In vitro fertilisation (IVF) daily practice reveals that couples are willing to take greater risks than doctors if there is a higher chance of pregnancy. Arising from this is a frequently addressed issue regarding the embryo transfer strategy: single or double embryo transfer? The dilemma is faced by patients, as well as physicians, who are caught between the possibility of no pregnancies at all and facing the prospect of iatrogenic twin gestation. How could the couple's preferences concerning how many children (...) they would like be taken into account in determining the number of embryos transferred? How should the physician exercise his medical responsibility towards his patients and the unborn child? An effective approach could be to enhance a couple’s autonomy by advocating a medical beneficence that incorporates patients’ values. This can be achieved through a case-by-case approach in a deliberative process of decision-making which includes real patient-centred communication. (shrink)

Introducción: la formación de profesionales competentes es una de las misiones esenciales de la Educación Médica Superior, esto exige que los tecnólogos posean habilidades comunicativas para un correcto desempeño laboral en aras del mejoramiento humano. Objetivo de la investigación: identificar las barreras que inciden en la comunicación tecnólogo - paciente en las carreras de Licenciatura en Traumatología, Podología, Terapia Física y Rehabilitación Social Ocupacional, en áreas de rehabilitación. Métodos: se presenta un estudio observacional, descriptivo longitudinal y retrospectivo entre junio de (...) 2008 y junio 2011 que consistió en la observación a exámenes estatales prácticos y a la educación en el trabajo, en las carreras de referencia, además se aplicó una encuesta a pacientes para la obtención de información acerca de las barreras que afectan el proceso de la comunicación entre tecnólogos y pacientes. Resultados: existen insuficiencias en la comunicación entre los futuros profesionales y pacientes. Conclusiones: se demuestra un insuficiente dominio de las habilidades comunicativas y por tanto barreras que interfieren en la comunicación como las semánticas y personales. Introduction: the training of competent professionals is one of the essential missions of higher medical education; this requires that technologists have communication skills in order to develop a proper job performance for the sake of human improvement. So the objective of the research is to identify barriers affecting technologist - patient communication in the careers of degree in Trauma, Podiatry, Physical Therapy, and Occupational Social Rehabilitation in areas of rehabilitation. Methods: an observational, longitudinal descriptive and retrospective study is presented between June 2008 and June 2011 that consisted on observation to practical state exams and training at work, in the reference degrees; in addition, a survey was applied to patients to obtain information about the barriers that affect the communication process between technologists and patients. Results: there are communication inadequacies between the future professionals and patients. Conclusions: An insufficient mastery of the communication skills is demonstrated and therefore barriers that interfere with communication as the semantic and personal barriers. (shrink)

The purpose of the study is to analyze the phenomenon of communicative barriers in the context of phenomenological and hermeneutic representations, to identify the main semantic causes of the formation of conflict barriers inherent in the communicative consciousness. The scientific novelty of the research lies in the fact that the phenomenon of communicative barriers is considered in the context of the ontological foundations of communication interaction, the semantic aspects of the barriers of misunderstanding, their role (...) in the historical and social development of consciousness are analyzed. The combination of phenomenological and hermeneutic approaches creates justifications for revealing the causal - target orientation of communication dynamics. In this regard, the dialectical essence of communication barriers is pointed out. As a result, the conclusion is made about the creative role of communicative barriers in the development of human consciousness, culture and social existence. (shrink)

