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At least 19 recordsLinked to original sources
PubMed2026

Assessment and CommuniCation ExcelLEnce foR sAfe paTient outcomEs (ACCELERATE): A stepped-wedge cluster randomised trial evaluating the effectiveness of a nurse-led assessment and handover communication intervention on patient adverse events.

BACKGROUND: Patients continue to experience harm from undetected deterioration, falls and pressure injuries. We aimed to implement and evaluate an organisational, ward-level nurse-led assessment and communication intervention to proactively reduce patient adverse events. METHODS: A stepped-wedge cluster randomised Trial over 12-months was conducted at three metropolitan hospitals. Our intervention comprised a comprehensive, systematic patient assessment at shift commencement; a structured patient-centred bedside nurse-to-nurse clinical handover; and multidisciplinary communication consisting of nurse participation in medical ward rounds. Evidence-based implementation strategies informed intervention delivery to nine clusters (20-35 bed-wards with &#x2265;70% permanent nurses) over three sequential 14-week steps. Routinely collected patient-level data were used to measure intervention effect. The primary outcome was a composite measure of medical emergency team calls, unplanned intensive care unit admissions, in-hospital falls; and stage 2-4 pressure injuries. Secondary outcomes were: individual measures of the primary outcome; nurse-reported perceptions of safety culture; organisational readiness to change; barriers to physical assessment; staff engagement; and patient-reported experience measures of safety and overall hospital experience. Analyses were adjusted for age, sex, hospital, pre/post intervention, and Trial step (fortnight), with random effects for ward and patient. RESULTS: There were 13,753 eligible admissions. No change was observed in the primary composite outcome measure (odds ratio (OR) [95% confidence interval (CI)]: 0.99 [0.77, 1.28]; p&#xa0;=&#xa0;0.95). There was no significant difference in medical emergency team calls (OR [95% CI]: 1.02 [0.75, 1.39]; p&#xa0;=&#xa0;0.91); unplanned intensive care unit admissions (OR [95% CI]: 1.35 [0.57, 3.20]; p&#xa0;=&#xa0;0.50) and falls (OR [95% CI]: 1.53 [0.96, 2.45]; p&#xa0;=&#xa0;0.07). However, stage 2-4 pressure injuries significantly decreased by 41% (OR [95% CI]: 0.59 [0.38, 0.93]; p&#xa0;=&#xa0;0.02); a significant absolute effect improvement of 0.8% ([95% CI: 0.3%-1.3%], p&#xa0;<&#xa0;0.01). There were statistically significant improvements in nurses' overall perceptions of Safety Attitudes (Pre: 74.6, Post: 79.7; p&#xa0;=&#xa0;0.02), and the Organisational Readiness to Change subscales of, leader culture (Pre: 3.73, Post 3.91; p&#xa0;=&#xa0;0.02), leadership behaviour (Pre: 3.85, Post: 4.11; p&#xa0;=&#xa0;0.03), and general resources (Pre: 3.06, Post: 3.30; p&#xa0;=&#xa0;0.03). A statistically significant decrease in Barriers to Physical Assessment (Pre: 2.48, Post: 2.24; p&#xa0;<0.001) and in six of seven sub-scales was observed. Patients' overall Measure of Safety remained high, but unchanged (Pre: 3.94 Post: 3.92; p&#xa0;=&#xa0;0.07). CONCLUSION: The ACCELERATE Trial demonstrated that nurse-driven initiatives, emphasising structured physical assessments by nurses, patient-centred clinical handovers, and multidisciplinary communication, significantly: reduced pressure injuries; decreased nurses' perceived barriers to performing physical assessments; and improved leadership behaviour, communication, and ward safety culture perceptions. Results highlight the transformative potential of this approach, which now warrants testing at scale for broader implementation. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ID: ACTRN12621000265875.

Humans↗
PubMed2025

Parent-Child Communication after Parental Exposure to Potentially Traumatic Events: A Systematic Review.

