Low intensity pulsed ultrasound (LIPUS) for bone healing: A clinical practice guideline

Does low intensity pulsed ultrasound (LIPUS) accelerate recovery in adults and children who have experienced bone fractures or osteotomy (cutting of a bone)? An expert panel rapidly produced these recommendations based on a linked systematic review triggered by a large multi-centre randomised trial in adults with tibial fracture

Socially valid outcomes of intervention for people with mental retardation and challenging behaviour : a preliminary descrptive analysis of the views of different stakeholders.

Potentially salient outcomes of intervention for challenging behavior shown by people with mental retardation (MR) were identified by focus groups and through a literature review. Items generated by this process were subsequently rated by 150 respondents from seven stakeholder groups: 28 people with MR, 9 parents of people with MR, 22 clinical psychologists, 7 psychiatrists, 31 nurses, 33 managers, and 20 direct support workers. Results indicated that reduction in the severity of challenging behavior was considered the most important outcome of intervention for a child/young adult living with his or her family by four of the seven stakeholder groups; reduction in the severity of challenging behavior was considered the most important outcome of intervention for an adult living in a community-based group home by three of the seven stakeholder groups; alternative outcomes considered to be the most important by stakeholder groups included increased friendships and relationships, changes in the perceptions of individuals by others, learning of alternative ways of getting needs met, increased control, and empowerment; there were moderate levels of agreement on the relative importance of outcomes between individual members of stakeholder groups who did not have MR; there were high levels of agreement on the relative importance of outcomes between stakeholder groups of people who did not have MR; and levels of agreement on the relative importance of outcomes between people with MR and members of all other stakeholder groups did not reach the level of statistical significance

Influence of deposition parameters on composition and refractive index of femtosecond and nanosecond pulsed laser deposited gallium lanthanum oxysulphide

The influence of the deposition parameters on femtosecond and nanosecond pulsed laser deposited gallium lanthanum oxysulphide (GLSO) glass has been investigated. A systematic comparison between films deposited by femtosecond and nanosecond pulsed laser deposition (PLD) shows that the compositional range of each regime varies significantly; in particular femtosecond PLD shows a unique potential for selective fabrication of films with high lanthanum content well outside the conventional glass melting region. We demonstrate how manipulation of PLD parameters can influence the stoichiometric transfer of the PLD process, leading to thin films with compositions significantly different from the GLSO target material, and reveal how refractive index of the as-deposited films is dependent upon the composition (and hence deposition parameters). We also briefly discuss the thermal properties of GLSO material for various compositions for applications in data storage device applications

RAPID RECOMMENDATIONS Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline

Trauma Surger

The role of nurses in preventing adverse events related to respiratory dysfunction: literature review

Aims. This paper reports a literature review examining the relationship between specific clinical indicators of respiratory dysfunction and adverse events, and exploring the role of nurses in preventing adverse events related to respiratory dysfunction.Background. Adverse events in hospital are associated with poor patient outcomes such as increased mortality and permanent disability. Many of these adverse events are preventable and are preceded by a period during which the patient exhibits clearly abnormal physiological signs. The role of nurses in preserving physiological safety by early recognition and correction of physiological abnormality is a key factor in preventing adverse events.Methods. A search of the Medline and CINAHL databases was conducted using the following terms: predictors of poor outcome, adverse events, mortality, cardiac arrest, emergency, oxygen, supplemental oxygen, oxygen therapy, oxygen saturation, oxygen delivery, assessment, patient assessment, physical assessment, dyspnoea, hypoxia, hypoxaemia, respiratory assessment, respiratory dysfunction, shortness of breath and pulse oximetry. The papers reviewed were research papers that demonstrated a relationship between adverse events and various clinical indicators of respiratory dysfunction.Results. Respiratory dysfunction is a known clinical antecedent of adverse events such as cardiac arrest, need for medical emergency team activation and unplanned intensive care unit admission. The presence of respiratory dysfunction prior to an adverse event is associated with increased mortality. The specific clinical indicators involved are alterations in respiratory rate, and the presence of dyspnoea, hypoxaemia and acidosis.Conclusions. The way in which nurses assess, document and use clinical indicators of respiratory dysfunction is influential in identifying patients at risk of an adverse event and preventing adverse events related to respiratory dysfunction. If such adverse events are to be prevented, nurses must not only be able to recognise and interpret signs of respiratory dysfunction, but must also take responsibility for initiating and evaluating interventions aimed at correcting respiratory dysfunction.<br /