EmoBridge: Bridging the Communication Gap between Students with Disabilities and Peer Note-Takers Utilizing Emojis and Real-Time Sharing

Rik Donckels is the director of the SME Research Institute, UFSAL University College, Brussels, Belgium. Jan Degadt is a senior researcher at the same institute. In the first part of the paper, some theoretical considerations are given. Public authorities are considered as being a multi-dimensional component of the external environment. The distance problem between SMEs on the one hand and public authorities on the other hand is described, and attention is paid to the existing communication lines and information flows. The second part of the paper is based on empirical research for Belgium, the results of which are compared to findings for other countries. The bottom-up communication line from SMEs to public authorities comes first. Afterwards the top-down communication line is studied. In the last section of the paper some conclusions can be found. The most important conclusions are: -SMEs and PAs should make special efforts to shorten the distance between them and to bridge the communication and information gap. -There is a need for a standardised "Bank of SME-knowledge" on an international scale. -The administration burden involved by information gathering by PAa is considered to be annoying and a rather unproductive type of work. SME-people ask for a feedback relevant to them and useful for their particular business. -The information-awareness of SME-managers should be increased. There is no systematic search for information and the attitude towards information varies as a function of the individual characteristics of the entrepreneur, the content of the information and the dimension of the firm. -Bridging the communication and information gap is also a matter of how to procure information and how to ask for data. The diffusion of modern communication techniques will go on. One has to take advantage from this evolution in order to increase effectivity and efficiency as well. There is a need for a fundamental change, which is to be based on personal motivation, insight, education and training.

We know what we need: Exploring the communicative and structural gaps in support for caregivers of adults with sickle cell disease (CASPS)

Pediatric patients with life-limiting diagnoses frequently seek care in the pediatric emergency department (PED) during times of acute illness, or at end-of-life (EOL) . Although the population of patients with life-limiting diagnoses is heterogenous, clinician expertise in EOL communication is essential to providing family-centered care. In this study, we explored PED physician and nurse experiences with communication when eliciting EOL values, including factors specified to the PED environment, clinician perceptions of family supports and preferences, and clinicians' self-reflection of their skills and challenges in this sphere. We performed a prospective qualitative study using semistructured interviews of PED physicians and nurses recruited from a quaternary care center. Thematic content analysis was performed on the transcribed interviews to identify codes and, ultimately, themes. We interviewed 17 emergency department clinicians, including 10 physicians and 7 nurses. Thematic content analysis revealed 6 salient themes. The first theme related to contextual factors of the emergency department environment. Two additional themes related to patient and family characteristics, including unique patient and family factors and clinician interpretation of parental/family needs. Lastly, we found 3 clinician-focused themes including knowledge gaps in EOL communication, communication styles and priorities in EOL conversations with families, and coping with ethical challenges. PED clinicians report communication-related challenges to providing optimal care for families and patients with life-limiting diagnoses. Participants self-identified gaps in communication skills in this area. Future studies should focus on clinician educational interventions on the basis of this needs assessment and include family perspectives to develop best practice.

A safety data sheet (SDS) is an established hazard communication tool for chemicals, for which no comparable document exists in the biotherapeutics industry. As the cell and gene therapy (CGT) field expands, industry leaders have identified a growing need to address this gap in communication of the unique occupational health and safety risks posed by CGT materials and products. Following the sections of a traditional chemical SDS, information was modified by industry subject matter experts, relevant to CGT biological materials. This guide was developed based on assumptions of a maximum biosafety level 2, and any chemical components present in the material were excluded from the hazard classification. The guide contains necessary information to conduct a workplace risk assessment and communicate the unique workplace hazards posed by potential exposures to the material. The target audience is intended to be entities handling and producing these materials, plus collaborators, contractors, or operations sites receiving and handling the CGT material. An example of a CGT SDS is provided in Table 1. The CGT SDS provides industry with a best practice to address an existing gap in hazard communication for CGT. We expect that, as the field evolves, so may the contents. The CGT SDS can be used as a reference for other biological modalities in the field. This initial CGT SDS communicates workplace hazards and assesses the unique risks posed by these biological materials and can assist in creating exposure control plans specific to the workplace hazards.

