By R. Moff. Nazarene Bible College.
Peer review will help you to develop your ideas tegretol 200 mg cheap, improve the scientific integrity of your results order 400 mg tegretol visa, and produce an eminently more readable paper. The good news is that, with good writing practice, peer review should not be too painful or too depressing. If you start with a plan in mind, design the paper with a purpose, and write in short, clear sentences, you will create a product that the reviewers will find easy to read and therefore can respond to more easily in an intellectual way. This is important because intellectual contributions are far more valuable to the advancement of papers than comments on grammar and organisation. When papers are badly constructed and poorly written, reviewers tend to concentrate on trying to fix the immediate problems of presentation rather than thinking about the content and the big picture. This, in turn, prompts an endlessly frustrating review-edit-amend roundabout without any major focus on content. Naturally, it is better if a paper stays on a sensible and planned track from day one rather than being continually pushed and pulled into everyone’s different ideas of what shape it should take. Constructing a paper with well- articulated aims from square one tends to focus on content and to ensure that major structural changes are not requested at the end, just when you thought you were finished. If you can achieve this, the whole review process is shorter and more purposeful, and everyone enjoys the rewards of seeing the paper progress quickly towards a publishable document. By asking for peer review, you are in effect asking colleagues to assist you with the scholarship of your work. You should never pass a draft out for review before it is truly ready, that is before it has reached the highest standard to which you can take it. The thoughtlessness of repeatedly handing out ill-prepared documents tends to wear reviewers down. To receive the most valuable feedback, drafts must be at the highest standard that you can possibly achieve before you ask your colleagues for comment. This will ensure that everyone spends their time efficiently because the number of drafts is minimised and the quality of the feedback is maximised. By incorporating each reviewer’s improvements before you pass the document on again, the next reviewer receives the most advanced version of your work and coauthors do not have to duplicate each other’s work. Some groups of coauthors find it is very productive to hold miniwriters’ groups and brainstorm some ideas together rather than reviewing in isolation.
The apophyses of the the high proportion of shock-absorbing cartilage anterior superior iliac spine and the ischial tuberosity and the limited presence of high-energy traumata (biceps femoris order tegretol 100mg on line, semimembranosus and semitendi- in children explain the rarity of these injuries and nosus muscles; ⊡ Fig buy 100mg tegretol visa. External bruising, pain on pelvic compression, pain and Type III: Stable, single pelvic ring injuries involve, hematomas in the perineal region, leg-length discrepan- in ascending order of frequency, isolated iliosacral cies, asymmetrical contours, pain on hip movement, and joint subluxations and fractures, isolated traumatic concomitant nerve lesions of the lumbosacral plexus, rupture of the symphysis pubis, ischial fractures and sciatic, femoral and obturator nerves are signs of pelvic pubic ramus fractures. While life-threatening hemorrhages are rare, (usually the upper ramus), two contralateral or even it should nevertheless be borne in mind that a child’s two ipsilateral rami. While the latter appear relatively circulation can compensate for even major blood losses trivial on the x-ray, they are frequently complicated over a prolonged period. Even in a case of severe dis- of concomitant urogenital and abdominal injuries, which location a second fracture of the pelvic ring is not can accompany even relatively minor bone injuries, a necessarily present thanks to the intrinsic elasticity multidisciplinary approach is essential. Symphysis must be assumed in a child with polytrauma until evi- injuries do not tear the fibrocartilage, as in adults, but dence to the contrary has been found. The ala and obturator view should eral, double pubic ramus fractures or rupture of the not be x-rayed routinely in view of the additional symphysis pubis with double ipsilateral ramus frac- radiation exposure. Compared to adults, both the tures (»straddle fracture«); rupture of the symphysis symphysis and the iliosacral joint space are wider in combined with fracture/dislocation of the elements children, which can give rise to misinterpretations. Correlation with the clinical findings is pelvic fractures during the growth phase and are pri- crucial, following the principle »if all else fails, exam- marily seen in adolescents. Otherwise the standard bined with pelvic fractures, x-ray on its own can provide sufficient information – Type C: linear with hip instability,. Fracture types In types B–D the triradiate cartilage can also be af- ▬ Type I: Apophyseal avulsion fractures occur as a result fected with increasing frequency and severity. Types of sudden muscle contractions, rarely as a result of A, C and D represent concomitant lesions accompa- long-term repetitive traction. Clinical diagnosis is therefore particularly important and is based on local tenderness and swelling, usually over the lower part of the sacrum, and pain on rectal palpa- tion. Pelvic injuries without serious late sequelae: Pelvic wing fractures and isolated ilium fractures (right half of the pelvis), isolated tures depends to a large extent on the concomitant pubic ramus fractures and avulsions of the anterior inferior and supe- local and remote injuries. The bone lesions them- rior iliac spine (left half of the pelvis) selves rarely require surgical management.
The corset is not worn all day buy tegretol 400 mg visa, thereby allowing This hinders their use and serves as an obstacle to im- sufficient muscle activity for maintaining strength discount tegretol 200 mg free shipping. A better solution ly, the muscle strength has been impaired merely by virtue is a trunk orthosis that reduces the patient’s postural effort of the dynamic instability, and the patients have to make and facilitates, or even allows in the first place, balanc- the extra effort to withstand the effects of gravity. A trunk orthosis will also stop patients with thoracic, and in some cases lumbar, hyperkyphosis Braces for head control from having to sit down and hold their necks in extreme In many patients the head control is impaired as well as lordosis by way of compensation in order to look straight 4 trunk control. Other options include lengthening of the corset in manage to balance the head above a stabilized trunk, the the manner of a Milwaukee brace, a cervical collar or Glis- braces are designed to minimize the force required to hold son sling. It can be difficult, if not impossible, to even though a Glisson sling, for example, is ideal since it satisfy all the demands of the patient, parents, therapists, holds the patient’s head while allowing movement in all carers and the outside world in a single appliance. A distinction is made between an active wheel- chair, in which patients propel themselves forward by their own muscle power, and a pushed wheelchair. The electric wheelchair provides locomotion if the patient’s own muscle power is not enough. Wheelchairs are technically designed to be smooth-run- ning and can be maneuvered by patients with the mini- mum of effort. To this end, large wheels with a low rolling resistance are fitted at the back, where most of the weight is located. If the chair is used outdoors then these wheels should not be too small, otherwise they will catch on small obstacles, e. On the other hand, patients with a good sense of balance can maneuver their wheelchair themselves in almost any situation. The weight can be shifted from the front wheels to the back wheels by weight trans- fer. The wheelchair travels more easily, but is less stable to backward falls. Otherwise, the weight should not be trans- ferred too far back over the back wheels, or else brackets should be fitted at the back to prevent a fall.