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Replications are an important part of the research process because they allow for greater confidence in the findings of communication research. However, engaging in replications is often undervalued, replication studies can be difficult to publish, and thus it is difficult for individual scholars to devote their resources toward replication. This essay outlines the importance of replications for communication science and provides a framework for this special issue on replications. The authors also issue a call for communication scholars to consider future projects and structural changes that would incentivize future replication studies. [ABSTRACT FROM AUTHOR]

Background: How can we use stories from other people to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, systematically persuading the listeners to change their attitudes, or altering behaviors in nonoptimal ways? More practically, should narratives be used in health education, promotion, or behavior change interventions?Method: In this article, we address these questions by conducting a narrative review of a diverse body of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their role in communication, engagement, recall, persuasion, and health behavior change. We also review broad theories about information processing and persuasion from psychology and more specific models about narrative messaging found in the health communication and marketing literatures to provide insight into the processes by which narratives have their effect on health behavior.Results: To address major gaps in our theoretical understanding about how narratives work and what effects they will have on health behavior, we propose the Narrative Immersion Model, whose goal is to identify the parameters that predict the specific impact of a particular narrative (e.g. persuade, inform, comfort, etc.) based on the type of narrative message (e.g. process, experience, or outcome narrative). Further, the Narrative Immersion Model describes the magnitude of the effect as increasing through successive layers of engagement with the narrative: interest, identification, and immersion. Finally, the Narrative Immersion Model identifies characteristics of the narrative intervention that encourage greater immersion within a given narrative.Conclusions: We believe there are important communication gaps in areas areas of behavioral medicine that could be addressed with narratives; however, more work is needed in order to employ narrative messaging systematically. The Narrative Immersion Model advances our theoretical understanding about narrative processing and its subsequent effects on knowledge, attitudes, and behavior. [ABSTRACT FROM AUTHOR]

An important step in building a computational model is its documentation; a comprehensive and structured documentation can improve the model applicability and transparency in science/research and for regulatory purposes. This is particularly crucial and challenging for environmental and/or human exposure models that aim to establish quantitative relationships between personal exposure levels and their determinants. Exposure models simulate the transport and fate of a contaminant from the source to the receptor and may involve a large set of entities (e.g. all the media the contaminants may pass though). Such complex models are difficult to be described in a comprehensive, unambiguous and accessible way. Bad communication of assumptions, theory, structure and/or parameterization can lead to lack of confidence by the user and it may be source of errors. The goal of this paper is to propose a standard documentation protocol (SDP) for exposure models, i.e. a generic format and a standard structure by which all exposure models could be documented. For this purpose, a CEN (European Committee for Standardisation) workshop was set up with objective to agree on minimum requirements for the amount and type of information to be provided on exposure models documentation along with guidelines for the structure and presentation of the information. The resulting CEN workshop agreement (CWA) was expected to facilitate a more rigorous formulation of exposure models description and the understanding by users. This paper intends to describe the process followed for defining the SDP, the standardisation approach, as well as the main components of the SDP resulting from a wide consultation of interested stakeholders. The main outcome is a CEN CWA which establishes terms and definitions for exposure models and their elements, specifies minimum requirements for the amount and type of information to be documented, and proposes a structure for communicating the documentation to different users. [ABSTRACT FROM AUTHOR]

The unforeseen trials of arts-based research may suppress creative and innovative explorations. Photovoice, a visual method of investigation employing participatory photography, presents a host of apprehensions. Yet, photovoice is both a valid and rich methodology that can greatly expand the reach and scope of applied communication research. In this essay, we – three applied communication researchers – discuss the complexities of photovoice, highlighting areas of consideration that interested researchers should contemplate before utilizing this methodology. Briefly exploring three of our research studies and their varying topics (i.e. long-term cancer survivors, domestic violence organizational advocacy, male body culture), we discuss three broad areas of difficulty in photovoice research: analysis, control, and exposure. Despite the unique obstacles that photovoice presents, we argue that it, along with other forms of arts-based research, are profitable and definitely worth the challenge. [ABSTRACT FROM PUBLISHER]

Aim: To examine the perspectives of patients identified as being at ‘high risk’ of cardiovascular events, with particular reference to the potential responses to risk messages. Background: Systematic population screening for cardiovascular disease (CVD) aims to identify those at high risk and provide medication and lifestyle support. In the United Kingdom, this takes the form of the National Health Service Health Check. Methods: We conducted a qualitative interview study. In 2011 we interviewed 37 patients, from seven UK primary care practices, who were at high risk of developing CVD. Findings: Risk messages were delivered via face-to-face consultations or by letter and were relayed in either a ‘downplaying’ or ‘serious warning’ style. Patients’ accounts of receiving information about risk revealed two broad response styles: ‘committed’ (active resistance; commitment to change) and ‘non-committed’ (procrastination; downplaying and fatalism). Responses to risk messages are usually assumed to be due to individual characteristics but they may be explained by an interaction between the way risk is communicated and the patient’s response style. [ABSTRACT FROM PUBLISHER]

Military families with young children face unique psychological and relational challenges during reintegration because of attachment disruption. This can increase psychological stress for service members. We examined three phases of the deployment cycle: predeployment, deployment, and reintegration to reveal risk and resilience factors that may impede or promote attachment relationships. We also explored the impact of predeployment preparation and deployment communication on service members' parenting stress at reintegration. We conducted (N = 30) semistructured interviews with fathers who were deployed within 2 years of the study, and whose youngest child was 6 years old or younger during the deployment. We found that military fathers whose families did not have preparation strategies for maintaining father-child relationship during the deployment experienced more parenting stress after the deployment than did fathers whose families did use preparation strategies. All participants reportedly communicated with their children during deployment, although number of communication methods did not predict later parenting stress. The most common reintegration experiences were described as an adjustment period, parental stress, and time off of work. Strategies for building attachment as a means of promoting resilience throughout the deployment cycle are identified and discussed. [ABSTRACT FROM AUTHOR]

