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1

Cipolla, M. "ONE COMMUNICATION AND ONE HEALTH: COMMUNICATION IN VETERINARY MEDICINE TO IMPROVE HUMAN HEALTH." Doctoral thesis, Università degli Studi di Milano, 2014. http://hdl.handle.net/2434/232569.

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Health communication has become recently an essential and powerful tool for public health. Its role has been largely recognized in human medicine, but it has been less considered in veterinary medicine even if this latter field is not less decisive for the human health. The One Health concept unified the two medicines recognizing that human health is inextricably connected to animal health and environment. Within this framework, we design this study to investigate the relationship between health communication and One Health. Particularly, we focused on the role of communication in veterinary medicine and how it has the potential to improve human health. Veterinary medicine competences include a broad spectrum of aspects, which can’t be covered in a single study. Moreover, we were interested in investigate if communication has a role also in the veterinary areas traditionally considered less linked to public health. Therefore, this study was focused on clinical communication, both in companion and in food-producing animals practice. This study confirmed the outcomes from previous surveys and showed the importance of communication in veterinary medicine in improving human health. Communication in veterinary medicine is not less important for human health, and is not different from what is usually considered health communication. Indeed, both of them cover the same issue (zoonoses, food safety etc.) and use the same strategies. Therefore, a “One Communication” approach appear to be the most helpful tool in improving human health in the One World-One Health-One Medicine.
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Hägglund, Karin, and Helena Roos. "Cultural Meetings in Child Health Centers : An Interview Study about Child Health Nurses experience of Intercultural Communication." Thesis, Kristianstad University College, Department of Health Sciences, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-3290.

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Increasing immigration to Sweden has transformed a culturally homogeneous society into a more heterogeneous one. As a consequence intercultural communication and interaction have been increasing. Child health care agencies have encountered these increases. The aim of this study was to examine what the health care professionals experienced and communicated in these intercultural environments. Eight interviews with child health care nurses were carried through at four child health care centers in the south of Sweden. The results have shown that the child health nurses were affected by their different backgrounds and cultural diversity. An ethnocentric approach, including biased values of right and wrong, caused unsuccessful encounters with families from foreign countries. A culturally sensitive approach, on the other hand, with an understanding of cultural differences, proved to be successful and associated to plain communication and trust. A conclusion is that the nurses in childcare services should be provided with the opportunity to develop the necessary knowledge and tools needed for managing problems and obstacles they may encounter in their practices. Furthermore it was found that reflection was used for learning. We conclude that the nurses should be provided with opportunity to learn this way about their own culture and cultural relativity. A culturally sensitive approach leads to a better acceptance for cultural difference. From a health promotion point of view, this means that the prospect of promoting good health for immigrant children in the long run can be increased.

Keywords: Intercultural communication, child health centers, ethnocentrism, cultural sensitivity, reflection.

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Carstens, Charl. "Major Incident Communication Cascade Evaluation." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/2858.

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4

Moorhead, Robert George. "Communication skills training for general practice." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09MD/09mdm825.pdf.

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Bibliography: leaves 554-636. Examines aspects of teaching medical students communication skills at a time when they are entering their clinical years. Integrates reports of 12 data-gathering exercises centred on medical student communication skills with the international literature, and with the author's reflections as an experienced educator and G.P. Recommends that communication skills training in a general practice setting should be a crucial factor in all future training of medical students.
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Keller, Alyse. "Performing Narrative Medicine: Understanding Familial Chronic Illness through Performance." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6876.

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This study presents the process of creating a performance ethnography of my family’s narratives about familial chronic illness and disability. I label this process performing narrative medicine. By documenting and granularly analyzing the process of my performance ethnography, the following chapters provide a step-by-step discussion of how families communicate about chronic illness/disability through storytelling and humor, and how/what performance does as a method, metaphor and object of study to further our current communicative practices and understandings of chronic illness and disability in families. I argue that performing narrative medicine is a heuristic for families living with chronic illness and disability, and a method that may be used and applied outside the context of my own family. The chapters in my dissertation directly address the following questions: How does my performance work as embodied knowledge to gain greater understanding of the lived experience of familial disability/chronic illness? How does the use of humor as a communicative construct, and performance ethnography work as a practice of “performing narrative medicine?” What are our scholarly stakes in performing narrative? How too might binding narrative medicine to performance inform how we do qualitative research? How do the respective motions of narrative medicine and research practices/principles of performance ethnography converge and cross-fertilize each other? Does a work like narrative medicine endow storytelling and performance with a consequentiality? This performance ethnography of familial disability and chronic illness contributes to understandings of families dealing with chronic illness/disability, extends narrative medicine as a theoretical construct, and speaks to a long tradition of the practice of performance ethnography. Overall, performing narrative medicine reveals the underlying communication competencies at work in families living with chronic illness and disability. Through the use of humor and performance as a communication practice, I reveal the power of empathy. The power in realizing our own human capacities to relate to one another across differences, and continue the work of “living well.” This dissertation emphasizes the power of performance to constitute alternative ways of performing and understanding familial chronic illness, by emphasizing the work of creating, implementing and studying performance.
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Vuza, Xolisa. "Social and technical issues of IP-based multi-modal semi-synchronous communication: rural telehealth communication in South Africa." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Most rural areas of developing countries are faced with problems like shortage of doctors in hospitals, illiteracy and poor power supply. Because of these issues, Information and Communication Technology (ICT) is often sees as a useful solution for these areas. Unfortunately, the social environment is often ignored. This leads to inappropriate systems being developed for these areas. The aims of this thesis were firstly, to learn how a communication system can be built for a rural telehealth environment in a developing country, secondly to learn how users can be supported to use such a system.
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7

Nickell, Debra Faith. "SCREEN DOOR MEDICINE: THE INFORMAL MEDICAL CONSULTATION." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/6.

