Research Output
1 - 10 of 20
Publication
Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll project
2022-09-04, Rainford, Louise A., Santos, Joana, Alves, Francisco, McNulty, Jonathan P., Foley, Shane J., et al.
Background: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
Publication
The challenges, coping mechanisms, and recovery from the initial waves of the COVID-19 pandemic among academic radiographers
2022-10, Knapp, K. M., Venner, S., McNulty, Jonathan P., Rainford, Louise A.
Introduction: The COVID-19 pandemic arrived in Europe in March 2020 and created major challenges across healthcare provision and for healthcare education programmes as well as having a major impact on society. Within the profession of Radiography changes in medical imaging, radiotherapy, and teaching practices have been reported along with the negative impact on radiographers and students. The aim of this study was to investigate key challenges relating to academic practice during the COIVD-19 pandemic; how radiography academics have coped and to identify recommendations for further support required to facilitate recovery of the academic faculty as the pandemic ebbs. Methods: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Open questions relating to the challenges of providing radiography education during the COVID-19 pandemic and the and coping strategies used were included. Thematic analysis was conducted using NVivo (QSR International, MA). Results: 533 academic radiographers responded to the whole survey from 43 different countries, with 340 responses relating to challenges and 327 for coping strategies. The main themes for the challenges were clinical practice, communication with colleagues, lack of face to face, managing change, students (support), and staff support. The coping strategy themes were communication with colleagues, physical exercise, self-care and wellbeing. Conclusion: These data demonstrate a multitude of challenges for academic radiographers and the pressure they worked under during the first year of the COVID-19 pandemic was clear. However, the majority employed healthy coping strategies to help them deal with the pressure, uncertainty and trauma of the situation. Implications for practice: COVID-19 had a significant impact on academic radiographers and while many reported good strategies for coping, the level of pressure is unsustainable. This study highlights the need to support academic radiographers to ensure a sustainable workforce.
Publication
Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey
2023-04-01, Santos, Joana, Foley, Shane J., Andersson, Jonas, Rainford, Louise A., McNulty, Jonathan P., et al.
Purpose: To analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges. Method: An online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research. Results: The majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%). Conclusions: A heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.
Publication
Establishment of diagnostic reference levels for CT trunk examinations in the Western region of Saudi Arabia
2014-12-02, Qurashi, Abdulaziz A., Rainford, Louise A., Foley, Shane J.
Diagnostic reference levels (DRLs) are an important optimisation tool, which aid in identifying abnormally high dose levels. These are currently not available in Saudi Arabia, and this research aims to remedy this. CT dose data (DLP and CTDIvol) were collected for a minimum number of 10 adult patients of average size (60–80 kg) presenting for a range of CT examinations from public hospitals in the western region of Saudi Arabia. These include routine chest, high-resolution chest (HRCT), pulmonary angiography (CTPA), abdomen and pelvis (AP) and the combined chest, abdomen and pelvis (CAP) CT examinations. Mean values for each site were calculated, and the 75th percentile of DLP and CTDIvol was used as a basis for DRLs. Data for 550 patients were collected from 14 hospitals over a 7-month period. The rounded third-quartile CTDIvol and DLP were 18 mGy and 630 mGy cm−1 for chest CT, 20 mGy and 600mGy cm−1 for HRCT, 18 mGy and 480 mGy cm−1 for CTPA, 15 mGy and 800 mGy cm−1 for AP, and 16 mGy and 1040 mGy cm−1 for CAP, respectively. Regional DRLs have been proposed from this study. Dose variations across CT departments have identified an urgent need for optimisation to improve distribution of observed doses for CT examinations.
Publication
The impact of COVID-19 upon student radiographers and clinical training
2021-05-01, Rainford, Louise A., Zanardo, M., Buissink, C., McNulty, Jonathan P., et al.
Introduction: To investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning. Methods: Between mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases. Results: 1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use. Conclusion: Student radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience. Implications for practice: As the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.
Publication
An evaluation of in-plane shields during thoracic CT
2013-08, Foley, Shane J., McEntee, Mark F., Rainford, Louise A.
The object of this study was to compare organ dose and image quality effects of using bismuth and barium vinyl in-plane shields with standard and low tube current thoracic CT protocols. A RANDO phantom was scanned using a 64-slice CT scanner and three different thoracic protocols. Thermoluminescent dosemeters were positioned in six locations to record surface and absorbed breast and lung doses. Image quality was assessed quantitatively using region of interest measurements.Scanning was repeated using bismuth and barium vinyl in-plane shields to cover the breasts and the results were compared with standard and reduced dose protocols. Dose reductions were most evident in the breast, skin and anterior lung when shielding was used, with mean reductions of 34, 33 and 10 % for bismuth and 23, 18 and 11 % for barium, respectively. Bismuth was associated with significant increases in both noise and CT attenuation values for all the three protocols, especial-ly anteriorly and centrally. Barium shielding had a reduced impact on image quality. Reducing the overall tube current reduced doses in all the locations by 20-27% with similar increases in noise as shielding, without impacting on attenuation values. Reducing the overall tube current best optimises dose with minimal image quality impact. In-plane shields increase noise and attenuation values, while reducing anterior organ doses primarily. Shielding remains a useful optimisation tool in CT and barium is an effective alternative to bismuth especially when image quality is of concern.
Publication
Exploring the translational challenge for medical applications of ionising radiation and corresponding radiation protection research
2022-03-18, Bockhold, Sophie, Foley, Shane J., Rainford, Louise A., McNulty, Jonathan P.