Objective: To explore camp staffs reports of their interactions with campers during mealtimes at residential summer camps. Design: Thirty-minute semistructured, face-to-face interviews with staff. Setting: Two residential summer camps in northeastern Pennsylvania. Participants: Fifty-two adult (>18 years of age) staff. Phenomenon o f Interest: Staff s perceived responsibilities, problems encountered, and feeding practices used during camp mealtimes. Analysis: Qualitative interviews were analyzed using a hybrid analysis approach that combined deductive directed content analysis with inductive thematic analysis to identify themes and subthemes. Results: The majority of staff indicated their responsibility during mealtimes was to ensure that campers eat. Common problems mentioned were campers’ tendencies toward picky eating and overeating. Staff reported a number of strategies to deal with common mealtime problems including reasoning, modeling, limits or rules, punishment/contingencies, and responding to campers’ needs/preferences. Conclusions and Implications: Most staff expressed concern about promoting campers’ healthy eating behaviors. Although staff discussed several mealtime strategies that can be interpreted as adaptive in authoritative contexts, they need more guidance related to what they should and should not do during mealtimes. Avenues for future research to inform the promotion of healthier mealtime behaviors in camps are discussed. [ABSTRACT FROM AUTHOR]

The current study investigated forms of technology (phone calls, texts, email and Facebook) for maintaining contact with homeless youth over baseline, 1-week, 6-week, and 3-month follow-up interviews. The study combined quantitative tracking of youths’ response patterns and open-ended interviews regarding youths’ preferred methods of communication. Results indicate that maintaining communication with homeless youth requires persistence, including frequent contact attempts over several days. Cell phone contacts (calls or texts) were most successful in communicating with youth, with e-mail and Facebook messaging useful when phones were lost or stolen. Youth who maintained contact were strikingly similar to youth who discontinued contact. [ABSTRACT FROM AUTHOR]

As antiretroviral treatment (ART) becomes more readily available to children in sub-Saharan Africa (SSA), it is important that the experiences of children and their caretakers be carefully examined from more than just a logistical perspective. This paper is based upon an original exploratory and qualitative study that focused on ART in Mozambique. Through in-depth semi-structured interviews, the study examined the experiences of 26 caretakers—primarily mothers—of pediatric patients aged 3–12 receiving ART through the Pediatric Day Hospital of the Maputo Central Hospital (Mozambique) as well as those of their clinicians (7 physicians and 2 dedicated nurses). The interviews focused on the effect of standard HIV prevention communications on pediatric treatment-seeking and ART adherence via several mediating factors such as: 1) Caretakers' sources of HIV information and their perceived reliability; 2) Levels of trust and communication between providers and patients/caretakers related to the completeness of discussions dealing with HIV risk factors and modes of transmission (particularly for the 19% of mothers interviewed who were uninfected themselves) and; 3) The potential propagation of shame and fear through HIV prevention messages which may contribute to sub-optimal adherence (marked, for example, by fear of involuntary disclosure to others in the child's household). The results indicate that all three of these mediating factors deserve further attention as caretakers did, indeed, report adverse effects on initial treatment-seeking and adherence for the children in their care broadly linked with these factors. As patients and their caretakers often must progress through several counseling sessions before or during commencement of ART, there is ample opportunity for these interpersonal and psychosocial factors to be addressed without the need for further financial or human resource allocations. [ABSTRACT FROM AUTHOR]

Understanding the perspectives of children on antiretroviral therapy is very important in order to support them to live with treatment. This article describes how different social settings facilitate or constrain HIV + children's communication regarding their health and medicines. Through participant observation and semi-structured interviews, we explored communication practices of 35 HIV + children aged 8–17 years. Results show that communication in homes was limited to issues about medicines and was influenced by the hierarchical structure of domestic relations, which were not conducive for communication. At the club meetings, where children were in control of the activities, the communication was more egalitarian and child centered. At the treatment centers, there were elements of both hierarchical and egalitarian communication practices. The health workers tended to be rather authoritarian, speaking mostly to adult caregivers. Efforts to control information about HIV/AIDS were evident in all the three places but were more pronounced in homes. Children were active in using the different spaces, and in seeking information about their health and treatment. The Convention on the Rights of the Child and Ugandan National Guidelines on HIV Counseling and Testing encourage more open communication than is currently the case. Adults need support to achieve this goal. [ABSTRACT FROM AUTHOR]

Mass communication health campaign messages play critical roles in public health, yet studies show mixed effectiveness in reaching and impacting underserved populations. The purpose of this study was to evaluate the benefits of using visual and participatory research techniques toward health message development targeting older Hispanic women. Demographic information and levels of physical activity were first obtained in a sample of older Mexican women (n= 23; ages 71.9 ± 7.6 years) living in the city of Chicago. Perceptions of physical activity were then assessed using a visual research method known as photo-elicitation. Health message concepts promoting physical activity were developed with a subsample of the target population using a participatory approach. Photo-elicitation helped develop a unique understanding into the many factors impacting physical activity among older Mexican women. Follow-up in-depth interviews provided detailed narratives that (a) built upon visual data and (b) identified characteristic differences between physically active and inactive women. Ultimately, these findings were beneficial in constructing new, culturally tailored message concepts. Findings suggest that this method may be a valuable tool in the development of mass communication health messages, extracting rich and meaningful data from target audiences while fostering a sense of partnership between researchers and community members. Tailoring and improving the message design process around the needs of underserved populations is essential in the effort to eliminate the burden of health disparities. This study uses innovative interdisciplinary research techniques to explore new approaches to public health communication in underserved populations. [ABSTRACT FROM PUBLISHER]

This article reviews literature to provide context for a reflective narrative on a collaborative research project undertaken by disabled people, practitioners and academics. This approach required reconsidering many aspects of methodology and practice as the research relationships are altered. The article reflects on how the collaborative and participatory approach was developed and sustained and how it impacted on the research process and its outcomes. The article explores how the group of people worked together on a complex large-scale research project to bring the voices of service users and other key players together in a discussion about social care. The article is written by one of the academic partners and draws on consortium documents and reflections from other consortium members provided for the article. [ABSTRACT FROM AUTHOR]

Since 2009, the U.S. Veterans Administration has made concentrated efforts to end homelessness among veterans. As part of these efforts, the Iowa City, Iowa, VA Health Care System in collaboration with local community providers deployed a supportive housing program aimed at homeless veterans. Called the Lodge program, it is intended to serve a Mid-Western mid-size city and its surrounding rural communities. This article presents qualitative findings from a mixed-method, two-year formative evaluation of the Lodge’s implementation. Primary barriers to the effectiveness of the Lodge program were regulations hindering cooperation between service programs, followed by problems regarding information sharing and client substance abuse. Facilitators included personal communication and cooperation between individuals within and among service groups. The feasibility of implementing a Lodge program in a more rural community than Iowa City was also discussed. [ABSTRACT FROM AUTHOR]

The article analyzes the papers of the Research Group (RG) Communication and Sport published in the proceedings of the XXXV Brazilian Congress of Communication Sciences (CBCC), held in September 2012, having sport as a central theme. All 33 articles on Communication and Sport GP were read. From a qualitative point of view, we discuss the theoretical and methodological consistency and compliance with scientific parameters. It is concluded that several studies still show weaknesses in these respects. From the quantitative point of view, we took into account the sport analyzed and the type of media / materials investigated. The analysis shows that the vast majority of them is dedicated to football and that the most common media as a source and / or subject is the internet. [ABSTRACT FROM AUTHOR]

Purpose: The authors sought to investigate the influence of a comprehensive range of factors on the decision making of caregivers of children with hearing loss regarding the use of speech, the use of sign, spoken language multilingualism, and spoken language choice. This is a companion article to the qualitative investigation described in Crowe, Fordham, McLeod, and Ching (2014). Method: Through a questionnaire, 177 caregivers of 157 Australian children with hearing loss (ages 3;5 to 9;4 [years;months], Mage = 6;6) rated the importance of a range of potential influences on their decision making regarding their children's communication. The majority of children were reported to use speech (96.6%) as part or all of their communication system, with fewer children reported to use sign (20.9%). Few children used more than one spoken language (8.3%). Results: Proportional analyses and exploratory factor analyses were conducted. Overall, caregivers' decisions were influenced by their children's audiological and intervention characteristics, communication with those around them, community participation, access to intervention and education services in English, and concerns about their children's future lives. The advice of speech-language pathologists, audiologists, and specialist teachers was more important to caregivers than advice from medical practitioners and nonprofessionals. Conclusion: Caregivers' decision making regarding communication mode and language use is influenced by factors that are not equally weighted and that relate to child, family, community, and advice from others. Knowledge of these factors can assist professionals in supporting caregivers making choices regarding communication. [ABSTRACT FROM AUTHOR]

As the United States moves forward with health reform, the communication gap between researchers and policy makers will need to be narrowed to promote policies informed by evidence. Social media represent an expanding channel for communication. Academic journals, public health agencies, and health care organizations are increasingly using social media to communicate health information. For example, the Centers for Disease Control and Prevention now regularly tweets to 290,000 followers. We conducted a survey of health policy researchers about using social media and two traditional channels (traditional media and direct outreach) to disseminate research findings to policy makers. Researchers rated the efficacy of the three dissemination methods similarly but rated social media lower than the other two in three domains: researchers’ confidence in their ability to use the method, peers’ respect for its use, and how it is perceived in academic promotion. Just 14 percent of our participants reported tweeting, and 21 percent reported blogging about their research or related health policy in the past year. Researchers described social media as being incompatible with research, of high risk professionally, of uncertain efficacy, and an unfamiliar technology that they did not know how to use. Researchers will need evidence-based strategies, training, and institutional resources to use social media to communicate evidence. [ABSTRACT FROM AUTHOR]

