The Future Of Nuclear Security: A Medical Physicist’S Perspective, Katharine E. Thomson

International Journal of Nuclear Security

Planning for the future of nuclear security is a vital and complex task, requiring cooperation and contribution from many disciplines and industries. This diversity of expertise should include the medical sector, which faces many of the same challenges as the nuclear industry: controlling access to dangerous material, creating a strong security culture, cooperating with the wider world and engaging the public.

Medical physicists, of which the author is one, oversee all aspects of small-scale radiation use. This paper discusses three key areas increasingly important to both medical and nuclear uses of radioactive materials: public engagement, prevention of nuclear and radiological …

Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan

Patient Experience Journal

Hospital systems interested in improving patient experience and physician engagement may look to physician communication skills training (CST) as a means of improving both. This study examines a 7.5-hour, multi-specialty, hospital-wide physician CST workshop in a large academic hospital system and its effects on participants’ self-efficacy, attitudes, and behaviors related to communicating with patients. Data was gathered from October 2014 through June 2016 through a web-based questionnaire sent to participants 6-weeks post-workshop which focused on skills taught in the course, attitudes toward communication training, and provider behaviors when communicating with patients. Along with demographic questions, a ten question retrospective pre-post …

Patient And Provider Experiences With Relationship, Information, And Management Continuity, Jeanette Jackson, Gail Mackean, Tim Cooke, Markus Lahtinen

Patient Experience Journal

From 2003 to 2014, the Health Quality Council of Alberta (HQCA) monitored patient experiences with healthcare services through a biennial Satisfaction and Experience with Healthcare Services (SEHCS) survey. The findings consistently showed a direct link between coordination of care, an aspect of continuity of care, and healthcare outcomes. Specifically, it showed that better coordination is linked to positive outcomes; the reverse is also true. Given the critical role continuity of care plays in the healthcare system, the HQCA conducted in-depth interviews, interactive feedback sessions and focus groups with patients and providers to explore factors that influence both seamless and fragmented …

Healthcare Providers Versus Patients' Understanding Of Health Beliefs And Values, Betty M. Kennedy, Matloob Rehman, William D. Johnson, Michelle B. Magee, Robert Leonard, Peter T. Katzmarzyk

Patient Experience Journal

This study examined how well healthcare providers perceive and understand their patients’ health beliefs and values compared to patients’ actual beliefs, and to determine if communication relationships maybe improved as a result of healthcare providers’ understanding of their patients’ illness from their perspective. A total of 61 participants (7 healthcare providers and 54 patients) were enrolled in the study. Healthcare providers and patients individually completed survey instruments and each participated in a structured focus group. Healthcare provider and patient differences revealed that patients perceived greater meaning of their illness (p = 0.038), and a greater preference for partnership (p = …

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when …

Faculty Perceptions Of Communication At An Academic Medical Center: A Faculty Forward Qualitative Analysis, Brian L. Rutledge, Jessica H. Bailey

The Qualitative Report

The purpose of the study is to examine the faculty’s suggestions on how to improve communication at five schools in an academic medical center. The University of Mississippi Medical Center facilitated the administration of the Faculty Forward Engagement Survey by the Association of American Medical Colleges to faculty in the schools of medicine, nursing, dentistry, pharmacy, and health related professions. This survey included open-ended questions with narrative responses. On these responses to one question about communication, the authors performed the constant comparative method of grounded theory design, a foundational form of qualitative inquiry. In reviewing and coding the 201 responses, …

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside …

How Do Money, Sex, And Stress Influence Marital Instability?, E. Jeffrey Hill, David B. Allsop, Ashley B. Lebaron, Roy A. Bean

Journal of Financial Therapy

This study explored how money and sex simultaneously predicted marital instability, and what financial therapists might focus on with clients to address problems in these areas. Specifically, this paper concurrently examined the relationship of marital instability to financial and family stressors (financial stressors, work-family conflict, and parenting stressors); financial and sexual resources (couple income and couple sexual frequency); and financial and sexual perceptions (financial dissatisfaction and sexual dissatisfaction). Couple financial communication and couple relational communication were explored as intervention points for financial therapists. Data came from Wave 2 of the Flourishing Families data set (N = 301). Data were organized …

Young Adult Perspectives On The Selection Of Pharmaceuticals For Mental Health Treatment, Alaina N. Talboy, Angela M. Aylward, Daniel Lende, Rodney P. Guttmann

