'IF it Ain't in the Notes…’ Dental Record-keeping in Adversity

2019 ◽  
Vol 8 (2) ◽  
pp. 49-52
Author(s):  
Stephen Henderson
Keyword(s):  
At Risk ◽  
Trial Judge ◽  
Record Keeping ◽  
Opposite View ◽  
As If

There are some dento-legal mantras that have, by default, come to be understood as the truth, for example: “If it ain't in the notes, it didn't happen” and “Good records, good defence; poor records, poor defence; no records, no defence.” The opposite view was offered by the trial judge in a dental clinical negligence case in recent years. The judge's view can be summed up as: “If you don't make a note of something that has happened, you leave yourself at risk of proceedings like these.”

scholarly journals Practical management of polyposis syndromes

2019 ◽  
Vol 10 (4) ◽  
pp. 379-387 ◽  
Author(s):  
Roshani Patel ◽  
Warren Hyer
Keyword(s):  
At Risk ◽  
Endoscopic Therapy ◽  
Polyposis Syndrome ◽  
Causative Gene ◽  
Record Keeping ◽  
Diagnosis And Management ◽  
Risk Patients ◽  
Polyposis Syndromes ◽  
Peutz Jeghers Syndrome ◽  
Mutyh Associated Polyposis

Hereditary bowel tumours are usually part of a distinct syndrome which require management of both intestinal and extra-intestinal disease. Polyposis syndromes include: Familial adenomatous polyposis, MUTYH-associated polyposis, Serrated polyposis syndrome, Peutz-Jeghers syndrome, Juvenile polyposis syndrome and PTEN-hamartomatous syndromes. Of all colorectal cancers (CRC), 5%–10% will be due to an underlying hereditary CRC syndrome. Diagnosis and management of polyposis syndromes is constantly evolving as new scientific and technological advancements are made with respect to identifying causative genes and increased sophistication of endoscopic therapy to treat polyps. This, in addition to data yielded from meticulous record-keeping by polyposis registries has helped to guide management in what are otherwise relatively rare conditions. These data help guide clinical management of patients and their ‘at-risk’ relatives. Diagnosis is both genetic where possible but clinical recognition is key in the absence of an identifiable causative gene. Furthermore, some syndromes can overlap which can additionally complicate diagnosis. The principle goals of polyposis management are first to manage and treat the presenting patient and then to identify ‘at-risk’ patients, through screening and predictive genetic testing, endoscopic surveillance to allow therapy and guide surgical prophylaxis. Due to the complexity of diagnosis and management, patients and their families should be referred to a genetics centre or a polyposis registry where dedicated management can take place.

scholarly journals Wounds at risk of tetanus: unexpected level of underimmunization in a patient cohort

2020 ◽  
Author(s):  
Gaia Bavestrello Piccini ◽  
Jean-Christophe Cavenaile ◽  
Maria Antonietta Bressan
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
The Elderly ◽  
Risk Category ◽  
The European Union ◽  
Medical Systems ◽  
Clostridium Tetani ◽  
Record Keeping ◽  
Awareness Campaigns ◽  
Significant Difference

Abstract Background: Tetanus is an acute and potentially fatal disease caused by Clostridium tetani, an extremely resilient pathogen. This bacterium can contaminate traumatic wounds which account for approximately 5.4% of all visits to the Emergency Department. According to several surveillance programs, the incidence of clinical tetanus in Italy is tenfold higher than in other industrialised countries. In 2010, Italy accounted for 57 of the 74 confirmed cases reported within the European Union.Methods: The study analyses data from 1094 patients who presented to the Emergency Department of the Fondazione IRRCS Policlinico San Matteo between April 2016 and November 2017 with wounds potentially at risk of infection with Clostridium tetani. Results: Data showed that, in conformity with the literature, the elderly (> 60 years old) constitutes a high-risk category, with 219 unprotected individuals out of 238. Also, among patients aged more than 60 years old, there was a statistically significant difference between female and male subjects. From the comparative analysis of the data, it was found that even younger patients are lacking in protective immunity. Conclusions: When considering other medical systems, both European and non-European ones, and analysing their guidelines for the prevention of tetanus infection, the necessity of adopting a well-defined algorithm becomes evident. This would help avoiding the excessive administration of prophylaxis, as well as putting in place the necessary preventive measures for each patient. This study highlights the need for greater patient and clinician awareness, and for an improvement in record keeping and management of the documentation related to vaccinations. The analysed data also suggest the need for conducting awareness campaigns on the topic of vaccines and vaccine preventable infections. Patients should be made aware of the importance of keeping track of their own immunization status, and of remembering the date of the last administration of the vaccine or, of carrying around their vaccination card.

scholarly journals Wounds at risk of tetanus: unexpected prevalence of immunization in a patient cohort

2020 ◽  
Author(s):  
Gaia Bavestrello Piccini ◽  
Jean-Christophe Cavenaile ◽  
Maria Antonietta Bressan
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
The Elderly ◽  
Risk Category ◽  
Medical Systems ◽  
Clostridium Tetani ◽  
Record Keeping ◽  
Awareness Campaigns ◽  
Significant Difference ◽  
Surveillance Programs