In April 2020, the New York State Department of Health issued guidelines regarding suspension of hospital visitation due to coronavirus disease 2019 to protect staff and patients and prevent spread of the virus. Recognizing that patients would need extraordinary emotional support as they faced this frightening journey, two hospitals from a health system in the national epicenter provided avenues to bridge gaps in connectedness and communication. Our program provided virtual, visual and emotional connectivity by utilizing repurposed staff to serve as patient experience ambassadors. This program reduced the burden on clinical staff while preventing furlough. A descriptive correlational study was conducted that measured satisfaction of the program and connection provided. Subjects recruited for the study included patients and family members who used virtual platforms. Variables were measured using a Likert – type scale ranging from excellent to poor. Relationships between the variables were examined. This study revealed that participants were satisfied that the program improved connectedness; provided an adequate alternative to limited hospital visitation; provided emotional support and peace and closure in end-of-life situations. Respondents were satisfied with the patient experience ambassadors and would recommend the program. The overall rating was "good" (Mean = 3.267 SD 0.1039 Range 3.12 – 3.37) indicating a moderate to high degree of satisfaction. There were statistically significant differences in responses for connectedness, adequate alternative and rating in end-of-life visits versus others. There were no significant differences by hospital. The virtual communication platforms were successful in providing emotional support and bridging the gap in communication between patients and their loved ones.

Homogeneous waiting group (HWG) criteria are central to the patient referral process, guiding primary care physicians and hospitalists in directing patient care to specialists. This cross-sectional observational study, conducted in South Tyrol, Italy, in 2023, aimed to assess the implementation and impact of HWG criteria on healthcare from the perspective of general practitioners and hospital physicians. A questionnaire was developed to gain knowledge about referral practices as perceived by general practitioners and specialists. The survey included 313 participants (82 general practitioners and 231 hospital physicians) and was designed to capture a range of factors influencing the application of HWG criteria, including communication and collaboration practices. The results showed moderate levels of familiarity with HWG criteria and opinions about the need for criteria refinement among hospitalists, indicating that further education and refinement of these criteria are warranted. Both general practitioners and hospital physicians expressed dissatisfaction with the current specialist referral system, highlighting the significant gaps in effective communication and collaboration. The survey also demonstrated the influence of patient demands and waiting times on referral practices, and the need for streamlined and accessible specialist care. This study highlights the need for improvement and adaptation of HWG criteria to better meet the needs of healthcare providers and patients in South Tyrol. By addressing the identified gaps in communication, collaboration, and education related to the HWG system, the efficiency, effectiveness, and patient-centeredness of the referral process can be improved, ultimately leading to better health outcomes.

e21015 Background: Nonmelanoma skin cancer (NMSC), comprised mainly of cutaneous squamous cell (CSCC) and basal cell (BCC) carcinomas, represent the most common malignancies worldwide. Despite generally favorable outcomes, patients often face barriers that impact care. Effective management relies on a multidisciplinary team (MDT) to provide effective comprehensive care, yet many patients lack awareness of MDT roles and available support, leading to gaps in communication and optimal care. The objective of this analysis was to explore the perspectives of patients living with NMSC, focusing on treatment experiences, barriers to care, and satisfaction with the MDT. Methods: A custom, online patient/caregiver 19-question survey accessed by WebMD users was designed to gather perspectives on NMSC care. Questions addressed demographic qualities, therapies employed, treatment satisfaction, experiences in accessing and transitioning care, barriers, and communication/collaboration with the MDT. Results were streamlined to analyze those that specifically indicated they have been diagnosed and are living with NMSC. The survey was launched June 2024; data were collected until July 2024. Results: The analysis included 50 participants diagnosed and living with NMSC. Of those, 36% lived in the Midwest, 64% were aged 66 years and older, 56% were first diagnosed with NMSC on the head and neck region, and 52% were currently undergoing treatment. Reported treatments given included surgery (77%), immunotherapy (6%), and clinical trial enrolment (2%). Dermatologists were most associated with performing surgery, while oncologists were associated with chemotherapy and radiation treatment. The top three barriers encountered in receiving surgical care were limited access to the MDT, being diagnosed too late, and difficulty navigating the healthcare system. The top three barriers encountered in receiving immunotherapy were issues with treatment adherence as well as access to and poor communication with the MDT. The largest areas for improvement identified were awareness of support groups, prioritization of mental/emotional well-being, and exploring options related to treatment costs and resources. Notably, 16% of participants indicated that the MDT did nothing to their satisfaction during their care. Conclusions: The findings highlight key insights into the experiences of patients living with NMSC. Treatment characteristics and MDT roles present as ongoing educational opportunities for patients to help ensure optimal and comprehensive care. More pressing, the high level of dissatisfaction underscores a critical gap in patient-provider communication and depicts a critical need for MDTs to prioritize patient-centered support. Future efforts should focus on expanding patients’ knowledge of treatment characteristics and ensuring that they are equipped to engage effectively with their MDT.

