Communication Statements Research Articles

Perspectives on technology: urethral slings in a post-mesh world.

To detail the history of synthetic mid-urethral slings (SMUSs) and fascial slings, their efficacy, associated complications, and changes to practice that have occurred after the issuing of the 2011 US Food and Drug Administration (FDA) Safety Communication statement on transvaginal mesh (TVM), and to highlight the need for surgical registries and high-quality randomised controlled data to guide recommendations for continence procedures, in view of current concerns regarding mesh. A literature search was conducted in EMBASE, PubMed, and the Cochrane Database of systematic reviews to identify articles published from 2011 onward, following the FDA Safety Communication regarding TVM. Prior to the formal FDA Safety Communication in 2011, TVM was considered a safe option for the treatment of both pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The 2011 FDA safety communications and ensuing widely publicised litigation against TVM manufacturers have shifted both surgeon and patient acceptance of mesh products. Several efforts by medical and government bodies have been made to establish ways to monitor the surgical outcomes and safety of mesh products. The Australasian Pelvic Floor Procedure Registry is one such example. Although SMUSs have a long and established safety profile, perceptions of mesh products for SUI have also been negatively affected. The extent of this, however, has yet to be adequately measured through qualitative and quantitative data. The available data suggest it has been difficult for patients and consumers to distinguish between TVM morbidity for POP vs SUI. Furthermore, there remains a lack of high-quality randomised or real-world registry data to definitively exclude the SMUS from the SUI treatment algorithm. Since SMUSs are a viable option for SUI treatment, the concept of a 'post-mesh world' remains contentious. Controversies surrounding SMUSs have changed the treatment landscape of SUI. Against the background of significant litigious action following the FDA warnings against mesh use, there has been significant reduction in the uptake of synthetic mesh products. Although there are ample data related to surgical outcomes and safety for both autologous fascial and retropubic SMUSs in carefully selected patients, informed consent and surgical training will be of paramount importance as newer synthetic materials reach clinical maturity.

Organizational communication strategies in response to major disruptions: the case of the worsening situation in the Russia-Ukraine conflict

PurposeThe purpose of this paper is to understand communication strategies formed by multinational subsidiaries in a transition economy during disruptive events. The authors develop and test a framework based on political realism and situational crisis communication theory (SCCT).Design/methodology/approachThe authors collect and analyze communication statements from multinational subsidiaries located in Russia and made in the first two months (March–April, 2022) of the Russia–Ukraine conflict.FindingsThis study’s main findings are twofold. First, this study extends SCCT by showing that multinational subsidiaries use communication strategies that go beyond the traditional categories of diminish, rebuild and bolster. In particular, this study identifies so-called “shut the door” and “burning bridges” methods as possible industrial and home country contingent communication strategies. Second, this study shows that possession of a political realism lens provides us with powerful communication strategies made requisite during disruptive events.Practical implicationsThe results provide practical hands-on advice for subsidiary managers on how to communicate effectively and efficiently during disruptive events such as the one described. This study offers novel communication strategies that help to understand the wider implications for managers in both home and host countries.Originality/valueTo the best of the authors’ knowledge, this is one of the first papers to apply SCCT and political realism to a current disruptive event for multinational enterprises, i.e. the ongoing Russia–Ukraine conflict. In that context, this study expands both perspectives by highlighting their complementarities and their conceptual boundaries. The authors can base those insights on two unique and purpose-built databases of multinational subsidiary characteristics in Russia-proper.

Cognitive Hybrid Intelligent Diagnostic System: Typical Architecture

The research refers to the modeling of the meaningful and relatively stable visual-figurative and verbal-sign representation of real problems in medical diagnostics of the human organs and systems. The core results of the research are presented. Here, a new visual metalanguage is proposed. It describes the solution of a diagnostic problem by combining several interconnected processes of reasoning in different languages defining “a state of human organs and systems”, “a diagnostic problem” and elements of its decomposition. In the paper, a subject-figurative model of the cognitive hybrid intelligent diagnostic system, its typical architecture, and a synthesis algorithm are provided. Due to the integration of imitation of an internal subject-figurative vision of medical diagnostic problems and the corresponding communication statements of private diagnoses with imitation of the behavior inherent for councils in problem situations, the future implementation of such system prototypes will reduce the number of medical errors. The further stage of this research is the approbation of all solutions for the problem of diagnosing diseases of the pancreas on the materials of the Kaliningrad Regional Clinical Hospital and experimental study of the system. The research is limited by the subject area of medicine but can be generalized to the other areas.

