Machine verification radiographs: an opportunity for role extension?

Purpose: To improve the efficiency of the established system of verification film assessment by transferring the responsibility from clinicians to therapy radiographers.Methods:Radiographers assessed films before clinicians during a blind pilot study. They recorded their verdict on the films’ accuracy and included comments about any remedial action that they would recommend. Eighty-nine percent agreement with the clinicians was achieved. Following these results, a further study was established. Guidelines for assessment were issued to both radiographers and clinicians. Radiographers were responsible for film assessment for up to five radiotherapy treatment fractions before the films were viewed by clinicians. All grades of radiographer participated in the assessment process. The radiographers’ decisions were compared to the clinicians’ and the clinicians’ decisions were regarded as the gold standard.Results: Five hundred and seventeen films were assessed. The results were analysed quantitatively using the predictivity test which is used to compare a sample to the gold standard. Radiographers demonstrated 97% overall accuracy in comparison to the clinicians. A small questionnaire evaluated whether radiographers and clinicians perceived a benefit to the service delivery as a result of the transfer of responsibility.Conclusions: Radiographers demonstrated sufficient parity with the clinicians to warrant a change to the departmental protocol. There was a significant improvement to the efficiency of the process and consequently the service delivery. Radiographers have continued to assess verification films without clinician supervision.     

Chiropractic management of breast-feeding difficulties: a case report

Objective

The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties.

Clinical Features

The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic.

Intervention and Outcome

Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days.

Conclusion

The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently.