Difficulties associated with access to training and clinical support for Reporting Radiographers – A narrative evidence synthesis

ObjectivesThis narrative synthesis of evidence identifies and explores issues that impact upon the expansion or effectiveness of Reporting Radiographers working in all diagnostic modalities within the United Kingdom (UK). The publication focuses on accessibility to training for prospective Reporting Radiographers as well as clinical support within and beyond training.Key findingsFifteen studies informed the themes of this article, they were published between 2014 and 2021. Reporting Radiographers often found it difficult find support during training and once qualified, this was usually due to the availability and workload of supervising staff. Although resistance and obstruction were experienced by many. Concerns relating to pay, promotion and interest were expressed by some respondents whilst access to courses and finance were highlighted as areas of variance across the UK.ConclusionInadequate support of Reporting Radiographers is impairing expansion of the specialism, whilst impacting capability and morale. This increases risk of patient harm, delays to care and inefficiency, it also threatens the sustainability of services. Negative interactions between Reporting Radiographers and Radiologists or managers is disappointing considering development of the specialism; evidence of Reporting Radiographer effectiveness and current collaboration between Royal College of Radiologists and Society of Radiographers. Issues raised in relation to pay/promotion and litigation could be clarified with ease, this should be considered when guidance is updated. Access to finance and courses is a major barrier in some regions of the UK. Scope exists for further exploration of training. England has used grants to facilitate uptake, these may prove to be an important tool in other countries.Implications for practiceDrivers to increase recruitment should be implemented alongside measures to facilitate accessibility to training and improvements to support infrastructure.     

足头向穿刺路径在膈肌下方肝肿瘤消融治疗中的CT模拟测量研究

【摘要】 目的 对足头向穿刺路径进行模拟测量并评价在膈肌下方肝肿瘤热消融治疗中的临床应用价值。方法 重建患者上腹部CT图像，选取有代表性的3个矢状面和1个冠状面作为标准层面，在各层面建立膈下标准病灶模型，并采用足头向穿刺路径进行模拟穿刺。测量各平面上膈肌高度、穿刺路径长度及间距。采用可到达性评价模拟穿刺时穿刺针分布于标准病灶中的最理想的位置情况。结果 纳入86例患者行测量研究，多数患者矢状2、3面的膈肌高度低于2cm，仅分别对平面内1511%的病灶e和813%的病灶f进行了测量。标准病灶a、b、c、d、b’的完全到达比例分别为5243%、6097%、3837%、5294%、6353%，中位路径长度分别为1039cm、1337cm（背侧，腹侧1266cm）、1315cm、888cm、1126cm，中位穿刺路径间距分别为21cm、209cm（背侧，214cm腹侧）、206cm、211cm、2145cm。结论 采用足头向穿刺路径进行穿刺，标准病灶a、b、d、b’有较高的完全到达比例，穿刺宽容度较高，有进一步在临床中应用的价值。标准病灶c的完全到达率不高。标准病灶e、f需要采用该路径穿刺的比例不高。     

Barriers and interventions for postpartum reclassification of glycemic status in women with gestational diabetes mellitus: A scoping review

Background and aimsOur aim was to summarize, analyze and disseminate the current state of knowledge about the barriers and facilitators in postpartum reclassification that women who have had gestational diabetes face.MethodsData collection was carried out from January to March 2021 in PubMed, Scopus, Web of Science (WoS), Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.ResultsOf the 361 studies initially retrieved in the search, 32 articles published between 2010 and 2020 were selected because they were within our objective.ConclusionMultiple barriers and interventions were found regarding the reclassification of the glycemic status of women who had Gestational Diabetes during pregnancy. Therefore, further studies are needed to achieve a better intervention for this condition.     

Accessibilité, politiques inclusives et droit à l’éducation : considérations conceptuelles et méthodologiques

The right to education promoted by the United Nations’ Convention on the Rights of Disabled Persons aims at fighting against discriminations persons with disabilities face in this matter. Identifying existing discriminations require however reliable data allowing for analyzing education systems’ ability to provide Special Educational Needs students with equal opportunities in terms of access, success, prospects and affiliation. This article describes the conceptual framework developed to identify indicators required to monitor the implementation of right to education in the European Union building upon an OECD research made on the transition to higher education and to employment of SEN students.     

Principles of effective communication with patients who have intellectual disability among primary care physicians

ObjectiveExamine physicians’ implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors.MethodsFocus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID.ResultsSubjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect.ConclusionGreater familiarity may enhance care for these patients.Practice implicationsIncrease exposure to patients with ID within training.