Evaluating Preferred Augmentative and Alternative Communication Strategies for Patients in Long-Term Health Care Hospitals

2014 ◽  
Vol 23 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Susan Fager ◽  
Jenna LeDoux ◽  
David Beukelman
Keyword(s):  
Augmentative And Alternative Communication ◽  
Extended Period ◽  
Ease Of Use ◽  
Special Treatment ◽  
Care Hospital ◽  
Medical Problems ◽  
Allied Health Professionals ◽  
Wide Range ◽  
Flat Screen

Long-term acute medical care hospital (LTACH) units serve a wide range of individuals, with serious medical problems requiring intense, special treatment for an extended period of time. Some of LTACH patients are unable to meet all of their communication needs using their natural speech, either temporarily or permanently. The purpose of this investigation was to survey personnel groups who routinely work in LTACH units regarding their preferences related to 3 communication options containing 27 representative communication boards, that were supported by mobile technology including an iPad only, an iPad with a flat screen that mirrored the iPad screen, and an iPad with a projected image that mirrored the iPad screen. Participants from 3 groups, (1) registered nurses and nursing assistants; (2) allied health professionals including respiratory, physical, and occupational therapists; and (3) speech-language pathologists, ranked the iPad-only AAC choice highest for patients in LTACH units followed by the iPad with screen, and iPad with projector. For the ease of use items by patients, families, and staff, all participant groups rated the iPad alone higher than the iPad with flat screen or the iPad with projector.

scholarly journals Impact of Diagnosed and Undiagnosed Respiratory Pseudomonas on VAP and VAE During Long-Term Acute Care

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s259
Author(s):  
James Harrigan ◽  
Ebbing Lautenbach ◽  
Emily Reesey ◽  
Magda Wernovsky ◽  
Pam Tolomeo ◽  
...  
Keyword(s):  
Bacterial Community ◽  
Acute Care ◽  
Statistical Significance ◽  
Rrna Gene ◽  
Care Hospital ◽  
16S Sequencing ◽  
Increased Risk ◽  
Wide Range ◽  
The Impact

Background: Clinically diagnosed ventilator-associated pneumonia (VAP) is common in the long-term acute-care hospital (LTACH) setting and may contribute to adverse ventilator-associated events (VAEs). Pseudomonas aeruginosa is a common causative organism of VAP. We evaluated the impact of respiratory P. aeruginosa colonization and bacterial community dominance, both diagnosed and undiagnosed, on subsequent P. aeruginosa VAP and VAE events during long-term acute care. Methods: We enrolled 83 patients on LTACH admission for ventilator weaning, performed longitudinal sampling of endotracheal aspirates followed by 16S rRNA gene sequencing (Illumina HiSeq), and bacterial community profiling (QIIME2). Statistical analysis was performed with R and Stan; mixed-effects models were fit to relate the abundance of respiratory Psa on admission to clinically diagnosed VAP and VAE events. Results: Of the 83 patients included, 12 were diagnosed with P. aeruginosa pneumonia during the 14 days prior to LTACH admission (known P. aeruginosa), and 22 additional patients received anti–P. aeruginosa antibiotics within 48 hours of admission (suspected P. aeruginosa); 49 patients had no known or suspected P. aeruginosa (unknown P. aeruginosa). Among the known P. aeruginosa group, all 12 patients had P. aeruginosa detectable by 16S sequencing, with elevated admission P. aeruginosa proportional abundance (median, 0.97; IQR, 0.33–1). Among the suspected P. aeruginosa group, all 22 patients had P. aeruginosa detectable by 16S sequencing, with a wide range of admission P. aeruginosa proportional abundance (median, 0.0088; IQR, 0.00012–0.31). Of the 49 patients in the unknown group, 47 also had detectable respiratory Psa, and many had high P. aeruginosa proportional abundance at admission (median, 0.014; IQR, 0.00025–0.52). Incident P. aeruginosa VAP was observed within 30 days in 4 of the known P. aeruginosa patients (33.3%), 5 of the suspected P. aeruginosa patients (22.7%), and 8 of the unknown P. aeruginosa patients (16.3%). VAE was observed within 30 days in 1 of the known P. aeruginosa patients (8.3%), 2 of the suspected P. aeruginosa patients (9.1%), and 1 of the unknown P. aeruginosa patients (2%). Admission P. aeruginosa abundance was positively associated with VAP and VAE risk in all groups, but the association only achieved statistical significance in the unknown group (type S error <0.002 for 30-day VAP and <0.011 for 30-day VAE). Conclusions: We identified a high prevalence of unrecognized respiratory P. aeruginosa colonization among patients admitted to LTACH for weaning from mechanical ventilation. The admission P. aeruginosa proportional abundance was strongly associated with increased risk of incident P. aeruginosa VAP among these patients.Funding: NoneDisclosures: None

