Browsing by Subject "Tape Recording"

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    Communication practices in physician decision-making for an unstable critically ill patient with end-stage cancer.
    (J Palliat Med, 2010-08) Mohan, Deepika; Alexander, Stewart C; Garrigues, Sarah K; Arnold, Robert M; Barnato, Amber E
    BACKGROUND: Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. OBJECTIVE: To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, using the framework of shared decision-making. DESIGN: Analysis of audiotaped encounters between physicians and a standardized patient, in a high-fidelity simulation scenario, to identify best practice communication behaviors. The simulation depicted a 78-year-old man with metastatic gastric cancer, life-threatening hypoxia, and stable preferences to avoid intensive care unit (ICU) admission and intubation. Blinded coders assessed the encounters for verbal communication behaviors associated with handling emotions and discussion of end-of-life goals. We calculated a score for skill at handling emotions (0-6) and at discussing end of life goals (0-16). SUBJECTS: Twenty-seven hospital-based physicians. RESULTS: Independent variables included physician demographics and communication behaviors. We used treatment decisions (ICU admission and initiation of palliation) as a proxy for accurate identification of patient preferences. Eight physicians admitted the patient to the ICU, and 16 initiated palliation. Physicians varied, but on average demonstrated low skill at handling emotions (mean, 0.7) and moderate skill at discussing end-of-life goals (mean, 7.4). We found that skill at discussing end-of-life goals was associated with initiation of palliation (p = 0.04). CONCLUSIONS: It is possible to analyze the decision making of physicians managing unstable critically ill patients with end-stage cancer using the framework of shared decision-making.
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    What Do North American Babies Hear? A large-scale cross-corpus analysis.
    (Developmental science, 2019-01) Bergelson, Elika; Casillas, Marisa; Soderstrom, Melanie; Seidl, Amanda; Warlaumont, Anne S; Amatuni, Andrei
    A range of demographic variables influences how much speech young children hear. However, because studies have used vastly different sampling methods, quantitative comparison of interlocking demographic effects has been nearly impossible, across or within studies. We harnessed a unique collection of existing naturalistic, day-long recordings from 61 homes across four North American cities to examine language input as a function of age, gender, and maternal education. We analyzed adult speech heard by 3- to 20-month-olds who wore audio recorders for an entire day. We annotated speaker gender and speech register (child-directed or adult-directed) for 10,861 utterances from female and male adults in these recordings. Examining age, gender, and maternal education collectively in this ecologically valid dataset, we find several key results. First, the speaker gender imbalance in the input is striking: children heard 2-3× more speech from females than males. Second, children in higher-maternal education homes heard more child-directed speech than those in lower-maternal education homes. Finally, our analyses revealed a previously unreported effect: the proportion of child-directed speech in the input increases with age, due to a decrease in adult-directed speech with age. This large-scale analysis is an important step forward in collectively examining demographic variables that influence early development, made possible by pooled, comparable, day-long recordings of children's language environments. The audio recordings, annotations, and annotation software are readily available for reuse and reanalysis by other researchers.