e18589 Background: About 20,000 people are diagnosed with Myeloproliferative Neoplasms (MPNs) in the US each year, and almost 300,000 have the disease. Age, race, and gender can affect clinical outcomes. Although this condition is rare, the diverse patient population shows the need for a culturally sensitive approach to address gaps in communication regarding MPN care and the unique challenges that physicians face. The Empowering Providers to Empower Patients (EPEP) MPN initiative, developed by the Patient Empowerment Network, aims to improve physician-patient communication, shared decision-making, and the role of patients, care partners, and providers in that process. We evaluated engagement with the initiative to understand its impact. Methods: In 2024, the initiative produced two roundtables and six short videos, primarily with physicians of color. The roundtables were: “Advancing Practice and Enhancing Myeloproliferative Neoplasm Care,” and “Breaking Through Myelofibrosis Practice Barriers.” In the latter, Dr. Raajit K. Rampal emphasized “open lines of communication. I think that from the perspective of [health care professionals] in the community, we want to know that [patients] have questions. We want to make ourselves available to answer those questions. And then I think from the specialist side of things, we have to make ourselves available to address these questions and make ourselves accessible.” After each roundtable, viewers (n=26) completed a mixed methods questionnaire. Quantitative ratings assessed their satisfaction and confidence to facilitate shared decision-making and qualitative questions elicited whether they found relevant resources to share with patients and other topics they wanted to see. Results: Almost all viewers were highly satisfied with the roundtables and rated them extremely positively. The majority strongly agreed that the program gave them the confidence to better facilitate shared decision-making with their patients. Overall, respondents appreciated the resources, found them informative, and valued their role in enhancing the provider’s ability to deliver quality, patient-centric care. Almost all said they found relevant tools to share with their patients, including knowledge of the appropriate language, an emphasis on cultural humility in healthcare, and patient advocacy groups. Suggested future topics included education on symptoms & side effects, the role of care partners in patient interactions, and understanding of treatment goals vs QOL goals. The initiative has been viewed 12,035 times. Conclusions: The initiative is a powerful resource that could enhance physician-patient communication through targeted strategies that equip providers with cultural competency tools. EPEP is a unique contribution to MPN care education and a model for future programs to address gaps in cancer communication for rare diseases.

Objective: The aim was to explore the existence of health care leadership gaps in communication, which occurred during the COVID-19 pandemic, by utilizing a qualitative research approach. Materials and Methods: Participants were recruited from a single professional organization. The volunteer leadership group was the frame for recruiting study participation. This work was conducted with a flexible research design method. A demographic survey, interview guide, and data triangulation survey were used to collect data from 21 participants over a four-week period. The participant responses were then analyzed through a process of coding and thematic analysis. Results: Five themes were generated from this cohort’s data, which alluded to gaps in leadership communication. These gaps occurred in the leader/employee relationship, at their respective institutions. Triangulation of the data from surveys underscored the presence of these communication gaps. Conclusion: The findings of this study may suggest the importance of a set of communication competencies for those in health care leadership, regardless of the complexities of a pandemic.

