A substantial number of patients with psychiatric illnesses present to the Imaging Department across the Irish Republic each year. Patients who have a psychiatric illness may present difficulties for the radiographer during a radiographic examination. These difficulties may include communication difficulties, and an increased prevalence to become violent due to their illness. To investigate if radiographers feel confident interacting with psychiatric patients. To ascertain if radiographers need more training in this area of patient interaction. A qualitative approach was used drawing upon six radiographers working in a regional hospital with a psychiatric unit attached. The radiographers were interviewed individually and the results were thematically analysed. The results indicated that the level of the radiographers own confidence in relation to interacting with psychiatric patients was influenced by the number of years since qualification. The majority of radiographers in the study displayed a poor knowledge of psychiatric conditions and how they affect patients. Based upon this small study, the results suggest that newly qualified radiographers do not feel confident in their own abilities when interacting with psychiatric patients and would welcome and benefit from specific training with regards to strategies to deal with psychiatric patients. The radiographers reported that particular areas which may be improved upon are more information on psychiatric illnesses, manifestations of different types of psychiatric illness and the subsequent effect on patients. A larger study encompassing the whole of the Republic of Ireland would be valuable as a precursor to a European comparative study in order to investigate this phenomenon at a deeper level. Additionally it is recommended that further research is conducted within a wider European context on student radiographers and lecturers teaching on undergraduate radiography courses to ascertain if this topic is addressed at undergraduate level.
This was a Study to Investigate Infection Control and Administering Policies Regarding Radiographer Performed Intravenous Injections. The hypotheses of the research study were:
Non-biological, yet signal-responsive, MR phantom materials are becoming increasingly commonplace. One such novel agent, semi-solid manganese chloride (MnCl2), has recently been described as a potential calibration standard for direct assessment of in vivo cartilage fluid content. Given the established correlation between intervertebral disc (IVD) hydration state and physiologic spinal functioning, such a tool, allowing calibration for ‘quantitative’ appraisal of disc fluid content, has many potential applications. The purpose of this study was to demonstrate MR signal-to-noise ratio (SNR) measurement reliability of a novel MnCl2-based signal calibration phantom for in vivo disc hydration analysis, using a 10 × 10 inter- and intra-observer reliability analysis in the pre-clinical setting. A series of novel MnCl2 calibration phantoms were imaged to assess intra-/inter-observer reliability during measurement of signal intensity. The phantoms were imaged under ten different MR sequences, generating 75 signal regions from which SNR values were measured. Inter-observer reliability was tested by inviting ten individuals to obtain signal measurements from each image, on a single occasion. To test intra-observer reliability, a single participant was asked to record measurements of the same features on ten separate occasions. 1425 Discrete measurement points were available for combined reliability analyses. Single-measure intraclass correlation coefficients showed high measurement agreement, with both intra- and inter-observer values approaching 1.00. This study demonstrates that signal measurements can be obtained using MnCl2 disc phantoms, with a high degree of observer reliability, supporting their use as a signal calibration standard during orthopaedic MR-based cartilage imaging.
The purpose of this review is to discuss the difficulties in interpreting paediatric dual energy X-ray absorptiometry (DXA) scans and examine the methods used to overcome these problems. There are several approaches to aid interpretation of DXA results, however despite agreement that a method should be employed; there is currently no consensus as to which method is the most appropriate.
The College of Health Sciences, Makerere University has been training health professionals since 1924 using a lecture based curriculum. After a curriculum review, the curriculum was changed to Problem Based Learning (PBL)/Community Based Education and Service (PBL/COBES) for all undergraduate programmes of which radiography is part. This study was carried out to find the attitudes and perceptions of students and faculty about PBL in the radiography curriculum. To find out the attitudes and perceptions of students and teachers about PBL in the radiography curriculum. The study was conducted at the College of Health Sciences, Makerere University. It was a cross-sectional descriptive study in which self-administered questionnaires were used and focus group discussions conducted with both radiography students and faculty. All the students and 80% of teachers rated PBL highly as a good instructional method. 100% of the students and 100% of the teachers reported that PBL is a gateway to the acquisition of key generic skills like team work, problem-solving and self-directed learning. In adequate learning resources as well as student assessment in PBL were noted as the major challenges. Both students and teachers affirmed that PBL is an excellent method of training radiographers. There is need however to avail students with adequate learning resources in order to sustain the programme.
