Infectious chest complications in haematological malignancies.

The management of infections in haematology is dictated by the patient's type of acquired or induced immune deficiency (neutropenia, deficiency in cell-mediated or antibody-mediated immunity), and findings from clinical examination, laboratory studies, or morphologic investigations. The CT scan dominates in the initial management and follow-up of these patients, since clinical features very often appear to be non-specific. The radiologist's role is to guide the clinician towards a specific diagnosis such as aspergillosis or pneumocystosis, or to point them towards a non-infectious cause: tumour localisation, hypervolaemia, bronchiolitis obliterans suggestive of GVH disease, drug toxicity, or embolism.

[Nurses' representations of the managerial function, what professional commitment does this mean?]. / Répresentation infirmière de la fonction d'encadrement, quel engagement professionnel infirmier?

THE SUBJECT OF THIS RESEARCH: "What idea nurses have about the managerial function; from a professional point of view what commitments does this function entail?" is connected with: The fact that at a legislative level there is no reglementation of the managerial function. From a legal point of view, the nature of the commitments in connection with this function is not accurate enough as there is no law explaining exactly what does the job of charge nurse consist in. Therefore, the opinions the whole medical profession have about the managerial function are various. On the other hand, taking into consideration what charge nurses think about their own function can help to explain the behaviour as, usually the ideas determine the practice (cf. ABRIC 1994). The methodology used was based on a scientific procedure and first of all I had to break with my prejudices and wrong opinions which only give you the illusion that you can understand the matters. Readings and exploratory talks helped me in that way and so I could formulate the problem. I worked within this theoretical context and I practically tested the facts by means of semi-directed interviews. The result of the analysis invalidated the hypothesis put forward at the beginning. As regards to the idea nurses have about the managerial function, the difference expressed is more regarding the connection between the nurses values and those ones of the charge nurses, rather than regarding the adequacy between the function and the place of the charge nurse. This is somewhere the notion of project according to ARDOI-NO (1984) in which it is necessary to define the aim of the project first and to establish the means used for the realization after. To formulate the problem only--in our research: the job description--is not enough. It must be developped. So, this procedure enable me, first, to consider the problems differently and to study complicated situations in which we can feel uncertain. The question is at the same time to anticipate and to accept to discover something different. Therefore, there is no model explaining how to understand the complexity of a problem. The charge nurse who is, on one hand, responsible of a conformity must accept to discover, on the other hand, something new: it is one of the paradox of this function.