From the stage of early childhood, throughout their lives, individuals need to understand that they cannot live their lives in seclusion and loneliness. Hence, it is of utmost significance for them to form an effective social circle, comprising family and community members. Apart from family, there are other individuals with whom one needs to communicate. For this purpose, individuals must implement effective communication processes. They need to treat each other with respect and courtesy, and provide factual information. Furthermore, there are certain instances that individuals experience, which can overwhelm them due to a communication gap. They either lack positive feelings or experience unpleasant situations with others. Hence, individuals must implement ways that facilitate promoting a typical mindset. In some cases, individuals do not feel comfortable communicating with others, and as a result, they become overwhelmed by the communication gap. However, when a communication gap arises in the personal and professional lives of individuals, they are unable to reinforce their connections with others effectively. When one has to deal with and work with others in professional settings, they need to emphasise overcoming the communication gap. In other words, it should prevent creating impediments during the implementation of tasks and activities. Therefore, it is well-understood that a communication gap impedes the formation of an effective social circle. The primary concepts examined in this research paper are understanding the meaning and significance of the communication gap, measures to be implemented for overcoming it, and the disadvantages associated with the communication gap.

BackgroundFragmentation of care (that is, the use of multiple ambulatory providers without a dominant provider) may increase the risk of gaps in communication among providers. However, it is unclear whether people with fragmented care (as measured in claims) perceive more gaps in communication among their providers. It is also unclear whether people who perceive gaps in communication experience them as clinically significant (that is, whether they experience adverse events that they attribute to poor coordination).MethodsWe conducted a longitudinal study using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including a survey on perceptions of healthcare (2017–2018) and linked fee-for-service Medicare claims (for the 12 months prior to the survey) (N = 4,296). We estimated correlation coefficients to determine associations between claims-based and self-reported numbers of ambulatory visits and ambulatory providers. We then used logistic regression to determine associations between claims-based fragmentation (measured with the reversed Bice-Boxerman Index [rBBI]) and self-reported gaps in care coordination and, separately, between claims-based fragmentation and self-reported adverse events that the respondent attributed to poor coordination.ResultsThe correlation coefficient between claims-based and self-report was 0.37 for the number of visits and 0.38 for the number of providers (p < 0.0001 for each). Individuals with high fragmentation by claims (rBBI ≥ 0.85) had a 23% increased adjusted odds of reporting any gap in care coordination (95% CI 3%, 48%) and, separately, a 61% increased adjusted odds of reporting an adverse event that they attributed to poor coordination (95% CI 11%, 134%).ConclusionsMedicare beneficiaries with claims-based fragmentation also report gaps in communication among their providers. Moreover, these gaps appear to be clinically significant, with beneficiaries reporting adverse events that they attribute to poor coordination.

BackgroundStudies have reported large scale overprescribing of antibiotics for urinary tract infection (UTI) in hospitalised older adults. Older adults often have asymptomatic bacteriuria, and clinicians have been found to diagnose UTIs inappropriately based on vague symptoms and positive urinalysis and microbiology. However, the joined perspectives of different staff groups and older adult patients on UTI diagnosis have not been investigated.MethodsThematic analysis of qualitative interviews with healthcare staff (n = 27) and older adult patients (n = 14) in two UK hospitals.ResultsInterviews featured a recurrent theme of discrepant understandings and gaps in communication or translation between different social groups in three key forms: First, between clinicians and older adult patients about symptom recognition. Second, between nurses and doctors about the use and reliability of point-of-care urinary dipsticks. Third, between nurses, patients, microbiologists and doctors about collection of urine specimens, contamination of the specimens and interpretation of mixed growth laboratory results. The three gaps in communication could all foster inappropriate diagnosis and antibiotic prescribing.ConclusionInterventions to improve diagnosis and prescribing for UTIs in older adults typically focus on educating clinicians. Drawing on the sociological concept of translation and interviews with staff and patients our findings suggest that inappropriate diagnosis and antibiotic prescribing in hospitals can be fuelled by gaps in communication or translation between different staff groups and older adult patients, using different languages and technologies or interpreting them differently. We suggest that interventions in this area may be improved by also addressing discrepant understandings and communication about symptoms, urinary dipsticks and the process of urinalysis.