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This study explores the phenomenon of the informal medical consultation, a communication event in which an individual asks for medical information, advice, or care from an off-duty health professional with whom the individual has no formal patient-provider relationship. Using surveys and interviews, the study describes these consultations from the perspective of the health care professional and the informal patient. The study explores foundational theories that offer explanations for the phenomenon. The theories considered include social support, decision-making, social exchange, perceived partner responsiveness to needs, and uncertainty management. This study suggests health care providers perceive informal medical consultations to be more problematic than do the informal patients who consult them. The problematic nature of informal consultations increases as the type of request moves from purely informational to a request for treatment. Informal patients do not perceive this distinction. The informal patient’s motivation to pursue an informal consultation instead of a formal consult is affected by the relationship with, trust in, and access to the informal consultant. The willingness of the informal consultant to engage in an informal consultation is affected by the relationship with the informal patient, the type of request made, and perception of risk/benefit for both the provider and the patient. The study supports the idea that informal medical consultations are potentially problematic within the current medico-legal-ethical environment. Alternately, these consultations may be viewed as offering positive contributions to the health and well-being of informal patients. The study suggests translational research is needed to guide health professionals in considering requests for informal medical consultations.
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Howell, Erin. "Volunteer Tourism: Fulfilling the Needs for God and Medicine in Latin America." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6865.

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This study seeks to understand how short-term medical missions fulfill health needs for their recipients in Honduras, and how in turn, mission participants experience need fulfillment as well. By using the theoretical concept of co-construction of health to see how health needs are or are not met, I conducted a thematic analysis of the Baptist Medical and Dental Mission International (BMDMI) resulting in the following themes: 1.) Mission workers receive fulfillment from their experiences in the mission field. 2.) Mission recipients receive partial fulfillment of needs from the mission. 3). Through a calling, missions are a means to an end. Through these themes, this projects examines ethical stances on missions, communication about health in mission contexts, and whose needs are met, privileged, and silenced.
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Gaag, Anna van der. "Evaluating the communication skills of adults with learning disabilities." Thesis, University of Strathclyde, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341636.

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Ivander, Christin, and My Olsson. "Webbplats för kursen EBM : Evidence Based Medicine." Thesis, Blekinge Tekniska Högskola, Sektionen för teknokultur, humaniora och samhällsbyggnad, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-3757.

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Vi har gjort vårt kandidatarbete på en webbyrå i Stockholm som heter Boman Communication. Där har vi gjort en databasdriven webbplats i flash och asp. Webbplatsen är ett komplement till en kurs som heter EBM. Kursen EBM hålls av myndigheten SBU som i sin tur är en kund till Boman. Målgruppen för EBM och därmed också webbplatsens målgrupp är bland annat professorer och läkare inom medicin och vård. På kursen tar man upp riktlinjer för hur man botar olika sjukdomar eller skador. Webbplatsen innehåller information om och till kursen. Den är uppdelad i tre delar: Allmän, Före kursen och Efter kursen. Den allmänna delen är till för att väcka ett intresse för kursen hos besökaren. Denna del kommer alla åt. De två övriga delarna kräver inloggning och är bara till för dem som anmält sig på kursen. Inloggningen är datumstyrd vilket innebär att när kursen inte har varit ännu kommer man till delen före kursen och när kursen har varit kommer man till delen efter kursen. Före kursen hittar man information på webbplatsen som man bör ta del av för att förereda sig till kursen, man kan även finna information om föreläsarna och övriga kursdeltagare. Efter kursen är webbplatsen uppdaterad med en sida för dokumentation som föreläsarna har rekommenderat, här finns även en utvärdering som kursdeltagarna uppmanas att fylla i. Vi har framförallt använt oss av programmen Macromedia Flash MX 2004 och Macromedia Dreamweaver MX 2004 men även program som Adobe Photoshop CS, Adobe Illustrator CS.
Detta är en reflektionsdel till en digital medieproduktion.
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Thacker, Alice Joanna. "The manifestation of schizophrenic formal communication disorder in sign language." Thesis, St George's, University of London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300411.

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Arora, Aarti B. "Communication in Complementary and Alternative Medicine: A Situated Exploration of Communication Interactions Between Yoga Students and Their Yoga Teachers in India." Ohio University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1597683490208638.

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13

Lavelle, Mary. "Nonverbal communication in schizophrenia : a 3-D analysis of patients' social interactions." Thesis, Queen Mary, University of London, 2012. http://qmro.qmul.ac.uk/xmlui/handle/123456789/2485.

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Background: Schizophrenia is a severe mental illness affecting approximately 0.4% of the population. A core feature of schizophrenia is social dysfunction, however, the precise nature of patients’ social deficits remain unknown. During face-to-face interaction we use nonverbal cues to coordinate, regulate and manage conversation. Patients have difficulty perceiving nonverbal cues in social cognitive tests, but it is unclear if this difficulty persists in their social encounters. The aim of this thesis is to determine if patients’ social deficits are manifest in the nonverbal behaviour of their social interactions, specifically investigating; (1) interpersonal coordination between the head movements of interacting partners and (2) the head and hand movements of patients and their partners in the context of conversation role. The relationship between nonverbal behaviour and patients’ symptoms, social cognition, rapport and social outcomes will also be assessed. Methods: The experimental study involved twenty patient (1 patient, 2 healthy participants) and twenty control (3 healthy participants) three-way groups. Groups were motion captured while discussing a moral dilemma. Healthy participants were unaware a patient was present. Results: (1) interpersonal coordination was reduced in patients’ three-way interactions (2) patients displayed less head and hand movement, while their healthy participant partners displayed more. Increased patients’ negative symptoms intensified this pattern and were associated with reduced patient rapport. Patients spending more time actively involved in their three-way interactions had poorer social outcomes. Patients’ performance on social cognitive assessments showed no association with their nonverbal behaviour. Interpretation: Patients’ three-way interactions display atypical patterns of nonverbal behaviour. The presence of a patient changes the behaviour of the healthy participants they are interacting with; even when they are unaware a patient is present. Patients’ symptoms mediate the behaviour of patients and their partners, and influence patients’ rapport.
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Frean, Isobel. "Modelling communication requirements in aged care using HL7 V3 methods." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20070221.131236/index.html.

