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When we are no more : how digital memory is shaping our future
Examines how humanity records and passes on its culture to future generations, from the libraries of antiquity to the excess of information available in the digital age, and how ephemeral digital storage methods present a challenge for passing on current cultural memory to the future.
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125949 Diagnostic accuracy and aetiological landscape of third cranial nerve palsy in children
Third cranial nerve (CNIII) palsy in children has various aetiologies, including congenital, traumatic, and acquired. Diagnosis and management varies according to age, characteristics of presentation, and associated signs and symptoms. The aim of this audit was to review children (<16years) diagnosed or referred with CNIII palsy, assess diagnostic accuracy, and evaluate treatment strategies.A retrospective audit was conducted at Moorfields Eye Hospital NHS Foundation Trust. Magic XP tool was used to identify children (<16years) referred with suspected CNIII palsy between 01/09/2009 and 31/12/2023. Data on the aetiology, misdiagnosis, ptosis, pupillary involvement, and treatment strategies, were collected.145 cases were identified. 75/145(52%) were definitively diagnosed with CNIII palsy. Misdiagnosis occurred in 69/145(48%) cases. Common misdiagnoses included ptosis and physiological anisocoria. Among the confirmed cases, 42/75(56%) were congenital and 24/75(32%) were acquired. Trauma was the commonest acquired cause (25%). Ptosis was documented in only 51% of cases, and pupillary involvement in 29%. Treatment strategies included surgery (22), patching (9), medication (4), refractive error correction (4), Botulinum toxin (1), and cosmetic contact lenses (1).We identified significant misdiagnosis rates and inconsistencies in documentation, particularly regarding ptosis and pupillary involvement, which are both poorly documented in children. This has significant implications on diagnostic and treatment pathways. Improved consistency in documentation is crucial for early accurate diagnosis and management.This large case series highlights the difficulties in assessing children, and the audit cycle highlighted gaps in documentation. However, to improve care in paediatric CNIII palsy, there is a need to standardize diagnostic criteria and documentation practices.
Journal Article
Atranos Kalesi Burç Kalıntılarının Belgelenmesi
Bursa ilinin güneyinde dağlık bir coğrafyaya sahip olan Orhaneli ilçesi 2. yüzyılda İmparator Hadrianus tarafından Hadrianoi (ad Olympum) adıyla kurulmuştur. 1325 yılında Osmanlı Beyliği kontrolüne geçen yerleşim Atranos adıyla anılmaya devam etmiş, Doğu Roma İmparatorluğu’na ait Atranos Kalesi ise fetihten sonra yıktırılmıştır. Günümüzde bu kalenin sadece iki burcuna ait kısmi kalıntılara ve bu iki burç arasındaki bazı burç temel kalıntıları ve sur duvar kalıntısına ulaşabilmektedir. 2014 yılında 3. derece arkeolojik sit alanı ilan edilen kalede herhangi bir koruma çalışması yapılmamış veya koruma önlemi alınmamıştır. Çevre koşullarına karşı savunmasız bırakılan kule kalıntıları hızla yok olmaktadır. Bu çalışma kapsamında lazer tarayıcı ve drone yardımıyla kalıntıların rölöve çalışmaları ve belgelemeleri yapılmıştır. Yapılan belgeleme çalışmaları tarama sonucu elde edilen nokta bulutu verisi ve bu veriden elde edilen ortofotoların yanı sıra, kalıntılar üzerindeki malzeme analizleri ve hasar durumlarını da içermektedir. Gelecekteki potansiyel arkeolojik kazılar ve olası restorasyon çalışmalarının akademik ve yerel ortamda merak uyandırması, alanın ziyaretçiler için bir cazibe merkezi hâline gelerek nihayetinde yerel ekonomiye fayda sağlaması umulmaktadır.
Journal Article
Wicked, incomplete, and uncertain : user support in the wild and the role of technical communication
\"How to document technologies that may hybridize into forms that not even their designers would have anticipated, and offers insight into the evolving role of a technical writer in an age of increasing user reliance on YouTube tutorials, message boards, and other resources for guidance\"--Provided by publisher.
