Assessment and diagnosis of Developmental Language Disorder: The experiences of speech and language therapists

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: For many years research and practice have noted the impact of the heterogeneous nature of Developmental Language Disorder (also known as language impairment or specific language impairment) on diagnosis and assessment. Recent research suggests the disorder is not restricted to the language domain and against this background, the challenge for the practitioner is to provide accurate assessment and effective therapy. The language practitioner aims to support the child and their carers to achieve the best outcomes. However, little is known about the experiences of the language practitioner in the assessment process, in contrast to other childhood disorders, yet their expertise is central in the assessment and diagnosis of children with language disorder. Aims: This study aimed to provide a detailed qualitative description of the experiences of speech and language therapists involved in the assessment and diagnosis of children with Developmental Language Disorder. Methods & Procedures: The qualitative study included three focus groups to provide a credible and rich description of the experiences of speech and language therapists involved in the assessment of Developmental Language Disorder. The speech and language therapists who participated in the study were recruited from three NHS Trusts across the UK and all were directly involved in the assessment and diagnosis procedures. The lengths of practitioner experience ranged from 2 years to 38 years. The data was analysed using a thematic analysis in accordance with the principles set out by Braun & Clarke (2006). Outcomes & Results: The data showed a number of key themes concerning the experiences of speech and language therapists in assessing children with Developmental Language Disorder (DLD). These themes ranged from the participants’ experiences of the barriers to early referral, challenges for assessment and the concerns over continued future support. Conclusions & Implications: This study provides first-hand evidence from speech and language therapists in the assessment of children with Developmental Language Disorder, drawing together experiences from language practitioners from different regions. The findings provide insight to the barriers to referral, the potential variations in the assessment process, the role of practitioner expertise and the challenges faced them. The importance of early intervention, useful assessment tools and future support were expressed. Taken together, the results relate to some issues to be addressed on a practical level and a continuing need for initiatives to raise awareness of DLD in the public domain.Peer reviewe

Next-of-Kin Involvement in Regulatory Investigations of Adverse Events That Caused Patient Death: A Process Evaluation (Part II: The Inspectors' Perspective)

OBJECTIVE: The aim of the study was to explore regulatory inspectors' experiences with a new method for next-of-kin involvement in investigation of adverse events causing patient death. A resilient healthcare perspective is used as the theoretical foundation. METHODS: The study design was a qualitative process evaluation of the new involvement method in 2 Norwegian counties. Next of kin, who had lost a close family member in an adverse event, were invited to a 2-hour face-to-face meeting with the inspectors. Data collection involved 3 focus group interviews with regulatory inspectors and observation (20 hours) of the meetings (2017-2018). Data were analyzed by a thematic content analysis. RESULTS: Next-of-kin involvement informed the investigations by additional and new information about the adverse events and by different versions of the investigators' earlier obtained information, such as time sequences, what happened and how, and who were involved. Inspectors considered next of kin as a key source of information that contributed to improve the quality of the investigation. The downside was that the involvement method increased work load and could challenge the principle of equal treatment in regulatory practice. CONCLUSIONS: Involvement of next of kin in regulatory investigation of adverse events causing patient death contributes to a better understanding of work as done in clinical practice and contributes to strengthen the learning potential in resilience

Resilience perspective on healthcare professionals' adaptations to changes and challenges resulting from the COVID-19 pandemic: a meta-synthesis

Objective To identify, review and synthesise qualitative literature on healthcare professionals’ adaptations to changes and challenges resulting from the COVID-19 pandemic. Design Systematic review with meta-synthesis. Data sources Academic Search Elite, CINAHL, MEDLINE, PubMed, Science Direct and Scopus. Eligibility criteria Qualitative or mixed-methods studies published between 2019 and 2021 investigating healthcare professionals’ adaptations to changes and challenges resulting from the COVID-19 pandemic. Data extraction and synthesis Data were extracted using a predesigned data extraction form that included details about publication (eg, authors, setting, participants, adaptations and outcomes). Data were analysed using thematic analysis. Results Forty-seven studies were included. A range of adaptations crucial to maintaining healthcare delivery during the COVID-19 pandemic were found, including taking on new roles, conducting self and peer education and reorganising workspaces. Triggers for adaptations included unclear workflows, lack of guidelines, increased workload and transition to digital solutions. As challenges arose, many health professionals reported increased collaboration across wards, healthcare teams, hierarchies and healthcare services. Conclusion Healthcare professionals demonstrated significant adaptive capacity when faced with challenges imposed by the COVID-19 pandemic. Several adaptations were identified as beneficial for future organisational healthcare service changes, while others exposed weaknesses in healthcare system designs and capacity, leading to dysfunctional adaptations. Healthcare professionals’ experiences working during the COVID-19 pandemic present a unique opportunity to learn how healthcare systems rapidly respond to changes, and how resilient healthcare services can be built globally.publishedVersio

