Malleolar Zone Algorithm | Ankle Fracture


In this video we are going to present
the Malleolar Zone Algorithm used to exclude fractures of the malleolar zone in children with acute ankle injuries Get our very own assessment E-book and mobile app, links are in the video description! Hi welcome back to Physiotutors! The Malleolar Zone Algorithm was developed by Dayan et al. (2004) Their goal was todevelop a maximally sensitive clinical prediction rule to identify fractures after ankle injuries in children younger
than 18 years of age This includes fractures of the tibia, fibula or talus. They argued the importance of such a new CPR as validation studies of the Ottawa
ankle rules in a population of children resulted in conflicting results. A recent
systematic review by Bareldts et al. (2017) pooled the results of three studies
investigating the Malleolar Zone Algorithm and reports a positive
likelihood ratio of 1.24 and negative likelihood ratio of 0.23 and in
our opinion it has a moderate clinical value ((to exclude fractures in children) The Malleolar Zone Algorithm goes
as follows and aims to identify significant or high-risk fractures in
children younger than 18 years of age after acute twisting ankle injury:
1. you will check for tenderness at any area of the lateral or medial malleolus.
In case the first step is negative assess whether the fibula is tender just
proximal to the malleolus. If that is the case there’s a high risk for fracture. If
you found tenderness of the malleolus during the first step, check if the child
is able to walk four steps. If the child is unable to do so, there’s a higher risk
for fracture. Is the child able to walk four steps, but there’s swelling over the
lateral or medial malleolus, then there’s – again – a high risk for fracture, which
would warrant radiographic investigation. Alright, thanks for watching! The authors
have also developed a CPR for the mid-foot so go check out this video next
by clicking or tapping on the left! Make sure to hit the “like” button before you leave and check the links in the video description for info on our ebook as
well as our app and links to our other social media accounts where we post on a daily basis! As always this was Andreas for Physiotutors, I’ll see you next time –
bye!

Chronic Multisymptom Illness – VA/DoD Clinical Practice Guideline


♪ compelling music As a military Service Member,
a family member or as a Veteran who
proudly served you are aware of the potential
hazards of military service but what should you do if you
are experiencing health issues that are difficult to diagnose,
or medically unexplained? How can you and your
Healthcare Team work together to manage symptoms
that are consistent with Chronic Multisymptom Illness
or CMI? CMI is an important health concern for service members and Veterans It is also a critical healthcare issue for the Veterans Health Administration and the Department of Defense I’m an internist and I specialized in post-deployment healthcare. I’m also a primary care provider so I’ve spent 16 years working in the VA, helping Veterans with deployment-related health concerns. Chronic Multisymptom Illness
is one of those concerns. I think the most important thing for providers to know about CMI is, what it is, and how to
recognize it. To assist healthcare teams in delivering the best patient
centered care focused on improving health outcomes for individuals with CMI DoD and VA experts have worked together to develop a clinical practice guideline I am a doctor at
Walter Reed National Military Medical Center I trained in both internal medicine
and psychiatry. military providers need to be aware of the clinical practice guidelines for chronic multisymptom illness
in order to provide care for active duty service members,
family members, and retirees. The CPG can help us do that. Chronic multisymptom illness is a term used by the medical community for chronic medically
unexplained symptoms. While it can exist in civilian populations, for Veterans and service members CMI includes military-specific, medically unexplained illnesses, such as Gulf War Illness,
Gulf War Syndrome, or other post-deployment
syndromes including chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome. Symptoms vary but can include
combinations of excessive tiredness headaches, concentration
or attention problems changes in mood,
muscle or joint pain cough, sore throat, ear
or nasal symptoms or stomach and digestive problems If you, as a service member or Veteran, have multiple symptoms
like these lasting longer than six months ask your healthcare provider
about an evaluation for CMI and work closely with
your Healthcare Team on the best way to
manage your symptoms. The clinical practice guideline is a great
resource for providers because it, first of all,
defines what CMI is. It talks about what some
of the risk factors are for chronic multisymptom illness, and then, really importantly,
it talks about the general management strategies as well as some very
specific treatment options that may work for
your patient A toolkit has been
developed to give Veterans, service members and
their healthcare providers access to The CMI
clinical practice guideline and other useful resources. Visit the US Army Medical Department Office of Quality Management
website and the VA/DoD clinical practice
guidelines website for more information on
obtaining toolkit items. The CMI toolkit includes a summary of the CMI
clinical practice guideline a CMI pocket card, for
healthcare providers and frequently asked questions for patients and family members. The clinical practice
guidelines includes the basics and framework
of providing the recommendations
of care for patients experiencing
chronic multisymptom illness. The full CPG can
be found at this website Here, healthcare providers will find valuable CMI managemet strategies including A collaborative,
team-based approach The use of shared-decision
making principles to develop a comprehensive and
personalilzed treatment plan and critical domains where
enhanced knowledge may be beneficial when caring for patients with CMI. Using the tools and strategies
in the CMI Clinical Practice Guideline can improve health outcomes
and help providers to Optimize the use of
available therapies to reduce the symptoms of CMI and enhance
quality of life Minimize preventable complications and emphasize the use of personalized, proactive, patient-driven care By taking the time to
learn more about these tools we can accomplish the mission of improved care and quality of life ♪ uplifting music

