Recent Submissions

  • Exploratory study of fathers providing Kangaroo Care in a Neonatal Intensive Care Unit

    Dong, Q.; Steen, M.; Wepa, Dianne; Eden, A. (2022)
    Aim and Objectives: To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU). Background: Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs. Methods: Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study. Findings: Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: ‘Positive psychological connection’, ‘Embracing father-infant Kangaroo Care’ and ‘Challenges to father-infant Kangaroo Care’. Conclusion: The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father–infant KC within the fields of neonatal care. Relevance to Clinical Practice: It is important for nurses and other health professionals to support and enable fathers to give KC. Father–infant KC is recommended in neonatal care settings.
  • Effects of social restrictions on people with dementia and carers during the pre-vaccine phase of the COVID-19 pandemic: Experiences of IDEAL cohort participants

    Pentecost, C.; Collins, R.; Stapley, S.; Victor, C.; Quinn, Catherine; Hillman, A.; Litherland, R.; Allan, L.; Clare, L. (2022)
    This qualitative study was designed to understand the impact of social distancing measures on people with dementia and carers living in the community in England and Wales during a period of social restrictions before the COVID-19 vaccination roll-out. We conducted 12 semi-structured interviews with people with dementia aged 50-88 years, living alone or with a partner, and 10 carers aged 61-78 years, all living with the person with dementia. Three of the interviews were with dyads. Participants were recruited during November and December 2020. We used framework analysis to identify themes and elicit suggestions for potential solutions. We identified three interrelated themes. People with dementia experienced a fear of decline in capabilities or mood and attempted to mitigate this. Carers noticed changes in the person with dementia and increased caring responsibilities, and for some, a change in the relationship. Subsequently, reduced confidence in capabilities to navigate a new and hostile environment created a cyclical dilemma of re-engaging where an inability to access usual activities made things worse. People with dementia and carers experienced neglect and being alone in their struggle, alongside feeling socially excluded during the pandemic, and there was little optimism associated with the upcoming vaccine programme. People found their own solutions to reduce the effects of isolation by keeping busy and being socially active, and practising skills deemed to help reduce the progression of dementia. This and some limited local public initiatives for the general public facilitated feelings of social inclusion. This study adds understanding to existing evidence about the longer-term experience of social isolation several months into the pandemic. It highlights the importance of health and community groups and suggests how services can find ways to support, include, and interact with people with dementia and carers during and after social restrictions.
  • Recruitment and retention of care workers: A rapid review

    Randell, Rebecca (2021-12)
    Introduction: Challenges in the recruitment and retention of care workers is a long-standing issue [1]. However, these challenges have worsened during the Covid-19 pandemic. In October 2021, there was an average staff vacancy rate of 17% [2], and in November 2021, care homes feared they would lose around 8% of their care home staff as a direct result of the policy of vaccination being a condition of deployment in care homes [3]. This has profound impacts, not only on those in care homes and receiving care at home, but on the health service as a whole, with 33% of social care providers limiting or stopping admissions from hospital [2]. Therefore, this review was undertaken to identify learning about how to support recruitment and retention of care workers during the pandemic. Methods: To identify strategies that are currently being used to support recruitment and retention of care workers, a Google search was undertaken, combining termsthat referred to the setting or role (“social care”, “care worker”) and the topics of interest (recruitment, retention), and for some searches adding in terms that referred to the type of literature being sought (“case study”). Through this, we identified that research on recruitment and retention of care workers since the pandemic was already being published and so a search was also undertaken on Google Scholar for research published since 2020. This was supplemented by a review of websites recommended by an expert working in the area: Care England, National Care Forum, Care Forum, Care Choices, Care Workers Charity, National Association of Care & Support Workers, and Skills for Care. We also reviewed the websites of NHS Confederation, NHS Employers, and the Local Government Association. Inclusion criteria were reports that included recommendations and/or examples of strategies to recruit and retain the social care workforce. While we focused on reports published since the start of the pandemic, given that recruitment and retention of care workers is a long-standing challenge, we also included some significant reports that were published before then. A number of the documents included did not provide a publication date. While many of the reports identified discussed the problems that have led to the social care workforce crisis, we limit our discussion of these in this report, instead focusing on possible solutions. Findings: From the Google and Google Scholar searches, 190 records were screened and 22 potentially relevant documents were reviewed in detail for possible inclusion. Alongside this, seven potentially relevant documents from the websites listed above were reviewed in detail for possible inclusion. From this, 21 relevant documents were identified and included in this review. These included seven documents reporting case studies, one Government report, one report based on a survey of employers, four reports based on surveys of care workers, two reports based on interviews with stakeholders, one report based on interviews and focus groups with care workers, managers, and commissioners, and one based on interviews with care workers. It quickly became apparent that potential strategies for improving recruitment of care workers were closely interlinked with strategies for improving retention of care workers. Below we consider those strategies relevant to both, before moving on to consider specific recruitment strategies and strategies focused specifically on increasing retention.
  • A scoping review: Strategic workforce planning in health and social care