In the past two decades radiography has experienced a wealth of changes, involving the teaching site, learning methods, curriculum, professional status, educational funding, and public expectations. Consequently this period witnessed the transition of radiography from a mainly hospital-linked to a mainly university-linked degree, from a knowledge-based discipline to an evidence-based practice. The early 1990s saw the establishment of graduate programs, the role expansion of radiographers, the technological advancements in medical imaging, the participation of the Radiography Schools in Research Assessment Exercise (RAE) schemes.
Any Medical imaging practice or education which is not based on current best evidence is unscientific and lacks the capability for sustainable quality and improvement. From literature search, there has not been any structured or empirical research to determine the knowledge attitudes and perceptions of radiographers to evidence based medical imaging in Nigeria. The purpose of this study was to assess the knowledge and attitudes towards the use of evidence based medical imaging among medical imaging scientists (radiographers) in south eastern Nigeria. Quantitative research methods were employed. A questionnaire was sent to all radiographers working in hospitals in south eastern Nigeria for whom contact could be established (n = 60). The questionnaire included questions seeking information on radiographer’s definition of EBMI, attendance at EBMI courses, beliefs regarding patients’ willingness and capability to participate in EBMI and their perceived barriers to use of EBMI. Data analysis involved descriptive statistics and theme analysis of suggestions made by radiographers. SPSS (11.0) was used. Fifty out of the sixty questionnaires were returned. None of the respondents have ever attended an EBMI course, reads regularly or subscribes to a journal. 88% of respondents ticked the correct definition of EBMI. 62% of radiographers commented that EBMI is new to them. Analysis of barriers to the use of EBMI showed that no access to EBMI resources was the dominant barrier (36%). 15 (30%) of radiographers believe that 10% of patients can participate in EBMI, while 4 (8%) of radiographers believe that 100% of patients can participate. The majority of respondents (48%) believe that mass education of radiographers will improve the practice of EBMI. We conclude that there is poor knowledge and attitude towards the use of EBMI by most radiographers (medical imaging scientists) in the south east Nigeria. Individual and organizational barriers to the use of evidence based medical imaging were identified. Mass education and better organizational platforms are needed to improve the practice of EBMI in Nigeria. A broad-based approach that integrates EBMI into practical clinical, teaching, administration and research domains is canvassed for Nigerian radiographers.
The purpose of this paper was to review the literature relating to the extension of the radiographer role in the UK National Health Service, 1995–2009; focusing on those activities where this role extension had been most pronounced. In this paper descriptive research method was used. This literature review was focused on five key research surveys together with other peer reviewed primary research articles. Government and professional bodies’ publications were also reviewed. The number of trusts adopting extended radiographer roles had grown considerably over the period 1995–2009, encompassing a diverse range of activities, many of which have become well established. These included radiographer reporting in ultrasound and in skeletal X-ray examinations and intravenous injection administration. Influencing factors were increased service demand, shortage of radiologists and increased capacity of radiology services and equipment.
Although various rates of sonographic detection of foetal anomalies abound, no available data exist on the prevalence and patterns of anomalies in the South–South (Niger Delta) region of Nigeria. A retrospective analysis of the records of 10,440 prenatal sonograms and anomaly register over a two year period was performed. 72 foetuses were identified with a total of 88 anomalies.
The usefulness of anti-scatter grid in digital pediatric chest radiography was investigated by a phantom study assessing image quality using subjective evaluations and dose measurements. A contrast detail study was undertaken. Images were taken with and without anti-scatter grids (grid ratio 15:1), for PMMA phantom thickness ranging from 1 to 15 cm. Fourteen radiographers, experienced in digital pediatric and/or skeletal radiography, read 96 images. At each thickness, the image with and without grid technique was read three times, and in random order. Correct Observation Ratio (COR) and Image Quality Figures (IQF) were calculated. Dose Area Products were measured with DAP-meter. The COR and IQF values indicated statistically significant (p < 0.05) enhanced image quality when using anti-scatter grid for all thicknesses 5 cm and more. The DAP values increased significantly by grid techniques (p = 0.01). Grid techniques may be beneficial to image quality for PMMA objects over 5 cm, but this leads to a higher dose. Although the magnitude of dose may be low, the dose should be kept at a minimum. In conclusion, improving image quality should be based on optimizing post-processing settings and image evaluation conditions.