Good communication between healthcare providers and patients is vital to effective healthcare. In order to understand patients’ complaints, make accurate diagnoses, obtain informed consent and explain treatment regimens, clinicians must communicate well with their patients. This can be challenging when treating patients from unfamiliar cultural backgrounds, such as the Deaf. Not only are they a linguistic and cultural minority, they are also members of the world’s largest and oft-forgotten minority group: the disability community. Under Article 25 of the United (...) Nations Convention on the Rights of Persons with Disabilities, persons with disabilities have rights to the same range, quality and standard of free or affordable healthcare and programmes as provided to other people. Yet communication barriers and healthcare providers’ lack of familiarity with Deaf culture can impair the quality and accessibility of healthcare for the Deaf. This essay analyses the scope of this issue in Singapore: a state party to the CRPD which has a vibrant Deaf community, and yet no legislative or constitutional guarantees of the rights of persons with disabilities. In addition to exploring the communication barriers faced by Deaf patients in Singapore, this essay highlights ways in which healthcare providers and the state can support community-based initiatives to overcome these barriers. (shrink)

When people speak about “communication barriers”, what they usually think about are such things as the limitations set by human nature itself, or the constraints that are inherent in the tools we use for communicating. As an example of the first, consider the limited range of the naked human voice; for the second, we may think of the limitations imposed by such primitive communicative devices as the bonfire, the heliograph, or an old-fashioned megaphone.Our contribution draws attention to the (...) fact that, despite enormous advances on the technological side of human communication (such as demonstrated by the existence and use of computers as communication devices), there still are some barriers to be removed as far as the human side is concerned. We call these barriers the “stumble-blocks of the mind”. Their existence is demonstrated by the study of two case stories, which show that understanding the communicative implications of computerizing information is more important than increased emphasis on ever fancier and more expensive hardware products.The next question has to do with the reasons for these “stumbling blocks” to occur. Current communicative and linguistic theoretical findings are used in an effort to explain and solve the communicative dilemmas that are encountered in the organization of our communication, among others in the area of human-computer interface. In particular, the notion of “privacy” in speech acting is suggested as an overlooked aspect, and the notion of “information transfer” is replaced by that of “creating mental activity”.Finally, some conclusions are drawn, and a number of practical applications are offered. (shrink)

When conducting research on sensitive topics, it is challenging to use new methods of data collection given the apprehensions of Institutional Review Boards (IRBs). This is especially worrying because sensitive topics of research often require novel approaches. In this article a brief personal history of navigating the IRB process for conducting sex communication research is presented, along with data from a survey that tested the assumptions long held by many IRBs. Results support some of the assumptions IRBs hold about (...) sex communication research, but do not support some other assumptions. (shrink)

GPs usually care for their patients for an extended period of time, therefore, requests to not only discontinue a patient’s treatment but to assist a patient in a suicide are likely to create intensely stressful situations for physicians. However, in order to ensure the best patient care possible, the competent communication about the option of physician assisted suicide as well as the assessment of the origin and sincerity of the request are very important. This is especially true, since patients’ (...) requests for PAS can also be an indicator for unmet needs or concerns. Twenty-three qualitative semi-structured interviews were conducted to in-depth explore this multifaceted, complex topic while enabling GPs to express possible difficulties when being asked for assistance. The analysis of the gathered data shows three main themes why GPs may find it difficult to professionally communicate about PAS: concerns for their own psychological well-being, conflicting personal values or their understanding of their professional role. In the discussion part of this paper we re-assess these different themes in order to ethically discuss and analyse how potential barriers to professional communication concerning PAS could be overcome. (shrink)

Despite the great expansion and many benefits of information and communication technologies in healthcare, the attitudes of Polish general practitioners to e-health have not been explored. The aim of this study was to determine the GPs’ perception of ICT use in healthcare and to identify barriers to the adoption of EMR in the Podlaskie Voivodeship. Online and telephone surveys were conducted between April and May 2013. Responses from 103 GP practices, 43% of all practices in the region, were (...) analysed. The results showed that 67% of the respondents agreed that IT systems improve quality of healthcare services. In the GP group who declared at least partial EMR implementation, 71.4% see the positive impact of IT on practice staff processes and 66.1% on personal working processes. In this group, more than three-quarters of GPs did not see any positive impact of ICT on the average number of patients treated per day, number of patients within the practice or scope of services. The four most common barriers to EMR implementation were: lack of funds, risk of a malfunction in the system, resistance to change, and lack of training and proper information. Although the use of ICT by Polish GPs is limited, their attitude to e-health is generally positive or neutral and resembles the overall pattern in Europe. Barriers identified by GPs need to be taken into account to ensure the effective implementation of e-health across the country. (shrink)

Tracing the origin and circulation of the “jargon” spoken at Canton, the paper examines how “jargon” became an issue of Sino-foreign communication conflicts in the early 19th century, and how Westerners responded to it. As a lingua franca spread extensively in the Canton trade, the so-called “jargon” (a pidgin form of patois) played an essential role as communication tool between Chinese and foreign traders. However, in the eyes of missionaries in early 19th century China, the normal Sino-foreign contact (...) process was interrupted and distorted by both parties’ overusing of the jargon. In this regard, early Protestant missionaries’ support of Chinese language study reveals an initial effort to break through the “jargon” barrier. (shrink)

Wexler and Specker Sullivan (2023) reflect on the field of neuroethics by highlighting criticisms from both scholars within and outside the field. Among these criticisms, are claims that neuroethic...

Micro and small businesses contribute the majority of business activity in the most developed economies. They are typically embedded in local communities and therefore well placed to influence community wellbeing. While there has been considerable theoretical and empirical analysis of corporate citizenship and corporate social responsibility (CSR), the nature of micro-business community responsibility (mBCR) remains relatively under-explored. This article presents findings from an exploratory study of mBCR that examined the approaches, motivations and barriers of this phenomenon. Analysis of data (...) from 36 semi-structured interviews with micro-business owner-operators in the Australian city of Brisbane revealed three mBCR approaches, suggesting an observable mBCR typology. Each mBCR type was at least partly driven by enlightened self-interest (ESI). In addition to a pure ESI approach, findings revealed ESI combined with philanthropic approaches and ESI combined with social entrepreneurial approaches. The combination of doing business and doing good found amongst participants in this study suggests that many micro-business owner-operators are supporters of their local communities and, therefore, driven by more than profit. This study provides a fine-grained understanding of micro-business involvement in community wellbeing through a lens of responsible business behaviour. (shrink)

Contemporary realities of global population movement increasingly bring to the fore the challenge of quality and equitable health provision across language barriers. While this linguistic challenge is not unique to immigration contexts and is likewise shared by health systems responding to the needs of aboriginal peoples and other historical linguistic minorities, the expanding multilingual landscape of receiving societies renders this challenge even more critical, owing to limited or even non‐existing familiarity of modern and often monolingual health systems with the (...) particular needs of new linguistic minorities. The centrality of language to health beliefs, attitudes, practices, cultural scripts, and conceptual frameworks emphasizes its pivotal role in the healthcare process, and consequently in the adverse effects of treatment that is language‐insensitive and unaware. Such an attitude on the part of medical authorities risks considerable epistemic injustice in the form of a (mis)judgement of patients’ intelligence, credibility, and rationality based on the language that they speak and the manner in which they speak it, consequently impacting the quality and equity of care provided. This danger, I argue, may be effectively countered by fostering among the participants in the healthcare process a sense of epistemic humility through greater metalinguistic awareness. Outlining a range of operative steps that can be used to facilitate this. I argue that the reality of language barriers in the healthcare process, while not entirely eliminable, may nevertheless be successfully addressed, in order to mitigate the challenge of quality and equitable healthcare provision in multilingual societies. (shrink)

