Ethical Considerations for Healthcare Organizations.

Ethical misbehavior in the delivery of healthcare creates harm not only to individual therapists and administrators who might choose to overstep ethical boundaries but also, more broadly, causes harm to patients, to healthcare organizations, to professional organizations, and ultimately to society. Both corporate codes of conduct and professional codes of ethics are important, because they set standards of conduct and penalize noncompliant or unethical conduct. The purposes of this article are (1) to differentiate corporate compliance from ethics in a healthcare organization; (2) to explain the application of ethics principles to organizational and professional behaviors; (3) to discuss three important ethical issues (cultural competence, conflict of interest, and employer demands); and (4) to emphasize that, whether applying a corporate code of conduct or a professional code of ethics (or both), the integrity of each individual is essential to ethical behavior. To illustrate these concepts, ASHA's Code of Ethics is discussed in detail (including the ethics complaint adjudication process), and hypothetical case studies are presented under the macro headings of Cultural Competence, Conflict of Interest, and Employer Demands.

Transcranial magnetic stimulation (TMS): potential progress for language improvement in aphasia.

Aphasia researchers and clinicians share some basic beliefs about language recovery post stroke. Most agree there is a spontaneous recovery period and language recovery may be enhanced by participation in a behavioral therapy program. The application of biological interventions in the form of pharmaceutical treatments or brain stimulation is less well understood in the community of people who work with individuals having aphasia. The purpose of this article is to review the literature on electrical brain stimulation as an intervention to improve aphasia recovery. The article will emphasize emerging research on the use of transcranial magnetic stimulation (TMS) to accelerate stroke recovery. We will profile the current US Food and Drug Administration (FDA)-approved application to depression to introduce its potential for future application to other syndromes such as aphasia.

Emotional intelligence: the Sine Qua Non for a clinical leadership toolbox.

UNLABELLED: Over the past decade, it has become increasingly clear that although IQ and technical skills are important, emotional intelligence is the Sine Qua Non of leadership. According to Goleman [Goleman, D. (1998). What makes a leader? Harvard Business Review, 93-102] "effective leaders are alike in one crucial way: they all have a high degree of emotional intelligence...and can also be linked to strong performance." The original five dimensions of EIQ are described and applied to both supervisory and clinical scenarios. LEARNING OUTCOMES: As a result of reading this work, you will be able to: (1) define and provide an illustration of each of the five components of emotional intelligence (EIQ); (2) outline the relationship of EIQ to success in your profession and your personal life; (3) create a strategic action plan to enhance each dimension of EIQ in your daily life; (4) list at least three real-life experiences that could have resulted a favorable outcome with an improved EIQ; (5) complete a self-evaluation of your EIQ.

The aphasia syndromes: Localization and classification.

The premise of this article is that the members of the stroke team speak an abbreviated but common language when discussing the person with aphasia. The team's initial goal is to assess a person with stroke who has sustained left hemisphere injury and to be able to communicate effectively with each other and the patient in order to accomplish the rehabilitation goals. The article discusses differential diagnosis in aphasia and the advantages and disadvantages of aphasia classification. Given that aphasia classification is a necessary clinical charge, the various definitions of aphasia are presented, since what one does with the person with aphasia depends on what one thinks aphasia is. The syndrome approach is described as the method of choice for classifying persons with aphasia, and the various aphasia syndromes are then described both in terms of behavior and site of lesion. Finally, clinical implications are discussed in the context of applying the syndrome approach to aphasia classification in stroke rehabilitation.

Drawing and gesture as communication options in a person with severe aphasia.

The following case study demonstrates the efficacy of a gestural and graphic treatment approach for an individual with chronic Broca's aphasia. RJ. presented with global aphasia as a result of a stroke in 1985. He had a 2-year history of aphasia therapy without notable results, followed by a 3-year hiatus from any form of therapy. At the request of the patient's daughter, a speech-language pathology (SLP) evaluation was conducted nearly 5 years post onset and over 3 years after any form of communication intervention. Initially R.J. was so severe and perseverative that no formal testing could be administered. A novel, intensive treatment regime commenced, and after 6 weeks of aphasia treatment that focused on gesture and drawing as expressive modalities, R.J. was discharged home a functional communicator.