The expression of emotion through nonverbal behavior in medical visits

Relationship-centered care reflects both knowing and feeling: the knowledge that physician and patient bring from their respective domains of expertise, and the physician’s and patient’s experience, expression, and perception of emotions during the medical encounter. These processes are conveyed and reciprocated in the care process through verbal and nonverbal communication. We suggest that the emotional context of care is especially related to nonverbal communication and that emotion-related communication skills, including sending and receiving nonverbal messages and emotional self-awareness, are critical elements of high-quality care. Although nonverbal behavior has received far less study than other care processes, the current review argues that it holds significance for the therapeutic relationship and influences important outcomes including satisfaction, adherence, and clinical outcomes of care.     

Breastfeeding by Aboriginal mothers in Perth

Objective: To document the breastfeeding practices of Aboriginal mothers delivering in Perth. Design and methods: A cohort of mothers was followed from the time of delivery for six months to obtain details of infant feeding practices. Subjects: A total of 455 mothers delivered during the study period and were asked to participate. A total of 425 mothers completed the initial questionnaire. Setting: The study was undertaken in six public hospitals in Perth, Western Australia. Data analyses: The data were analysed using spss . Breastfeeding duration was calculated using Kaplan–Meier survival analysis. Main outcome measures: Breastfeeding initiation and duration. Results: The mean age of the Aboriginal mothers was 21.8 years (range 14–39 years, SD 5.32) and the average gestational age was 38.3 weeks. Almost 50% of the mothers in the study delivered by Caesarean section. At discharge from hospital 89.4% (CI 86.6–92.1) of mothers were breastfeeding, declining to 58.8% (CI 53.5–64.1) at six months. When compared with non‐Aboriginal mothers, the Aboriginal breastfeeding rates were higher than the non‐Aboriginal average breastfeeding rates, but lower than the highest socioeconomic group. Conclusions: The breastfeeding rates of Aboriginal mothers are higher than for other Australians. This is despite the low maternal age and level of education and the high rates of low‐birth‐weight infants and Caesarean section among this population. The World Health Organization recommendation for infant feeding is exclusive breastfeeding until six months, but less than one‐third of Aboriginal mothers achieved this recommendation.     

Non-invasive Assessment of Coronary Flow Velocity Reserve: A New Method Using Transthoracic Doppler Echocardiography

Coronary flow reserve (CFR) has been used toassess coronary microcirculation and epicardial coro-nary stenoses[1— 3 ] . CFR is defined as the ratio ofcoronary flow under maximal coronary vasodilatationto coronary flow under resting conditions[4 ] .Whenthe cross- sectional area of epicardial coronary arteriesis constant,coronary flow velocity (CFV) ratios areequal to volume flow ratios.The most common method used clinically formeasuring CFVR is intracoronary Doppler flow(ICD) analysis re…     

Parents' Views about Special Provision for their Child with Severe or Profound and Multiple Learning Difficulties

This paper reports on the findings of a research study, conducted via a postal questionnaire, which aimed to elicit the wishes, needs and satisfaction with special educational provision of parents of children with severe or profound and multiple learning difficulties. Parents' views regarding services received, type of housing and employment preferred for their child, present and future concerns are also reported. The results indicated that the majority of parents in the sample are generally satisfied with their child's current special school placement and do not want a change of placement. However, one in five parents did indicate a desire for a change of placement, with the preferred option being a special class in an ordinary school. A priority for their child's learning is communication skills. A desire for a high level of involvement in their child's education was indicated but, on the whole, parents did not achieve as high a level as they would wish. Parents were generally satisfied with services received but a significant proportion expressed a desire for additional services. In terms of the future, the majority of parents expect that their child is unlikely to live or work independently or semi-independently as an adult. The paper concludes by discussing ways of enhancing parents' involvement in the decision-making process regarding special provision for their child.