How is alcohol withdrawal syndrome best managed in the emergency department?

Alcohol abuse is a major cause of morbidity and mortality and subsequently presents a substantial burden on the NHS. Whether presentations are directly or indirectly linked, the emergency department (ED) holds a predominant role in dealing with this matter. Alcohol withdrawal syndrome is a common complication of alcohol misuse. Given its pathophysiology and manifestation of symptoms, early recognition and treatment is paramount in preventing a medical emergency. From a review of the associated literature, a standardised protocol for its management in ED is consequently advocated. This includes: Identification of those at risk via routine screening; Monitoring progression and severity using an alcohol withdrawal scale; Implementation of symptom-triggered therapy on the basis of objective evidence collected. Nonetheless, further studies are required to aid the choice of tools and ascertain the efficacy of such protocols within the ED department. Due to time constraints of this real-world setting, feasibility may be considered as important as reliability and validity if new practices are to be considered.     

Advocating prevention over punishment: the risks of HIV criminalization in Burkina Faso

In 2004, parliamentarians from 12 countries in West and Central Africa created a template for legislation aimed at protecting the rights of people with HIV and stemming rising HIV infection rates by criminalizing HIV transmission. Since then, the template has been adopted as national law in 15 African countries, including Burkina Faso in 2008. The Burkina Faso law offers a number of protections for people with HIV, such as confidentiality of HIV test results, and holds the government accountable for providing health services for people with HIV and education about HIV in schools. However, other articles in the law, which criminalize HIV transmission and mandate disclosure of HIV status, may contribute to violations of the human rights of women and men with HIV. This article reviews the two cases brought in Burkina Faso under the 2008 HIV law to date, both against women, and explores the implications of specific elements of the legislation. It recommends that Burkina Faso use guidance provided by UNAIDS and the Southern Africa Development Community to repeal harmful articles in the HIV-specific legislation and implement the positive provisions. Prioritizing HIV prevention over punishment is the best way to respect the rights of people living with HIV and AIDS.     

Clinical research with the prosody-voice screening profile

The Prosody-Voice Screening Profile (PVSP) is a clinical research instrument that quantifies a speaker's conversational speech status in seven suprasegmental domains: phrasing, rate, stress, loudness, pitch, laryngeal quality and resonance. The PVSP has been used to assess the prosody-voice characteristics of children and adult speakers with typical speech-language development and with a variety of speech-language disorders of known and unknown origin. PVSP coding requires a trained examiner to determine, on an utterance-by-utterance basis within each of the seven domains, whether a speaker's prosody-voice characteristics can be defined as appropriate based on a set of auditory-perceptual criteria. This report provides brief overviews of the development, administration, and psychometric features of this screening tool, and summarizes prosody-voice findings to date for several typically speaking and clinical populations.