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Articles 8761 - 8790 of 18484
Full-Text Articles in Social and Behavioral Sciences
Open Access And The Public Library Of Medicine, Summary Of A Presentation By Dr. Harold Varmus, Michael J. Miller
Open Access And The Public Library Of Medicine, Summary Of A Presentation By Dr. Harold Varmus, Michael J. Miller
Urban Library Journal
Dr. Varmus opened his comments with a vignette regarding his own foray into the publishing world. Based upon his exposure to Cornell's arXiv.org, (the evolutionary result of Ginsbarg's "e-print archives" for electronic research publications for physics materials), he eventually pursued similar means of electronic research publishing in the areas of biology and medicine. Though challenged by the academy, these efforts guided by accompanying constructive criticisms led to the development of PubMed Central(tm). ...
'This Would Be Much Funner In Person': A Qualitative Grounded Theory Analysis Of Cybergrooming, Maurice Jason Gauz
'This Would Be Much Funner In Person': A Qualitative Grounded Theory Analysis Of Cybergrooming, Maurice Jason Gauz
Dissertations and Theses
The rather novel phenomenon of cybergrooming, or the solicitation of minors for sex via the Internet, has yet to be fully explored. This is a problem because such predatory behavior can lead to psychological and/or physical abuse of minors. The present study seeks to fill this knowledge by performing a qualitative, grounded theory analysis of naturally-occurring cybergrooming discourse. Data were drawn from the website of the online watchdog group, Perverted Justice. The first 20 lines of talk transmitted by the adults in these chat conversations were sampled from 100 transcripts published by Perverted Justice.
Multi-step coding, facilitated by the qualitative …
Appropriate Strategies For Developing Information Marketing In Iranian Faculties Of Agriculture, Mojtaba Sookhtanlo, Hamid Movahed Mohammadi, Ahmad Rezvanfar, Yousef Hedjazi
Appropriate Strategies For Developing Information Marketing In Iranian Faculties Of Agriculture, Mojtaba Sookhtanlo, Hamid Movahed Mohammadi, Ahmad Rezvanfar, Yousef Hedjazi
Library Philosophy and Practice (e-journal)
The main purpose of this research was to identify strengths and weaknesses, opportunities and threats associated with information marketing and appropriate strategies for the development of information marketing in Iranian Faculties of Agriculture. The research population consisted of all staff employed in central libraries of in the selected Faculties of Agriculture (Universities of Tehran, Ferdowsi of Mashhad, Shiraz, Tabriz and Isfahan technology) (N=107). The respondents selected by census sampling method so that ultimately number of 90 questionnaires obtained (n=90). According to the findings, the majority of respondents (72.3%) has a positive and very positive attitude to applying information marketing factors. …
Emotion Focused Therapy For Couples In Addiction Treatment: The Relationship Between Quality Of Recovery, Attachment Style, And Relational Satisfaction, Bonnie Bassett
Doctoral Dissertations and Projects
This study investigates the efficacy of Emotion Focused Therapy (EFT) for couples in an addiction recovery program. The literature review revealed that individuals with a secure attachment style experience increased relational satisfaction and report better ability to manage life's challenges as compared with individuals with an insecure attachment style. A pretest-posttest design was used to investigate the effect of EFT on quality of recovery from addiction. The primary measure's percentile rank scores were comparatively analyzed. A single case multiple baseline design was implemented to draw inferences based on examining the participants' assessment scores across baseline and intervention phases. The purpose …
David Douglas School District Enrollment Forecasts 2014-15 To 2033-34, Portland State University. Population Research Center, Charles Rynerson, Kevin Christopher Rancik, Ryan Dann
David Douglas School District Enrollment Forecasts 2014-15 To 2033-34, Portland State University. Population Research Center, Charles Rynerson, Kevin Christopher Rancik, Ryan Dann
School District Enrollment Forecast Reports
This report presents the results of a demographic study conducted by the Portland State University Population Research Center (PRC) for the David Douglas School District (DDSD). The study includes analysis of population, housing and enrollment trends affecting the District in recent years, estimates of the impacts of housing development on DDSD enrollment, and forecasts of district‐wide and individual school enrollments for the 2014‐15 to 2033‐34 school years.
