What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients.

To examine the feedback given by nurse educators and clinicians on the quality of communication skills of nurses in interactions with simulated patients.

A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research

Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.

Assessing communication in people with severe-profound disabilities: co-constructing competence

The recent focus on a human rights agenda in Australia has highlighted the vulnerability of people who have little or no speech in gaining access to their communication rights. This paper discusses the complexities of supporting communication for people with severe–profound disabilities within a framework of human rights. People with severe–profound intellectual disabilities are often considered not only unable to speak, but also unable to communicate. This preconception has been refuted and legislation enacted to protect the communication rights of people with severe–profound disabilities. In this paper we present an overview of good communication practices for people with severe–profound intellectual disabilities. Such practice consists of collaborative and transactional assessment and intervention supports, as exemplified in emerging models of supported and person-centred decision-making.

End of life clinician-family communication in ICU: a retrospective observational study - implications for nursing

Objective: The objective of this study was to identify practice issues that influence end of life communication and care of patients and families in the intensive care unit (ICU).

Design: This study used a retrospective observational approach utilising a medical record review. Setting: An Australian metropolitan mixed medical/surgical ICU. Subjects: There are two parts to this study. The first part related to all of the patients who died in the ICU in one calendar year, a total of 97. The second part of this study related to a random selection of 25% of these patients, a total of 24.

Results: This study showed that death in the ICU was often anticipated, and that whilst communication between family and medical personnel was evident in the medical record, the involvement or occurrence of communication between the nurse and the family was not recorded, and that nurses were included in only 25% of formal family meetings.

Conclusion: Whilst this study confirmed that death is often predicted for critically ill patients, and opportunities for communication with the family or next of kin assists to achieve consensus on end of life decisions, the involvement of nurses, as primary care-givers is not well represented in the medical record, thus undermining the importance of the nurses role in direct patient care that extends to the family in the ICU.

Ill-defined versus precise pre-play communication in the traveler's dilemma

This article reports results from an experiment comparing the effects of vague versus precise pre-play communication in a highly competitive two-player game with conflicting interests. In the classic Traveler's Dilemma, non-binding precise messages about intent of play are pure cheap talk. We conjecture that a form of imprecise pre-play communication whereby subjects can submit ill-defined messages may help foster cooperation because of their vagueness. Comparing behavior both across modes of communication and to a baseline case without communication, we find that cooperation is highest when players can communicate using precise numerical messages. When communication with ill-defined messages is allowed, then conditional on receiving a message, subjects act more cooperatively than when no message is received. However, overall, the ability to exchange ill-defined messages does not substantially improve cooperation.

Trustworthiness-hypercube-based reliable communication in mobile social networks

In mobile social networks (MSNs), the routing packet is forwarded from any user of in a group to any user of the other group until it reaches the destination group - the group where the destination is located. However, it is inevitable that malicious groups could compromise the quality and reliability of data. To alleviate such effect, analyzing the trustworthiness of a group has a positive influence on the confidence with which a group conducts transactions with that group. In our previous work, the feature-based first-priority relation graph (FPRG) of MSNs is proposed, in which two vertices (groups) are connected iff they have a first-priority relationship. In this paper, the trustworthiness computation of a group is firstly presented in the algorithm TC (Trustworthiness Computing) based on the FPRG. The trustworthiness of a group is evaluated based on the trustworthiness of neighbors and the number of malicious users in the group. We then establish the Trustworthiness-Hypercube-based Reliable Communication (THRC) algorithm in MSNs. The algorithm THRC can provide an effective and reliable data delivery routing. Finally, we also give two scenario simulations to elaborate the processes of the trustworthiness computation and reliable communication.

Framing everyday experience

This practice-based research involved two blogs created within different contexts: one in the small Western Australian town of Kellerberrin, the other in the Sydney suburb of Petersham. Blogging was developed as an artform: to deepen social connection within small geographical areas; to reveal new knowledge about these specific localities; and to extend and critique traditions of socially-engaged and "relational" art practice.

Deaf education and underlying structures of power in communication

This article argues that claims of diversity in communication in deaf education are empty rhetoric when underlying structures of power are unexamined and remain unchanged. The field of deafness provides a powerful example of the way in which competing interests can be played out under the guise of choice of communication methods. Historically, teachers of the deaf have been divided about whether deaf children should be educated through speech or sign. However, recognition of the legitimacy of native sign languages has caused a shift in the debate to the linguistic basis of this communication and the way in which language policy privileges one cultural group and its method of communication over another.

