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Objective: Some attorneys claim that to adequately cross examine neuropsychological experts, they require direct access to protected test information, rather than having test data analyzed by retained neuropsychological experts. The objective of this paper is to critically examine whether direct access to protected test materials by attorneys is indeed necessary, appropriate, and useful to the trier-of-fact. Method: Examples are provided of the types of nonscientific misinformation that occur when attorneys, who lack adequate training in testing, attempt to independently interpret neurocognitive/psychological test data. Results: Release of protected test information to attorneys introduces inaccurate information to the trier of fact, and jeopardizes future use of tests because non-psychologists are not ethically bound to protect test content. Conclusion: The public policy underlying the right of attorneys to seek possibly relevant documents should not outweigh the damage to tests and resultant misinformation that arise when protected test information is released directly to attorneys. The solution recommended by neuropsychological/psychological organizations and test publishers is to have protected psychological test information exchanged directly and only between clinical psychologist/neuropsychologist experts.

Pronoun usage's psychological underpinning and behavioral consequence have fascinated researchers, with much research attention paid to second-person pronouns like "you," "your," and "yours." While these pronouns' effects are understood in many contexts, their role in bilateral, dynamic conversations (especially those outside of close relationships) remains less explored. This research attempts to bridge this gap by examining 25,679 instances of peer review correspondence with Nature Communications using the difference-in-differences method. Here we show that authors addressing reviewers using second-person pronouns receive fewer questions, shorter responses, and more positive feedback. Further analyses suggest that this shift in the review process occurs because "you" (vs. non-"you") usage creates a more personal and engaging conversation. Employing the peer review process of scientific papers as a backdrop, this research reveals the behavioral and psychological effects that second-person pronouns have in interactive written communications., (© 2024. The Author(s).)

Abstract Introduction Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation.

Background: Good communication is consistently recognised as essential for effective complaint handling, while failures in communication correlate with risk of escalation. Nonetheless, communication in National Health Service complaint handling remains underexamined., Objectives: To examine complainants' lived experience of the complaints journey through (1) micro-analysis of their communication with National Health Service representatives; (2) their self-reported expectations and experiences throughout the complaints journey; to survey patient perceptions of the culture of the National Health Service; to develop 'Real Complaints' - an evidence-based communication training resource., Design: The project triangulates microlevel conversation analysis and discourse analysis of spoken and written complaints encounters with complainants' appraisals of those encounters in longitudinal case studies. This is underpinned by an audit of patient views of the cultural-institutional context of the National Health Service., Setting and Participants: Data were gathered in the complaints-handling services of two National Health Service trusts and a Patient Advocacy Service in Northern Ireland. Twenty-three complainants consented to longitudinal data collection and 58 to initial encounter recording; 115 members of the Patient Advocacy Service mailing list completed the cultural audit; 3 trust complaint handlers, 1 Patient Advocacy Service complaint handler and 2 trust complaints managers were interviewed., Data Sources: This yielded 1155 minutes of recorded calls, 113 written encounters, 36 diaries, 6 meetings, 23 interviews and 115 cultural audit responses collected over a period of 24 months., Results: Our analysis illuminates the dual nature of complaints: as personal expressions of dissatisfaction and as systemic critiques. The complaint experience is a dynamic journey with evolving narratives reflecting complainants' shifting perceptions, expectations and experiences of the 'system', both moment-by-moment and encounter-by-encounter in the overall journey. Key interpersonal priorities for complainants significantly affected complaint outcomes, most important of which was the need to be respected as a 'reasonable complainant'. Also key is the conversation analytic concept of affiliation, which involves taking a stance towards the event(s) being described that matches the complainant's stance. Use of affiliation by call handlers supported effective and efficient person-centred complaints handling, while absence of affiliation typically led to escalation of the scope, scale and emotional intensity of the complaint, sometimes to the point of an expressed intention to litigate (particularly in the case of written responses). Viewed holistically, successful complaints communication requires person-centredness, and affiliative interactions framed by shared expectations. These findings were applied in the development of Real Complaints Training and Guidance for spoken and written complaints communication., Limitations: The COVID pandemic significantly constrained trust participation, particularly the participation of front-line clinical staff, and one trust introduced 'telephone resolution' to which we were not given access. Additionally, calls viewed by staff as 'challenging' and ethnic minority communities are both under-represented in the final data set., Conclusions: Addressing the complainant's desire to be perceived as reasonable was revealed as crucial for fostering a more person-centred approach to handling complaints and addressing the gap between expectations and experience. This finding holds particular significance for recommendations, guidance and training relating to both spoken and written communication., Future Work: Direct extensions of the project include the piloting and evaluation of Real Complaints Training and further primary research involving communication between complainants and front-line service/clinical staff and complaint handling by ombudsman complaints investigators. An emerging question relates to social exclusion and access to complaints procedures., Study Registration: This study is registered as Research Registry: researchregistry5049., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR127367) and is published in full in Health and Social Care Delivery Research Vol. 12, No. 33. See the NIHR Funding and Awards website for further award information.

