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.

Understanding quality of life in medicine : a new approach

This article introduces the subjective side of quality of life as it has evolved within the discipline of psychology. Subjective well-being is also of special interest within medicine due to its links to pathology and the fact that it is managed by a homeostatic system. This form of management offers an explanation for the unusual properties of subjective well-being, including its normal positivity, stability, and nonlinear relationship to objective variables, such as physical health. Central to understanding is the proposition that subjective well-being mainly consists of a specific form of trait mood. This homeostatically protected mood has a genetic set point and it is the experience of this set-point mood that homeostasis is defending. The resources required to maintain normal homeostatic control are described. If these resources are inadequate to protect the experience of set-point mood, mood positivity falls, and there is a high probability of depression. In this article, the process of homeostasis is shown to assist understanding of intervention effectiveness within both psychology and medicine. This concerns matters of resilience, the nonlinear relationship between levels of subjective well-being, and the strength of challenging agents, and the important understanding that interventions designed to raise subjective well-being are critically dependent on its level at baseline. Key teaching points: • The physiological process of homeostasis has a parallel in psychology in the homeostatic management of subjective well-being. • Subjective well-being is a more globally informative construct than health-related quality of life. • How people feel about themselves and their lives cannot be simply predicted through measures of health. • When subjective well-being homeostasis is defeated, there is a high probability of depression.

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.

A NEW FIBRIN SEALANT FROM Crotalus durissus terrificus VENOM: APPLICATIONS IN MEDICINE

Fibrin sealant, a widely available tissue adhesive, has been used since 1940 in a variety of clinical applications. Commercially available fibrin sealant products are synthesized from bovine thrombin and human fibrinogen, which may transmit infectious diseases, and recipients may also develop antibodies against bovine thrombin. Bearing these disadvantages in mind, a new fibrin sealant was developed in 1989 by a group of researchers from the Center for the Study of Venoms and Venomous Animals, in São Paulo State, Brazil. The main purpose was to produce an adhesive fibrin without using human blood, to avoid transmitting infectious diseases. The components of this novel sealant were extracted from large animals and a serine proteinase extracted from Crotalus durissus terrificus snake venom. The applicability of this sealant was tested in animals and humans with beneficial results. The new fibrin sealant can be a useful tool clinically due to its flexibility and diversity of applications. This sealant is a biological and biodegradable product that ( 1) does not produce adverse reactions, ( 1) contains no human blood, ( 3) has a good adhesive capacity, ( 4) gives no transmission of infectious diseases, and ( 5) may be used as an adjuvant in conventional suture procedures. The effectiveness of this new fibrin sealant is reviewed and its development and employment are described.

Chemical communication in isoptera

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

On the reliability of visual communication in vertebrate-dispersed fruits

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

GRAMMAR and COMMUNICATION IN PORTUGUESE AS A FOREIGN LANGUAGE A Study in the Context of Teletandem Interactions

This paper presents a study about the role of grammar in on-line interactions conducted in Portuguese and in English, between Brazilian and English-speaking interactants, with the aim of teaching Portuguese as a foreign language (PFL). The interactions occurred by means of chat and the MSN Messenger, and generated audio and video data for language analysis. Grammar is dealt with from two perspectives, an inductive and a deductive approach, so as to investigate the relevance of systematization of grammar rules in the process of learning PFL in teletandem interactions.

Comparison of simulated periodontal bone defect depth measured in digital radiographs in dedicated and non-dedicated software systems

Objectives: To compare simulated periodontal bone defect depth measured in digital radiographs with dedicated and non-dedicated software systems and to compare the depth measurements from each program with the measurements in dry mandibles.Methods: Forty periodontal bone defects were created at the proximal area of the first premolar in dry pig mandibles. Measurements of the defects were performed with a periodontal probe in the dry mandible. Periapical digital radiographs of the defects were recorded using the Schick sensor in a standardized exposure setting. All images were read using a Schick dedicated software system (CDR DICOM for Windows v.3.5), and three commonly available non-dedicated software systems (Vix Win 2000 v.1.2; Adobe Photoshop 7.0 and Image Tool 3.0). The defects were measured three times in each image and a consensus was reached among three examiners using the four software systems. The difference between the radiographic measurements was analysed using analysis of variance (ANOVA) and by comparing the measurements from each software system with the dry mandibles measurements using Student's t-test.Results: the mean values of the bone defects measured in the radiographs were 5.07 rum, 5.06 rum, 5.01 mm and 5.11 mm for CDR Digital Image and Communication in Medicine (DICOM) for Windows, Vix Win, Adobe Photoshop, and Image Tool, respectively, and 6.67 mm for the dry mandible. The means of the measurements performed in the four software systems were not significantly different, ANOVA (P = 0.958). A significant underestimation of defect depth was obtained when we compared the mean depths from each software system with the dry mandible measurements (t-test; P congruent to 0.000).Conclusions: the periodontal bone defect measurements in dedicated and in three non-dedicated software systems were not significantly different, but they all underestimated the measurements when compared with the measurements obtained in the dry mandibles.

