Implications of the Ankle Injury Management (AIM) trial

2019 ◽  
Vol 101-B (12) ◽  
pp. 1472-1475 ◽  
Author(s):  
David J. Keene ◽  
Keith Willett
Keyword(s):  
Care Pathway ◽  
Close Contact ◽  
Controlled Trial ◽  
Ankle Injury ◽  
Early Management ◽  
Injury Management ◽  
The United Kingdom ◽  
Key Issues

The Ankle Injury Management (AIM) trial was a pragmatic equivalence randomized controlled trial conducted at 24 hospitals in the United Kingdom that recruited 620 patients aged more than 60 years with an unstable ankle fracture. The trial compared the usual care pathway of early management with open reduction and internal fixation with initially attempting non-surgical management using close contact casting (CCC). CCC is a minimally padded cast applied by an orthopaedic surgeon after closed reduction in the operating theatre. The intervention groups had equivalent functional outcomes at six months and longer-term follow-up. However, potential barriers to using CCC as an initial form of treatment for these patients have been identified. In this report, the results of the AIM trial are summarized and the key issues are discussed in order to further the debate about the role of CCC. Evidence from the AIM trial supports surgeons considering conservative management by CCC as a treatment option for these patients. The longer-term follow-up emphasized that patients treated with CCC need careful monitoring in the weeks after its application to monitor maintenance of reduction. Cite this article: Bone Joint J 2019;101-B:1472–1475.

37. Sentencing

2017 ◽  
Author(s):  
Andrew Ashworth ◽  
Julian V. Roberts
Keyword(s):  
Media Coverage ◽  
Sentencing Guidelines ◽  
Race And Gender ◽  
The United Kingdom ◽  
Political Criticism ◽  
Key Issues ◽  
And Gender ◽  
The Uk ◽  
The Impact

Sentencing represents the apex of the criminal process and is the most public stage of the criminal justice system. Controversial sentences attract widespread media coverage, intense public interest, and much public and political criticism. This chapter explores sentencing in the United Kingdom, and draws some conclusions with relevance to other common law jurisdictions. Sentencing has changed greatly in recent years, notably through the introduction of sentencing guidelines in England and Wales, and more recently, Scotland. However, there are still doubts about the fairness and consistency of sentencing practice, not least in the use of imprisonment. Among the key issues to be examined in this chapter are the tendency towards net-widening, the effects of race and gender, the impact of pleading guilty, the use of indeterminate sentences, the rise of mandatory sentences, and the role of the victim in the sentencing process. The chapter begins by outlining the methods by which cases come before the courts for sentencing. It then summarizes the specific sentences available to courts and examines current sentencing patterns, before turning to a more detailed exploration of sentencing guidelines, and of the key issues identified above. The chapter addresses two critical questions: What is sentencing (namely who exerts the power to punish)? Does sentencing in the UK measure up to appropriate standards of fairness and consistency?

Discharge from hospital and early supported discharge

2020 ◽  
pp. 345-352
Author(s):  
Catherine Gaynor
Keyword(s):  
Discharge Planning ◽  
Models Of Care ◽  
Effective Discharge ◽  
The United Kingdom ◽  
Early Supported Discharge ◽  
Hospital To Home ◽  
Discharge From Hospital ◽  
Applied Health Research

‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.

Introduction

2018 ◽  
pp. 1-8
Author(s):  
Mary Gilmartin ◽  
Patricia Burke Wood ◽  
Cian O’Callaghan
Keyword(s):  
United States ◽  
United Kingdom ◽  
Transnational Corporations ◽  
The United States ◽  
State Sovereignty ◽  
The United Kingdom ◽  
Key Issues ◽  
State Boundaries

This introductory chapter provides an overview of the book's main themes. This book addresses three key issues that are central to the current politicisation of migration and citizenship, but that take particular forms in the United Kingdom and the United States. These three issues, each of which is discussed in a separate chapter, are borders and walls, mobility, and belonging. Borders and walls are the material articulation of state boundaries and state sovereignty. The role of borders is increasingly seen as the regulation of the movement of people: facilitating easy movement across borders for some, but making that movement more difficult for most. In contrast, the mobility of capital, through the actions of transnational corporations in particular, receives little attention.

