scholarly journals On pain – Virginia Woolf and the language of poets and patients

2021 ◽  
pp. 204946372110092
Author(s):  
Carsten Bantel ◽  
Peter Sörös
Keyword(s):  
Virginia Woolf ◽  
Healthcare Providers ◽  
Clinical Experiences ◽  
Cognitive Mechanisms ◽  
Important Contributor ◽  
American Poets

Influenced by Virginia Woolf pain is traditionally believed to be a private object that defies language. However, our analysis of classical and contemporary works of British and American poets, in addition to our own clinical experiences, leads us to challenge this notion. In accordance with Wittgenstein we instead view pain as a concept and objective experience that should encourage interaction. Reasons why patients and healthcare providers often assume language to be insufficient to grasp the complexity of pain are manifold. Based on neuro-cognitive mechanisms we propose an important contributor might be that patients in pain speak a different language than their pain-free peers and doctors.

scholarly journals Clinical experiences with the use of oxytocin injection by healthcare providers in a South-Western State Nigeria: A Cross sectional study

2018 ◽  
Author(s):  
Chioma Stella Ejekam ◽  
Ifeoma Peace Okafor ◽  
Chimezie Anyakora ◽  
Ebenezer A. Ozomata ◽  
Kehinde Okunade ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Cross Sectional Study ◽  
World Health ◽  
Clinical Experiences ◽  
Sectional Study ◽  
Cross Sectional ◽  
First Choice ◽  
Lagos State ◽  
The U.S

AbstractBackgroundPost-Partum Hemorrhage (PPH), is a leading cause of maternal mortality in Nigeria and most low and middle income countries(LMIC). The World Health Organization(WHO) strongly recommends oxytocin as effective, affordable and the safest drug of first choice in the prevention and treatment of PPH in the third stage of labor. However, there are concerns about its quality. Very high prevalence of poor-quality oxytocin, especially in Africa and Asia has been reported in literature. Excessive and inappropriate use is also common with oxytocin in low-resource settings.ObjectiveTo assess clinical experiences with quality of oxytocin used by healthcare providers in Lagos State Nigeria.MethodsIt was a descriptive cross-sectional study done in 2017. Seven hundred and five respondents (doctors and nurses) who use oxytocin for obstetrics and gynaecological services were recruited from 195 health facilities (public and registered private) across Lagos State. Data collection was quantitative, using a pretested self-administered questionnaire. Data analysis was done using IBM SPSS version 21. Statistical significance was set at 5%(p<0.05). Ethical approval was obtained from Lagos University Teaching Hospital Health Research Ethics Committee. Funding support was provided by the Promoting the Quality of Medicines, a program funded by the U.S. Agency for International Development and implemented by the U.S. Pharmacopeia Convention.ResultsOnly 52 percent of the respondents knew oxytocin should be stored at 2°C to 8°C. About 80% of the respondents used oxytocin for augmentation of labor; 68% for induction of labor, 51% for stimulation of labor and 78% for management of PPH. Forty-one percent used 20IU and as much as 10% used 30IU to 60IU for management of PPH. About 13% of the respondents have experienced use of an ineffective brand of oxytocin in their practice. Just over a third (36%) of the respondents had an available means of documenting or reporting perceived ineffectiveness of drugs in their facility. Of these, only about 12% had pharmacovigilance forms available in their facilities to report the ineffectiveness.ConclusionThe inappropriate and inconsistent use of oxytocin especially overdosing likely led to the spuriously high perception of medicine effectiveness among respondents. This is also coupled with lack of suspicion of medicine ineffectiveness by clinicians as a possible root cause of poor treatment response or disease progression. Poor knowledge of oxytocin storage and consequent poor storage practices could have contributed to the ineffectiveness reported by some respondents. There is need for the establishment of a unified protocol for oxytocin use with strict compliance to the guidelines. Continued training of healthcare providers in medicines safety monitoring is advocated.

scholarly journals Infections due to Cellulosimicrobium species: case report and literature review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
María Rivero ◽  
Javier Alonso ◽  
María Fernanda Ramón ◽  
Nancy Gonzales ◽  
Ana Pozo ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Healthcare Providers ◽  
Venous Catheter ◽  
Frequent Pattern ◽  
Clinical Experiences ◽  
Foreign Body Removal ◽  
Case Presentation ◽  
Human Infections ◽  
Work Up

Abstract Background Cellulosimicrobium species, formely known as Oerskovia species, are gram-positive bacilli belonging to the order Actinomycetales. They rarely cause human infections. The genus comprises two pathogenic species in humans: C. cellulans and C. funkei. Based on a case report, we provide a review of the literature of infections caused by Cellulosimicrobium/Oerskovia, in order to improve our knowledge of this unusual infection. Case presentation An 82-year-old woman with aortic prosthetic valve presented to the hospital with fever and heart failure. Further work up revealed the diagnosis of C. cellulans infective endocarditis (IE). The strain was identified by MALDI-TOF MS, API Coryne and 16S rRNA sequencing. The patient was deemed not to be an operative candidate and died despite the antibiotic therapy 35 days after admission. Conclusions Reviewing cases of Cellulosimicrobium species infections and communicating the successful and unsuccessful clinical experiences can assist future healthcare providers. Our case and those previously reported indicate that Cellulosimicrobium species usually infect immunocompromised patients or foreign body carriers. The most frequent pattern of infection is central venous catheter related bacteremia. The optimal treatment should include foreign body removal and valve surgery should be considered in case of IE.

