'Our Darker Purpose' : the calculus of desire in King Lear : a Girardian reading

Rene Girard has always seen in Shakespeare's work a supreme example of his mimetic theory applied with genius in a dramatic context. He sees in King Lear a kind of summa which brings to 'a sharp focus . .. the mimetic vision.' Using key Girardian concepts like mimetic desire and rivalry, the crisis of Degree, sacred violence, and the victimage mechanism as hermeneutical tools, and applying them rigorously and systematically to the text may yieldfresh and illuminating insights into one of the greatest tragedies of Shakespeare.peer-reviewe

The role of biomedical physics-engineering in the development of medical device education for the healthcare professions

Biomedical physics-engineering involves the development of medical devices and their effective, safe and efficient application in the clinical milieu. Modern healthcare relies heavily on the twin pillars of pharmaceutical and medical device technology. Unfortunately, whilst pharmaceutical education has been given a lot of attention in healthcare professional curricular development, medical device education has been sorely lacking. Meanwhile, the array, variety and complexity of medical devices have been increasing rapidly with the swift advances in technology. On the other hand, as device education has not kept pace so have underutilization of devices and the number of instances of improper and unsafe use.peer-reviewe

An inventory of biomedical imaging physics elements-of-competence for diagnostic radiography education in Europe

Purpose: To develop an inventory of biomedical physics elements-of-competence for diagnostic radiography education in Europe.Method: Research articles in the English literature and UK documentation pertinent to radiography education, competences and role development were subjected to a rigorous analysis of content from a functional and competence analysis perspective. Translations of radiography curricula from across Europe and relevant EU legislation were likewise analysed to ensure a pan-European perspective. Broad Subject Specific Competences for diagnostic radiography that included major biomedical physics components were singled out. These competences were in turn carefully deconstructed into specific elements-of-competence and those elements falling within the biomedical physics learning domain inventorised. A pilot version of the inventory was evaluated by participants during a meeting of the Higher Education Network for Radiography in Europe (HENRE), held in Marsascala, Malta, in November 2004. The inventory was further refined taking into consideration suggestions by HENRE members and scientific, professional and educational developments. Findings: The evaluation of the pilot inventory was very positive and indicated that the overall structure of the inventory was sensible, easily understood and acceptable – hence a good foundation for further development. Conclusions: Use of the inventory by radiography programme leaders and biomedical physics educators would guarantee that all necessary physics elements-of-competence underpinning the safe, effective and economical use of imaging devices are included within radiography curricula. It will also ensure the relevancy of physics content within radiography education. The inventory is designed to be a pragmatic tool for curriculum development across the entire range of radiography education up to doctorate level and irrespective of whether curriculum delivery is discipline-based or integrated, presentation-based or problem-based. It is suggested that the methodology used in the evolution of the inventory be applied to the development of inventories of elements-of-competence for other learning domains within health professional curricula.peer-reviewe

Maltese radiographers’ attitudes towards continuing professional development : an initial study using concept maps

Purpose: The Council for the Professions Complementary to Medicine in Malta recently published a draft document regarding the introduction of mandatory continuing professional development (CPD) for radiographers. This study explored the attitudes and motivators of Maltese radiographers prior to the implementation of mandatory CPD in order to provide the necessary information required by management to develop CPD successfully. Concept maps are used as part of a methodology to analyse qualitative data. Methods: All radiographers working in the National Health Service were invited to complete an anonymous web-based questionnaire. Results: The study showed that participants generally had a positive attitude towards CPD but were concerned about the mandatory aspect. The participants were mostly motivated by increasing professional knowledge, updating existing qualifications, and enhancing the status of the profession as a whole. Radiographers identified several difficulties with respect to CPD participation, such as lack of funding, lack of management support, and not enough local CPD opportunities. CPD participation was also negatively influenced by family commitments. Conclusion: The study showed that the majority of radiographers were self-motivated to engage in CPD activities, but there were some concerns. Based on these results, the authors suggest recommendations for allaying apprehension and producing the necessary conditions for a successful mandatory CPD scheme.peer-reviewe

The changing concept of competence and categorisation of learning outcomes in Europe : implications for the design of higher education radiography curricula at the European level

The Bologna process has made the qualifications framework of the European Higher Educational Area based on three cycles and on learning outcomes central to curriculum development in higher education in Europe. The Tuning Educational Structures in Europe project recommended that learning outcomes be expressed in terms of competences. The expression of educational programme learning outcomes as inventories of competences has since become the norm at the European level. However, the more recent European Qualifications Framework for lifelong learning utilises a tripartite set of categories of learning outcomes, namely, knowledge, skills and competence. In addition, the definition of competence used though overlapping with that used by Tuning, is however not identical. This article reviews and discusses the changing definition of the concept of competence and changes in categorisation of learning outcomes in Europe and their potential impact on curriculum development in radiography at the European level. It is proposed that the shift in the definition of competence and in the categorisation of learning outcomes should be taken into account in the formulation of new European curricula or the updating of present ones so that they may reference in a more direct manner to the levels of the European Qualifications Framework.peer-reviewe

A qualitative comparative survey of first cycle radiography programmes in Europe and Japan