scholarly journals Comparative analyses of technical characteristics of modern models of personal respiratory protective equipment

2019 ◽  
Vol 87 (3) ◽  
pp. 43-55
Author(s):  
L.A. Ustinova ◽  
R.M. Shvets ◽  
N.V. Kurdil ◽  
V.A. Barkevych ◽  
V.I. Saglo ◽  
...  
Keyword(s):  
Scientific Information ◽  
Armed Forces ◽  
Ease Of Use ◽  
International Standards ◽  
Special Treatment ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Military Equipment ◽  
Wide Range ◽  
Operational Service

ABSTRACT. This article analyses the main features of respiratory protective equipment used during combat actions under the conditions of chemical and radiation contamination. Objective: To study the technical characteristics of respiratory protective equipment that the Armed Forces of Ukraine are equipped with for compliance with NATO standards. Materials and methods. Analysis of sources of scientific information about respiratory protective equipment in operational service with Ukraine and NATO have been conducted. Study methods used: analytical, historical, bibliographic, systematic and informational approach. Results and discussion. It was established that the majority of respiratory protective equipment that the Armed Forces of Ukraine are equipped with has been manufactured before 1991. Their shelf lives exceed the acceptable ones, and the standards by which they were manufactured do not meet modern requirements. The authors have defined the principal directions for improving respiratory protective equipment: versatility for various tactical tasks; possibility of use along with optical devices; compliance of intercommunication systems and breathing valves with NATO standards; providing respiratory protection against a wide range of chemicals; long shelf life; resistance to special treatment means (degassing); possibility of rapid switch to combat position; portability and ease of use. Conclusion. Modern technical characteristics of respiratory protective equipment should comply with the nature of the threats and the best international standards. An important direction in the development of weaponry and military equipment in Ukraine is the improvement of domestic technologies and development of own production of personal protective equipment, technologically compatible with the samples that are in the operational service with NATO countries. Keywords: military toxicology, military radiology, medical protection, respiratory protective equipment.

scholarly journals 1209. Impact of Respiratory Staphylococcus aureus Abundance on Risk for Ventilator-Associated Pneumonia During Long-Term Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S626-S626
Author(s):  
James J Harrigan ◽  
Hatem Abdallah ◽  
Erik Clarke ◽  
Ebbing Lautenbach ◽  
Emily Reesey ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Mechanical Ventilation ◽  
Bacterial Community ◽  
Acute Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
16S Sequencing ◽  
Wide Range ◽  
The Impact