Background: Conversational training programmes are increasingly being reported for partners of people with aphasia. The approach, formats used and ways in which these programmes have been evaluated vary. The literature to date provides evidence that conversation partner training can be effective, but it remains unclear as to what specific components contribute to successful outcomes. In this regard, the effectiveness of a learner-centred training programme was demonstrated in the author’s previous work with five couples living with chronic aphasia. Results of this programme, which was delivered in a one-to-one format, included improvements in the quality of conversation for the couples who participated. Aims: The aim of this study was to determine whether similar results could be obtained if the programmes’ original format was modified to include a combination of both individual and group sessions. An additional aim was to describe the content and contribution of both the types of sessions. Methods & Procedures: Four couples living with aphasia participated in this study with a case series descriptive design. The training, delivered by a speech-language pathologist (SLP) and communicative disorders assistant (CDA), consisted of an 8-week communication training programme incorporating content and adult learning strategies similar to the original programme. The modified format included four individual and four group sessions. Couples were seen once a week and were encouraged to practice conversation strategies at home. Outcomes & Results: Results were consistent with those previously reported using the one-on-one format and included an increase in spouses’ use of supportive conversation strategies and an increase in the partner with aphasia’s participation in conversation. Couples reported improved ability to discuss more complex topics, increased positive feelings about conversation and perceived the supportive communication strategies as being useful in their interactions at home. Additional positive effects were reported related to the group experience including the reinforcement of communication strategies learned in training sessions as well as mutual aid and peer support. Conclusions: The use of a format incorporating both individual and group learner-centred training sessions demonstrated positive changes in attitudes and communication behaviours for couples in this study. The group process enhanced the value of the programme by promoting mutual aid and the validation of the personal experiences of each couple. These results have implications for SLPs’ work with couples living with aphasia in the community and demonstrate the benefits of using an adult learning approach that includes both individual and group sessions. [ABSTRACT FROM AUTHOR]

Objective: Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as:" any news that adversely and seriously affects an individual's view of his or her future". Recent studies indicate that the patients' and physicians' attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures . In the present study, we aimed to evaluate the patients' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background. Methods: A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire. Results: In this study, 165 patients (82.5%) claimed to be aware of the diagnosis; however, only 121 patients (73%) were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93%) and accepted patient as the first person to be informed (n = 151, 75.5%) by their physician (n = 174, 87%). The preference of being alone or with a family member when exposed to bad news was almost the same . Most patients (n = 169, 84.5%) believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70%) and life expectancy (n = 121, 60.5%) were the most desirable topics to be discussed. Most patients (n = 144, 72%) agreed upon allowing them to express their emotional feelings. Conclusion: According to the patients' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options. [ABSTRACT FROM AUTHOR]

This article describes a study that involved interviewing eight managers of residential services, who have made referrals to community learning disability teams (CLDTs) for challenging behaviour. Thematic analysis and a critical perspective are combined to analyse and interpret what referrers said about the process of the referral. The study found that managers referred people with intellectual disabilities to the CLDT primarily in order to manage organisational problems rather than to directly manage challenging behaviour. The referrals enlisted the services of professionals to legitimise the residential services, to confirm their practices and to provide credibility to existing decisions by managers. In referring a man or woman with intellectual disabilities to the CLDT, the managers submit themselves, their staff and the person with the intellectual disabilities to the power of the health and psy-complex professionals. [ABSTRACT FROM AUTHOR]

The authors investigated how parents living with HIV/AIDS communicate about HIV prevention with their 10- to 18-year-old children. Semistructured interviews with 76 mothers and fathers were analyzed for (a) their experiences discussing HIV prevention with adolescents and (b) advice for other parents about how to best broach HIV-related topics. Interactive conversations were regarded as particularly effective. A five-step process for interactive communication emerged as a result of these discussions. Parents emphasized that adolescents should have a “voice” and a “choice” in HIV-related talks. Health care professionals can facilitate adolescent sexual health by encouraging parents to actively involve their children in discussions about HIV prevention. Future HIV prevention programs could benefit by providing parents with appropriate tools to foster interactive discussions about sexual health with adolescents. [ABSTRACT FROM PUBLISHER]

To address the need for more information concerning hospital decision making, we conducted in-depth interviews among African Americans with heart failure and their family caregivers (n = 11 dyads). Using a case scenario, we asked participants about their anticipated hospitalization decisions. Most patients indicated that they would seek care to avoid further deterioration or death from their worsening condition. Many family caregivers anticipated having an active influence on hospitalization decisions. Findings suggest that social workers should encourage the development of adequate home-based services, recognize diverse communication styles, and use this information to facilitate medical decision making by these patients and their caregivers. [ABSTRACT FROM AUTHOR]

This paper draws on interviews with 27 deafblind people and the mother of an autistic deafblind woman carried out as part of a larger research project on travel issues for blind, partially sighted and deafblind people to investigate and report on issues related to the use of communication and mobility assistive devices, in particular long canes, guide dogs, hearing aids and wheelchairs. The interviewees came from six different countries and both similarities and differences were found between the experiences in the different countries. One of the main themes that arose in the context of the use of these devices was stigmatisation. This is already frequently a problem for deafblind people due to the additive or multiplicative effects of what could be seen as two distinct impairments. Consequently actual experiences or fears of being stigmatised as a result of using assistive devices led to some deafblind people who might benefit from these devices not using them. This generally makes them more dependent on other people for personal assistance and may reduce their quality of life, as such assistance is not always available. However, deafblind people are as diverse as any other population group and many of the interviewees used communication and mobility assistive devices and considered their benefits to outweigh any possible stigmatisation. Several of the interviewees used several assistive devices and had found some of them easier to accept than others. [ABSTRACT FROM AUTHOR]

Objective To determine preferred communication methods of abused women. Design and Sample A naturalistic study utilizing principles of Community Based Participatory Research. A total of 300 first time users of criminal justice or safe shelter for abused women were interviewed in person. Measures The Preferred Communication Questionnaire was used to determine preference. Results Given the choice of phone voice, face to face, phone text, e-mail, or Facebook, traditional methods of communication (face-to-face communication and phone voice) were the primary (80% combined) and secondary (58.6% combined) preferred sources among abused women. A total of 292 women (97.3%) gave at least two preferred methods of communication, 255 (85%) gave three preferred methods, 190 (63%) gave four, and 132 (44%) used all five methods. Conclusions Public health nurses and other professionals who serve abused women should be aware of their preferred method of communication for contact. The women in the sample preferred face-to-face and phone-voice communication; however, many were open to newer forms of communication such as texting and Facebook. Caution should be used to protect the safety of abused women when using any kind of communication. [ABSTRACT FROM AUTHOR]