First Aid & CPR Basics : Current CPR Guidelines

First Aid & CPR Basics : Current CPR Guidelines


Hello, I’m Michelle Boyer of the AD HOC
Group of North Colorado. I’m going to be demonstrating the steps of CPR for adults,
children and infants. We’re going to be using the most current guidelines. Before
I begin, and to help keep this simple, think of these steps as part of three basic groups
of things to do. The first is to assess for a response and call for help, the second is
to assess for breathing and give rescue breaths if they’re needed, and the third is to start
CPR, the compressions and continue until help arrives. The first step is to check for a
response, if there’s no response and the victim is an adult, go call for help before
continuing. If the victim is a child or an infant, you’ll do two minutes of CPR and
then you’ll go call for help. If someone else is around, have them go call for help
right away, whether it’s an adult, infant or a child. Be sure to tell them to come back,
you’ll want to know whether or not they reached someone, how long its going to be
before help arrives, and you may need their help later on. Stay with the victim so that
you can do CPR if it’s needed, when checking for a response, be sure to speak loudly, people
can often hear long after they’ve seen to have lost consciousness, your voice may be
the one thing that keeps them connected to you. Also, don’t tell the victim that you’re
trying to help them, tell them that you are helping them. If there’s no response, but
the person is breathing adequately, that would be a breath every five to six seconds, then
the person is going to have a heart beat. If you get no breathing response, the heart
will stop if it hasn’t already, so begin breathing and compressions. Watch while I
demonstrate how to check for a response and how to get help. “Are you okay?” “Are
you okay?” “Go call for help please and come right back.” Okay now if you want to
practice along, go get a teddy bear or a pillow and you can practice along using that while
we do the next clips.

CPR for Infants (Newborn to 1 Year)

CPR for Infants (Newborn to 1 Year)


If you arrive on the scene: Check the scene
for safety. Check the infant for consciousness. Gently
tap the shoulder or flick the bottom of the heel and shout. No Response: Call 911 immediately. If the infant is lying on their stomach, turn
them over onto their back. They should be lying on a hard flat surface. Check for Breathing and signs of life:
Watch their chest for any normal movement. Look for signs of life and breathing for no
more than 10 seconds. No Breathing or signs of life. Begin CPR:
a. Position 2 or 3 fingers on the center of the infant’s breastbone, just below the nipple
line. b. Compress the chest 1½ inches in depth
30 times. c. After giving compressions, give breathes.
Tilt the infant’s head back, slightly, using one hand on the forehead and lifting up on
the infant’s chin with two fingers of your other hand. Cover both the infant’s nose and
mouth with your mouth and give 2 small slow breaths, watching for the infants chest to
rise. d. Continue with 30 compressions/2 breathes,
30 compressions/2 breaths, etc. Continue CPR until another rescuer takes over,
you see signs of life or help arrives.

CESSONS D’AIDER L’AFRIQUE !

CESSONS D’AIDER L’AFRIQUE !