Impact Of Soil Moisture–Atmosphere Interactions On Surface Temperature Distribution, Alexis Berg, Benjamin R. Lintner, Kirsten L. Findell, Sergey Malyshev, Paul C. Loikith, Pierre Gentine
Impact Of Soil Moisture–Atmosphere Interactions On Surface Temperature Distribution, Alexis Berg, Benjamin R. Lintner, Kirsten L. Findell, Sergey Malyshev, Paul C. Loikith, Pierre Gentine
Geography Faculty Publications and Presentations
Understanding how different physical processes can shape the probability distribution function (PDF) of surface temperature, in particular the tails of the distribution, is essential for the attribution and projection of future extreme temperature events. In this study, the contribution of soil moisture–atmosphere interactions to surface temperature PDFs is investigated. Soil moisture represents a key variable in the coupling of the land and atmosphere, since it controls the partitioning of available energy between sensible and latent heat flux at the surface. Consequently, soil moisture variability driven by the atmosphere may feed back onto the near-surface climate—in particular, temperature. In this study, …
Can Cognitive Priming Influence The Reinforcing Efficacy Of Alcohol Within A Behavioral Economic Framework?, Lauren J. Adams
Can Cognitive Priming Influence The Reinforcing Efficacy Of Alcohol Within A Behavioral Economic Framework?, Lauren J. Adams
USF Tampa Graduate Theses and Dissertations
A considerable body of research supports the application of behavioral economic principles to study the relative reinforcing efficacy of drug and alcohol use. One self-report measure, the Alcohol Purchase Task, is thought to account for individual differences in the subjective valuation of alcohol consumption. To date, however, behavioral economic approaches have not evaluated the possible influence of memory-based expectations regarding the cognitive and behavioral effects of substance use on their measures. Alcohol expectancy research has found that more positive expectancies about the effects alcohol directly mediate drinking behavior and are associated with a number of alcohol-related outcomes. Given the importance …
Applying Public Relations Theory To Assess Service-Learning Relationships, Karen Strand
Applying Public Relations Theory To Assess Service-Learning Relationships, Karen Strand
USF Tampa Graduate Theses and Dissertations
In Service-Learning (S-L) partnerships, universities and community organizations exchange resources and influence. Community engagement scholars Cruz and Giles proposed that relationships within S-L partnerships serve as units of analysis for the study of community outcomes of engagement. Yet, the scholarship of engagement lacks a suitable instrument to assess such relationships. This study brings together two lines of scholarship-relationship studies within community engagement and cocreational studies within public relations-to address the problem of assessing the community outcomes of S-L relationships, and it applies Cruz and Giles' ideas about using relationship analysis to assess community outcomes when it considers the perspectives of …
Striving For Success In An Uncertain Environment, Sandra Stershic
Striving For Success In An Uncertain Environment, Sandra Stershic
USF Tampa Graduate Theses and Dissertations
Using one's success and failure experiences can be an indicator of how well risk is being managed in uncertain situations, particularly because exact probability information about outcomes is often missing. Experience-based paradigms include this more real-world aspect of a lack of information when studying risk taking behavior. This thesis builds upon experience-based paradigms to include the element of skill.