Path similarity-based scheduling sequence sorting for multi-path coverage of parallel programs

Testing is an important way of improving the reliability of a software product. Uncertain communication statements in the message-passing parallel program can lead to uncertainty in the order of the execution of processes, which increases the difficulty of testing. Taking into consideration the influence of an uncertain process-execution order on the difficulty of covering target paths, in this paper, we focus on a method for sorting scheduling sequences in a message-passing parallel program to enable multi-path coverage and improve the efficiency of generating test data for multi-path coverage. To fulfill this task, we first execute a parallel program on each sample in each scheduling sequence to generate a path coverage matrix. Then, we produce a number of path similarity matrixes based on the similarity of each path in the coverage matrix and for each target. Next, we evaluate each scheduling sequence with respect to the characteristics of the similarity matrixes, based on which we sort the scheduling sequences. Finally, we generate test data for multi-path coverage by performing a random sampling of the sorted scheduling sequence set, which are evaluated using the APFD index. We applied the proposed method to nine benchmark parallel programs, and compared the performances of the random and traditional methods. The experimental results indicate that the proposed method has no effect on path coverage, but significantly reduces the number of program executions during the test and running time.

High school project “I am Ecomanifest” in the system of digital communications

An exhibition of posters and a presentation of the interactive project “I am Ecomanifest”, dedicated to environmental issues, took place at the Institute of Public Policy of Russian Presidential Academy of the National Economy and Public Administration on December 20, 2019. The training project has become an independent communication statement. A system of visual communications has been developed, using modern digital tools that help to solve the environmental problems.

Perspective of students’ science communication in science learning: opportunity in developing makerspace STEM learning approach

The demands of the 21st century encourage education in Indonesia so that it is expected to create quality human beings who are able to compete in the global competition in the 21st century by having skills, one of them is science communication skills. This study aimed to describe and analyze the perceptions of students’ science communication which is applied with learning that integrated with Science, Technology, Engineering, and Mathematics (STEM) approach. The study was conducted at junior high schools in Bandar Lampung involving 100 students. The method used in this study was a mixed method with Sequential Explanatory Design. The research instrument used a questionnaire containing 10 oral communication statements and 10 written communication statements that were used to analyze students’ scientific communication profiles. The results showed that science oral communication was good (63.75%), but low (36.25%) in writing. In addition, learning with STEM approach in this context through practicum and project is preferred by students compared to discussion or traditional learning.

Reclaiming Communication

AbstractThis article focuses on the history of the ecumenical discussion on communication, as reflected in the assemblies of the World Council of Churches (WCC). It examines, in particular, the communication statements that emerged from the WCC assemblies in Uppsala in 1968 and in Vancouver in 1983, as well as the more tentative moves at the Harare assembly of 1998 to develop an understanding of communication as an integral part of an “ecumenical space.” The article goes on to argue that the changing perspectives manifested at these assemblies, each 15 years apart, were linked to changing paradigms of social and theological reflection that were themselves the product of economic and political transformation. Finally, the article considers how the insights gained can be brought to bear on the challenges presented by digital transformation.

The discursive strategy of legitimacy management: A comparative case study of Google and Apple’s crisis communication statements

This case study assesses how firms deployed language tactically to cope with crisis events. By applying the Systemic Functional Grammar (SFG) approach, we identify linguistic characteristics of Google and Apple’s crisis communication in China and note that different discursive strategies were adopted to manage their organizational legitimacy. When facing a major constitutional crisis that threatens the organization’s cognitive and moral legitimacy, the linguistic components consist of words and grammars with associative relationship, strong rhetoric, and inclusion of audience views to secure a wide range of support. When a legitimacy crisis is instrumental, the wording and grammars used are more with realistic relationships and technical rhetoric, with different expected outcomes.

Using Simulation as an Investigational Methodology to Explore the Impact of Technology on Team Communication and Patient Management: A Pilot Evaluation of the Effect of an Automated Compression Device.