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15

Forde, Colin Ainsworth. "Emergency Medicine Triage as the Intersection of Storytelling, Decision-Making, and Dramaturgy." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5354.

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This dissertation presents a comprehensive qualitative study of the decision-making aspects of emergency department (ED) triage at a large urban Trauma I hospital in the Southeast. Specifically, this study addresses the following research questions: (1) What do triage nurses perceive as the primary role of the triage process? (2) How do triage nurses interpret patient performances? These questions are explored through illuminating the intricacies of triage decision-making by the use of semi-structured interviews and observations. The findings of this study indicate: (1) a better understanding of the triage decision- making process yielding more practical insights related to the informal, emergent, and often improvisational ways patients are received, categorized, and treated was needed, and (2) providing a clearer understanding of the processes involved in sorting patients may provide much-needed insight regarding clinical concerns and/or issues regarding patient categorization, adverse clinical events, and excessive patient wait times. These findings are of particular importance due to the widespread overuse of EDs for nonemergent care. Essentially, EDs are designed for patients to visit due to an alteration in their physical and/or mental state. Once a patient enters the ED, a medical professional is tasked with the responsibility of interpreting the physical and/or mental state of the patient, which is generally achieved by interpreting the patient story - the precipitating event that brought them into the ED. What this study contributes to the literature is a deeper understanding of the communicative processes that ED triage nurses leverage to make sense of patient stories.
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Kaplan, Rachel S. W. "The Rhetoric of the Opioid Crisis and Addiction to Prescription Pain Medicine." Thesis, Duquesne University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10787609.

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In this historical moment, the United States is amidst an opioid crisis killing the young and the old; at least seventy-eight people die every day from an opioid-related overdose (Enomoto in Murthy III). Changing mindsets of the doctors who prescribe opioids is just as important as asking the patients who are prescribed them to demand an alternative medication. The different parties involved in the crisis all have a different agenda and their rhetorical bias is explored throughout this project. The pharmaceutical companies have launched aggressive marketing campaigns expressing the benefits of opioids and encouraged physicians to prescribe, the CDC has encouraged physicians to stop the overprescribing of opioids, and local police departments and hospitals are overwhelmed with overdoses. Future generations are now being affected by their parents’ opioid usage; one must stop and realize opioids are not the solution. Perhaps one of the most important implications from this project is to suggest all women, regardless of socioeconomic status and level of health literacy, be warned of the dangers opioids pose to her and any future children. When taking opioids during pregnancy, NAS is not the only concern; but also the larger concern is the complete dysfunction that opioid addiction brings and the personal chaos it creates for addicts and their families

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Bi, Hongwei. "A doctor-patient communication tool (DPCT) Ryodoroku application on the web." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2044.

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LaBarge, Monica Claire. "Integral affect and attitude strength in health communications /." view abstract or download file of text, 2007. http://proquest.umi.com/pqdweb?did=1421612801&sid=1&Fmt=2&clientId=11238&RQT=309&VName=PQD.

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Thesis (Ph. D.)--University of Oregon, 2007.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 189-197). Also available for download via the World Wide Web; free to University of Oregon users.
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Pineda, Kimberly Rose. "Intercultural communication in healthcare interpreting : an exploration of possibilities." Scholarly Commons, 2010. https://scholarlycommons.pacific.edu/uop_etds/754.

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This thesis will present an exploration of how healthcare interpreters utilize intercultural communication skills as they interact with cultural differences in their work. I will review the literature on healthcare interpreting, including provision laws, standards, codes of ethics, paradigms, and roles. I will focus on intercultural communication literature in order to demonstrate possible ways that it can be applied to the healthcare interpreting field. In order to better understand how intercultural communication is being used in healthcare interpreting, I will conduct interviews with healthcare interpreters who have had intercultural training. In conclusion, elements of a training framework will be introduced that could be developed in order to train advanced interpreters who are interested in using an intercultural approach in their work.
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Tuell, Dawn S., Beth A. Fox, and Ivy A. Click. "Let’s Give Them Something to Talk About: Assessment of Communication Skills in Pediatric Residents." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6369.

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Objective To assess whether utilization of a validated communication tool corresponds with faculty assessment and resident self-assessment on the pediatric communication milestone continuum. Methods Pediatric residents were recruited to participate in the communication skills assessment. Continuity clinic faculty completed an assessment of each residents communication skills utilizing the 6 pediatric milestones that address interpersonal and communication skills. Each participating resident completed a self-assessment of their own communication skills utilizing the same milestones. After being placed on the milestones, the residents participated in a standardized patient interview that was recorded and subsequently evaluated by a faculty observer utilizing the Common Ground Instrument. Results 16/16 of pediatric residents participated in the study. The milestones and common ground instrument were scored on a scale from 1 to 5 with 5 representing an expert rating. For PGY-1 residents, the average faculty score on the milestones was 3.17, self-assessed average score was 2.92 and common ground average score was 3.67. For PGY-2 residents, the average faculty score on the milestones was 4.40, self-assessed score average was 4.10 and common ground average score was 3.20. For PGY-3 residents, the average faculty score on the milestones was 4.70, self-assessed score average was 4.10 and common ground average score was 3.60. PGY-1s had significantly lower self and faculty assessments than PGY-2s or -3s. There were no significant differences among PGYs on the Common Ground Interview score. Faculty rated residents significantly higher than they rated themselves. Previous clinical skills training, standardized patient training, and English as a first language had no significant effect on the self-assessment, faculty assessment or Common Ground Instrument score. Conclusion Faculty and residents observe an improvement in communication skills as residents progress through training; however, scores on a validated communication tool do not reflect this improvement.
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Wong, Sau-Yee. "Determinants of patient satisfaction towards medication information in SOPD patients DISMIS study /." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972330.