Abstract BackgroundTetanus is an acute and potentially fatal disease caused by Clostridium Tetani, an extremely resilient pathogen. The bacterium can contaminate traumatic wounds which account for approximately 5.4% of all visits to the Emergency Department. According to several surveillance programs, the incidence of clinical tetanus in Italy is ten-fold higher than in other industrialised countries. In 2010, Italy accounted for 57 of the 74 confirmed cases reported in the European Union.Methods The study analysed data from 1094 patients who presented to the Emergency Department of the Fondazione IRRCS Policlinico San Matteo between April 2016 and November 2017 with wounds potentially at risk for infection with Clostridium Tetani.Results Data showed that, in conformity with the literature, the elderly (> 60 years old) constitute a high-risk category, with 219 unprotected individuals out of 238. Also, among patients aged more than 60 years old, there was a statistically significant difference between female and male patients. From the comparative analysis of the data however, it was surprisingly found that even younger patients are lacking protective immunity.Conclusions When considering other medical systems, both European and non-European ones, and analysing their guidelines for the prevention of tetanus infection, the necessity of adopting a well-defined algorithm becomes evident. This, also in order to avoid the excessive administration of prophylaxis, as well as to allow to put in place the necessary preventive measures for each patient. This study highlights the need for a better patient and clinician awareness, and an improvement in record keeping and management of the documentation related to the vaccinations. The analysed data also suggests the need for conducting awareness campaigns on the topic of vaccines and vaccine preventable infections. Patients should be made aware of the importance of keeping track of their own immunization status, and of remembering the date of the last administration of the vaccine or, of carrying around their vaccination card.

scholarly journals Predator Vigilance Costs of Allogrooming in Wild Blue Monkeys

Behaviour ◽  
1995 ◽  
Vol 132 (7-8) ◽  
pp. 559-569 ◽  
Author(s):  
Marina Cords
Keyword(s):  
At Risk ◽  
Time Of Day ◽  
Short Term ◽  
Systematic Relationship ◽  
Catarrhine Primates ◽  
Two Factors ◽  
Foliage Density ◽  
Blue Monkeys ◽  
As If

AbstractAlthough allogrooming in Catarrhine primates is often interpreted as if it were a costly behavior for the groomer, such costs have not been convincingly documented. This paper presents data on rates of vigilance for aerial predators, measured as looking up toward the sky, in wild blue monkeys engaged in allogrooming, and compares these vigilance rates to those occurring when the same individuals engaged in other activities, namely feeding and resting. Grooming individuals have much lower vigilance rates than resting or feeding individuals, suggesting that grooming individuals are more likely to be at risk of being preyed upon. These results are not caused by a systematic relationship in the sample between activity and either foliage density or time of day, two factors potentially related to levels of safety from predation. Nor was there evidence that blue monkeys avoid the vigilance costs of grooming by engaging in this behavior primarily at safe times or in safe locations. Although the data suggest that vigilance costs occur, they may accrue to the recipient ofgrooming as well as the groomer, and may be compensated for both partners by long- or short-term benefits.

Double identity in Orissa's Golden Triangle

Antiquity ◽  
2000 ◽  
Vol 74 (285) ◽  
pp. 682-687
Author(s):  
N. James
Keyword(s):  
At Risk ◽  
Political Interest ◽  
Distinct Region ◽  
Golden Triangle ◽  
National Values ◽  
Hindu Temples ◽  
As If

The Medieval Hindu temples of Puri, Rhubaneswar and Konark are promoted as Orissa's version of northern India's ‘Golden Triangle’ of Agra, Fatehpur Sikri and Jaipur. One of the less affluent States in India, Orissa stands to benefit from tourism (FIGURE 1). The promotion seeks to appeal to all Indians and foreigners and also to prompt an image of Orissa as a distinct region. Such duality is typical among the diversity of community, ethnic, communal, federalist and national values at issue in India (Chatterjee 1993: 75).Cultivation of the temples is nothing new. Whatever the original purposes of icons, significance is ascribed, not simply inherent. It depends on economic or political interest and context (Cohen 1985). Harrison (1999) has argued that images of ethnicity tend to be defended as if at risk of pollution or theft by outsiders. Under the influence of European ideology, the commonest symbol for ethnic or nationalist aspiration is language but religion and other markers of culture have been used too (Smith 1981). Other than religion, one of the criteria for invoking the temples is the discipline of archaeology. However, archaeology too is a Western conceptual idiom (Cohn 1983: 209). Although literacy — including in the ‘English medium’ — is spreading, archaeology is not appreciated by everyone in Orissa. Partly for that reason, there have been various views as to how the temples should be presented and to whom.

scholarly journals Layers of Agency

Games ◽  
2020 ◽  
pp. 52-73
Author(s):  
C. Thi Nguyen
Keyword(s):  
At Risk ◽  
Risk Of Failure ◽  
The Moment ◽  
As If