Abstract Background Patients admitted to long-term acute care hospital (LTACH) for ventilator weaning are at high risk for ventilator-associated pneumonia, which may contribute to adverse ventilator-associated events (VAE). Staphylococcus aureus (Sa) is a common cause of VAP. We sought to evaluate the impact of respiratory Sa colonization and bacterial community dominance on subsequent Sa VAP and VAE during long-term acute care. Methods We enrolled 83 subjects dependent on mechanical ventilation at LTACH admission, collected endotracheal aspirates, performed 16S rRNA gene sequencing (Illumina HiSeq) and bacterial community profiling (QIIME2). Statistical analysis was performed with R and Stan; mixed effects models were fit to relate the abundance of respiratory Sa on admission to clinically-diagnosed VAP and VAE. Results Of the 83 subjects, 8 were diagnosed with Sa pneumonia during the 14 days prior to LTACH admission (“Known Sa”), and 17 additional subjects received anti- Sa antibiotics within 48 hours of admission (“Suspected Sa”); 58 subjects had no known or suspected Sa (“Unknown Sa”). Among the Known Sa group, all 8 had Sa detectable by 16S sequencing, with elevated admission Sa proportional abundance (median 0.36; range 0.0013 - 1). Among the Suspected Sa group, only 7 had Sa detectable by 16S sequencing, with a wide range of admission Sa proportional abundance (median 0; range 0 - 0.96). 25 of 58 subjects in the Unknown Sa group also had detectable respiratory Sa, and a wide range of Sa proportional abundance at admission (median 0; range 0 - 0.93). Incident Sa VAP was observed within 30 days among 2 (25%) of the Known Sa subjects, 0 (0%) of the Suspected Sa subjects, and 3 (5.17%) of the Unknown Sa subjects. VAE was observed within 30 days among 0 (0%) of the Known Sa subjects, 3 (18%) of the Suspected Sa subjects, and 1 (1.7%) of the Unknown Sa subjects. Admission Sa abundance was positively associated with 30-day VAP risk in the Suspected Sa (type S error &lt; 0.001) and Unknown Sa (type S error &lt; 0.001) groups. Conclusion Among patients admitted to LTACH for weaning for mechanical ventilation, we observed a high prevalence of respiratory Sa colonization. Respiratory Sa abundance was associated with risk of incident Sa VAP, particularly among subjects without recognized Sa colonization. Disclosures All Authors: No reported disclosures

scholarly journals Wide Range of Carbapenem-resistant Enterobacteriaceae Incidence and Trends in Emerging Infections Program Surveillance, 2012–2015

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S50-S50
Author(s):  
Nadezhda Duffy ◽  
Cedric J Brown ◽  
Sandra N Bulens ◽  
Wendy Bamberg ◽  
Sarah J Janelle ◽  
...  
Keyword(s):  
The United States ◽  
Effective Control ◽  
High Morbidity ◽  
Care Hospital ◽  
Emerging Infections ◽  
Term Care ◽  
Carbapenem Resistant ◽  
Wide Range ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent threat in the United States because of high morbidity and mortality, few treatment options, and potential for rapid spread among patients. To assess for changes in CRE epidemiology and risk among populations, we analyzed CDC Emerging Infections Program (EIP) 2012–2015 surveillance data for CRE. Methods Active, population-based CRE surveillance was initiated in January 2012 at 3 EIP sites (GA, MN, OR) and expanded to 5 additional sites (CO, MD, NM, New York, TN) by 2014. An incident case was the first Escherichia coli, Enterobacter, or Klebsiella isolate (non-susceptible to at least one carbapenem and resistant to all third-generation cephalosporins tested) collected from urine or a normally sterile body site from a patient during a 30-day period. Data were collected from patients’ medical records. Cases were hospital-onset (HO) or long-term care facility (LTCF) onset if patients were in the respective facility ≥3 days prior to culture or at the time of culture; and community-onset (CO) otherwise. We calculated incidence rates based on census data for EIP sites and described by type of infection onset. Results A total of 1,582 incident CRE cases were reported in 2012–2015. Most cases (88%) were identified through urine cultures; 946 (60%) were female, and median age was 66 years (interquartile range: 55–77). The median incidence by site was 2.95 per 100,000 population (range: 0.35–8.98). Among the three sites with four full years of data, a different trend was seen in each (Figure). Trends in GA and MN were statistically significant, and no significant trend was seen in OR. Overall, 480 cases (30%) were HO, 524 (33%) were LTCF onset, and 578 (37%) were CO. Of CO cases, 308 (53%) had been hospitalized, admitted to a long- term acute care hospital or were a LTCF resident in the prior year. Conclusion CRE incidence varied more than 20-fold across surveillance sites, with evidence of continued increases in MN. Measuring impact of programs aimed at reducing CRE transmission in other regions will require obtaining local data to identify cases occurring during and after healthcare facility discharge. Further study of changes in incidence in some settings and areas might offer opportunities to refine and expand effective control strategies. Disclosures All authors: No reported disclosures.

