Doctor-patient communication starts from medical students

Currently,with the increasing tensionin doctor-patient relationship and medical disputes,it is of great practical importance to train medical students’communication skills in order to establisha harmonious doctor-patient relationship to improve the quality of clinical teaching.This paper emphasizes the importance of cultivation of communication skills in medical education and suggests ways to improve communication skills among medical students.

Effective doctor-patient communication skills training optimizes functional organization of intrinsic brain architecture:a restingstate functional MRI study

We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.

Research on psychological factors which influence Doctor-Patient communications among outpatients

An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Patient relationship. This article, from the perspective of psychology, investigates into the common psychological factors which affect the Doctor-Patient communication, the appearance of the communication problem, and make suggestions on possible solutions accordingly.

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.

A Study on Doctor-patient Communication under Defler Interaction Process Model

At present,doctor-patient relationship has become a sensitive topic in society,and frequent doctor-patient communication problems have become an important factor affecting the tension of the relationship.From the perspective of communication,this paper analyzes the causes of doctor-patient communication barriers based on the communication mode of interaction process proposed by Deffler and puts forward relevant solutions.

Decision Tree Based Key Management for Secure Group Communication

Group communication is widely used by most of the emerging network applications like telecommunication,video conferencing,simulation applications,distributed and other interactive systems.Secured group communication plays a vital role in case of providing the integrity,authenticity,confidentiality,and availability of the message delivered among the group members with respect to communicate securely between the inter group or else within the group.In secure group communications,the time cost associated with the key updating in the proceedings of the member join and departure is an important aspect of the quality of service,particularly in the large groups with highly active membership.Hence,the paper is aimed to achieve better cost and time efficiency through an improved DC multicast routing protocol which is used to expose the path between the nodes participating in the group communication.During this process,each node constructs an adaptive Ptolemy decision tree for the purpose of generating the contributory key.Each of the node is comprised of three keys which will be exchanged between the nodes for considering the group key for the purpose of secure and cost-efficient group communication.The rekeying process is performed when a member leaves or adds into the group.The performance metrics of novel approach is measured depending on the important factors such as computational and communicational cost,rekeying process and formation of the group.It is concluded from the study that the technique has reduced the computational and communicational cost of the secure group communication when compared to the other existing methods.

A Secure Session Key Distribution Scheme for Group Communications

In a secure group communication system, messages must be encrypted before being transmitted to group members to prevent unauthorized access. In many secure group communication schemes, whenever a member leaves or joins the group, group center (GC) immediately changes the common encryption key and sends the new key to all valid members for forward and backward secrecy. If valid members are not on-line, they will miss the re-keying messages and will not be able to decrypt any ciphertext. Therefore, group members must be able to store the state of the system. In some applications, like global positioning systems (GPS) or pay-per-view systems, it is not reasonable to ask group members to stay on-line all the time and save the changes to the system. A hierarchical binary tree-based key management scheme are proposed for a secure group communication. This scheme reduces the key storage requirement of GC to a constant size and the group members are not required to be on-line constantly (stateless).

Uniquely Decomposable Constellation Group-Based Sparse Vector Coding for Short Packet Communications

Sparse vector coding(SVC)is emerging as a potential technology for short packet communications.To further improve the block error rate(BLER)performance,a uniquely decomposable constellation group-based SVC(UDCG-SVC)is proposed in this article.Additionally,in order to achieve an optimal BLER performance of UDCG-SVC,a problem to optimize the coding gain of UDCG-based superimposed constellation is formulated.Given the energy of rotation constellations in UDCG,this problem is solved by converting it into finding the maximized minimum Euclidean distance of the superimposed constellation.Simulation results demonstrate the validness of our derivation.We also find that the proposed UDCGSVC has better BLER performance compared to other SVC schemes,especially under the high order modulation scenarios.

SECURE GROUP COMMUNICATIONS FOR LARGE DYNAMIC MULTICAST GROUP

As the major problem in multicast security, the group key management has been the focus of research But few results are satisfactory. In this paper, the problems of group key management and access control for large dynamic multicast group have been researched and a solution based on SubGroup Secure Controllers (SGSCs) is presented, which solves many problems in IOLUS system and WGL scheme.

Overlay Share Mesh for Interactive Group Communication with High Dynamic

An overlay share mesh infrastructure is presented for high dynamic group communication systems, such as distributed interactive simulation (DIS) and distributed virtual environments (DVE). Overlay share mesh infrastructure can own better adapting ability for high dynamic group than tradition multi-tree multicast infrastructure by sharing links among different groups. The mechanism of overlay share mesh based on area of interest (AOI) was discussed in detail in this paper. A large number of simulation experiments were done and the performance of mesh infrastructure was studied. Experiments results proved that overlay mesh infrastructure owns better adaptability than traditional multi-tree infrastructure for high dynamic group communication systems.

Integrating IPsec within OpenFlow Architecture for Secure Group Communication

Network security protocols such as IPsec have been used for many years to ensure robust end-to-end communication and are important in the context of SDN. Despite the widespread installation of IPsec to date, per-packet protection offered by the protocol is not very compatible with OpenFlow and tlow-like behavior. OpenFlow architecture cannot aggregate IPsee-ESP flows in transport mode or tunnel mode because layer-3 information is encrypted and therefore unreadable. In this paper, we propose using the Security Parameter Index （SPI） of IPsec within the OpenFlow architecture to identify and direct IPsec flows. This enables IPsec to conform to the packet-based behavior of OpenFlow architecture. In addition, by distinguishing between IPsec flows, the architecture is particularly suited to secure group communication.

A Secure Key Management Scheme for Heterogeneous Secure Vehicular Communication Systems

Intelligent transportation system （ITS） is proposed as the most effective way to improve road safety and traffic efficiency. However, the future of ITS for large scale transportation infrastructures deployment highly depends on the security level of vehicular communication systems （VCS）. Security applications in VCS are fulfilled through secured group broadcast. Therefore, secure key management schemes are considered as a critical research topic for network security. In this paper, we propose a framework for providing secure key management within heterogeneous network. The seeurity managers （SMs） play a key role in the framework by retrieving the vehicle departnre infi^rmation, encapsulating block to transport keys and then executing rekeying to vehicles within the same security domain. The first part of this framework is a novel Group Key Management （GKM） scheme basing on leaving probability （LP） of vehicles to depart current VCS region. Vehicle＇s LP factor is introduced into GKM scheme to achieve a more effieient rekeying scheme and less rekeying costs. The second component of the framework using the blockchain concept to simplify the distributed key management in heterogeneous VCS domains. Extensive simulations and analysis are provided to show the effectiveness and effieiency of the proposed framework： Our GKM results demonstrate that probability-based BR reduees rekeying eost compared to the benchmark scheme, while the blockchain deereases the time eost of key transmission over heterogeneous net-works.

Group Activities in Task-based Communicative Classroom

In a task-based communicative classroom, group activities are effective ways to devdop students' 4 basic language skills. However, not all group activities can reach the expected results. English teachers should pay attention to some aspects in organizing a classroom group activity.

On improving students＇ communicative competence by group interaction

In foreign language teaching, the communicative approach has been a dominant method for decades. However, some misconceptions of the communicative approach affect the results of group interaction teaching. This article tries to explore some existing problems as well as some relevant solution in the application of group activities in colleges with the aid of observation, questionnaire and interview.

A Discrepancy between An Advocacy of Group Work and the Reality of Its Poor Implementation ELT Classrooms of Junior High Schools in China's Mainland

The paper investigates how group work was implemented in English teaching classrooms in a junior high school of China's Mainland as a case study. The research data was collected by classroom observations, a survey of the students and interviews with the classroom teachers. The research finds a mismatch between an advocacy of group work and the reality of its poor implementation. It has implications on English curriculum innovation and the advocacy of group work in ELT classrooms in China's Mainland.