By drawing up a model of the internal communication system of Bangladeshi ready-made garment factories, Helene Blumer identifies the existence and intensity of its communication flows. She furthermore discloses a connection from this communication system to labor unrest. The absence of a functioning formal channel within the factory, the lack of effective labor representation and the rare physical presence of the factory owners confirm the existence of a communication barrier. As symptom of a flawed communication (...) system, this barrier confirms a connection to labor unrest and the management's unawareness of its emergence, which would thwart any modes to predict and prevent work disruptions. Contents - Introduction to the Bangladeshi ready-made garment sector - Illustration of the internal communication system of Bangladeshi ready-made garment factories - Display of a communication barrier and its connection to labor unrest Target Groups - Academics in the fields of corporate responsibility and corporate/internal communication - Practitioners in the fields of corporate responsibility, corporate communication, development cooperation and garment industry About the Author Helene Blumer obtained her Master of Science in Business Administration (major in New Business Development) at the University of Applied Sciences HTW Chur. She currently works at the Swiss Institute for Entrepreneurship (SIFE) in the fields of corporate responsibility and business internationalization. (shrink)

Hospital ethics committees are common, but not universal, in small hospitals. A needs assessment was completed at a 155-bed community hospital in order to adapt an academic tertiary center model for a clinical ethics committee to fit the needs of the small hospital community. Of 678 questionnaires distributed, 209 were completed. Data suggested that clinical staff frequently experienced ethical dilemmas. Significantly more nonphysicians indicated that they would utilize a consultation service, if available, compared to physicians (p = 0.0067). The data (...) also indicated that the majority of staff (>80 percent) desired more education in clinical ethics. Physicians preferred annual or bi-annual hospital-wide grand rounds, compared to nonphysicians, who preferred more frequent department-based teaching (p < 0.001). The data presented in this article were used to subsequently develop a clinical ethics support committee, the process of which is also described. (shrink)

Background Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role. Research question What would cause nurses to take no action when they witness (...) situations that require them to act as health advocates for their clients or communities? Research Design An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis. Participants and research context Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions. Ethical considerations The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study. Findings Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role. Conclusions Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates. (shrink)

The purpose of this study was to examine the perceptions of Black African‐born nurses (BABN) with non‐native accents regarding their nursing career advancement in the United States. Data were collected using individual interviews. Fifteen nurses originally from three sub‐Saharan African countries were included in the study. The findings were reported under six themes: perceived low level of intelligence, not suitable to lead, making fun of/belittling, prejudging without evidence, downgrading, and accent modification. The finding indicated that participants believed that their race (...) and accent influenced their professional nursing opportunities. These results are relevant to BABNs, nurse educators, and healthcare organization leaders. BABNs are capable of participating in nursing leadership and education despite their non‐native accent. (shrink)

Barriers to mental health interventions globally remain a health concern; however, these are more prominent in low- and middle-income countries. The barriers to accessibility include stigmatization, financial strain, acceptability, poor awareness, and sociocultural and religious influences. Exploring the barriers to the utilization of mental health services might contribute to mitigating them. Hence, this research aims to investigate these barriers to mental health service utilization in depth at the Kabutare District Hospital of the Southern Province of Rwanda. (...) The qualitative approach was adopted with a cross-sectional study design. The participants were patients with mental illnesses seeking mental health services at the hospital. Ten interviews were conducted in the local language, recorded, and transcribed verbatim and translated by the researchers. Thematic analysis was applied to analyze the data collected. The results revealed that the most common barriers are fear of stigmatization, lack of awareness of mental health services, sociocultural scarcity, scarcity of financial support, and lack of geographical accessibility, which limit the patients to utilize mental health services. Furthermore, it was revealed that rural gossip networks and social visibility within the communities compounded the stigma and social exclusion for patients with mental health conditions. Stigmatization should be reduced among the community members for increasing their empathy. Then, the awareness of mental disorders needs to be improved. Further research in Rwanda on the factors associated with low compliance to mental health services with greater focus on the community level is recommended. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using (...) a stratified purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

Civil wars vary greatly in their duration. This book argues that conflicts are longer when they involve more actors who can block agreement and identifies specific problems that arise in multi-party bargaining. Quantitative analysis of over 200 civil wars since World War II reveals that conflicts with more of these actors last much longer than those with fewer. Detailed comparison of negotiations in Rwanda and Burundi demonstrates that multi-party negotiations present additional barriers to peace not found in two party (...) conflicts. In addition, conflicts with more veto players produce more casualties, are more likely to involve genocide and are followed by shorter periods of peace. Because they present many barriers to peace, the international community has a poor track record of resolving multi-party conflicts. David Cunningham shows that resolution is possible in these wars if peace processes are designed to address the barriers that emerge in multi-party conflicts. (shrink)