A Randomized Controlled Trial Evaluating the Efficacy of a Psychoeducation Program for Families of Children and Adolescents With ADHD in the United Kingdom: Results After a 6-Month Follow-Up

2016 ◽  
Vol 24 (5) ◽  
pp. 768-779 ◽  
Author(s):  
Maite Ferrin ◽  
Viviana Perez-Ayala ◽  
Samaa El-Abd ◽  
Teresa Lax-Pericall ◽  
Brian Jacobs ◽  
...  
Keyword(s):  
Group Treatment ◽  
Treatment Time ◽  
Controlled Trial ◽  
Control Group ◽  
Significant Treatment ◽  
Treatment As Usual ◽  
Time Interaction ◽  
The United Kingdom ◽  
Additional Approach

Objective: Psychoeducation forms part of the current practice for ADHD; however, its efficacy is yet to be established. Method: Sixty-nine children/adolescents with ADHD were randomly assigned for their families to receive either a well-structured psychoeducation program ( n = 35), or belong to a control group (treatment-as-usual, n = 34). Results: One-way analyses of variance showed a statistically significant Treatment × Time interaction, for ADHD total symptoms, inattention/cognition, and hyperactivity/impulsivity subdomains according to the parents, the first two with medium-large effect sizes. The effects of the intervention on the ADHD total and the inattention/cognition domain persisted after 6 months follow-up. No significant differences in teacher ratings were found; however, an improvement in clinical functioning as measured by clinicians was observed. Conclusion: This psychoeducation program has shown effectiveness in reducing ADHD symptoms when compared with treatment as usual. Psychoeducation needs to be considered as a valid and additional approach in ADHD.

scholarly journals Role of Topical Cyclosporine in Prevention of Pterygium Recurrence, after Primary Excision

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Munawar Ahmed, Atif Mansoor Noman Ahmed, Ghazi Khan Mari Azfer Ahmed Mirza
Keyword(s):  
Controlled Trial ◽  
Healing Time ◽  
Complete Healing ◽  
Eye Drops ◽  
Once Daily ◽  
Randomized Controlled ◽  
Department Of Ophthalmology ◽  
Recurrent Pterygium

Purpose: To study the effect of cyclosporine on pterygium recurrence after primary excision Study Design: Non randomized controlled trial. Place and Duration of Study: The study was conducted in the department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro from 2015 to 2017. Material and Methods: One hundred and thirty eyes of 65 patients having bilateral pterygium, at least 2 mm encroaching on the cornea, were selected for study. Dimensions of pterygium were measured on slit lamp. Half of the eyes were selected for post-operative cyclosporine and was named as cyclo- eye and fellow other eye was named as non-cyclo eye. Immediate post-operative treatment was tobramycin dexamethasone eye ointment twice and moxifloxacin eye drops three times daily until corneal epithelium was restored, followed by moxifloxacin and Cyclosporine eye drops twice daily until complete healing of ocular surface occurred and then cyclosporine 0.05% alone once daily in the evening up to three months. In the fellow eye tobramycin dexamethasone eye ointment and moxifloxacin eye drops were used for complete healing time followed by tears alone three times for three months. Follow up was done for six months. Results: Only Fifty-three patients who completed 6 months of follow-up were included in the results. In cyclo-eyes recurrent pterygium was observed only in 4 (07.55%) and in non-cyclo eyes recurrence was observed in 23 (43.40%) eyes. Mean healing time in cyclo-eyes was 21.1354 days and in non-cyclo-eyes, 15.0213 days. Conclusion: Cyclosporine is effective in reducing the recurrence rate of pterygium. Key Words: Pterygium, Cyclosporine, Cornea.

scholarly journals What is the Role of Chest CT Scan for Pediatric Patient Diagnosis of COVID-19?