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Wu, Yingli, and 吳映莉. "The effects of Chinese medical terms on patient comprehension of information in a simulated clinical consultation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2015. http://hdl.handle.net/10722/208579.

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Doctor's use of medical terms is generally considered to be one of the reasons for patients' poor comprehension of medical information. However, little research has been done on the effects of Chinese medical terms, which are constructed rather differently compared to English medical terms. This study manipulated the use of Chinese medical terms in a simulated clinical consultation, to investigate its effects on patients’ comprehension of medical information and their confidence for seeking further information. One hundred and eighty one eligible Hong Kong laypersons were randomly assigned to watch one of three video clips, which differed in the use of words explaining the underlying pathological changes and the treatment of prolapsed intervertebral disc: one with lay terms only (group 1), another with medical terms alone (group 2), and another one with medical terms supplemented with lay terms (group 3). After that, a computer-based questionnaire was used to assess the participants' comprehension of the information and confidence for seeking further information, followed by a semi-structured face-to-face interview on their perceptions of the utility of Chinese medical terms. Results suggested that although Chinese medical terms were perceived to be useful in assisting patients to look for further information on their diseases, the use of Chinese medical terms, either used with or without the supplements of lay terms, did not add to patients' comprehension of medical information and confidence for seeking further information. Regression models showed a significant trend of decreasing comprehension of the cause of the disease (β = -0.241, P = 0.002) and knowledge test scores (β = -0.214, P = 0.006) with increasing age of the participant. However, older persons had better comprehension of the word used (β = 0.238, P = 0.001). Participants' educational level was the most important determinant of knowledge test scores (β = 0.364, P < 0.001). In addition, persons with higher education (β = 0.207, P = 0.024), professional occupation (β = 0.173, P = 0.015) had better comprehension of the cause of disease. The findings of the study have implications for doctor-patient communication as well as medical education. To improve the effectiveness of doctor-patient communication, it may be more rewarding to enhance doctors' overall communication skills, rather than simply advocating their use or not use of medical language.
published_or_final_version
Anatomy
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Master of Philosophy
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Roth, Adam David. "Reciprocal influences between rhetoric and medicine in ancient Greece." Diss., University of Iowa, 2008. http://ir.uiowa.edu/etd/3.

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Dickson, Brett William. "Wireless communication options for a mobile ultrasound system." Worcester, Mass. : Worcester Polytechnic Institute, 2008. http://www.wpi.edu/Pubs/ETD/Available/etd-090208-162440/.

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BARTZ, CLAUDIA CAROL. "NURSE-PATIENT COMMUNICATION DURING CRITICAL ILLNESS EVENTS." Diss., The University of Arizona, 1986. http://hdl.handle.net/10150/183833.

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The purpose of this study was to explore and describe nurse-patient communication during critical illness events. The theoretical structure of the study was drawn from communication, sociolinguistic, and nursing theory. Data were collected in a 374-bed private hospital in the Southwest. The sample consisted of six registered nurses and nine patients experiencing cardiac surgery. Nine observed and audiotaped nurse-patient interactions, and fourteen audiotaped partcipant interviews provided the data base for analysis. Content analysis was used to organize the data. Findings were presented in terms of language, paralanguage, and nonverbal expression, and in terms of content, process, and product of nurse-patient communication. Participants used biomedical-technical language and casual-everyday language during the interactions. Nurses talked about what patients would experience while patients talked about themselves as a way of establishing their credibility within the biomedical setting. Nurses viewed nurse-patient communication as variable depending on the patients' needs and responses. Patients viewed nurse-patient communication as straightforward, not requiring adjustment for the needs of the participants. Products of communication for patients involved increased knowledge, reassurance, and increased confidence. Products of communication for nurses involved relieving the patients' anxieties, considering the patients' remembering, and increasing the nursing staff's knowledge about the patient while helping the patient to know the goals of the nursing staff. The introduction and closure segments of the six nurse-patient interactions for preoperative preparation of the patient were analyzed. Nurses began the introductions by assuming that the patients needed relief from anxiety but the patients demonstrated politeness more than anxiety. Nurses used strategies of questioning, starting the physical assessment, topic persistence, and self-monitoring to control the closure segments. Patients used narratives and humor as control strategies. The study findings suggest conceptual areas relevant to nurse-patient communication which may ground theoretical model development for nurse-patient communication. Nurses in clinical settings can compare their patient communication experiences with the findings of the study in order to increase their understanding of expression, form, and function of nurse-patient communication.
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Danis, Ajau. "Health communication and health literacy : participants perspectives on the PROSTAR Health Promotion Programme." Thesis, Liverpool John Moores University, 2006. http://researchonline.ljmu.ac.uk/5800/.

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Leydon, Geraldine Marie-Claire. "Communication in UK outpatient oncology consultations." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429092.

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Moran, Janette Elizabeth. "Assessing communication strategies in routine aonsultations between health professionals and patients with type I and II diabetes." Thesis, University of Leeds, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275559.

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Clifford, Julie Veronica. "Computers in general practice consultations : impact on doctor-patient relationships /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc637.pdf.

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Wiens, Miriam E. "Family communication and genetics: Developing a framework for effective interventions." Thesis, University of Ottawa (Canada), 2008. http://hdl.handle.net/10393/28037.

