Unclear Communication Research Articles

Design of Anti-Broadband Electromagnetic Interference Wired Phone Based on Speech Enhancement

In order to develop an anti-broadband electromagnetic interference wired phone, speech enhancement, electromagnetic shielding, PCB board electromagnetic compatibility and filtering are the usual measures. Realization of speech enhancement can resolve practical problems of SLT dialing error in strong electromagnetic interference, voice unclear and intermittent communication. The experiment shows that in 50m radiating field of high-power VHF radar or shortwave radio, speech intelligibility of phone designed was higher than that of general phone and had no whistling or ringing.

Longing for existential recognition: A qualitative study of everyday concerns for people with somatoform disorders

ObjectivePatients with somatoform disorders could be vulnerable to stressors and have difficulties coping with stress. The aim was to explore what the patients experience as stressful and how they resolve stress in everyday life. MethodsA cross-sectional retrospective design using 24 semi-structured individual life history interviews. Data-analysis was based on grounded theory. ResultsA major concern in patients was a longing for existential recognition. This influenced the patients' self-confidence, stress appraisals, symptom perceptions, and coping attitudes. Generally, patients had difficulties with self-confidence and self-recognition of bodily sensations, feelings, vulnerability, and needs, which negatively framed their attempts to obtain recognition in social interactions. Experiences of recognition appeared in three different modalities: 1) “existential misrecognition” covered the experience of being met with distrust and disrespect, 2) “uncertain existential recognition” covered experiences of unclear communication and a perception of not being totally recognized, and 3) “successful existential recognition” covered experiences of total respect and understanding. “Misrecognition” and “uncertain recognition” related to decreased self-confidence, avoidant coping behaviours, increased stress, and symptom appraisal; whereas “successful recognition” related to higher self-confidence, active coping behaviours, decreased stress, and symptom appraisal. ConclusionDifferent modalities of existential recognition influenced self-identity and social identity affecting patients' daily stress and symptom appraisals, self-confidence, self-recognition, and coping attitudes. Clinically it seems crucial to improve the patients' ability to communicate concerns, feelings, and needs in social interactions. Better communicative skills and more active coping could reduce the harm the patients experienced by not being recognized and increase the healing potential of successful recognition.

Bringing integrated ecosystem assessments to real life: a scientific framework for ICES

Abstract An ecosystem approach to management (EAM) aims to secure a healthy ecosystem along with sustainable use of its goods and services. Although the main principles of EAM are agreed upon and desirable, wider implementation of EAM is still a challenge. The difficulties stem from unclear definition and communication of the EAM, lack of routines or protocols to develop ecosystem-based advice, inappropriate institutional structures, and communication issues between scientists, advisers, and managers. Integrated ecosystem assessment (IEA) is an instrument that has proven to help in the implementation of EAM. For successful implementation of EAM and IEA in the European regional seas context, an international forum is required that develops tailor-made EAM tools specific to the different regional ecosystems to overcome fragmented national strategies. We describe a multinational peer network of working groups developed within the International Council for the Exploration of the Sea (ICES) under the auspice of Science Steering Group on Regional Sea Programmes. Available is a wealth of data, expertise, scientific methods, and models for each regional sea. This network can be instrumental in advancing IEA for the implementation of EAM in the North Atlantic seas.

The OA Gourmand

It is trendy to be a supporter of Open Access publication with even journal publishers finding a role in communicating research results through this mechanism. When discussing Open Access it is rare for all parties to be clear about why Open Access is endorsed. The differences between Green Open Access and Gold Open Access can lead to unclear communication when the distinctions between the two are avoided.

SU‐E‐T‐232: Safety and Quality Improvements in a Pediatric Total Body Irradiation Procedure

