Evaluating the role of speech-language pathology with patients with communication disability in the acute hospital setting using the ICF

The practice of speech-language pathology in the acute care hospital setting has changed dramatically over the last 20 years. Speech-language pathologists now routinely assess and manage patients with dysphagia as well as patients with acquired communication disorders. In practice, clinicians have tended to direct their limited resources toward the assessment and management of patients with dysphagia before addressing the needs of patients with acquired communication disorders. This practice has resulted in a decline in speech-language pathology services for patients with communication disorders and has led some clinicians to question the role of the speech-language pathologist in the acute care hospital setting. This article continues this discussion by evaluating the role of the speech-language pathologist in the acute care hospital setting within the context of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF; WHO, 2001). It argues that by adopting the ICF, speech-language pathologists have a sound rationale for broadening their role to identify the communication needs of all hospital inpatients who experience communication difficulties in the acute care hospital setting.

The downsides of downsizing: Communication processes and information needs in the aftermath of a workforce reduction strategy

This study explored the impact of downsizing on levels of uncertainty, coworker and management trust, and communicative effectiveness in a health care organization downsizing during a 2-year period from 660 staff to 350 staff members. Self-report data were obtained from employees who were staying (survivors), from employees were being laid off (victims), and from employees with and without managerial responsibilities. Results indicated that downsizing had a similar impact on the amount of trust that survivors and victims had for management. However, victims reported feeling lower levels of trust toward their colleagues compared with survivors. Contrary to expectations, survivors and victims reported similar perceptions of job and organizational uncertainty and similar levels of information received about changes. Employees with no management responsibilities and middle managers both reported lower scores than did senior managers on all aspects of information received. Implications for practice and the management of the communication process are discussed.

Meeting in the middle: Improving communication in primary health care consultations with people with an intellectual disability

The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate. This qualitative study in which five GPs, three people with intellectual disability, seven carers and two advocates (parent and friend) were interviewed was conducted in Brisbane, Australia. The aim was to better understand the factors that have an impact upon the success of communication in a medical consultation. Findings suggested that GPs were concerned with the aspects of communication difficulties which influenced their ability to adequately diagnose, manage and inform patients. Implications for practice management were also identified. People with intellectual disability reported frustration when they felt that they could not communicate adequately with the GP and annoyance when they were not included in the communication exchange. Carers were strong advocates for the person with intellectual disability, but indicated insufficient skill and knowledge to provide the level of assistance required in the consultation. The outcome was a model of cooperation that outlined the responsibilities of all players in the medical encounter, prior to, during and after the event.

Gap-junction communication between subtypes of direction-selective ganglion cells in the developing retina

The On-Off direction-selective ganglion cells (DSGCs) in the rabbit retina comprise four distinct subtypes that respond preferentially to image motion in four orthogonal directions; each subtype forms a regular territorial array, which is overlapped by the other three arrays. In this study, ganglion cells in the developing retina were injected with Neurobiotin, a gap-junction-permeable tracer, and the DSGCs were identified by their characteristic type 1 bistratified (BiS1) morphology. The complex patterns of tracer coupling shown by the BiSl ganglion cells changed systematically during the course of postnatal development. BiSl cells appear to be coupled together around the time of birth, but, over the next 10 days, BiSl cells decouple from each other, leading to the mature pattern in which only one subtype is coupled. At about postnatal day 5, before the ganglion cells become visually responsive, each of the BiSl cells commonly showed tracer coupling both to a regular array of neighboring BiSl cells, presumably destined to be DSGCs of the same subtype, and to a regular array of overlapping BiSl cells, presumably destined to be DSGCs of a different subtype. The gap-junction intercellular communication between subtypes of DSGCs with different preferred directions may play an important role in the differentiation of their synaptic connectivity, with respect to either the inputs that DSGCs receive from retinal interneurons or the outputs that DSGCs make to geniculate neurons. (C) 2004 Wiley-Liss, Inc.

Parents' and staff's perceptions of parental needs during a child's admission to hospital: an English perspective

The aim of this research was to compare perceptions of parental needs held by parents of hospitalized children and the staff caring for them, so that potential communication breakdown could be avoided. A well-trialled tool was used with a convenience sample in paediatric facilities in a National Health Service trust in north-east England. Some differences were found between parents and staff for scores for perceived importance of the 51 needs that were included in the questionnaire, and whether or not they were being satisfactorily met during the child’s hospital admission, but there were no consistent patterns, so it is difficult to draw conclusions. Parents declared themselves more independent than the staff perceived them to be. Such findings facilitate improvements in communication between parents and staff and can be included in education programmes for both.

