'Saying it without words': a qualitative study of oncology staff's experiences with speaking up about safety concerns.

OBJECTIVES To explore the experiences of oncology staff with communicating safety concerns and to examine situational factors and motivations surrounding the decision whether and how to speak up using semistructured interviews. SETTING 7 oncology departments of six hospitals in Switzerland. PARTICIPANTS Diverse sample of 32 experienced oncology healthcare professionals. RESULTS Nurses and doctors commonly experience situations which raise their concerns and require questioning, clarifying and correcting. Participants often used non-verbal communication to signal safety concerns. Speaking-up behaviour was strongly related to a clinical safety issue. Most episodes of 'silence' were connected to hygiene, isolation and invasive procedures. In contrast, there seemed to exist a strong culture to communicate questions, doubts and concerns relating to medication. Nearly all interviewees were concerned with 'how' to say it and in particular those of lower hierarchical status reflected on deliberate 'voicing tactics'. CONCLUSIONS Our results indicate a widely accepted culture to discuss any concerns relating to medication safety while other issues are more difficult to voice. Clinicians devote considerable efforts to evaluate the situation and sensitively decide whether and how to speak up. Our results can serve as a starting point to develop a shared understanding of risks and appropriate communication of safety concerns among staff in oncology.

Lexical Pragmatics and Theory of Mind: The Acquisition of Connectives

The concept of theory of mind (ToM), a hot topic in cognitive psychology for the past twenty-five years, has gained increasing importance in the fields of linguistics and pragmatics. However, even though the relationship between ToM and verbal communication is now recognized, the extent, causality and full implications of this connection remain mostly to be explored. This book presents a comprehensive discussion of the interface between language, communication, and theory of mind, and puts forward an innovative proposal regarding the role of discourse connectives for this interface. The proposed analysis of connectives is tested from the perspective of their acquisition, using empirical methods such as corpus analysis and controlled experiments, thus placing the study of connectives within the emerging framework of experimental pragmatics.

Análisis del discurso del entrenador de baloncesto experto en competición

En el ámbito de la competición deportiva profesional, el entrenador es una figura clave dentro del equipo y afecta de manera significativa al rendimiento del mismo. El comportamiento del entrenador, las decisiones que tome durante el partido, sus formas, tiempos, etc. afectan a las actuaciones de los jugadores dentro de la pista y suponen un aspecto muy importante a tener en cuenta a la hora de analizar el rendimiento de los equipos en una competición. Los condicionantes de la competición, la urgencia en las decisiones, la incertidumbre de su cumplimiento, etc., afectan a su conducta verbal. Por tanto, debemos conocer algunos de los comportamientos que resultan más eficaces por parte del entrenador para conseguir el mayor rendimiento de su equipo durante el partido y a partir de ahí tratar de construir un modelo teórico sobre que requisitos debería cumplir esta conducta verbal, ya que creemos que es a través del análisis de la observación de una conducta en una situación real como se pueden establecer estos parámetros teóricos sobre la comunicación. Para ello realizamos un estudio de 6 casos de entrenadores expertos en los que observamos su comportamiento verbal durante 4 partidos para extraer una información que comparada con los estudios previos, determine si es posible o no, establecer un modelo mínimo común de comportamiento eficaz en competición. En cuanto al objeto de la observación en el estudio de los casos nos hemos centrado en el contenido de la información, el que, su significado y sólo de tipo verbal, ya que consideramos la comunicación no verbal como algo más sujeto a posibles interpretaciones, aspecto que no estudiamos. ABSTRACT In the area of the sports professional competition, the coach is a key figure inside the team and concerns in a significant way the performance of the same one. The behavior of the coach, the decisions that it takes during the game, his forms, times, etc. They concern the actions of the players inside the track and suppose a very important aspect to bear in mind at the moment of analyzing the performance of the teams in a competition. The determining ones of the competition, the urgency in the decisions, the uncertainty of his fulfillment, etc., they concern his verbal behavior. Therefore, we must know some of the behaviors that turn out to be more effective on the part of the coach to obtain the best performance of his team during the game and from there tries to construct a theoretical model on whom requirements it should fulfill this verbal behavior, since we believe that it is across the analysis of the observation of a conduct in a true situation since these theoretical parameters can be established on the communication. For it we realize a study of 6 cases of expert coaches in that we observe his verbal behavior during 4 games to extract information that compared with the previous studies, it determines if it is possible or not, establishes a minimal common model of effective behavior in competition. As for the object of the observation in the study of the cases we have centered on the content of the information, the fact that, his meaning and only of verbal type, since we consider the not verbal communication as slightly more subject to possible interpretations, aspect that we do not study.