This pilot study used a simulation-based platform to evaluate the effect of an automated mechanical chest compression device on team communication and patient management. Four-member emergency department interprofessional teams were randomly assigned to perform manual chest compressions (control, n = 6) or automated chest compressions (intervention, n = 6) during a simulated cardiac arrest with 2 phases: phase 1 baseline (ventricular tachycardia), followed by phase 2 (ventricular fibrillation). Patient management was coded using an Advanced Cardiovascular Life Support-based checklist. Team communication was categorized in the following 4 areas: (1) teamwork focus; (2) huddle events, defined as statements focused on re-establishing situation awareness, reinforcing existing plans, and assessing the need to adjust the plan; (3) clinical focus; and (4) profession of team member. Statements were aggregated for each team. At baseline, groups were similar with respect to total communication statements and patient management. During cardiac arrest, the total number of communication statements was greater in teams performing manual compressions (median, 152.3; interquartile range [IQR], 127.6-181.0) as compared with teams using an automated compression device (median, 105; IQR, 99.5-123.9). Huddle events were more frequent in teams performing automated chest compressions (median, 4.0; IQR, 3.1-4.3 vs. 2.0; IQR, 1.4-2.6). Teams randomized to the automated compression intervention had a delay to initial defibrillation (median, 208.3 seconds; IQR, 153.3-222.1 seconds) as compared with control teams (median, 63.2 seconds; IQR, 30.1-397.2 seconds). Use of an automated compression device may impact both team communication and patient management. Simulation-based assessments offer important insights into the effect of technology on healthcare teams.

Experiential Learning in Primary Care: Impact on Veterinary Students’ Communication Confidence

Experiential learning is essential in medical and veterinary student education and can improve students’ communication with clients during medical appointments. There is limited research in veterinary education investigating the effectiveness of experiential learning environments to provide an integrative approach to teaching. The present study uses an experiential learning environment to introduce an integrative approach to communication skills training in veterinary clinical education. Participants were final year veterinary students whose self-confidence around 28 common clinical communication statements frequently discussed in clinical practice was assessed before and after a 3-week experiential learning rotation. Client and veterinary doctor ratings on students’ performance were also assessed. Students’ self-confidence in all but one of the clinical communication statements improved significantly ( p < .05). Veterinary doctor and clients’ ratings were overall positive. The results from this study supports the use of experiential learning to promote an integrated learning approach in veterinary education.

Understanding the black box of communication in a common-pool resource field experiment

It is well proven that communication enhances cooperation in public goods and common-pool resource experiments. It is less well understood why and how communication affects cooperative behavior and whether that impact is mediated by the sharing of a common context and the individuals’ every day experiences. This paper aims to close this gap by means of a systematic content analysis of communication transcripts from field experiments. The paper analyzes communication statements shared by participants in a series of common-pool resource experiments conducted in rural Colombia. We first classified each statement under two categories: topic and function. Then, we tested hypotheses about the impact of those statements on cooperation depending on (1) their reference to the “field context” and other topic categories; and (2) the “informational”, “disapproval”, or “group solidarity” function of the statements. According to our results, statements that contain references to the context affect cooperation depending on the function of those statements. When the statements fulfill an information role, the effect is negative, but when statements have the function of enhancing group solidarity, the effect is positive. The statements that have the strongest positive impact on cooperation are those fulfilling a disapproval function, particularly when the topic of the messages are the payoffs obtained by the group.

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care specialists engage in less task-focused communication when managing conflict with surrogates compared with intensivists. These differences may help explain the benefit of palliative care involvement in conflict and could be the focus of interventions to improve clinicians' conflict resolution skills.

Abstract 15955: Impact of an Automated Chest Compression Device on Team Communication During Simulated Cardiac Arrest Resuscitations - A Pilot Study

