Improving Communication in Adolescent Cancer Care: A Multiperspective Study.

BACKGROUND Professionals treating adolescents with cancer must communicate well with them and their parents. Evidence suggests that the communication needs of this population are rarely met. Skills training can improve professional communication, but has been criticized for not being based on the experience of the participants in the clinical encounter. We took a multiperspective approach, drawing on perspectives of former adolescents with cancer, patients' parents, physicians, and nurses with the aim to provide suggestions for improvement in communication in adolescent cancer care. METHODS Adolescent cancer survivors (n = 16), parents (n = 8), pediatric oncologists (n = 12), and pediatric oncology nurses (n = 18) participated in 11 focus groups. They discussed their experiences communicating with each other. Transcripts were analyzed by thematic analysis. RESULTS We identified themes within the following sections: (1) The framework in which professionals communicate with adolescents with cancer (regression in a time of detachment, adolescents' perception and knowledge of illness, cognitive versus legal maturity, "lost in transition" between pediatric and adult oncology); (2) communication difficulties between professionals and patients and parents (professionals and patients/parents identified the other party as the source of difficulties), and (3) effective professional communication (there was some overlap on how doctors and nurses should communicate, along with substantially different expectations for the two professions). CONCLUSIONS The framework within which professionals communicate, the different perspectives on the factors that make communication difficult, and the different expectations regarding good communication by doctors and nurses should be considered when communication skills training courses are developed for professionals who work in adolescent oncology.

Noise peaks influence communication in the operating room. An observational study

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries.

Multiple-Choice Testing in Science and Technology Courses

Wide spread and continuing use of multiple-choice testing in technical subjects is leading to a mindset amongst students which is antithetical with actual use of intellect.

Investigator/IRB-led community communication in genetic research: A descriptive feasibility pilot study

This pilot study, conducted in the Houston, TX, area, established a structured dialogue among a university Institutional Review Board, its researchers, and its local community members (i.e. pool of potential research participants) for the purpose of further educating all three parties about genetic research and community concerns related to such research. An IRB-designed educational presentation aimed at assisting potential subjects in making an informed decision to participate in genetic research was provided to four community groups (n=54); this presentation also included a current example of genetic research being conducted in the community as explained by the researcher, and a question-and-answer session designed to assist the IRB and the researcher in understanding the community's concerns about genetic research. Comparisons of pre- and post- presentation community questionnaires indicate that the joint presentation was effective in increasing community knowledge about genetic research, most notably related to the risks and benefits of this research to the individual, as well as the understanding that protections are in place for research participants. While researchers are optimistic about the idea of a collaborative effort with the IRB and the community, the feasibility of such a program and the benefit to the participating researchers remain unclear; additional research is necessary to establish the most effective method of communication for all groups involved, as well as to obtain statistically significant results with regard to race/ethnicity, gender, and education levels of community participants. ^

Doctor-patient communication in the medical interaction: Context, implications, and practice

Effective communication; whether from an interpersonal, mass media, or global perspective, is a critical component in public health. It is an essential conduit in increasing public awareness of available health resources, potential health hazards and related disease prevention strategies, and in delivering better health care. Within this context, available literature asserts doctor-patient communication as central to healthcare delivery. It has been shown to affect patient health outcomes, satisfaction with care, adherence to treatment recommendations, and even understanding of medical information. While research supports the essential imperative of interventions aimed at teaching doctors and patients the communication skills necessary for a successful and meaningful medical interaction, most interventions to date, focus on teaching these communication skills to doctors and seem to rely, largely, on mass media for providing patients with the information needed to increase communication efficacy. This study sought to fill a significant gap in the doctor-patient communication literature by reviewing the context of the doctor-patient exchange in the medical interaction, the implications of this exchange in resulting care of the patient, and the potential improvements to practice through interventions aimed at improving the communication exchange. Closing with an evaluation of a patient-centered communication intervention, the “How to Talk to Your Doctor” (HTTTYD) program that combines previously identified optimal strategies for improving communication between doctors and patients, this study examined the patients’ perspective of their potential as better communicators in the medical interaction. ^ Specific Aims, Hypotheses or Questions (Aim I) To examine the context of health communication within a public health framework and its relation to health care delivery. (Aim II) To review doctor-patient communication as a central focus within health care delivery and the resulting implications to patient care. (Aim III) To assess the utility of interventions to improve doctor-patient communication. Specifically, to evaluate the effectiveness of a patient-centered community education intervention, the “How to Talk to Your Doctor” (HTTTYD) program, aimed at improving patient communication efficacy.^