Detecção dos herpesvirus humanos na mucosa oral de pacientes irradiados para tratamento de carcinoma epidermoide em região de cabeça e pescoço

A radioterapia para tratamento das neoplasias malignas em região de cabeça e pescoço é acompanhada de diversas complicações, decorrentes do comprometimento dos tecidos radiossensíveis localizados próximos ao tumor. Entre essas complicações a mucosite é a que merece maior destaque. A mucosite é uma reação tóxica inflamatória da mucosa oral causada pelo tratamento citorredutivo induzido pela radioterapia (RT) ou pela quimioterapia (QT). Ela manifesta-se com sinais de edema, eritema, úlcera e formação pseudomembrana, resultando em sintomas de ardência, que pode progredir para dor intensa e consequente prejuízo na alimentação e comunicação verbal. Infecções bacterianas, fúngicas ou virais podem acometer a mucosa bucal irradiada e exacerbar a manifestação da mucosite oral por meio da ativação de fatores de transcrição da resposta inflamatória. Existem poucos dados na literatura sobre a participação dos herpesvirus humanos na mucosite oral induzida pela radioterapia. A proposta desse trabalho foi avaliar a excreção oral dos herpesvirus humanos (HSV-1, HSV-2, EBV, CMV, VZV, HHV6, HHV7 e HHV8) e sua possível associação com o desenvolvimento e agravamento da mucosite oral, em pacientes diagnosticados com carcinoma epidermoide (CEC) de boca e orofaringe, submetidos à radioterapia associado à quimioterapia. Nesse estudo foram analisadas 158 amostras de lavado bucal, de 20 pacientes, submetidos à radioterapia para CEC em região de cabeça e pescoço, coletadas semanalmente, durante todo o tratamento. Foi realizada a extração do DNA dessas amostras e em seguida sua amplificação através da PCR utilizando dois conjuntos de primers: HSVP1/P2 para os subtipos HSV-1, HSV-2, EBV, CMV e HHV-8 e o VZVP1/P2 para os subtipos VZV, HHV-6 e HHV-7. As amostras positivas foram submetidas à digestão enzimática com enzimas de restrição BamHI e BstUI para determinação específica de cada um dos oito herpesvirus. Foi também avaliada clinicamente, a mucosite oral, em cada uma das coletas, seguindo os critérios da OMS e NCIC. As análises da amostra mostraram a excreção do EBV, HHV-6 e HHV-7, em todas as semanas de tratamento radioterápico, enquanto que a excreção do HSV1 não pode ser observada no momento da triagem. Considerando-se todos os períodos em conjunto (Triagem, semanas de radioterapia e Controle), a maior frequência foi de pacientes que excretaram EBV (55,0%), seguida daqueles que excretaram HHV-7 (20,5%). A frequência de excreção de EBV foi significativamente maior do que a dos demais vírus (Teste ?2, p<0.001 para todos os cruzamentos). A frequência de excreção de HHV-7 foi significativamente maior do que a de HSV-1 (5,9%) e HHV-6 (5,5%) (Teste ?2, p=0.001 para ambos os cruzamentos). Não houve diferenças estatísticas significantes entre as frequências de HSV-1 e HHV-6. Como conclusão, verificou-se uma correlação positiva entre a excreção oral do EBV e a presença de mucosite induzida pela associação de radioterapia e quimioterapia com graus >=2, sobretudo se considerarmos as três últimas semanas de radioterapia, período este em que a severidade da mucosite foi estatisticamente maior. Esses achados nos possibilitam inferir que o ambiente inflamatório local de mucosites com grau >=2 seja mais favorável para excreção oral do EBV.

La fraseología en la clase de lengua extranjera: ¿misión imposible?

En este artículo ofrecemos una perspectiva diferente del aprendizaje y la enseñanza de la fraseología en clase de lengua extranjera (LE). Partiendo de la premisa sobre el carácter eminentemente holístico del lenguaje, concebimos las unidades fraseológicas (UF) como elementos habituales e inherentes en la comunicación verbal, por lo que no pueden excluirse del proceso de adquisición de la competencia comunicativa en una LE. Nuestra propuesta consiste en partir de la fraseología para optimizar el desarrollo de diversas subcompetencias de la competencia comunicativa. Para ello, resulta imprescindible indagar en la configuración y el funcionamiento del significado fraseológico, que, según defendemos en este trabajo, conforma un conjunto de informaciones de diversa índole que se articulan en dos niveles, el semántico y el pragmático. Tal indagación permite desarrollar una serie de consideraciones con interesantes implicaciones didácticas.

