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Reversible hyperosmotic blood-brain barrier disruption (BBBD) has been used in pharmaceutical research as well as human medicine to enhance drug delivery across the blood-brain barrier. However a technique for repeatable BBBD in the canine has not been described. This study describes a repeatable technique for BBBD in the dog and evaluates the clinical and morphological effects of BBBD. Using fluoroscopic guidance, an arterial catheter was directed into the internal carotid artery via the femoral artery in ten dogs. BBBD was achieved in 5 dogs using 25% mannitol while 5 control dogs received only saline. Following recovery, dogs were monitored for clinical signs before a second, non-survival procedure was performed 2-3 weeks later. BBBD was estimated using CT densitometry as well as Evan's blue staining on post-mortem exam. Histopathological evaluation of the brain was performed on all dogs. Seven dogs completed the study. Two treatment dogs were lost after the first infusion with deteriorating neurologic function attributed to CNS edema and increased intracranial pressure. One control dog was lost due to vessel wall damage during catheterization. The remaining dogs exhibited only transient neurologic, ocular, and vasculature injury. Successful BBBD was demonstrated in all treatment dogs as evidenced by CT and Evan's blue staining. Histopathological evaluation revealed multifocal areas of infarction in all dogs indicating refinement of the technique is needed. This study shows that repeatable disruption the BBB in the dog is possible and opens the way for further investigations of BBBD using the dog as a model. / Master of Science

No / Advanced practice roles are emerging in all disciplines at a rapid pace and reporting radiographers are ideally placed to work at such level. Advanced practitioners should demonstrate expert practice and show progression into three other areas of higher level practice. Most existing literature has focussed on the image interpretation aspect of the role, however there is little evidence that plain film reporting radiographers are undertaking activities beyond image interpretation and fulfilling the role of advanced practitioner. Letters were posted to every acute NHS trust in the UK, inviting reporting radiographers to complete an online survey. Both quantitative and qualitative information was sought regarding demographics and roles supplementary to reporting. A total of 205 responses were analysed; 83.3% of reporting radiographers describe themselves as advanced practitioner, however significantly less are showing progression into the four core functions of higher level practice. A total of 97.0% undertake expert practice, 54.7% have a leadership role, 19.8% provide expert lectures and 71.1% have roles encompassing service development or research, though most of these fall into the service development category. 34.5% felt that they were aware of the differences between extended and advanced practice though much less (9.3%) could correctly articulate the difference. Few individuals are aware of the difference between extended and advanced practice. Though the majority of plain film reporting radiographers identify themselves as advanced practitioners, significantly less evidence all four core functions of higher level practice. The number of individuals undertaking research and providing expert-level education is low.

No

This thesis examines the way in which purpose and identity are realised in the written case reports of radiography students in comparison with those of professional writers. Students entering a new discourse community have to take on a new social identity and this identity is expressed by means of familiarity with the appropriate discourse conventions, including genre as the most overt expression of rhetorical purpose. Also important are the pragmatic choices used by writers to guide readers’ understanding of text and to construct interaction between them, i.e. metadiscourse, which here provides an additional and complementary way of viewing purpose and identity. The study aims, at a more theoretical level, to make a contribution to writing research by integrating genre analysis and metadiscourse analysis within a single framework to provide new insight into the resources available to writers to construe identity in text. At a descriptive level, it provides analyses of a hitherto neglected genre of medical writing. Because the study compares the writing of novices and professionals, the description of this genre makes findings available for pedagogical application. Radiographers and radiologists work as members of the same professional teams and both publish case reports, often in the same journals. Data for the study is provided by two corpora of reports, one produced by radiography students and the other published in national journals by professionals. The genre analysis establishes the move structure of the radiological case study for both corpora and a cross-corpus analysis of metadiscourse demonstrates how identity is realised in the text as the moves unfold. Both quantitative and qualitative approaches are adopted with regard to the data. The student reports appear to be examples of a sub-genre of case reports with the move structure and metadiscoursal strategies differing in several significant ways, reflecting the different purposes and identities of the writers. Student writers are found not to be concerned with the more persuasive rhetorical functions of the genre and tend to align themselves with the viewpoint of the patient rather than the medical profession, drawing on school essay discourse and making use of metadiscoursal strategies associated with textbooks. / Linguistics / D.Litt. et Phil. (Linguistics)