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Objective. To create a theory-based framework to guide the development of interventions for assisting genetics health services clients to communicate results of genetic testing to at-risk family members. Methods. Systematic review methods were used to collect evidence on the barriers and facilitators of disclosure. After appraisal of several theories against key criteria, the Theory of Planned Behaviour (TPB) was chosen as the theory to base the framework on. The framework was developed through a qualitative process which incorporated the all the available evidence from the literature. A preliminary examination of the utility of the framework was done through a cross-sectional survey. Results. The framework explains the act of disclosing a genetic test results to at-risk family members in terms of the TPB. Results from the cross-sectional survey, conducted in a population not previously studied, were generally consistent with the information presented in the framework and found in the literature. Conclusions. The framework has potential to be used in developing interventions; however, results need to be replicated in prospective studies with larger samples.
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Rüter, Anders. "Disaster medicine- performance indicators, information support and documentation : a study of an evaluation tool /." Linköping : Linköping University, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7990.

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Kaufman, David R. "Representation and utilization of information during the clinical interview in medicine." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59603.

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This study evaluated the ability of subjects at 3 levels of expertise, expert physicians, residents and medical students, in the acquisition, representation, and utilization of patient information in the context of solving a complex medical problem. Each subject interviewed a volunteer medical outpatient and was subsequently requested to provide a differential diagnosis. The doctor-patient dialogue was analyzed using cognitive methods of discourse analysis. These methods were used to characterize differences in the content and nature of the history-taking process and in the development of problem representations. The study characterized differences at two levels of representation, observations and findings. Observations are the minimal semantic units of the doctor patient discourse. Findings are higher order units that derive meaning in specific medical contexts.
Differences were found between groups of subjects in the accuracy of diagnoses and in the qualitative nature of representations. These differences were manifested most clearly in terms of a series of efficiency measures designed to characterize the ability of subjects to generate findings. In general, the expert physicians were more selective in the elicitation and processing of critical and relevant findings. An attempt is made to characterize these differences in terms of the strategies used to acquire and represent patient information.
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Thompson, Laura. ""So you feel a bit anxious?" : psychiatrist-patient communication and treatment adherence in schizophrenia." Thesis, Queen Mary, University of London, 2013. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8561.

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24 million people worldwide are affected by schizophrenia. Its complex psychopathology, including changes in perception, can incur substantial personal distress and economic burden. Finding appropriate treatment that attracts voluntary adherence is an ongoing challenge for clinicians to prevent relapse and poor prognosis. This thesis conceives the psychiatrist-patient alliance - mediated through talk - as an intervention point that demands analytic attention. Conceptualising ‘good’ communication is however hindered by a lack of a) conceptual clarity on its constituents b) knowledge of what actually happens in psychiatric encounters. Abstract ideals of ‘Patient Centredness’ and ‘Shared Decision Making’ are widely endorsed as beneficial to adherence, but do not pragmatically translate into specific practices, conducive to training. Following a preparatory systematic review, this thesis addresses a gap in literature by observing psychiatric communication in 3 mixed method studies. Synthesising coding methodologies and statistical analyses with principles of conversation analysis, two studies explore the association - and explanatory mechanism - between adherence and specific communication practices: patient other-initiated repair and psychiatrist questions. Treatment decisions, the precursor to adherent behaviour, are also examined: alternative resources that psychiatrists employ and their interactional consequences are mapped, with a focus on patients’ overt resistance. The findings collectively extend knowledge on medical interaction and demonstrate the utility of a novel approach to outcome research in field dominated by cross sectional studies. Clinical, methodological and theoretical contributions are yielded relating to six themes 1) the consequentiality of psychiatrists’ communicative choices 2) the manifestation of alliance and adherence in clinical talk 3) orientations to experiential expertise and the contingencies of antipsychotic medication adherence 4) reconceptualising ‘good’ communication: misalignment as key to clinical success 5) evidence of the interaction order in schizophrenia 6) reconciling the nuances of naturalistic interaction with global clinical outcomes.
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Ding, Huiling. "Rhetoric of a global epidemic intercultural and intracultural professional communication about SARS /." online access from Digital Dissertation Consortium, 2007. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?3291232.

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35

Hess, Rick, Nicholas E. Hagemeier, Reid B. Blackwelder, Daniel Rose, Nasar Ansari, and Tandy Branham. "Teaching Communication Skills to Medical and Pharmacy Students Using a Blended Learning Course." Digital Commons @ East Tennessee State University, 2016. https://doi.org/10.5688/ajpe80464.

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Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts. Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions. Results. Performance in all communication skill domains increased significantly for all students. No additional significant pre/postcourse differences were noted across disciplines. Conclusion. Students’ patient-centered interpersonal communication skills improved across multiple domains using a blended learning educational platform. Interview abilities were embodied similarly between medical and pharmacy students postcourse, suggesting both groups respond well to this form of instruction.
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Chasi, Colin Tinei. "A Kierkegaardian-existentialist critique of pragmatic communication on HIV/AIDS, with respect to selected Ikageng residents / C.T. Chasi." Thesis, Potchefstroom University for Christian Higher Education, 2001. http://hdl.handle.net/10394/2745.

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37

Yavner, Steven David. "Stress, fatigue, and medical students' study resource selection| Implications for the design of educational multimedia." Thesis, New York University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10129593.

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BACKGROUND AND METHOD: Medical students are generally considered to be a unique group of experienced learners, functioning under high levels of stress and fatigue. The use of multimedia in digital environments has become a standard feature in most medical schools, but it has met with limited success. A study was designed to investigate the impact of stress and fatigue on general study resource selection, with particular interest in multimedia, and its limited uptake by medical students. A series of 58 focus groups with 107 third and fourth year medical students at the NYU School of Medicine was conducted in the spring of 2015. A survey instrument was also administered. Quantitative data analysis was conducted in SPSS-23; the qualitative data analysis was conducted through open coding and grounded theory procedures in ATLAS.ti.