The aim of this discussion paper is to explore factors and contexts that influence how nurses might conceptualise and assign personhood for people with altered consciousness, cognition and behaviours. While a biomedical framing is founded upon a dichotomy between the body and self, such that the body can be subjected to a medical and objectifying gaze, relational theories of self, multiculturalism and technological advances for life‐sustaining interventions present new dilemmas which necessitate discussion about what constitutes personhood. The concept of personhood is dynamic and evolving: where historical constructs of rationality, agency, autonomy and a conscious mind once formed the basis for personhood, these ideas have been challenged to encompass embodied, relational, social and cultural paradigms of selfhood. Themes in this discussion include: the right to personhood, mind–body dualism versus the embodied self; personhood as consciousness, rationality and narratives of self; social relational contexts of personhood and cultural contexts of personhood. Patricia Benner's and Christine Tanner's clinical judgement model is then applied to consider the implications for nursing care that seeks to reflexively incorporate personhood. Nurse clinicians are able to move between conceptions of personhood and act to support the body, as well as presumed autonomy and relational, social and cultural personhood. In doing so, they use analytical, intuitive and narrative reasoning which prioritises autonomous constructions of self. They also incorporate relational and social contexts of the person receiving care within the possibilities of technological advances and constraints of contextual resources. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

The controversy over online misinformation and social media has opened a gap between public discourse and scientific research. Public intellectuals and journalists frequently make sweeping claims about the effects of exposure to false content online that are inconsistent with much of the current empirical evidence. Here we identify three common misperceptions: that average exposure to problematic content is high, that algorithms are largely responsible for this exposure and that social media is a primary cause of broader social problems such as polarization. In our review of behavioural science research on online misinformation, we document a pattern of low exposure to false and inflammatory content that is concentrated among a narrow fringe with strong motivations to seek out such information. In response, we recommend holding platforms accountable for facilitating exposure to false and extreme content in the tails of the distribution, where consumption is highest and the risk of real-world harm is greatest. We also call for increased platform transparency, including collaborations with outside researchers, to better evaluate the effects of online misinformation and the most effective responses to it. Taking these steps is especially important outside the USA and Western Europe, where research and data are scant and harms may be more severe., (© 2024. Springer Nature Limited.)

When communicating, individuals alter their language to fulfill a myriad of social functions. In particular, linguistic convergence and divergence are fundamental in establishing and maintaining group identity. Quantitatively characterizing linguistic convergence is important when testing hypotheses surrounding language, including interpersonal and group communication. We provide a quantitative interpretation of linguistic convergence grounded in information theory. We then construct a computational model, built on top of a neural network model of language, that can be deployed to measure and test hypotheses about linguistic convergence in "big data." We demonstrate the utility of our convergence measurement in two case studies: (1) showing that our measurement is indeed sensitive to linguistic convergence across turns in dyadic conversation, and (2) showing that our convergence measurement is sensitive to social factors that mediate convergence in Internet-based communities (specifically, r/MensRights and r/MensLib). Our measurement also captures differences in which social factors influence web-based communities. We conclude by discussing methodological and theoretical implications of this semantic convergence analysis., (© 2023. The Psychonomic Society, Inc.)

Background: Hearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL., Methods: A randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made., Results: Compared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up., Conclusions: The ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health., Trial Registration: ISRCTN54021189 (retrospectively registered on 18/07/2023)., (© 2024. The Author(s).)

Infertility can be stressful for infertile couples. This study aims to examine the intra-dyadic associations between stigma, communication patterns, and infertility-related stress in couples undergoing artificial insemination by donor semen (AID). This cross-sectional study was conducted from January to April 2021. Two hundred and three couples undergoing AID were recruited from a reproductive centre in China. All of the couples completed a two-item stigma questionnaire, Communication Pattern Questionnaire, and Fertility Problem Inventory. The actor-partner interdependence mediation analysis was performed using AMOS 23.0. The analysis demonstrated significant actor-actor effects for couples undergoing AID. More specifically, higher levels of stigma among wives and husbands were associated with more negative communication patterns, thereby increasing their own infertility-related stress. Simultaneously, there was a significant partner-actor effect among infertile wives, demonstrating that the husband's stigma can affect his wife's infertility-related stress by influencing her communication patterns. Couples undergoing AID experience increased infertility-related stress when they have high levels of stigma and negative communication patterns, and husbands' stigma is correlated to wives' communication patterns. Therefore, dyadic interventions aiming to improving stigma and enhancing positive communication may be conducive to reducing infertility-related stress., (© 2024 John Wiley & Sons Ltd.)

