RESUMEN
The Care Quality Commission recently acknowledged the use of mechanical restraint/s as an intervention for the management of self-harm. I implemented the use of mechanical restraint for a female patient in life-threatening circumstances. This involved an exploration of the defining characteristics as well as the history and ethics of mechanical restraint. Informed consent and examining the legal, ethical and organizational frameworks supporting the use of this intervention in the clinical setting were critical to implementation. Ultimately the outcome not only proved to be life saving, but also a 'catalyst for change'.
Asunto(s)
Trastornos Mentales/terapia , Restricción Física , Femenino , Humanos , Planificación de Atención al Paciente , Restricción Física/ética , Restricción Física/legislación & jurisprudencia , Restricción Física/métodos , Restricción Física/psicología , Restricción Física/estadística & datos numéricos , Conducta Autodestructiva/prevención & controlRESUMEN
To aid in diagnostic chest film interpretation of coal workers' pneumoconiosis, a composite profile of common radiologic patterns was developed in 98 Appalachian former coal miners who were diagnosed as having coal miner's pneumoconiosis and who applied for black lung benefits. The mean age was 61 years, with a lifetime coal mine dust exposure of 18.7 years. Results showed that chest radiographs of coal workers' simple pneumoconiosis contained small irregular linear opacities more frequently (47%) than small rounded opacities. Sparse profusion of all small opacities was the rule. Small opacities involved two out of six lung zones simultaneously 39% of the time while other combinations occurred less frequently. Lower zones were involved more frequently than upper ones. Thickened pleura occurred in 18% of radiographs. Other frequent radiographic abnormalities were parenchymal calcifications (19%), marked emphysema (12%), and inactive tuberculosis (12%). Calcification of the aortic knob, a degenerative process reflecting age, occurred in 9%. Only one instance of complicated coal workers' pneumoconiosis (progressive massive fibrosis) was encountered (0.7%). Many of the descriptive features of coal workers' pneumoconiosis noted in the literature were not observed in this study. Only one instance of complicated pneumoconiosis was encountered.
Asunto(s)
Minas de Carbón , Pulmón/diagnóstico por imagen , Neumoconiosis/diagnóstico por imagen , Región de los Apalaches , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Estudios RetrospectivosRESUMEN
Eight of ten cigarette smokers successful in a smoking cessation group therapy program were examined, initially, and at six and 12 months postcessation. Examination included completion of a respiratory questionnaire and selective pulmonary function testing that included maximum expiratory flow volume curves, slope of phase 3 alveolar plateau, and closing volume. Two symptomatic subjects became symptom-free within six months postcessation. Results indicate a mean weight gain of 4.1 kg within 12 months (P less than 0.01), deterioration in mean forced expiratory volume in one second as percent of forced vital capacity (P less than 0.05), and deterioration in mean forced expiratory volume in three seconds as percent of forced vital capacity postcessation (P less than 0.05). Other tests derived from the maximum expiratory flow-volume curve, slope of phase 3, or closing volume showed no change. These results may be explained by a number of factors and may have implications for future studies.