    Prowse, Julie M.; Sutton, Claire; Eyers, Emma; Montague, Jane; Faisal, Muhammad; Neagu, Daniel; Elshehaly, Mai; Randell, Rebecca (2022-04)
    Aim This aim of this scoping review was to undertake a detailed review of the pertinent literature examining strategic workforce planning in the health and social care sectors. The scoping review was tasked to address the following three questions: 1. How is strategic health and social care workforce planning currently undertaken? 2. What models, methods, and tools are available for supporting strategic health and social care workforce planning? 3. What are the most effective methods for strategic health and social care workforce planning? Methods The scoping review utilised the five-stage scoping review framework proposed by Arksey and O’Malley (2005). This includes identifying the research question; identifying relevant studies; study selection; charting the data and collating, summarizing, and reporting the results. The search included a range of databases and key search terms included “workforce” OR “human resource*” OR “personnel” OR “staff*”. Relevant documents were selected through initially screening titles and abstracts, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and abstract screening, 654 were identified as potentially relevant. Screening of full texts resulted in 115 items of literature being included in the synthesis. Both national and international literature covers strategic workforce planning, with all continents represented, but with a preponderance from high income nations. The emphasis in the literature is mainly on the healthcare workforce, with few items on social care. Medical and dental workforces are the predominate groups covered in the literature, although nursing and midwifery are also discussed. Other health and social care workers are less represented. A variety of categories of workforce planning methods are noted in the literature that range from determining the workforce using supply and demand, practitioner to population ratios, needs based approach, the utilisation of methods such as horizon scanning, modelling, and scenario planning, together with mathematical and statistical modelling. Several of the articles and websites include specific workforce planning models that are nationally and internationally recognised, e.g., the workload indicators of staffing needs (WISN), Star model and the Six Step Methodology. These models provide a series of steps to help with workforce planning and tend to take a more strategic view of the process. Some of the literature considers patient safety and quality in relation to safe staffing numbers and patient acuity. The health and social care policies reviewed include broad actions to address workforce planning, staff shortages or future service developments and advocate a mixture of developing new roles, different ways of working, flexibility, greater integrated working and enhanced used of digital technology. However, the policies generally do not include workforce models or guidance about how to achieve these measures. Overall, there is an absence in the literature of studies that evaluate what are the most effective methods for strategic health and social care planning. Recommendations The literature suggests the need for the implementation of a strategic approach to workforce planning, utilising a needs-based approach, including horizon scanning and scenarios. This could involve adoption of a recognised workforce planning model that incorporates the strategic elements required for workforce planning and a ‘one workforce’ approach across health and social care.
  • Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study

    Iqbal, Halima; West, Jane; McEachan, Rosemary; Haith-Cooper, Melanie (2022)
    British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner-city areas of Bradford. Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women-only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.
  • Reproductive life histories: can incremental dentine isotope analysis identify pubertal growth, pregnancy and lactation?