Has the fact that Africa is often described as the developing continent ever stood out to you? Or, more transparently, the “poor continent” Why ? Why are we trying to nurture this negative image of Africa? Based on human development criteria, poverty can be seen on both sides of the fence. Besides, how can we roughly generalize the poverty of Africa, when each country of this continent has different policies, industrialization and raw materials? When we say development, it will supposedly be at the level of economic, political, scientific and cultural conditions Though there are, undeniably, improvements pertinent to all African states but, But why does Africa need to compare itself to Western standard in order to define itself as a developed continent? Doesn’t Africa have the right to be different while also being called a “developed continent”? In parallel, if Africa is struggling to develop itself nowadays, it is because of five factors : its colonial heritage the slave trade the influence of corrupt African elite religion and the external human intervention One of the principal issues is African government officials exploiting national natural resources for personal gain. These governments are capable of self-financing and therefore have the capacity to run their own government affairs without needing to depend directly on national taxation As a consequence they do not consider what is best for their people Then, they do their business “legally” with the West And this is shameful for the Western countries to play blind out to further their own interest However, looking from a post-colonial perspective English-speaking African nations are generally more advanced and stable nowadays because there is a difference in the way English-speaking and French-speaking colonial states exploited African people The first ones employed more long-term thinking towards investment, development and maintenance. On the other hand, French-speaking African countries have generally been exploited for their raw natural resources with little attention paid towards future growth and sustainability. If you remember, the Truman Doctrine (implemented by the USA) aimed to encourage and provide humanitarian assistance to populations in crisis. The only condition was to resist the communist regime at the time This episode created for the first time in history a feeling of international solidarity However, the less savoury aspect of that was that this aid was accompanied by by economic and political interests.. In most East African countries almost all cars are Toyota. The reason being that they were generously donated by the Japanese Government And this was not out of kindness but a shrewd business decision in order to familiarise the populace with their cars and prevent competition. More recently, however, Chinese investment in the African region has been more measured in its interest. Hospitals, infrastructure, and public services have all been financed by Beijing One should be mindful that these are also not charitable gestures but are a deliberate move to ensure preference for Chinese investors long-term and to cater for the needs of their own citizens while working remotely Additionally, a universal condition of Chinese investment is the accepting of binding debt packages in order to cement deeper dependence on Chinese involvement Even so, these actions are providing tangible assets which will benefit some of the globe’s most neglected populace and allow them to accelerate domestic social and economic development Moreover, not to mention charity and humanitarian aid, all of which have the same goal : To relieve human suffering So why is it that, instead of uniting it seems more like it is a competitive sector? Western people, of all ethnicities, must stop helping Africa, because : This will perpetuate a dominant-dominated relationship. Then the more that African governments are dependent on external financial support the less they will be accountable to their own populations and in the event of a dispute merely the people will continue to be persecuted by the authorities thanks to donations diverted to finance the Police Making donations will also serve to maintain corruption to nurture favors for a group in exchange of their support for politics and for the PERSONAL fortune of leaders because there is no clear distinction between the budget of the state and of the staff Consider, if you will, that more than one hundred thousand billion dollars of aid has been sent to Africa We must ask, therefore, for what reasons have situations not changed significantly so far? This situation also discourages investments due to the instability Therefore, companies will prefer to go elsewhere and this will continue to maintain an economic poverty within the continent Stop even donating clothes Mali is one of the largest cotton producers in the world but there is no textile production company over there because of the clothing donations from the West If you really want to help a specific African area involve yourself personally and your own money directly to those you want to help. Transfer your knowledge or skills directly in the field. However, in reality Africa does not need the World’s charity Africa only needs to be afforded practical autonomy Present policies are so destructive that future generations are endangered by well-meaning but misguided assistance. Donations of cash in an attempt to “throw money at the problem” simply serves to worsen the ecological and social balance, inequality and also the renewal of resources In order to truly benefit Africa, we must start by addressing it on equal footing with the rest of the world. The use of language is so important for equity Calling african people (im)migrants when they reach european countries while Western citizens are classified as « expatriates » is not normal ! One of the most valuable ways in which you as an individual can help is by transforming the way you think and thereby help to shape the wider discourse.

