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In 1991, the creation of the Media Unit at the St. Augustine Campus, University of West Indies, first established medical illustration as an organized profession within the public healthcare provision of Trinidad and Tobago. Since then the Unit has overcome many difficulties, some of them unusual for medical illustrators in the developed world, not least in obtaining equipment unavailable in the country, in finding suitable working facilities, and in developing practices for veterinary work. Today the Media Unit services a wide range of the University's schools, clinics and media services, and has been instrumental in educating a new generation of healthcare professionals.
Dyes are used in current ophthalmological practice, both as diagnostic and therapeutic aids. Commonly used dyes include sodium fluorescein, indocyanine green, rose bengal and methylene blue. The properties of these agents are outlined, along with indications for their use. The article concentrates mainly on intravenous sodium fluorescein and fundus fluorescein angiography, although topical and intracameral use of other dyes is highlighted. Ocular tissue responses are discussed, in particular those of the retinal vasculature and choroidal circulation. The normal blood-retinal barriers and pathology of abnormal angiography findings is presented. Pharmacokinetics and pharmacodynamics of intravenous dye are discussed, along with potential systemic complications.
The past decade has witnessed a dramatic increase in the number of patients presenting with pigmented lesions to general practitioners. This increase is reflected in the number of patients referred for whole body mole-monitoring photographs to the Medical Photography and Illustration Department of the University Hospital of North Durham. Through a process of qualitative and quantitative research, an improved method of whole body photographic mole-monitoring was devised and implemented within this department. All aspects of the mole-monitoring service were evaluated, from the original photographic request to the photographic session and patient interaction. This process also offered the opportunity to explore the possible use of new technologies.
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.
In paediatrics, a wide variety of procedures and interventions (protocols) are standardized. The entire hard-copy collection of paediatric protocols used in Malta (47 to date) was put together as a website, and is hosted on the hospital intranet. Some protocols consist of Excel spreadsheets that are used for the calculation of fluids and drugs. This archive has proved very useful for medical and paramedical staff in the Department of Paediatrics, both in the hospital and in peripheral health centres and hospitals. Changes or new protocols may be uploaded at any time, with instantaneous updating of the archive. The website was created, and is maintained and updated by the author, thanks to the ease with which modern software allows users to create hypertext markup language.
The Biomedical Photographic Communications Department at the Rochester Institute of Technology currently offers the only university-based degree programme in this field in the United States. With an enrollment of more than eighty students, the curriculum and its delivery are continually challenged by the 'new world' of imaging and the needs of the increasingly diversified industry where its graduates are finding employment. This paper reports on a recent self-study of the programme and examines the future directions for educating tomorrow's information imaging professionals. In particular, the paper evaluates the name of the department, which has become both an asset and liability in describing the programme to perspective students.
Experience, supported by research, has shown that people interpret pictures against a complex network of communication factors, including various socio-cultural factors. In the process of developing interactive health learning materials for primary schools of less developed communities of South Africa, a set of prototype trigger pictures was pre-tested to determine its suitability for sexuality and HIV/AIDS education. The results suggest a link between socio-cultural factors related to sexual behaviour among young people, and the way they 'read' these pictures. By way of an explanatory model it is recommended that media producers should seek a balance between learner factors, picture coding factors, and socio-cultural factors in the design of contextualized trigger pictures.
In medical photography linear scales are widely used to monitor change in size. Although accuracy on the image is generally accepted as being perfectly adequate, there is a degree of uncertainty. This led the first author to investigate the use of linear scales when photographing skin lesions at the Victoria Hospital, Kirkcaldy. Established methods of determining photographic accuracy are by themselves insufficient: the outcome must relate to how the end product is used, i.e., by visual assessment and/or manual measurement. As well as showing that the accuracy concerned is adequate for current requirements, this work presents a definitive value.
Government, media and public focus on waiting times in the National Health Service in the United Kingdom has forced the organization to look closely at the process by which a patient progresses through an increasingly complex and ever changing system. In an effort to streamline the patient journey or care pathway, modernizers have turned to business and manufacturing for solutions. Whilst medical photographers need to recognize their role in this context, they are also facing major technological modernization through the development of digital photography. Part 1 of this paper looks at the origins of some of the techniques presently being used to modernize the patient journey. Part 2 shows how these tools of modernization 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 unforseen consequences of unconsented clinical photography when images are required for publication is an issue that affects medical practitioners and clinical photographers. This paper discusses, a scenario based on a typical event, the nature of informed consent and its relationship to ethical theory and the development of codes of practice. It includes a critique of ethical theory and describes mapping or codification of moral behaviour and the relationship to protocols or codes of practice, and concludes with a call to improve understanding and expertise in the study of ethics and its context in medical illustration.