Purpose: Through the use of incident learning, safety‐critical areas were identified in our current procedure for pediatric patients undergoing total body irradiation (TBI) for bone‐marrow transplant. These are relatively rare and complex procedures requiring non‐standard setups and administration of anesthesia. The purpose of this study is to simplify and standardize the simulation and planning procedure for pediatric TBI to improve the safety and quality of care. Methods: Motivated by near‐miss incidents, a systematic review of current TBI procedures was conducted, and the following issues were identified: unclear communication describing variations in setup at simulation versus treatment related to anesthesia requirements, confusion about measurement units, unclear criteria for various setup options to accommodate patients ranging in age from infancy to 7 years, and variations in compensator design methods. To address these issues, a simulation form was designed with detailed instructions and documentation requirements. Dose calculation and tissue compensation procedures were redesigned to remove set‐up variations. Calculations were performed on 28 previously‐treated patients to determine the dose uniformity with the new vs. old method. Results: Feedback from clinical staff indicates that the new simulation form improves interdepartmental communication and decreases the risk of treating patients in a setup that differs from that used during the simulation. The new compensator design significantly improved patient dose uniformity: 0.8±0.4% (new method) vs. 4.2±2.3% (old method) (p < 0.01). The data indicates the new compensator design will Results in fewer out‐of‐tolerance in vivo dosimetry readings and reduce associated re‐planning efforts, which is especially critical for single‐fraction treatment. Conclusion: For an institution averaging one pediatric TBI case per month, standardization of the procedure simplifies the planning process and improves patient safety. Since there are few technical reports about pediatric TBI, this experience may be especially beneficial for other centers with low volumes of pediatric TBI patients.

Taming the Leviathan - A New Approach to Risk for the Military Leader

Military operations involve risk. A central question for military leaders is whether they have the tools available to them to deal with risk. Part of the leader’s risk toolbox is the training and education they receive. However the military leader is not exposed to formal training and education modules that specifically address risk. With a lack of formal risk doctrine and training in the CF, the leader may use narrowly defined and inconsistent engineering risk processes or high level generic frameworks that are not easy to standardize, track, understand, or apply. The result may be shallow analysis, poor management, unclear communication and poor decisions involving risk. To address these issues, this paper will first examine some weaknesses of selected risk management processes. A wider understanding of risk will then be developed by other perspectives using philosophical, psychological and sociological theories as a basis for discussion. Finally the paper develops its comprehensive risk approach by layering these wider though processes on top of the common risk management methodologies.

Barriers facing patients referred for kidney transplant cause loss to follow-up

End stage renal disease impacts many Americans, however, transplant is the best treatment option increasing life years and offering a higher quality of life than possible with dialysis. Ironically, many who are eligible for transplant do not follow through on the complex work-up protocols required to be placed on the transplant waiting list. Here we surveyed vascular access clinic patients at an academic medical center referred for transplant that did not follow up on the needed work-up to be added to the national transplant waiting list. The most frequent responses of 83 patients for not pursuing transplantation were that the patients did not think they would pass the medical tests, they were scared of getting a transplant, and they could not afford the medicine or the transplantation. These impediments may result from unclear provider communication, misinformation received from peers or other sources, misperceptions related to transplant surgery, or limited health literacy/health decision making capacity. Thus, patients with end stage renal disease lost to follow up after referral for kidney transplant faced both real and perceived barriers pursuing transplantation.

Understanding of the Word “Spirituality” by Theologians Compared to Lay People: An Empirical Study from a Secular Region

Although widely used, we know very little of the meaning of the word spirituality in secular, non-English speaking societies, and different understandings might lead to misunderstandings and unclear communication. This empirical study compares a theologian and a lay group on their understandings of the term spirituality by analysis of a questionnaire consisting of 115 possible associations of the word spirituality. Analysis compares six understandings of spirituality: 1) positive dimensions in human life and well-being; 2) new Age-ideology; 3) integrated part of established religious life; 4) vague striving, opposed to religion; 5) selfishness; and 6) ordinary inspiration in human activities. Results show the theologians understand spirituality more as part of established religious life than the lay group, whereas the lay group understands spirituality more as a striving toward something transcendent, vaguely defined. In conclusion, it is suggested never to use the term spirituality without a notion or some keywords framing the meaning of the word in the specific context.

국내거주 외국인의 정주화에 따른 한국 음식점 선택

The article is to investigate selection of Korean cuisine restaurants and levels of acculturation for foreigner living in Korea and to suggest some guidelines for drawing them and enlargement in consuming market. Out of 250 questionnaires, 220 questionnaires were used for data analysis. The findings are showed visiting for taking experience other culture and learning technology & training, not knowing well much about Korean culture, and eating experience Korean food on 30.5%, less than 2 years length in Korea. And the most difficult points are showed unclear communication, rude behavior, attitude, and language in living Korea. Second, the purpose of visiting restaurant is to spend good time with friends and to eat out special food, then foreigners usually have lunch & dinner Korean food, their own food on weekend. Third, `service` and `sanitation & cleanness` factors were ranked highly for foreigners living less than 2 years, but `location` factor was ranked highly for residents living more than 4 years in the Korea. Last, foreigners living less than 2 years recognized highly on `identification and Korea culture` in the Korea.