In striving play, we not only take up disposable ends, but we take them up as if they were final. To become absorbed in games, we need to create an alternate agency and submerge ourselves within it. We need to put out of our minds, for the moment, our larger purposes, and give ourselves up to a temporary and narrowed form of agency. Otherwise, it would be impossible to achieve the sorts of wholehearted play that so many of us desire. This is a familiar technique that agents use for pursuing self-effacing ends. Games simply formalize it. This picture help us to explain why we put ourselves at risk of failure in games. For the striving player, failure in a game isn’t really a lasting failure. Rather, it is only a failure of the temporary constructed agent.

scholarly journals Wounds at risk of tetanus: unexpected level of underimmunization in a patient cohort

2020 ◽  
Author(s):  
Gaia Bavestrello Piccini ◽  
Jean-Christophe Cavenaile ◽  
Maria Antonietta Bressan
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
The Elderly ◽  
Risk Category ◽  
The European Union ◽  
Medical Systems ◽  
Clostridium Tetani ◽  
Record Keeping ◽  
Awareness Campaigns ◽  
Significant Difference

Abstract Background: Tetanus is an acute and potentially fatal disease caused by Clostridium tetani, an extremely resilient pathogen. This bacterium can contaminate traumatic wounds which account for approximately 5.4% of all visits to the Emergency Department. According to several surveillance programs, the incidence of clinical tetanus in Italy is tenfold higher than in other industrialised countries. In 2010, Italy accounted for 57 of the 74 confirmed cases reported within the European Union.Methods: The study analysed data from 1094 patients who presented to the Emergency Department of the Fondazione IRRCS Policlinico San Matteo between April 2016 and November 2017 with wounds potentially at risk of infection with Clostridium tetani. Results: Data showed that, in conformity with the literature, the elderly (> 60 years old) constitute a high-risk category, with 219 unprotected individuals out of 238. Also, among patients aged more than 60 years old, there was a statistically significant difference between female and male patients. From the comparative analysis of the data however, it was surprisingly found that even younger patients are lacking protective immunity. Conclusions: When considering other medical systems, both European and non-European ones, and analysing their guidelines for the prevention of tetanus infection, the necessity of adopting a well-defined algorithm becomes evident. This, in order to avoid the excessive administration of prophylaxis, as well as to allow to put in place the necessary preventive measures for each patient. This study highlights the need for greater patient and clinician awareness, and for an improvement in record keeping and management of the documentation related to vaccinations. The analysed data also suggest the need for conducting awareness campaigns on the topic of vaccines and vaccine preventable infections. Patients should be made aware of the importance of keeping track of their own immunization status, and of remembering the date of the last administration of the vaccine or, of carrying around their vaccination card.

Improvement of an artificial test substrate technique for evaluation of em immunocytochemical labeling

1987 ◽  
Vol 45 ◽  
pp. 762-763
Author(s):  
G. D. Gagne ◽  
M. F. Miller
Keyword(s):  
Bovine Serum Albumin ◽  
Serum Albumin ◽  
Bovine Serum ◽  
Artificial Substrate ◽  
Chemical Fixation ◽  
As If

We recently described an artificial substrate system which could be used to optimize labeling parameters in EM immunocytochemistry (ICC). The system utilizes blocks of glutaraldehyde polymerized bovine serum albumin (BSA) into which an antigen is incorporated by a soaking procedure. The resulting antigen impregnated blocks can then be fixed and embedded as if they are pieces of tissue and the effects of fixation, embedding and other parameters on the ability of incorporated antigen to be immunocyto-chemically labeled can then be assessed. In developing this system further, we discovered that the BSA substrate can also be dried and then sectioned for immunolabeling with or without prior chemical fixation and without exposing the antigen to embedding reagents. The effects of fixation and embedding protocols can thus be evaluated separately.

Phonological Awareness Screening to Identify At-Risk Readers

1998 ◽  
Vol 29 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Margie Gilbertson ◽  
Ronald K. Bramlett
Keyword(s):  
At Risk ◽  
Phonological Awareness ◽  
Reading Ability ◽  
At Risk Students ◽  
First Grade ◽  
Receptive Vocabulary ◽  
Standardized Assessments ◽  
Cutoff Score ◽  
Invented Spelling ◽  
Reading Measures

The purpose of this study was to investigate informal phonological awareness measures as predictors of first-grade broad reading ability. Subjects were 91 former Head Start students who were administered standardized assessments of cognitive ability and receptive vocabulary, and informal phonological awareness measures during kindergarten and early first grade. Regression analyses indicated that three phonological awareness tasks, Invented Spelling, Categorization, and Blending, were the most predictive of standardized reading measures obtained at the end of first grade. Discriminant analyses indicated that these three phonological awareness tasks correctly identified at-risk students with 92% accuracy. Clinical use of a cutoff score for these measures is suggested, along with general intervention guidelines for practicing clinicians.

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