Medical literature and the number of patients diagnosed with head and neck angiosarcomas are very limited. Our case report presents clinical history, imaging procedures, treatment (surgery) and histological findings of angiosarcoma in non-irradiated parotid gland.
Magnetic Resonance Imaging (MRI) techniques have been increasingly applied to the study of molecular displacement (diffusion) in biologic tissue. The magnetic resonance measurement of an effective diffusion tensor of water in tissues can provide unique biologically and clinically relevant information that is not available from other imaging modalities. For this purpose Diffusion Tensor Imaging (DTI) is applied. DTI is an MRI variation that may significantly improve our understanding of brain structure and neural connectivity. DTI measures are thought to be representative of brain tissue microstructure and are particularly useful for examining organized brain regions, such as white matter tract areas. DTI measures the water diffusion tensor using diffusion weighted pulse sequences sensitive to microscopic random water motion. The resultant images display and allow for quantification of how water diffuses along axes or diffusion encoding directions. This can help measure and quantify a tissue's orientation and structure, making it an ideal tool for examining cerebral white matter and neural fiber tracts. In this article we discuss the theory on which DTI depends on, how can be used in mapping fiber tracts. Also the fiber tracking algorithms are presented.
To encourage local participation in patient dose data acquisition, a mathematical method of entrance skin doses determination, developed by Harpen, has been used to determine patient doses and radiographic/technical image quality for 169 adult patients undergoing non-grid chest radiography in three Nigerian hospitals. Calculated doses were found to be about 12.5% (range 8.9–13.3%) higher than doses obtained with thermoluminescence dosemeters (TLD). This level of discrepancy was about 4% higher than the value reported in the literature. Radiographic/technical quality was rated at 53.7% while image quality obtained against a standard image according to the European guidelines was rated with an above average score (58%). Notable variation between the hospitals was observed and the need for optimization highlighted in technical areas like collimation, film processing and in patient dose reduction using better exposure techniques. This study presents patient entrance doses and image quality in hospitals where such data was not existing and could therefore be used as a basis for future studies in dose and image quality, towards the development of local and national reference parameters. The mathematical method, though highly susceptible to errors, can be employed until dose monitoring equipment become more accessible.
This study compared the proportion of mammograms classified as perfect, good, moderately good or inadequate by a radiographer specially trained for doing such a classification at a breast centre (local-PGMI radiographer) with the proportion similarly assessed by an expert-PGMI radiographer. The results were compared with the recommendations given in the quality assurance manual of the Norwegian Breast Cancer Screening Programme. The reasons for classifying the mammograms into other than perfect, such as good, moderately good or inadequate were investigated.
The purpose of the present study was to identify the factors having the largest influence on the patients, experiences of mammography screening and if these factors can be generalised for different centres. Three-hundred-and-ninety-three women attending mammography examination during two randomly selected days at four screening centres in the Southern Health Region of Norway were approached. A questionnaire designed to survey socio-demographic variables and their experience with mammography screening was distributed upon attendance. The answers to the questionnaire were related to the level of breast compression which was recorded for every patient. Statistical analyses were performed to assess women's satisfaction, discomfort and level of pain during mammography screening. Eighty-two percent (324/393) completed the questionnaire. Ninety-one percent were 'satisfied' or 'very satisfied' with the service at the mammography screening centres. Still, 80% reported high level of discomfort related to the examination. 'Moderate', 'strong' or 'intense' pain during breast compression was reported by 25% of the women. Mean breast compression ranged from 8.5 ± 1.2 kg to15.7 ± 2.2 kg. In all, 23% of women experienced strong and intense pain at a compression of more than 16 kg, while none of the women experienced strong or intense pain for compression less than 8 kg. Our results concur with earlier studies showing high level of satisfaction among Norwegian women undergoing breast screening. The present study clearly demonstrates that the level of compression is vital to the patients' experience of pain, but do not seem to influence their level of satisfaction with the procedure.