Book
G485 Emergency care planning – are we discussing it, are we recording it, and are we acting on it? An audit of ECP implementation in children with life limiting conditions
AimThe use of Emergency care plans (ECPs) is recommended by ‘Together for Short Lives’, (TFSL) to prevent inappropriate escalation to futile interventions in children with incurable life-limiting conditions (LLC).The aim was to assess compliance with TSFL guidelines for ECP in children on a High-Dependency Unit (HDU), at a large children’s hospital:proportion of children with completed ECPswhether care during an acute episode was consistent with ECPMethodsChildren with LLCs admitted to HDU over a 6 month period were identified. Underlying condition; reason for admission; record of discussion of end-of-life (EoL) preferences; HDU treatment; escalation to PICU.Results45 patients were evaluable. Fourteen (31.1%) patient notes recorded EoL preference. (24.4% completed ECP, 6.7% discussion alone). In two cases preferences were not followed because situation changed (1 parental wishes, 1 alternative intervention). 3/11 ECPs were physical hard copies in the notes that would be sought in an emergency, five could not be located.ConclusionsDocumentation of preference in EoL care should be accessible in 100% of patients with LLC admitted to HDU. That target was not reached. For most, there was no record of any EoL discussion. Documentation was mis-filed in many cases, potentially rendering it difficult to access at crucial points in patient care. Where ECPs were in place, they were followed unless there was a reason for deviation.We would recommend:A lower threshold for clinicians to raise the subject of ECPs in life-limited childrenA dedicated copy of any ECP to be filed at the front of the patient notesA clinical portal copy of the ECP
Journal Article
Engineering documentation control/configuration management standards manual : policies, procedures, flow diagrams, forms and form instructions for product manufacturing companies
\" Describes the best of the best management practices for the configuration management processes\" -- Provided by publisher.
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G192(P) Diversifying documentation of the evening ward round
IntroductionWith increased emphasis on consultant led care and the frequency of ward rounds, documentation is paramount. We observed that during busy periods, the progress and plan from the evening consultant led ward round was not always transcribed to medical notes.MethodWe devised an efficient, clear and practical way of documenting the patient’s progress and plan made during these consultant led rounds – whether it be a ‘board round’ or bedside review. We designed and printed a proforma onto adhesive stickers which can be completed by the ward patient board list or bedside and then transferred to the medical notes. The proforma allows for notes on progress through the day and plan.Since implementation, we have carried out an audit to evaluate whether the stickers improved:Documentation of the evening ward roundsAdherence to the medical planCommunication of the medical plan through the multi-disciplinary team (MDT)We compared five days of notes of acute medical admissions (31 notes) with a sample of notes from previous admissions (31 notes).ResultsSince the introduction of stickers, 100% of patients audited had an evening ward round entry with a plan documented. This compared to only 16% prior to the introduction. Since our intervention, we noted that the plan documented was adhered to in 94% of patients compared to 80% previously. On surveying the nursing staff, we found 80% of nurses agreed the stickers improve communication of the medical plan and 100% agreed they made it easier for the night team to follow the plan made.ConclusionBedside reviews or board based ward rounds will always generate a plan, and it is essential this plan is accessible and recorded in the correct place. The stickers allow for an efficient and rapid way for the reviews and decisions made to be recorded in the medical notes; contributing to continuity of care. The evening round stickers also improved communication through the MDT hence improving adherence to the plan. We recommend any department looking to improve documentation, consider alternative and inventive methods which can contribute to efficiency and improve patient care.
Journal Article
Observation and assessment
The debate surrounding testing and accountability in early childhood education continues, but one thing is universally agreed upon: effective observation and assessment of young children's learning are critical to supporting their development. Educators balance what they know about child development with observation and assessment approaches that both inform and improve the curriculum. This foundational resource for all educators of children from birth through third grade explores What observation and assessment are, why to use them, and how; Ways to integrate documentation, observation, and assessment into the daily routine ; Practices that are culturally and linguistically responsive ; Ways to engage families in observation and assessment processes ; How to effectively share children's learning with families, administrators, and others ; Find inspiration to intentionally develop and implement meaningful, developmentally appropriate observation and assessment practices to build responsive, joyful classrooms.
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