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If the appearances represent active pathology, then further critical analysis is required to identify the most likely diagnosis and/or to provide a list of differential diagnoses. Medical interpretation the interpretation of the findings and subsequent report must be considered in the light of the wider clinical picture. In order to produce a relevant diagnostic report, review and understanding of any previous imaging or relevant investigations may be required. In this context, it is essential that the report author has extensive medical knowledge to reach a diagnosis or a series of ranked differential diagnoses on which clinical decisions can be made. Whether the report is produced by a medically qualified or non-medically qualified ultrasound practitioner it is essential that there are governance procedures in place to ensure that the individual does possess the knowledge, skills and competence to effect this duty without detriment to the patient outcome. In addition, there must be a failsafe mechanism to ensure that, when required, a radiological or equivalent expert opinion can be obtained promptly to allow issue of the report without undue delay. Advice It is essential that the report author is aware of the diagnostic accuracy of the examination related to the individual patient. If a definitive diagnosis cannot be made then advice on further appropriate imaging investigations should be provided, when required. Local policy should exist clearly stating mechanisms for advising on relevant further investigations that takes account of the professional background of the report author, which may be a non-medical one. Communication with the referrer There needs to be an effective mechanism in place locally to ensure timely dissemination of the ultrasound report. A mechanism to allow the referring clinician to discuss the report findings with the report author to ensure better understanding of the clinical impact of the report on management is appropriate. For example, a dedicated department email address may be set up to allow communication between referrers and reporters for such queries. Taking appropriate action the report author also has a duty of care to the patient to ensure that when immediate or urgent action is required that this information is delivered to the referring clinician promptly. Communication with the patient It may/may not be possible for the report author to pass on information regarding the outcome of the examination to the patient, particularly if there has not been time to review the wider clinical aspects of the case. Caution is recommended when discussing the clinical findings with the patient, particularly in respect of possible management strategies where the report author may not have adequate knowledge. Staff should also adhere to the guidance provided on communication by their professional body. Appropriate training should be undertaken prior to giving any bad news to ensure that such news is given sensitively and effectively and without ambiguity. Report authors must be aware that patients may have access to the report and therefore caution in the wording is advocated.

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Held: Murphy was estopped from denying that Coker had a good title to the Bedford. Estoppel by negligence If the owner has made no representation, an alternative claim open to the innocent third party is to argue that the owner is estopped by negligence from asserting his ownership. If there is a representation, it is quite clear that even a wholly innocent representation, made without negligence, will be sufficient to found the estoppel: see, for example, Henderson v Williams (above). However, as we have already seen, this would amount to a mortgage which is registrable under the Bills of Sale Acts and finance companies are generally reluctant to make such agreements with private individuals. Instead, she decided to deal through an apparently respectable car dealer called Phelan with whom she was friendly. Phelan said that he would enquire how much he could get for the car and report back over the telephone to Hamblin before proceeding. Things went wrong when Phelan filled in the hire-purchase proposal forms which had been signed by Hamblin. He sent them to Mercantile Credit along with a further form in which Phelan claimed to be the owner of the Jaguar and offered to sell it to the finance company. Phelan obtained fi800 for the Jaguar from the finance company and absconded 418 Chapter 20: Transfer of Title by a Non-Owner with the money, leaving Hamblin to pay the hire-purchase on the car. Mercantile Credit argued that Hamblin was estopped by her conduct in signing the blank forms from asserting her ownership. However, it was held that the defence failed because the document she signed was of the same character as the one she thought she was signing. It was held that she had not made a representation to Mercantile Credit that Phelan was the owner of the car. You will recall that in Henderson v Williams, the owner of a consignment of sugar was held to be estopped by a representation which was made to the innocent third party, not by the owner himself but on his behalf, by his warehouseman.

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Hakluyt complained in it that the English were missing opportunities and should seize the moment: I marvel not a little that since the first discovery of America (which is now full forescore and ten years) after so great conquest and planting by the Spaniards and the Portingales there, that we of England could never have the grace to set fast footing in such fertile and temperate places as are left as yet unpossessed by them. I conceive great hope that the time approacheth and now is that we of England may share and part stakes (if we will ourselves) both with the Spaniard and Portingale in part of America and other regions as yet undiscovered. Ralegh is the first great man in the story of the American people to come into close focus from the documents, and it is worth looking at him in detail. He had certain strongly marked characteristics which were to be associated with the American archetype. He was of ancient family, but penniless, born in Devon about 1554 and `spake broad Devonshire until his dying day. Fully Anglicized territory, radiating from Dublin, the capital, was known as the Pale, and the Irish were allowed inside it only under close supervision. One such uprising had occurred in 1580, in Munster, and Ralegh had raised a band of l00 footmen from the City of London and taken a ruthless part in suppressing it. And, just as the money from the reconquista went into financing the Spanish conquest of the Americas, so Ralegh put the profits from his Irish estates towards financing his transatlantic expedition.

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Buckingham Mclntee J and I Crompton, 1997, the psychological effects of trauma on children. In Bates J, R Pugh and N Thompson, 1997, Protecting Children: Challenges and Change. Illinois Millar J, 2000, Keeping track of welfare reform: the New Deal programmes. Connecticut Morrow V and M Richards, 1996, Transitions to adulthood: a family matterfi London Niner P, 1997, the Early Impact of the Housing Act 1996 and the Housing Benefit Changes. Nordstrom C and A Robben, 1995, Eds Fieldwork under fire: Contemporary studies of violence and survival. London Pleace N, 1995, Housing Vulnerable Single Homeless People: Research Report. University of York Pleace N, 1998, the Open House Project for People Sleeping Rough: An Evaluation. London Pavialin M, M Sosin, A Westerfelt and R Matsueda, 1993, the Duration of Homeless Careers: an exploratory study. April 2nd 1993 Power A, 1987, Property Before People: the Management of Twentieth-Centurv Council Housing. London Power A, and R Tunstall, 1995, Swimming Against the Tide: Polarisation or progress on 20 unpopular council estates. Joseph Rowntree Foundation, York Power A and R Tunstall, 1997, Dangerous Disorder: Riots and Violent Disturbances in Thirteen Areas of Britain. Joseph Rowntree Foundation, York 228 Randall G and S Brown, 1993, the Rough Sleepers Initiative: An Evaluation. London Randall G and S Brown, 1994a, Falling Out: A Research Study of Ex-service People.

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