Careers and Emerging Opportunities in Visual Communication in Medicine: Medical photography in Norway.

The community of medical photographers in Norway is relatively small. Except for one they are all employed with titles such as research technicians, department engineers, senior consultants and skilled workers. At the present there is no formal education in medical photography. The most common educational attainment for photographers is the Journeyman's certificate. Until recently, the requirement for employment for photographers at Norwegian hospitals was the Journeyman's Certificate. However, the Institutt for Klinisk Medisin at University in Oslo recently advertised a vacancy for a departmental Engineer to run its photographic and video services. The post required that the candidates possess either a Bachelor's degree in a relevant subject. This is the first vacancy in medical photography in nine years. The Norwegian health services have been reformed in the direction of New Public Management (NPM). To utilise the resources effectively, tasks that normally would be performed by one health profession are shifted to another with a different or lower education and training. There are reasons to believe that the shift of medical photography from professional photographers to other health personnel without specialist training or qualifications is an attempt to utilise resources more effectively. During the next two years a mixed methods research will be carried out to explore the current situation for medical photography in Norway.

Tele-dietetics with food images as dietary intake record in nutrition assessment.

RATIONALE: Tele-dietetic is not common in current practice. To promote this, food images as dietary intake records should be validated before application. Two-dimensional (2D) digital images are reliable and have been validated in previous studies. However, the depth is virtual with a 2D image. And ingredient types, sauce types, cooking methods, and amount of oil added have not been researched for accurate food analysis. AIM: This study was designed to compare the reliability and accuracy of these parameters estimated using 2D and three-dimensional (3D) food images. METHODS: Ten nutritionists evaluated 10 selected food items between January 2008 and June 2008. Ten 2D food images and ten 3D images of the same food items were captured for the observers' evaluation. The actual weightings or volume of the food items were measured as the gold standard for comparisons. Intraclass correlations (ICCs), percentage agreement, and one-sample t-tests were analyzed to compare the reliability and accuracy of each type of images. RESULTS: Both images showed high reliability among observers with 3D images giving less variance (2D: ICC=0.916, F=17.001, p<0.001; 3D: ICC=0.846, F=6.501, p<0.001). Both images resulted in good ingredient and cooking method identification, but 3D was better in identifying sauce type. 2D images provided better volume and oil estimation when compared with 3D images. CONCLUSIONS: The research findings confirmed the application of 2D and 3D food images as reliable and accurate dietary records for nutritionists to evaluate clients' dietary habits. This implied the feasibility of tele-dietetics that one's nutrition status could be assessed over the Internet.

Setting up your office for clinical photography.

Most clinical photographs utilized in a plastic surgical practice are taken in the office setting, primarily to document surgical results. This article will discuss the various ways that the office environment can be optimized for clinical photography.

Snap decisions.

Innovative ways of making children's voices heard to shape services are being supported by the Picker Institute charity as part of its Patients Accelerating Change scheme. These include photographic projects at two NHS trusts.

Facilitating narrative medical discussions of type 1 diabetes with computer visualizations and photography.

OBJECTIVE: Patient-centered approaches to medicine suggest the need for physicians to become more aware of concerns and needs expressed in patient narratives. However, patients and physicians have different goals and discourse styles during consultations. We attempt to bridge these differences by providing patients with ways to collect, visualize, and describe behavioral and biomedical data. METHODS: We describe an intervention where individuals with type 1 diabetes photograph health-related behaviors. These images and blood glucose records are displayed in computer visualizations and used during patient-physician interviews. RESULTS: Qualitative analyses of interview data with patients who photographed their lives suggest the range of difficulties associated with diabetes self-management. The visualizations helped them articulate concerns about stress, peer relations, and unhealthy routines. CONCLUSION: Interventions that combine biomedical and biopsychosocial data during patient-physician consultations may be beneficial for patients, helping them reflect on correlations between behaviors and health. Physicians are provided with contextual evidence to better understand patient issues around diabetes management. PRACTICE IMPLICATIONS: We suggest that this and similar interventions could be used as an occasional diagnostic to help patients articulate stories of their health-related practices. Annotated archives of photographs and glucose data may also be useful tools for sharing diabetes experiences with newly diagnosed patients.

Modernizing medical photography, part 2.

Part 1 of this paper explored the origins of process activity mapping, one of the major tools currently being used to modernize patient pathways in the National Health Service in Great Britain. Within medical photography the current notion of modernization is inextricably linked to the development of digital technology. Whilst the core principle of capturing light on a sensitive medium remains as clear and relevant as ever, the mechanisms by which the image is processed and presented to the client have changed profoundly. Part 2 shows how the principles of lean thinking and process activity mapping can be utilized to harness the advantages of digital technology to provide a modern and appropriate medical photography service in a large disparate teaching hospital.

The design and construction of an interactive website concerning biomedical photography.

The purpose of this communication is to make readers aware of what the authors believe is an important online resource about medical and scientific photography for doctors, scientists and students. It is a website freely accessible and its URL is http://msp.rmit.edu.au. The site is designed as a resource base: it is not meant to be a 'course' but the reader will find much practical information about technique and applications of scientific imaging methods. The site is currently a comprehensive collection of resources relating to invisible radiation photography but there are plans to expand the site to a range of clinical recording topics, and other potential contributors are asked to join the project. It contains a vast collection of photographs from many photographers as well as graphs, diagrams, tables and references. This paper also discusses some of the important issues surrounding the 'publication' of such a site such as currency and access versus credibility; technological obsolescence, site design and usage.

The use of digital photography to support a medical mission to Honduras.

The South Texas Physicians Outreach (STPO) organization makes at least one annual mission to Santa Rosa de Copan, Honduras to provide much needed medical and surgical care to the residents of western Honduras. The author was named the team photographer for both a trip in 1998 and a subsequent visit in 1999. In preparing for the 1999 trip, a plan to reduce the expenditure by STPO for photography support was put into motion. It was decided that digital photography would eliminate most of the cost for documentation of the team's activities in clinics, surgery, and human interest activities. This article provides a short history of the organization, a brief overview of the 1998 trip, and a discussion of the photographic aspects of the 1999 trip.

Professional bereavement photographs: one aspect of a perinatal bereavement program.

Although professionals can do little to cushion the emotional trauma for parents and family when an infant dies, many institutions have implemented bereavement programs to offer counseling, support, and assistance. Included in such programs are photographs of the deceased infant. The value of such photographs has been documented in the literature. Some institutions provide parents with instantly developed photos of the deceased infant. Unfortunately, instant prints may blue and often fade with time. To improve services to bereaved families at a hospital in Massachusetts, a program was implemented to use the skills of the hospital's professional biomedical photographers and the nursing team. The perinatal clinical nurse specialist or her designee takes a 35-mm black-and-white photograph of the infant. The biomedical photographers process the negatives and use hand coloring techniques and matting to produce professional-quality photographs. The response by parents and families to the improved photographs has been positive. As the number of photographs taken has increased, the staff have continued to improve the service.