Speech-Language Pathology and Audiology in South Africa: Clinical Training and Service in the Era of COVID-19

Introduction and purpose: The novel coronavirus (COVID-19) presented new and unanticipated challenges to the provision of clinical services, from student training to the care of patients with speech-language and hearing (SLH) disorders. Prompt changes in information and communication technologies (ICT), were required to ensure that clinical training continued to meet the Health Professions Council of South Africa’s regulations and patients received effective clinical care. The purpose of this study was to investigate online clinical training and supervision to inform current and future training and clinical care provision in SLH professions. Methodology: A scoping review was conducted using the Arksey and O'Malley (2005) framework. The electronic bibliographic databases Science Direct, PubMed, Scopus, MEDLINE, and ProQuest were searched to identify publications about online clinical training and supervision and their impact on clinical service during COVID-19. Selection and analysis were performed by three independent reviewers using pretested forms. Results and Conclusions: The findings revealed important benefits of teletraining and telepractice with potential application to South African clinical training and service provision. Five themes emerged: (1) practice produces favorable outcomes, (2) appreciation for hybrid models of training and service delivery, (3) cost effectiveness is a “big win” (4) internationalization of remote clinical training and service provision, and (5) comparable modality outcomes. These findings may have significant implications for teletraining and telepractice in low-and-middle income countries (LMICs) in the COVID-19 era and beyond, wherein demand versus capacity challenges (e.g., in human resources) persist. Current findings highlight the need for SLH training programmes to foster a hybrid clinical training model.  Few studies were conducted in LMICs, indicating a gap in such research. &nbsp

Development and Implementation of a Violence Risk Assessment Tool

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. Healthcare organizations are mandated to develop violence prevention programs and greater reporting of incidents. Healthcare organizations have workplace prevention programs in place but still fail to protect healthcare workers from injury. Additional measures are needed to cope up with the increasing incidence of workplace violence specifically related to assaults and injuries caused by patients in healthcare settings. Research shows that the use of a violence risk assessment tool has been proven effective in attempts to prevent workplace violence. This paper will examine patient initiated violence in the workplace, explore the use of a workplace violence risk assessment tool to identify patients with propensity for violence in hospitals, and analyze the implication of the use of a violence risk assessment tool to the nursing practice

Broadcasting the body: affect, embodiment and bodily excess on contemporary television

In recent years television has seen a notable increase in evocative images of the human body subject to exploration and manipulation.Taking the increasing viscerality of television’s body images as a starting point, the work presented in this thesis asserts the importance of considering television viewing as an embodied experience. Through a focus on displays of the body across a range of television formats this thesis demonstrates the significance and complexity of viewers’ affective and embodied engagements with the medium and offers an alternative to accounts of television which are focussed only on the visual, narrative or semiotic aspects of television aesthetics. This work challenges approaches to television which understand the pleasures of looking at the body as simply an exercise in power by considering the role of the body in fostering the sharing of affect, specifically through feelings of intimacy, shame and erotic pleasure. Additionally, the research presented here accounts for and situates the tendency toward bodily display that I have described in terms of traditional television aesthetics and in relation to conditions within the television industry in the United States and the United Kingdom. Rather than considering the trend toward exposing the body as a divergence from traditional television, this thesis argues that body-oriented television is a distinctly televisual phenomenon, one that implicates the bodies onscreen and the bodies of viewers located in domestic space in its attempts to breach the limitations of the screen, making viewers feel both intimately and viscerally connected to the people, characters and onscreen worlds that television constructs for us. The methodological approach taken in this thesis is based on close textual analysis informed by a focus on affect and embodiment. This thesis relies on the author’s own embodied engagement with televisual texts as well as detailed formal analyses of the programmes themselves. In order to understand the place of explicit body images on television this thesis engages with a broad range of contemporary debates in the field of television studies and with the cannon of television studies. This thesis is also deeply informed by writing about affect developed in film studies and studies of reality television. This thesis is structured around a set of case studies which each explore different dimensions of the trend toward bodily excess across a broad range of genres including reality television, science programming and the drama series. The chapters in this thesis are organised around four tendencies or modes related to traditional television aesthetics: Intimacy, community, public education and melodrama. Each of these case studies examines how the affective body capitalises upon and extends the traditional pleasures of television through an affective appeal to the body