To assess whether radiographic findings were documented in the clinical notes by the referring medical team. All radiographs should be checked by the referring medical team, and documented in the clinical records. All adult inpatients at City Hospital Birmingham, UK. Prospective spot audit of medical records. We established which plain radiographs had been performed during that admission using PACS (picture archiving and communication system). This was reconciled against the patients' notes to determine if findings were documented by the referring medical team, and the delay in documenting their findings. A baseline audit was performed in September 2007, and re-audited in August 2008. A letter highlighting the importance of documenting findings was circulated. Stickers were affixed to clinical notes to act as a reminder for the referring medical team. For the baseline audit we assessed 388 radiographs of 164 adult inpatients. 147 (37.9%) showed no evidence of being checked by the referring medical team. Of the 241 radiographs which were documented, 230 (95.8%) were documented within 2 days of being performed. For the re-audit in August 2008, we assessed 687 radiographs of 279 adult inpatients. 492 radiographs were documented, of which 467 (94.9%) were reported within 2 days. The absolute reduction in the proportion of undocumented radiographs was 9.6% which represents a 25% improvement (p < 0.002). This audit demonstrates that many inpatient radiographs have no evidence documented in clinical notes of being checked or acted upon by the referring medical teams. Affixing a reminder sticker to medical notes improves reporting rates.
Saphenous varix is a rare vascular malformation occurring in the groin and its recognition may pose a diagnostic challenge.
To determine whether radiation therapists (RTT) can correctly identify field placement errors and recommend appropriate isocentre moves using electronic portal imaging. A systematic review of the literature was made using the keywords: "radiation therapy OR radiotherapy AND electronic portal imaging"; radiation therapist OR radiographer OR radiologic technologist AND electronic portal imaging"; "electronic portal imaging"; "verification AND electronic portal imaging"; "verification AND radiation therapist"; "verification films"; "image approval"; "radiation therapist AND role expansion"; and "radiation therapist experience". Eighteen relevant articles were found. These were collated into three topic areas: 1) current practice, 2) ability to assess EPIs, and 3) experience/education needed. It is common practice for RTTs to review EPIs in Canada, Australia and New Zealand. Education is carried out in the clinic. Concordance between RTTs and radiation oncologists (ROs) in error detection and iso-move decisions was between 90.1% and 97.3%. RTT inter-observer variability was 0.7–1.4 mm and intra-observer variability was 0.4–0.7 mm. RTTs provide acceptable alternatives to ROs for rapid review of EPIs, enabling prompt corrections to be made with the patient on the treatment couch. It is recommended that RTTs take on this role, using an internal accrediting program and ongoing continual professional education.
The purpose of this article is to describe and discuss the development and challenges faced by radiography science as a new academic discipline. New academic disciplines develop continually from different circumstances and for different purposes. As they develop, they are faced with the challenge of justifying their status as independent academic disciplines in various ways. Radiography science is one of the youngest disciplines among health sciences in Finland, challenged by the academic community, society and clinical practice. Radiography science in Finland has already shown considerable development and achieved many substantial and structural criteria set for independent academic disciplines. However, resources are still very limited and the profile of radiography science needs to be clarified. Challenges should be considered as inspirational opportunities and takeoff for the development of radiography science nationally and internationally.
Magnetic Resonance Imaging (MRI) is an important diagnostic imaging tool that has seen rapid expansion in recent years with a commensurate increase in the number of radiographers undertaking MRI scans. This imaging modality is a complex one and the strong magnetic fields associated with MRI scanners pose a very serious risk to patients and staff. Therefore it is essential that MR radiographers receive appropriate training in the correct operation and safe use of MRI. The education of radiographers undertaking MRI examinations is largely provided “in-house” by radiographers or applications specialists. This training is usually informal and focuses on essential safety training and the use of scanner software. This learning is not usually formally assessed and therefore its value is not properly evaluated.
