In this article the authors discuss the use of augmentative and alternative communication (AAC) as used to enhance comprehension and expression of people with autism. A theoretical model for AAC assessment and intervention planning is presented. Application of the model is illustrated through a case report of a 6-year-old boy with autism who had severe expressive and receptive language impairments.

Autistic Disorder↗

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A gerontologic nurse practitioner in every nursing home: a necessary expenditure.

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Aged↗

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Ineffective diastolic filling in tachycardia-induced cardiomyopathy with total pulsus alternans.

We report a case of total pulse alternans in a patient with paroxysmal ectopic atrial tachycardia and echocardiographic findings obtained before and after radiofrequency catheter ablation (RFCA) that terminated the arrhythmia. The patient was a 27-year-old man with history of paroxysmal palpitations with worsening episodic dizziness, chest tightness, and dyspnea. Electrocardiography (ECG) showed atrial tachycardia at 160 to 170 beats/min while the simultaneous pulse was in the 80s beats/min. Echocardiogram showed that aortic and mitral valves opened with alternating excursions and outflow velocities. Furthermore, despite similar ventricular wall thickening during systole of consecutive cardiac cycles, there was alternating mitral valve opening during diastole of the same cycles, providing direct evidence that ineffective diastolic filling and mitral valve opening may play a role in the pathogenesis of pulse alternans. Repeat ECG and echocardiography after the successful RFCA showed normal sinus rhythm and normal opening excursion and the velocity across the aortic and mitral valves.

Adult↗

PubMedDate not supplied

Quality as the driving force for cost-effective psychiatric managed care.

The mental health profession is plagued by the perception that it is a vague, ambiguous, and sometimes ineffective field. A confluence of worldwide megatrends is affecting the mental health and substance abuse delivery system. Two different methods of providing psychiatric clinical care are addressed.

Case Management↗