Intergenerational traumatization poses a risk for the well-being of children whose parents have been exposed to potentially traumatic events (PTEs). Previous research has implied that parent-child communication may significantly contribute to the transmission of trauma across generations, but findings remain limited and inconclusive, particularly regarding the mechanisms and factors that could underlie this process. Therefore, the present paper performed a mixed methods systematic literature review to methodically map how PTE-exposed parents communicate with their children-both in general and about parental PTEs-and how such communication may contribute to trauma transmission. Five electronic databases were accessed to conduct keyword-led searches, yielding a final inclusion of 31 peer-reviewed, empirical studies that investigated parent-child communication among PTE-exposed parents and/or their nonexposed children. Parental PTE exposure was found to have a negative impact on general parent-child communication, often due to the presence of parental anger, irritability, and withdrawal. Conversations about parental PTEs showed substantial diversity in their frequency, content and style, with strategies of partial/modulated disclosure appearing most common. How parents approached PTE communication frequently stemmed from a desire to keep their children safe and unburdened by their previous experiences. Finally, both general communication and PTE communication were implied to contribute to trauma transmission, revealing a significant impact of parent-child communication on child functioning, identity, and well-being. Based on these key findings, the authors discuss meaningful implications for future research (i.e., prospective directions, addressing methodological concerns) and formulate suggestions for clinicians and policymakers surrounding the treatment of PTE-exposed parents and their offspring.

Humans↗
PubMed2026

Evaluating a culturally adapted question prompt list to improve end-of-life communication among indonesian migrant caregivers: A randomized controlled trial with qualitative insights.

OBJECTIVE: Indonesian caregivers serve as essential providers of end-of-life (EOL) care in Taiwan. But often face communication challenges due to language, cultural, and hierarchical barriers. This study evaluated the effectiveness of a culturally adapted Question Prompt List (QPL). METHODS: This study employed a two-arm randomized controlled trial design supplemented with qualitative interviews. The study was conducted in a hospice ward and home care setting within a medical center in Taiwan. A total of sixty Indonesian caregivers were recruited and randomly assigned to either the intervention group (n&#x202f;=&#x202f;30) or the control group (n&#x202f;=&#x202f;30). The intervention group received routine end-of-life (EOL) education along with a culturally adapted Question Prompt List (QPL), which consisted of 37 items covering domains including the dying process, emotional support, communication, symptom management, and care decision-making. The control group received routine EOL education. Outcome measures included caregiving preparedness, communication self-efficacy, satisfaction, and question-asking behavior. In addition, semi-structured interviews were conducted with eight participants, and the data were analyzed using thematic content analysis. RESULTS: Analysis of covariance revealed no statistically significant between-group differences in caregiving preparedness (F = 1.58, p&#x202f;=&#x202f;.215 [-0.41, 0.44]) or communication selfefficacy (F = 0.83, p&#x202f;=&#x202f;.366 [-0.44, 0.79]). However, communication satisfaction was significantly higher in the intervention group (F = 4.19, p&#x202f;<&#x202f;.05 [0.04, 0.44]). The number of questions asked was also significantly higher in the intervention group (t&#x202f;=&#x202f;-4.35, p&#x202f;<&#x202f;.001 [-5.41, -1.98]). Thematic analysis of qualitative data identified 4 themes and 14 subthemes, illustrating how the QPL reduced anxiety, clarified care needs, and improved confidence. CONCLUSIONS: A culturally adapted QPL can enhance communication engagement and satisfaction among migrant caregivers. PRACTICE IMPLICATIONS: Integrating culturally tailored QPLs into caregiver education and palliative care practice may promote more inclusive and effective communication.

Humans↗
PubMed2025

scACCorDiON: a clustering approach for explainable patient level cell-cell communication graph analysis.

MOTIVATION: Combining single-cell sequencing with ligand-receptor (LR) analysis paves the way for the characterization of cell communication events in complex tissues. In particular, directed weighted graphs naturally represent cell-cell communication events. However, current computational methods cannot yet analyze sample-specific cell-cell communication events, as measured in single-cell data produced in large patient cohorts. Cohort-based cell-cell communication analysis presents many challenges, such as the nonlinear nature of cell-cell communication and the high variability given by the patient-specific single-cell RNAseq datasets. RESULTS: Here, we present scACCorDiON (single-cell Analysis of Cell-Cell Communication in Disease clusters using Optimal transport in Directed Networks), an optimal transport algorithm exploring node distances on the Markov Chain as the ground metric between directed weighted graphs. Benchmarking indicates that scACCorDiON performs a better clustering of samples according to their disease status than competing methods that use undirected graphs. We provide a case study of pancreas adenocarcinoma, where scACCorDion detects a sub-cluster of disease samples associated with changes in the tumor microenvironment. Our study case corroborates that clusters provide a robust and explainable representation of cell-cell communication events and that the expression of detected LR pairs is predictive of pancreatic cancer survival. AVAILABILITY AND IMPLEMENTATION: The code of scACCorDiON is available at https://scaccordion.readthedocs.io/en/latest/. and https://doi.org/10.5281/zenodo.15267648. The survival analysis package can be found at https://github.com/CostaLab/scACCorDiON.su.