Increasing community capacity to prevent childhood obesity: challenges, lessons learned and results from the Romp & Chomp intervention

BackgroundObesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp.MethodsA mixed methods evaluation with three data sources was utilised. 1) Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development); 2) Thematic analysis of key informant interviews (n = 16); and 3) the quantitative Community Capacity Index Survey.ResultsDocument analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity.ConclusionsRomp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives.Trial Registration NumberANZCTRN12607000374460

Epilepsy in Ireland: Towards the primary–tertiary care continuum

Background Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. Objective To explore the interface between primary care and specialist epilepsy services in Ireland. Methods Using appreciative inquiry, focus groups were held with healthcare professionals ( n = 33) from both primary and tertiary epilepsy specialist services in Ireland. Results There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary–tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary–tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Conclusion Epilepsy services across the primary–tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system.

Detection and Management of Depression in Patients with Vision Impairment

Depression is common in people with vision impairment and has a number of debilitating effects. However, it is often not identified and therefore is left untreated. This study aimed to explore eye healthcare professionals' views of depression in patients with vision impairment and identify current management practices and barriers to effective care. Six focus groups and two semistructured interviews were conducted with 26 staff members from a large tertiary eye care hospital. Participants included orthoptists, ophthalmic nurses, and support staff. The data were analyzed using an inductive analytical approach based on the constant comparative method. Participants reported relying mainly on observational cues of patients' behavior or using other indirect methods to identify depression. On the basis of these observations, they acknowledged that the prevalence of depression in visually impaired patients at the hospital was high and believed it impacts negatively on patients' practical and emotional functioning. Few reported overtly discussing depression with patients. Responses to suspected depression varied according to individual staff knowledge of resources or referral options. Various barriers to adequate management of depression were identified, including confusion over roles and responsibilities, and unclear communication pathways between staff. Participants were enthusiastic about resolving these obstacles and establishing clear pathways to care both within the hospital and in the wider community. They were also receptive to receiving training and education about depression, with specific reference to the visually impaired population. There is considerable scope and enthusiasm for improving depression management in this tertiary eye care facility. The results may not, however, be generalizable to all ophthalmic settings. New initiatives need to be tailored to suit implementation within such ophthalmic services.

Interpersonal Processes of Care and Patient Satisfaction: Do Associations Differ by Race, Ethnicity, and Language?

Describe association of patient satisfaction with interpersonal processes of care (IPC) by race/ethnicity. Interview with 1,664 patients (African Americans, English- and Spanish-speaking Latinos, and non-Latino Whites). Cross-sectional study of seven IPC measures (communication, patient-centered decision making, and interpersonal style) and three satisfaction measures (satisfaction with physicians, satisfaction with health care, and willingness to recommend physicians). Regression models explored associations, controlling for patient characteristics. In all groups: patient-centered decision making was positively associated with satisfaction with physicians (B=0.10, p<.0001) and health care (B=0.07, p<.001), and "recommend physicians" (OR=1.23, 95 percent CI 1.06, 1.43); discrimination was negatively associated with satisfaction with physicians (B=0.09, p<.05) and health care (B=0.17, p<.001). Unclear communication was associated with less satisfaction with physicians among Spanish-speaking Latinos. Explaining results was positively associated with all satisfaction outcomes for all groups with one exception (no association with satisfaction with physicians for Latino Spanish-speakers). Compassion/respect was positively associated with all outcomes for all groups with two exceptions (no association with satisfaction with health care among English-speaking Latinos and Whites). All IPC measures were associated with at least one satisfaction outcome for all groups except for unclear communication.

What Part of 'Yes' Don't You Understand?