Revelationary art of Joyce Lorraine Sullivan : an artist's experience of her inner dimensions, an inner journey of discovery

[No Abstract]

Feminist poetics : symbolism in an emblematic journey reflecting self and vision

My thesis tilled Feminist Poetics: Symbolism in an Emblematic Journey Reflecting Self and Vision, consists of thirty oil paintings on canvas, several preparatory sketches and drawings in different media on paper, and is supported and elucidated by an exegesis. The paintings on unframed canvases reveal mise en scčnes and emblems that present to the viewer a drama about links between identities, differences, relationships and vision. Images of my daughter, friends and myself fill single canvases, suites of paintings, diptyches and triptychs. The impetus behind my research derives from my recognition of the cultural means by which women's experience is excluded from a representational norm or ideal. I use time-honoured devices, such as, illusionist imagery, aspects of portraiture, complex fractured atmospheric space, paintings and drawings within paintings, mirrors and reflective surfaces, shadows and architectural devices. They structure my compositions in a way that envelops the viewer in my internal world of ideas. Some of these features function symbolically, as emblems. A small part of the imagery relies on verisimilitude, such as my hands and their shadow and my single observing eye enclosed by my glasses. What remains is a fantasy world, ‘seen’ by the image of my other eye, or ‘faction’, based on memories and texts explaining the significance of ancient Minoan symbols. In my paintings, I base the subjects of this fantasy on my memories of the Knossos Labyrinth and matristic symbols, such as the pillar, snake, blood, eye and horn. They suggest the presence of a ritual where initiates descended into the adyton (holy of holies) or sunken areas in the labyrinth. The paintings attempt a ‘rewriting’ of sacrality and gender by adopting the symbolism of death, transformation and resurrection in the adyton. The significance of my emblematic imagery is that it constructs a foundation narrative about vision and insight. I sought symbolic attributes shared by European oil painting and Minoan antiquity. Both traditions share symbolic attributes with male dying gods in Greek myths and Medusa plays a central part in this linkage. I argue that her attributes seem identical to both those of the dying gods and Minoan goddesses. In the Minoan context these symbols suggest metaphors for the female body and the mother and daughter blood line. When the symbols align with the beheaded Medusa in a patriarchal context, both her image and her attributes represent cautionary tales about female sexuality that have repercussions for aspects of vision. In Renaissance and Baroque oil painting Medusa's image served as a vehicle for an allegory that personified the triumph of reason over the senses. In the twentieth century, the vagina dentata suggests her image, a personified image of irrational emotion that some male Surrealists celebrated as a muse. She is implicated in the male gaze as a site of castration and her representation suggests a symbolic form pertaining to perspective. Medusa's image, its negative sexual and violent connotations, seemed like a keystone linking iconographic codes in European oil painting to Minoan antiquity. I fused aspects of matristic Minoan antiquity with elements of European oil paintings in the form of disguised attribute gestures, objects and architectural environments. I selected three paintings, Dürer's Setf-Portrait, 1500, Gentileschi's Self-Portrait as the Allegory of Painting, 1630 and Velazquez's Las Meniruis, 1656 as models because 1 detected echoes of Minoan symbolism in the attributes of their subjects and backgrounds. My revision of Medusa's image by connecting it to Minoan antiquity established a feminist means of representation in the largely male-dominated tradition of oil painting. These paintings also suggested painting techniques that were useful to me. Through my representations of my emblematic journey I questioned the narrow focus placed on phallic symbols when I explored how their meanings may have been formed within a matricentric culture. I retained the key symbols of the patriarchal foundation narratives about vision but removed images of violence and their link to desire and replaced it with a ritual form of symbolic death. I challenged the binary oppositional defined Self as opposed to Other by constructing a complex, fluid Self that interacts with others. A multi-directional gaze between subjects, viewers and artist replaces the male gaze. Different qualities of paint, coagulation and random flow form a blood symbolism. Many layers of paint retaining some aspects of the Gaze and Glance, fuse and separate intermittently to construct and define form. The sense of motion and fluidity constructs a form of multi-faceted selves. The supporting document, the exegesis is in two parts. In the first part, I discuss the Minoan sources of my iconography and the symbolic gender specific meanings suggested by particular symbols and their changed meanings in European oil painting, I explain how I integrate Minoan symbols into European oil paintings as a form of disguised symbolism. In the second part I explain how my alternative use of symbolism and paint alludes to a feminist poetic.

The staging of identity in other/s' spaces

Exploring the framing of identity within different modes of representation, particularly Australian art, the thesis built on poststructural discussions of inside/outside power relations, conceptualising art as a political tool for the staging of identity, not only for the subjects inside the artwork, but also the viewer, and marginalised artist/author.

Communication pathways in community aged care: an Australian study

Background:
Health and social care practitioners collaborate in discharge planning for older people. Difficulties securing timely and quality discharge information and unclear role boundaries can be challenging. There are limited reports in the literature describing community-based practitioners' roles communicating client information.

Aim:
To describe the roles of community-based practitioners in communication of older clients' information in an Australian context.

Design:
A descriptive and exploratory qualitative research design was applied.

Methods:
Four focus groups were conducted in 2009 with a small sample (n = 16) of district nurses, practice nurses and aged care case managers.

Results:
All participants described communication as a core characteristic of their role focused on minimising risks for older people. Participants valued dialogue with other health and social care providers in real time with an emphasis on telephone communication, face-to-face meetings, and case conferences. Telephone communication was considered important where there was an urgent need to problem solve. Written communication was noted as less effective.

Conclusions:
There is an increasing need for stronger models of communication in community-based settings to facilitate safe, efficient and sustainable health and social outcomes for older people.

Implications for practice:
There is limited available research with this focus to guide practice. Findings from this exploratory study indicate a number of important areas for further research: (i) to understand how communication feedback systems and pathways between community and inpatient providers could improve information exchange and (ii) to describe community nurses' roles in communication and medication risks for older people.