A puzzle task was developed. A goal was given to participants to try to discern a pattern in each puzzle that would yield consistently positive outcomes. Participants were randomly assigned to a high or low success rate, but told that skill …
The Effect Of Ovulation As A Male Mating Prime On Drinking And Other Mating Behaviors, Robin Tan
The Effect Of Ovulation As A Male Mating Prime On Drinking And Other Mating Behaviors, Robin Tan
USF Tampa Graduate Theses and Dissertations
A recent line of research grounded in evolutionary theory has shown that exposure to women's fertility cues affects men's mating cognition and behavior. This area of research has not yet been examined in relation to alcohol. As alcohol has also been shown to facilitate the formation of sexual connections for males, establishing the intersection between these two lines of research seems necessary to understand the impetus behind human behavior. Ninety-eight male participants were primed with either the scent of a fertile woman or the scent of nonfertile woman and then completed measures assessing their level of attraction to pictures of …
Craniometric Ancestry Proportions Among Groups Considered Hispanic: Genetic Biological Variation, Sex-Biased Asymmetry, And Forensic Applications, Meredith L. Tise
Craniometric Ancestry Proportions Among Groups Considered Hispanic: Genetic Biological Variation, Sex-Biased Asymmetry, And Forensic Applications, Meredith L. Tise
USF Tampa Graduate Theses and Dissertations
Today, groups considered Hispanic in the United States consist of populations whose complex genetic structures reflect intermixed diverse groups of people who came in contact during Spanish colonization in Latin America. After coming in contact and wiping out most of the Native Americans who occupied North and Latin America, the Spanish also introduced West African individuals for labor to begin developing crops to be shipped back to Europe, resulting in the Trans-Atlantic African slave trade. These migration events and differential gene flow among males and females that occurred throughout Latin America have led to populations that have been genetically transformed …
Hermes, Technical Communicator Of The Gods: The Theory, Design, And Creation Of A Persuasive Game For Technical Communication, Eric Walsh
USF Tampa Graduate Theses and Dissertations
For my thesis, I have undertaken the creation of a persuasive game to advance a particular argument of the way that work is performed in the field of technical communication. Designed using procedural rhetoric, with an attention to aesthetics, fun, and the qualities that make games viable pedagogical tools, my game has been programmed using HTML5 and JavaScript, and made freely available online at RhetoricalGamer.com. This written document is meant to serve as a supplement to the game, providing a rationale for the use of games in education and in technical communication; a definition of procedural rhetoric and the necessary …
Guaman Poma's Legacy: Snapshots Of Globalization, Identity, And Literacy Through The Urban Amazonian Indigenous Intellectual Lens, Roger Maurice Villamar
Guaman Poma's Legacy: Snapshots Of Globalization, Identity, And Literacy Through The Urban Amazonian Indigenous Intellectual Lens, Roger Maurice Villamar
USF Tampa Graduate Theses and Dissertations
This dissertation initially utilizes the analogy of an Andean intellectual's magnum opus of resistant visual art and text created in the 1600s, to explore the impact of current global influences on the identity of Awajún and Wampís Amazonian students residing in Lima, the capital city of Perú. The participants in this study are urban Amazonian indigenous intellectuals applying to enter, currently studying in degree programs, or pursuing graduate degrees at local universities of Lima. Using an amalgamation of Photovoice and Photo-Elicitation components, digital photography, open-source applications, and computer technology, participants creatively expressed through their visual discourse what it means to …
Leges, Plebiscita, Et Rogationes: Democratization And Legislative Action, 494 - 88 Bc, Eric Wolters
Leges, Plebiscita, Et Rogationes: Democratization And Legislative Action, 494 - 88 Bc, Eric Wolters
USF Tampa Graduate Theses and Dissertations
This study intends to analyze the importance of institutional trust in the process of democratization. In this particular case, the period from 494 to 88 BC in the Roman republic is examined. The theories of Charles Tilly and Robert Putnam are utilized to more deeply examine the concepts and manifestations of trust and democratization. Using the ideas and theories of these authors together provides a unique insight into the means by which a population comes to trust that government is responsive, and further comes to expect increased responsiveness in the future. Institutional trust as an element of mutually binding consultation …
An Examination Of Motives, Experiences, And Behaviors Of Mmorpg Players, Theresa Lynn Woods