The Pine Needle, November 1949

Libraries and archives collect materials from different cultures and time periods to preserve and make available the historical record. As a result, materials such as those presented here may reflect sexist, misogynistic, abusive, racist, or discriminatory attitudes or actions that some may find disturbing, harmful, or difficult to view. Both a humor and literary magazine, The Pine Needle was a University of Maine student-produced periodical that began publication in the fall of 1946, the first post-World War II semester that saw GIs returning to campus. The Needle reflected an edginess and rebellion not found in previous UMaine student publications. While past student publications relied on euphemisms for alcohol and dating on campus, The Needle openly promoted the sexualization of co-eds and the use of drugs, tobacco, and alcohol by students who experienced war. Cover art for this issue is a pen-and-ink illustration by Len Keenan depicting a first year student wearing a freshman cap and bow tie, smoking a pipe that appears to be making him ill. Leonard F. Keenan (1929-1984), graduated from the University of Maine in 1951 with a B.S. in Forestry. He later earned his MBA from the Army Comptrollership School at Syracuse University and served as a civilian in the Army Budget Office. Though his career with the Army hit a snag in 1976, when he was among four men receiving formal, written reprimands for ...failing to detect and present accounting [failures] that lead to massive overspending... at the end of the Vietnam War, Keenan was honored following his death by the establishment of the Leonard F. Keenan Memorial Award at Syracuse University. The award continues to be presented annually to the U.S. Department of Defense\u27s outstanding financial manager. Keenan died in Virginia on April 30, 1984 from congestive heart failure

The hybrid identity of micro enterprises: Contrasting the perspectives of community pharmacies’ owners-managers and employees

Purpose: The purpose of this paper is to examine the effect of ownership of community pharmacies on the perception of organizational identity and its relationships with organizational performance. Design/methodology/approach: A survey was carried out on a sample of pharmacists working in community pharmacies in Portugal. The sample comprised 1,369 pharmacists, of whom 51 percent were owner-managers. Measures of pharmacies’ normative (community health oriented) and utilitarian (business oriented) identities, identity strength (clear and unifying), substantive (stockholder focused) and symbolic (society focused) performance were included. Findings: Both owners and employed pharmacists rated the normative identity of pharmacies higher than the utilitarian identity. Compared with employed pharmacists, owners perceive a lower level of utilitarian identity, the same level of normative identity, and higher levels of identity strength. Normative identity and identity strength predicted symbolic performance. Normative and utilitarian identities and identity strength predicted substantive performance. The relationship between utilitarian identity and substantive performance was significant among owner pharmacists but not among employed pharmacists. Research limitations/implications: The limitations include the use of perceptive measures and the focus on the individual level of analysis. Practical implications: In order to improve pharmacies’ performance, pharmacists who manage community pharmacies are challenged to reconcile tensions arising from the co-existence of business and community health identities and from their own agency (self-serving) and stewardship (altruistic) motives. Originality/value: This study draws on institutional, identity and stewardship theories to understand how pharmacists, owners and employees, view the identity of community pharmacies and how identity relates to organizational performance

Translating research on quality improvement in five European countries into a reflective guide for hospital leaders: the 'QUASER Hospital Guide'

Objective The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy. Design The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide. Setting The research was carried out in two hospitals in each of five European countries. Participants In total, 389 interviews with healthcare practitioners and 803 hours of observations. Intervention None. Main outcome measure None. Results The QUASER Hospital Guide was designed for leadership teams to diagnose their organization’s strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper. Conclusions The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization

Genome-wide association study of receptive language ability of 12 year olds

Purpose: We have previously shown that individual differences in measures of receptive language ability at age 12 are highly heritable. The current study attempted to identify some of the genes responsible for the heritability of receptive language ability using a genome-wide association (GWA) approach. Method: We administered four internet-based measures of receptive language (vocabulary, semantics, syntax, and pragmatics) to a sample of 2329 12-year-olds for whom DNA and genome-wide genotyping were available. Nearly 700,000 single-nucleotide polymorphisms (SNPs) and one million imputed SNPs were included in a GWA analysis of receptive language composite scores. Results: No SNP associations met the demanding criterion of genome-wide significance that corrects for multiple testing across the genome (p < 5 ×10-8). The strongest SNP association did not replicate in an additional sample of 2639 12-year-olds. Conclusion: These results indicate that individual differences in receptive language ability in the general population do not reflect common genetic variants that account for >3% of the phenotypic variance. The search for genetic variants associated with language skill will require larger samples and additional methods to identify and functionally characterize the full spectrum of risk variants