Background: Communication and teamwork failures correlate with diagnostic errors and deviations from ACLS protocols during cardiac arrest (CA) resuscitation. High task workloads stress teams’ capacity and negatively impact team effectiveness. The LUCAS ® Chest Compression System (Physio-Control, Redmond, WA) is an automated chest compression device intended to reduce workload associated with chest compression delivery. Objective: To assess the impact of LUCAS on team communication and adherence to ACLS algorithms during a simulated CA resuscitation. Methods: Resuscitation teams (n=12) were randomly assigned to manual compressions (control) or LUCAS (intervention) during a simulated CA consisting of Phase 1, pre-arrest (Baseline), and Phase 2, ventricular fibrillation phase (Arrest). Phase 1 metrics included total team communication statements and 10 patient care actions. Phase 2 communication was measured as number of statements related to (a) CPR coordination, (b) compression performance, and (c) diagnosis. Phase 2 patient care metrics included (a) adherence to ACLS algorithm and (b) quality of compressions. Statistical analyses included descriptive statistics, paired t-test, and effect size (Hedge’s g). Results: In Phase 1 there was no difference in either communication or patient care outcomes. In Phase 2, teams in the intervention group (n=6) made more frequent statements focused on diagnosis (Hedge’s g = 1.88, t[df 10]=3.53, p=0.01) and fewer directed toward CPR coordination (Hedge’s g = -0.98, t[df 10] = -1.85, p = 0.1) and compression performance (Hedge’s g = -1.55, t[df 10]=-2.91, p = 0.02). Teams using the LUCAS had a 22.8% decrease (95% CI [-48.80, 3.24]) in delivery of poor quality chest compressions (Hedge’s g = 1.04, t[df 10] = -1.87, p=0.08) and fewer deviations in medication administration (Hedge’s g = -1.49, t[df 10] = -1.87, p=0.02) as compared to in the control group (n=6). Conclusions: In this small pilot study, use of an automated compression device was associated with an increase in team communication focused on diagnosis and improved adherence to ACLS algorithms. While not all outcomes reached statistical significance, the large effect sizes demonstrate practical significance. A larger study may reach statistical significance.

The influence of cross-cultural communication on stakeholder management process in international construction projects: turkish stakeholders’ perpective

The purpose of this study is to investigate the influence of cross-cultural communication (CCC) on stakeholder management process (SMP) in international construction projects from the Turkish stakeholders’ perspective. The research is based on a survey of Turkish stakeholders (contractors, consulting engineers, insurance brokers, and financial advisors) operating internationally. The useable survey comprised 141 individual responses from 205 distributed, giving a response rate of 68.78 percent. Structural equation modelling (SEM) is proposed as an effective tool to investigate the relations between various factors of cross-cultural communication and stakeholder management process and data regarding the Turkish stakeholders have been used to demonstrate its applicability. The results demonstrate that “Communication behaviours” and “Communication strategies” proved to be strongly significant and positively related to SMP, whereas “Communication barriers” have significantly negative effect on SMP. Research findings may encourage the principles and practices of CCC between the stakeholders to be adequately recognized and understood by the international contracting firms operating abroad. Although findings reflect the Turkish stakeholders’ perspectives, it is believed that the parameters identified in this study can further be used as a benchmark to conduct similar studies in other countries. Managers of international contracting firms can develop a Cross-cultural Communication Statement (OCQS) to assess, report, and develop cross-cultural communication between stakeholders of a multi-cultural project environment.

A formal semantics for debugging synchronous message passing-based concurrent programs

In this paper, we propose a semantic framework to debug synchronous message passing-based concurrent programs, which are increasingly useful as parallel computing and distributed systems become more and more pervasive. We first design a concurrent programming language model to uniformly represent existing concurrent programming languages. Compared to sequential programming languages, this model contains communication statements, i.e., sending and receiving statements, and a concurrent structure to represent communication and concurrency. We then propose a debugging process consisting of a tracing and a locating procedure. The tracing procedure re-executes a program with a failed test case and uses specially designed data structures to collect useful execution information for locating bugs. We provide for the tracing procedure a structural operational semantics to represent synchronous communication and concurrency. The locating procedure backward locates the ill-designed statement by using information obtained in the tracing procedure, generates a fix equation, and tries to fix the bug by solving the fix equation. We also propose a structural operational semantics for the locating procedure. We supply two examples to test our proposed operational semantics.

Caveats for Causal Interpretations of Linear Regression Coefficients for Fine Particulate (PM2.5) Air Pollution Health Effects