Vocabulary Associated With Medical Procedures

2012 ◽  
Vol 22 (3) ◽  
pp. 119-123 ◽  
Author(s):  
David Beukelman ◽  
Abbey Schrunk ◽  
Amber Thiessen ◽  
Susan Fager ◽  
Cara Ullman
Keyword(s):  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Acute Care Hospital ◽  
Medical Procedures ◽  
Care Hospital ◽  
Alternative Communication ◽  
Respiratory Therapists ◽  
Link Type ◽  
Medical Facilities

The purpose of this project was to identify unique vocabulary associated with specific medical procedures. Personnel from six medical facilities with acute care or long-term acute care hospital (LTACH) units participated by proposing vocabulary/messages associated with procedures in which they routinely participated. Speech-language pathologists, respiratory therapists, physicians, nurses, chaplains, and nursing aids participated in the project. The unique vocabulary associated with common medical procedures is available in this article and on our augmentative and alternative communication–related website, http://aac.unl.edu .

Interaction between biomass-burning aerosol and clouds under different climate/weather regimes

2020 ◽  
Author(s):  
Azusa Takeishi ◽  
Chien Wang
Keyword(s):  
Biomass Burning ◽  
Extended Period ◽  
Climate Regime ◽  
Maritime Continent ◽  
Convective Clouds ◽  
Wide Range ◽  
Biomass Burning Aerosol ◽  
Biomass Burning Particles ◽  
Insight Into

&lt;p&gt;The maritime continent in Southeast Asia is characterized by the frequent convective activities on a wide range of scales, as well as by the seasonal emissions of biomass-burning particles. The emission of biomass-burning particles in this region typically peaks in September and October, whereas its intensity varies considerably from year to year. Since the atmospheric circulation over the region is heavily influenced by a range of meteorological and climatological variabilities, such as ENSO, it is important to quantitatively examine the impacts of biomass-burning particles on clouds while taking weather/climate regimes into account. We investigate the effects of biomass-burning particles on clouds, especially convective ones, with cloud-resolving simulations by the WRF-CHEM model. Instead of focusing on a particular case, our simulations cover an extended period of time in the month of September, allowing us to examine both individual convection and an ensemble of convective clouds developing under different weather/climate regimes and hence different aerosol abundance and distributions. Such long-term and high-resolution simulations over the region will give us an insight into the climate-regime dependent two-way interaction between aerosols and clouds.&lt;/p&gt;

Comparative Effects of High-Tech Visual Scene Displays and Low-Tech Isolated Picture Symbols on Engagement From Students With Multiple Disabilities

2019 ◽  
Vol 50 (4) ◽  
pp. 693-702 ◽  
Author(s):  
Christine Holyfield ◽  
Sydney Brooks ◽  
Allison Schluterman
Keyword(s):  
Language Learning ◽  
Augmentative And Alternative Communication ◽  
Visual Analysis ◽  
Multiple Disabilities ◽  
Visual Scene ◽  
Future Research ◽  
High Tech ◽  
Single Subject ◽  
Wide Range ◽  
The Difference

Purpose Augmentative and alternative communication (AAC) is an intervention approach that can promote communication and language in children with multiple disabilities who are beginning communicators. While a wide range of AAC technologies are available, little is known about the comparative effects of specific technology options. Given that engagement can be low for beginning communicators with multiple disabilities, the current study provides initial information about the comparative effects of 2 AAC technology options—high-tech visual scene displays (VSDs) and low-tech isolated picture symbols—on engagement. Method Three elementary-age beginning communicators with multiple disabilities participated. The study used a single-subject, alternating treatment design with each technology serving as a condition. Participants interacted with their school speech-language pathologists using each of the 2 technologies across 5 sessions in a block randomized order. Results According to visual analysis and nonoverlap of all pairs calculations, all 3 participants demonstrated more engagement with the high-tech VSDs than the low-tech isolated picture symbols as measured by their seconds of gaze toward each technology option. Despite the difference in engagement observed, there was no clear difference across the 2 conditions in engagement toward the communication partner or use of the AAC. Conclusions Clinicians can consider measuring engagement when evaluating AAC technology options for children with multiple disabilities and should consider evaluating high-tech VSDs as 1 technology option for them. Future research must explore the extent to which differences in engagement to particular AAC technologies result in differences in communication and language learning over time as might be expected.