ANDRÉ GOMES READS FAN MAIL | MIDFIELDER OPENS LETTERS OF SUPPORT FOLLOWING INJURY


Hey guys. Well… I received a lot of letters and emails
and I would like to thank you all for your kind support. For real, it means a lot to me and it will
make this easier, so thank you very much to all of you. I have one here from Oliver. It says, ‘Dear
André, I hope you get well soon. I can’t wait for you to get back on Goodison Park
and score lots of goals’. Honestly, it’s like a young kid and it means
a lot – especially from a young lad and an Evertonian. From Regan: ‘I’m a Liverpool fan, but I hope
you get better soon’. Thanks a lot. We know how hard it is for a
football fan, especially from another team. It doesn’t matter the colour, so thank you
very much, Regan for your support. I have a few emails as well here… ‘Hi André. I was watching the game against
Spurs at home and I was so disappointed to see you injured that I kicked my table and
broke my toe.’ ‘Best wishes from Ben’. Wow, this is a weird one! Honestly, I feel
bad for you, Ben. I didn’t want that to happen to you. I hope you get well soon. I would
wish that nothing like this would happen to both of us, but thank you very much for your
message and your support. I’m giving best wishes to you as well. A new one… Sharon Richards. It says: ‘You will always have a special place
in our home after treating our Sam to a coat at Everton One last year. You are a brilliant
football player, but what a nice fellow too’. Erm… thank you! Thank you very much. I remember when this happened with Sam. As
I said to all of you before, thank you for your support. A big ‘hi’ to Sam as well. It’s
nice to receive this email from you and thank you – thank you once again. I have a lot of letters here. I will try to
take my time at home with everything. Honestly, guys… It’s almost impossible to put into words.
I feel sensitive and emotional because of what you have done for me. I just need to
thank you all. It’s emotion. I will be back back stronger, for sure. I want to help the team reach the goals we
set at the beginning of the season and once again, thank you. Thank you for everything.

Spare Change | Episode 14: Rock Reggae & Relief | Pressure Passafire G.Love

Spare Change | Episode 14: Rock Reggae & Relief | Pressure Passafire G.Love


Pittsburgh! We’re back! Partnering today with rock reggae and relief. a festival downtown that’s raising funds for the Puerto Rico Relief Fund and homelessness community in Pittsburgh. Just wanted to bring people back and say hey Forbes is back alive. We wanted to take it to the next level this year with much more impact in the neighborhood. We are raising some funds with Spare Change Let me see that bucket. We are raising funds for a great cause. So music has a way of transcending all generations, all cultures, and bringing people together for a great day of music fun and festivities. Whats up y’all, were Passafire. They are Spare Change. Woo! (Crispy Tunes LIVE) Yo, whats going on? I’m G Love. You’re listening to Spare Change Sessions (Crispier Tunes) So, we’ve got Spare Change TV They are giving attention to the cause. Raise some relief for our brothers and sisters (More Crispy Tunes)