Objective: To illuminate child healthcare nurses' experiences of communication with 4-year-old children during their visit to the child healthcare center., Design: A qualitative method, using data collected from individual interviews., Sample: Fifteen semistructured interviews with nurses working in a child healthcare center., Measurements: The results were analyzed using reflexive thematic analysis., Results: The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter., Conclusion: Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter-assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child-centered approach., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

The phenomenon of near death and dying experiences has been both of popular interest and of scientific speculation. However, the reality of mental perception at the point of death is currently a subjective experience and has not been formally evaluated. While postmortem gene expression, even in humans, has been evaluated, restoration of postmortem brain activity has heretofore only been attempted in animal models, at the molecular and cellular levels. Meanwhile, progress has been made to translate brain activity of living humans into speech and images. This paper proposes two inter-related thought experiments. First, assuming progress and refinement of the technology of translating human brain activity into interpretable speech and images, can an objective analysis of death experiences be obtained by utilizing these technologies on dying humans? Second, can human brain function be revived postmortem and, if so, can the relevant technologies be utilized for communication with (recently) deceased individuals? In this paper, these questions are considered and possible implications explored., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Expertise in physician-patient communication is a primary outcome measure for physicians. We evaluated residents' communication behaviors with clinic patients following an educational intervention as measured by the Communication Assessment Tool (CAT). Thirty-five internal medicine residents were assessed by patients using the CAT for 3 months before and after the educational intervention. The intervention included a simulated, videotaped patient encounter, mock CAT, and preceptor coaching during video review. The primary outcome was the percentage of CAT items receiving an "excellent" rating from patients before and after the intervention. Research results were compared to previously published CAT studies. Within-resident improvement in the percentage of excellent ratings was small with median changes between 0 and 3 percentage points. Compared to previously published studies, similar results were found for the highest and lowest-scored communication items. Many clinical encounters are time-limited, and physicians do not pursue time-consuming conversations that could reduce health care risk. This data and other published studies suggest seven communication items taking the most time to complete (i.e., shared decision-making) were items demonstrating little or no improvement. This study identified clinical performance risk factors applicable to the Enterprise Risk Management Framework that could impact complication and readmission rates if addressed by changes in physician-patient communication., (© 2024 American Society for Health Care Risk Management of the American Hospital Association.)

Forensic clinicians are often called upon to help courts determine the likelihood that someone will continue to commit sexually violent acts in the future. The utility of these evaluations depends largely on how effectively the results are communicated to and understood by the trier of fact. Actuarial results, such as those commonly reported in sexual offense risk assessments, appear particularly challenging for laypersons to understand. Using a representative sample of 206 U.S. adults, this study examines three methods of communicating actuarial risk via simulated expert testimony on participants' ratings of a hypothetical evaluee's risk of sexual re-offending. The results suggested that all participants, regardless of how results were communicated, over-estimated the examinee's risk level relative to the expert's probabilistic findings, but tended to agree with the expert's categorical predictions. Participants who were only shown actuarial data consistently rated the evaluee as more dangerous and likely to commit future sexually violent acts. Additionally, it was found that gender significantly impacted participants' perceptions, such that women found the evaluee more dangerousness and desired greater social distance from him. This study has implications for best practices regarding expert communication of actuarial results in cases involving sexual violence., (© 2024 American Academy of Forensic Sciences.)

Aim: To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention., Design: A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions., Methods: We implemented a tailored ward-based intervention to redesign nursing handover practice with co-constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre-implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio-recorded handover events (n = 233). Post-intervention we conducted interviews and focus groups (n = 79) and observed and/or audio-recorded handover events (n = 129) to qualitatively evaluate impact., Results: Our translational approach resulted in substantial changes post-intervention. Nurses conducted more shift-to-shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information., Conclusion: Contextualised training combined with changes to ward-level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward-level leadership, collaboration and mentoring. The speed and degree of change post-intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists., Relevance to Clinical Practice: Nurses are more likely to conduct efficient group handovers and informative, patient-centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward-level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change., Reporting Method: We adhered to the COREQ guidelines., Patient or Public Contribution: We interviewed patients on study wards pre and post intervention., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