This study investigated risks associated with the photography of materials that are a potential source of infection, the extent to which medical illustrators are aware of these risks, the relevant government regulations and guidance, and whether recommended control measures are adopted. To seek information about current practice, a questionnaire was sent to randomly selected Medical Illustration Units across the United Kingdom. The data indicated that a significant proportion of medical illustrators routinely photograph materials that could be a source of infection, but that a high percentage know little about the specific regulations and guidance which govern the handling of such materials. Apparent deficiencies in safety procedures currently applied in photographing microbiological materials were identified; recommendations that address these problems at little or no cost are proposed.
This paper introduces the fields of usability and interaction design in order to highlight their benefits and provide further resources for those that wish to find out more. It is hoped that this review will encourage medical illustrators to adopt certain principles and practices in their own project work, in order to strive towards (and ultimately produce) products and environments that provide more positive interactions for their users. Usability and interaction design are fields of study concerned with aims relating to ensuring that any given interactive product or environment is efficient, effective and safe to use, as well as easy to learn and remember. Of primary importance is the experience of the user whose interactions should be positive, as opposed to frustrating or counter-intuitive.
A long-held ambition for the regulation of clinical photographers is soon to be realized: in September 2004 the Health Professions Council formally approved an application by the Council for the Accreditation of Medical Illustration Practitioners, and it is anticipated that clinical photographers will be amongst the first group of healthcare scientists to join the national state register in 2005. This paper describes the application process and the ramifications for the profession.
The 'URL File Not Found' message is all too familiar to users seeking biomedical information on the Web, and occurs when a requested Web-site is no longer available. The complex and dynamic nature of information flow is grounded in computer server technologies and makes the Web difficult to preserve. Enhancements in Web-technologies are helping to improve the problem of Web-site transience. Some initiatives to manage Web-site loss include Google's memory cache, the Internet Archive with Wayback Machine, and Web-site recording tools such as Internet Researcher.
As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent obtaining and reading a number of publications. As a way of ensuring that the allocated time has been spent on the activities a number of self-assessment exercises (SAEs) have been included. Upon completion of this worksheet, you will be credited with 10 CPD points. The answers to the SAEs, along with any notes you make and other publications you find, should be kept in your CPD portfolio.
Rules and regulations founded on ethical principles permeate healthcare practice. NHS Trusts formulate policy to govern their activities in which duties and responsibilities are defined to protect patients from harm and protect themselves from potential litigation. Clinical photographers are not immune from the demands of ethical practice and need to have clearly defined duties and responsibilities. This paper maps the dynamics of ethical practice and how this may be expressed in codes of practice related to the principles of professional clinical photography.
This paper reports on a study that aims to fill a niche within scientific illustration by developing a method whereby evidence of disease and trauma in archaeological human remains can be translated into a meaningful visual reconstruction of a diseased or physically impaired individual in life. A case study is presented, which involved reconstructing the rhino-maxillary effects of leprosy in an adult male. It is suggested that such reconstruction illustrations could have an important role in communicating ideas both to specialists and particularly to non-specialists, and may also be valuable as research tools in their own right.
Much has been published relating to the treatment and surgical outcome of cleft lip and palate disorders. Clinical audit is one of the most important tools for assessing the quality of care provided, with medical photography an invaluable component of this process. The Clinical Standards Advisory Group Report 1998 recommended that cleft lip and palate patients should be audited when 0 (under 1 year of age), and then at the ages of 5, 10, 15 and 20 years. For both audit and research purposes, medical photographs need to be accurate and of a consistently high standard. This paper describes the development of a standardized photographic protocol for cleft patients of audit age, to the benefit of both the multidisciplinary team and the patients.
This paper considers several aspects of using linear scales in photographs. It describes a method used to measure the variations in scale size and subject size when the two are not on the same plane in a photograph. It discusses the results achieved from experiments using a measuring device and different lenses and lens settings. The results demonstrate the marked differences in measured size that occur as the scale and subject distances vary. The paper provides evidence that placement of scales within the field of view in photographs is critical for useful information to be extrapolated from the scale.
As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent obtaining and reading a number of publications. As a way of ensuring that the allocated time has been spent on the activities a number of self-assessment exercises (SAEs) have been included. Upon completion of this worksheet, you will be credited with 15 CPD points. The answers to the SAEs, along with any notes you make and other publications you find, should be kept in your CPD portfolio.