Textual communication in Virtual Environments for real world interaction

Ever since man invented writing he has used text to store and distribute his thoughts. With the advent of computers and the Internet the delivery of these messages has become almost instant. Textual conversations can now be had regardless of location or distance. Advances in computational power for 3D graphics are enabling Virtual Environments(VE) within which users can become increasingly more immersed. By opening these environments to other users such as initially through sharing these text conversations channels, we aim to extend the immersed experience into an online virtual community. This paper examines work that brings textual communications into the VE, enabling interaction between the real and virtual worlds.

Computer-mediated communication in distance MA programmes: the student's perspective

This paper reports on a study of computer-mediated communication within the context of a distance MA in TEFL programme which used an e-mail discussion list and then a discussion board. The study focused on the computer/Internet access and skills of the target population and their CMC needs and wants. Data were collected from 63 questionnaires and 6 in-depth interviews with students. Findings indicate that computer use and access to the Internet are widespread within the target population. In addition, most respondents indicated some competence in Internet use. No single factor emerged as an overriding inhibiting factor for lack of personal use. There was limited use of the CMC tools provided on the course for student–student interaction, mainly attributable to time constraints. However, most respondents said that they would like more CMC interaction with tutors. The main factor which would contribute to greater Internet use was training. The paper concludes with recommendations and suggestions for learner training in this area.

Priority setting in healthcare: from arbitrariness to societal values

This paper develops an account of the normative basis of priority setting in health care as combining the values which a given society holds for the common good of its members, with the universal provided by a principle of common humanity. We discuss national differences in health basket in Europe and argue that health care decision-making in complex social and moral frameworks is best thought of as anchored in such a principle by drawing on the philosophy of need. We show that health care needs are ethically ‘thick’ needs whose psychological and social construction can best be understood in terms of David Wiggins's notion of vital need: a person's need is vital when failure to meet it leads to their harm and suffering. The moral dimension of priority setting which operates across different societies’ health care systems is located in the demands both of and on any society to avoid harm to its members.

Changing building user attitude and organisational policy towards sustainable resource use in healthcare

Health care provision is significantly impacted by the ability of the health providers to engineer a viable healthcare space to support care stakeholders needs. In this paper we discuss and propose use of organisational semiotics as a set of methods to link stakeholders to systems, which allows us to capture clinician activity, information transfer, and building use; which in tern allows us to define the value of specific systems in the care environment to specific stakeholders and the dependence between systems in a care space. We suggest use of a semantically enhanced building information model (BIM) to support the linking of clinician activity to the physical resource objects and space; and facilitate the capture of quantifiable data, over time, concerning resource use by key stakeholders. Finally we argue for the inclusion of appropriate stakeholder feedback and persuasive mechanism, to incentivise building user behaviour to support organisational level sustainability policy.

Patient and public involvement in healthcare quality improvement: how organizations can help patients and professionals to collaborate

Citizens across the world are increasingly called upon to participate in healthcare improvement. It is often unclear how this can be made to work in practice. This 4- year ethnography of a UK healthcare improvement initiative showed that patients used elements of organizational culture as resources to help them collaborate with healthcare professionals. The four elements were: (1) organizational emphasis on nonhierarchical, multidisciplinary collaboration; (2) organizational staff ability to model desired behaviours of recognition and respect; (3) commitment to rapid action, including quick translation of research into practice; and (4) the constant data collection and reflection process facilitated by improvement methods.

Is communication guidance mistaken? Qualitative study of parent-oncologist communication in childhood cancer

background: Guidance encourages oncologists to engage patients and relatives in discussing the emotions that accompany cancer diagnosis and treatment. We investigated the perspectives of parents of children with leukaemia on the role of paediatric oncologists in such discussion. methods: Qualitative study comprising 33 audio-recorded parent–oncologist consultations and semi-structured interviews with 67 parents during the year following diagnosis. results: Consultations soon after the diagnosis were largely devoid of overt discussion of parental emotion. Interviewed parents did not describe a need for such discussion. They spoke of being comforted by oncologists’ clinical focus, by the biomedical information they provided and by their calmness and constancy. When we explicitly asked parents 1 year later about the oncologists’ role in emotional support, they overwhelmingly told us that they did not want to discuss their feelings with oncologists. They wanted to preserve the oncologists’ focus on their child’s clinical care, deprecated anything that diverted from this and spoke of the value of boundaries in the parent–oncologist relationship. conclusion: Parents were usually comforted by oncologists, but this was not achieved in the way suggested by communication guidance. Communication guidance would benefit from an enhanced understanding of how emotional support is experienced by those who rely on it.

Before transparency: control and communication in Early-Modern Europe

Today, transparency is hailed as a key to good governance and economic efficiency, with national states implementing new laws to allow citizens access to information. It is therefore paradoxical that, as shown by a series of crises and scandals, modern governments and international agencies frequently have paid only lip-service to such ideals. Since Jeremy Bentham first introduced the concept of transparency into the language in 1789, few societal debates have sparked so much interest within the academic community, and across a variety of disciplines, using different approaches and methodologies. Within these current debates, however, one fact is striking: the lack of historical reflection about the development of the concept of transparency, both as a principle and as applied in practice, prior to its inception. Accordingly, the aim of this special issue is to contribute to historicising the ways in which communication and control over fiscal policy and state finances operated in early modern European polities.

Chemical Communication in the Gregarious Psocid Cerastipsocus sivorii (Psocoptera: Psocidae)

The objectives of this study were: (1) to test the existence of an aggregation pheromone in the gregarious psocid Cerastipsocus sivorii; (2) to compare the attractiveness of odors from different aggregations; (3) to test whether nymphs are able to chemically recognize damage-released alarm signals. In a choice experiment conducted in the laboratory, we showed that psocids are able to detect chemical cues from groups of conspecifics. Laboratory experiments also showed that nymphs are capable of chemically recognizing the aggregations where they came from. Finally, in a field experiment, most aggregations dispersed when exposed to the body fluids of a crushed conspecific, but no aggregations dispersed upon exposure to a crushed termite. The implications of these results for the evolution of sociality in psocopterans are discussed.

Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care

ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.