Continuing professional development (CPD) in radiography: A collaborative European meta-ethnography literature review.

OBJECTIVES: The aim of the study was to complete a collaborative review of Radiography continuing professional development (CPD) research material to support the production of European Federation of Radiographer Societies (EFRS) CPD recommendations. A meta-ethnography approach to literature review was applied focussing upon commonalities rather than discrepancies between research outcomes. This facilitated exploration of context across the geographical region of Europe with national variations in CPD governance. The seven phases of the meta-ethnographic approach were followed by two independent experienced researchers. A third researcher mediated the findings which were then explored collaboratively with the EFRS CPD working group for concordance. KEY FINDINGS: Phase seven of the meta-ethnography involved interpreting an expression of the synthesis from the previous stages. Six main corroborating themes emerged in this process and following mediation were expressed as themes; knowledge, skills & competency, needs/gap analysis, multi-layered/multi-modal, barriers and drivers; regulation vs autonomy; fostering collaboration - harnessing technology. CONCLUSION: The primary feature of CPD activity should be the resulting impact - to patients, the service, the profession and the individual; with all stakeholders working in partnership. CPD activity must be flexible/multi-modal to support the changing growth/dynamic workforce. All stakeholders should utilise communication and technology resources and make efforts to improve collaboration between the management, regulators and educators to support Radiographers to develop meaningful CPD. Health services across Europe are under increasing stress and a principal factor going forwards will be managing increasing demands on healthcare staff whilst supporting enhancement of the knowledge, skills and competency base.

[A 2-month-old child with complex tracheal hypoplasia]. / Hypoplasie trachéale complexe chez un enfant de 2 mois.

We describe the case of a 2-month-old child with complex tracheal hypoplasia with bilateral bronchial hypoplasia and left pulmonary hypoplasia. Tracheal hypoplasia is complex when it is associated with critical stenosis, cricoid stenosis, bronchial hypoplasia, tracheal bronchus, or esophageal atresia with severe tracheomalacia. Slide tracheoplasty is the gold standard treatment for the complex tracheal hypoplasia.

Early versus late indomethacin treatment for patent ductus arteriosus in premature infants with respiratory distress syndrome.

OBJECTIVE: To compare efficacy and side effects of early versus late indomethacin treatment for patent ductus arteriosus (PDA) in premature infants. METHODS: One hundred twenty-seven neonates receiving ventilatory assistance (gestational age: 26-31 weeks) with PDA confirmed by echocardiography were randomly assigned in a prospective multicenter trial to either early (day 3, n = 64) or late (day 7, n = 63) intravenous indomethacin treatment (3 x 0.2 mg/kg every 12 hours). Treatment history and side effects were registered. RESULTS: The PDA closure rate was higher in the early treatment group at both 6 (73% vs 44%, P =.0008) and 9 days of age (91% vs 78%, P =.047). However, there was no significant difference in PDA ligation. Urine output was significantly lower (P <.0001), serum creatinine level was higher (P =.016), and more indomethacin courses were administered in the early treatment group (70 vs 26). Respiratory support, number of deaths, and intraventricular hemorrhages were similar in both groups. However, on the whole, major adverse events (death, necrotizing enterocolitis, and/or localized perforation, extension of hemorrhage, or cystic leukomalacia) occurred more frequently in the early treatment group (P =.017). CONCLUSION: Early indomethacin treatment improves PDA closure but is associated with increased renal side effects and more severe complications and has no respiratory advantage over late indomethacin administration in ventilated, surfactant-treated, preterm infants <32 weeks' gestational age.

Successful treatment of recurrent thrombotic thrombocytopenic purpura with plasmapheresis and vincristine.

An adolescent girl with severe thrombotic thrombocytopenic purpura (TTP) remained in a critical condition after 3 weeks of combined treatment with antiplatelet drugs, plasma infusions and plasma exchange. The introduction of vincristine resulted in gradual improvement and eventual complete remission which lasted for 2 years. When she relapsed, immediate improvement was observed with the combined treatment of plasmapheresis and vincristine. She has now been in complete remission again for 10 months. It is suggested that plasmapheresis plus vincristine should be used as the initial treatment for children with TTP.

[Neonatal listeriosis]. / Neonatale listeriosis.

During the period november 1988-december 1989 eight cases of early onset neonatal Listeria monocytogenes infection were registered in the 'Neonatal Intensive Care Unit' of the University Hospital in Leuven (Belgium). Before bacteriological proof was available, diagnosis could be made in 7 cases, based on a characteristic clinical picture: a maternal flu-like syndrome leading to preterm labour with intact membranes, meconium stained amniotic fluid, perinatal asphyxia and respiratory distress of the neonate. In 5 infants a maculopapulovesicular skin eruption was present. Laboratory findings were non-specific. An interesting finding was the predominance of monocytes in the endotracheal aspirate of infected infants. In 5 out of 8 patients meningitis and intraventricular hemorrhage were present; two of them died, three developed severe neurological sequelae.

[The random dot test as a screening method for the visual acuity in children (author's transl)]. / Zur Brauchbarkeit des "Random Dot Tests" für schulärztliche Untersuchungen.

The Random Dot Test was used for a screening of the visual acuity of children of 6 to 10 years of age. The testing time is reduced by 50% as compared with the examination by means of illiterate E images on cardboard charts. Children with refractive errors of up to 3 delta but normal visual acuity after correction are not detected at the examination distance of 1.30 m used in this study. None out of 672 children with severe eye diseases gave false negative results with the Random Dot Test. Disturbances of the binocular vision could also be detected with the Random Dot Test.

Dinferentiation in biology.

In this paper the authors give a survey of biological phenomena (both at the cellular level and in organisms), for which the term 'differentiation', used in the widest sense, has a meaningful application. The last chapter deals with some general aspects of differentiation and connected phenomena, such as polarity, symmetry, loss of potencies, dedifferentiation, redifferentiation, adifferentiation, regulation and integration. To prevent this article becoming too voluminous, the authors had to refrain from extending the treatment of differentiation to non-living matter and to human society.