Background Coping with end-of-life issues is a major challenge for governments and health systems. Despite progress in legislation, many barriers exist to its full implementation. This study is aimed at identifying these end-of-life barriers in relation to Israel. Methods Qualitative in-depth interviews using professionals and decision makers in the health-care and related systems were carried out, along with two focus groups based on brainstorming techniques consisting of nurses and social workers. Data was managed and analyzed using Naralyzer software. (...) Results Qualitative analysis showed identification of six primary barriers: 1) law, procedures, and forms; 2) clinical aspects; 3) human aspects; 4) knowledge and skills of medical teams; 5) communication; and 6) resource allocation. These were further divided into 44 sub area barriers. Conclusions This study highlights the role of the family doctor in end-of-life by training physicians in decision-making workshops and increasing their knowledge in the field of palliative medicine. Effectively channeling resources, knowledge, and support for medical teams, by accounting for the structure and response of the units for home treatment will improve patient’s access to information on and support for end-of-life laws, as well as reduce legislative barriers in other countries that face the same issues. (shrink)

In Japan, most residents with Hansen’s disease live in dedicated sanatoria because of an established quarantine policy, even after being cured of the primary disease. They suffer from secondary diseases and are advancing in age, and advance care planning is increasingly crucial for them to live their lives with dignity in a sanatorium. In this study, we have three aims: to understand how to promote communication about their wishes for medical treatment, care, and recuperation; to identify required assistance; and (...) to explore how to promote ACP in a sanatorium. This study is a qualitative research conducted through semi-structured interviews. The study included 57 ex-Hansen’s disease patients and 66 staff from 10 facilities. Ex-Hansen’s disease patients were expected to consider ACP, but this was in the context of uncertainty about whether a sanatorium would close and whether there would be doctors to manage their needs. They reported being confused when staff rushed to confirm their advance directives, feeling that they were not provided with enough information before being approached. Barriers to promoting ACP were found to be insufficient of team-based care and information sharing, ex-Hansen’s disease patients’ weak interest in their end of life, and their conservative thoughts. We believe that ACP can be achieved by listening to the wishes of recovered patients through regular home care visits by nurses and everyday support by care workers. Furthermore, multidisciplinary coordination is urgently needed for promoting ACP. (shrink)

The purpose of the considerations is to present and systematise barriers to creating innovation in the Polish economy in 2012–2016. The desk research was based on the results of Community Innovation Surveys (CIS 2012 and CIS 2014), thematic studies of the Central Statistical Office and a report from the Infuture hatalska foresight institute. The use of statistical and comparative analysis in conjunction with the review of the literature on innovation barriers leads to the conclusion that Polish enterprises recognise (...) the lack of financial resources as a major barrier to creating innovation, while non-financial barriers are much less important. The marginal treatment of non-financial barriers is a reversal of attitudes and directions of activities that are undertaken in the field of creating innovation in highly developed countries. (shrink)

BackgroundThe Pacific Islander population is the second fasting growing population in the United States and Arkansas is home to the largest Marshallese population in the continental US. The Marshal...

