Improving access to the justice system for people with communication difficulties : a training program for people working in the justice system

This training package is provided as a guide and resource to promote awareness and understanding of people who have complex communication needs and give people who work in law and justice system strategies to facilitate successful communication interactions. Complex communication needs are defined as communication problems associated with a wide range of physical, sensory and environmental causes which restrict/limit an individual's ability to participate independently in society. They and their communication partners may benefit from using Alternative and Augmentative Communication (AAC) methods. Alternative and Augmentative Communication (AAC) is an approach or communication system that makes it possible for a person without speech to communicate. AAC includes gestures and sign language, picture and alphabet boards and high technology electronic communication devices that produce computerised speech. Many people with complex communication needs use a combination of AAC communication to express themselves. It is hoped that this package will facilitate access to the justice system for a group of people who may experience social disadvantage as a result of their complex communication needs. The information included in the package is not exhaustive. It is designed to : provide the trainer and staff with a general understanding of complex communication needs; challenge misconceptions about people who have little or no functional speech; provide practical strategies and guidelines to assist staff to more successfully communicate with people with complex communication needs.

Focus group discussions of literacy assessment and world wide web-based reading intervention

Focus groups provide a means for participants in research to take on a greater role in the evaluation of the research and planning of its various stages. The role and outcomes of focus groups conducted with participants in a World Wide Web Project in literacy assessment and intervention are reported. Thirteen individuals with severe communication impairments participated in one of three focus groups. The groups were held after an assesment of reading skills and a trial period of intervention as part of the Web Project. The aim of the focus groups was to obtain feedback from participants about their involvement in the project and to discuss strategies for the next stage of the intervention. The focus groups offered a forum for participants to talk about what they did and did not like about the assessment and trial intervention. The discussions provided information about issues of both a practical and emotional nature that might have otherwise been unavailable to the researchers. Brainstorming of strategies provided valuable input for the next stage of the project and involved both the researchers and participants in a form of participatory action research.

A critical ethnography of communication processes involving the management of oral chemotherapeutic agents by patients with a primary diagnosis of colorectal cancer: study protocol.

AIM: To describe the protocol used to examine the processes of communication between health professionals, patients and informal carers during the management of oral chemotherapeutic medicines to identify factors that promote or inhibit medicine concordance. BACKGROUND: Ideally communication practices about oral medicines should incorporate shared decision-making, two-way dialogue and an equality of role between practitioner and patient. While there is evidence that healthcare professionals are adopting these concordant elements in general practice there are still some patients who have a passive role during consultations. Considering oral chemotherapeutic medications, there is a paucity of research about communication practices which is surprising given the high risk of toxicity associated with chemotherapy. DESIGN: A critical ethnographic design will be used, incorporating non-participant observations, individual semi-structured and focus-group interviews as several collecting methods. METHODS: Observations will be carried out on the interactions between healthcare professionals (physicians, nurses and pharmacists) and patients in the outpatient departments where prescriptions are explained and supplied and on follow-up consultations where treatment regimens are monitored. Interviews will be conducted with patients and their informal carers. Focus-groups will be carried out with healthcare professionals at the conclusion of the study. These several will be analysed using thematic analysis. This research is funded by the Department for Employment and Learning in Northern Ireland (Awarded February 2012). DISCUSSION: Dissemination of these findings will contribute to the understanding of issues involved when communicating with people about oral chemotherapy. It is anticipated that findings will inform education, practice and policy.

Improving online communication for students in higher education contexts

The study reported here sought to identify Higher Education students’ preferred modes of online communication whilst studying a wholly online research subject at University. The teacher education student participants from an Australian university were required to collaboratively conduct inquiry research projects in groups whilst relying upon computer-mediated communication. How do students communicate as a collaborative research group whilst only meeting online? The data were collected via the use of online pre-test and post-test surveys conducted ‘prior to’ and ‘post’ involvement in the unit of study and descriptive statistical analysis was applied. The findings revealed that important influences affecting students’ choice of communication mode included their own views on the capacity of online communication, their prior experience and the availability and accessibility of the modes. Furthermore, it was found that when given a choice, students preferred the use of asynchronous forms of digital communication to synchronous forms. Recommendations for improving online teaching, learning and research contexts in Universities are provided and the importance of considering blended mode delivery for wholly online units is argued.