A new group key management scheme based on keys tree, XOR operation and one-way function

By introducing XOR operation and one-way function chains to group key management schemes based on the keys tree, a new group key management scheme based on the keys tree, XOR operation and one-way function chains is proposed. Initialization, member adding and member evicting operations are introduced. The new scheme is compared with three other group key management schemes which are based on the keys tree： SKDC, LKH, and OFF. As far as transmission, computation and storage costs are concerned, the performance of the new group key management scheme is the best. The security problem of the new scheme is analyzed. This new scheme provides backward and forward security, i.e.. newly admitted group members cannot read previous multicast messages and evicted members cannot read future multicast messages, even with collusion by many arbitrarily evicted members.

Applying Communicative Teaching Method in English-teaching Classroom

Communicative language teaching is generally accepted in the field of second language teaching. In this paper, the author introduces a model of communicative language teaching. The authors also mention some practical requirements and methods in the application of this model, such as authentic materials and group work.

Doctor-patient Narrative Re-discovered from Overseas Traditional Chinese Medicine Practices

The doctor-patient narrative has been revisited and appreciated in both the West and the East due to the negative impact of biochemical medicine in the past two centuries on healthcare.Biochemical medicine system simply marginalized the roles of doctors and patients.More research and practice of“doctor's benevolence”and“humanistic medicine”have called for the return of the doctor-patient narrative.This paper draws on interviews with several non-Chinese overseas traditional Chinese medicine(TCM)practitioners,whose clients are also non-Chinese.We adopted discourse analysis to explore our data.We found that they actively engaged in doctor-patient narrative with localized interpretation of TCM.We believe such a return to basic doctor-patient narrative is caused by fundamental needs for doctor-patient narrative coinciding with loose control of TCM practices in the studied countries.This discovery may inspire further study on re-establishing doctor-patient narratives in healthcare institutions by re-positioning biochemical medicine.

HUFFMAN-BASED GROUP KEY ESTABLISHMENT SCHEME WITH LOCATION-AWARE

Time efficiency of key establishment and update is one of the major problems contributory key managements strive to address.To achieve better time efficiency in key establishment,we propose a Location-based Huffman(L-Huffman) scheme.First,users are separated into several small groups to minimize communication cost when they are distributed over large networks.Second,both user's computation difference and message transmission delay are taken into consideration when Huffman coding is employed to forming the optimal key tree.Third,the combined weights in Huffman tree are located in a higher place of the key tree to reduce the variance of the average key generation time and minimize the longest key generation time.Simulations demonstrate that L-Huffman has much better performance in wide area networks and is a little better in local area network than Huffman scheme.

Reliable Content Distribution in P2P Networks Based on Peer Groups

Peer-to-Peer (P2P) networks are highly dynamic systems which are very popular for content distribution in the Internet. A single peer remains in the system for an unpredictable amount of time, and the rate in which peers enter and leave the system, i.e. the churn, is often high. A user that is obtaining content from a selected peer is frequently informed that particular peer is not available anymore, and is asked to select another peer, or will have another peer assigned, often without enough checks to confirm that the content provided by the new peer presents the same quality of the previous peer. In this work we present a strategy based on group communication for transparent and robust content access in P2P networks. Instead of accessing a single peer for obtaining the desired content, a user request is received and processed by a group of peers. This group of peers, called PCG (Peer Content Group) provides reliable content access in sense that even as members of the group crash or leave the system, users continue to receive the content if at least one group member remains fault-free. Each PCG member is capable of independently serving the request. A PCG is transparent to the user, as the group interface is identical to the interface provided by a single peer. A group member is elected to serve each request. A fault monitoring component allows the detection of member crashes. If the peer is serving request crashes, another group member is elected to continue providing the service. The PCG and a P2P file sharing applications were implemented in the JXTA platform. Evaluation results are presented showing the latency of group operations and system components.