    Feuillâtre, C.; Beaumont, Julia; Elamin, F. (Taylor and Francis, 2022)
    Background: There are few reliable osteological indicators to detect parity or infer puberty in skeletal remains. Nitrogen (δ15N) and stable carbon (δ13C) isotope ratios in human tissues can be affected by metabolically unbalanced states engendered by pregnancy or rapid growth, offering potential biomarkers. Aim: This pilot study explores the potential of incremental dentine-collagen isotope ratio analysis to identify puberty and gestation. Methodology: Incremental dentine δ15N and δ13C profiles were produced by analysing third molars extracted as part of dental treatment of 10 individuals living in Sudan. Demographic and anthropometric data at the time of tooth extraction was available. Medical histories were unknown. Results: Isotopic signatures potentially related to pubertal growth, with an average δ15N reduction of 0.78±0.29‰, are indicated. Six isotopic signals suggestive of pregnancy, with an average δ15N decrease of 0.48±0.22‰, are also observed. The timing, speed and amplitude of post-partum δ15N patterns seemingly infer infant feeding practices and maternal nutritional status. Conclusion: This pilot study highlights the potential of incremental dentine isotope analysis for the reconstruction of early reproductive histories in skeletal remains. However, controlled studies with larger human cohort are needed to validate these findings, establish isotopic signals linked to puberty and lactation, and improve chronology accuracy.
  • Predictors of awareness of functional ability in people with dementia: the contribution of personality, cognition, and neuropsychiatric symptoms. Findings from the IDEAL programme

    Martyr, A.; Gamble, L.D.; Nelis, S.M.; Collins, R.; Alexander, C.M.; Morris, R.G.; Quinn, Catherine; Pentecost, C.; Rusted, J.M.; Victor, C.; et al. (2022)
    Introduction: Discrepancy scores reflecting the difference between parallel ratings made by people living with dementia (PwD) in the mild-to-moderate stages and by their informants provide a way to investigate awareness of functional ability in relation to activities of daily living (ADL). Methods: Two measures of ADL (Functional Activities Questionnaire; Dependence Scale) were completed by 1,227 PwD and their informants in the IDEAL cohort study baseline assessment. Self-rated and informant-rated scores were used to calculate discrepancies, which were used as an indicator of awareness of functional ability. Smaller discrepancy scores were considered to reflect greater awareness on the part of PwD. PwD completed questionnaires on depression, personality, comorbidities, neuropsychiatric symptoms, and completed a measure of cognition. Informants provided ratings of stress. Univariable and multiple regressions were used to investigate factors related to ADL discrepancy. Results: A similar pattern of associations were found for both ADL discrepancy scores. Smaller discrepancy scores were associated with higher levels of depression, higher neuroticism, fewer neuropsychiatric symptoms, higher comorbidity, lower carer stress, and receipt of less than 1 hour of care per day from the informant. Discussion/Conclusion: There was a clear pattern of factors that were associated with greater awareness for both measures of functional ability. These factors associated with smaller discrepancy scores could be used to identify PwD who might benefit from targeted interventions to support their independence.
  • Issues affecting supply of palliative medicines into community pharmacy: A qualitative study of community pharmacist and pharmaceutical wholesaler/distributor perspectives

    Campling, N.; Breen, Liz; Miller, E.; Birtwistle, J.; Richardson, A.; Bennett, M.; Latter, S. (Elsevier, 2022-06)
    ackground Patient access to medicines in the community at end-of-life (pertaining to the last year of life) is vital for symptom control. Supply of such medicines is known to be problematic, but despite this, studies have failed to examine the issues affecting community pharmacy access to palliative medicines. Objective To identify community pharmacists' and pharmaceutical wholesalers'/distributors' views on supply chain processes and challenges in providing access to medicines during the last year of life, to characterise supply in this UK context. Methods Qualitative design, with telephone interviews analysed using Framework Analysis. Coding frames were developed iteratively with data analysed separately and then triangulated to examine differences in perspectives. Findings Thirty-two interviews (24 community pharmacists and 8 wholesalers/distributors) were conducted. To ensure appropriate palliative medicines were available despite occasional shortages, community pharmacists worked tirelessly. They navigated a challenging interface with wholesalers/distributors, the Drug Tariff to ensure reimbursement, and multiple systems. IT infrastructures and logistics provided by wholesalers/distributors were often helpful to supply into community pharmacies resulting in same or next day deliveries. However, the inability of manufacturers to predict operational issues or accurately forecast demand led wholesalers/distributors to encounter shortages with manufactured stock levels, reducing timely access to medicines. Conclusions The study identifies for the first time how palliative medicines supply into community pharmacy, can be improved. A conceptual model was developed, illustrating how influencing factors affect responsiveness and speed of medicines access for patients. Work is required to strengthen this supply chain via effective relationship-building and information-sharing, to prevent patients facing disruptions in access to palliative medicines at end-of-life.
  • Barriers and facilitators of successful deprescribing as described by older patients living with frailty, their informal carers and clinicians: a qualitative interview study