Neural plasticity and the limits of scientific knowledge

Western science claims to provide unique, objective information about the world. This is supported by the observation that peoples across cultures will agree upon a common description of the physical world. Further, the use of scientific instruments and mathematics is claimed to enable the objectification of science. In this work, carried out by reviewing the scientific literature, the above claims are disputed systematically by evaluating the definition of physical reality and the scientific method, showing that empiricism relies ultimately upon the human senses for the evaluation of scientific theories and that measuring instruments cannot replace the human sensory system. Nativist and constructivist theories of human sensory development are reviewed, and it is shown that nativist claims of core conceptual knowledge cannot be supported by the findings in the literature, which shows that perception does not simply arise from a process of maturation. Instead, sensory function requires a long process of learning through interactions with the environment. To more rigorously define physical reality and systematically evaluate the stability of perception, and thus the basis of empiricism, the development of the method of dimension analysis is reviewed. It is shown that this methodology, relied upon for the mathematical analysis of physical quantities, is itself based upon empiricism, and that all of physical reality can be described in terms of the three fundamental dimensions of mass, length and time. Hereafter the sensory modalities that inform us about these three dimensions are systematically evaluated. The following careful analysis of neuronal plasticity in these modalities shows that all the relevant senses acquire from the environment the capacity to apprehend physical reality. It is concluded that physical reality is acquired rather than given innately, and leads to the position that science cannot provide unique results. Rather, those it can provide are sufficient for a particular environmental setting

Examining Electronic Medical Records System Adoption and Implications for Emergency Medicine Practice and Providers

This ethnographic research study documented the use and effects of an electronic medical records system (EMR) by healthcare providers working in a community hospital-based emergency room. Using data collected from participant observation, in-depth interviews, questionnaires, and hospital documents, the research findings suggest EMRs impinge providers’ agency, alter emergency room systems, affect communication patterns among providers, and exacerbate structurational divergence (SD) conditions. Findings suggest that providers’ attempts to regain lost agency tips the SD-nexus into an SD-cycle, characterized by negative communication spirals between providers. The discussion chapter examines the impact of EMRs on emergency room structures, system reproduction, providers’ workflow and communication patterns, patients’ experiences, and unintended consequences, and it expounds implications of the study with regard to what lessons learned from this analysis suggests might be best practices for hospitals and emergency rooms adopting EMRs

Occupational Therapy in the Intensive Care Unit: A Quick Reference Guide

Purpose: The purpose of this project was to create a quick reference guide for occupational therapists treating clients in the intensive care unit (ICU) in order to increase quality of care, decrease medical errors, and improve confidence. Methods: A literature review was conducted to determine the needs of occupational therapists and other health professionals working in the ICU environment. It was discovered that occupational therapists do not receive specific education on treating clients in the ICU and that there are no specific resources for occupational therapists currently available. Rehabilitation is beginning sooner within the ICU in order to decrease client length of stay and hospital costs, which will in turn bring more occupational therapists to work in this area of practice. The increasing number of therapists working in this area, establishes a need for this product. Results: Through the literature review and consultation with the University of North Dakota Simulation Center, a quick reference guide to occupational therapy within the ICU was created to provide occupational therapists with technical information about the person, the environment, and occupations within the ICU. The quick reference guide was designed through the guidance of Person-Environment-Occupation model. Conclusions: In order to provide quality and client centered care within the ICU; it is pertinent for health professionals to have specialized knowledge and skills specific to this area of practice. Through research and personal experience, it was evident that occupational therapists and many health professionals do not feel confident treating clients in the ICU. The limitations of this project include: the quick reference guide has not been piloted, the equipment is constantly advancing requiring the update of equipment in the guide frequently, and that it is not comprehensive and only provides the most relevant pieces of equipment to occupational therapy. Further recommendations for the quick reference guide include: implementing it into the University of North Dakota Occupational Therapy curriculum, use by fieldwork students, utilization by other health care professionals, and the adaptation of the guide for use by families