Visual and acoustic communication in the Brazilian torrent frog, Hylodes asper (Anura : Leptodactylidae)

We studied the signaling, territorial, and courtship behaviors of the diurnal frog Hylodes asper. Visual and acoustic communication were used during intraspecific interactions involving males, females. and subadults. Hylodes aspcr has a complex visual communication system, of which foot-flagging is the most distinctive display observed in the repertoire of visual signals. The splash zone produced by the waterfalls and torrents creates a high, nearly constant, humidity near the streams, reducing the risk of desiccation which enables the diurnal activity of H. asper. Although the ambient sound pressure levels (SPL), measured at the calling sites, are similar to the SPL of the advertisement calls, the high-pitched calls of H, asper, are spectrally different from the noise produced by the water current. Thus. The ambient noise produced by the water current may not interfere significantly with the acoustic communication of this species. The noise and the nearly constant and high humidity produced by the torrents and waterfalls, along with the availability of Light, probably favored the evolution of contrasting colors and visual communication in H. asper: Males of H, aspcr excavate underwater chambers that are probably used to shelter the eggs and to prevent the clutch from being drifted downstream.

Modulation of intercellular communication in macrophages: possible interactions between GAP junctions and P2 receptors

Gap junctions are connexin-formed channels that play an important role in intercellular communication in most cell types. In the immune system, specifically in macrophages, the expression of connexins and the establishment of functional gap junctions are still controversial issues. Macrophages express P2X(7) receptors that, once activated by the binding of extracellular ATP, lead to the opening of transmembrane pores permeable to molecules of up to 900 Da. There is evidence suggesting an interplay between gap junctions and P2 receptors in different cell systems. Thus, we used ATP-sensitive and -insensitive J774.G8 macrophage cell lines to investigate this interplay. To study junctional communication in J774-macrophage-like cells, we assessed cell-to-cell communication by microinjecting Lucifer Yellow. Confluent cultures of ATP-sensitive J774 cells (ATP-s cells) are coupled, whereas ATP-insensitive J774 cells (ATP-i cells), derived by overexposing J774 cells to extracellular ATP until they do not display the phenomenon of ATP-induced permeabilization, are essentially uncoupled. Western-blot and reverse-transcription polymerase chain reaction assays revealed that ATP-s and ATP-i cells express connexin43 (Cx43), whereas only ATP-s cells express the P2X(7) receptor. Accordingly, ATP-i cells did not display any detectable ATP-induced current under whole-cell patch-clamp recordings. Using immunofluorescence microscopy, Cx43 reactivity was found at the cell surface and in regions of cell-cell contact of ATP-s cells, whereas, in ATP-i cells, Cx43 immunoreactivity was only present in cytosolic compartments. Using confocal microscopy, it is shown here that, in ATP-s cells as well as in peritoneal macrophages, Cx43 and P2X(7) receptors are co-localized to the membrane of ATP-s cells and peritoneal macrophages.

Visual communication in Brazilian species of anurans from the Atlantic forest

Visual communication is widespread among several anuran families, but seems to be more common than currently thought. We investigated and compared visual communication in six species of an anuran community in the Brazilian Atlantic forest. Four are nocturnal species: Hyalinobatrachium uranoscopum (Centrolenidae), Hyla albomarginata, Hyla sp. (aff. ehrhardti), and Scinax eurydice (Hylidae), and two are diurnal species: Hylodes phyllodes and Hylodes asper ( Leptodactylidae). For H. uranoscopum, H. albomarginata, S. eurydice, and H. phyllodes, this is the first record of visual communication. Observations were made at Nucleo Picinguaba, Parque Estadual da Serra do Mar, in the Municipality of Ubatuba, State of São Paulo, Brazil. Descriptions of behaviour were based on individuals observed in the field, using sequence sampling with continuous tape recording for behavioural observations. Eight new behaviours are described: body wiping, face wiping, jump display, leg kicking, limb lifting, mouth opening, toe flagging, and vocal sac display. of the 42 anuran species known from Nucleo Picinguaba, at least six ( approximately 14%) display visual communication. The evolution of visual signals in these species may be related to the availability of ambient light, the structural complexity of the habitat, and/or the ambient noise. They may also have evolved to aid in the location of the individual, to avoid physical combat, and/or may be a by-product of seismic communication.