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By A. Lukjan. Wayne State College. 2018.

Give the name of the location where the client was seen cheap zenegra 100 mg on-line, for example on a home visit purchase 100 mg zenegra visa, as an out-patient or in the community clinic generic zenegra 100 mg line. A complete health record will provide the reader with all the information required to reach the same conclusions as the health professional who wrote the notes. The type and amount of information noted would be determined by the clinical need of the client, and the context in which the client is seen. For example, documenting an acute episode would vary from the on-going documentation required in a long-stay care facility. The position of the client along the care pathway will also have a bear­ ing on deciding the content of notes. The main stages in the health care process are: ° referral ° initial assessment ° intervention (including on-going evaluation) ° discharge ° post-discharge. The following sections offer guidance on the type of information to record at each stage of the care pathway. However, each clinician is reminded to refer to the standards and practices set down by his or her employing or­ ganisation and his or her professional body. Setting up a personal health record A personal health record is set up for the client either when a referral is re­ ceived by the service or at the first contact with the client. The Audit Com­ mission (1995), in a study of hospital records, found that there was no common approach to how these records were organised. They suggested that notes have a clear structure that is agreed with the users – that is, the health professionals and the administrative staff. This will help users in identifying the current epi­ sode and the most recent entry. Arranging data into specific sections like assessments, treatment and so on may also help the reader to quickly locate the relevant information. Every clinician has a responsibility to check, update and maintain the client records they are using. Identification details Each health record must contain the personal details that will enable the identification of the client to whom the information pertains. This will usually include the client’s: ° names (at least the first and the last name) ° title (Mr/Miss/Mrs/Dr) ° form of address preferred by the client (for example, first name or title with last name) ° address ° telephone number ° date of birth ° identification number (for example NHS number, social security number, number issued by health provider). Other relevant information would include: ° the name and address of the next of kin/carer/guardian ° preferred form of address for the next of kin/carer/guardian ° name and address of the client’s general practitioner ° details of other professionals in regular contact with the client. Referral stage One of the key pieces of information to note in the health record is the rea­ son why the client is being seen by your service. It is often the case that cli­ ents are referred by another health professional or an associated agency such as social services. In some cases there may be no referring agent, for instance clients who self-refer, or emergency admissions to accident and RECORD KEEPING 47 emergency. You will therefore need to record the circumstances or inci­ dent that has prompted the client’s attendance. Part of the record at this point in the process will include the client’s account of the reason for his or her contact with your service. In some cases it may be appropriate to also make a note about the attitude of the client or the family towards the referral. For example, parents may disagree that an appointment with the clinical psychologist is necessary, but still attend the appointment at the behest of the child’s school. A complete record at the referral stage in the care process will show: ° the name and position of the referrer ° the date of the referral ° the reason for the referral. Key documents to be kept on file: q referral letters/admission forms q reports accompanying referral. Initial assessment Assessment is a process that will involve gathering information through in­ terview, observation, clinical investigations and objective and behavioural tests. The type of information collected will relate to the theoretical ap­ proach of the record’s user (Pagano and Ragan 1992) – so the assessment process of a medic will differ from that of a nurse, and both will differ from that of a therapist. It is essential that, whenever possible, consent is obtained from the cli­ ent before assessment is initiated. This consent must be informed and the clinician has the responsibility to make sure that the client understands the nature of any assessment procedures, their purpose and any risks. Consent, whether it is given verbally, in writing or by implication, must be recorded in the notes.

