Paediatric Airway Clinic: an 18-month experience.

OBJECTIVE: The management of paediatric airway disease is an integral aspect of paediatric otolaryngology. Recently, paediatric tertiary referral centres have developed centres of excellence for various aspects of paediatric care. The Pediatric Otolaryngology Airway Clinic at The Children's Hospital of Alabama, was developed as a regional referral centre for the management of children with difficult airway problems. Primary participants include the paediatric otolaryngologist, the airway management nurse, and the speech pathologist, in addition to other health care personnel. Over an 18-month period, 195 patients were seen in the clinic. The purpose of this study was to assess both the demography and the airway pathology in this patient population-specifically evaluating presenting diagnoses, diagnostic evaluation techniques, surgical intervention, geographic and racial distribution, insurance coverage, and referral patterns. CONCLUSION: This multidisciplinary approach to the management of children with chronic tracheotomies and other conditions involving the airway provides a unique environment that optimizes care for these complex patients.

Jenny's story: reinventing oneself through occupation and narrative configuration.

Two life history interviews were conducted to discover how one women, Jenny, experienced a traumatic head injury, rehabilitation, and recovery. Narrative analysis of the transcribed interviews revealed a rich story of how Jenny had fashioned her identity and character through childhood occupations, including studying classical literature and music, and of how she drew upon resources developed in childhood to engineer her recovery. It also illustrated how Jenny used a recursive process of narrative construction and engagement in self-devised graduated occupations, including studying, playing music, writing, computer graphics, and theater production, to create a new identity and develop capacities to process complex information and exercise creativity. Jenny's story illustrates the usefulness of gaining a perspective on patients as occupational beings through the gathering of life histories focused on occupation, the importance of collaborative patient-therapist goal setting, and the necessity for considering both the doing (practic) and the meaning (narrative) aspects of occupation. Her story supports many scholars' arguments that the therapeutic relationship, and thus occupational therapy practice, may be enhanced through the use of life history interviewing in occupational therapy evaluation and treatment.