This is the result of research financed by PROCIENCIA-CONCYTEC, whose objective is to analyze the rural communication forms in the processes of productive innovation and the positioning of the aguaymanto as a native product of the Peruvian Andes, to propose communication strategies in rural sectors of Arequipa, physalis peruviana is a fruit of Andean origin, whose properties and characteristics surpass other similar fruits; the method of analysis is qualitative-quantitative, of the correlational, transectional type, the exploration is carried out (...) in five rural districts of Arequipa, applying 125 surveys and 10 interviews. (shrink)

Academic integrity is a vital pedagogical responsibility that educational institutions should explicitly address. One of the best ways to uphold academic integrity is to create a culture of academic integrity throughout the school. This is especially imperative at high schools where students develop their moral identity because students who act dishonestly at high school will likely behave accordingly in post-secondary education and ultimately be dishonest in familial and professional settings. Creating a culture of academic integrity is a challenging, long and (...) multifaceted journey. In this respect, this exploratory case study set out to create a culture of academic integrity at a high school in Türkiye and explore what facilitates and impedes the process. We followed Stephens’ (2016) Multilevel Intervention Model and implemented a School-Wide Education program to guide us through the process. We conducted various activities throughout one academic year, from seminars to competitions. At the end of the term, we conducted individual and focus group interviews with the members of the school community and analyzed the interview data to identify facilitators and barriers of the process. The analysis yielded five facilitators (1) creating buy-in, (2) administrative embracement and support, (3) activities that promote student involvement, (4) external expert and school collaboration as praxis, and (5) policy as the blueprint and five barriers (1) deficiencies in responding academic misconduct, (2) prioritization of academic success over academic integrity, (3) teacher resistance against change, (4) exam-based assessment design, and (5) timing of the activities. Each theme was discussed in detail, and recommendations were made for high schools which set out on a journey of creating academic integrity culture. (shrink)

Communication barriers long-associated with ideographs, including combinatorial grapholinguistic complexity, computational encoding–decoding complexity, and technological rendering and deployment, become trivialized through advancements in interoperable smart mobile digital devices. Such technologies impart unprecedented extended-reality user hazards only mitigated by unprecedented colloquial and bureaucratic societal norms. Digital age norms thus influence natural ideographic language origins and evolution in ways novel to human history.

La cura della salute è un fenomeno originario e insieme una necessità fondamentale, dinamica e non trascurabile della vita, dell’esistenza e dell’esperienza personale e comunitaria di ogni essere umano. La primarietà ontologica della cura, evidenziata anche negli studi filosofici più recenti dedicati alle pratiche dell’aver cura, richiama infatti, attraverso la dimensione co-esistentiva dell’essere insieme nel mondo l’uno con l’altro e l’uno per l’altro, alla stessa primarietà etica e al contempo politica della cura nel naturale e positivo sviluppo della struttura relazionale (...) personale e dell’esistenza condivisa. Si tratta di un processo di rilevazione e conseguente impegno nel favorire oggi concretamente percorsi di cura e umanizzazione della pratica medica e sanitaria, sia quotidiana che straordinaria, nonostante molteplici limiti e complessità rintracciabili nelle stesse pratiche contemporanee dell’aver cura, esemplificativamente ricercati e identificati in alcuni recenti lavori internazionali dal carattere necessariamente interdisciplinare. È significativo, infatti, che in alcuni rilevanti documenti circa gli sviluppi di una delle principali frontiere contemporanee dell’aver cura, come quella costituita dal processo di realizzazione, sviluppo, diffusione e promozione locale, nazionale e internazionale delle reti di cure palliative, vengano ad essere centralmente ricercati, identificati e positivamente ri-evidenziati i principali limiti, gli ostacoli e le barriere attualmente riscontrabili nello sviluppo delle reti di cure palliative; oltre alla messa in evidenza di una sempre positiva e necessaria opportunità di gettare lo sguardo verso il futuro e gli orizzonti di sviluppo della presa in carico globale della persona sofferente nelle varie fasi della malattia e in condizioni di estrema vulnerabilità percepita e vissuta. (shrink)

Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger’s phenomenology and hermeneutics to provide guidance (...) for medical professional–patient interactions. The phenomenological approach espoused emphasizes the particular, contextual nature of such interactions, and thus is opposed to abstract, theoretical principles. Heidegger’s hermeneutics provides a philosophical approach to communication that may guide the back-and-forth interpretation that should happen between medical professionals and patients to achieve effective communication. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, (...) adhered to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