The Chinese often answer with a very quick "yes" whenever you ask a question. This happens even when we know they haven't thought about the question long enough to even answer. Why do they say "yes" when they can't possibly mean it, and what do you do when this happens?If you do business in the Asia-Pacific region, you have no doubt encountered this situation. Confusion often arises over the word "yes" in response to our questions. We tend to assume that "yes" means "I agree," as it does in Western culture. This can have serious consequences in any communication, and not just when negotiating international sales agreements.Poor cross-cultural communication causes misunderstandings, delays, and decreased productivity. Worse, misinterpreting the Y word causes feelings of betrayal Cultural clashes affect the heart of your Asian business.Context is important, because when an Asian says "yes," it can mean any number of things. Sometimes it means maybe. Sometimes "yes" may only be a sign of respect, a signal that you have been heard. Sometimes "yes" may even n1ean "no."There is no intended deception. "Yes" is simply a more complicated word in Asian culture.Several Asian cultural factors come into play with the word "yes." Culture affects every business conversation, and not just the formal negotiation that secures the sale.Most Chinese people, especially those who don't have a lot of opportunity to talk with English speakers, use a sound ("yeah," "yes," or "oh") to keep the conversation going.It does not mean "I get what you're saying." It does not signal agreement. It just means ''I'm listening."Where there is confusion, they feel that if they can keep you talking long enough, then there is a good chance they will finally get your meaning. So hear it as acknowledgment that you have asked a question, and not as a response to your question.In the Chinese culture, it is considered an honor to be asked to do something. People are happy to help and eager to prove that they are the best able to assist. Eagerly saying "yes" will deepen the trust you have placed in them.Knowing this will prevent a feeling of distrust from developing when we encounter a "yes" that comes too quickly by Western standards.Where there is a risk oflosing face (yours or theirs) the Chinese will often pretend to understand your meaning. This happens srprisingly often, and is due to the language barrier-especially when other Chinese are also present. The one who is supposed to have the best grasp of the English language may feel ashamed at not understanding your question. And, by an interesting cultural twist, your unclear communication has the potential to cause you loss of face.A Chinese engineer who negotiated multimillion dollar deals for integrated software systems across China explained the thought process: "Usually, in our culture, the Chinese pretends to understand. I can't always say, 'Sorry, sorry, I don't understand,' or I will lose face. The Westerner will think, 'Why can't you understand?' So I just fake to understand. I say, 'Yes, yes.' If! can do that, I give you face."Even among Chinese people, where they use the same , language, they like to say 'yes' during the conversation."While it is bad manners to reject directly, indirect communication is totally acceptable. The meaning of "yes" becomes ambiguous. The word may then mean any number of things, including "maybe," "back up," ''I'm thinking," "give me time to prepare," "you've got to be kidding," or "let me get back to you with an answer."Some people greet the world with a "yes," some with a "no." Some cultures do the same.In the "can do" Chinese culture, the first response is always "yes." The easiest thing in the world is for a Chinese to say "yes," and then figure out how to do the thing later.This is one of the ways that Chinese differ fromJapanese. The Japanese will tend to first respond in the negative. But that is the subject of another conversation.The Asian "yes" is an automatic, habitual response. It almost never means "yes." For that reason, consider it a neutral constant. Train yourself to not hear "yes" as meaning agreement.Make it mean nothing in your mind, until you have had a chance to confirm what "yes" means in the specific context of your conversation.Small changes in the way we communicate will have a huge impact on our success with Asian colleagues, customers, and suppliers.

Wide variation in content of inpatient do-not-resuscitate order forms used at National Cancer Institute-designated cancer centers in the United States

Determining resuscitation status (RS) for inpatients with advanced cancer is emotionally charged and often conflictual. Available data suggest that clinicians have inconsistent practices when establishing and documenting do-not-resuscitate (DNR) orders. Lack of standardization may contribute to ineffective and unclear discussions regarding RS. To inform revisions of DNR order forms used at one comprehensive cancer center, we surveyed National Cancer Institute-designated cancer centers (NCICCs) to determine if a standardized approach to documenting inpatient DNR orders exists. Over a 12-week period in 2002-2003, the 50 NCICCs providing inpatient care were contacted regarding participation in this Institutional Review Board-approved study. Using a 69-item database, inpatient DNR order forms were analyzed for content and elements of process used to establish and document RS. Each form was evaluated by two raters to assess inter-rater reliability. Analysis was descriptive; inter-rater agreement was summarized using the kappa statistic. Sixty percent (30 out of 50) of NCICCs participated. Eighty percent of responding sites confined the order process exclusively to cardiopulmonary resuscitation and did not include other interventions for possible limitation. Two thirds of responding sites used preformatted order forms specific for establishing inpatient RS; forms varied widely in content and elements of process used to establish and document DNR orders. NCICCs do not have a standardized approach to establishing and documenting DNR orders. Lack of standardization may reflect the absence of a common understanding of these difficult issues which may contribute to unclear and ineffective communication when addressing RS.