This paper focuses on the importance of digital communication between medical teams and patients and their families when mediated by technological tools. Medicine is changing following the fourth industrial (the digital) revolution: from CAT scans, to X-rays, to UV radiation, to electronic records, to treatment tracking apps, to telemedicine, and the use of AI in doctors' decision-making processes. The COVID-19 pandemic highlighted both the fruitful and problematic sides of this medical evolution. Digital tools such as tablets, smartphones, and video calling apps proved to be essential. Accordingly, I analyze three cases that reveal the helpfulness and the limitations of new communication technologies: on physicians and non-hospitalized patients, on families and patients, and on healthcare professionals and patients' families. Since the medical relationship is not only clinical but also relational and human, one must pay attention to the communicative dimensions of it to remain at least partly human-e., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

The spread of misinformation through media and social networks threatens many aspects of society, including public health and the state of democracies. One approach to mitigating the effect of misinformation focuses on individual-level interventions, equipping policymakers and the public with essential tools to curb the spread and influence of falsehoods. Here we introduce a toolbox of individual-level interventions for reducing harm from online misinformation. Comprising an up-to-date account of interventions featured in 81 scientific papers from across the globe, the toolbox provides both a conceptual overview of nine main types of interventions, including their target, scope and examples, and a summary of the empirical evidence supporting the interventions, including the methods and experimental paradigms used to test them. The nine types of interventions covered are accuracy prompts, debunking and rebuttals, friction, inoculation, lateral reading and verification strategies, media-literacy tips, social norms, source-credibility labels, and warning and fact-checking labels., (© 2024. Springer Nature Limited.)

Communication challenges in persons with aphasia may negatively affect their health care. Building effective communication skills is critical for health professional student education, yet communication skills for interacting with persons with aphasia are often not taught or practiced within health care education. A review of the literature found that research is limited but does demonstrate evidence-based training can improve skills for health professional students. Through utilization of workshops, seminars, and standardized patients, medical students and other health professional students can build confidence and skills in successful communication for future encounters with persons with aphasia., (© 2023 American Academy of Physical Medicine and Rehabilitation.)

Antibiotic overprescription in China has long been considered a problem on the supply side, linked to the financial incentives of physicians. Based on the conversation analysis of 187 video-recorded naturally occurring medical consultations in Chinese paediatric primary care settings, this study finds that the driving force behind the problem of antibiotic overprescription in China has changed. Physicians use a low-authority communication style to recommend treatment, displaying a low level of medical authority and a willingness to accommodate caregivers' preferences in antibiotic prescribing decisions. The problem is now attributed to physician-caregiver interaction, doctor-patient relationship and the antibiotic-saturated prescribing culture. Practice implications involve deepening the understanding of the evolving nature of the antibiotic overprescription problem in China, building trust between physicians and patients/caregivers in order to facilitate the physicians' role as the gatekeeper of antibiotics and providing training programmes to help physicians develop effective communication skills., (© 2023 Foundation for the Sociology of Health & Illness.)

Introduction: How to communicate effectively with adolescent and young adults with cancer (AYACs) is a research priority. In a UK-wide survey of young people with cancer's research priorities, communication was a striking cross-cutting theme. It is increasingly recognised that AYACs have experiences and communication needs that differ significantly from those of younger children and older adults. The purpose of this review is to explore the features of effective clinical communication with AYACs., Methods: A literature search was undertaken to identify and map the available evidence using a broad scope to get an overview of the pertinent literature, identify knowledge gaps and clarify concepts. The searches yielded 5825 records, generating 4040 unique articles. These were screened and 71 full articles were read by four researchers with disagreements resolved by discussion leaving 29 included articles. Narrative synthesis was undertaken in relation to each of the research questions., Results: Three key themes were identified: being an adolescent/young adult, supporters, and healthcare professionals (HCPs). AYACs need to feel that HCPs understand their unique perspective. They want to be involved, this changes over time and in different contexts. Supporters are a central tenet, are most often parents and undertake several roles which are not always universally supportive. HCPs enable involvement of AYACs, and this needs to be actively promoted. AYACs preference for their level of involvement requires continual assessment. The three themes are interlinked and exist within the wider scope of the triadic encounter and cancer experience., Conclusion: Supporters, most often parents were a key feature across the data and were seemingly paradoxical in nature. Triadic communication, the presence of a third person, is a central tenet of communication with AYACs and we propose a conceptual model to represent the nuances, components, and facets of this complex communication., (© 2024 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd.)

