Almost everyone agrees that doctors' handwriting is not the only indecipherable and alienating communication practice in healthcare. The oral communication between doctors and patients is equally problematic. Few scholars in the field of rhetoric have attempted to analyze why and how these discursive practices have come about. Equally absent from the medical and rhetorical fields are alternative models that construct a better discourse between doctors and patients. My dissertation, Look Who's Not Talking: Recovering the Patient's Voice in the Clinique, not only examines how doctors talk to patients, but also begins an effort to change present discursive practices in healthcare. Michel Foucault began an academic conversation in The Birth of the Clinic and in Power/Knowledge that deconstructed certain institutionalized discourses. While his study went a long way toward analyzing the discourse of medicine, his language and theories have not moved into medical journals or patient rooms. My dissertation acts as a bridge between "high" rhetorical theory and the "marketplace" of medicine (an unfortunately apt metaphor for healthcare in this country). Foucault supplies one of the lenses I use to look at the discourse. Other lenses include those of Kenneth Burke and Lloyd Bitzer. One underlying assumption in the dissertation is that practices are more easily changed once they have been analyzed. I place the analysis within history and within current contexts. This strategy enacts a model opposing the usual acontextualized, ahistoric doctor/patient discourse. Both chapters 3 and 4 look at how doctor/patient discourse was constructed in Europe and America. In addition to making a contribution to the medical field, this dissertation breaks new ground within rhetoric and lays the basis for further explorations. Because of my extensive work in the healthcare field as cardio-pulmonary technician and special procedures nurse, I was able to draw on my own experience to use as examples of the particular problems within the discourse I isolate and propose alternatives to. The fifth chapter features a two-semester course I designed for first-year medical students. This course is rhetorically based and teaches doctors-to-be why the language they use with patients is important and how to effectively address patients.

The purpose of this field based study is to analyze the linguistic and cognitive transactions of immigrant language minority kindergarten students in the context of classroom collaborative talk in their native language and conducted through the observations and reflections of a teacher-researcher. The research questions addressed in this study are; (1) How do children use prior knowledge to negotiate meaning and develop shared understandings? (2) How do cognitive and linguistic processes develop as children participate in classroom collaborative talk to co-construct new knowledge and negotiate meaning? (3) In what ways do children extend and internalize understandings of vocabulary and word meaning while engaging in classroom collaborative talk? This case study draws upon the data collected during a year-long inquiry I conducted in my own classroom in an urban school. Twenty-seven students, all from Hispanic origin, mostly recent arrivals from Mexico, participated in the research. The collaborative talk transactions were transcribed and translated into English from thirteen videotaped sessions from which I selected excerpts of varying lengths to examine. The findings are threefold. First, the collaborative talk transactions, framed within a cognitive and linguistic stance, demonstrate how meanings and new understandings are constructed and restructured; show how the teacher and the learners make use of their cultural values, assumptions, attitudes and experiences to construct new meanings and shared understandings; and reveal how learners engage in oral literacies in collaboration with the teacher and then begin to formulate and test hypotheses without the teacher's mediation. Second, the collaborative discourse, situated within an empowerment through voice perspective, show how culturally responsive modes of teaching and learning maximize the use of language minority students I linguistic, cultural and cognitive resources; reveal that these learners display high motivation and interest when the topics are relevant to their lives; and illustrate how learners make connections between the concepts embedded in discourse and their own experiences and understandings. Finally, our discursive practices reflect the importance of native language use in allowing culturally and linguistic diverse students to express their thinking and understandings in their more competent linguistic system and in the language of their culture and social worlds.