FINDINGS: Results produced a model of stress and fatigue for third-year medical students, and showed a statistically significant increase in multimedia usage under fatigue but not under stress alone, and a statistically significant decline in textbook preference under conditions of stress and/or fatigue. Practice questions (i.e., “question banks”) and text-based websites (evidence-based, clinical decision resources related to diagnosis and case management) were the preferred study resources under all conditions. Further analysis of the qualitative data regarding multimedia’s strengths and weaknesses under stress and fatigue produced a series of 12 multimedia design and implementation factors.

DISCUSSION While these findings are based on the specific medical student population, there may be significant implications for the general learner population, which is also confronting increased stress and fatigue. As on-line learners and other populations of learners start to look more like medical students – trying to study when they are tired, stressed, and under severe time pressure – it’s worth considering that many of the suggestions for making multimedia resources more appealing to medical students might also have the same effects with other populations.

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Walker, Taylor M. "Practicing Medicine in Underserved Areas: Differences that Make a Difference in Vocational Anticipatory Socialization." Ohio University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1627574067134105.

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Walker, Taylor M. "Practicing Medicine in Underserved Areas: Differences that Make a Difference in Vocational Anticipatory Socialization." Ohio University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1627574067134105.

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40

Klein, Susan. "The effects of cancer patient participation in teaching communication skills to medical undergraduates a follow-up evaluation /." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 1996. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=59664.

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41

Bohannon, Katie Lynn. "Women in white coats : female physician role enactment in medical clinic interactions /." [Boise, Idaho] : Boise State University, 2009. http://scholarworks.boisestate.edu/td/43/.

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Brookes, Gavin John. "The discursive construction of diabulimia : a corpus linguistic examination of online health communication." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/37621/.

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This study is the first of its kind to examine the discursive construction of diabulimia. Diabulimia is a contested disease characterised by the deliberate restriction of insulin dosage by people with insulin-dependent diabetes in order to control their weight. The analysis takes a mixed methods approach, combining quantitative corpus linguistic techniques with qualitative discourse analytic methods to examine how diabulimia is discursively constructed in three English-speaking diabetes internet fora. By examining the discursive construction of diabulimia in this context, this study explores this emerging health phenomenon from the perspectives of those individuals who, in many cases, have lived, first-hand experience of it. The corpus analysis reveals the discursive construction of diabulimia in this context to be deeply influenced by medicalisation and the neoliberal imperative of autonomous diabetes self-management. Individuals with diabetes who restrict their insulin dosage to control their weight are likely to articulate their experiences and concerns using decidedly medicalising language, construing these experiences as the symptoms of a disease (diabulimia). It is also found that the demands of diabetes self-management figure in and shape individuals’ experiences and understandings of diabulimia in varying and conflicting ways. By providing novel insight into subjective experiences and understandings of diabulimia, the findings reported in this study give voice to those individuals affected by it, findings which also bear important implications for health care practitioners likely to encounter such individuals in the future.
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Brooks, Billy, David Blackley, and Megan Quinn. "Appalachian Environmental Cancer Communication Workshop." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/3193.

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Layton, Cheryl Marie. "Relationship Between Hospital Size, Staff Communication, Physician Communication, and Patient Experience Scores." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7816.

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Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of Healthcare Providers and Systems survey database for the years 2016 and 2017. The results of the multiple linear regression indicated the results were significant, F(5, 144) = 56.822, p <.001, R2 = .652. The findings may provide health care leaders with tools to communicate with staff on how to improve patient experience through improving employee and patient engagement, thereby improving patient experience scores.
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Leaviss, Joanna. "The role of usability, usefulness and frame in persuasive health communication." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/11986/.

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Background: A large proportion of ill-health is preventable (Signorelli 1993). A goal for health promoters is to provide information about health risks with the aim of persuading individuals to modify their behaviour. Previous research suggests that the readability of many health promotion materials is too low for effective comprehension. Evidence suggests that much of the health information available is written at a level that is too difficult for the target populations (e.g. Dollahite et al. 1996, Meade & Byrd 1989, Greenfield et al. 2005). Whilst this work is useful in identifying barriers to accessibility to health information, there has been little research that systematically explores the concept of usability within the context of health information. Objectives: The first objective of the thesis was to examine whether the concepts of usability and usefulness as outlined in the Technology Acceptance Model (Davis 1993) can be applied to the domain of health promotion and used to predict intentions to follow the advice given in health promotion leaflets. Second, the studies sought to make distinctions between subjective and objective usability and to explore the factors underlying subjective ratings of the usability of health information. Further, the thesis sought to demonstrate that both objective and subjective usability would influence the persuasive effect of health promotion materials. Finally, using theory from dual-processing models of persuasion (e.g. Elaboration Likelihood Model. Petty and Cacioppo 1986) it was predicted that when usability of leaflets was high, participants would be more likely to make judgements about their intentions to follow the advice given in the leaflets based on peripheral clues such as frame (Tversky and Kahneman 1981, Rothman and Salovey 1997, Levin et al. 1998). Methodology: 5 empirical studies examined the research questions. The first study consisted of two samples from working populations (n=441), and explored manual handling and use of hearing protection. Participants evaluated existing health and safety leaflets in relations to their usability and usefulness, and rated their intentions to follow the advice in the leaflets. The second study, also conducted on a working population (n=97), used experimentally manipulated leaflets on safe manual handling to test the hypothesis that framing effects would be found when usability of leaflets was high. The third study used a student sample (n=127) to explore factors that influence subjective usability. The study used experimentally manipulated leaflets about safe alcohol consumption to examine whether the concept of subjective usability is a function of reader characteristics (psychological constructs, mood, past exposure to the health problem) and leaflet characteristics (frame, objective reading ease). The fourth study used a student sample (n=238) to test the effect of objective reading ease on recall, in order to test for differences in processing of two experimentally manipulated leaflets about safe alcohol consumption. It was predicted that easy leaflets would be processed at a more shallow level than difficult leaflets. The fifth study, also conducted on a student sample using experimentally manipulated safe alcohol leaflets (n= 135), used pre and post testing to further explore the effects of usability on framing effects, and to test for a moderating role of prior knowledge on the effect of usability on intentions. Results: The studies showed that readers distinguish two separate components to health information leaflets: usability and usefulness. Subjective perceptions of usability and perceived usefulness predicted intentions to follow the advice given in the leaflets. Objective usability (reading ease) influenced the persuasive effect of the leaflets, with easy leaflets being more persuasive than difficult leaflets. Perceived usefulness partially mediated the relationship between subjective usability and intentions. Objective reading ease affected recall, with easy leaflets resulting in higher levels of both accurate and false recall of the information in the leaflets. Prior knowledge moderated the relationship between usability and intentions. Those with low prior knowledge were more persuaded when usability was high. Usability influenced the effect of frame on intentions. Framing effects were only found where usability was high. Where framing effects were found, negative frame was more persuasive than positive frame, offering support for Levin et al.'s (1998) typology of framing effects. Conclusions: Results from the studies show that the concepts of usability and usefulness, formalised in models of technology acceptance (TAM), can be applied to health information and used to predict intentions to follow health promotion recommendations. A distinction can be made between subjective and objective usability, and both of these can influence persuasion. Using theory from dual-processing models of persuasion, usability of health information leaflets can influence the effect of frame on intentions to follow the health promotion advice.
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Singh, Yesheen. "Communication and collaboration: an exploration of clinical governance Interventions in the Western Cape Department of Health over the past twenty years." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32979.