The article suggests that we can develop a better understanding of the dynamic of governing in social policies through the lens of ‘intimacy’. Intimacy – a deep personal knowledge about body and mind which changes during the dying process – encompasses validation of one’s emotional experience. In that way, intimacy links the emotional content of dying to discursive dimensions of dignity usually associated with end-of-life care. The analysis describes how the Czech organization Homecoming has constructed its concept of end-of-life care on intimacy, and in so doing, steers specific meanings in the policy field. Hence, intimacy suggests paying more attention to modes of ‘sharing a meaning’, through which policies come to be. The article mediates between psychosocial theorizing of emotions, poststructuralist policy analysis, and current debates on governing in health care and social policies in order to uncover the role of intimacy in the dynamics of governing. [ABSTRACT FROM PUBLISHER]

Objectives. We describe the demographics of the decedents from the tornado outbreak in Alabama on April 27, 2011; examine the circumstances of death surrounding these fatalities; and identify measures to prevent future tornado-related fatalities. Methods. We collected information about the decedents from death certificates, disaster-related mortality surveillance, and interview data collected by American Red Cross volunteers from the decedent's families. We describe demographic characteristics, circumstances and causes of death, and sheltering behaviors before death. Results. Of the 247 fatalities, females and older adults were at highest risk for tornado-related deaths. Most deaths were directly related to the tornadoes, on scene, and trauma-related. The majority of the deceased were indoors in single-family homes. Word of mouth was the most common warning mechanism. Conclusions. This tornado event was the third deadliest in recent US history. Our findings support the need for local community shelters, enhanced messaging to inform the public of shelter locations, and encouragement of word-of-mouth warnings and personal and family preparedness planning, with a special focus on assisting vulnerable individuals in taking shelter. [ABSTRACT FROM AUTHOR]

The aim of this longitudinal and naturalistic study was to compare aspects of imitative exchanges in dyadic grandmother-infant and mother-infant interactions. Sixteen Cretan Greek infants were video-recorded in the course of spontaneous dyadic interactions with maternal grandmothers or with mothers at home from the 2nd to the 10th month of their life (N = 48). The present study provides evidence that in interaction between grandmothers and infant grandchildren and between mothers and infants, there is similarity in the frequency, the structure, the direction of imitation, the kind of imitated acts, and the temporal patterns of the components of imitation. Infants' age was found to affect the developmental curve of grandmothers', but not mothers', imitative behavior. In the frame of the theory of innate intersubjectivity, we assume that similarity in these aspects of imitation may be related to invariant fundamental dimensions of Significant Other-infant communication ("kinematics" (temporal patterns), "physiognomics" (forms) and "energetics" (effort)). These similarities may have implications for both grandmothers' and infants' ability to regulate interpersonal challenges within an extended-family interactional context. [ABSTRACT FROM AUTHOR]

Background: Prognosis conversations are complex phenomena of substantial importance to palliative care (PC), yet these remain poorly understood. This study empirically identifies and describes major types of prognosis conversations that occur in the natural setting of PC consultation. Methods: We audio-recorded and coded 71 inpatient 'goals of care' PC consultations at a large academic medical center in the northeastern United States. We used quantitative Latent Class Analyses for identifying discrete prognosis conversation types and qualitative Dimensional Analyses for more fully describing the process and content of the latent classes. Results and Conclusions: We observed three discrete types of prognosis conversations, each placing different communication demands upon all participants for achieving goal-concordant care: Navigating Options & Goals (56% of consultations), Facilitating New Goals (23%) and Preparing for End-of-Life (21%). This study provides the first step for developing educational and clinical prognosis communication interventions that are tailored to common decision-making contexts facing seriously ill patients, their families, and PC clinicians. [ABSTRACT FROM AUTHOR]

Knowledge management (KM) is emerging as an important aspect of achieving excellent organizational performance, but its use has not been widely explored for hospitals. Taking a positive deviance perspective, we analyzed the applications of nine healthcare organizations (HCOs) that received the Malcolm Baldrige National Quality Award from 2002 to 2008. Baldrige Award applications constitute a uniquely comprehensive, standardized, and audited record of HCOs achieving near-benchmark performance. Applications are organized around leadership, strategy, customers, information, workforce, and operations. We find that KM is frequently referenced in all sections, and about two thirds of each application addresses KM-related issues. Many specific KM activities, such as strategic and action plans, communications, and processes to capture internal and external knowledge, are addressed by all nine applications. We present examples illustrating these frequently appearing KM concepts. Baldrige Award-recipient HCOs apply continuous improvement to KM processes, as they do to their organizations as a whole. We conclude that these HCOs have developed sophisticated, comprehensive KM processes to align both culture and specific procedures throughout the organization. KM in these organizations is a deliberate effort to keep all relevant knowledge at the fingertips of every worker, characterized by frequent communication, careful maintenance of content accuracy, and redundant distribution. We also conclude that the extent and rigor of their KM practice distinguish them from other U.S. hospitals. [ABSTRACT FROM AUTHOR]