Humans↗
PubMed1979

Developing a new perspective for biomedical Communications.

A three-dimensional model is utilized in an attempt to develop a complete picture of the many facets of biomedical communications. This model provides a suitable visual structure from which to explore the complex interactions of individuals, institutions, and activities in defining the field of biomedical communications. The first dimension of the model was developed through a historical overview of the environment of the biomedical communicator and suggests that changing organization goals, client needs, technology, and resources have influenced the evolution of different types of biomedical communicators. The second dimension of the model identifies five major work roles that may be performed by the biomedical communicator of today. The final dimension of the model is developed by a consideration of the major communication methods (illustration, photography, cinematography, television, audiovisual, and computer) of the biomedical communicator.

Administrative Personnel↗
PubMed2025

Psychological and emotional impacts of communicating breast cancer risk using multifactorial assessment with polygenic risk score: Findings from PERSPECTIVE I&I.

PURPOSE: To examine the psychological and emotional outcomes of personalized breast cancer risk communication up to 1 year after disclosure in a risk-stratified breast screening preimplementation study (Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation). METHODS: Among 3753 females aged 40 to 69, unaffected by breast cancer, with a prior mammogram, and who underwent multifactorial risk assessment to estimate their 10-year breast cancer risk, 2734 completed follow-up questionnaires up to 1 year after risk communication: 78.5% were at average risk, 16.5% at higher than average risk, and 5.0% at high risk. The impact of risk communication on breast cancer worry and psychological distress and factors associated with decisional regret were examined. RESULTS: Breast cancer worry and psychological distress scores remained low after risk communication and at 1 year follow-up. Up to 1 year after disclosure, small significant differences in breast cancer worry were observed between risk levels. Decisional regret was very low 1 year after risk communication. Lower levels of decisional regret were significantly associated with some factors, including higher satisfaction with the information received. CONCLUSION: This study suggests that personalized breast cancer risk communication has low negative psychological and emotional effects and highlights the importance of the information received for implementing this approach at population level.

Humans↗
PubMed2026

Sex pheromone communication and its regulation by the sex determination pathway in cockroaches.

Sexual communication in animals orchestrates a series of interactive behaviors from locating and recognizing potential partners to courtship and final mating decisions and is thus critical for sexual reproduction and population fitness. Highly efficient communication between the sexes requires not only the production and emission of species-specific signals but also their precise detection and interpretation by the receiving individuals. Cockroaches, as one of the most evolutionarily ancient and successful group of insects, are quintessential chemical communicators that rely heavily on sex pheromones for sexual communication. They have long served as excellent model organisms in studies of chemical ecology. Although the biochemical characterization of sex pheromones in several species was largely accomplished during the last century, the past two decades have witnessed remarkable progress in understanding the molecular genetics of sex pheromone communication and its regulation, particularly driven by functional genomics. This review first provides an updated comparative survey of the pheromone components identified across distinct taxa. We then synthesize, but not limited to, recent advances in identification of key molecules controlling sex pheromone production, characterization of candidate chemosensory receptors and their neural processing pathways, and the regulatory roles of the sex determination cascade in shaping sexually dimorphic traits in both pheromone production and perception. Finally, we highlight key scientific questions that remain unsolved and propose future directions aimed at extending our mechanistic understanding of cockroach pheromone communication, as well as at developing behavior-based pest management strategies.

biosynthetic pathway↗
PubMed2026

Experiences of stigma, bias, and communication challenges among pregnant healthcare workers: A systematic review of qualitative evidence.