Purpose: To qualitatively compare First Cycle Radiography programmes in Europe and Japan. Methods: This qualitative survey was conducted via a series of case-studies of university-based radiography curricula in Europe and Japan. Findings and conclusions: The main themes arising from the survey were that: (a) in Europe the freedom that most universities have in setting their own curricula and examinations means that in practice there is still a wide variability in curricula between and within states. On the other hand in Japan curricula are more uniform owing to central government guidelines regarding radiography education and a centrally administered national radiography examina- tion. This means that student and worker mobility is much easier for Japanese radiographers. (b) in some countries in Europe principles of reporting and healthcare management are being expanded at the expense of the more technological aspects of radiography. Physical science competences on the other hand are considered highly in Japanese culture and form a major part of the curriculum. This may indicate that Japanese students would be in a much better position to cope with role developments linked to changes in imaging technology. Pragmati- cally oriented studies need to be carried out to determine ways in which radiographers can enhance their role without sacrificing their technological competences. The profession cannot afford to lose its technological expertise e it is neither in the interest of the profession itself and even less of the patient.peer-reviewe

About developing a new profession – medical physics in Malta

Developing a new profession is not easy – and in a small, insular, island state, it is even more difficult. You knock on many doors – the response is always the same: “Medical Physics, what’s that?” They don’t even give you the time of day. Of course, in hindsight, it was to be expected when most administrators’ knowledge of physics was limited to Physics SEC level and Newton’s laws of motion. You are mocked when armed with a short well-crafted presentation you land at the Ministry of Health ready to do your bit to help ensure the effective and safe use of medical devices and physical agents (sources of energy such as x-rays, ultrasound, lasers) in Malta. But you persevere, slowly but surely build support, and in the end prevail. This editorial will first provide some background to the medical physics profession. This will be followed with some lessons learned based on my journey in developing the medical physics profession in Malta, the intention being to help any future leaders who might find themselves facing a similar challenge.peer-reviewe

Early school leaving and wellbeing in Malta and beyond : a statistical analysis

Early school leaving is a complex educational, economic, and social issue with significant negative consequences for individuals, societies, and national economies. While Malta has been applauded for its fast declining rates of early school leaving, the country is still significantly above the EU average and above the rate of early school leaving in all other EU countries, bar one. Due to inherited educational structures and prevailing social, economic, and labour market conditions, Malta is recently experiencing slower rates in decline of early school leaving and a slight increase in the number of females in the early school leaving bracket. One hopes that recent comprehensive measures included in the Malta National Reform Programme and Education policies of recent years will contribute to the further decrease of the early school leaving rate in Malta, hopefully close to the ambitious target of halving the ESL rate from 20.4% to 10% by 2020. This study aims to contribute to the ongoing analysis, debate, and efforts focused on the reduction of the early school leaving rate by providing relevant evidence for understanding potential links between early school leaving and various aspects of wellbeing. The study also sets out to identify the knowledge gaps that exist in this domain and to prepare background information for a potential second phase of the study, which would focus on conversations with early school leavers around issues flagged by the present study. Ultimately, we intend for this research to prepare the way for future applied studies of early school leaving.peer-reviewe

Surgical admissions to intensive therapy unit at Mater Dei Hospital : a prospective 3 month study

Introduction: Patient care in an acute hospital is divided into 4 levels, with level 0 being least demanding and level 3 comprising intensive care. A surgical high dependency unit (HDU) offers level 2 (intermediate) care and is indispensable when escalating or de-escalating from lower or higher levels of care respectively. Mater Dei Hospital lacks such a unit. -- Methods: Data was prospectively collected over a 3-month period and included all surgical patients admitted to the intensive therapy unit (ITU), including subspecialties. The duration and reasons for admission to hospital and ITU were documented. Hospital admissions were either planned or emergency. Reasons for ITU admission were either planned or unplanned after elective surgery, following emergency surgery, directly from the Emergency Department or following clinical deterioration in a level 0 ward. Number of organs supported, any surgical interventions during admission and the final outcome were noted. -- Results: There were 173 surgical patients admitted to ITU (116 males) with mean age 61.2 years. Most were post-surgery (71.7%, n=124) or after being stabilised at the Emergency Department (21.4%, n=37). Fewer required escalation from normal ward-based care (6.94%, n=12). Transfers from other hospitals occupied 3 ITU beds (1.73%). Mean ITU stay was 3.4 days per patient, with 6.5 beds being occupied by surgical cases on a daily basis. Forty-one percent of patients met the criteria for HDU. -- Conclusion: With an ever growing population, there is a need to set up a local surgical HDU. This will help relieve the recurrent shortage of ITU beds without compromising the level of healthcare delivered.peer-reviewe

Optimizing a magnetic resonance care pathway : a strategy for radiography managers

This study reports the optimization of a local MR care pathway. A search of the literature did not result in any studies regarding the optimization of MRI care pathways through a formal research process. Discussions with international MR radiographers indicated that such development is often carried out using informal methods that are highly dependent on local conditions, that are rarely reported in the public domain and the validities of which are therefore not open to scrutiny; in addition, care pathways need to be specific to local healthcare needs and culture. In this study, the authors propose a formal documented methodology for developing a local MRI care pathway based on the well-established nominal group technique.peer-reviewe