American women continue to be severely underrepresented in the number of elected political positions held. One of the obstacles that women face when seeking public office are gender stereotypes which reinforce beliefs that women may be less viable candidates than men. Gender stereotypes influence a range of evaluations about candidates including judgments about their credibility, competency, and communication strategies. This study analyzes communication campaign strategies as one area in which gender stereotyping may influence voters. Television political advertisements are the context for this analysis because of the increased relevance of advertising in imparting candidate image and issue information to the voters. Language Expectancy Theory and literature from the nonverbal communication field provided the theoretical rationale for this study. A micro-level analysis of the verbal and nonverbal communication strategies in political advertising was conducted to determine if these strategies adhered to or countered gender stereotypes. A total of 124 political advertisements of male and female candidates were content analyzed. Results of the study indicate that differences existed in how male and female candidates presented their image to the electorate. Specifically, for the verbal strategies examined, women candidates used less intense language, less humor, less direct attacks, and more prosocial strategies than their male counterparts. However, no differences were found between how men and women made references to autonomy nor were differences identified in their use of opinionated language. For the nonverbal communication strategies, women were coded as having more pleasant voices, and as using more immediate and dominant kinesic cues. No differences were identified in regard to trait characteristics emphasized nor issues mentioned in the ads. The discussion focuses on how these findings can assist scholars in understanding the communication strategies male and female candidates utilized, and if these strategies supported or violated communication stereotypes. The findings of the study can facilitate future research related to understanding how female candidates can increase the persuasive efficacy of their political advertisements.

<p> Freshman Sen. William H. Seward of New York was not expected to say anything noteworthy in his "Freedom in the New Territories" speech against the Compromise bills on March 11, 1850. The venerated "Great Triumvirate" had previously addressed the Senate&mdash;Sen. Henry Clay on Jan. 29, Sen. John C. Calhoun on March 4, and Sen. Daniel Webster on March 7&mdash;so everything there was to say was thought to have been said. Seward's "Freedom in the New Territories" speech, however, is recalled as one of the more divisive of Compromise orations and most significant of Senate maiden speeches in history because of its appeal to "a higher law than the Constitution." The utterance drew a maelstrom of criticism from the partisan press and congressional adversaries and colleagues; however, Seward's rhetoric introduced a reformist interpretation of the phrase "higher law" to the slavery discourse. </p><p> This thesis applies concepts from the literature on rhetoric of agitation and control and ideographs to define Seward's rhetoric as managerial, show his motives as socio-economic, and discover how the senator's reformist arguments were controlled by the establishment after the Christiana Riot in 1851. The researcher suggests that the establishment employed a kind of denial of rhetorical means to obstruct Seward's reformist rhetoric of its solidifying slogans. Future research into the control response to agitative rhetoric is suggested to understand the strategies and tactics used to control reformist rhetoric. </p>

<p>This paper is a systematic review of scholarly studies that examines how organizations enhance their ability to generate value through social media. It explores why some organizations are able to adopt and benefit from social media while others cannot. Specifically, it examines: (i) how <i> people</i> and social networks are essential to create value at the organizational level, (ii) how <i>leadership</i> sets the vision and convinces others on the need for change, and (iii) what types of <i>strategy</i> can be implemented to enable knowledge creation through social networks. Argument is made on the vital importance of two variables in particular&mdash;leadership and strategy&mdash;and their role in moderating how the organization accepts and incorporates change to enhance overall effectiveness and efficiency. Evidence-based research is used to describe relevant theory and practice through qualitative and quantitative sources. It examines how organizations overcome the hurdles associated with change, and how individuals learn to accept new methods to connect, share knowledge, and create value through Web 2.0 technology. </p><p> Social media challenges an organization&rsquo;s ability to manage individuals and information. It requires a shift in the way people work and think; it requires a culture adjustment in how people collaborate in new, more inclusive ways other than relying on the same imbedded methods and inner core of co-workers for answers. </p><p> <i>Keywords:</i> Social Media, Social Networks, Leadership, Strategy, and Organizational Culture. </p>