BACKGROUND: Healthcare work environments are fraught with occupational hazards that can impact pregnant healthcare workers' health as well as patient care. Despite the feminization of healthcare globally, systematic discrimination against pregnant workers persists across diverse healthcare settings and cultural contexts. The intersection of stigma, bias, and communication challenges creates substantial barriers to career advancement and wellbeing. However, no systematic review has synthesized qualitative evidence on how these three constructs interact across healthcare professions and cultural contexts using an integrated theoretical framework. OBJECTIVE: To systematically review and synthesize qualitative evidence on experiences of stigma, bias, and communication challenges among pregnant healthcare workers across different healthcare settings and cultural contexts using an integrated theoretical framework. DESIGN: Systematic review of qualitative studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with thematic synthesis. DATA SOURCES: Seven databases were searched from inception to January 2026. REVIEW METHODS: Included qualitative studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist and synthesized through theory-guided thematic synthesis. Confidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. RESULTS: Fourteen studies encompassing 1223 participants across 17 countries revealed four major themes: (1) professional identity stigma and workplace discrimination through systematic labeling and stereotyping; (2) gender-based institutional bias rooted in masculine organizational logic; (3) multilevel communication failures creating fear-based climates; and (4) individual and collective resistance strategies developed despite constraints. Occupational hazards specific to pregnancy included exposure to infectious diseases, imaging, physical tasks, cleaning products, patient violence, and medication administration. Support from coworkers and supervisors was identified as the most critical facilitator for avoiding hazards and making necessary modifications, while the desire to be 'supernurses' and fear of consequences emerged as significant barriers. These patterns were consistent across healthcare professions, settings, and cultural contexts, with specialty culture and healthcare system type moderating discrimination intensity. Confidence in core findings was rated high using GRADE-CERQual. CONCLUSIONS: Pregnant healthcare workers globally experience interconnected stigma, bias, and communication challenges that are systematically embedded within healthcare organizational structures. These challenges operate synergistically, requiring comprehensive multilevel interventions beyond policy compliance. Healthcare organizations must implement evidence-based strategies addressing stigma reduction, bias interruption, and communication transformation simultaneously to retain skilled workers and ensure quality patient care.

Female↗
PubMed2026

Family communication patterns and adolescent depressive symptoms: sequential mediating effects of hedonic capacity and anger expression.

OBJECTIVE: Depression is increasingly prevalent among adolescents, highlighting the need to explore its underlying developmental mechanisms to inform effective prevention. This study examined how different family communication patterns longitudinally impact adolescent depressive symptoms, with a focus on the mediating roles of diminished hedonic capacity and anger expression. METHOD: A total of 729 Chinese adolescents from five high schools participated in this two-wave longitudinal study over a six-month period. Participants completed the Family Communication Patterns Scale (FCPS), the Children's Depression Inventory (CDI), the Anhedonia Scale for Adolescents (ASA), and the Children's Inventory of Anger (ChIA). Mediation analyses were conducted using Hayes' PROCESS macro, alongside cross-lagged panel analyses to explore longitudinal effect. RESULTS: Cross-sectional analyses indicated that diminished hedonic capacity and anger experience sequentially mediated the relationship between family communication patterns and adolescent depressive symptoms. Specifically, this mediating effect existed for conversation orientation in junior high school students and female senior high school students, as well as for conformity orientation among female junior and senior high school students. In addition, longitudinal analyses revealed that diminished hedonic capacity mediated the associations at Wave 2. CONCLUSION: Our findings suggest that enhanced hedonic capacity and reduced anger expression may play a key role in the relationship between family communication patterns and adolescent depression, and hedonic capacity should be prioritized in practical interventions. These results support the potential value of interventions that promote positive family communication patterns as a means of mitigating adolescent depression, particularly for families with daughters.

anger expression↗
PubMed2024

Family genetic risk communication and reverse cascade testing in the BabySeq project.

PURPOSE: Genomic sequencing of newborns can initiate disease surveillance and therapy for children and may identify at-risk relatives through reverse cascade testing. We explored genetic risk communication and reverse cascade testing among families of newborns who underwent exome sequencing and were identified as having a risk for an autosomal dominant disease. METHODS: We conducted semistructured interviews with parents of newborns enrolled in the BabySeq Project who had a pathogenic or likely pathogenic variant associated with an autosomal dominant childhood- and/or adult-onset disease returned. We used directed content analysis to derive themes. RESULTS: From 11 families, all first-degree relatives (n&#xa0;= 32, 100%), 29 second-degree relatives (76%), and 26 third-degree relatives (43%) were informed of their risk. All parents (n&#xa0;= 22, 69% of first-degree relatives), 4 (11%) second-degree relatives, and 1 (2%) third-degree relatives underwent cascade testing. Most parents preferred to handle risk communication themselves. Parents with positive cascade testing but no associated symptoms were less inclined to share findings with relatives but highly motivated to share results if the variant's associated disease severity was high, as perceived with adult-onset conditions. One new subtheme, family member traits, was identified and defined as a relative's propensity to anxiety/concern after risk communications but did not diminish risk communication. CONCLUSION: Findings can inform more effective notification and testing practices for families of newborns at risk for hereditary genetic conditions.

Humans↗
PubMed2026

Communication crossroads: Exploring generational dynamics in nursing from the bedside to the boardroom.