This study presents findings on patterns of communication between internationally adopted children and their mothers in order to better understand the nature of these interactions and their influence on language learning. We examined maternal language use and joint attention behaviors of mothers and their children in 21 mother-child pairs: 10 pairs included children adopted from China living in francophone families, and 11 included francophone children living with their biological families; all were matched for socioeconomic status, sex, and age. The children were, on average, 15 months of age at initial testing when they were video-taped with their mothers for purposes of describing the mothers' language use and the mothers' and children's joint attention behaviors. Vocabulary development was assessed at 15 and again at 20 months of age using the MacArthur Communicative Development Inventory. The results support the conclusion that adoptive mothers play an active role in promoting and maintaining joint attention and that the redirecting style they used the most and that correlated with their children's later vocabulary development contrasts with the following style that correlates with vocabulary development in nonadopted children raised in mainstream North American families. [ABSTRACT FROM AUTHOR]

Aim The goal of the first part of the study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in community nursing. The purpose of phase two of the research and of this article was to develop guidelines for value-sensitive clinical accompaniment of student nurses by professional nurses in community nursing Background Undergraduate students have reported that owing to different cultures and values, value conflicts are experienced during clinical accompaniment, which affects clinical learning in community nursing negatively. Method A qualitative, exploratory and descriptive research design was done in a specific context; guidelines were formulated as a result of the findings in phase 1. Once the guidelines were formulated the guidelines were validated and refined by presenting them to a panel of experts for validation. The accessible population was experts in the field of community health nursing and the participants that were conveniently selected were asked to validate the guidelines. Results Three main categories were identified, namely, respect during clinical accompaniment, value-sensitive communication and sensitivity to quality of clinical accompaniment. The validated and refined guidelines were described. Conclusion and implications for nurse managers Guidelines for value-sensitive clinical accompaniment of student nurses by professional nurses as experts in community nursing should be implemented by nurse managers as they are important in any relationship to set the climate for both personal and professional wellbeing. [ABSTRACT FROM AUTHOR]

Introduction Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. Methods A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Results Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Conclusions Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. [ABSTRACT FROM AUTHOR]

Background The analysis of nursing errors in clinical management highlighted that clinical handover plays a pivotal role in patient safety. Changes to handover including conducting handover at the bedside and the use of written handover summary sheets were subsequently implemented. Aim The aim of the study was to explore nurses' perspectives on the introduction of bedside handover and the use of written handover sheets. Method Using a qualitative approach, data were obtained from six focus groups containing 30 registered and enrolled (licensed practical) nurses. Thematic analysis revealed several major themes. Findings Themes identified included: bedside handover and the strengths and weaknesses; patient involvement in handover, and good communication is about good communicators. Finally, three sources of patient information and other issues were also identified as key aspects. Conclusions How bedside handover is delivered should be considered in relation to specific patient caseloads (patients with cognitive impairments), the shift (day, evening or night shift) and the model of service delivery (team versus patient allocation). Implications for nursing management Flexible handover methods are implicit within clinical setting issues especially in consideration to nursing teamwork. Good communication processes continue to be fundamental for successful handover processes. [ABSTRACT FROM AUTHOR]

This article examines community planning and communications approaches used by mental health housing organizations in the siting process for community-based psychiatric housing. Drawing on interviews with housing administrators in 7 states, it assesses variations in the approach, content, timing, and modes of agency communications with community leaders, neighbors, and local citizens, and the association of these communications methods with initial and longer-term community responses to the site. The study provides evidence to inform practice for the development of community approaches to the siting of psychiatric housing. [ABSTRACT FROM AUTHOR]

Background: Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient's experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Methods: Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. Results: The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. Conclusions: The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader 'fit' with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved. [ABSTRACT FROM AUTHOR]

Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice. Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data. Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task. Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship. [ABSTRACT FROM AUTHOR]

Context: The Disclosure, Apology, and Offer (DA&O) model, a response to patient injuries caused by medical care, is an innovative approach receiving national attention for its early success as an alternative to the existing inherently adversarial, inefficient, and inequitable medical liability system. Examples of DA&O programs, however, are few. Methods: Through key informant interviews, we investigated the potential for more widespread implementation of this model by provider organizations and liability insurers, defining barriers to implementation and strategies for overcoming them. Our study focused on Massachusetts, but we also explored themes that are broadly generalizable to other states. Findings: We found strong support for the DA&O model among key stakeholders, who cited its benefits for both the liability system and patient safety. The respondents did not perceive any insurmountable barriers to broad implementation, and they identified strategies that could be pursued relatively quickly. Such solutions would permit a range of organizations to implement the model without legislative hurdles. Conclusions: Although more data are needed about the outcomes of DA&O programs, the model holds considerable promise for transforming the current approach to medical liability and patient safety. [ABSTRACT FROM AUTHOR]