Bakgrund: Yrket röntgensjuksköterska är under ständig utveckling i Sverige gällande kompetensutveckling. Internationellt sett finns det många vägar att gå för röntgensjuksköterskor. Man kan till exempel vidareutbilda sig beskrivande radiograf. Utbildningarna har uteslutande gett positiva resultat. På grund av förändringar bland patienter måste vården utvecklas, detta gäller även röntgenverksamheten. I Sverige har man, trots den internationella utvecklingen, ännu inte fullt ut sett behovet. Syfte: Syftet med studien är att ta reda på vilket behov samt vilka förutsättningar till kompetensutveckling det finns på olika sjukhus för röntgensjuksköterskor. Metod: Studien är en kvalitativ intervjustudie med semi-strukturerade frågor. Ett strategiskt urval gjordes med inklusions- och exklusionskriterier. De kvalitativa intervjuerna utfördes per telefon eller i direkta möten och samtalen spelades in för att sedan analyseras med kvalitativ manifest innehållsanalys. Resultat: Det har varit omväxlande svar från deltagarna. De deltagande har varierande haft stora och små behov av kompetensutveckling för sina röntgensjuksköterskor. Bristen på personal är påtaglig. Alla deltagare uttryckte att de hade möjligheter och förutsättningar för att deras röntgensjuksköterskor skulle få kompetensutveckling även om utbudet varierade. Resultatet visar att kompetensutveckling behövs inom alla områden. Trots detta uttrycker inte alla sjukhus att kompetensutveckling är viktigt för deras verksamhet. Slutsats: Kompetensutveckling för röntgensjuksköterskor är ett stort ämne. Det finns mer att ta reda på och det finns många utvecklingsmöjligheter. Det finns ett behov att kompetensutveckla anställda röntgensjuksköterskor för att få en förbättring i sin profession, vilket leder till utveckling både individuellt som röntgensjuksköterska och tillsammans som röntgenavdelning. / Background: Profession as radiographer is constantly developing in Sweden valid skills development. There are many different ways in order to improve the profession internationally. One can, for example, take advanced practicing to become a reporting radiographer. The advanced practicing has exclusively showed positive results. Nowadays the patients are changing in conditions rapidly that the healthcare industry needs to adapt itself. Even the international development for radiographers seems bright, the need is yet fully realized in Sweden. Purpose: The purpose of this study is to find out which needs and possibilities are available for Swedish radiographers to improve and develop their own professional skills. Method: A qualitative interview study with semi-structured questions. The participants were selected by inclusions and exclusions. The interviews were conducted by telephone or physical meetings and the interviews were recorded and analyzed using qualitative content analysis manifest. Results: The responses from the participants have been varied. Lack of radiographers is palpable. All participants expressed that they had opportunities and possibilities for their radiographers to receive an advanced practicing in skills development even though the supply varied. The result shows that skills development is needed in all areas. Despite this, all hospitals do not express that skill development is important for their radiology department. Conclusion: Advanced skills development for radiographers is an interesting topic. There are more to figure out valid skill development. There is a need to develop radiographers in order to improve individually and together as X-ray department.