Patient Experience Journal

Shared decision making places an emphasis on patient understanding and engagement. However, when it comes to treatment selection, research tends to focus on how doctors select pharmaceutical treatments. The current study is a qualitative assessment of how patients choose among three common treatments that have varying degrees of scientific support and side effects. We used qualitative data from 157 undergraduates (44 males, 113 females; mean age = 21.89 years) that was collected as part of a larger correlational study of depression and critical thinking skills. Qualitative analysis revealed three major themes: shared versus independent decision making, confidence in the research …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

The Pribram – Bohm Hypothesis Part Ii: The Physiology Of Consciousness, Shelli R. Joye

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

A physiology of consciousness is elaborated, based upon implications of the Pribram-Bohm hypothesis (developed in Part I of this series). The model presented here is in sharp contrast to the prevailing conviction among neuroscientists that consciousness will eventually be discovered to be a physiological epiphenomenon of neuronal electrical impulses firing in the brain. In contrast, the Pribram-Bohm theory holds that consciousness, inherent in what Bohm views cosmologically as “the Whole,” manifests as a dynamic conscious energy resonance bridging the explicate space-time domain with the nonlocal, transcendent flux domain termed the “implicate order.” Presented in Part I, the Pribram-Bohm hypothesis posits …

Can Social Media Reduce Discrimination And Ignorance Towards Patients With Long Term Conditions? A Chronic Kidney Disease Example In The Uk And More Widely, Shahid N. Muhammad, Amy J. Zahra, Howard J. Leicester, Heather Davis, Stephen Davis

Patient Experience Journal

Long Term Conditions (LTCs) are increasing in prevalence and cost in Western healthcare. Patients with such conditions are often classed as “disabled”, because of impacts of self-care on “activities of daily life” or secondary consequences of conditions (impairments) affecting factors such as mobility, concentration and communications. Disability needs are often ignored in the design of services and treatment of individuals. It manifests as services which some find difficult to use and lack of personal respect (discrimination) often based on lack of understanding by the healthcare profession itself (ignorance). This paper explores how Social Media (SM), an example “Assistive Technology” in …

The Pribram – Bohm Hypothesis, Shelli R. Joye

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

A holoflux theory of consciousness as modulated energy is hypothesized and shown to support both local and non-local properties. This thesis emerges from an integral evaluation of evidence drawn from: (1) the holonomic mind/brain theories of Karl Pribram, (2) the ontological interpretation of quantum theory by David Bohm. Applying an integral methodology to superimpose and correlate seemingly disparate concepts from among these sources and others, a composite-theory emerges, a “holoflux” theory of consciousness, after the term favored by Karl Pribram to describe David Bohm’s “holomovement” between an explicate order andan implicate order. This Pribram–Bohm composite holoflux theory is shown to …

A Vision For Using Online Portals For Surveillance Of Patient-Centered Communication In Cancer Care, Hardeep Singh, Neeraj K. Arora, Kathleen M. Mazor, Richard L. Street Jr

Patient Experience Journal

The Veterans Health Administration (VHA) is charged with providing high-quality health care, not only in terms of technical competence but also with regard to patient-centered care experiences. Patient-centered coordination of care and communication are especially important in cancer care, as deficiencies in these areas have been implicated in many cases of delayed cancer diagnosis and treatment. Additionally, because cancer care facilities are concentrated within the VHA system, geographical and system-level barriers may present prominent obstacles to quality care. Systematic assessment of patient-centered communication (PCC) may help identify both individual veterans who are at risk of suboptimal care and opportunities for …

Bringing Patient Advisors To The Bedside: A Promising Avenue For Improving Partnership Between Patients And Their Care Team, Karine Vigneault, Johanne Higgins, Marie-Pascale Pomey, Josée Arsenault, Valérie Lahaie, Audrey-Maude Mercier, Olivier Fortin, Alain M. Danino

Patient Experience Journal

This paper presents an innovative model of care, which brings patients who have already been through a similar experience of illness (patient advisors) directly to the bedside of patients, where they are viewed as full-fledged members of the clinical team. As part of a pilot project, three patient advisors were recruited and met with patients who had sustained a traumatic amputation and were admitted to the only center of expertise in replantation of the upper limb in Canada. Several individual interviews and focus groups with patients and patient advisors have revealed very promising results. Indeed, patients have expressed …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Book Review: The Language Of Caring Guide For Physicians: Communication Essentials For Patient-Centered Care (2nd Edition), Chet Wyman Md

Patient Experience Journal

In thie book review for Wendy Leebov and Carla Rotering’s The Language of Caring Guide for Physicians: Communication Essentials for Patient-Centered Care (2nd edition), the author/reviewer conveys his perspective on the essential value of this publication. He offers his recommendation of this book for anyone who wants to improve their own communication skills and also for physician leaders responsible for initiatives to engage physicians and improve service quality, patient outcomes, and CAHPS scores for a department or organization, noting it is an essential read in today’s healthcare environment.