Nurses have up to four times more patient contact than physicians, positioning them as central drivers of communication in health care. Effective communication directly influences patient outcomes, teamwork, staff engagement, and the overall care experience. Today's nurses operate within a highly diverse environment that includes four generations in the workforce and up to eight generations of patients, each with distinct values, expectations, and communication preferences. This article examines how generational differences shape communication across three key relational domains: peer-to-peer, nurse-to-patient, and nurse-to-leader interactions, and offers insights to strengthen collaboration, engagement, and quality of care.

Humans↗
PubMed2026

Differential cell signaling testing for cell-cell communication inference from single-cell data by dominoSignal.

MOTIVATION: Algorithms for ligand-receptor network inference have emerged as commonly used tools to estimate cell-cell communication from reference single-cell data. Many studies employ these algorithms to compare signaling between conditions and lack methods to statistically identify signals that are significantly different. We previously developed the cell communication inference algorithm Domino, which considers ligand and receptor gene expression in association with downstream transcription factor activity scoring. We developed the dominoSignal software to innovate upon Domino and extend its functionality to test statistically differential cellular signaling. RESULTS: This new functionality includes the compilation of active signals as linkages from multiple subjects in a single-cell data set and testing condition-dependent signaling linkage. The software is applicable for analysis of single-cell data sets with multiple subjects as biological replicates as well as with bootstrapped replicates from data sets with few or pooled subjects. We use simulation studies to benchmark the number of subjects in compared groups and cells within an annotated cell type sufficient to accurately identify differential linkages. We demonstrate the application of the Differential Cell Signaling Test (DCST) in the dominoSignal software to investigate consequences of cancer cell phenotypes and immunotherapy on cell-cell communication in tumor microenvironments. These applications in cancer studies demonstrate the ability of differential cell signaling analysis to infer changes to cell communication networks from therapeutic or experimental perturbations, which is broadly applicable across biological systems. AVAILABILITY: dominoSignal is available through Bioconductor at https://www.bioconductor.org/packages/release/bioc/html/dominoSignal.html.

Cell Communication↗
PubMed1979

Communication and cooperation between professionals in the field of rehabilitation.

Some criteria and characteristics of Rehabilitation as a complex, multidimensional and interdisciplinary field of theory, practice and research are pointed out at the beginning of this paper. It is shown, that such a rehabilitation concept demands the cooperation between professionals in this field (a) in practice within the rehabilitation team, (b) in research for the realization of well coordinated and problem-oriented interdisciplinary projects, (c) in theory for the development of more adequate theoretical concepts and better strategies for teaching and training personnel. Improved mutual information on an international level is regarded as a basis or prerequisite for such cooperation. The multiple dimensions and directions of communication necessary to assure such cooperation are illustrated. In a description of barriers to communication in the field of rehabilitation the following facts are considered as possible causes for the present insufficient cooperation among professionals in this field- (1) specialization and exclusiveness, (2) language and presentation, (3) differences in culture, demographical situations and economic/historical development, (4) geographical, national, legal or administrative barriers, (5) professional competition, patenting and copyright, (6) lack of adequate documentation and dissemination of information, (7) inadequate use of existing information systems and communication channels. The article closes with suggestions on ways to improve communications and cooperation between professionals in rehabilitation.

Communication↗
PubMed2026

Interfollicular communication among preovulatory follicles after luteinizing hormone signaling.

Luteinizing hormone (LH) triggers the resumption of oocyte meiosis and ovulation in preovulatory ovarian follicles. These events have generally been viewed as autonomous responses occurring independently within each follicle. Here, however, we show that mouse preovulatory follicles can communicate with one another through an LH-induced paracrine signaling network. Isolated preovulatory follicles lacking LH receptors (Lhr-KO) resumed oocyte meiosis when co-cultured with LH-stimulated wildtype follicles, despite being unable to respond directly to LH. Oocytes within Lhr-KO follicles also resumed meiosis when exposed to conditioned medium from LH-treated wildtype follicles, demonstrating that diffusible factors mediate this interfollicular communication. Neutralizing antibodies against the epidermal growth factor receptor ligands epiregulin and amphiregulin inhibited the LH-induced interfollicular communication, identifying these LH-induced factors as key signaling molecules. Although epiregulin and amphiregulin are known to transmit LH signals within individual follicles, our findings indicate that they can also coordinate responses among neighboring follicles. Together, these results demonstrate that LH regulates a communication network between preovulatory follicles rather than acting solely at the level of individual follicles.

epidermal growth factor receptor↗