For a variety of reasons, professionals are taking greater control over their own professional development and demonstrating a commitment to lifelong learning. Online resources and social media outlets have provided new ways for professionals to connect and form learning communities to build core knowledge and set standards of practice. The National Center for Hearing Assessment and Management at Utah State University launched a learning community to increase and promote the knowledge base regarding the use of telepractice as an early intervention service delivery model for children who are deaf or hard of hearing and their families. The learning community was comprised of administrators and providers from six programs that were providing early intervention therapeutic services via telepractice. Members employed a variety of mechanisms to support their engagement with one another, including in-person meetings, web-based and phone meetings, and internetbased social media. Evaluation results gathered over a 1-year period showed that individuals reported that they gained new knowledge to guide their efforts. Collective accomplishments of the learning community included refinement of telepractice implementation strategies and the dissemination of new information to the field of early intervention. These outcomes, along with recommendations for the use of learning communities, are discussed. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To develop a descriptive framework of the communication processes used by Latinos with prostate cancer to communicate about their diagnosis.Research Approach: A constructivist grounded theory approach was used to analyze and build a descriptive framework from semistructured interviews.Setting: A university-affiliated urban hospital in southern California.Participants: 30 Latinos treated for prostate cancer, who had at least one first-degree male relative (FDMR), and who lived near the medical center.Methodologic Approach: Semistructured interviews with bilingual Latinos were conducted in participants' homes in the language they preferred. Individual and collaborative analyses of translated transcripts were guided by constructivist grounded theory.Findings: Analysis uncovered an overarching process of purposeful interacting. Components of the process included occasionally overlapping spheres of communication, which were connected to purposes and content. Balanced in and influenced by the spheres were cross-cutting processes of respectful silence and selective disclosure.Conclusions: Men communicated different content about their prostate cancer to people representing different reference groups. Respectful silence and selective disclosure could be viewed as men's enactment of social interaction-using and choosing words based on the symbolic meaning the men perceived would have their intended meaning for the people in each of the spheres.Interpretation: Culturally sensitive educational interventions should be targeted at Latinos with prostate cancer to understand risk and encourage disclosure to FDMRs. [ABSTRACT FROM AUTHOR]

Accessible summary Community Learning Disability Nurses were asked to talk about how they felt they had helped people in their care feel better., They talked about helping as a positive approach to problems, making the most of existing help, understanding what it means to have a Learning Disability, using time and communication, and teaching and learning., This is important because it can help people to understand the needs of people with learning disability and what help Community Learning Disabilities Nurses give., Summary This literature review and primary qualitative research explores therapeutic role from the perspective of Community Learning Disability Nurses. Semi-structured interviews, based on Critical Incident Technique ( Psychol Bull, 51, 1954, 327), and descriptive phenomenological methodology were adopted to elicit data amenable to systematic content analysis (Mayring 2000). This resulted in the identification of six inductive categories (therapeutic optimism, maximising support networks, time as a therapeutic tool, creative communication, understanding Learning Disability and initiating learning). Three deducted categories were derived from relevant literature (nature of the events, outcomes of therapeutic role, and therapeutic relationship). The sample consisted of seven practicing Community Learning Disability Nurses with two or more years experience managing an adult caseload, recruited via a professional networking forum. A conceptual model was developed indicating the multicomponent and interconnected nature of the therapeutic role. [ABSTRACT FROM AUTHOR]

Background: Aphasia affects family members in addition to the individuals with the communication disorder. In order to develop appropriate services for the relatives of people with aphasia post-stroke, their rehabilitation goals need to be identified. Aim: The aim of the current investigation was to identify the rehabilitation goals that family members of individuals with aphasia have for themselves. Methods & Procedures: Forty-eight family members of adults with aphasia post-stroke participated in in-depth semi-structured interviews to identify the rehabilitation goals they had for themselves. All the interviews were transcribed verbatim and analysed using qualitative content analysis. Outcomes & Results: Analysis revealed seven categories of goals that the family members had for themselves: to be included in rehabilitation, to be provided with hope and positivity, to be able to communicate and maintain their relationship with the person with aphasia, to be given information, to be given support, to look after their own well-being, and to be able to cope with new responsibilities. A few participants reported that, at certain times during the rehabilitation process, they did not have any goals for themselves. Conclusions & Implications: This study highlights that family members of individuals with aphasia have a number of aphasia-related rehabilitation goals for themselves. In order to provide a family-centred approach to rehabilitation, health professionals, including speech-language pathologists, need systematically to identify and address family members' goals in light of the categories revealed in this investigation. [ABSTRACT FROM AUTHOR]

Objective The obvious gap between evidence and practice in health care is unfavourable for patient care and requires the promotion of a scientific attitude among health care professionals. The aim of the present study was to determine the utilization of knowledge of and interest in research and development among primary care staff by means of a strategic communication process. Method A cohort consisting of primary care staff ( n = 1276) was designed and strategic communication was utilized as a platform over a 7-year period. Quantitative and qualitative methods were taken in account. Results We found that 97% of the staff had gained knowledge of research and development, 60% of whom remained interested in the subject. The oral communication channel was the most powerful for creating research interest. Organizational culture was a barrier to interest in science. Conclusion The study demonstrates a significant increase in knowledge and interest among primary care staff as a result of a strategic communication process. Practice implications Strategic communication should lead to a more evenly distributed research commitment among all health care professionals, thus facilitating communication between them and patients in order to clarify, for example, the causes of disease. [ABSTRACT FROM AUTHOR]

Background: In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clinicians in time to be of use in the family's care. Methods: Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life communication with their child's clinicians. They completed the questionnaire again two to three weeks later and responded to three open-ended questions to assess the benefit:risk ratio of their study participation three months after the intervention. Clinicians received the interview data within hours of the parent interview and evaluated the usefulness of the information three weeks later. Results: All preestablished intervention feasibility criteria were met; 77.3% of families consented; and in 100% of interventions, information was successfully provided individually to 3 to 11 clinicians per child before the child died. No harm was reported by parents as a result of participating; satisfaction and other benefits were reported. Clinicians reported moderate to strong satisfaction with the intervention. Conclusion: The communication intervention was feasible within hours of decision making, was acceptable and beneficial without harm to participating parents, and was acceptable and useful to clinicians in their care of families. [ABSTRACT FROM AUTHOR]