Interventions to change clinician behaviour in relation to suicide prevention care in the emergency department: A scoping review protocol

2020 ◽  
Author(s):  
Hwayeon Danielle Shin ◽  
Christine Cassidy ◽  
Janet Curran ◽  
Lori Weeks ◽  
Leslie Anne Campbell ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicide Prevention ◽  
Behaviour Change ◽  
Clinical Care ◽  
Grey Literature ◽  
Allied Health Professionals ◽  
Wide Range ◽  
Knowledge And Attitude ◽  
Clinician Behaviour ◽  
Google Search

Objective: This review aims to explore, characterize, and map the literature on interventions implemented to change emergency department (ED) clinicians’ behaviour related to suicide prevention using the Behaviour Change Wheel (BCW) as a guiding theoretical framework. Introduction: An ED is a critical place for suicide prevention. Yet, many patients who present with suicide-related thoughts and behaviours are discharged without proper assessment or appropriate treatment. Supporting clinicians (who provide direct clinical care, including nurses, physicians, allied health professionals) to make the desired behaviour change following evidence-based suicide prevention care is an essential step toward improving patient outcomes. However, reviews to date have yet to take a theoretical approach to investigate interventions implemented to change clinicians’ behaviour. Inclusion criteria: This review will consider literature that includes interventions that target ED clinicians’ behaviour change related to suicide prevention. Behaviour change refers to observable practice changes as well as proxy measures of behaviour change including knowledge and attitude. There are many ways in which an intervention can change clinicians’ behaviour (e.g., education, altering service delivery). This review will include a wide range of interventions that target behaviour change regardless of the type but exclude interventions that exclusively target patients.Methods: Multiple databases will be searched: PubMed, PsycInfo, CINAHL and Embase. We will also include grey literature, including Google search, ProQuest Dissertations and Theses Global, and Scopus conference papers. Full text of included studies will be reviewed, critically appraised and extracted. Extracted data will be coded to identify intervention functions using the BCW. Findings will be summarized in tables accompanied by narrative reports.

From the history of the development of electronic dictionaries: foreign and domestic experience

2020 ◽  
Vol 11 (1) ◽  
pp. 6-12
Author(s):  
O. Y. Balalaieva ◽  
Keyword(s):  
Human Activity ◽  
Current Level ◽  
Ease Of Use ◽  
Advanced Search ◽  
Wide Range ◽  
Promising Area ◽  
History Of ◽  
Machine Readable ◽  
Everyday Communication ◽  
Educational Professional

The purpose of the article is to study the dynamics of electronic dictionaries development abroad and in Ukraine using methods of analysis of scientific sources, comparison, generalization and systematization. Electronic dictionaries have been found to be a relatively new phenomenon in the lexicographic market, evolving from machine-readable dictionaries, exact copies of paper editions to complex digital lexicographic systems with a powerful arsenal of functions over the decades. The stages of development of autonomous and online dictionaries are described. Electronic dictionaries due to the advanced search capabilities, speed, simplicity, ease of use, accessibility and compactness have gained popularity among a wide range of users. Today they are used in many spheres of human activity – scientific, educational, professional, everyday communication. However, the analysis of the current level of development of Ukrainian electronic resources indicates a shortage of electronic dictionaries both common and terminological vocabulary. The lack of electronic dictionaries is due to a number of objective problems, both practical and theoretical, that is why research in the field of domestic computer lexicography is a promising area of further research.

Modern prevention and active longevity programs on the basis of disruptive domestic technologies: positive experience and prospects for application

2020 ◽  
pp. 66-73
Author(s):  
A. Simonova ◽  
S. Chudakov ◽  
R. Gorenkov ◽  
V. Egorov ◽  
A. Gostry ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Early Detection ◽  
Laboratory Diagnostics ◽  
Positive Experience ◽  
Practical Application ◽  
Wide Range ◽  
Integrated Program ◽  
Long Term Experience ◽  
Early Detection And Prevention

The article summarizes the long-term experience of practical application of domestic breakthrough technologies of preventive personalized medicine for laboratory diagnostics of a wide range of socially significant non-infectious diseases. Conceptual approaches to the formation of an integrated program for early detection and prevention of civilization diseases based on these technologies are given. A vision of the prospects for the development of this area in domestic and foreign medicine has been formed.

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