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This study examines how organizational capacity and environmental pressures shape social media adoption in local government. Using a mixed‐methods approach, we analyze Facebook adoption patterns across 6,254 Czech municipalities by scanning their official websites for Facebook links, a questionnaire survey ( = 330), and thematic analysis of posts from municipalities with extended powers. Results reveal a strong relationship between municipal size and Facebook adoption, with rates ranging from 14.1% in the smallest municipalities (fewer than 200 inhabitants) to 88.6% in the largest (10,000+). Primary adoption motivations include communication speed, ensuring citizen awareness, and meeting public expectations for a modern online presence, while resource constraints and fear of negativity constitute major barriers. Thematic analysis reveals dominance of practical information and community event promotion over dialogic engagement. The findings demonstrate how resource limitations create a digital divide in local government communication, with smaller municipalities facing structural barriers to social media adoption. This research contributes to understanding technology diffusion dynamics in fragmented administrative systems and the gap between social media’s dialogic potential and actual government communication practices.

Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients. We performed a prospective qualitative interview study in a multidisciplinary intensive care unit. Ten alert, orientated adult patients who previously underwent MV for at least 24h and were able to speak at the time of interview were recruited. Semi-structured interviews with stimulated recall technique were conducted. A descriptive thematic analysis was performed of the patient-generated content using a free coding technique, where recurrent themes and subthemes were noted, coded and analyzed. Patients' communication content included medical discussions with clinicians; communication with family to provide advice or comfort, make requests and plans, express feelings and convey personal perspectives on medical care; and expression of their own psychoemotional needs. The scope of communication content of ventilated ICU patients was broad, extending far beyond task-focused subject matter. Content ranged from conveying symptom-related messages to active participation in medical discussions, to conversing with family about a range of complex multi-dimensional issues, to sharing their own psychoemotional experiences. These patient-centered needs should be recognized and addressed in communication strategies. •Mechanically ventilated critically ill patients' scope of communication is broad.•Ventilated patients want to communicate complex personal and psychoemotional issues.•Communication during this non-vocal period can be frustrating.•Communication strategies should recognize and address these needs.

Energy-efficient renovation (EER) is a complex process essential for reducing emissions in the built environment. This research identifies homeowners as the main decision-makers, whereas intermediaries and social interactions between peers are highly influential in home renovations. It investigates information and communication barriers encountered during the initial phases of EERs. The study reviews AI tools developed within the EERs domain to assess their capabilities in overcoming these barriers and identifies areas needing improvement. This research examines stakeholders, barriers, and the AI tools in the literature for EERs. The discussion compares the functionalities of these tools against stakeholder needs and the challenges they face. Findings show that tools often overlook methodologies in human–computer interaction and the potential of textual and visual AI methods. Digital tool development also lacks insights from social science and user feedback, potentially limiting the practical impact of these innovations. This article contributes to the EERs literature by proposing an AI-supported framework and outlining potential research areas for future exploration, particularly improving tool effectiveness and stakeholder engagement to scale up the EER practice.

This study aims to examine the challenges associated with thirst management among patients undergoing tracheal intubation in intensive care units (ICUs), and to inform the development of more effective clinical strategies. A qualitative research design was employed using semi-structured interviews with 32 participants, including healthcare professionals and patients who had experienced tracheal intubation and associated thirst in the ICU. Interview content addressed themes such as the expression, recognition, and management of thirst. Thematic analysis was used to identify key patterns within the data. Four major themes emerged from the analysis: (1) communication barriers in the expression and recognition of thirst; (2) difficulty distinguishing between physiological and psychological thirst; (3) limitations and deficiencies in current thirst management practices; and (4) cognitive disparities between healthcare providers and patients regarding thirst perception. These findings underscore the multifaceted nature of thirst management in tracheal intubation. Thirst management for patients undergoing tracheal intubation in the ICU involves complex, multidimensional challenges. The findings offer clinically relevant insights that may enhance the ability of healthcare providers to recognize and assess thirst, support the development of targeted communication strategies and interventions, and facilitate greater patient involvement in care decisions, thereby contributing to improved treatment adherence and nursing quality.

Communicating with patients who speak different languages in health care environments is a well-known challenge, for which there are myriad solutions to provide increased access for patients with low proficiency in the language of care. Clinicians often overlook communication challenges with patients for whom language is not a barrier, but mismatches in cultural and personal communication styles can lead to poor communication between doctor and patient that can negatively affect the clinical relationship and patient care. Just as patients who require interpreters require more time, clinicians must expect to spend more time to navigate different communication styles. Physicians should have a high index of suspicion for communication challenges, and hospitals and clinics must provide flexible clinic environments that allow clinicians the time required to overcome them.

Good communication is essential in neurological consultations, yet this is obviously compromised by the absence of a common language. Interpreters can make valuable contributions to improving consultations, but translation has its shortcomings. The consultation dialogue is not always interpreted correctly or accurately, even (or especially) when friends or family are translating. Clinicians should therefore try to ensure that key information has been communicated and understood, perhaps by repetition or asking the patient to say what they have understood. Cultural factors are also important in the patient–physician interaction. Physicians should try to adopt a culturally sensitive approach during consultations, familiarising themselves with cultural norms within the prevalent ethnic minority groups in their area. They should resist directive approaches to save time and try to involve the patient in decision-making. This requires allocating extra time to consultations with patients for whom English is not their first language.

iii Psychoanalysis, History, and Radical Ethics: Learning to Hear explores the importance of listening, being able to speak, and those who are silenced, from a psychoanalytic perspective. In particular, it focuses on those voices silenced either collectively or individually by trauma, culture, discrimination and persecution, and even by the history of psychoanalysis. Drawing on lessons from philosophy and history as well as clinical vignettes, this book provides a comprehensive guide to understanding the role of trauma in creating silence, and the importance for psychoanalysts of learning to hear those silenced voices.

While it is recognized that language can pose a barrier to the transfer of scientific knowledge, the convergence on English as the global language of science may suggest that this problem has been resolved. However, our survey searching Google Scholar in 16 languages revealed that 35.6% of 75,513 scientific documents on biodiversity conservation published in 2014 were not in English. Ignoring such non-English knowledge can cause biases in our understanding of study systems. Furthermore, as publication in English has become prevalent, scientific knowledge is often unavailable in local languages. This hinders its use by field practitioners and policy makers for local environmental issues; 54% of protected area directors in Spain identified languages as a barrier. We urge scientific communities to make a more concerted effort to tackle this problem and propose potential approaches both for compiling non-English scientific knowledge effectively and for enhancing the multilingualization of new and existing knowledge available only in English for the users of such knowledge.

The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop.