Postweiss3325

INTRODUCTION A hospital environment can be a significant burden and a health risk especially for dementia patients. Mobile x-ray equipment (ME) is used to enable imaging of these patients at home. The aim was to compare image quality (IQ) of chest, hip and pelvis images from ME to the stationary equipment (SE) used in a hospital department. METHODS We analysed examinations of the chest (n = 20), hip (n = 64) and pelvis (n = 32). Images were equally obtained from each setting of ME and SE. All images were graded using Visual Grading Analysis (VGA) by three radiographers (hip and pelvis) and three radiologists (chest). Technical IQ assessment was done by 80 additional images of a Contrast-Detail Radiography phantom (CDRAD). RESULTS All chest images were approved for diagnostic use, as well as the hip AP and pelvis images from SE. 'Approved proportion of ME images was for HIP antero-posterior (AP) and pelvis, 78% [95% CI 52-94%] and 81% [95% CI 54-96%] respectively. Hip axial had an overall low, but not significant different approval rate. Ordered logistic regression indicated higher IQ of HIP AP and pelvic images from SE. This contrasts that the CDRAD substudy indicated better IQ, expressed as IQFinv, from ME. CONCLUSION The VGA showed higher IQ for the SE system, while the CDRAD showed higher IQ for the ME system. IMPLICATIONS FOR PRACTICE Dementia patients can be examined at their home if the acquisition is optimised according to image quality in conjunct to radiation dose. Performing imaging out of the hospital and coordinating the patients' further treatment are new work areas for radiographers and requires excellent communication skills. INTRODUCTION Clinical placements provide rich learning environments for health professional pre-registration education but add significant workload pressure to clinical departments. Advances in simulation approaches mean that many aspects of students' clinical learning can be undertaken in the academic environment. There is, however, little data identifying specific pedagogical gains afforded by simulation compared to clinical placement. This study measured the impact of a comprehensive integrated simulation placement on student clinical skill acquisition. METHODS A virtual department was developed using a range of simulation equipment and software, with actors and service users providing a range of patients for students to engage with. A cohort of 29 first-year undergraduate therapeutic radiography students were randomly assigned to either simulated or conventional clinical placement. Clinical skills assessment scores provided by a blinded assessor were then compared. RESULTS Mean overall assessment scores for each cohort were within 3% of each other. The simulation cohort had over 10% higher "communication" scores than the traditional group (p = 0.028). The ability to gain both technical and interpersonal skills simultaneously improved learning compared to clinical placement. Students valued the structured approach of the simulated placement and the opportunity to practice techniques in a safe unpressured environment. CONCLUSION An integrated simulated placement can help students to achieve clinical learning outcomes and lead to improved interpersonal skills. IMPLICATIONS FOR PRACTICE Use of blended simulation resources can enable students to acquire technical, procedural and interpersonal skills which in turn may enable reduction of overall clinical placement time and departmental training burden. INTRODUCTION Transgender and gender non-conforming people have historically been hidden in society. Increasing visibility has led to an awareness of the systematic discrimination experienced by this community. Transgender people experience factors that increase their need for healthcare while experiencing a lack of trans appropriate care. The aim of the research was to identify the lived experiences of transgender individuals in accessing radiology METHODS A qualitative approach was used to determine the lived experiences of transgender individuals in accessing radiology for care unrelated to their transition process. In depth semi-structured interviews were used to collect data from six participants who identified as transgender or gender non-conforming. Participants were recruited by personal connection and subsequent snowball style sampling. Systematic thematic analysis was applied to the recorded interviews from each participant RESULTS Thematic analysis identified a diverse range of individual lived experiences with 3 themes and a series of sub themes (1) cultural competence (2) social stigma and (3) environment CONCLUSION The study findings identify that negative healthcare experiences of transgender individuals are often the result of a lack of transgender knowledge demonstrated by healthcare professionals. Positive healthcare experiences were characterised by the use of inclusive language and the provision of an inclusive environment. IMPLICATIONS FOR PRACTICE Improving the lived experience of healthcare for transgender individuals will require an improved inclusive curriculum within undergraduate education, as well as post qualification for all healthcare professionals. Healthcare professionals, including radiographers may make immediate improvements in the adoption of a more inclusive language and the display of signs and symbols which reflect a supportive environment. Longer term environmental improvements may include increasing access to gender neutral restrooms and changing facilities. IκB inhibitor INTRODUCTION Despite protocols, patients are not positioned exactly alike at radiostereometric (RSA) follow-up examinations, and it is unknown how much variation is tolerable. We report precision for optimal and extreme position differences from a phantom hip-study, and clinical precision of hip-RSA. METHODS A femoral stem with 3 bead-towers was fixed in a saw bone with bone-markers (phantom), and series of RSA examinations within optimal (5 × 5 cm and 5°) and extreme (20 × 30 cm and 30°) phantom positions were obtained. Double-examination RSA of 12 patients with the same femoral stem type were analyzed. Both model-based (CAD) and marker-based (MM) analysis was used. Precision was reported as standard deviation of differences. RESULTS Precision for translations in the optimal and extreme phantom position were below 0.06 mm and 0.02 mm for MM analysis, and below 0.05 mm and 0.18 mm for CAD analysis, respectively. Precision for rotations in the optimal and extreme phantom rotation were below 0.18° and 0.26° for MM analysis, and below 0.34° and 0.52° for CAD analysis, respectively. Clinical precision was 0.29 mm and 0.44° for MM analysis, and 0.40 mm and 1.59° for CAD analysis. CONCLUSION Extreme differences in patient position during RSA examination negatively affects precision, and CAD model-analysis was more sensitive than MM analysis. Longitudinal translation and rotation about the long stem-axis are the effect parameters which are most affected by position and rotation changes, and also the best indicators of implant loosening. IMPLICATIONS FOR PRACTICE Based on our research, we recommend that similar patient positioning between follow-up RSA examinations is debated and prioritized. INTRODUCTION Gallbladder polyps (GBPs) are gallbladder lesions which can progress to gallbladder malignancy. The incidence has been estimated as high as 12.1% of all cholecystectomy patients. Gallbladder malignancy typically presents late, and therefore carries a poor prognosis. link2 By identifying potential GBPs early, it would be possible to treat polyps before they undergo malignant change. The current gold standard for GBP identification is with histological examination which is performed after cholecystectomy. This study sought to assess whether radiological imaging could reliably identify GBPs and therefore guide management. METHODS 1000 consecutive patients already undergoing cholecystectomy were sampled from two UK hospitals. link3 Patients who underwent ultrasonography and had histological analysis of their gallbladders were selected. Overall 905 patients were included in the study. RESULTS There were 12 histologically confirmed GBPs in the cohort (1.33%). US correctly detected 1 GBP, with a sensitivity of 8.3% (95% CI 0.2-38.5%) and specificity of 96.0% (95% CI 94.5-97.2%). The overall accuracy was 94.8 (95% CI 93.2-96.2%). CONCLUSION These data show that US is an ineffective tool for GBP identification. The lack of prior operator exposure, imprecise nature of US and possible obstruction of images from underlying gallstone disease delivered a high rate of false positives. IMPLICATIONS FOR PRACTICE Surgical or oncological decisions regarding GBPs should not be based upon US findings alone as this would lead to unnecessary interventions. MRI should be investigated as an alternative imaging modality for GBP identification, as its differentiation of soft tissues could guide surgical management. INTRODUCTION Clinical practice guidelines (CPGs) are expected to make evidence-based recommendations, thus guiding practice and reducing unwarranted variation. CPGs are particularly helpful in guiding complex procedures such as the Videofluoroscopic Swallowing Study (VFSS) for the assessment of dysphagia, but there is a suspected high level of variability among them. To explore the extent of this variation, this study aimed to systematically identify and appraise all VFSS CPGs available worldwide. METHODS A systematic search of 3 academic databases and other sources was conducted to identify relevant CPGs; independent reviews of each CPG were undertaken by a Speech and Language Therapist and a Radiographer. Both reviewers completed a pre-determined checklist of expected professional content for each CPG. CPGs were then assessed for quality using the Appraisal of Guidance for Research & Evaluation II (AGREE II) instrument. Findings from the professional content review and the methodological quality review were synthesised to inform an assessment of suitability of each CPG to inform clinical practice. RESULTS Seven VFSS CPGs were identified worldwide, none of which were co-designed by radiographers or aimed at a radiographer audience. Each differs in their professional content, recommendations, underpinning evidence base and professional focus. Average AGREE ll scores across the quality domains vary considerably, ranging from 93 to 22%. No CPGs scored highly on all six AGREE II domains. CONCLUSION There is no standardisation between VFSS guidelines. Six CPGs are not recommended for clinical use; only one of the seven identified CPGs is recommended for use following significant modification. IMPLICATIONS FOR PRACTICE The lack of a comprehensive, evidence-based guideline encourages unwarranted variation in clinical practice which potentially compromises clinical care. Further research is needed to define VFSS best practice. INTRODUCTION Deterioration of visual acuity (VA) and visual impairment has been linked to age-related subtle changes, gender, and a correlation to socioeconomic status. This study aimed to assess first-year diagnostic radiography students' visual functional abilities by applying the International Classification of Impairments, Disabilities and Handicaps (ICIDH) recommendations of functional VA screening and health-related quality of life questionnaire (HRQOL). METHODS The design followed the World Health Organisation (WHO) electronic VA testing of monocular sight using LogMAR charts and binocular vision using Snellen charts, and an HRQOL questionnaire assessing for reduced ability of visual-based tasks in activities of daily living (ADL). The data was evaluated in correlation to the participant's visual correction, age, gender, and socioeconomic background. RESULTS Seventy students were recruited, all meeting the WHO standard level for visual ability, with 100% (n = 70/70) met or achieved above normal binocular vision, correlating to expected normal population results from published studies for age.