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Then you would need to ask: ‘If you wash your car order 100 mg zenegra, HOW TO CONSTRUCT QUESTIONNAIRES/ 91 how many times a year? Have a look at Exercise 2 which will help you to think about some of the issues involved in the wording and structuring of questions purchase 100 mg zenegra. EXERCISE 2 Read the following questions and decide what is wrong with them purchase zenegra 100 mg with visa. What do you think about the Green Peace attempt to blackmail the Government? What is wrong with the young people of today and what can we do about it? The problem with this question is in the categories supplied for the answer. Everybody has a different idea as to what words such as ‘sometimes’ and ‘fre- quently’ mean. Instead, give specific time frames such as ‘twice a year’ or ‘once a month’. Also, the order of answers should follow a logical sequence – in the example above, they do not. It assumes that Green Peace is blackmailing the Government and assumes that someone knows about the issues and would be able to answer. A filter question would have to be used in this case and the word ‘blackmail’ changed. The word ‘wrong’ is emotive and sug- gests there is something not normal about the young people of today. It asks the respondent to distance themselves and comment from the moral high ground. This question may contain prestige bias – would peo- ple be more likely to say they have read plenty of books when they might not have read any? Also, the categories for the answers need modification – which box would you tick for someone who answered ‘20’? This question assumes knowledge and could only be asked of someone who has the figures to hand. It also asks for what could be confidential information which a respondent might be reluctant to give. The word ‘profit’ has different meanings for different people, especially if the question is asked by an inter- viewer, rather than read by the respondent. In an of- ten quoted case, when this question was used, the respondent took it to mean ‘prophet’ and as such was unable to answer the question. In this question it is assumed that the respondent thinks something should be done about global warn- ing and that they are able to comment on the issue. This question leads the respondent into having an opinion about something on which they might not otherwise have one. LENGTH AND ORDERING OF QUESTIONS When you’re constructing a questionnaire, keep it as short as possible. If it has to be longer because of the nat- ure of your research, think about whether your respon- dents will actually take the time to fill it in. Some people will do so if they feel there is some personal benefit to be gained. This is why long consumer behaviour sur- veys offer entry into large prize draws for completed ques- tionnaires. If your budget is limited, you might be able to offer a copy of the final report or other information which may be of use to the respondent as an incentive. Include filter questions with answers such as ‘If no, go to question 28’. Psychologically it’s good for respondents to be able to jump sections as it stops people becoming frustrated by unnecessary or irrelevant questions. As with interviewing or focus groups, when designing a questionnaire start with easy questions which respondents will enjoy answering, thus encouraging them to continue filling in the questionnaire. If you begin with complex questions which need long responses, your respondents will be less likely to fill in the form. If you’re constructing a combined questionnaire, keep your open-ended ques- tions for the end as, once someone has spent time com- pleting the rest of the questionnaire, they are more likely to continue with those questions which take a little more effort to complete.

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He was on papers represents an interest in a wide variety of the Membership Committee for 8 years 100mg zenegra otc, was a orthopedic subjects generic 100 mg zenegra mastercard. His formal papers were member of the Executive Committee for at always well considered and conservative; his dis- least 35 years buy zenegra 100mg free shipping, and Editor of The Journal of cussions were pertinent, based as they were on a Orthopaedic Surgery for 20 years. His records were among the best the writer has Without doubt the most important was his tenure ever seen. His influence was manifest in his wise of the editorship, which covered the period from counsel in committees and conferences. Brackett was elected Editor of The Journal His sterling qualities were duly valued and of Orthopedic Surgery in 1921. With the issue of respected, as has been abundantly evidenced by the following January it again became a quarterly the confidence reposed in him by the Executive and the name was changed to The Journal of Bone Committee, and through them by the entire mem- and Joint Surgery. When he took over the editorship, the Journal The years immediately following the founda- had not progressed very far beyond the transac- tion of the Association, in 1887, were years tions stage of its evolution. It often happened that under this rule, their task to raise the specialty to a respected posi- papers were published that were not worthy of a tion among the other specialties. At that time journal having a nationwide circulation, and the neither the profession nor the public looked with new editor recognized this. Early in his adminis- much favor upon specialization, and in certain tration an advisory editorial staff was organized. The next step was the appointment of a group As more and more men became interested of foreign editors who kept Dr. Brackett informed in the problems of orthopedic surgeons, their about the development of the specialty in their distribution over the USA and Canada became countries, from time to time sending in reports more general; and, during the earlier years, the of meetings and papers by their colleagues. This policy was advocated by publication could be a real factor in the develop- 36 Who’s Who in Orthopedics ment of better understanding and closer coopera- His intimate acquaintance with the member- tion between nations. It was, therefore, a special ship of the Association for so many consecutive satisfaction to him when contributions began to years made it possible for him to be of the great- come from representative surgeons in different est assistance to younger men sending in papers countries, many of them men he had met person- for publication. From the to have the papers he thought worthy of publica- correspondence with these foreign contributors tion brought up to the standard he had set. Brackett became Editor, the total list be present at orthopedic congresses in France, of subscribers numbered 797. At the time of his Belgium, Italy, Germany, Czecho-Slovakia, and death, the number of paid subscriptions was over Switzerland. During the 20 years of his editorship, the that came from these contacts was his visit to budget of the Journal was increased eightfold. Leningrad in the summer of 1936, when he had The realization of some of his aspirations for the opportunity of meeting Prof. Henry Turner, the Journal has come through the broadening of with whom a warm friendship had developed the field of its usefulness, as shown by the fact through years of correspondence, and of seeing that there has been a steady increase in the the remarkable work for crippled children that number of foreign, as well as domestic, sub- had resulted from the labors of this pioneer, a man scribers. At the end of 1939 (the beginning of the of British parentage who had devoted his life to war), the Journal was being mailed regularly to the development of orthopedic surgery in Russia. Brackett had with the officials of the USSR Society for Cul- charge of the Journal, he provided office space in tural Relations with Foreign Countries, through his own house. He never received salary for his whose interest many of the contacts of the work, and at the time the Association made the Journal with Soviet publications had been made first attempt to show their appreciation of his possible. This sum was set up by over the standard of the papers presented at the the Association as the Elliott G. Brackett Endow- annual meetings, and the creation of a Board of ment Fund. Since the appointment of the a second attempt was made by the Association to latter, all papers have been submitted to this body, show their esteem, and a large number of letters and gradually the editor impressed upon them his were written to him, and a gift was made with the ideals and standards for a journal. No one not intimately associated with and to the Association, he found time to serve his him has any idea how much time and thought he community in its hospitals and in promoting gave to it. To him it was not merely a rostrum many movements to aid the physically handi- from which an author might exploit his ideas. He was identified with various Boston must present something that was new, or at least, hospitals, in his early years at the House of the if not wholly new, it must be presented in a better Good Samaritan, later as orthopedic surgeon at form than ever before. In 1911 he became chief the writers that brevity should be an accompani- of the orthopedic service at the Massachusetts ment of clarity in expression, and that it was a General Hospital and continued in that position mistake to rush into print before sufficient time until 1918, when he resigned to go into war had elapsed for a definite opinion to be formed as service.

