Caring for the Suffering: Meeting the Ebola Crisis Responsibly

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk.     

Disturbed coarticulation in apraxia of speech: acoustic evidence

The results of a recent perceptual study (W. Ziegler & D. von Cramon, 1985, Anticipatory coarticulation in a patient with apraxia of speech. Brain and Language 26, 117-130) provided evidence for disturbed coarticulation in verbal apraxia. Further support for this finding is now provided by acoustic analyses. Formant frequencies and LP reflection coefficients were chosen to assess anticipatory vowel-to-vowel coarticulation and vowel anticipation in stop consonants, respectively. These parameters revealed a lack of coarticulatory cohesion in the speech of a patient suffering from verbal apraxia, explainable by a consistent delay in the initiation of anticipatory vowel gestures. The findings are discussed with respect to prosodic features and to theoretical and clinical concepts of verbal apraxia.