‘Mr Police Officer, I thought cannabis was legal’—Introducing new policy regarding cannabis in Belgium: A story of good intentions and Babel

Over the last five years, the announced new policy on drugs, cannabis in particular, has been the subject of much debate within the Belgian Federal Government and between the government and the opposition parties. Unclear policies and poor public communication from the Federal Government, the competent minister and the other parties caused immense confusion about whether and when the possession of cannabis would be legal and what the criteria would be for prosecution when found possessing cannabis. This confusion has been illustrated by a survey by Gelders and Van Mierlo (2004) Legalized or not? Poor public communication causes confusion over the new cannabis policy in Belgium. Drugs: Education, Prevention and Policy, 2, 167–177. Aims: (1) to present the most relevant policy developments specifically from the last two years, and (2) to determine whether there is still confusion and to assess the knowledge of young people about current prosecution practices. Methods: (1) an analysis of policy documents and legal texts, and (2) a more up-to-date survey among 748 Belgian youngsters. Findings: only 35.1% answered the basic-knowledge questions correctly while 59.2% assessed the prosecution practice in an appropriate manner. Conclusion: there is still a lot of confusion regarding the current cannabis legislation and prosecution.

Communicating Risk to Reduce Human Loss in Large-Scale Disasters

TM2-O-06 Introduction: Risk communication is vital to saving lives in disasters as recent catastrophes have shown. Risk communication is difficult to categorize, since it is complex and multidimensional and its effectiveness is often dependent on context. This paper identifies, assembles, and categorizes indicators of human behavior toward communication in the face of large-scale disasters. Indicators are then applied to a disaster scenario to craft messages to achieve desired behaviors that minimize loss of life and injury. Methods: An extensive risk communication empirical literature covering numerous disciplines and cases of major catastrophes was reviewed involving natural hazards and acts of terrorism. Cases covered incidents involving biologic and chemical agents and physical disruption for both natural hazards and terrorist attacks. Two criteria were used to categorize indicators: 1) effectiveness of reaching recipients further subdivided into communication technology, information source, and message form, and 2) effectiveness of recipient comprehension of messages in terms of trust and personal attributes. The core research involved applying these indicators to a Sarin attack scenario in a confined transportation system environment. A timeline, patterned after the Tokyo Sarin attack, was constructed, and actual and desired behavior was distributed over time for affected individuals (fatalities, injured, exposed, and off-site), emergency responders, service operators, the media, managers, and political leaders. Messages were then designed for combinations of message senders and recipients over time to achieve desired life-saving behaviors. Results: Indicators of human behavior toward communication in catastrophes provide the theoretical basis for designing messages for catastrophes. Severe obstacles to effectiveness of reaching recipients include unclear communication pathways between senders and recipients, difficulty in identifying recipients and their locations, and technologic limitations. Effectiveness of recipient comprehension of messages is framed by numerous social-psychologic factors and ways people react to communication that need to be an explicit part of the design of messages. Discussion/Conclusions: The development of indicators of behavior toward communication is critical to the diagnosis and design of risk communication in large scale catastrophes to reduce the loss of human life. It is an ongoing process of synthesis and meta-analyses, and the model presented provides an important contribution to this effort. Supported by New York University's Center for Catastrophe Preparedness and Response, through its U.S. Department of Homeland Security Grant No. 2004-GT_TX-0001. Any opinions, findings, and conclusions or recommendations in this document are those of the authors and do not necessarily reflect views of the U.S. Department of Homeland Security. This work greatly benefited from the overall Large Scale Emergency Readiness (LaSER) project under the leadership of the NYU School of Medicine under the directorship of Dr. Lewis Goldfrank.