Purpose This paper aims to assess the usage pattern of telecentres, how rural women frame telecentres and barriers that limit use of telecentres. Further, the study examined the effects of demographic characteristics and location on telecentre usage. Design/methodology/approach The study used a sequential mixed research design in three rural districts surrounding telecentres: Kongwa, Sengerema and Kilosa districts. The study population comprised rural women who were users and non-users of telecentres. The study conducted six focus group discussions with 37 users (...) and six FGDs with 36 non-users in the first phase of the study in 2014; questionnaires were administered to 90 users and 90 non-users in the second phase of the study in 2015. Findings The primary use of telecentres among users was to access internet, followed by information and communication technology training courses and secretarial purposes. Rural women used internet for educational purposes, followed by news, information on health issues, job opportunities, social and entertainment issues. Rural women currently using internet were more likely to be better educated and have higher incomes at both bivariate and multivariate analysis. Users indicated that they faced the following barriers towards using telecentre: short duration of ICT training, frequent power outages, low speed of internet and few computers at the telecentres. Non-users were not using telecentres because of lack of ICT skills and language barriers. Originality/value This study provides empirical evidence to telecentres, libraries and other rural ICT initiatives to design rural ICT services that are gender-sensitive and demand-driven. (shrink)

The objective of this book is to shed some light through a variety of contributed chapters on Ubuntu, Africa's unique philosophy because Knowledge of 'Ubuntu' will help minimize cross-cultural communication barriers when people from outside Sub-Saharan Africa interact with those of other regions of the world.

BackgroundPatients with chronic conditions are less physically active than the general population despite knowledge of positive effects on physical and mental health. There is a variety of reasons preventing people with disabilities from achieving levels of physical activities resulting in health benefits. However, less is known about potential facilitators and barriers for physical activity in people with severe movement impairments. The aim of this study was to identify obstacles and facilitators of PA in individuals with severe disabilities.Materials and methodsUsing (...) a qualitative approach to explore individuals’ subjective perspectives in depth, five community-dwelling adults living with chronic mobility impairments after stroke that restrict independent PA were interviewed. A semi structured topic guide based on the theoretical domains framework was utilized. The interview data was analyzed thematically, and the theoretical domains framework constructs were mapped onto the main and sub-categories.ResultsThe six main categories of facilitators and barriers along the capability, opportunity, motivation–behavior framework were: physical capabilities, psychological capabilities, motivation reflective, motivation automatic, opportunity physical, and opportunity social. The physical capabilities to independently perform PA were variable between participants but were not necessarily perceived as a barrier. Participants were highly motivated to maintain and/or increase their abilities to master their everyday lives as independently as possible. It became clear that a lack of physical opportunities, such as having access to adequate training facilities can present a barrier. Social opportunities in the form of social support, social norms, or comparisons with others can act as both facilitators and barriers.ConclusionWhile confirming known barriers and facilitators that impact the ability of individuals with functional limitations to be active, the findings highlight the need and opportunities for comprehensive service models based on interdisciplinary collaborations. (shrink)

Mental health challenges appear to be extremely problematic among correctional service employees, affecting persons working in community, institutional, and administrative correctional services. Focusing specifically on giving voice to correctional workers employed by the Ontario Ministry of Community Services and Corrections, we shed light on their interpretations of the complexities of their occupational work and of how their work affects staff. We show that participants encounter barriers to treatment seeking, which they describe as tremendous, starting with benefits, wages, and shift (...) work. We let the voices of staff elucidate what is needed to create a healthier correctional workforce. Recommendations include more training opportunities and programs; quarterly, semi-annual, or annual appointments with a mental health professional who can assess changes in the mental health status of employees; off-site assessments to ensure confidentiality; and team building opportunities to reduce inter-personal conflict at work and increase moral by improving the work environment. (shrink)

