The Nuclear Crisis: Insights from Metatheory and Clinical Change Theories

1989 ◽  
pp. 234-250 ◽  
Author(s):  
Michael J. Bopp
Keyword(s):  
Clinical Change ◽  
Nuclear Crisis

NSAIDs' Safety Issues May Spur Clinical Change

2005 ◽  
Vol 36 (9) ◽  
pp. 50-51
Author(s):  
BRUCE JANCIN
Keyword(s):  
Clinical Change ◽  
Safety Issues

scholarly journals Use radiography rarely, not routinely, for hip hemiarthroplasty

2021 ◽  
Author(s):  
Lucy Clare Maling ◽  
John Martin Lynch ◽  
Robert William Walker ◽  
Mark Ross Norton ◽  
Rory George Middleton
Keyword(s):  
Patient Safety ◽  
Cognitive Impairment ◽  
Limited Resources ◽  
Cognitively Impaired ◽  
Clinical Change ◽  
Index Procedure ◽  
Hip Hemiarthroplasty ◽  
Operative Care ◽  
Fluoroscopic Imaging ◽  
Retrospective Database

Abstract Purpose Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS). Methods We undertook a retrospective database review of 1563 HA procedures to assess whether the routine ordering of check radiographs played an important role in a patient’s post-operative care. Results 18 (1.2%) mechanical complications led to a return to theatre within 6 weeks of the index procedure. All were dislocations. Ten had a normal post-operative radiograph and five had documented suspicion of dislocation prior to radiography. The post-operative check radiograph was the sole identifier of dislocation in only three patients (0.2%). All three of these patients were pre-morbidly bed bound and non-communicative due to cognitive impairment (AMTS 0/10). Conclusion Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.

Psychosocial Interventions Situated Within the Natural Environment with Young People Who Have Experienced Trauma: A Scoping Review

2020 ◽  
Author(s):  
Jennifer Boddy ◽  
Maddy Slattery ◽  
Jianqiang Liang ◽  
Hilary Gallagher ◽  
Amanda Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Scoping Review ◽  
Natural Environment ◽  
Psychosocial Interventions ◽  
Database Search ◽  
Inclusion Criteria ◽  
Clinical Change ◽  
Social Work Interventions ◽  
The Impact

Abstract The natural environment is increasingly used in therapeutic psychosocial interventions for young people who have experienced trauma. However, as the research in this area has yet to be synthesised, very little is known about the types and outcomes of interventions. This prevents the optimisation of social work interventions in outdoor settings. Consequently, a scoping review of peer-reviewed research published from 2008 to 2018 was undertaken to examine how nature is being used in psychosocial interventions with young people aged ten to twenty-four years who have experienced trauma and the impact of these interventions on young people’s mental health. The database search identified 5,425 records; however, only ten papers met the inclusion criteria. These papers suggested that positive changes across a range of mental health outcomes for young people were achieved in psychosocial interventions which were situated in, or made use of the natural environment, although it is unclear whether the environment influenced the outcomes. The scoping review also highlighted the need for conducting further research that examines how environmental factors contribute to clinical change for young people who have experienced trauma.

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