Medical Marijuana A Relief For Some Seeking To Manage Pain

Medical Marijuana A Relief For Some Seeking To Manage Pain


THE NEWSROOM, MIKE PARKER, CBS 2 NEWS. AND MAKING NEWS. IT HAS BEEN A HISTORIC DAY IN ILLINOIS. LOOK AT THE LINE OF PEOPLE WAITING TO BE THE FIRST TO BUY MEDICAL MARIJUANA. FOUR DISPENSARIES OPENED FOR PATIENTS COPING WITH EVERYTHING FROM CANCER TO MULTIPLE SCLEROSIS. CBS 2 HAS ONE MAN’S STORY. MIKE MCCONNEL IS BREAKING OPEN SOMETHING LEGAL. I BOUGHT GRAMS OF SUFFICIENT BECAUSE YOU CAN TASTE IT. FIGURE OUT WHICH ONE YOU LIKE. Reporter: THE 68-YEAR-OLD IS DIAGNOSED WITH STAGE FOUR ESOPHOGEAL CANCER. IT’S WAY DIFFERENT. THE BUDS. THIS IS ALL FLOWER. THERE’S NO SEEDS. NO STEMS. Reporter: TODAY WITH PRESCRIPTION, HE BOUGHT FIVE GRAMS OF MEDICAL MARIJUANA FOR $135. IN HIS SUBURBAN KITCHEN, HE LIGHTS UP AND GETS SOME RELIEF. THIS IS A LIGHT HIGH FOR ME. IT’S LIKE I FEEL A BUZZ IN THE HEAD, BUT I’M NOT HUFFING AND PUFFING. Reporter: A FEW MINUTES EARLIER, WE TALKED WITH MCCONNEL. I DIDN’T TOUCH MARIJUANA FOR 26 YEARS. Reporter: ABOUT THE DIFFERENCE THE DRUG MAKES IN HIS LIFE. I USE THE POT FOR PAIN, ANXIETY, APPETITE, AND SLEEP. SOP THOSE THINGS. AND OF COURSE, I GET HIGH. AND, YOU KNOW, WITH WHAT I’VE GOT GOING ON RIGHT NOW IN MY LIFE, BEING HIGH IS A GOOD THING. IT BEATS BEING DEPRESSED. WHAT DOES IT FEEL LIKE NOT HAVING TO GO THROUGH A FRIEND OF A FRIEND OF A FRIEND? OH, BOY. WHAT A BLESSING THAT IS. YOU COULD GET IT ON THE STREET, BUT FOR PEOPLE MY AGE, YOU DON’T HAVE THAT MANY CONNECTIONS ON THE STREET. I LIKE THIS. IT’S GOOD. AND I HAVE FOUR MORE TO TRY. Reporter: NOW, MCCONNEL IS ONE OF 300 PATIENTS IN THE STATE WHO HAVE BEEN APPROVED FOR USE. DIFFERENT PRODUCTS TODAY HAVE NAMES LIKE GRAPE GOD OR BRUCE BANNER WHICH WE ARE TOLD HAS SOMETHING TO DO WITH THEIR AROMA AND POTENCY. MOST OF THE DISPENSARIES WERE SELLING FLOWERS TODAY AND LATER WILL SELL EDIBLES LIKE CHOCOLATES OR GUMMIES. MCCONNEL TOLD ME HE FELT RELIEF BEING ABLE TO DRIVE IN HIS CAR WITH THE CANNIBUS HE HAD PURCHASED AND DIDN’T WORRY ABOUT BEING STOPPED. HE HAS A CARD THAT ALLOWS HIM TO LEGALLY HAPPEN. THAT WAS A RELIEF FOR SOMEONE SUFFERING FROM WHAT IS TERMINAL CANCER A YEAR AGO. HE’S ONLY BEEN GIVEN A YEAR TO LIVE. THERE ARE SO MANY STORIES OF PEOPLE WHO ARE ON DOZENS OF PILLS A DAY WHO ARE HOPING TO GET OFF A LOT OF THEM. THIS MAY BE THEIR ONLY HOPE. HE TAKES 13. HE’S HOPING HE CAN AVOID THREE OR FOUR. ANXIETY RELIEF IN DIFFERENT WAYS HERE. SMOKING IT AND ALSO THE RELIEF OF NOT HAVING TO GET CAUGHT BY BEING PULLED OVER.

Liverpool provide Joe Gomez injury update on leg fracture

Liverpool provide Joe Gomez injury update on leg fracture


 Liverpool defender Joe Gomez will undergo an operation on his leg fracture today   Gomez hasn’t played since picking up the injury against Burnley at the start of December  He was initially tipped to be back within six weeks but the Reds are now not putting a time limit on his return  There are no fears he will miss the rest of the season, though.   Liverpool boss Jurgen Klopp has ruled the defender out of the first leg of the Reds’ Champions League last-16 clash with Bayern Munich later this month   But he is likely to miss both legs as well as key Premier League games against Manchester United and Everton Read More Liverpool handed major Champions League boost ahead of Bayern Munich clash    Klopp said: “It’s a blow for the boy and for us – because prior to the injury he was in such fantastic shape  “But he is too valuable to take any risk with, both for our present and future, so we get this procedure done and he comes back when he’s ready  “His attitude during this rehab has been outstanding but it just hasn’t healed as we’d have liked so we will make this intervention and then he will come back ” Read More Liverpool predicted line-up vs West Ham as Jurgen Klopp considers changes    The defender added: “Obviously being out for longer than we’d first hoped for is hard to swallow but it’s part and parcel of the industry  “It was an injury caused by an impact, like nearly all the injuries I’ve had in my career, so I know it’s just a case of when it’s fully healed I’m good to go again  “The hardest part is not being able to help the team and contribute on the pitch at the moment, so it’s important I come back ready to go and this procedure will help with that  “My only focus is getting back for Liverpool as soon as possible and I can promise the supporters I’ll be working hard every day to do that ” Read More Mirror Football’s Top Stories