Client-Provider Communication in Postabortion Care

Muchos trabajadores de la salud que tratan a las mujeres que sufren complicaciones de aborto inducido o espontáneo están dispuestos a admitir que estas mujeres necesitan asesoría, pero a menudo ven la consejería como una función no médica que requiere una formación específica, un tiempo especialmente designado, aparte de la prestación de servicios postaborto y otras instalaciones separadas y privadas. De este modo, los proveedores de servicios de atención postaborto a menudo creen que el asesoramiento no es una de sus responsabilidades de trabajo y que carecen de la formación y las instalaciones para hacerlo

ICTD Work, Plus mFeel : improving communication in resource-poor settings

This issue's Works-In-Progress department has four entries related to the issue's theme, Information and Communication Technologies for Development (ICTD). They are “Sustainable ICT in Agricultural Value Chains”, “Measuring Social Inclusion in Primary Schools”, “An Architecture for Green Mobile Computation”, and “Improving Communication in Resource-Poor Settings”. A fifth entry, “mFeel: An Affective Mobile System”, covers the mFeel mobile system, which combines context awareness with affective and cognitive techniques.

Secundary school profile in science and technology versus the first year at the Technical University of Madrid. Cause of failure or quitting?

Se analiza el absentismo, el fallo y el abandono de los estudiantes en los primeros semestres del grado sobre la base de su formación en la educación secundaria.

Proposal for a semantic hierarchy of terminological metaphors in science and technology

Cognitive linguistics is considered as one of the most appropriate approaches to the study of scientific and technical language formation and development, where metaphor is accepted to play an essential role. This paper, based on the Cognitive Theory of Metaphor, takes as the starting point the terminological metaphors established in the research project METACITEC(Note 1), which was developed with the purpose of unfolding constitutive metaphors and their function in the language of science and technology. After the analysis of metaphorical terms and using a mixed corpus from the fields of Agriculture, Geology, Mining, Metallurgy, and other related technical fields, this study presents a proposal for a hierarchy of the selected metaphors underlying the scientific conceptual system, based on the semantic distance found in the projection from the source domain to the target domain. We argue that this semantic distance can be considered as an important parameter to take into account in order to establish the metaphoricity of science and technology metaphorical terms. The findings contribute to expand on the CTM stance that metaphor is a matter of cognition by reviewing the abstract-concrete conceptual relationship between the target and source domains, and to determine the role of human creativity and imagination in the language of science and technology configuration

The Annual of scientific discovery: or, Year-book of facts in science and art.

1866-1867

The Annual of scientific discovery: or, Year-book of facts in science and art.

1870

The Annual of scientific discovery: or, Year-book of facts in science and art.

1859

The Annual of scientific discovery: or, Year-book of facts in science and art.

1863

Domain–domain communication in a miniature archaebacterial tRNA synthetase

The three-dimensional structure of tRNA is organized into two domains—the acceptor-TΨC minihelix with the amino acid attachment site and a second, anticodon-containing, stem–loop domain. Aminoacyl-tRNA synthetases have a structural organization that roughly recapitulates the two-domain organization of tRNAs—an older primary domain that contains the catalytic center and interacts with the minihelix and a secondary, more recent, domain that makes contacts with the anticodon-containing arm. The latter contacts typically are essential for enhancement of the catalytic constant kcat through domain–domain communication. Methanococcus jannaschii tyrosyl-tRNA synthetase is a miniature synthetase with a tiny secondary domain suggestive of an early synthetase evolving from a one-domain to a two-domain structure. Here we demonstrate functional interactions with the anticodon-containing arm of tRNA that involve the miniaturized secondary domain. These interactions appear not to include direct contacts with the anticodon triplet but nonetheless lead to domain–domain communication. Thus, interdomain communication may have been established early in the evolution from one-domain to two-domain structures.