<p>Incivility is a low-level form of violence that has been found to threaten safety and has gained increasing attention from healthcare leaders. Incivility at work causes distractions and threatens the culture of safety. Locations providing mental health services are among such high-risk areas. The purpose of this study was to evaluate the effectiveness of a nurse leader&rsquo;s educational approach to improve civility in the mental health (MH) nursing workplace using assertiveness training with role-play. </p><p> The civility score in this study was measured by staffs&rsquo; perceptions of eight items: respect; conflict resolution; cooperation; anti-discrimination; value differences; diversity acceptance; personal interest; and reliability of team members. In this study, the principal investigator (PI), a MH nurse leader, prepared and implemented a six-month plan of evidence-based actions intended to improve civility and to strengthen the sense of community. </p><p> Role-play exercises were included in assertiveness training sessions. Personalized brochures that summarized information and future direction for improving civility were prepared and distributed. </p><p> Civility awareness and assertiveness were reinforced by sharing literature, facilitating discussions, and practicing occasional role-plays to problem-solve past and current incivilities as they surfaced. Follow-up measurements showed a rapid and sharp increase in civility, with improved scores for each of the eight items. These findings support continued use of assertiveness training with role-play as an effective approach for improving civility in a culturally diverse MH nursing staff. Limitations of this study are discussed. </p>

Throughout the pages of nineteenth-century American fiction men remain fascinated by the sound of women's speech. Literary depictions of men's intense interest in women's pleasing and distinct utterance occur with a frequency that suggest not so much that there "are" unalterable differences between American men's and women's speech, but that the imagining of that difference is central to the nation's understanding of itself as a distinct entity or to the creation of what Lauren Berlant calls a "national symbolic." These lengthy depictions of women's speech thus participate in cultural work of a profound, enduring, and to date unspecified nature. It is the project of this dissertation to describe the cultural burden placed on women's language in mainstream nineteenth-century American literature and, then, to carve out new ways of thinking about the public significance of women's speech and its impact on the nineteenth-century political arena. In chapter one, I analyze the writings of, among others, Henry James, Sarah Hale, and Noah Webster in order to show that the separation of women's speech from the public arena was a process that depended for its success on the attention that men paid to the sound of women's talk and to the desire that sound produced. In short, I establish a clear relation between the creation and reinforcement of the public sphere and the depictions of women's speech that occur repeatedly in American fiction. In my second chapter, however, I show that by mid-century a minority of American writers, including Herman Melville and E. D. E. N. Southworth had begun arguing that the sexually explicit subject matter, rather than eroticized sound, of women's language recenters their speech in the public sphere. Using their figuration as a departure point, I show, in chapters three through six, how Maria Monk, Caroline Lee Hentz, Harriet Jacobs, Lillie Devereux Blake, and Elizabeth Stuart Phelps employed and foregrounded this alternative paradigm of women's speech in their political fictions in order to influence, respectively, the nativist, pro-slavery, abolitionist, women's suffrage, and labor reform movements. My analysis thus revises the critical consensus that nineteenth-century women's speech failed to impact America's political life.

<p> Open and sincere communication produces an atmosphere that allows family members to articulate love and respect for one another. Results make it obvious that family communication is an important untapped resource when discussing increasing rates of HIV/AIDS infections. This study examines family communication, African Americans and HIV/AIDS prevention.</p><p> With 32% of the reported cases of AIDS are African Americans and only 12 % of American population is African American. It is essential to find new preventative measure to suppress HIV rates in African American communities. By assessing the communication orientation(s) that work best when providing sex education to teenagers it can establish a foundation for further research on communication about sex education, HIV and STD prevention. With the findings of what communication style(s) work best it can alter the stigmas of homosexuality tied to HIV in the African American community, delineating the discouragement of homosexual sex education lowering the rate of HIV and STD transmission. </p><p> Using semi-structured interviewing with open-ended questions made interviews more informal and easy for participants to divulge specific information. Participants were African American men and women, between the age of 18-25, residing in Southern Maryland and had a younger sibling. With the use of spiral of silence theory the study found that mass opinion given by the black church of abstinence and the lack of education on HIV/AIDS prevention due to biblical text has created a moral divide for those within the congregation that would like to speak out for preventative provisions.</p>