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Background: The tension between the increasing cost of healthcare provision and the need to provide a quality level of care to a rising number of people is a global phenomenon. A focus on one over the other could result in a rise in adverse patient outcomes, or a health system too costly to be sustainable. Clinical governance is an approach policymakers can use to walk the middle line of creating a healthcare service that meets quality of care standards in a cost-effective manner, as has been done in Australia, Burundi, Egypt, Spain, UK and Yemen (Goyet et al, 2019; Abd El Fatah et al, 2019, Mannion et al, 2015; Aguilar Martin et al, 2019). This study examines the practice of clinical governance in one LMIC setting that has been able to successfully do this balancing walk for 20 years. Understanding how this was done in the Western Cape province of South Africa helps inform how clinical governance can be used to continue adding value as the health system moves towards universal healthcare. In addition, this South African experience adds to the still small pool of relevant experience from low- and middle-income countries reported in the international literature. Methods: A mixed methods qualitative design was used for data collection and involved three phases: (1) a document review of all policies in the province to identify clinical governance structures; (2) observation of these structures in action, comparing lived to written experience of clinical governance; and (3) interviews with key stakeholders in the province to get their perspectives on past, present and future forms of clinical governance. The Donabedian model was used to frame analysis into three dimensions of care, viz. structure, process and outcome. Results: Beyond a comprehensive policy framework, collaborative structures and consultative leadership styles facilitated strengthened clinical governance in the Western Cape. For example, although corporate-governance-inspired structures, such as clinical audits and M&E events, may become punitive and corrosive, the potential negative impact on clinical governance outcomes and organisational culture was tempered by healthy communication and supportive relationships between colleagues. Family physicians have become the champions of clinical governance in a decentralized health system and when supported in this by policy and management, the quality of care in health systems thrive. Conclusions Clinical governance is an effective strategy or tool LMICs can use to ensure quality of care is maintained or improved upon, even in resource-challenged settings. But while some structures, processes and outcomes may be borrowed from other LMIC or HIC settings, these need to be contextualized to local conditions. Appropriate clinical governance champions need to be identified and given the appropriate mandate. Human relationships are key to the successful implementation of interventions of this nature and space needs to be created in policy for this to be cultivated.
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Richert, Adam. "Developing a Portable System for Medicine Dosage." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-235738.

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The project presented in this report is set out to develop a portable electronic system to be used as a medicine pill container. With the functionality to configure up to twelve daily repeated alarms, the purpose of the medicine dosage system is first and foremost to remind the user when they should take their medicine. Secondly, LED lights and user-recorded voice notifications are to be implemented to further aid the user in taking the right medicine each time. The device is also to have a memory log, recording up to one hundred missed dosages, enabling an authorized medicine professional to verify the medicine adherence of the user.Prior to the start of the project, an outline for the functionality and physical appearance of the device was set by the project owner, Victrix AB. This project covers the hardware and software development, as well as the design choices within. The aim is to follow the proposed functionality specification as close as possible, while making justified hardware and software choices considering simplicity, efficiency, power consumption, and availability. By following the specification, the goal is ultimately to increase the medicine adherence for users of the device developed with this thesis.Using qualitative research methods, a valid background study was created, preceding the development of the medicine dosage system. Hardware for a first prototype of the device was then chosen based on the gathered information about existing technologies and related work. With thorough testing and recurrent information exchange with the client, a prototype of the medicine dosage system, based on an Arduino microcontroller, was constructed. The prototype was evaluated to fulfill 92% of the requirements considered as high priority by Victrix.
Projektet som presenteras i denna rapport är tänkt att utveckla ett portabelt elektroniskt system för användning som en medicinsk pillerbehållare. Med funktionaliteten att konfigurera upp till tolv dagligen upprepande alarm är syftet med medicindoseringssystemet först och främst att påminna användaren när de ska ta sin medicin. Lysdioder och användarens egna inspelade röst som notifikationer ska implementeras för att vidare hjälpa användaren att ta rätt medicin vid varje tillfälle. Enheten ska också ha en minneslogg som sparar upp till etthundra missade doseringar, vilket gör det möjligt för auktoriserad sjukvårdspersonal att verifiera användarens följsamhet till medicineringen.En översiktlig beskrivning av funktionaliteten samt det fysiska utseendet av enheten skrevs av projektägaren Victrix AB innan projektet startades. Det som detta projekt täcker är hårdvaruoch mjukvaruutvecklingen, så väl som där tillhörande designval. Projektet siktar på att följa den föreslagna funktionalitetsspecifikationen så nära som möjligt, och samtidigt göra välgrundade val för hårdoch mjukvara med enkelhet, effektivitet, energiförbrukning och tillgänglighet i åtanke. Genom att följa specifikationen är det slutliga målet att frambringa ökad medicinföljsamhet för användare av den med det här projektet utvecklade enheten.Utvecklingen av medicindoseringssystemet föregicks av en befogad bakgrundsstudie utformad genom användningen av kvalitativa forskningsmetoder. Hårdvara att användas för en första prototyp av enheten valdes sedan baserat på den insamlade informationen om existerande teknologier och relaterat arbete. Genom grundliga tester och regelbundet informationsutbyte med kunden konstruerades en prototyp av medicindoseringssystemet baserat på en Arduinomikrokontroller. Prototypen utvärderades att uppfylla 92% av kraven som Victrix ansåg vara av hög prioritet.
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Wainer, Rafael. "When medicine cannot cure : dying children, palliative care, and the production of companionship." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/1597.