Rural realities: digital communication challenges for rural Australian local governments

Purpose – This article explores challenges for rural Australian local governments during the transition to high-speed broadband infrastructure. Despite the National Broadband Network’s promised ubiquitous connectivity, significant access discrepancies remain between rural and urban areas.Methodology – Empirical findings are drawn from a full-day workshop on digital connectivity, which included participants from seven rural local governments in New South Wales, Australia. Thematic analysis of the workshop transcript was undertaken in order to extrapolate recurring nuances of rural digital exclusion. Findings – Rural communities face inequitable prospects for digital inclusion, and authorities confront dual issues of accommodating connected and unconnected citizens. Many areas have no or poor broadband access, and different digital engagement expectations are held by citizens and local governments. Citizens seek interactive opportunities, but rural authorities often lack the necessary resources to offer advanced participatory practices. Research limitations/implications – While this research draws from a small sample of government officials, their insights are nonetheless heuristically valuable in identifying connectivity issues faced in rural Australia. These issues can guide further research into other regions as well as civic experiences of digital inclusion. Practical/social implications – There is a need to reconceive Australia’s current policy approach to broadband. Greater rural digital inclusion may be achieved by focusing on connectivity as a public interest goal, targeting infrastructure developments to suit local contexts, and implementing participatory digital government practices. Originality/value – The actions suggested would help ensure equity of digital inclusion across Australian municipal areas. Without such changes, there is a risk of rural citizens facing further marginalisation through digital exclusion.

Improving communication when seeking informed consent: a randomised controlled study of a computer-based method for providing information to prospective clinical trial participants

OBJECTIVE: To assess the efficacy, with respect to participant understanding of information, of a computer-based approach to communication about complex, technical issues that commonly arise when seeking informed consent for clinical research trials. DESIGN, SETTING AND PARTICIPANTS: An open, randomised controlled study of 60 patients with diabetes mellitus, aged 27-70 years, recruited between August 2006 and October 2007 from the Department of Diabetes and Endocrinology at the Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne. INTERVENTION: Participants were asked to read information about a mock study via a computer-based presentation (n = 30) or a conventional paper-based information statement (n = 30). The computer-based presentation contained visual aids, including diagrams, video, hyperlinks and quiz pages. MAIN OUTCOME MEASURES: Understanding of information as assessed by quantitative and qualitative means. RESULTS: Assessment scores used to measure level of understanding were significantly higher in the group that completed the computer-based task than the group that completed the paper-based task (82% v 73%; P = 0.005). More participants in the group that completed the computer-based task expressed interest in taking part in the mock study (23 v 17 participants; P = 0.01). Most participants from both groups preferred the idea of a computer-based presentation to the paper-based statement (21 in the computer-based task group, 18 in the paper-based task group). CONCLUSIONS: A computer-based method of providing information may help overcome existing deficiencies in communication about clinical research, and may reduce costs and improve efficiency in recruiting participants for clinical trials.

The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia.

METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used.

RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process.

CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication.

Patient engagement in clinical communication: an exploratory study

AIM: Existing practice strategies for actively involving patients in care during hospitalisation are poorly understood. The aim of this study was to explore how healthcare professionals engaged patients in communication associated with care transitions.

METHOD: An instrumental, collective case study approach was used to generate empirical data about patient transitions in care. A purposive sample of key stakeholders representing (i) patients and their families; (ii) hospital discharge planning team members; and (iii) healthcare professionals was recruited in five Australian health services. Individual and group semi-structured interviews were conducted to elicit detailed explanations of patient engagement in transition planning. Interviews lasted between 30 and 60 minutes and were digitally recorded and transcribed verbatim. Data collection and analysis were conducted simultaneously and continued until saturation was achieved. Thematic analysis was undertaken.

RESULTS: Five themes emerged as follows: (i) organisational commitment to patient engagement; (ii) the influence of hierarchical culture and professional norms on patient engagement; (iii) condoning individual healthcare professionals' orientations and actions; (iv) understanding and negotiating patient preferences; and (v) enacting information sharing and communication strategies. Most themes illustrated how patient engagement was enabled; however, barriers also existed.

CONCLUSION: Our findings show that strong organisational and professional commitment to patient-centred care throughout the organisation was a consistent feature of health services that actively engaged patients in clinical communication. Understanding patients' needs and preferences and having both formal and informal strategies to engage patients in clinical communication were important in how this involvement occurred.

Exploring the integration of social media within integrated marketing communication frameworks: perspectives of services marketers

Purpose – At present no frameworks exist for services marketers to incorporate social media (SM) within marketing communications planning. The majority of integrated marketing communications (IMC) frameworks were developed prior to the development of the widespread use of digital and SM for information seeking, sales and service. The purpose of this paper is to investigate this issue for services marketers specifically as they differ from FMCG, industrial and durable marketers in terms of marketing messages, branding, media and channels. Furthermore, as they are less reliant on outsourced sale channels they have more potential than other industries to integrate social and digital media to build awareness, brands and sales.

Design/methodology/approach – Depth interviews were conducted with eight senior services marketing executives to identify the impact of SM on marketing communications planning, implementation and measurement.

