Coming full circle

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101766/1/bju12311.pd

Fair school admissions: What is the contribution of the Choice Advice initiative

This paper assesses the contribution of Choice Advice to making admissions to English secondary schools fairer. The initiative characterises the unfairness of admissions as unequal opportunity for poorer parents to access good schools because they are less able to negotiate the admissions process. A major objective of Choice Advice is to enable more poor parents to gain access to popular and high performing secondary schools. The results of an evaluation in 15 Local Authorities are presented showing that Choice Advice provided a valuable service to some families but the proportion of poorer families helped was too small to make a significant impact on the numbers of poorer parents gaining access to popular schools. The characterisation of the problem is, we argue, flawed and, as a consequence, so is the way this policy was designed. Choice Advice is an example of a discursively complex initiative that is ambivalent in its effects. It provides a symbol of political will and is of real benefit to some parents, but it sustains a way of characterising the problem that plays a part in labelling poorer parents as deficient while making no significant impact on the unfairness of admissions

Ernest Hemingway and Alice Walker: Branding the Great American Writer

Ernest Hemingway and Alice Walker: Branding the Great American Writer discusses how Public Relations efforts have shaped the work of 20th century authors, Alice Walker and Ernest Hemingway through their respective stories The Color Purple and The Old Man and The Sea. The tactics of this field have created two of the most prominent literary figures of our time, writers who have both produced timeless works and summoned a global audience to pay close attention to their work. Understanding how this attention is garnered is vital to recognizing the way authorship is created, shaped, and consumed by the reading public

Validation of the Ottawa Ankle Rules in Iran: A prospective survey

BACKGROUND: Acute ankle injuries are one of the most common reasons for presenting to emergency departments, but only a small percentage of patients – approximately 15% – have clinically significant fractures. However, these patients are almost always referred for radiography. The Ottawa Ankle Rules (OARs) have been designed to reduce the number of unnecessary radiographs ordered for these patients. The objective of this study was to validate the OARs in the Iranian population. METHODS: This prospective survey was done among 200 patients with acute ankle injury from January 2004 to April 2004 in the Akhtar Orthopedics Hospital Emergency Department. Main outcome measures of this survey were: sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) of the OARs. RESULTS: Sensitivity of the OARs for detecting 37 ankle fractures (23 in the malleolar zone and 14 in the midfoot zone) was 100% for each of the two zones, and 100% for both zones. Specificity of the OARs for detecting fractures was 40.50% for both zones, 40.50% for the malleolar zone, and 56.00% for the midfoot zone. Implementation of the OARs had the potential for reducing radiographs by 33%. CONCLUSION: OARs are very accurate and highly sensitive tools for detecting ankle fractures. Implementation of these rules would lead to significant reduction in the number of radiographs, costs, radiation exposure and waiting times in emergency departments

Paramedics and dementia

Paramedic students are learning more about dementia care, but how many intend to work in the field? Joanne Brooke and Marlon Stiell’s study produced some worrying findings. Dementia requires a person-centred, holistic approach to care which considers the unique challenges faced by each individual. It is essential that health care professionals are competent in a range of skills to support and care for people with dementia as this will form a major part of their role in many cases (Clissett et al 2014). Care of people with dementia has been included in many undergraduate programmes for health care professionals such as nursing and medicine (Alushi et al 2015), but has only recently been acknowledged in paramedic science programmes (Ross 2012)

Evaluation of the accuracy of capillary hydroxybutyrate measurement compared with other measurements in the diagnosis of diabetic ketoacidosis: a systematic review

A complication of diabetes is diabetic ketoacidosis (DKA), which if left untreated is a life threatening condition. Prompt and accurate diagnosis of DKA is required for the commencement of life saving interventions. Measurements of ketone bodies in DKA have usually been through nitroprusside urine acetoacetate testing. The aim of this systematic review was to examine whether capillary β-hydroxybutyrate (β-OHB) testing is more accurate compared to other diagnostic methods of DKA. The following electronic databases were searched: EBSCO Host, MEDLINE, PSYCHInfo, CINAHL and Science Direct for publications from 1 January 2005 and up to and including 1 January 2016. Inclusion criteria were: Adults 18 years and over and known type 1 or type 2 diabetes. Retrospective and prospective observation studies were included. A total of nine studies met the inclusion criteria. Capillary β-OHB was found to have high sensitivity, specificity, positive predictive value and negative predictive value in identifying DKA compared to urinary ketone testing

Risk Adjustment Measures and Outcome Measures for Prehospital Trauma Research: Recommendations from the Emergency Medical Services Outcomes Project (EMSOP)

Objectives:  The objectives were to conduct a comprehensive, systematic review of the literature for risk adjustment measures (RAMs) and outcome measures (OMs) for prehospital trauma research and to use a structured expert panel process to recommend measures for use in future emergency medical services (EMS) trauma outcomes research. Methods:  A systematic literature search and review was performed identifying the published studies evaluating RAMs and OMs for prehospital injury research. An explicit structured review of all articles pertaining to each measure was conducted using the previously established methodology developed by the Canadian Physiotherapy Association (“Physical Rehabilitation Outcome Measures”). Results:  Among the 4,885 articles reviewed, 96 RAMs and/or OMs were identified from the existing literature (January 1958 to February 2010). Only one measure, the Glasgow Coma Scale (GCS), currently meets Level 1 quality of evidence status and a Category 1 (strong) recommendation for use in EMS trauma research. Twelve RAMs or OMs received Category 2 status (promising, but not sufficient current evidence to strongly recommend), including the motor component of GCS, simplified motor score (SMS), the simplified verbal score (SVS), the revised trauma score (RTS), the prehospital index (PHI), EMS provider judgment, the revised trauma index (RTI), the rapid acute physiology score (RAPS), the rapid emergency medicine score (REMS), the field trauma triage (FTT), the pediatric triage rule, and the out‐of‐hospital decision rule for pediatrics. Conclusions:  Using a previously published process, a structured literature review, and consensus expert panel opinion, only the GCS can currently be firmly recommended as a specific RAM or OM for prehospital trauma research (along with core measures that have already been established and published). This effort highlights the paucity of reliable, validated RAMs and OMs currently available for outcomes research in the prehospital setting and hopefully will encourage additional, methodologically sound evaluations of the promising, Category 2 RAMs and OMs, as well as the development of new measures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87101/1/j.1553-2712.2011.01148.x.pd