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This was only one of many such awards School of Medicine and began his work on the that he received zenegra 100 mg. This work received the Rhinelander was a careful observer and inves- Kappa Delta Award for outstanding research in tigator discount zenegra 100 mg otc. He was meticulous in his technical prepa- orthopedic surgery discount 100 mg zenegra amex, presented by the American rations from which he drew his conclusions. The following year he was named professor of ortho- pedic surgery at the Johns Hopkins University, Baltimore, MD, a position that he filled with dis- tinction until his retirement in 1979. During his years in Baltimore, Robinson continued to do basic research in the anatomy and physiology of the bone matrix. He was a founding member of the Orthopedic Research Society, and an inspira- tion to a generation of young investigators. Robinson served the orthopedic community as an active member of numerous boards, committees, and associations, including a term as president of the American Orthopedic Association. ROBINSON 1914–1990 Alexandre Rodet was trained in Paris and became chief surgeon at the hospital of l’Antiquaille in Robert A. Robinson was born in Rochester, NY, Lyon, where he spent the better part of his career. After In 1884, a paper by Rodet on experimental infec- 288 Who’s Who in Orthopedics tious osteomyelitis was read to the Academy of Science in Paris by Bouley, one of its fellows. It is the first recorded experimental demonstration of the disease now known as hematogenous osteomyelitis. César ROUX 1857–1934 César Roux, born March 23, 1857 at Mont-la- Ville, died December 21, 1934, in Lausanne. Roux was educated in the Lausanne schools and pursued medical studies in Berne from Silvio ROLANDO 1874–1880. After 1 year of study in Vienna, Prague and Halle, he became first assistant at Köcher’s clinic and L’Hópital de L’Ile. He With the publication of his article “Fracture de la rapidly achieved a reputation of an extremely base du premier metacarpien,” Silvio Rolando skillful surgeon. In 1887, he was asked to become became the third Milanese surgeon to have a frac- the physician in charge of one of the two surgical ture named after him, a distinction he shares with services at the regional hospital in Lausanne, and Monteggia and Galeazzi. Like his colleagues, in 1890, Roux was given a title of extraordinary Rolando was a general surgeon. During a period professor and in 1893, ordinary professor of of 30 years, he published papers in Italian and surgery. Roux knew how to incite students to French medical periodicals on a wide variety of observe and think. Rolando was a member of the and scientific activities lasted almost 40 years. Roux’s name is closely linked to important progress in modern surgery, especially in the treatment of typhlitis, an affliction that Roux named more pertinently appendicitis, and opera- tive treatment of recurrent dislocation of the patella. His operative methods represent important innovations (thoracoplasty in pul- monary tuberculosis, esophagojejunogastrosto- mosis in esophageal stenosis, posterior gastroenterostomy in Y-manner in gastric carci- noma, etc. There is practically no surgical inter- vention that Roux has not modified technically in 289 Who’s Who in Orthopedics an original manner. A great number of new instru- Raymond was an intern at the Hôpitaux de ments and apparatuses are attributed to him. In his Paris Medical School from 1952 to 1958 and, in later years, Roux was particularly interested in the 1955, he served as an aide d’anatomie de la goiter problem. It was during his internship that he had to choose between general surgery and orthopedics. He had been influenced by Patel, Couvelaire, Hepp, and Cordier in the former field and by Lence, Merle d’Aubigné, Petit, Fevre, and Judet in the latter. Having studied under the most important person- alities of that time, Robert Judet and Gaston Cordier, Raymond chose to remain in orthopedics with Judet. In 1957, Raymond presented his thesis on pseudarthroses of the long bones, which was based on his work as a member of the anatomy department.

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