Background Ensuring individual free and informed decision‐making for research participation is challenging. It is thought that preliminarily informing communities through ‘community sensitization’ procedures may improve individual decision‐making. This study set out to assess the relevance of community sensitization for individual decision‐making in research participation in rural Gambia. Methods This anthropological mixed‐methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. (...) Results/discussion Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Conclusion Community sensitization is effective in providing first‐hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. (shrink)

This article is an attempt to answer the following two questions: What is the specific form of imperialism today? And, is it possible for individual and collective actors to adapt and exercise Trudeau’s civic ethos within and against it in the name of another freedom and another world? Section one is an analysis of the rise of networks as the defining form of communicative and social organization in the present. Section two is an analysis of the forms of control, exclusion, (...) hierarchy and concentration of power that have developed along with communication networks and govern the transmission of knowledge and information. Section three is an analysis of the possibility of critical and effective forms of “social, political and cultural action” within the array of networks and controls in which we are both enabled and constrained to communicate and interact today. These critical and effective forms of action are examples of the emerging form of civic communicative freedom of the governed that I call “democratic communicative action.” It is a new form of civic freedom appropriate to being governed through the types of imperial networks and controls discussed in sections one and two. The enactment of democratic communicative freedom in and against concentrations of network power and their communicative barriers, I will argue, is one way of adapting and applying Trudeau’s civic ethos to the present. (shrink)

Change is one of the central aims of professional development for information and communication technologies integration in education. Studies on the use of ICT in education highlights the large investments in infrastructure and professional development, and the limited results in students learning. Teachers’ professional development for ICT integration in education has evolved from the development of technical skills to pedagogical skills and content-related knowledge. The gold standard and design-based approaches have dominated TDP-ICT. This study presents the Change Laboratory method (...) as a formative intervention to motivate teachers to identify and overcome the barriers to ICT integration. The results showed that a professional development intervention based on CL stimulates transformative agency in the participants. Six forms of transformative agency, namely resisting, criticizing, explicating, envisioning, committing to actions, and taking actions, were found during the CL. The transformative agency was essential to motivate teachers to identify and propose a model solution to overcome both first-order and second-order contextual barriers. (shrink)

The dissemination of experimental materials, instruments, and methods is central to the progress of research in genetics. In recent years, competition for research funding and intellectual property issues have increasingly presented barriers to the dissemination of this "research-related information. "Information gathered in interviews with experimental geneticists and analysis of acknowledgment patterns in published genetics research are used to construct a series of basic scenarios for the exchange of genetic materials and research methods. The discussion focuses on factors affecting individuals' (...) behavior and expectations as information requesters and information providers. (shrink)

Les rencontres de Royaumont de 1998 ont donné naissance à un superbe volume, richement illustré, faisant le point sur l’histoire des femmes au sein de l’ordre cistercien, du Moyen Âge jusqu’à nos jours. Cet ouvrage vient à point nommé pour enrichir l’historiographie de cet ordre, largement dominée jusqu’ici par le masculin. Les communications, nombreuses et variées, se sont réparties en deux journées selon deux thèmes centraux. Le premier s’intéresse à l’architecture et à l’organisation de l’...

Government communication has been playing an important role in mass vaccination to conduct the largest vaccination campaign of the world for COVID-19 and to counter vaccine hesitancy. This study employs the health belief model to examine the association between government communication and the COVID-19 vaccination intention. A survey of Chinese adults was conducted in March 2021, and partial least squares structural equation modeling was employed to estimate the multi-construct relationships. The findings indicate that government communication has both (...) direct positive association with vaccination intention and indirect association with vaccination intention through the mediation of perceived severity, benefits, and barriers. Multi-group comparisons suggest that individuals from private sectors are more easily mobilized to receive COVID-19 vaccination by government communication than those from public sectors. Similarly, the correlation between government communication and the vaccination intention of individuals with a good health status was stronger than that of those with a poor health status. The theoretical and practical implications of these findings are further discussed. (shrink)