Fraseodidáctica: a fraseoloxía para a didáctica

In this article it is offered a different view of the role of phraseology in the foreign language class. Considering the holistic nature of language, phraseological units are conceived as inherent elements in the verbal communication, which confirms its importance in the formation process of the communicative competence in a foreign language. With attention to the modular conceptions of the communicative competence (Canale 1983) and of the phraseological meaning (Timofeeva 2012), it is proposed conceiving the phraseology as a starting point for developing the different parts of communicative competence. As it is explained, phraseological meaning is conformed by several informational chunks articulated in two levels, the semantic and the pragmatic. The connexions between these chunks and the parts of communicative competence allow to use more effectively the phraseological contents for the foreign language learning and teaching.

Interpersonal relations and nurses' job satisfaction through knowledge and usage of relational skills

Background/rationale: Many interpersonal labor disputes stem from the lack of communication skills and the relational problems in the interactions between health professionals. Aims/methods: A qualitative study was conducted in a Spanish hospital in order to get to know how the communicative interaction between hospital nurses is like in relation to the nurses' interpersonal interaction and communication skills developed in their working relationships. Twenty-one hospital nurses between 29 and 55 years old, working in different wards, were interviewed. Open-ended interview discourses were transcribed verbatim and analyzed using qualitative content analysis. Results: The following four key themes were analyzed: communication and sender; communication and awareness of who has the problem; non-verbal communication; communication and recipient. Conclusion: The results of this study highlight the need to broaden nurses' relational–communication skills in order to increase job satisfaction.

Predicting Successful Dental Examination for Children with Autism Spectrum Disorder

Thesis (Master's)--University of Washington, 2016-06

A Way of Doing Things: Exploring and Applying the Alexander Technique for Choral Conductors

Thesis (D.M.A.)--University of Washington, 2016-06

SANTA MARIA FÉA E O CULTO POPULAR: ANÁLISE DA DIVULGAÇÃO DE MILAGREIROS PELA MÍDIA IMPRESSA LOCAL.

Estudo sobre a cobertura pela mídia de assuntos relacionados à personagem Maria Féa, considerada santa não-canônica, no período de 1994 a 2004. O objetivo foi analisar as manifestações (ex-votos) atribuídas ao credo a essa personagem, a divulgação de assuntos sobre a personagem em jornal local, além de fazer um resgate histórico do caso a partir da mídia impressa local. Tanto quanto um meio de comunicação, as manifestações de religiosidade popular podem ser consideradas formas de comunicação e a divulgação destes cultos nãocanônicos (a santos ainda não canonizados) pela mídia contribui para a continuidade destes eventos. A metodologia utilizada engloba uma série de procedimentos relativos a pesquisa bibliográfica e documental, a análise de conteúdo de veículos de mídia impressa, entrevistas semi-estruturadas e observação participante. Conclui-se que a mitificação popular com relação à Maria Fea é resultado de um grupo de fatores como a divulgação pela mídia do histórico do crime, a divulgação pela comunicação oral dos feitos espetaculares atribuídos à personagem pelos devotos, e os objetos deixados como ex-votos que comprovam seu status de santa . No caso da mídia, esta abastece seu público com elementos, como textos e fotos, que validam as várias versões sobre a personagem.(AU)

Medical emergency alarm dissemination in urban environments

During medical emergencies, the ability to communicate the state and position of injured individuals is essential. In critical situations or crowd aggregations, this may result difficult or even impossible due to the inaccuracy of verbal communication, the lack of precise localization for the medical events, and/or the failure/congestion of infrastructure-based communication networks. In such a scenario, a temporary (ad hoc) wireless network for disseminating medical alarms to the closest hospital, or medical field personnel, can be usefully employed to overcome the mentioned limitations. This is particularly true if the ad hoc network relies on the mobile phones that people normally carry, since they are automatically distributed where the communication needs are. Nevertheless, the feasibility and possible implications of such a network for medical alarm dissemination need to be analysed. To this aim, this paper presents a study on the feasibility of medical alarm dissemination through mobile phones in an urban environment, based on realistic people mobility. The results showed the dependence between the medical alarm delivery rates and both people and hospitals density. With reference to the considered urban scenario, the time needed to delivery medical alarms to the neighbour hospital with high reliability is in the order of minutes, thus revealing the practicability of the reported network for medical alarm dissemination. © 2013 Elsevier Ltd. All rights reserved.

