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The aim of this dissertation thesis is to develop a complex diagnostic-therapeutic programme for adults who stutter. The thesis is divided into two parts: theoretical and empirical. The theoretical part consists of 4 chapters and is based on an analysis of foreign and Czech specialized literature, studies and electronic media. This part presents the theoretical basis of the dissertation and shows the topic of stuttering from a broader perspective. It describes how people who stutter (PWS) are affected by this disorder, its effect on speech, how PWS try to cope with it and how their perception, opinions and feelings change. The dissertation describes stuttering in children, adolescents and adults. It deals with the critical period of the onset of stuttering by specifying various risk factors. It also includes a description of other fluency disorders. A special attention is paid to the personality of the therapist and his/her impact on the therapy process. The dissertation also explains the application of ICF (International Classification of Functioning, Disability and Health) model as a starting point for diagnosis and therapy of PWS as proposed by Yaruss and Quesal (2004). The empirical part is divided into two chapters. The first part consists of a case study which presents the experimental use of...

Nonvocal alert patients in the intensive care unit setting often struggle to communicate due to inaccessible or unavailable tools for augmentative and alternative communication. A novel communication tool, the Manually-Operated Communication System (MOCS), was developed for use in intensive care settings for patients unable to speak due to mechanical ventilation. It is a speech-generating device designed for patients whose limited manual dexterity precludes legible writing. In a single-arm device feasibility trial, 14 participants (11 with tracheostomies, 2 with endotracheal tubes, and 1 recently extubated) used MOCS. Participants, family members, and observing nurses were interviewed whenever possible. Interviews included a modified version of the System Usability Scale (SUS) as well as open-ended questions; a qualitative immersion/crystallization approach was used to evaluate these responses. Participants with a tracheostomy and their family members/care providers rated MOCS on the SUS questions as consistently “excellent” (average rating across all groups was 84 +/- 17; all subgroups also rated the device highly). Through a qualitative interview process, these stakeholders expressed support for the use of MOCS in the ICU. Based on these data, MOCS has the potential to improve communication for nonvocal patients with limited manual dexterity.

Previous research has shown gender differences in the motivations to be physically active, in mobile phone gratifications, and social media usage, but so far these areas have not been studied together. Based on the uses and gratification approach and self-determination theory, we aimed to identify gender-specific gratifications and determinants of fitness app usage in combination with fitness-related Facebook groups. Results of an online survey (N = 171) and of a mobile experience sampling method (N = 31) revealed that the app Runtastic was primarily used for achieving goals and to improve enjoyment for physical activity, with men and older participants sharing results with others in Facebook groups more often than women and younger participants. Conclusions regarding genderspecific targeting strategies and user-centered design and content of mHealth features are presented.

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is on the rise. I also found that the language and cultural barriers to the Hispanic population receiving quality healthcare are a significant reason why the Hispanic population reports a lower satisfaction with U.S. healthcare. Through years of observation and practice, I developed research questions to help guide one in discovering what areas the Hispanic population is least satisfied with in healthcare. To discern what those areas of the greatest dissatisfaction are exactly, this research study manifests in the creation of a survey designed to improve the quality of healthcare received by the Hispanic population of Northeast Tennessee by identifying some of the principal issues faced by the Hispanic population within the U.S. healthcare system. The goal of this thesis is to highlight these issues as areas of focus for healthcare providers when they care for patients specifically in interpreted appointments.

Objectives: The objectives of this research were to describe the interactions (formal and informal) in which macrocognitive functions occur and their location on a pediatric intensive care unit (PICU); describe challenges and facilitators of macrocognition using three constructs of space syntax (openness, connectivity, and visibility); and analyze the health care built environment (HCBE) using those constructs to explicate influences on macrocognition. Background: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple health care settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, “Macrocognition in the Health Care Built Environment” (m-HCBE) addresses this relationship. Methods: A focused ethnographic study was conducted, including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data. Results: Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs). Conclusions: Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help to advance the m-HCBE theory for improving physical space by designing new spaces or refining existing spaces, or for adapting IPT practices to maximize formal and informal SMI opportunities; this lays the groundwork for future research to improve safety and quality for patient and family care.

Breastfeeding has been established as providing the best and most complete nutrition for newborns, as this method promotes the infant’s health and supports infant growth (American Academy of Pediatrics [AAP], 2005). Mass media have been suggested as powerful and universal means of communication with the potential to impact social norms. Thus, this qualitative descriptive study explored, within the context of the Socioecological Framework, women’s decision making on whether to breastfeed or bottle-feed their infants and the effect of mass media on their decision. Data were collected in individual audiotaped interviews with participants recruited from the Massachusetts Breastfeeding Coalition and UMass Memorial Medical Center. Interview data were compared to text and visual representation from 12 Internet sites on parenting and infant feeding. Data analysis was conducted simultaneously with data collection and was continued until saturation was achieved. The comparison findings demonstrated that the emerging themes from the participant interviews reflected the information represented on the Internet sites. The main theme Media Matters Not suggested that mass media did not influence infant feeding decisions for this group of mothers. What did have an important impact on infant feeding decisions was the information and emotional support provided by partners, family, and HCPs (subtheme of Influences on Decisions). The participants offered suggestions of media messages they would like see in the future such as public service announcements of women breastfeeding their infants. In addition, the participants discussed media issues that had potential for influencing infant feeding decisions (Media Messages—Good and Bad), emphasized the need for public opinion to be altered so that breastfeeding in public would be viewed as more acceptable (Community/Public Opinions), and described suggestions for enhancing media messages about breastfeeding (Recommendations for Future Media Messages). The implications for nursing practice, public policy, and future research related to the topic were discussed.

Much research about advertisements for menstrual products reveals the ways in which such advertising perpetuates shame and reinforces unrealistic ideals of femininity and womanhood. This study aims to examine the content of Instagram posts by four different menstrual product brands in hopes of understanding how these functions may or may not be carried out by social media posts by these brands as well. Building on the body of research about menstrual shame and advertising, I specifically ask: How do the Instagram pages for four menstrual product brands dissuade individuality; how do they prescribe femininity; and how do these functions differ across brands? From a liberal feminist perspective, the examined media exhibits some signs of progress—such as better racial representation—but overall maintains the status quo as to who should be using which products, what womanhood means, and what menstruation entails. These findings indicate that within menstrual product advertising, harmful gender, ability, race, class, and wealth stereotypes continue. Further research of a broader scope is needed to investigate changes on a larger scale, such as within advertising on other platforms and by more brands.

<p>Health communication is a growing field of research under interpersonal and family communication. Gaining enough health information is primarily the duty of healthcare providers. However, our immediate source of health information is family members; but most people decide to privatize and keep their health information from other relatives. The criterion for withholding health information, what contributes to the information shared, and how communication patterns affect health communication were all examined to understand the reasons behind this action.</p> <p>This qualitative study used the narrations on health communication from various families to form themes. In addition,  responses were mostly from non-Western cultures, which helps to expand the applicability of the theory used.</p> <p>Some of the results were consistent with the criteria within the theory. However, other criteria were found that expand the theory in relation to health information. The new criteria found were when disclosing the information, age matter, I don’t understand the condition myself so how can my family, the number of people in the family matters. Also, reasons such as anticipated reactions from family members, and the severity of the condition came up when exploring what impacts how much health information family members share with one another. Finally, the frequency of communication and the initiator of conservations were found to influence health communication in families.</p> <p>To conclude, healthy communication in the family may impact individual communication on health. </p>

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