How Visibility May Reduce Security Issues in Community Hospitals' Emergency Departments.

This research explored the relationship between visibility and the level of security risks as perceived by nurses and physicians in emergency departments (EDs). Security in EDs has been reported as a major global concern, and visibility has been identified as a design factor impacting behavior. However, few previous studies have rigorously investigated the role of visibility in reduction of ED security risks with evidence-based design approach. There is a lot of significant questions about how visibility impacts the reduction of security issues in EDs. METHODS: How visibility may influence ED security was explored via qualitative methods in five EDs using semi-structured one-on-one interviews with 17 clinical staff and 48 hr of field observations. The coding process for both interviews and observational notes followed the principles of naturalistic inquiry. RESULTS: The findings suggest security risks can be decreased by improving visibility. Medical staff (registered nurses and physicians) felt more secure in the EDs with higher visibility. DISCUSSION: This study provides a framework to identify preferable levels of visibility in EDs and proposes design strategies to minimize security issues. Registered nurses and physicians can improve their team's sense of security by considering visibility throughout their daily practices.

Combining Teletherapy and On-line Language Exercises in the Treatment of Chronic Aphasia: An Outcome Study.

We report a 12-week outcome study in which nine persons with long-term chronic aphasia received individual and group speech-language teletherapy services, and also used on-line language exercises to practice from home between therapy sessions. Participants were assessed at study initiation and completion using the Western Aphasia Battery, a portion of the Communicative Effectiveness Index, ASHA National Outcome Measurement System, and RIC Communication Confidence Rating Scale for Aphasia; additionally participants were polled regarding satisfaction at discharge. Pretreatment and post-treatment means were calculated and compared, and matched t-tests were used to determine significance of improvements following treatment, with patterns of independent on-line activity analyzed. Analysis of scores shows that means improved on most measures following treatment, generally significantly: the WAB AQ improved +3.5 (p = .057); the CETI Overall (of items administered) - +17.8 (p = .01), and CCRSA Overall - + 10.4 (p = .0004). Independent work increased with time, and user satisfaction following participation was high.

Steps to success with technology for individuals with aphasia.

This article discusses how the Snyder Center for Aphasia Life Enhancement, an aphasia center in Baltimore, MD, currently uses technology in its programming to empower individuals with aphasia to actively participate in communications with families, friends, and the community. We describe the steps used to promote successful use of technology in everyday life. This process includes: (1) identifying a client's strongest modality/modalities for communication; (2) matching the individual's strengths with their personal goals and preferences; (3) developing a way to determine personal goals for technology use; and (4) selecting and training use of technologies that will support them in achieving their goals. Three brief case studies are presented to demonstrate the process by which programs were judged to be "best fits" for each member, and permitted them to reach a self-chosen goal. Finally, the steps that promoted successful learning and generalization to everyday life are described.

Widening the temporal window: processing support in the treatment of aphasic language production.

Investigations of language processing in aphasia have increasingly implicated performance factors such as slowed activation and/or rapid decay of linguistic information. This approach is supported by studies utilizing a communication system (SentenceShaper) which functions as a "processing prosthesis." The system may reduce the impact of processing limitations by allowing repeated refreshing of working memory and by increasing the opportunity for aphasic subjects to monitor their own speech. Some aphasic subjects are able to produce markedly more structured speech on the system than they are able to produce spontaneously, and periods of largely independent home use of SentenceShaper have been linked to treatment effects, that is, to gains in speech produced without the use of the system. The purpose of the current study was to follow up on these studies with a new group of subjects. A second goal was to determine whether repeated, unassisted elicitations of the same narratives at baseline would give rise to practice effects, which could undermine claims for the efficacy of the system.

Narrative and procedural discourse production by severely aphasic patients.

Five cbronically aphasic subjects were trained on a computerized iconographic communication system (C-VIC). Their performance in producing single sentences scripts. and narratives was assessed using both spoken English and C-VIC. The requisite vocabulary necessary and the narrative complexity of the target productions were controlled. Subject performance using C-VIC indicates that the ability to construct discourse at the macrostructural level is largely intact. Despite significant improvements in spoken production after C-VIC training, especially at the single sentence level, the subjects' spoken discourse remains severely impaired by their failures at the microlinguistic level. These results point to the limits of currently available approaches to the remediation of aphasia and suggest avenues for future research.