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[en] The rapid growth in the use of ultrasound as a diagnostic imaging technology over the past forty years, has led to a demand for a workforce with the appropriate skills to perform and interpret the scans. In the UK, ultrasound investigations now comprise the largest group of all diagnostic imaging examinations.1 However, there remains no statutory regulation of the practice of sonography in the UK, and little recognition of the considerable training that many practitioners have undertaken to obtain the skills to become safe and competent sonographers. Many in the field consider that this should change, and are working to obtain professional status for the practice of sonography.2–5 Although the Health Care Professions Council (HCPC) has recommended regulation of sonography practice, this is unlikely to happen in the near future. This paper discusses the evolution of sonography practice and explores some of the complex issues associated with the professionalisation of sonography
[en] Aim: To systematically review the currently available high quality evidence evaluating treatments for moist desquamation in radiotherapy patients. Design: Systematic literature review. Methods: Electronic databases, websites, reference lists, key journals and conference proceedings were searched. Attempts were also made to uncover unpublished material. Relevant studies proceeded to data extraction and quality assessment. Results: Twenty studies were found; 10 were eligible for inclusion. Although many studies were small, none had unacceptably poor quality. No meta-analysis was undertaken as the studies were not homogenous in their interventions or methods. No convincing evidence for any intervention was found. Conclusion: Despite being recommended by many guidelines (College of Radiographers Summary of Intervention for Acute Radiotherapy Induced Skin Reactions in Cancer Patients (London, 2001); NHS Quality Improvement Scotland Best Practice Statement: Skincare of Patients Receiving Radiotherapy (Edinburgh, 2004)); there is mixed evidence concerning the use of hydrogels and hydrocolloid dressings. However, improved patient comfort was sometimes seen, which is arguably equally important. There was limited evidence to support other interventions. Further research is urgently needed.
[en] Cost-effective protected area networks require that decision makers have sufficient information to allocate investments in ways that generate the greatest positive impacts. With applications in more than 50 countries, the Rapid Assessment and Prioritization of Protected Area Management (RAPPAM) method is arguably the tool used most widely to assist such prioritization. The extent to which its indicators provide useful measures of a protected area’s capacity to achieve its conservation objectives, however, has seldom been subject to empirical scrutiny. We use a rich spatial dataset and time series data from 66 forest protected areas in the Brazilian Amazon to examine whether RAPPAM scores are associated with success in avoiding deforestation. We find no statistically significant association between avoided deforestation and indicators that reflect preferential targets of conservation investments, including budget, staff, equipment, management plans and stakeholder collaboration. Instead, we find that the absence of unsettled land tenure conflicts is consistently associated strongly with success in reducing deforestation pressures. Our results underscore the importance of tracking and resolving land tenure in protected area management, and lead us to call for more rigorous assessments of existing strategies for assessing and prioritizing management interventions in protected areas. (letter)
[en] A new approach to scenarios focused on environmental concerns, changes and challenges, i.e. so-called 'environmental scenarios', is necessary if global environmental changes are to be more effectively appreciated and addressed through sustained and collaborative action. On the basis of a comparison of previous approaches to global environmental scenarios and a review of existing scenario typologies, we propose a new scenario typology to help guide scenario-based interventions. This typology makes explicit the types of and/or the approaches to knowledge ('the epistemologies') which underpin a scenario approach. Drawing on previous environmental scenario projects, we distinguish and describe two main types in this new typology: 'problem-focused' and 'actor-centric'. This leads in turn to our suggestion for a third type, which we call 'RIMA'-'reflexive interventionist or multi-agent based'. This approach to scenarios emphasizes the importance of the involvement of different epistemologies in a scenario-based process of action learning in the public interest. We suggest that, by combining the epistemologies apparent in the previous two types, this approach can create a more effective bridge between longer-term thinking and more immediate actions. Our description is aimed at scenario practitioners in general, as well as those who work with (environmental) scenarios that address global challenges.
[en] The purpose of this paper is to explain how the regulatory environment created by planning and building regulations interacts with land and property markets. Since this regulatory environment operates as a form of intervention within property markets in general and the development process in particular, it is essential first to understand the nature, structure and operation of land and property markets. These are covered in the first section. The second section identifies the aims and components of the planning system and building regulations. From this basis, four broad types of policy intervention are reviewed in the third section. These cover policies that seek to shape, regulate or stimulate market activity, and those that aim to build state or market capacity to produce desired outcomes. The final section uses the private residential development process as a case study to explore the extent to which state intervention can influence producer-consumer relationships in one important market sector. The paper argues that effective intervention in land and property markets requires the creation of a broad range of policy tools and their appropriate deployment to suit particular market circumstances. (author)
[en] An overview of radon programme experience is presented. The paper summarises broad topics concerning radon issue: philosophy of radon policy, radon measurements strategies with respect to indoor radon variation, progress in radon measurement of an individual house (radon diagnosis), national programmes, the role of preventive measures and interventions with respect to existing and future exposure and knowledge of radon risk, problems of remediation strategies, radon mapping process and sense of delineation of radon prone areas, public awareness on radon issue and publicity campaign. Some research activities are proposed aiming at effective solutions for radon issues in the future. (authors)
[en] Laser micro-adjustment is an application of laser forming for the adjustment of micro-, fiber- and electro-optical systems. Experience has shown that conventional material models cannot properly describe the micro-scale deformation behavior due to size effects. As a result, traditional macro-scale laser forming is not suitable for the micro-scale laser forming process. In this study, the mechanical behavior of two-bridge actuators in laser micro-adjustment is investigated under the condition of geometrically scaled actuators. Numerical simulation is conducted by using a material model that takes into account the size effects. Simulation results obtained for cases with and without consideration of the size effects are compared, showing that size effects have a significant influence on the laser forming of micro-adjustment. The results with consideration of the size effects are found to agree well with the experimental data
[en] Highlights: • Present day methods deliver new knowledge about socio-ecological past of the lake. • Long term investigation reveals shifting goal setting of restoration over time. • Different, intertwined temporal scales complicate lake restoration endeavors. • Interannual weather variability influences restoration endeavors. • Prevailing understandings influence the anticipated futures of the lake. - Abstract: The history and future of the restoration efforts at the hypereutrophic southern Finnish lake, Tuusulanjärvi, are investigated. The interdisciplinary study is conducted within a modified DPSIR- framework, which allows us to both trace back and envision the future of the dynamics of the complex socio-ecological processes involved in restoration. The study covers the time period from the early 1970s up to 2030. The longitudinal study integrates environmental historical, limnological, and futures studies. The analyses reveal the multiple time scales of social and ecological processes present in long term restoration, the changing perceptions of and emphasis on restoration goals and outcomes over time, and the challenges that incidental and uncertain parameters, such as weather conditions, pose to sustainable and efficient restoration endeavors.
[en] Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.