Always a burden? Healthcare providers’ perspectives on moral distress

2017 ◽  
Vol 103 (5) ◽  
pp. F441-F445 ◽  
Author(s):  
Trisha M Prentice ◽  
Lynn Gillam ◽  
Peter G Davis ◽  
Annie Janvier
Keyword(s):  
Neonatal Intensive Care ◽  
Qualitative Methodology ◽  
Moral Distress ◽  
Healthcare Providers ◽  
Medical Decision ◽  
Neonatal Intensive Care Units ◽  
Clinical Experiences ◽  
Positive Role ◽  
Negative Impacts ◽  
Neonatal Population

BackgroundCurrent conceptualisations of moral distress largely portray a negative phenomenon that leads to burnout, reduced job satisfaction and poor patient care.ObjectiveTo explore clinical experiences, perspectives and perceptions of moral distress in neonatology.DesignAn anonymous questionnaire was distributed to medical and nursing providers within two tertiary level neonatal intensive care units (NICUs)—one surgical and one perinatal—seeking their understanding of the term and their experience of it. Open-ended questions were analysed using qualitative methodology.ResultsA total of 345 healthcare providers from two NICUs participated (80% response rate): 286 nurses and 59 medical providers. Moral distress was correctly identified as constrained moral judgement resulting in distress by 93% of participants. However, in practice the term moral distress was also used as an umbrella term to articulate different forms of distress. Moral distress was experienced by 72% of providers at least once a month. Yet despite the negative sequelae of moral distress, few (8% medical, 21% nursing providers) thought that moral distress should be eliminated from the NICU. Open-ended responses revealed that while interventions were desired to decrease the negative impacts of moral distress, moral distress was also viewed as an essential component of the caring profession that prompts robust discussion and acts as an impetus for medical decision-making.ConclusionsMoral distress remains prevalent within NICUs. While the harmful aspects of moral distress need to be mitigated, moral distress may have a positive role in advocating for and promoting the interests of the neonatal population.

scholarly journals An Outpatient Telehealth Elective for Displaced Clinical Learners during the Coronavirus Pandemic

2020 ◽  
Author(s):  
Alec M. Weber ◽  
Anoushka Dua ◽  
Kitae Chang ◽  
Hamsitha Jupalli ◽  
Farsha Rizwan ◽  
...  
Keyword(s):  
Clinical Education ◽  
Healthcare Providers ◽  
Clinical Information ◽  
Learning Opportunities ◽  
Ambulatory Setting ◽  
Clinical Experiences ◽  
Educational Value ◽  
Management Plans ◽  
Survey Results ◽  
Risk Of Exposure

Introduction: In response to the Coronavirus pandemic, medical schools suspended clinical rotations. This displacement of students from the wards has limited experiential learning opportunities. Concurrently, outpatient practices are experiencing reduced volumes of in-person visits and shifting towards virtual healthcare. This transition comes with its own logistical challenges. Here, we discuss a workflow that enabled students to engage in meaningful clinical education while helping the RWJMS outpatient practices implement remote telehealth visits. Methods: A four-week virtual elective was designed to offer clerkship students the opportunity to participate in virtual telehealth patient encounters. Students were prepared with EMR training and introduced to an outpatient workflow that supports healthcare providers in the ambulatory setting. Patients were consented to telehealth services before encounters with students. All collected clinical information was documented in the EMR, after which students transitioned patients to a virtual Doxy.me video call appointment. Clinical and educational outcomes of students' participation were evaluated. Results: Survey results showed students felt well-prepared to initiate patient encounters. They also expressed comfort while engaging with patients virtually during telehealth appointments. Students further identified educational value, citing opportunities to develop patient management plans consistent with in-person clinical experiences. A significant healthcare burden was also alleviated by student involvement. Over 1000 total scheduled appointments were serviced by students who transitioned over 80% of patients into virtual provider waiting rooms. Discussion: After piloting this elective with rising fourth-year students, pre-clerkship students were also recruited to act in a role normally associated with clinical learners (e.g., elicit patient histories, conduct a review of systems, etc.). An additional telehealth elective is being designed so medical students can contribute to inpatient care without risk of exposure to SARS-CoV-2. These efforts are designed

scholarly journals Clinical experiences with the use of oxytocin injection by healthcare providers in a southwestern state of Nigeria: A cross-sectional study

PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0208367 ◽  
Author(s):  
Chioma Stella Ejekam ◽  
Ifeoma Peace Okafor ◽  
Chimezie Anyakora ◽  
Ebenezer A. Ozomata ◽  
Kehinde Okunade ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Clinical Experiences ◽  
Sectional Study ◽  
Cross Sectional ◽  
Southwestern State

The bottleneck may be the solution, not the problem

2016 ◽  
Vol 39 ◽  
Author(s):  
Arnon Lotem ◽  
Oren Kolodny ◽  
Joseph Y. Halpern ◽  
Luca Onnis ◽  
Shimon Edelman
Keyword(s):  
Working Memory ◽  
Language Acquisition ◽  
Recent Theory ◽  
Cognitive Mechanisms ◽  
Selection Pressures ◽  
Biological Trait ◽  
Memory Bottleneck

AbstractAs a highly consequential biological trait, a memory “bottleneck” cannot escape selection pressures. It must therefore co-evolve with other cognitive mechanisms rather than act as an independent constraint. Recent theory and an implemented model of language acquisition suggest that a limit on working memory may evolve to help learning. Furthermore, it need not hamper the use of language for communication.

Developing an Early Intervention Preservice Specialization in Speech-Language Pathology

1995 ◽  
Vol 4 (2) ◽  
pp. 31-36 ◽  
Author(s):  
Joanne E. Roberts ◽  
Elizabeth Crais ◽  
Thomas Layton ◽  
Linda Watson ◽  
Debbie Reinhartsen
Keyword(s):  
Early Childhood ◽  
Early Intervention ◽  
Intervention Program ◽  
Graduate Program ◽  
Master's Level ◽  
Clinical Experiences ◽  
Speech Language Pathology ◽  
Early Intervention Program ◽  
Language Pathology ◽  
Family Centered

This article describes an early intervention program designed for speech-language pathologists enrolled in a master's-level program. The program provided students with courses and clinical experiences that prepared them to work with birth to 5-year-old children and their families in a family-centered, interdisciplinary, and ecologically valid manner. The effectiveness of the program was documented by pre- and post-training measures and supported the feasibility of instituting an early childhood specialization within a traditional graduate program in speech-language pathology.

Speech-Language Pathologists' Comfort Level With Use of Term “Stuttering” During Evaluations

2020 ◽  
Vol 29 (2) ◽  
pp. 841-850 ◽  
Author(s):  
Courtney T. Byrd ◽  
Danielle Werle ◽  
Kenneth O. St. Louis
Keyword(s):  
Communication Disorders ◽  
Academic Experiences ◽  
Comfort Level ◽  
Future Research ◽  
Clinical Experiences ◽  
Speech Language Pathologists ◽  
Comfort Levels ◽  
Parents And Children ◽  
Evaluation Feedback ◽  
Study Participants

Purpose Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term “stuttering,” might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of “stuttering” to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders. Method One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings. Results SLPs were significantly less likely to feel comfortable using the term “stuttering” compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences. Conclusions SLPs were significantly less comfortable relaying the diagnosis “stuttering” to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.

A Response Evocation Program for /ɝ/

1975 ◽  
Vol 40 (1) ◽  
pp. 92-105 ◽  
Author(s):  
Lawrence D. Shriberg
Keyword(s):  
Service Delivery ◽  
Motor Skills ◽  
Task Analysis ◽  
Professional Issues ◽  
Clinical Experiences ◽  
Program Outcomes ◽  
Program Step ◽  
Skills Learning ◽  
Learning Principles

A response evocation program, some principles underlying its development and administration, and a review of some clinical experiences with the program are presented. Sixty-five children with developmental articulation errors of the /ɝ/ phoneme were administered the program by one of 19 clinicians. Approximately 70% of program administrations resulted in a child emitting a good /ɝ/ within six minutes. Approximately 10% of children who were given additional training on program step failures emitted good /ɝ/'s in subsequent sessions. These preliminary observations are discussed in relation to the role of task analysis and motor skills learning principles in response evocation, clinician influences in program outcomes, and professional issues in service delivery to children with developmental articulation errors.

Preservice Efforts To Promote School-Based SLPs' Roles in Written Language Development

2011 ◽  
Vol 12 (4) ◽  
pp. 121-127 ◽  
Author(s):  
Elizabeth Lanter ◽  
Claire Waldron
Keyword(s):  
Public Schools ◽  
Language Development ◽  
Clinical Education ◽  
Written Language ◽  
School Age Children ◽  
Leadership Roles ◽  
Clinical Experiences ◽  
School Based ◽  
Language Pathology ◽  
Written Language Development

Abstract The authors describe an innovative clinical education program that emphasizes the provision of written language services by preservice speech-language pathology graduate students at Radford University in Virginia. Clinicians combined academic coursework in language acquisition in school-age children and clinical experiences that target children's written language development to promote future literacy-based leadership roles and collaborative efforts among school-based speech-language pathologists (SLPs). These literacy-based experiences prepare SLPs to serve in the growing numbers of American public schools that are implementing Response to Intervention models.

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