Making media work in space: An interdisciplinary perspective on media and communication requirements for current and future space communities

As humans expand into space communities will form. These have already begun to form in small ways, such as long-duration missions on the International Space Station and the space shuttle, and small-scale tourist excursions into space. Social, behavioural and communications data emerging from such existing communities in space suggest that the physically-bounded, work-oriented and traditionally male-dominated nature of these extremely remote groups present specific problems for the resident astronauts, groups of them viewed as ‘communities’, and their associated groups who remain on Earth, including mission controllers, management and astronauts’ families. Notionally feminine group attributes such as adaptive competence, social adaptation skills and social sensitivity will be crucial to the viability of space communities and in the absence of gender equity, ‘staying in touch’ by means of ‘news from home’ becomes more important than ever. A template of news and media forms and technologies is suggested to service those needs and enhance the social viability of future terraforming activities.

Crisis management and risk communication: Why the food industry must get it right

There is public unease about food-related issues including food additives, food poisoning bacteria and GM ingredients. The public wants evidence of no risks, but all regulators can ever offer is no evidence of risk or evidence of a very small risk. The situation is complex because experts and non-experts can perceive the same risk in vastly different ways. The way in which the food industry manages crises and communicates risks will determine the public acceptance and success of new technologies such as GM foods and nanomaterials. There is a need for the food industry (including regulators and scientific experts) to sharpen up their risk communication skills to ensure that technical innovations are accepted by consumers, and crises such as food recalls do not undermine the public's confidence in the food industry. The AIFST has a key role to play in driving the risk communication process and allaying public unease about food-related issues.

Supportive care needs of people with brain tumours and their carers

Goals of work: The diagnosis and treatment of a brain tumour may result in long-term changes in a patient's functional and social abilities and/or in a greatly reduced life span. A qualitative investigation was conducted to examine the supportive care needs of patients with brain tumour and their carers. Materials and methods: Overall, 18 patients and 18 carers participated in focus groups or telephone interviews, following a structured interview guide to elicit supportive care services of importance to these patients and carers. Main results: Six major themes were identified using the framework analysis method, including needs for information and coping with uncertainty, practical support, support to return to pretreatment responsibilities or prepare for long-term care, support to deal with social isolation and organize respite care, support to overcome stigma/discrimination and support to discuss potentially reduced life expectancy. Conclusions: Five recommendations to improve service delivery include: assignment of a dedicated member of the care team or case manager; proactive dissemination of information, education and psychosocial support; access to objective assessment of neuropsychological functioning; facilitating easier access to welfare payments; and services facilitating communication about difficult illness-related topics. Provision of services along these recommendations could improve supportive care of brain tumour patients and their carers.

Facilitating IPM: The role of participatory workshops

Successful, long-term implementation of Integrated Pest Management (IPM) requires the integration of key technical and management activities and the participation of a wide range of stakeholders including farmers, researchers, extension officers, crop consultants, government agencies, and industry. A key issue that needs urgent attention is how to achieve the high quality interaction between these different groups which is necessary for sustained IPM. Problem specification and planning workshops (PSPWs) provide one means of facilitating an integrated strategy for tackling complex pest management issues. Since 1992, the Cooperative Research Centre for Tropical Pest Management has facilitated over 20 PSPWs, focusing on different farming systems in Australia. This paper describes the philosophy, the process involved, and the impact that these PSPWs have had. It examines three specific cases to describe the relationship between plans and results and ways of improving impact. The results reinforce the major role that social scientists can play in providing mechanisms for collaborating with technical researchers and other partners to facilitate effective, participatory ventures in IPM.

Two Australian islander communitities as audiences, and their news needs

Many of the 8000 mapped islands within the Australian Exclusive Economic zone are home to full-time but small communities, and many in the far north are home to relatively large Indigenous communities. But small remote communities such as on these islands, and individuals within those communities, become isolated because conventional news media providers regard them as unviable markets. Community development is at risk in such apparently unviable news media markets because individuals an lose touch with each other, others in the community and those in the "outside world".

Campfire culture and computer culture: Museums of the present

In Australia indigenous peoples have never had a treaty with the dominant cultures; and their on-going marginalisation is some testimony to this. However, they have not languished entirely in a policy free environment: media is one area where some policy advances have been made; but media policy development has experienced a number of problems. It has tended to be monolithic in a situation demanding multi and complex treatments. And funding, as always, never seems sufficient to meet those multi and complex needs. This paper examines a small remote community on the island of Milingimbi off the northern coast of Arnhem Land in Australia's far north. People in East Arnhem Land refer to themselves collectively as Yolngu. This community is not typical of many documented cases of media relations between indigenous and non-indigenous peoples; however, the fact that it tends to overturn much of the conventional scholarship surrounding indigenous peoples and the media, helps shed new light on the inadequacy of not only monolithic media policy, but the inadequacy of media-only approaches to policy. Arguably, the significance of the media in Milingimbi is part of a 'triangulated' relationship between indigenous and dominant cultures. That triangulation also involves appropriate forms of government and education, which coupled with appropriate media appear to offer new ways of seeing self-government alongside relative cultural and economic autonomy.