2020 ◽  
Author(s):  
Yaqin Zhang ◽  
Guangming Li ◽  
Hongsheng Liu ◽  
Binghui Chen ◽  
Zeyu Cai ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Virus Disease ◽  
Close Contact ◽  
Ground Glass ◽  
Imaging Features ◽  
Illness Onset ◽  
Significant Difference ◽  
Line Test

Abstract Objectives To retrospectively analyze the CT imaging features and patterns at baseline and as they evolve with time as the disease progresses or resolves in a cohort of pediatric patients affected with 2019 corona virus disease (COVID-19) pneumonia from three different cities in China.Methods We evaluated 29 pediatric patients with COVID-19 in the authors’ institution from Jan 1 to Feb 20, 2020. Cases were confirmed by laboratory test and were analyzed for epidemiological, demographic, clinical, radiological features and patterns.Results 29 initial scans and 23 follow-up scans were obtained from 29 patients. 15(52%) patients had been to Hubei Province and 26 (90%) of them had close contact with the COVID-19 positive patients in 14 days prior to the illness onset. The peak severity time was 5-8 days after symptom onset. A significant difference between the number of involved segments at different time points was indicated (p=0.019). Half (52%) of the laboratory confirmed patients had no CT positive findings. Nine (31%) of the laboratory confirmed patients had no symptoms. Six (21%) had no CT positive findings nor symptoms. All the patients of one center(n=6) whose fecal samples remained positive after the respiratory samples became negative.Conclusion The common positive CT findings included ground-glass opacities (50%), ground-glass opacities mixed with consolidation (36%), peribronchial thickening (21%), and consolidations (14%). We recommend for pediatric patients CT should not be used as a first-line test to diagnose COVID-19.

scholarly journals The Use of the Internet in School Libraries: An International Comparative Survey

2021 ◽  
pp. 217-226
Author(s):  
James E. Herring
Keyword(s):  
The Internet ◽  
School Librarians ◽  
The United Kingdom ◽  
Curricular Material ◽  
Key Issues ◽  
Information Skills ◽  
International Comparative ◽  
Use Of The Internet ◽  
The Web

This research sought to gain an impression of the use of the Internet by school librarians in the United Kingdom and South Africa. The research questions addressed the issues of access to the Internet by school librarians, the purposes for which school librarians used email and the Web, the demand from teachers for access to the Web, the key issues identified by school librarians in relation to the use of the Internet in schools in the next five years, and any differences between the responses of librarians from the two countries. The key findings were that there was limited access to the Internet in the respondents' schools; school librarians used the Web mainly for curricular material; science and geography departments were the heaviest users of the Web; and the key future issues identified included information skills, cost, inservice training, and the role of the school librarian. There were no significant differences between the two countries studied.

scholarly journals To Study the Role of Zinc Supplementation on Growth of Low Birth Weight Infants

2014 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Ravindra Sonawane ◽  
Suhas Patil ◽  
Lalit Gulati ◽  
Sagar Sonawane
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Head Circumference ◽  
Zinc Supplementation ◽  
Controlled Trial ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Length Gain

This was a randomized controlled trial undertaken to study the role of zinc supplementation on growth of low birth weight infants (b.wt≤2500 gm). Out of 120 LBW infants, 23 were excluded due to loss of follow up. The remaining 97 LBW eligible neonates were randomized in to 2 group (zinc & control group), zinc group were given zinc supplementation at a dose of 2 mg/kg/day for 8 weeks from enrollment. They were then followed up every 4 weeks up to 8 weeks. At each visit, detail anthropometry including e weight, length, and head circumference were recorded at each visit. The infants in the zinc group had significantly higher weight gain (p<0.000), length gain (p<0.000), linear growth velocity and head circumference at 8 weeks. We concluded that zinc supplementation at 2 mg/kg/day for 8 weeks in LBW infants improves their growth during infancy.

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