Languages show substantial variability between their speakers, but it is currently unclear how the structure of the communicative network contributes to the patterning of this variability. While previous studies have highlighted the role of network structure in language change, the specific aspects of network structure that shape language variability remain largely unknown. To address this gap, we developed a Bayesian agent-based model of language evolution, contrasting between two distinct scenarios: language change and language emergence. By isolating the relative effects of specific global network metrics across thousands of simulations, we show that global characteristics of network structure play a critical role in shaping interindividual variation in language, while intraindividual variation is relatively unaffected. We effectively challenge the long-held belief that size and density are the main network structural factors influencing language variation, and show that path length and clustering coefficient are the main factors driving interindividual variation. In particular, we show that variation is more likely to occur in populations where individuals are not well-connected to each other. Additionally, variation is more likely to emerge in populations that are structured in small communities. Our study provides potentially important insights into the theoretical mechanisms underlying language variation., (© 2024 Cognitive Science Society LLC.)

The integration of artificial intelligence technologies, such as large language models (LLMs), in health care holds potential for improved efficiency and decision support. However, ethical concerns must be addressed before widespread adoption. This article focuses on the ethical principles surrounding the use of Generative Pretrained Transformer-4 and its conversational model, ChatGPT, in healthcare settings. One concern is potential inaccuracies in generated content. LLMs can produce believable yet incorrect information, risking errors in medical records. Opacity of training data exacerbates this, hindering accuracy assessment. To mitigate, LLMs should train on precise, validated medical data sets. Model bias is another critical concern because LLMs may perpetuate biases from their training, leading to medically inaccurate and discriminatory responses. Sampling, programming, and compliance biases contribute necessitating careful consideration to avoid perpetuating harmful stereotypes. Privacy is paramount in health care, using public LLMs raises risks. Strict data-sharing agreements and Health Insurance Portability and Accountability Act (HIPAA)-compliant training protocols are necessary to protect patient privacy. Although artificial intelligence technologies offer promising opportunities in health care, careful consideration of ethical principles is crucial. Addressing concerns of inaccuracy, bias, and privacy will ensure responsible and patient-centered implementation, benefiting both healthcare professionals and patients., (Copyright © 2023 by the American Academy of Orthopaedic Surgeons.)

The aim of this study is to discuss the need for improved intercultural communicative competence (ICC) training for pre-service Chinese as a Second Language (CSL) teachers who travel abroad to teach. Previous studies have shown that pre-service CSL teachers often struggle with intercultural communication, and this study investigates the reasons behind their difficulties and suggests ways to address them. The researchers used the Intercultural Sensitivity Scale (ISS) and the Intercultural Effectiveness Scale (IES) to measure the ICC of 217 pre-service CSL teachers. The study found that while pre-service CSL teachers have strong intercultural communicative emotional ability, their behavioral ability in intercultural communication is weak. In particular, they lacked skills in interactive control, interactive relaxation, identity management, information skills, and behavioral flexibility. The study proposes several strategies to improve ICC training for pre-service CSL teachers. One potential approach is the use of Computer Assisted Language Learning to provide teacher-trainee students with opportunities to practice intercultural communication skills in simulated contexts, receive personalized feedback, and engage with authentic materials and cultural information relevant to their host country. CALL could also facilitate communication between pre-service CSL teachers and former CSL teachers, providing a platform for information exchange and additional psychological support. The study also suggests that pre-service training should distinguish between foreign language learning and intercultural communication skills training. Specifically, it recommends that foreign language proficiency should be improved, while training should focus on educational culture and work culture in the host country, rather than providing a general introduction to the national conditions of the country. Finally, the study proposes that pre-service training should establish contact between pre-service CSL teachers and former CSL teachers as early as possible so that trainees can learn specific relevant information in advance, which can help them get ready, avoid intercultural communication mistakes, and obtain additional psychological support. By incorporating CALL and addressing the areas of weakness identified in the study, pre-service CSL teachers can be better prepared to navigate the challenges of intercultural communication and provide effective and culturally sensitive instruction abroad., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This paper documents the existence of a 'formality effect' in government communications. Across three online studies and three field experiments in different policy contexts (total N = 67,632), we show that, contrary to researcher and practitioner predictions, formal government communications are more effective at influencing resident behaviour than informal government communications. In exploring mechanisms, we show that formality operates as a heuristic for credibility and importance. Recipients view the source of a formal letter as more competent and trustworthy, and view the request itself as more important to take action on, despite no evidence of change in comprehension or in perceived ease of taking action. These findings have immediate implications for government communicators and open the door for a renewed focus on how the design and presentation of information impacts behaviour., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)