The paper deals with the analysis of the environmental agenda setting in local mass media, social media and emerging communication gaps. The theoretical and methodological basis for the study of environmental communication gaps is the theory of agenda setting and the factor model of mass communication by G. Maletzke, who takes into account the "pressure" of the mediator and various social and psychological characteristics of the subjects. The aim of the study is to analyze communication gaps in environmental agenda in mass media and social media in the Chelyabinsk and Sverdlovsk regions. The study applies a set of methods, namely comparative analysis, document analysis with the elements of content analysis, and a survey. Communication gap is understood as a state of ineffective communication, accompanied by interference and barriers, misinterpretations, and one-way communication. The study is based on 4701 environmental media texts from 16 mass media sources and 7 VK social communities in Chelyabinsk and Sverdlovsk regions for the period 2019-2023. The respondents are 305 people aged between 18 and 30 as the most active users of modern information technologies who receive information online and represent the largest group of the population consuming information from digital media. The analysis of environmental media coverage reveals the following gaps: thematic gaps that manifest in the thematic asymmetry of the information narrative; psycholinguistic as a predominance of negative headlines; political and organizational gaps expressing the uneven representation of the interests of environmental communication participants in the information agenda; reputation gaps as a lack of trust in information sources among the population; and behavioral gaps as a low involvement in solving environmental problems. The presence of communication gaps leads to insufficient interaction between participants in the communication process in solving environmental problems and its low efficiency.

In the context of ongoing anthropogenic climate change, the building sector bears a significant responsibility to curtail greenhouse gas emissions. To quantify and reduce their environmental impact, building industry professionals are rapidly adopting life cycle assessment (LCA) tools. However, before LCA is adopted in practice as a routine part of the design process, three gaps must be addressed – the knowledge gap of understanding upstream emissions from other economic sectors, the communication gap of effectively conveying LCA study results, and the method gap of matching LCA tools to design team needs. This paper presents a meta-analysis of forty-nine recent LCA studies completed by the Miller Hull Partnership in pursuit of carbon-sequestering design, and describes lessons learned in traversing the knowledge, communication, and method gaps in order to embed LCA in the design process. Our experience demonstrates three possible strategies – the knowledge gap can be closed when practitioners engage with professionals in adjacent sectors in interdisciplinary research; the communication gap can be closed when design teams leverage replicable data collection and visualization tools; and the method gap can be addressed by deliberately framing LCA studies as iterative hotspot analyses rather than retroactive, static performance studies.

BackgroundDigitally delivering healthcare services is very attractive for tuberculosis (TB) management as this disease has a complex diagnosis and lengthy management and involves multiple medical and nonmedical specialists. Especially in low- and middle-income countries, eHealth could potentially offer cost-effective solutions to bridge financial, social, time, and distance challenges.ObjectiveThe goal of the research is to understand what would make eHealth globally applicable and gain insight into different TB situations, opportunities, and challenges.MethodsWe performed focus group interviews with TB experts and patients from 6 different countries on 4 different continents. The focus group interviews followed the theory of planned behavior framework to offer structured recommendations for a versatile eHealth solution. The focus group interviews were preceded by a general demographic and technology use questionnaire. Questionnaire results were analyzed using basic statistics in Excel (Microsoft Corporation). Focus group interview data were analyzed using ATLAS.ti 8 (ATLAS.ti Scientific Software Development GmbH) by assigning codes to quotations and grouping codes into the 5 domains within the framework.ResultsA total of 29 patients and 32 medical staff members were included in our study. All medical staff had used the internet, whereas 31% (9/61) of patients had never been online. The codes with the most quotations were information in relation to eHealth (144 quotations) and communication (67 quotations). The consensus among all participants from all countries is that there are important communication and information gaps that could be bridged by an eHealth app. Participants from different countries also highlighted different challenges, such as a majority of asylum-seeker patients or lack of infrastructure that could be addressed with an eHealth app.ConclusionsWithin the 6 countries interviewed, there is high enthusiasm toward eHealth in TB. A potential app could first target information and communication gaps in TB, with additional modules aimed at setting-specific challenges.