Findings – The findings revealed that the unique characteristics of SM (such as interactivity and individualisation, integration of communication and distribution channels, immediacy and information collection) impact traditional marketing communications frameworks. These impacts manifested in 12 modifications specific to services and SM to traditional generic IMC frameworks encompassed by the themes of reach, service channel, word-of-mouth advocacy, consumer generated messages, listening and behavioural measurement.

Practical implications – The rapidly evolving nature of SM means senior services marketers need to educate organisational stakeholders regarding implementation issues, which may be a barrier to effective integration of SM within marketing communications.

Originality/value – With digital marketing communications budgets reaching 30 per cent within some organisations, it is timely to put forward a marketing communication decision-making framework that first incorporates SM and second is suitable for services marketers.

Evaluation of the Cartographic Communication Performance of a Route Guidance and Navigation System

This study evaluates the influence of different cartographic representations of in-car navigation systems on visual demand, subjective preference, and navigational error. It takes into account the type and complexity of the representation, maneuvering complexity, road layout, and driver gender. A group of 28 drivers (14 male and 14 female) participated in this experiment which was performed in a low-cost driving simulator. The tests were performed on a limited number of instances for each type of representation, and their purpose was to carry out a preliminary assessment and provide future avenues for further studies. Data collected for the visual demand study were analyzed using non-parametric statistical analyses. Results confirmed previous research that showed that different levels of design complexity significantly influence visual demand. Non-grid-like road networks, for example, influence significantly visual demand and navigational error. An analysis of simple maneuvers on a grid-like road network showed that static and blinking arrows did not present significant differences. From the set of representations analyzed to assess visual demand, both arrows were equally efficient. From a gender perspective, women seem to took at the display more than men, but this factor was not significant. With respect to subjective preferences, drivers prefer representations with mimetic landmarks when they perform straight-ahead tasks. For maneuvering tasks, landmarks in a perspective model created higher visual demands.

How Communication experts express communicative competence

Este estudo teve por objetivo compreender como especialistas brasileiros em comunicação expressam sua competência comunicativa. Investigou-se um grupo de professores universitários de enfermagem, especialistas na área de comunicação, utilizando-se a seguinte pergunta norteadora: Como você expressa sua competência comunicativa? Os entrevistados referiram expressar sua competência comunicativa vivenciando-a em sua vida profissional e em sua rotina diária, ouvindo outras pessoas, percebendo a comunicação não-verbal, validando a compreensão de mensagens, quebrando barreiras de comunicação, demonstrando afetividade e desenvolvendo o autoconhecimento. Os resultados obtidos a partir deste estudo nos permitiram compreender a comunicação como algo a ser aprendido, sentido e vivenciado, ou seja, percebendo as nossas próprias emoções e sentimentos assim como os de outras pessoas, tanto no cuidado em enfermagem quanto em ações da vida diária.

Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953: a brief communication

Objectives: This study aimed to verify the dental caries prevalence in Baixo Guandu, the first Brazilian city to fluoridate its public water supplies; to compare the findings with the data from the national survey; and also to compare the prevalence in the 12-year-old age group with the data obtained before the beginning of the fluoridation. Methods: All the lifetime residents aged 5, 12, 15 to 19, and 35 to 44 years old were clinically examined (World Health Organization). Results: The means of dmft/DMFT were lower than in the Brazilian population living in fluoridated communities. The DMFT Index in 12-year-old residents decreased between 1953 and 2005 from 8.61 to 1.55. Conclusions: The addition of fluoride to public water supplies was an important ally in the improvement of the oral health of Baixo Guandu inhabitants.

Chemical communication of handling stress in fish

We investigated whether juveniles of the nocturnal fish jundia (Rhamdia quelen) and the diurnal fish Nile tilapia (Oreochromis niloticus) are able to chemically communicate stress to conspecifics. Groups of 8 fish were reared in tanks under recirculated water (water exchanged among all the tanks) for each species. Fish were handled in half of the tanks (stressor fish) and whole-body cortisol concentrations were compared among handled fish, non-handled fish exposed to water from the handled fish, and non-handled control fish held with no water communication. For each treatment cortisol concentrations were determined before exposure to the stressor (basal levels) and after 1, 2, 4, 8, and 24 h. Basal levels of cortisol confirmed fish were unstressed in the beginning of the experiment. Cortisol was increased in the stressor fish 1 h after handling. Fish receiving water from the stressor fish increased cortisol levels later (2 h after the stressor fish were handled). As the isolated control group maintained cortisol levels unchanged throughout the experiment, we concluded that some chemical factor was released by the stressed fish in the water and thus stressed the conspecifics. This pattern was similar for both unrelated species, thus suggesting that this communication might have evolved earlier in fish and reinforcing the biological value of this kind of information. Published by Elsevier B.V.