    Peat, George W.; Fylan, Beth; Marques, Iuri; Rayner, D.K.; Breen, Liz; Olaniyan, Janice; Alldred, D.P. (2022-03)
    Objective To explore the barriers/facilitators to deprescribing in primary care in England from the perspectives of clinicians, patients living with frailty who reside at home, and their informal carers, drawing on the Theoretical Domains Framework to identify behavioural components associated with barriers/facilitators of the process. Design Exploratory qualitative study. Setting General practice (primary care) in England. Participants 9 patients aged 65+ living with frailty who attended a consultation to reduce or stop a medicine/s. 3 informal carers of patients living with frailty. 14 primary care clinicians including general practitioners, practice pharmacists and advanced nurse practitioners. Methods Qualitative semistructured interviews took place with patients living with frailty, their informal carers and clinicians. Patients (n=9) and informal carers (n=3) were interviewed two times: immediately after deprescribing and 5/6 weeks later. Clinicians (n=14) were interviewed once. In total, 38 interviews were undertaken. Framework analysis was applied to manage and analyse the data. Results 6 themes associated with facilitators and barriers to deprescribing were generated, respectively, with each supported by between two and three subthemes. Identified facilitators of deprescribing with patients living with frailty included shared decision-making, gradual introduction of the topic, clear communication of the topic to the patient and multidisciplinary working. Identified barriers of deprescribing included consultation constraints, patients' fear of negative consequences and inaccessible terminology and information. Conclusions This paper offers timely insight into the barriers and facilitators to deprescribing for patients living with frailty within the context of primary care in England. As deprescribing continues to grow in national and international significance, it is important that future deprescribing interventions acknowledge the current barriers and facilitators and their associated behavioural components experienced by clinicians, patients living with frailty and their informal carers to improve the safety and effectiveness of the process.
  • Method of Micro-Sampling Human Dentine Collagen for Stable Isotope Analysis

    Curtis, Mandi J.; Beaumont, Julia; Elamin, F.; Wilson, Andrew S.; Koon, Hannah E.C. (2022-07-15)
    Sampling of dentine for stable carbon (δ13 C) and nitrogen (δ15 N) isotope ratios in the direction of tooth growth allows the study of temporal changes to the diet and physiological stress of an individual during tooth formation. Current methods of sampling permanent teeth using 1mm increments provide temporal resolution of six - nine months at best depending on the tooth chosen. While this gives sufficient sample sizes for reliable analysis by mass spectrometry, sectioning the dentine across the incremental structures results in a rolling average of the isotope ratios. A novel method of incremental dentine collagen sampling has been developed to decrease the collagen increment size to 0.35mm along the incremental structures thus reducing averaging and improving the temporal resolution of short-term changes within the δ13 C and δ15 N values. This study presents data for a MicroMill-assisted sampling method that allows for sampling at 0.35mm width x 1mm depth increments following the incremental growth pattern of dentine. A NewWave MicroMill was used to sample the demineralised dentine section of modern donated human third molars from Sudan and compared to data from the same teeth using the 1mm incremental sectioning method 2 from Beaumont et al. (2013). The δ13 C and δ15 N isotopic data showed an increased temporal resolution, with each increment providing data for two-four months of dentine formation. The data show the potential of this method for studying dietary reconstruction, nutritional stress, and physiological change with greater temporal resolution potentially to seasonal level and with less attenuation of the δ13 C and δ15 N values than was previously possible from human dentine.
  • Impact of COVID-19 on carers of people with dementia in the community: Findings from the British IDEAL cohort