The Relationships Between Hcahps Communication And Discharge Satisfaction Items And Hospital Readmissions, Fadi Hachem, Jeff Canar, Francis Fullam Ma, Andrew S. Gallan Phd, Samuel Hohmann, Catherine Johnson

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has become a key metric used by organizations and patients to evaluate patient experience. Readmissions also continue to be a metric used to evaluate performance because of the added cost to both healthcare systems and patients. Both measures are also seen in programs such as Value Based Purchasing that have an effect on hospital reimbursements. Previous studies have demonstrated a relationship between patient perceptions and quality of care, and have found patients to be reliable evaluators of their care. While good communication and positive provider relationships have been related …

A Rhetorical Analysis Of The Rethinking Aids Website, Jennifer Dettmann

Journal of Undergraduate Research at Minnesota State University, Mankato

A group of scientists known as the Group for Scientific Reappraisal of the HIV-AIDS hypothesis created a web site title, Rethinking AIDS. The group behind the web site argues that AIDS is not a sexually transmitted disease. They even question the existence of the virus entity. My analysis is driven by the critical question: Does the web site construct a reality that affectively alters our perception of HIV-AIDS? In order to answer this question, Goodnight and Poulakos 1981 article, Conspiracy rhetoric: from pragmatism to fantasy to public discourse (Western Journal of Speech), will be utilized.

Patient Care Experiences And Perceptions Of The Patient-Provider Relationship: A Mixed Method Study, Jennifer Tabler Ms, Debra L. Scammon Ms, Phd, Jaewhan Kim Phd, Timothy Farrell Md, Andrada Tomoaia-Cotisel Mph, Mha, Michael K. Magill Md

Patient Experience Journal

Improving interpersonal continuity of care—the personal relationship forged between a patient and their primary care provider (PCP) over time—is often considered a goal of primary care. Continuity of care is frequently assessed in terms of longitudinal continuity, or the proportion of encounters with one practitioner, overlooking aspects of the patient-provider relationship that are key to interpersonal continuity of care. Further, few studies explore patients’ perspectives regarding which care experiences enhance or detract from the patient-provider relationship. This study, using focus group interviews, a patient experience CAHPS-PCMH survey, and electronic medical records, explored how patients’ experiences at 10 primary care clinics …

Book Review: Understanding The Misunderstandings In Pilot-Controller Dialogue, Jason M. Newcomer

International Journal of Aviation, Aeronautics, and Aerospace

Misunderstandings in any environment can be detrimental, if not counterproductive, to the intentions, expectations, or objective(s) of any communication, but in complex airspace congested by heavy traffic, pilot-controller transmissions, and various meteorological phenomena, they can be catastrophic. Barshi and Farris combine 45 years of aviation experience, 20 years of related research, and advanced education with sound methodology to deliver a well-balanced combination of theoretical and practical work to the fields of aviation, human factors, and psychology. Though Misunderstandings in ATC Communications, the authors guide readers through a series of experiments, literature, and transcribed air traffic control recordings to explore …

Conversations About The Weight Of America's Children: Barriers Which Prevent Healthcare Providers From Discussing Childhood Obesity, Catherine Blow, Alisa Allicock, Carolynn Desandre, Chandra Cooper-Samuels

Journal of Human Sciences and Extension

A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers) and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare providers must be able to effectively communicate with caregivers and put childhood obesity at the front of healthcare discussions. This article provides a synthesis of the relevant literature and makes recommendations for healthcare providers to overcome the …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

Commentary: Changing The Channel: Public Health Communication In The 21st Century, Anna Goodman Hoover

Frontiers in Public Health Services and Systems Research

This commentary asserts the need for research examining the use and efficacy of social media as a tool for meeting public health stakeholders’ information needs. The author points to several potential research questions for the field, situates studies addressing these questions within the PHSSR Research Agenda, and introduces the work of Harris et al. that is included in this issue of Frontiers. The commentary closes with a call for horizontal stakeholder communication that supports evidence-based decision-making.

A Model Of Organizational Responsiveness To Stakeholders, Caron Chess

RISK: Health, Safety & Environment (1990-2002)

Dr. Chess explores the relationship between risk management and risk communication and its affect on an organization/stakeholder relationship.

Risk Perception And Drug Safety Evaluation, Ilan B. Vertinsky, Donald A. Wehrung

RISK: Health, Safety & Environment (1990-2002)

The authors present a Risk communication framework based on a survey of empirical research concerning public Risk perceptions. They also apply it to the area of pharmaceutical regulation to suggest more effective regulatory strategies.