Organisation and provision of head and neck cancer surgical services in the United Kingdom: United Kingdom National Multidisciplinary Guidelines.

This is the official guideline endorsed by the surgical specialty associations involved in the care of head and neck cancer patients in the UK. This paper summarises the current state of play in the organisation and provision of head and neck cancer surgical services in the UK.

Variations in radiotherapy delivery in England - evidence from the national radiotherapy dataset.

AIMS, MATERIALS AND METHOD: Data in the national radiotherapy dataset for England for 2009-2011 is based upon downloads of activity from every linear accelerator in the country through its oncology management system linked to the local patient administration system to give a full overview of each patient episode. RESULTS: An analysis of this dataset shows that there is still a considerable variation in radiotherapy activity across the country, with a two-fold variation between the most and least active networks. Lower activity is seen in London and the southeast compared with the rest of the country, but when the data are split between the north and south of the country, no such variation is seen. Activity is higher in smaller centres and non-teaching centres. About half of all treatment is palliative and this proportion does not vary with geography, although there is considerable variation between individual centres in the proportion of radical radiotherapy given. There is a trend towards less use of radiotherapy, both radical and palliative, in the more deprived population groups, although no change in the relative use of palliative and radical treatment. CONCLUSION: It is important to emphasise that these data currently reflect activity patterns only and do not reflect quality of care or treatment outcomes, which will be achieved by linkage with cancer registry data in the future.

A new formula for calculating weight in the fetus of < or = 1600 g.

OBJECTIVE: To develop and test a new formula for estimating weight in the fetus of < or = 1600 g. METHODS: A formula for sonographic estimation of fetal weight was produced retrospectively from 84 singleton fetuses with a birth weight of < or = 1600 g, examined sonographically within 1 week before delivery. Exclusion criteria were multiple pregnancy, intrauterine death and major structural or chromosomal anomalies. The new formula was then compared prospectively in an evaluation group of fetuses (n = 87) with six currently available equations for estimating weight in the preterm fetus. RESULTS: Stepwise regression analysis with gestational age (in days) and fetal biometric parameters was employed to yield the best-fit formula for predicting fetal weight at birth. The new formula (estimated fetal weight = 5381.193 + 150.324 x head circumference + 2.069 x femur length3 + 0.0232 x abdominal circumference3-6235.478 x log(head circumference)) proved to be superior to established equations. The lowest mean +/- SD absolute error was 66.2 +/- 59 g and the lowest mean absolute percentage error was 7.1 +/- 5.9% SD when studied prospectively in the evaluation group. With the new formula, 48.3% of estimates fell within +/-5% of the actual weight at birth, 73.6% fell within +/-10%, 90.8% fell within +/-15% and 95.4% fell within +/-20%. CONCLUSION: Our new formula is relatively easy to use and needs no adjustment to weight centiles or to fetal lie. It allows reliable weight estimation in the fetus < or = 1600 g.

Development of the St. George Hospital Memory Disorders Clinic Occupational Therapy Assessment Scale.

The St. George Hospital Memory Disorders Clinic Occupational Therapy Assessment Scale (OTAS) is a performance-based assessment of activities of daily living (ADL) administered in the home environment to monitor function among patients with early cognitive decline. Of the 30 items investigated, 19 items that measured "higher" functional domains were found to be useful in discriminating between subjects. Psychometrically, these 19 items had high internal consistency (coefficient alpha = .89) and high interrater reliability (kappa coefficient range: .71-1.0), and correlated well with other measures of higher function (Lawton's instrumental activities of daily living scale: r = .75; Nottingham extended ADL scale: r = .67). However, unlike these latter measures, the OTAS also correlated well with the Mini-Mental State Examination (r = .73), indicating that OTAS is a valid instrument that should be sensitive to functional problems among patients in the early stages of cognitive impairment.

The future for radiography practice.

In evaluating the future face of radiography practice, a historical review of developments to date has been undertaken, together with a look at the changes which will face the profession into the new millennium. This article focuses on changing healthcare provision, changing radiographic practice, the changing face of the healthcare professions and the changing focus of education and training. The opportunities for further development of the profession are explored along with an overview of some of the possible barriers to progress. Our contention is that radiographers are more than adequately prepared for a rapidly changing future. To ensure that they are prepared, however, it is essential for the profession to adopt an appropriate vision, formulate an achievable strategy, and promote a culture of professional practice which is able to respond adequately to the problems facing its continued existence.

Oxygen affinity of avian blood.

Oxygen dissociation curves plotted directly on whole blood during oxygenation using a Radiometer DCA 1 gave P50 values of 39.2 +/- 2.2 mm Hg and 51.3 +/- 6.2 mm Hg for pigeon and chicken blood, respectively, at 41 degrees C, pH 7.5 and PCO2 29 mm Hg. These values agree well with earlier results obtained by a variety of methods; however, they do conflict with recent findings of a much higher oxygen affinity in avian blood which were obtained using a different plotting method. It was shown that with the method used in this paper the high metabolic rate of avian blood has little effect on the plotted curve at saturations below 50%. At higher saturations O2 consumption of red cells affects a progressive shift of the curve to the left so that to obtain accurate curves at high saturation it is necessary to correct the plotted curves for the oxygen utilization.