Person reference as a trouble source in dysarthric talk-in-interaction

This chapter provides an analysis of talk between people with acquired motor speech disorders (dysarthria) and family members. Using conversation analytical principles it focuses on how person references are treated as trouble sources in everyday interaction, how they arise and are collaboratively managed. Following a review of relevant literature we present a detailed examination of person references produced by people with dysarthria in conversation with family members. We will show that person references are vulnerable to becoming trouble sources given their potential ambiguity or relatively weak relationship to immediately prior talk

Understanding students’ learning experience on a cultural school trip: findings from Eastern Indonesia

Despite the current increase of studies on school trips and experiential learning, questions remain about what aspects of school trips best contribute to students and how it affects students’ learning experience. This study attempts to explore students’ learning experience participating in 1-day cultural school trips in Papua, eastern Indonesia. Conducting trips to two cultural venues (a cultural museum and cultural village) and integrating topics in secondary schools’ curriculum (Papuan local content and Papuan art and culture), we evaluated student learning experiences against Bloom et al.’s (1956)taxonomy of educational objectives. The study found several emergent categories: students’ previous experiences, emotional experiences, impressions on seeing new perspective, reidentifying cultural identity, cultural awareness, personal effect, and framing and comparing learning strategy. The results provide insight into the effectiveness of school trip in the cultural setting in less developed countries and suggest areas for further study

Klinische Leitlinien zur Behandlung der Amyotrophen Lateralsklerose

The evidence base for diagnosis and management of Amyotrophic Lateral Sclerosis (ALS) is still weak, and curative therapy is lacking. Nonetheless, early diagnosis and symptomatic and therapy can profoundly influence care and quality of life of the patient and relatives, and may increase survival time. This review addresses the current optimol clinical approach to ALS. The literature search is complete to December 2006. Where there was lack of evidence but consensus was clear we have stated our opinion as good practice points. We conclude that a diagnosis of ALS can be achieved by early examination by an experienced neurologist. The patient should be informed of the diagnosis by the consultant. Following diagnosis, a multi-diciplinary care team should support the patient and relatives. Medication with riluzole should be initiated as early as possible. Percutaneous endocopic gastrostomy (PEG) is associated with improved nutrition and should be inserted early. Non-invasive positive pressure ventilation improves survival and quality of life but is underused in Europe. Maintaining the patient's ability to communicate is essential. During the course of the disease, every effort should be made to maintain patient autonomy. Advance directives for palliative end of life care are important and should be discussed early with the patient and relatives if they so wish

Good practice in the management of Amyotrophic Lateral Sclerosis: clinical guidelines. An evidence-based review with good practice points. EALSC Working Group

The evidence base for diagnosis and management of ALS is still weak, and curative therapy is lacking. Nonetheless, early diagnosis and symptomatic therapy can profoundly influence care and quality of life of the patient and relatives, and may increase survival time. This review addresses the current optimal clinical approach to ALS. The literature search is complete to December 2006. Where there was lack of evidence but consensus was clear we have stated our opinion as good practice points. We conclude that a diagnosis of ALS can be achieved by early examination by an experienced neurologist. The patient should be informed of the diagnosis by the consultant. Following diagnosis, a multi-diciplinary care team should support the patient and relatives. Medication with riluzole should be initiated as early as possible. PEG is associated with improved nutrition and should be inserted early. The operation is hazardous in patients with VC <50%: RIG may be a better alternative. Non-invasive positive pressure ventilation improves survival and quality of life but is underused in Europe. Maintaining the patient's ability to communicate is essential. During the course of the disease, every effort should be made to maintain patient autonomy. Advance directives for palliative end of life care are important and should be discussed early with the patient and relatives if they so wish

EFNS task force on management of Amyotrophic Lateral Sclerosis : guidelines for diagnosing and clinical care of patients and relatives

Despite being one of the most devastating diseases known, there is little evidence for diagnosing and managing patients with amyotrophic lateral sclerosis (ALS). Although specific therapy is lacking, correct early diagnosis and introduction of symptomatic and specific therapy can have a profound influence on the care and quality of life of the patient and may increase survival time. This document addresses the optimal clinical approach to ALS. The final literature search was performed in the spring of 2005. Consensus recommendations are given graded according to the EFNS guidance regulations. Where there was lack of evidence but consensus was clear we have stated our opinion as good practice points. People affected with possible ALS should be examined as soon as possible by an experienced neurologist. Early diagnosis should be pursued and a number of investigations should be performed with high priority. The patient should be informed of the diagnosis by a consultant with a good knowledge of the patient and the disease. Following diagnosis, the patient and relatives should receive regular support from a multidisciplinary care team. Medication with riluzole should be initiated as early as possible. PEG is associated with improved nutrition and should be inserted early. The operation is hazardous in patients with vital capacity < 50%. Non-invasive positive pressure ventilation improves survival and quality of life but is underused. Maintaining the patients ability to communicate is essential. During the entire course of the disease, every effort should be made to maintain patient autonomy. Advance directives for palliative end of life care are important and should be fully discussed early with the patient and relatives respecting the patients social and cultural background