An Examination Of Motives, Experiences, And Behaviors Of Mmorpg Players, Theresa Lynn Woods
USF Tampa Graduate Theses and Dissertations
Massively multiplayer online role-playing games (MMORPGs) are growing in popularity and use worldwide. This study seeks to explore the motivations and experiences of MMORPG players through an extensive online survey with more than a thousand participants (n=1,422). The findings support a complex relationship between the variables, including the direct effects of motivations and flow on the time invested by players in MMORPG play, as well as the mediated effects of motivation via flow. Causal relationships are examined in addition to the significance of direct and indirect effects on frequency of play, yielding several significant results, including (1) the overwhelming importance …
Troubled Waters: Georgia, Florida And Alabama's Conflict Over The Waters Of The Acf River Basin, Johnny King Alaziz Wong
Troubled Waters: Georgia, Florida And Alabama's Conflict Over The Waters Of The Acf River Basin, Johnny King Alaziz Wong
USF Tampa Graduate Theses and Dissertations
Since 1989, the co-riparian States of Georgia, Florida and Alabama have been locked in an overt and institutionalized conflict to secure access to the waters of the Apalachicola-Chattahoochee-Flint (ACF) River Basin. In 1997, in an effort to end this interstate conflict which had earned the reputation as the longest water conflict in U.S. history, public officials at the federal and state scales agreed to suspend all pending litigation against one another and concurrently deployed a dispute resolution mechanism, known as `compact negotiations,' in the hope of equitably allocating the waters of the ACF Basin. Despite proclamations by public officials, exclaiming …
Caregiving And The Experience Of Health And Illness In Children Living With Hiv/Aids In Gulu District Northern Uganda: An Ethnographic Research Narrative, Constantine S.L. Loum Phd
Caregiving And The Experience Of Health And Illness In Children Living With Hiv/Aids In Gulu District Northern Uganda: An Ethnographic Research Narrative, Constantine S.L. Loum Phd
Patient Experience Journal
In this paper we discuss the experience of caregiving for children living with HIV in a resource poor environment in Gulu municipality in northern Uganda; the main research questions of the study were: what are the perceptions of caregivers on the care of children with HIV, and what barriers and enablers exist that undermine or promote better care for children respectively? The experience of caregivers and their perceptions on managing HIV in children is believed to shape the health seeking behaviour towards treatment and efforts to cope with its negative impact on the body. Women and children are the greatest …
The Role Of Governing Boards In Improving Patient Experience: Attitudes And Activities Of Health Service Boards In Victoria, Australia, Marie Bismark, Susan Biggar, Catherine Crock, Jennifer M. Morris, David M. Studdert
The Role Of Governing Boards In Improving Patient Experience: Attitudes And Activities Of Health Service Boards In Victoria, Australia, Marie Bismark, Susan Biggar, Catherine Crock, Jennifer M. Morris, David M. Studdert
Patient Experience Journal
The authors sought to determine the attitudes of public health service board members and senior executives toward patient experience and to describe the governance activities of the boards in this area. The study was based on an online survey of 322 board members from 85 public health services and semi-structured interviews with 35 board members and senior executives from 13 public health services in Victoria, Australia. The results showed that while some health service boards had high aspirations and clear plans for improving patient experience, others remained sluggish or even cynically resistant to changing their existing models of care. Interviewees …
Patients’ Experiences In The Uk: Future Strategic Directions, Sophie Staniszewska, Neil Churchill
Patients’ Experiences In The Uk: Future Strategic Directions, Sophie Staniszewska, Neil Churchill
Patient Experience Journal
Over the last decade policy has emphasised the importance of a good patient experience as a cornerstone of high quality health and social care in the UK, with many initiatives attempting to develop patient-centred practice. More recently, the Francis Inquiry has addressed the significant failings in care identified at Mid Staffordshire NHS Foundation Trust in England and has been pivotal in raising the importance of patient experience.1 The Francis report made 290 recommendations, with many emphasizing the importance of patient experience through their focus on specific ways in which the quality of experiences can be enhanced, for example, by …
What Matters Most To Patients? Participative Provider Care And Staff Courtesy, Andrew H. Van De Ven
What Matters Most To Patients? Participative Provider Care And Staff Courtesy, Andrew H. Van De Ven