Simulation is an important tool when training is hazardous, time consuming, or expensive. Simulation can also be used to enhance reality by adding features normally not available in the real world. The aim with this work has been to develop and evaluate methods that could improve learning in oral radiology utilising a radiation-free simulator environment. Virtual reality software for radiographic examinations was developed. The virtual environment consisted of a model of a patient, an x-ray machine, and a film. Simulated radiographic images of the patient model could be rendered as perspective projections based on the relative position between the individual models. The software was incorporated in an oral radiology simulator with a training program for interpretation of spatial relations in radiographs. Projection geometry was validated by comparing length dimensions in simulated radiographs with the corresponding theoretically calculated distances. The results showed that projection error in the simulated images never exceeded 0.5 mm. Dental students participated in studies on skill in interpreting spatial information in radiographs utilising parallax. Conventional and simulator based training methods were used. Training lasted for 90 minutes. Skill in interpreting spatial information was assessed with a proficiency test before training, immediately after training, and eight months after training. Visual-spatial ability was assessed with mental rotations test, version A (MRT-A). Regression analysis revealed a significant (P<0.01) association between visual-spatial ability and proficiency test results after training. At simulator training, proficiency test results immediately after training were significantly higher than before training (P<0.01). Among students with low MTR-A scores, improvement after simulator training was higher than after conventional training. Eight months after simulator training proficiency test results were lower than immediately after training. The test results were, however, still higher than before training. In conclusion, the simulation software produces simulated radiographs of high geometric accuracy. Acquisition of skill to interpret spatial relations in radiographs is facilitated for individuals with high visual-spatial ability. Simulator training improves acquisition of interpretative skill and is especially beneficial for individuals with low visual-spatial ability. The results indicate that radiology simulation can be an effective training method.

Thesis (Ph. D.)--UCLA, 2009. / Vita. Includes bibliographical references (leaves 135-149).

This thesis examines the way in which purpose and identity are realised in the written case reports of radiography students in comparison with those of professional writers. Students entering a new discourse community have to take on a new social identity and this identity is expressed by means of familiarity with the appropriate discourse conventions, including genre as the most overt expression of rhetorical purpose. Also important are the pragmatic choices used by writers to guide readers’ understanding of text and to construct interaction between them, i.e. metadiscourse, which here provides an additional and complementary way of viewing purpose and identity. The study aims, at a more theoretical level, to make a contribution to writing research by integrating genre analysis and metadiscourse analysis within a single framework to provide new insight into the resources available to writers to construe identity in text. At a descriptive level, it provides analyses of a hitherto neglected genre of medical writing. Because the study compares the writing of novices and professionals, the description of this genre makes findings available for pedagogical application. Radiographers and radiologists work as members of the same professional teams and both publish case reports, often in the same journals. Data for the study is provided by two corpora of reports, one produced by radiography students and the other published in national journals by professionals. The genre analysis establishes the move structure of the radiological case study for both corpora and a cross-corpus analysis of metadiscourse demonstrates how identity is realised in the text as the moves unfold. Both quantitative and qualitative approaches are adopted with regard to the data. The student reports appear to be examples of a sub-genre of case reports with the move structure and metadiscoursal strategies differing in several significant ways, reflecting the different purposes and identities of the writers. Student writers are found not to be concerned with the more persuasive rhetorical functions of the genre and tend to align themselves with the viewpoint of the patient rather than the medical profession, drawing on school essay discourse and making use of metadiscoursal strategies associated with textbooks. / Linguistics and Modern Languages / D.Litt. et Phil. (Linguistics)

This research was conducted to obtain information regarding the feasibility of using non-medical personnel to obtain measurements of radiologic total lung capacity (TLC). Operators from each of four groups (general undergraduates, nursing students, medical students, radiologists) differing in the amount of medical training and/or experience reading x-rays, performed each of two tasks. The first task was the measurement of radiologic TLC for a set of twenty x-rays. The second task consisted of tracing the outline of the anatomical structures that must be identified in the execution of the radiologic TLC measurement task. Data from the radiologic TLC measurement task were used to identify possible group differences in the reliability and validity of the measures. The reliability analyses were performed within the framework of Generalizability Theory. While the results are not conclusive, due to small sample sizes, the analyses suggest that group differences in reliability of the measures, if they exist, are small. The concurrent validity of the measures was assessed by obtaining, for each experience level, the correlation between the group mean radiologic TLC for a film set and the TLC for that patient, obtained from a body plethysmograph. Only small differences in the group correlation coefficients were observed. A liberal test of these differences indicated they were not statistically significant. Additionally, two experience level by film sets ANOVAs were performed to determine possible group differences in how well the actual magnitudes of the radiologic TLC measures approximated those obtained with the body plethysmograph. These analyses indicated that the magnitude of the differences between radiologic and plethysmographic TLC measures were smaller for the undergraduates than for the nursing students and radiologists. Lastly, a number of analyses of the anatomical structure tracings were performed. Few interpretable group differences were found.