles and the use of orienting cues would increase the communicative responses of the participants. METHOD: A naturalistic observation research method was employed in order to examine the interaction of three student-teacher dyads in three special schools. Three different activity types were videotaped from which interactions were coded and analysed. RESULTS: Multi-modal cueing facilitated communicative responses of children with Rett syndrome. However, increased communication opportunities provided by caregivers did not elicit increased responses from the girls. CONCLUSION: There is a difference in cueing by teachers in their interactions with children with multiple disabilities. Also, more frequent communicative interactions did not necessarily lead to increased student responses. It is suggested that amount and type of cueing may need to be considered to be effective in generating student responses. The small number of participants, however, means findings should be viewed cautiously and that more research is indicated.

Abnormalities, Multiple↗
PubMedDate not supplied

Acquisition of graphic communication by a young girl without comprehension of spoken language.

PURPOSE: To describe a graphic-mode communication intervention involving a girl with intellectual impairment and autism who did not develop comprehension of spoken language. The aim was to teach graphic-mode vocabulary that reflected her interests, preferences, and the activities and routines of her daily life, by providing sufficient cues to the meanings of the graphic representations so that she would not need to comprehend spoken instructions. METHOD: An individual case study design was selected, including the use of written records, participant observation, and registration of the girl's graphic vocabulary and use of graphic signs and other communicative expressions. RESULTS: While the girl's comprehension (and hence use) of spoken language remained lacking over a 3-year period, she acquired an active use of over 80 photographs and pictograms. CONCLUSIONS: The girl was able to cope better with the cognitive and attentional requirements of graphic communication than those of spoken language and manual signs, which had been focused in earlier interventions. Her achievements demonstrate that it is possible for communication-impaired children to learn to use an augmentative and alternative communication system without speech comprehension, provided the intervention utilizes functional strategies and non-language cues to the meaning of the graphic representations that are taught.

Abnormalities, Multiple↗
PubMed2006

Multimodality: a basis for augmentative and alternative communication--psycholinguistic, cognitive, and clinical/educational aspects.

PURPOSE: Message generating is a complex process involving a number of processes, including the selection of modes to use. When expressing a message, human communicators typically use a combination of modes. This phenomenon is often termed multimodality. This article explores the use of models that explain multimodality as an explanatory framework for augmentative and alternative communication (AAC). METHOD: Multimodality is analysed from a communication, psycholinguistic, and cognitive perspective. RESULTS: Theoretical and applied topics within AAC can be explained or described within the multimodality framework considering iconicity, simultaneous communication, lexical organization, and compatibility of communication modes. CONCLUSION: Consideration of multimodality is critical to understanding underlying processes in individuals who use AAC and individuals who interact with them.

Adult↗