N Ebrahim

Patterns and Mechanisms of Injury in Non Accidental Injury in Children (NAI)

Abstract The relationship between the family practitioner and the radiographer and radiologist is of utmost importance. Radiographers are among the healthcare workers who are at the first point of care and often only communicate with a radiologist after an x-ray examination is performed. The role of the radiographer has been extended to pattern recognition of skeletal images and selected ultrasound examinations. In some countries radiographers perform and report on invasive radiological techniques. The communication among healthcare workers about the possibility of child abuse is of utmost importance in the suspicion/recognition of abuse. Non-accidental injury in children may or may not be accompanied by sexual abuse, but in any situation where telltale signs of abuse are recognised, further investigation is necessary. The aim of this article is to assist the family practitioner in recognising some of the unusual radiographic patterns seen in paediatric radiography together with mechanisms of what may have contributed to the debilitating injuries sustained by survivors of abuse.

Clinical efficacy, efficiency and outcomes

The success of change will depend upon explicit clarification at the outset and/or vision of the expected outcome(s). The success of effective change is dependent on co-operation of all stakeholders. According to Davies, ‘change from within is invariably more successful than that which is imposed or initiated from outside’. 1 The aim of this article is to clarify the meaning of clinical ‘efficacy’, ‘effectiveness’ and ‘outcomes’.

The process of becoming an EB practitioner

Reasons for change One of the main reasons for a change in practice may be due to financial constraints. Healthcare systems have undergone major transformations in the past decade. It is in this context that evidence-based health care has flourished as a means of establishing ‘the best evidence for healthcare practice’. Change occurs at different levels. In the case of health services, change occurs when they respond to the demands made upon them from the government, publ ic or employers.

Evidence-Based Practice (EBP): How to Appraise an Article?

Introduction With reference to our article entitled ‘Evidence-Based Practice (EBP): The Meaning of Evidence, the subtle difference between research-based practice and evidence-based practice was discussed. It is obvious that evidence-based practice relies on traditional research as its foundation. However, it goes one step further to close the gap between research and practice. This is achieved by critically evaluating the research done by others, drawing on own experience, taking cognisance of patients’ needs and implementing the finding in practice. The following chronological guide serves to assist the family practitioner on how to critically appraise an article.