    Quinn, Catherine; Gamble, L.D.; Parker, S.; Martyr, A.; Collins, R.; Victor, C.; Dawson, E.; Hunt, A.; Pentecost, C.; Allan, L.; et al. (2022-05)
    Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID-19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID-19 pandemic on carers for community-dwelling people with dementia and compare responses with pre-pandemic data. Data were collected between September 2020 and April 2021 in England and Wales. Carers were identified from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort and data were collected either through the telephone, video conferencing, or an online questionnaire. Responses from 242 carers were compared against benchmark data from the IDEAL cohort collected pre-pandemic. Analyses were conducted for the full sample of carers and spousal/partner carers only. In total 48.8% of carers thought their healthcare needs were negatively affected during the pandemic. Compared with pre-pandemic data carers were more lonely and experienced less life satisfaction. There was little impact on carers' experience of caregiving, although carers felt trapped in their caregiving role. Carers were more optimistic and had higher social contact with relatives. There were changes in the methods carers used for contacting relatives and friends. Most carers coped very or fairly well during the pandemic. There was little difference in the experiences of spousal/partner carers and the full sample. After a long period of providing care under pandemic conditions carers require additional support. This support needs to be focused on alleviating feelings of loneliness and increasing life satisfaction. Services need to consider how to improve access to health care, particularly resuming face-to-face appointments.
  • Interventions for self-management of medicines for community dwelling people with dementia, mild cognitive impairment and family carers: a systematic review

    Powell, Catherine; Tomlinson, Justine; Quinn, Catherine; Fylan, Beth (2022)
    Background People with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicines self-management could be supported for this population is unclear. This review identifies interventions to improve medicines self-management for people with dementia, MCI and their family carers, and which core components of medicines self-management they address. Methods A database search was conducted for studies with all research designs and ongoing citation searches from inception to December 2021. Selection criteria included community dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. Exclusion criteria were wrong population, not focusing on medicines management, incorrect medicines self-management components, not in English and wrong study design. Results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. Results Thirteen interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person’s knowledge and understanding, supply management, monitoring effects and side-effects and communicating with healthcare professionals; and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. Conclusion Interventions, and measures to assess self-management, need to be developed which address all components of medicines self-management, to better meet the needs for people with dementia and MCI and their family carers.
  • Career intentions, their influences and motivational factors in diagnostic radiography: A survey of undergraduate students

    Hizzett, Kayleigh; Snaith, Beverly (2022-02)
    Introduction: The choice of career and speciality can be a complex process. It is unclear what influences career decisions within undergraduate radiographers and whether the curriculum provides sufficient support. Methods: An online cross-sectional survey was undertaken. All undergraduate diagnostic radiography students within one UK higher education institution were invited to participate. Questions were related to anticipated career choice, motivational factors and influences. Results: The response rate was 67.6% (90/133). The most popular specialist area for career preference was general radiography. The top three motivational factors were work life balance, career development and job satisfaction. The most influential factors on career choice were clinical placements, radiographers on placements and formal teaching. Career guidance was predominantly sourced from the personal academic tutor and was informed by role models. Conclusion: Radiography academic teams and clinical placement providers must work together to ensure that students have access to high quality placements across specialities. The experiences received during undergraduate training are important in specialty choice. Implications for practice: Career guidance is essential and should begin as early as possible. Clinical and academic radiographers need to appreciate the influence they have on students future career plans.
  • Evaluating the potential for cone beam CT to improve the suspected scaphoid fracture pathway: InSPECTED - A single-centre feasibility study