Background: Medical applications of ionising radiation and associated radiation protection research often encounter long delays and inconsistent implementation when translated into clinical practice. A coordinated effort is needed to analyse the research needs for innovation transfer in radiation-based high-quality healthcare across Europe which can inform the development of an innovation transfer framework tailored for equitable implementation of radiation research at scale. Methods: Between March and September 2021 a Delphi methodology was employed to gain consensus on key translational challenges from a range of professional stakeholders. A total of three Delphi rounds were conducted using a series of electronic surveys comprised of open-ended and closed-type questions. The surveys were disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field. Approximately 350 professionals were invited to participate. Participants’ level of agreement with each generated statement was captured using a 6-point Likert scale. Consensus was defined as median ≥ 4 with ≥ 60% of responses in the upper tertile of the scale. Additionally, the stability of responses across rounds was assessed. Results: In the first Delphi round a multidisciplinary panel of 20 generated 127 unique statements. The second and third Delphi rounds recruited a broader sample of 130 individuals to rate the extent to which they agreed with each statement as a key translational challenge. A total of 60 consensus statements resulted from the iterative Delphi process of which 55 demonstrated good stability. Ten statements were identified as high priority challenges with ≥ 80% of statement ratings either ‘Agree’ or ‘Strongly Agree’. Conclusion: A lack of interoperability between systems, insufficient resources, unsatisfactory education and training, and the need for greater public awareness surrounding the benefits, risks, and applications of ionising radiation were identified as principal translational challenges. These findings will help to inform a tailored innovation transfer framework for medical radiation research.
Publication
Paediatric CT optimisation utilising Catphan® 600 and age-specific anthropomorphic phantoms
2014-12-04, Santos, Joana, Carmo Batista, Maria do, Foley, Shane J., Rainford, Louise A., et al.
The purpose of the study is to perform phantom-based optimisation of paediatric computed tomography (CT) protocols and quantify the impact upon radiation dose and image noise levels. The study involved three Portuguese paediatric centres. Currently employed scanning protocols for head and chest examinations and combinations of exposure parameters were applied to a Catphan®600 phantom to review the CT dose impact. Contrast–noise ratio (CNR) was quantified using Radia Diagnostic® tool. Imaging parameters, returning similar CNRs (<1) and dose savings were applied to three paediatric anthropomorphic phantoms. OsiriX software based on standard deviation pixel values facilitated image noise analysis. Currently employed protocols and age categorisation varied between centres. Manipulation of exposure parameters facilitated mean dose reductions of 33 and 28 % for paediatric head and chest CT examinations, respectively. The majority of the optimised CT examinations resulted in image noise similar to currently employed protocols. Dose reductions of up to 33 % were achieved with image quality maintained.
Publication
The risk of burnout in academic radiographers during the COVID-19 pandemic
2022-11, Knapp, K. M., Venner, S., McNulty, Jonathan P., Rainford, Louise A.
Introduction: The COVID-19 pandemic created major challenges across society, healthcare provision and also for those delivering healthcare education programmes. Clinical placements were disrupted and, in many incidences cancelled. Higher education institutions were required to move completely to online delivery methods with little notice. This created significant additional workload, stress and the need to learn new skills at a time of great uncertainty. This study explored the risks of burnout in academic radiographers during the first 12 months of the pandemic. Methods: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Disengagement and exhaustion were measured using the Oldenburg burnout inventory. Descriptive statistics and a one-way ANOVA were used to analyse the quantitative data using STATA V16 (Statacorp, TA). Results: 533 academic radiographers responded to the survey from 43 different countries. Mean disengagement was in the medium range and exhaustion was high for the total dataset. In a subset of countries with 10 or more responses, there was significant variation between countries, with the UK having highest mean exhaustion score and the UK, Ireland and France sharing the highest mean disengagement score. In the total dataset, 86% agreed workload had increased during the pandemic and 35% had considered leaving academia in the last year. Conclusion: These data demonstrate the stark reality of the impact of the COVID-19 pandemic on academic radiographers’ workload, wellbeing, and intention to leave their roles. Implications for practice: COVID-19 has had a significant impact on academic radiographers and this study highlights the urgent need for remedial measures to better support academic radiographers in order to ensure a sufficient, and sustainable workforce.
Publication
Establishment of CT diagnostic reference levels in Ireland
2012-10, Foley, Shane J., McEntee, Mark F., Rainford, Louise A.
Objective: To propose Irish CT diagnostic reference levels (DRLs) by collecting radiation doses for the most commonly performed CT examinations. Methods: A pilot study investigated the most frequent CT examinations. 40 CT sites were then asked to complete a survey booklet to allow the recording of CT parameters for each of 9 CT examinations during a 12-week period. Dose data [CT volume index (CTDIvol) and dose–length product (DLP)] on a minimum of 10 average-sized patients in each category were recorded to calculate a mean site CTDIvol and DLP value. The rounded 75th percentile was used to calculate a DRL for each site and the country by compiling all results. Results are compared with international DRL data. Results: Data were collected for 3305 patients. 30 sites responded with data for 34 scanners, representing 54% of the national total. All equipment had multislice capability (2–128 slices). DRLs are proposed using CTDIvol (mGy) and DLP (mGy cm) for CT head (66/58 and 940, respectively), sinuses (16 and 210, respectively), cervical spine (19 and 420, respectively), thorax (9/11 and 390, respectively), high resolution CT (7 and 280, respectively), CT pulmonary angiography (13 and 430, respectively), multiphase abdomen (13 and 1120, respectively), routine abdomen/pelvis (12 and 600, respectively) and trunk examinations (10/12 and 850, respectively). These values are lower than current DRLs and comparable to other international studies. Wide variations in mean doses are noted across sites. Conclusions: Baseline figures for Irish CT DRLs are provided on the most frequently performed CT examinations. The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimisation of examinations.