The employability skills provision within a construction project management degree programme

This study was geared at assessing the employability skills provision within a construction project management degree programme through a questionnaire survey. Students were required to assess their level of ability in relation to the most common skills and competencies most sought after by construction project management graduate employers. The study identified team-working ability as the most sought after skill by the employers investigated followed by verbal communication, written communication and leadership ability. It was found that students were very confident of their ability in 12 of the 14 identified skills and competencies. But ironically, leadership, an important skill sought by employers is one that majority of the students felt most insecure in their ability. The study concludes that the BSc programme equips students with these employability skills and competencies, but more effort is needed to make the leadership development opportunities in the programme more conspicuous. With recommendations on how to achieve this proffered.

Lecturers' experiences of assessing generic skills in an active learning environment for engineering education in Malaysia - Emergent findings

The aim of this paper is to explore the engineering lecturers' experiences of generic skills assessment within an active learning context in Malaysia. Using a case-study methodology, lecturers' assessment approaches were investigated regarding three generic skills; verbal communication, problem solving and team work. Because of the importance to learning of the assessment of such skills it is this assessment that is discussed. The findings show the lecturers' initial feedback to have been generally lacking in substance, since they have limited knowledge and experience of assessing generic skills. Typical barriers identified during the study included; generic skills not being well defined, inadequate alignment across the engineering curricula and teaching approaches, assessment practices that were too flexible, particular those to do with implementation; and a failure to keep up to date with industrial requirements. The emerging findings of the interviews reinforce the arguments that there is clearly much room for improvement in the present state of generic skills assessment.

Profiling The Campus Recruiter At A Four-Year Hospitality Program

Profiling the Campus Recruiter At a Four-Year Hospitality Program, is a written profile, supported by anecdotal rather than stridently empirical evidence, by Al lzzolo, Assistant Professor, College of Hotel Administration, University of Nevada, Las Vegas. “Each year major chain corporations as well as single unit companies interview hospitality students throughout the country. A study conducted at the University of Nevada, Las Vegas, was designed to profile the hospitality industry campus recruiter and to provide meaningful data to college students who would be interviewing with these recruiters,” the author initially proffers. “Recruiting at the four-year hospitality program, by its nature, is not a science, nor is it highly quantifiable. The interviewing and selection processes are highly subjective and vary from company to company,” says Izzolo to preface his essay. “Data were collected via a questionnaire specifically designed to answer questions about the recruiters and/or the companies that sent interviewers to the placement office of the university's hospitality program,” our author says to explain the process used to gather information for the piece. Findings of the study indicate that the typical recruiter is male, college educated – but not necessarily in a Hospitality’ curriculum – and almost 80 percent of respondents said they had the authority to hire management trainees. Few campuses are visited by hospitality industry recruitment staff as evidenced by Izzolo’s observations/data. Table 3 analyzes the desirable traits a recruiter deems appropriate for the potential employee candidate. Personal appearance, work experience, grade point average, and verbal communication rank high on the list of distinguishable attributes. The most striking finding in this portion of the study is that a student’s GPA is virtually ignored. “Recruiting for the hospitality industry appears to be very subjective,” Izzolo says. “Recruiters are basing decisions to hire not on knowledge levels as determined by an academic grade point average but rather on criteria much less definitive, such as verbal skills and personal appearance,” our author opines. In closing, Izzolo concedes this is not a definitive study, but is merely a launching pad to a more comprehensive investigation on the recruitment subject.

Arteterapia en el final de la vida

El arteterapia permite una aproximación creativa biográfica particularmente valiosa en la etapa final de la vida. La persona enferma presenta múltiples necesidades – físicas, emocionales, sociales y espirituales – que solo una atención holística puede pretender abarcar, tal como lo contempla la filosofía de los cuidados paliativos. El arteterapeuta integrado en el equipo interdisciplinar contribuye a aliviar y acompañar el sufrimiento del paciente y su familia. Se presentan aquí las bases teóricas y la metodología de la intervención, así como el marco sanitario en el cual se inscribe.