Much of the research on orphan and vulnerable children in sub-Saharan Africa has focused on their risks and vulnerabilities. This article describes the ‘funds of knowledge’ (Moll and Greenberg, 1990) and means of acquiring new knowledge of children living in child-headed households in Uganda’s Rakai District. Using ethnographic methods, the authors documented the experiences and activities of children in five rural home contexts. They advance the view of children as resourceful, competent, and knowledgeable, highlighting their ability to build on, utilize, and acquire new funds of knowledge while simultaneously recognizing their conditions of extreme adversity. The authors’ aim is to expand and strengthen the current knowledge base on children living in child-headed households by providing a more nuanced understanding of the relationship between children’s risks and capabilities. [ABSTRACT FROM PUBLISHER]

Objective: to describe the experiences of immigrant parents of an ultrasound examination in the second trimester of pregnancy, highlighting information, communication, thoughts, feelings and well-being. Methods: An exploratory, qualitative study using in-depth interviews with parents separately. Content analysis was used. A total of nine Farsi-speaking couples, in all 18 persons, who now live in Sweden, were interviewed. Results: Four main categories emerged from the parents’ descriptions: experiencing professionals who were informative and communicative, experiencing the first encounter with their unborn child, experiencing a well-planned routine and experiencing a humanistic encounter within the healthcare organisation. Conclusion: Parents saw the ultrasound examination as a means of: getting visual confirmation of their pregnancy, reassurance about the health and well-being of their foetus and making connection with their baby; and receiving confirmation of their baby’s gender. The parents were impressed by the quality of their communication with the care-givers, which influenced their judgement of the whole procedure, including the technical quality of the care. [ABSTRACT FROM PUBLISHER]

Background and Aim: The communication process includes both verbal and nonverbal elements. Nonverbal behavior or body language includes facial expression, eye contact, posture and prosody. Prosody conveys semantic or affective information to a listener. Nonetheless, so far in Iran no report on assessment of speech prosody comprehension in patients has ever been published. The aim of this study was to measure the validity and reliability of the prosody comprehension test specifically designed for the Persian language and culture. Methods: This study is a type of test development. 73 sentences were orated by 22 professional vocalists in eight different prosodies. A total of 6582 voices were prepared which were listened by 200, 18-30 year-old students and a voice specialist. Having the content validity calculated for all voices, 1473 voices were found to be unanimously agreed upon by all participants in terms of emotional status which were analyzed by a voice specialist. Eventually, 169 voices were selected for developing the prosody comprehension test including the following four subtests: none motional prosody discrimination, emotional discrimination, naming of prosody and naming conflicts. Reliability of the test was determined by performing the test on 32, 18-60 year-old normal people. Results: The designed test of comprehension prosody had 100% content validity ratio and 94% reliability and the correlation of test of prosody was 89% (p=0.001). Conclusion: This test in Persian language has appropriate validity and reliability and is appropriate for assessment of prosody comprehension. [ABSTRACT FROM AUTHOR]

How to cite this article: Hancock R.E.E., Bonner G., Hollingdale R. & Madden A.M. (2012) 'If you listen to me properly, I feel good' a qualitative examination of patient experiences of dietetic consultations. J Hum Nutr Diet. 25, 275-284 Abstract Background: There is considerable interest in healthcare research regarding communication skills and some debate surrounding the effectiveness of a patient-centred approach to care. Understanding patient experiences of consultations can help indicate how consultations can be modified to improve effectiveness. At present, there is little research exploring patient experience of dietetic consultations. The present study aimed to achieve a better understanding of patients' experiences of dietetic consultations using qualitative analysis. Methods: Patients undergoing consultations with a dietitian were invited to discuss their experience of the consultation with a research dietitian who was not involved in their care. Individual interviews and focus groups were conducted and analysed using the Framework approach. Results: Seventeen patients participated and described their experiences of consultations, which were varied and influenced by factors such as information given (resources, explanation, repetition, consistency); their dietitian's approach (prescriptive or nonprescriptive, use of behaviour change skills), behaviour (listening skills, body language) and appointment (expectations, involvement of the multidisciplinary team, length of time); and their own internal experience (confidence, guilt, frustration). Patients agreed that certain factors, such as good communication and rapport, receiving effective and reliable information and resources, and nonjudgmental, regular support, were important factors in creating a positive experience of their consultation. However, they differed in what they believed constituted these factors. Conclusions: Patients like dietitians to adopt a patient-centred approach, which might be either patient- or practitioner-led, and to take account of what they wanted from consultations, adapting these to meet their individual requirements. [ABSTRACT FROM AUTHOR]

Background: Inadequate or inaccurate transfer of medication information can challenge optimal medication management. Studies of medication information transfer typically involve the hospital-community interface in urban settings. There is little research on medication information transfer between community health services, between hospitals (rural and metropolitan) and rural community settings. Aim: To explore medication information transfer issues faced by rural healthcare providers and their perspectives on initiatives to optimise the process. Method: Semi-structured interviews were conducted with 49 health professionals in 4 towns in rural Queensland on issues surrounding medication supply and management. Interviews were recorded, transcribed verbatim and analysed thematically. Results: Some of the issues identified included: discrepancies in medication records, lack of a coordinated system to communicate medication or prescription information between health professionals, and inadequate communication between secondary/tertiary facilities and rural primary care providers. According to the participants, the root causes of these challenges related to workforce issues and inefficiencies in communication and networking systems. Conclusion: Key issues were identified relating to medication information transfer between healthcare providers and between healthcare settings, which impacted on optimal medication management for rural patients. [ABSTRACT FROM AUTHOR]