Patient Experience Journal
Although there is growing recognition of the importance of having satisfied patients, we know little about what aspects of care matter most to patients. The sources of patient satisfaction and how care delivery can influence them need more empirical study. The objective of this study was to identify which aspects of a patient’s experience of care are most important to patient satisfaction, and how dimensions of care relate to clinic size, economic performance, and employee job satisfaction. To explore our question, longitudinal survey data were obtained on patients and employees over two years (1996 and 1997). Relationships between patient satisfaction …
Psychometric Properties Of The New Patients’ Expectations Questionnaire, Ann Bowling Bsc, Msc, Phd, Gene Rowe Phd
Psychometric Properties Of The New Patients’ Expectations Questionnaire, Ann Bowling Bsc, Msc, Phd, Gene Rowe Phd
Patient Experience Journal
The authors explore the development of the Patients’ Expectations Questionnaire (PEQ) and examination of psychometric characteristics it encompasses by reviewing surveys of primary care and hospital outpatients before and after their clinic visit. Three scales were developed for Pre-visit Ideal and Realistic expectations, and Post-visit Experiences (met expectations), based on literature review, semi-structured interviews, and subsequently piloted and refined. Patients completed the questionnaire about their ideal and realistic expectations before they saw the doctor, and were asked if their expectations had been met afterwards. The results show the scales met acceptability criteria for reliability (Cronbach’s alphas exceeded α 0.70), administration …
Factors In Patients’ Experience Of Hospital Care: Evidence From California, 2009–2011, Edmund R. Becker Phd, Jason M. Hockenberry Phd, Jaeyong Bae Ma, Ariel C. Avgar Phd, Sandra S. Liu Phd, Mba, Ira Wilson Md, Msc, Arnold Milstein Md, Mph
Factors In Patients’ Experience Of Hospital Care: Evidence From California, 2009–2011, Edmund R. Becker Phd, Jason M. Hockenberry Phd, Jaeyong Bae Ma, Ariel C. Avgar Phd, Sandra S. Liu Phd, Mba, Ira Wilson Md, Msc, Arnold Milstein Md, Mph
Patient Experience Journal
The use of measures of patient-centered care to evaluate hospital care is mandated by The Patient Protection and Affordable Care Act of 2010. Using three years of data from 315 California acute-care hospitals and data collected from patients via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, we seek to evaluate patients’ hospital-care experience by (1) analyzing patients’ experience-of-care scores in light of these hospitals’ patient profiles, structural characteristics, and outcomes in 2011, and (2) determining and analyzing the extent of changes in patients’ experience of care over the three-year period 2009–2011. For 2011, we find significant …
Veterans’ Experiences Of Patient-Centered Care: Learning From Guided Tours, Sara M. Locatelli Phd, Stephanie Turcios Bs, Cepep, Sherri L. Lavela Phd, Mph, Mba
Veterans’ Experiences Of Patient-Centered Care: Learning From Guided Tours, Sara M. Locatelli Phd, Stephanie Turcios Bs, Cepep, Sherri L. Lavela Phd, Mph, Mba
Patient Experience Journal
In this paper the authors seek to examine Veterans’ experiences with patient-centered care (PCC) at 2 United States Veterans Affairs (VA) facilities. The authors conduct their research through a process of guided tours, in which the participant leads the evaluator through an environment and shares thoughts, feelings, and experiences. Tours were conducted in April 2013 with 30 Veterans receiving care at these VA facilities. Via the tours participants discussed aspects of the environment of care, and described some as ‘welcoming,’ while describing others as ‘chaotic.’ Participants provided multiple examples of PCC, frequently defining PCC in terms of accessibility of appointments, …
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 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 …
The Impact Of The Resident Duty Hour Regulations On Surgical Patients’ Perceptions Of Care, Shital Shah Phd, Mary Katherine Krause Ms, Fache, Francis Fullam Ma, Susan Vanderberg-Dent Md, Amie E. Solber Ms
The Impact Of The Resident Duty Hour Regulations On Surgical Patients’ Perceptions Of Care, Shital Shah Phd, Mary Katherine Krause Ms, Fache, Francis Fullam Ma, Susan Vanderberg-Dent Md, Amie E. Solber Ms
Patient Experience Journal
Implementation of the 2003 Accreditation Council for Graduate Medical Education (ACGME) resident duty-hour regulations and access to publicly reported patient satisfaction measures have challenged administrators and clinicians to balance resident’s educational experience, patient care quality, and patients’ satisfaction and perceptions. A pre-post retrospective study design investigated association between implementation of ACGME regulations and patient satisfaction/perceptions using multinomial logistic regressions. The sample consisted of all surgical inpatients (July 2001 – June 2005), who responded to surveys at an academic medical center. Patients gave lower ratings for physician interactions (patient-physician interaction time, clinical updates, and courtesy) following the implementation of post-duty hour …