    Snaith, Beverly; Harris, M.; Hughes, J.; Spencer, N.; Shinkins, B.; Tachibana, A.; Bessant, G.; Robertshaw, S. (2022-03)
    The suspected scaphoid fracture remains a diagnostic conundrum with over-treatment a common risk-averse strategy. Cross-sectional imaging remains the gold standard with MRI recommended but CT used by some because of easier access or limited MRI availability. The aim of this feasibility study was to evaluate whether cone beam computed tomography (CBCT) could support early diagnosis, or exclusion, of scaphoid fractures. Patients with a suspected scaphoid were recruited fracture between March and July 2020. All underwent a 4-view X-ray. If this examination was normal, they were immediately referred for a CBCT scan of the wrist. Those with a normal scan were discharged to research follow-up at 2 and 6-weeks. 68 participants were recruited, 55 had a normal or equivocal X-ray and underwent CBCT. Nine additional radiocarpal fractures (16.2%) were demonstrated on CBCT, the remainder were discharged to research follow-up. Based on the 2-week and 6-week follow up three patients (4.4%) were referred for MRI to investigate persistent symptoms with no bony injuries identified. CBCT scans enabled a rapid pathway for the diagnosis or exclusion of scaphoid fractures, identifying other fractures and facilitating early treatment. The rapid pathway also enabled those with no bony injury to start rehabilitation, suggesting that patients can be safely discharged with safety-net advice following a CBCT scan.
  • Five years of #MedRadJClub: An impact evaluation of an established twitter journal club

    Bolderston, A.; Meeking, K.; Snaith, Beverly; Watson, J.; Westerink, Woznitza (2022-06)
    Twitter journal clubs are a relatively new adaptation of an established continuing professional development (CPD) activity within healthcare. The medical radiation science (MRS) journal club 'MedRadJClub' (MRJC) was founded in March 2015 by a group of academics, researchers and clinicians as an international forum for the discussion of peer-reviewed papers. To investigate the reach and impact of MRJC, a five-year analysis was conducted. Tweetchat data (number of participants, tweets and impressions) for the first five years of MRJC were extracted and chat topics organised into themes. Fifth anniversary MRJC chat tweets were analysed and examples of academic and professional outputs were collated. A total of 59 chats have been held over five years with a mean of 41 participants and 483,000 impressions per hour-long synchronous chat. Ten different tweetchat themes were identified, with student engagement/preceptorship the most popular. Eight posters or oral presentations at conferences, one social media workshop and four papers have been produced. Qualitative analysis revealed five core themes relating to the perceived benefits of participation in MRJC: (1) CPD and research impact, (2) professional growth and influencing practice, (3) interdisciplinary learning and inclusion, (4) networking and social support and (5) globalisation. MRJC is a unique, multi-professional, global community with consistent engagement. It is beneficial for both CPD, research engagement, dissemination and socialisation within the MRS community.
  • Comparison of scattered entrance skin dose burden in MSCT, CBCT, and X-ray for suspected scaphoid injury: Regional dose measurements in a phantom model

    Hughes, J.; Harris, M.; Snaith, Beverly; Benn, H. (2022)
    Introduction: Scaphoid radiography has poor sensitivity for acute fracture detection and often requires repeat delayed imaging. Although magnetic resonance (MR) imaging is considered the gold standard, computed tomography (CT) is often used as an alternative due to ease of access. Cone-Beam CT (CBCT) offers equivalent diagnostic efficacy to Multi Slice CT (MSCT) at reduced dose. We aimed to establish the difference in scattered dose between modalities for scaphoid imaging. Methods: Anatomical regional entrance surface dose measurements were taken at 3 regions on an anthropomorphic torso phantom positioned as a patient to a wrist phantom undergoing scaphoid imaging for three modalities (CBCT, MSCT, four-view projection radiography). Exposure factors were based on audit of clinical exposures. Each dose measurement was repeated three times per anatomical region, modality, exposure setting and projection. Results: Under unpaired T-test CBCT gave significantly lower mean dose at the neck (1.64 vs 18 mGy), chest (2.78 vs 8.01) and abdomen (1.288 vs 2.93) than MSCT (p
  • A single-centre experience of implementing a rapid CXR reporting and CT access pathway for suspected lung cancer: Initial outcomes