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Although the curative model of medical care is predominant it is necessary to consider the palliative strategies at the end-of-life. The inter-relation of dying children, their families and pediatric palliative care teams are seldom analyzed outside Palliative Care. However, it is important to ethnographically think about the disturbing experiences of body and subject disintegration while people are directly experiencing them, even when the person is a child or a newborn baby. A central topic in this study is how personhood, body formation and disintegration, and childhood can be understood within the context of unevenly constructed and shared palliative communication with and without words. Hence, I analyze in this study how a Palliative Care Team in the city of Buenos Aires provides care, communicates, and ultimately produces a particular companionship to dying children and their families. This work is built on qualitative information gathered and produced during my four-month fieldwork with the Palliative Care Team. The ethnographic techniques (participant observation, non-participant observation and open-ended semi-structured interviews) I conducted show that their strategies of care and communication have as the main goal the process of companionship at the end of children’s lives. It is necessary to understand how patients, parents, and other family members are situated in this field of tensions between restorative and palliative medicine, and brought into this culture of Palliative Care in a public children’s hospital. My research asks, in what ways are pediatric Palliative Care practices exclusive to the social and cultural contexts of Buenos Aires? This work has three main sections: 1. care, 2. communication, and 3. companionship. In section one I focus on the clinical and non-clinical aspects of care involving the professionals’ and volunteers’ practices of giving care. In section two I concentrate my attention on the verbal and non-verbal aspects of the Palliative Care Team communication with children and families. In section three I consider the professional production of ‘companionship’. In this thesis I will demonstrate the significance of this concept according to the Palliative Care Team members and how care and communication are the base for the ‘production of companionship.’
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Holland, Emma-Joy. "The feasibility of delivering motivational interviewing to those with communication difficulties following a stroke." Thesis, University of Central Lancashire, 2015. http://clok.uclan.ac.uk/12084/.

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Mood problems are common in stroke survivors, as are communication difficulties, which are experienced in around a third of patients. Patients with communication difficulties have a greater risk of depression. Despite this they are often excluded from trials that either treat or prevent depression using talking-therapies, such as Motivational Interviewing (MI). Through a series of studies this thesis aims to explore the feasibility of widening access to MI for patients with moderate to severe communication difficulties. In the first study, a secondary analysis of data from an earlier MI trial with stroke patients explored the communication characteristics of participants. Patients receiving MI were shown to benefit in mood compared to those receiving usual care, and this was more prominent in those with communication difficulties. The analysis found that no individual component of communication could account for changes in mood outcome. This highlighted the need for suitable tools to assess communication and mood in patients with communication difficulties post-stroke. Through a series of integrative reviews, tools suitable for the screening and assessment of communication and mood in patients with communication difficulties were explored. A number of tools were available, however few had been adequately validated in this patient group. Of the tools considered in the review, a small number were identified as suitable. Using the tools identified, a feasibility study explored delivering MI to patients with communication difficulties after stroke. The study found that with the implementation of aids and adaptations for communication difficulties, it is possible to deliver MI to patients with moderate to severe communication problems. The final study explored the implementation of the intervention from the perspective of staff involved in the trial. Firstly, views of screening and recruitment were explored through interviews and analysis of the trial screening log. Further interviews were held with MI therapists before and after the trial. Perceived barriers to their roles within the study included holding dual roles, and facilitators included feedback from supervisors. This thesis has contributed to knowledge, showing that through the use of aids and adaptations for communication difficulties, it is feasible to widen access to MI for patients with moderate to severe communication problems. The thesis has further added to knowledge through exploring staff views of implementing the intervention.
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Davis, Sarah Harmon. "Does Family Communication Matter? Exploring Knowledge of Breast Cancer Genetics in Cancer Families." BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7246.

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Purpose: Knowledge of breast cancer genetics is critical for those at increased risk whomust make decisions about breast cancer screening options. The purpose of this study was toexplore cognitive and emotional variables that might influence knowledge of breast cancergenetics.Methods: This descriptive, exploratory study analyzed theory-based relationships amongvariables related to knowledge of breast cancer genetics in cancer families. Participants includedfirst-degree relatives of women with breast cancer who had received genetic counseling andtesting; participants themselves did not have breast cancer and had not received geneticcounseling or testing. Data were collected by telephone interview and survey. Variables analyzedinclude numeracy, health literacy, cancer-related distress, age, education, and the reportedamount of information shared by the participants<'> family members about genetic counseling.Results: The multiple regression model explained 13.9% of variance in knowledge of breastcancer genetics (p = 0.03). Best fit of the multiple regression model included all variables excepteducation. Reported amount of information shared was the only independently significantpredictor variable (p = 0.01).Conclusion: Participants who reported higher levels of information shared by a familymember about genetic counseling also demonstrated increased knowledge about breast cancergenetics.
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