Physician-Led Patient Experience Improvement Efforts: The Connect Program, An Emerging Innovation, Harris P. Baden Md, Jennifer E. Scott Mha
Physician-Led Patient Experience Improvement Efforts: The Connect Program, An Emerging Innovation, Harris P. Baden Md, Jennifer E. Scott Mha
Patient Experience Journal
In 2009, the leadership of the Children’s University Medical Group (CUMG) embarked on an effort to answer the question, “What would it take to promote and foster a culture of service amongst the medical staff?” The challenge was to engage the physician group in leading patient and family experience improvements within Seattle Children’s. In this article, an innovative, physician-designed and led approach to improving the patient experience is described. The effort focuses on encouraging local, grass roots strategies rooted in readily available and validated best practices. In support of that effort, novel tools that were developed and deployed …
Improving The Patient Experience Through Provider Communication Skills Building, Denise M. Kennedy Mba, John P. Fasolino Md, David J. Gullen Md
Improving The Patient Experience Through Provider Communication Skills Building, Denise M. Kennedy Mba, John P. Fasolino Md, David J. Gullen Md
Patient Experience Journal
The doctor’s interpersonal skills are arguably the most important to clinical outcome and patient experience. A peer-facilitated, communication skills-building course for physicians has been provided twice annually since its inception in 2004. The course was designed to increase personal awareness, as well as to help physicians develop new communication and interpersonal skills. Satisfaction data from 3,561 patient surveys on 80 providers who attended the course between 2006 and 2010 were analyzed one year before and one year after course participation. After completing the course, the proportion of “excellent” ratings of provider service (the highest rating on a 5-point scale) increased …
Transforming The Patient Experience: Bringing To Life A Patient- And Family-Centred Interprofessional Collaborative Practice Model Of Care At Kingston General Hospital, Anndale Mctavish Ma, Cynthia Phillips Rrt, Med
Transforming The Patient Experience: Bringing To Life A Patient- And Family-Centred Interprofessional Collaborative Practice Model Of Care At Kingston General Hospital, Anndale Mctavish Ma, Cynthia Phillips Rrt, Med
Patient Experience Journal
The Kingston General Hospital strategic plan includes transforming the patient experience and bringing to life new models of interprofessional care and education. The implementation of the Interprofessional Collaborative Practice Model has been the foundation of this transformational change. Areas identified for improvement included communication, discharge planning, and purposeful engagement of patients and families in the care process. Through a system-wide approach to change, it was expected that the organization would be better prepared to deliver safer, higher quality care and enriched experiences for patients, families and practitioners. From March to October 2009, 54 representatives from various disciplines and services gathered …
Patients And Families As Partners In Safety, Quality, And Experiences Of Care, Amy Jones, Kathy Dutton
Patients And Families As Partners In Safety, Quality, And Experiences Of Care, Amy Jones, Kathy Dutton
Patient Experience Journal
This case examines the highlights of Vidant Health’s journey to a more intentional focus on patient experience. Organizational inconsistencies lead to a focused long term plan putting a culture of patient centeredness at the core of Vidant’s efforts. The results show a clear and measured improvement in safety, quality and experience overall.
A Daughter’S Frustration With The Dearth Of Patient- And Family-Centered Care, Cindy Brach
A Daughter’S Frustration With The Dearth Of Patient- And Family-Centered Care, Cindy Brach
Patient Experience Journal
Patient involvement in decision-making is an increasingly recognized ethical imperative, one that requires attention to health literacy. Health care that is truly patient- and family-centered, however, is the exception rather than the rule. This first person account of a hospitalization describes the lack of patient and family inclusion in decision-making, failure to use plain language and other health literacy strategies, and disregard for patient and family preferences. The author concludes that if the health care system is going to shift from paternalistic to patient- and family-centered, providers must be trained how to communicate and partner with patients and families. Even …