<p> The underlying goal of this dissertation is to understand how the amygdala, a brain region involved in establishing the emotional significance of sensory input, contributes to the processing of complex sounds. The general hypothesis is that communication calls of big brown bats (<i>Eptesicus fuscus</i>) transmit relevant information about social context that is reflected in the activity of amygdalar neurons. </p><p> The first specific aim analyzed social vocalizations emitted under a variety of behavioral contexts, and related vocalizations to an objective measure of internal physiological state by monitoring the heart rate of vocalizing bats. These experiments revealed a complex acoustic communication system among big brown bats in which acoustic cues and call structure signal the emotional state of a sender. </p><p> The second specific aim characterized the responsiveness of single neurons in the basolateral amygdala to a range of social syllables. Neurons typically respond to the majority of tested syllables, but effectively discriminate among vocalizations by varying the response duration. This novel coding strategy underscores the importance of persistent firing in the general functioning of the amygdala. </p><p> The third specific aim examined the influence of acoustic context by characterizing both the behavioral and neurophysiological responses to natural vocal sequences. Vocal sequences differentially modify the internal affective state of a listening bat, with lower aggression vocalizations evoking the greatest change in heart rate. Amygdalar neurons employ two different coding strategies: low background neurons respond selectively to very few stimuli, whereas high background neurons respond broadly to stimuli but demonstrate variation in response magnitude and timing. Neurons appear to discriminate the valence of stimuli, with aggression sequences evoking robust population-level responses across all sound levels. Further, vocal sequences show improved discrimination among stimuli compared to isolated syllables, and this improved discrimination is expressed in part by the timing of action potentials. </p><p> Taken together, these data support the hypothesis that big brown bat social vocalizations transmit relevant information about the social context that is encoded within the discharge pattern of amygdalar neurons ultimately responsible for coordinating appropriate social behaviors. I further propose that vocalization-evoked amygdalar activity will have significant impact on subsequent sensory processing and plasticity.</p>

<p> This qualitative study investigated the information culture and beliefs within two United Church of Christ congregations in Northeast Ohio. One congregation was Open and Affirming (ONA), and one congregation was not. ONA refers to a congregation's decision to be listed as a place where LGBT individuals&mdash;in particular&mdash;are welcomed and accepted. Using a purposive sampling technique, 8 focus groups of 4-8 participants each were asked to discuss content derived from three research question areas: participant beliefs, information that participants used to inform these beliefs, and how this information was used.</p><p> Analysis found that both congregations espoused the superiority of their beliefs about inclusivity, thus creating a paradox whereby their inclusivity involved excluding beliefs of exclusion. Because the ONA congregation preferred a personal expression of belief, they were more comfortable with the potential divisions caused by this paradox than the non-ONA congregation, which preferred a communal expression of belief. </p><p> Analysis also found that most participants relied heavily and placed great authority in information from internal sources, e.g., prayer, meditation, and emotion. The ONA congregation reflected the presence of more unique information, indicating that they approached the Bible and other common religious information critically and with more freedom to come to different conclusions than fundamentalists and biblical literalists. </p><p> Despite these differences in belief expression and information type, the analysis found that both groups showed evidence of Chatman's Small Worlds theory. First, participants showed evidence of unmet information needs. Many lacked confidence in the ability to articulate personal beliefs. Second, participants noted the presence of long-term attendees who determined the relevancy of incoming information. Finally, participants tended to guard against disclosing information about personal problems to other congregants, preferring to anonymously seek out answers. </p><p> The research highlights the social nature of belief formation and the impact of religious tradition, pastoral sermons, and external information on these beliefs. It contains important implications for pluralistic communication and the social nature of organizational legitimization. It extends the literature on belief formation and information science by developing mid-range theories about the processes by which individuals in religious communities use information to form beliefs.</p>