Recent linear regression analyses have concluded that decreasing levels of fine particulate matter (PM2.5) air pollution have increased life expectancy in the United States. These findings have left unresolved questions about the causal relation between reductions in PM2.5 levels and changes in cause-specific (especially, cardiovascular disease, CVD) mortality risks. Their robustness (e.g., sensitivity to deletion of a single data point) has also been questioned. We investigate these issues in the National Mortality and Morbidity Air Pollution Study database. Comparing changes in PM2.5 levels and cause-specific mortality rates for elderly people in 24 cities between two periods separated by a decade (1987-1989 and 1999-2000) shows that reductions in PM2.5 were significantly associated with increases in respiratory mortality rates and with decreases in CVD mortality rates. CVD and all-cause mortality risks fell equally for all months of the year over this period, but average PM2.5 levels increased significantly for winter months. This casts doubts on the causal interpretation that declines in PM2.5 over the decade caused reduced short-term mortality risks. Nonlinear regression suggests that reduced or negative marginal health benefits are associated with reductions of PM2.5 below 1999-2000 levels (about 15 μg/m(3)). Such nonlinear relations imply that risk communication statements that project a constant incremental reduction in mortality risks per unit reduction in PM2.5 do not adequately reflect the realistic possibility of nonlinear exposure-response relations and diminishing returns to further exposure reductions.

Interpersonal factors affecting communication in clinical consultations

This study seeks to determine how process and latent errors in the interpersonal, organizational, health system, and public health domains impact doctor/patient communication and patient safety. There were 278 physicians from Manitoba, Canada who completed a self-report questionnaire during 2006. The largest specialty was family medicine, followed by internal medicine and pediatrics. Mean years of practice was 16, and 60 percent of the respondents were male. Respondents indicated the extent to which difficulties were encountered when communicating with patients. The study finds that physicians had more difficulties with patients in the 0-20 year age bracket on 12 of the 18 communication statements. Psychiatry and pediatrics reported more difficulties with language interpreters. Pediatrics reported more difficulties with patients using culturally-based alternative medicine. Internal medicine had more difficulty with patients not appearing to trust or participate in treatment decisions. Patients in the 41-60 years age bracket had the highest mean for non-adherence to treatment plans, health maintenance and needed lifestyle change. The female physician-female patient dyad had fewer communication difficulties on all statements. Further research should examine how family structure influences health-care delivery and health outcomes. Health care organizations can contribute to improving quality of care by seeking out and correcting sources of latent errors, and by supporting professional development and practice interventions. Few studies exist that have linked communication difficulties to adverse events. This study provides insight on sources of interpersonal errors in communication that directly impact the physician/patient relationship and which may represent threats to patient safety.

Special Issue: Euro‐Par 2008

AbstractPreface for the special issue on Euro‐Par 2008. Copyright © 2009 John Wiley & Sons, Ltd.

Writing productive stencil codes with overlapped tiling

AbstractStencil computations constitute the kernel of many scientific applications. Tiling is often used to improve the performance of stencil codes for data locality and parallelism. However, tiled stencil codes typically require shadow regions, whose management becomes a burden to programmers. In fact, it is often the case that the code required to manage these regions, and in particular their updates, is much longer than the computational kernel of the stencil. As a result, shadow regions usually impact programmers' productivity negatively. In this paper, we describe overlapped tiling, a construct that supports shadow regions in a convenient, flexible and efficient manner in the context of the hierarchically tiled array (HTA) data type. The HTA is a class designed to express algorithms with a high degree of parallelism and/or locality as naturally as possible in terms of tiles. We discuss the syntax and implementation of overlapped HTAs as well as our experience in rewriting parallel and sequential codes using them. The results have been satisfactory in terms of both productivity and performance. For example, overlapped HTAs reduced the number of communication statements in non‐trivial codes by 78% on average while speeding them up. We also examine different implementation options and compare overlapped HTAs with previous approaches. Copyright © 2008 John Wiley & Sons, Ltd.

Formal Sequentialization of Distributed Systems via Program Rewriting

Formal sequentialization is introduced as a rewriting process for the reduction of parallelism and internal communication statements of distributed imperative programs. It constructs an equivalence proof in an implicit way, via the application of equivalence laws as rewrite rules, thus generating a chain of equivalent programs. The variety of the possible sequentialization degrees which are attainable is illustrated with an example. The approach is static, thus avoiding the state explosion problem, has an impressive state-vector reduction in many cases, and could be combined, as a model simplification step, with model checking and interactive theorem proving in system verification. Prior grounding results needed in formal sequentialization are overviewed; more specifically, an algorithm for the automatic elimination of communications under the scope of sequential and parallel compositions, elimination laws which the algorithm applies, and a suitable equivalence criterion for the sequentialization process. The main contribution of this work is the extension of these results to encompass the formal elimination of both synchronous communications embedded within a subclass of selection statements, and of non-disjoint synchronous communication pairs. None of these cases has been treated in the literature before, and their solution considerably widens the application domain of formal sequentialization.