The future interventional radiologist: clinician or hired gun?

The field of interventional radiology is currently at a crossroads. The position and role of the future interventionalist will be defined by the direction taken by the current generation of practitioners. There are four key issues that must be dealt with: (i) the dichotomous relationship between diagnostic and interventional radiology, (ii) the idea of the "hired gun" interventionalist versus that of the clinician interventionalist, (iii) the public's image of the interventional radiologist, and (iv) "turf wars" with other specialties.     

The future of physical activity behavior change research: what is needed to improve translation of research into health promotion practice?

There is a gap between physical activity intervention research and the delivery of evidence-based programs in practice. We describe individual and setting level factors important for translation that moderate the impact of interventions and often are not reported in the literature. The Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework provides a useful way of organizing and reporting these factors.     

Musculoskeletal applications of platelet-rich plasma: fad or future?

OBJECTIVE: The purpose of this article is to detail the biology of platelet-rich plasma (PRP), critically review the existing literature, and discuss future research applications needed to adopt PRP as a mainstay treatment method for common musculoskeletal injuries. CONCLUSION: Any promising minimally invasive therapy such as PRP deserves further investigation to avoid surgery. Diagnostic imaging outcome assessments, including ultrasound-guided needle precision, should be included in future investigations.     

Treatment or crime? The status of stem cell therapies and research in South African law

The author develops a thorough analysis of current and proposed South African law in relation to the harvesting and use of stem cells. He begins with the question of ownership of the umbilical cord at birth and afterwards. The problems of informed consent in these situations are discussed. Changes in the law in South Africa, now in progress, should ameliorate some of the difficulties.     

The submarine service of the future?

Space missions, although now routine, are unique in terms of their environment and logistical requirements. The number of missions (man-hours) remains relatively small and planning still relies on comparisons with analogous missions, including submarine operations. Antarctic missions, which tend not to be classified, have provided more information about isolated communities because of the number of personnel per base. Space medicine has traditionally been an extension of aviation medicine with high g-forces involved in the transition from Earth to orbit and astronauts such as Neil Armstrong recruited from the test pilot fraternity. As the length of a mission increases and the space habitation relies more on regenerative systems, the environment becomes more analogous with today's nuclear submarines. As well as the air purification implications, radiation still is a significant hazard with even greater impact on future Mars missions requiring the provision of health physics monitoring, advice and countermeasures well established in the submarine flotilla. Nevertheless, the specialty space medicine will progress as a specialty in its own right, pooling expertise from other specialties such as aviation, radiation, emergency and occupational medicine taking human exploration beyond the confines of land and sea.     

Undergraduate research: theory or practice?

Purpose: The purpose of this study was to determine what the research needs of the radiography profession are and to discover how radiography education centres are equipping graduates to meet those needs.Methods: A comprehensive literature search provided information for a self-response postal questionnaire, which was distributed to all 25 radiography education centres in the United Kingdom. A response rate of 68% was obtained.Results: All radiography education centres taught a variety of research methods at undergraduate level. All but three of the centres taught their students how to use a computer statistical package, with the amount of statistical analysis the student could perform varying between centres. The degree to which the students shared the course with other disciplines varied across the education centres, although the delivery was often multi-professional.Primary research was undertaken by students at all the education centres since it was seen to encourage clinical staff to evaluate their own practice, encouraging an evidence-based approach. It was acknowledged that not all radiographers would perform research once they had graduated, but if the skills were acquired at undergraduate level, then radiographers would be more confident in their ability to undertake research and more likely to be seen as credible research colleagues by other practitioners.Conclusions: Research skills were thought to be necessary for reflection and Continuing Professional Development (CPD) activity and vital to the future of the profession. Primary research needs to be encouraged at undergraduate level, but because of the political and ethical sensitivity surrounding it, it may not be appropriate for all students. Newly qualified radiographers should be encouraged to undertake research once they enter the clinical setting and they should publish their findings.     

The role of consent in medical research: breaking or building walls? A call for legislative reform

Research has been integral to the practice of medicine for almost as long as the discipline has existed. Until fairly recently research used to be conducted on human subjects without mandatory requirement for their consent. However, over time medical research became associated with significant cruelty resulting in an outcry for regulation of research actives. This resulted in significant legislation in place for monitoring. Today it is mandatory to obtain consent from subjects before embarking on medical research, and indeed treatment. Its significant regulatory role notwithstanding, the issue of consent at times becomes a hindrance to research. This paper examines the issue of consent in relation to medical research in the context of present legislation. It lays out the background to medical research with respect to purpose, scope, standard protocol and related issues; it then addresses the issue of consent in various scenarios, highlighting problems and the need for legislative reform. It is maintained that while regulatory measures have brought a lot of sanity to medical research and the medical profession, some measures are building walls inhibitory to research activities. Research being integral to the development and growth of healthcare delivery, there is need for reformation of current medical law for balance between patient protectionism and progress in medical research for effective patient care.     

Psychiatric probation orders: failed provision or future panacea?

The psychiatric probation order has been a sentencing option for the courts for over fifty years. Many authors have lamented its underuse and described the inability of psychiatric and probation services to work together in a collaborative and effective way. The aim of this study was to describe probationers who had passed through Elliott House, a specialist bail and probation hostel for mentally disordered offenders. A retrospective case note review of all individuals who have been resident at Elliott House as a condition of a probation order was conducted. The individuals were mostly young, single men with a severe mental illness and comorbid substance misuse. As a group their previous contact with psychiatric services was irregular. A probation order at Elliott House appeared to provide social support and stability along with a period of regular psychiatric treatment and follow-up. The results suggest that psychiatric probation orders, if properly managed, can be a useful tool for both health and probation services in the short term.     

The future of nuclear medicine technology: are we ready for advanced practice?

OBJECTIVE: The purpose of this study was to identify the clinical skills, commonly performed by nuclear medicine technologists (NMTs), that are beyond the entry-level practice guidelines and to determine NMTs' interest in the development of an advanced practice career pathway for nuclear medicine technology. METHODS: The Society of Nuclear Medicine Technologist Section (SNMTS) conducted a survey of 1000 technologists certified by the Nuclear Medicine Technology Certification Board (NMTCB) to determine which advanced clinical skills were being performed by NMTs and the level of training required to perform these skills. RESULTS: Those who responded to the survey were older and tended to have more years of experience and a higher level of responsibility as compared to the average technologist. Sixty-two percent of the respondents thought the SNMTS should develop an advanced practice career pathway, and 85% thought that advanced practice education should be delivered in nontraditional formats such as nights, weekends, and by distance education. CONCLUSION: NMTs reported a high level of interest in an advanced practice career pathway that could be completed while they remained employed.