Impeding Scientists' Productivity

Life scientists are frustrated by aspects of their organizations that they feel make it harder to accomplish the goals for which they were trained and hired. They report unclear goals, communication silos, and insufficient time to do research as factors that reduce their ability to be innovative and productive. These are the principal findings of our recent survey of 22 life science companies on the challenges that currently exist in the areas of productivity and innovation in scientific research and strategic alliances. We conducted in-person interviews with over 25 executives, managers and scientists directly responsible for the success of scientific projects. The participants represented a diverse set of companies, ranging from leading pharmaceutical firms to small biotech efforts. Opaque Goals In our survey, scientists said that either they or other scientists they knew were working on goals that they did not think contributed to ultimate value for the company. For example, we found several cases where scientists were being rewarded for producing more of something (such as drug leads) that they thought likely to eventually fail further downstream, at much greater expense to the company. Since these objectives typically were tied to compensation, scientists pursued them in spite of their knowledge that much of their efforts would yield nothing of value and were counterproductive to the company. Part of the problem, particularly in large firms, was the inability to relate local activity by scientists to global value production for the firm. One variation of this issue occurred when corporate strategic goals shifted during a performance reporting period. Scientists and managers were sometimes unfairly punished because objectives were not realigned with new priorities due to the time lag between strategic shifts and the HR department's implementation of new objectives. Survey participants overwhelmingly felt that performance reviews were a waste of time, but felt there were no alternatives. They often tried to game the system through strategic selection of their performance objectives. Working in Silos Scientists and managers at large firms often used the term silo to describe the department or area in which they worked, reflecting the intense specialization and narrowed focus of individual groups. There was also recognition at virtually all levels of the firm, from senior management to scientists on the bench, that cross-functional efforts were crucial to success. While silos were advantageous in certain respects, they could make cross-functional cooperation more challenging. Within the research organizations, collaborative projects were often accomplished through matrix management arrangements that were unsupported with budgets and clear staff assignments. Further, participants' individual goals and objectives often did not include these collaborative efforts. Therefore, project managers in these situations become tax collectors, using persuasion and influence to attempt to accomplish goals, and often succeeding, but at a substantial of time and effort, for which they were not measured or rewarded explicitly. We found that in large companies, research groups and supporting organizations (such as IT and QC departments) were often at odds due to the focus on cost savings in support organizations. This resulted in substantial productivity losses to the research organizations when scientists were prevented from doing their work. We also found that support organizations often lacked perspective on how the objectives of their group contributed to the overall performance of the firm. In contrast, survey participants who had experience in small firms often reported a dramatically different cultural environment. …

Epigenetic Topography of Lymphocyte Nuclei and Endothelin-1 at Atherosclerosis

to analyze to cytokines, sCAM secretion within chromatin topography of lymphocytes at atherosclerosis. Two kinds of response were researched: coagulation (incubation of blood clot within 6 hrs at 37 C) and standardized viscosimetric flow rotational viscosimetr (shear rate 100 -1/s, 60 s at 37 C incubation within 6 hrs at 37 C). ET-1 and sP-, sE-selectin's, sICAM-1 (R&D, UK) were determined by ELISA kits (photometer "Biotech-1000", Beckman, U.S.A.). The chromatin of lymphocyte nuclei was studied using Computer TV Morphodensitometry System "DiaMorph"(Russia) in the smears dyed especially for DNA. After rheological test the decrease of chromatin activity happened. The significant decrease of selectin level's closely correlated to increased of ET-1 level. We observed the deep reorganization of nuclei after the coagulation test (proapoptotic?). ET-1 did not protect lymphocytes from chromatin changes even enchansed the chromatin inactivation. We established that the lymphocytes are the active participants in pro- and antiinflammatory cytokines. We hereby hypothesize that the unclear cell communication mechanisms of observed phenomena were triggered.

Attitudes of Physicians to Professional Roles of Community Pharmacists in Lebanon

Background: Pharmacists involved in patient‐centred clinical services can potentially reduce overall healthcare costs, morbidity and mortality. However, physicians might be ambivalent about pharmacists' capabilities.Aim: To determine the opinions of medical and dental practitioners (physicians) to professional activities which could be provided by community pharmacists in Lebanon.Method: 300 questionnaires were distributed by pharmacy students to registered physicians covering a range of specialties and experience. The questionnaire consisted of 20 closed questions and an open‐ended question to determine the physician's expectations of the pharmacist's role in patient care.Results: 198 questionnaires were analysed and overall the results indicated that physicians have a need for information of the type that pharmacists can supply. However, the healthcare system is fragmented because of unclear and infrequent communication. Physicians believe that increased consensual cooperation and communication between the professions could improve therapeutic outcomes and the quality of advice given to patients.Conclusion: There is a need for collaboration between physicians and pharmacists in Lebanon to improve the quality of pharmaceutical care for patients.