Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic ...imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists.
We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes.
Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism.
Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.
Abstract Purpose Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care ...providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. Methods We present 2 cases to begin characterisation of the radiographic findings in elder abuse. Results Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. Conclusions We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses.
Imaging of Tarsal Navicular Disorders Tuthill, Heidi L.; Finkelstein, Evan R.; Sanchez, Allen M. ...
Foot & Ankle Specialist,
06/2014, Letnik:
7, Številka:
3
Book Review, Journal Article
Recenzirano
The tarsal navicular is a bone within the midfoot that plays a critical role in maintaining the arch of the foot. This bone is clinically relevant because it may be affected by a wide array of ...pathologies. Our approach includes a detailed description of the imaging characteristics and disorders affecting the tarsal navicular. Organization includes (a) normal imaging, (b) accessory ossicles, (c) coalition, (d) fractures, (e) Kohler’s disease, (f) osteonecrosis, (g) osteochondral lesions, (h) arthropathies, and (i) tumors. The purpose of this article is to discuss normal variants and pathological processes that can affect the tarsal navicular, with emphasis on the often-overlooked imaging findings.
•Penetrating trauma covers gunshot wounds and stab and puncture wounds.•Firearm related injuries make up the bulk of the mortality in penetrating trauma.•Nonoperative management acceptable in select ...patients.•CT is accurate in predicting the need for laparotomy in penetrating abdominal trauma.•Specific CT findings can indicate need for laparotomy or endovascular therapy.
Penetrating abdominal trauma comprises a wide variety of injuries that will manifest themselves at imaging depending on the distinct mechanism of injury. The use of computed tomography (CT) for hemodynamically stable victims of penetrating torso trauma continues to increase in clinical practice allowing more patients to undergo initial selective non-surgical management. High diagnostic accuracy in this setting helps patients avoid unnecessary surgical intervention and ultimately reduce morbidity, mortality and associated medical costs. This review will present the evidence and the controversies surrounding the imaging of patients with penetrating abdominopelvic injuries. Available protocols, current MDCT technique controversies, organ-specific injuries, and key MDCT findings requiring intervention in patients with penetrating abdominal and pelvic trauma are presented. In the hemodynamically stable patient, the radiologist will play a key role in the triage of these patients to operative or nonoperative management.
ABSTRACTAcute intracranial infections of the central nervous system and skull base are uncommon but time sensitive diagnoses that may present to the emergency department. As symptoms are frequently ...nonspecific or lack typical features of an infectious process, a high index of suspicion is required to confidently make the diagnosis, and imaging may not only serve as the first clue to an intracranial infection, but is often necessary to completely characterize the disease process and exclude any confounding conditions. Although computed tomography is typically the initial imaging modality for many of these patients, magnetic resonance imaging offers greater sensitivity and specificity in diagnosing intracranial infections, characterizing the full extent of infection, and identifying potential complications. The aim of this article is to serve as a review of the typical and most important imaging manifestations of these infections that can be encountered in the emergent setting.
ABSTRACTOver the last 2 decades, the proliferation of magnetic resonance imaging (MRI) availability and continuous improvements in acquisition speeds have led to significantly increased MRI ...utilization across the health care system, and MRI studies are increasingly ordered in the emergent setting. Depending on the clinical presentation, MRI can yield vital diagnostic information not detectable with other imaging modalities. The aim of this text is to report on the up-to-date indications for MRI of the spine in the ED, and review the various MRI appearances of commonly encountered acute spine pathology, including traumatic injuries, acute non traumatic myelopathy, infection, neoplasia, degenerative disc disease, and postoperative complications. Imaging review will focus on the aspects of the disease process that are not readily resolved with other modalities.
This study was designed to capture the essence of what it is like for a mother raising a child with Autism Spectrum Disorder. The research question explored was: What has the mother experienced ...emotionally while raising her ASD child, and what growth has she gained and shared via blog entries from those experiences? Narrative Psychology was the theoretical framework and the concept of the collective narrative was utilized to explore the relationships mothers of children with ASD experience as shared via blog entries. Eight mothers of children on the spectrum who blog their journey were chosen as subjects for this project. Bloggers were chosen based off the public availability of their material and the lack of commercial advertisements to eliminate monetary motivation. All blog entries were coded for themes addressing stress-related growth and resilience. The most prolific and meaningful codes to emerge in terms of growth and resilience were advocacy, gratitude, and a strong mother-child relationship. These themes were present for all mothers and appeared to drive their resilient qualities. Recommendations for future studies are: a similar narrative from fathers who blog and their experience, a follow up with these mothers to see how things evolved for their families over time, and possibly a narrative from those individuals with autism who can share their experience to provide a total perspective on this subject.
The Colorado Springs Fire Department's Community and Public Health Division (CPH) is home to the Community Assistance Referral and Education Services (CARES) program, which works primarily with ...superutilizers of the emergency medical system and provides a thorough intake process and integrated intensive navigation for qualifying patients in Colorado Springs and El Paso County. The program lies like an IT "blanket" over the top of existing individual systems and allows each entity to hook into the process in an inexpensive manner, not requiring anyone to replace or modify their existing IT system. Since 2017 we have been able to tailor several of our system's features to the specific needs of our program. According to the CDC's A Comprehensive Technical Package for the Prevention of Youth Violence And Associated Risk Behaviors, "Dealing proactively and sustaining an effort with difficult issues typically involves multiple strategies and approaches and cannot be accomplished by the public health sector alone. Other vital sectors include education, healthcare (mental, behavioral, medical), justice, government (local, state, and federal), social services, business, housing, media, and organizations that comprise the civil society sector, such as faith-based organizations, youthserving organizations, foundations, and other nongovernmental organizations.
Massachusetts Institute of Technology, Dept. of Civil Engineering. Thesis. 1972. M.S.
MICROFICHE COPY ALSO AVAILABLE IN BARKER ENGINEERING LIBRARY.
Bibliography: leaves 230-235.
M.S.
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