    Hunter, R.; Wilkinson, Elaine; Snaith, Beverly (2022-05)
    Lung cancer remains a major cause of preventable death and early diagnosis is critical to improving survival chances. The chest X-ray (CXR) remains the most common initial investigation, but clinical pathways need to support timely diagnosis through, where necessary, escalation of abnormal findings to ensure priority reporting and early CT scan. This single-centre study included a retrospective evaluation of a rapid lung cancer CXR pathway in its first year of operation (May 2018-April 2019). The pathway was initially designed for primary care referrals but could also be used for any CXR demonstrating abnormal findings. A parallel cross-sectional survey of radiographers explored their understanding, adherence and concerns regarding their role in the pathway operation. Primary care referrals on the rapid diagnostic pathway were low (n = 51/21,980; 0.2%), with 11 (21.6%) requiring a CT scan. A further 333 primary care CXR were escalated by the examining radiographer, with 100 (30.0%) undergoing a CT scan. Overall, 64 of the CT scans (57.7%) were abnormal or demonstrated suspicious findings warranting further investigation. There were 39 confirmed primary lung carcinomas, most with advanced disease. Survey responses showed that most radiographers were familiar with the pathway but some expressed concerns regarding their responsibilities and limited knowledge of CXR pathologies. This baseline evaluation of the rapid lung cancer pathway demonstrated poor referral rates from primary care and identified the need for improved engagement. Radiographer escalation of abnormal findings is an effective adjunct but underlines the need for appropriate awareness, training, and ongoing support. Engagement of the multiprofessional team is critical in new pathway implementation. Rapid diagnostic pathways can enable early diagnosis and the radiographer has a key role to play in their success.
  • Developing conflict resolution strategies and building resilient midwifery students: A mixed methods research protocol

    Simpson, Naomi; Steen, M.; Vernon, R.; Wepa, Dianne (2022-02-18)
    This study will undertake a preparatory phase summarising the body of literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence.
  • Living with knee osteoarthritis: the positive impact of reducing the knee torque induced when sleeping supine. A randomised clinical trial

    Buckley, John G.; Scally, Andy J.; Bhattacharjee, C. (MDPI, 2022-03-09)
    When lying supine, due to the reaction force from the mattress acting mostly through the heel, an external knee-extension joint-torque is induced that keeps the knee fully extended. This torque becomes zero if the feet are hung over the end of the support. This study investigated, in patients with knee-osteoarthritis (knee-OA) who routinely sleep supine, whether a change to such a sleeping position would ameliorate the knee pain and associated physical problems they suffer. Patients were recruited (General-Practitioners Centre, UK) over a 9-month period; those eligible (51/70) were randomly allocated to an intervention (65% female; age 71.5 [11.3] yrs; BMI, 29.20 [5.54] kg/m2; knee-OA severity, 20 mild–mod/3 severe) or control group (63% female; age, 68.3 [9.7] yrs; BMI, 28.69 [5.51] kg/m2; knee-OA severity, 17 mild–mod/2 severe). The primary outcome was improvements (0 [worst] to 100 [best]) in knee pain at 3 months and was rated in the Knee-Injury-and-Osteoarthritis-Outcome-Score questionnaire (KOOS). Secondary outcomes were improvements (0–100) in the other four KOOS-subscales. There were no differences between groups in KOOS outcomes at baseline, and there were no changes in KOOS outcomes in the control group at 3 months. Relative to the baseline KOOS values in Knee-Pain (50.1), Symptoms (52.5), Activities-of-Daily-Living (53.8) and Quality-of-Life (31.5), were all seen to improve at 3 months in the intervention group (by between 11.9 and 12.9); however, when comparing to controls, only the improvements in the subscale Activities-of-Daily-Living (which improved by 12.2) were statistically significant. Findings indicate that for those with knee-OA who routinely sleep supine, sleeping with the feet over the end of the mattress (to prevent the knee being pushed into/held in full extension) can help ameliorate the physical problems they suffer.

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