Impact of COVID-19 on Radiography Practice: Radiographers’ Perspective

This study aims to evaluate the radiographers' perceptions of the impact of COVID-19 on radiography practice. From May to June 2022, a cross-sectional online survey was conducted of radiographers working in ten hospitals. Fifty respondents are involved (female=28; male=22). 94% of radiographers reported an increasing workload, with 30% frequently stressed. 68% and 60% are confident in their knowledge of COVID-19 transmission and infection control, even though 78% had received specific training to prepare for the pandemic. The high workload and fear of infection increase the radiographers' stress during the pandemic

Epidemiology

Epidemiology is a methodological, well grounded and versatile tool-kit to conduct evidence-based quantitative research in all health sciences. It integrates a wide spectrum of case studies and examples from the different disciplines thereby fostering the multi-disciplinary approach in the health sciences. It follows a two level 'methods based' approach differentiating between "basic" knowledge that all students of epidemiology should be familiar with and "beyond the basics" information for the interested or more advanced reader

Paediatric and adult bronchiectasis: monitoring, cross-infection, role of multi-disciplinary teams and self-management plans

Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi; clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimise further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (FEV1 %predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with P. aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalisation. Other tools that are currently used in research settings such as health-related quality of life questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multi-disciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalised self-management plans are also important despite limited evidence it improves quality of life or frequency of exacerbations

Outlook Magazine, Spring 2013

https://digitalcommons.wustl.edu/outlook/1189/thumbnail.jp

History of British Intensive Care, c. 1950–c. 2000

Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Intensive care developed in the UK as a medical specialty as the result of some extraordinary circumstances and the involvement of some extraordinary people. In 1952, the polio epidemic in Copenhagen demonstrated that tracheostomy with intermittent positive pressure ventilation saved lives and those infected with tetanus (common in agricultural areas) soon benefited. War-time developments such as triage, monitoring, transfusion and teamwork, and different specialists such as respiratory physiologists, anaesthetists and manufacturers of respiratory equipment all improved emergency treatment. These advances were rapidly extended to the care of post-operative patients, particularly with developments in cardiac surgery. Dedicated units appeared in the early 1960s in Cambridge, London and Liverpool, and later specialist care units were created for prenatal, cardiac and dialysis patients. The importance of specialist nursing care led to the development of nurse training, education and the eventual appointment of nurse consultants in the NHS in 1999. The specialty of intensive care was granted Faculty status by the GMC in 2010. Introduced by Professor Sir Ian Gilmore, this transcript includes, inter alia, the development of cardiac catheters, monitoring equipment, data collection techniques and the rise of multidisciplinarity, national audit, and scoring systems

Patients’ perceived needs for medical services for non-specific low back pain: A systematic scoping review

Background: An improved understanding of patients’ perceived needs for medical services for low back pain (LBP) will enable healthcare providers to better align service provision with patient expectations, thus improving patient and health care system outcomes. Thus, we aimed to identify the existing literature regarding patients’ perceived needs for medical services for LBP. Methods: A systematic scoping review was performed of publications identified from MEDLINE, EMBASE, CINAHL and PsycINFO (1990–2016). Descriptive data regarding each study, its design and methodology were extracted and risk of bias assessed. Aggregates of patients’ perceived needs for medical services for LBP were categorised. Results: 50 studies (35 qualitative, 14 quantitative and 1 mixed-methods study) from 1829 were relevant. Four areas of perceived need emerged: (1) Patients with LBP sought healthcare from medical practitioners to obtain a diagnosis, receive management options, sickness certification and legitimation for their LBP. However, there was dissatisfaction with the cursory and superficial approach of care. (2) Patients had concerns about pharmacotherapy, with few studies reporting on patients’ preferences for medications. (3) Of the few studies which examined the patients’ perceived need of invasive therapies, these found that patients avoided injections and surgeries (4) Patients desired spinal imaging for diagnostic purposes and legitimation of symptoms. Conclusions: Across many different patient populations with data obtained from a variety of study designs, common themes emerged which highlighted areas of patient dissatisfaction with the medical management of LBP, in particular, the superficial approach to care perceived by patients and concerns regarding pharmacotherapy. Patients perceive unmet needs from medical services, including the need to obtain a diagnosis, the desire for pain control and the preference for spinal imaging. These issues need to be considered in developing approaches for the management of LBP in order to improve patient outcomes

Liver Disease in Aboriginal and Torres Strait Islander People

Aboriginal and Torres Strait Islander people have a substantially higher prevalence of liver disease than non-Indigenous Australians. Cirrhosis and its complications were the sixth leading cause of mortality for Aboriginal and Torres Strait Islander people in 2020. Liver disease has been estimated to be the third leading cause of the mortality gap between Aboriginal and Torres Strait Islander and non-Indigenous people due to chronic disease, accounting for 11% of this gap. While current trends show reducing mortality rates for Aboriginal and Torres Strait Islander people for conditions including circulatory disease, diabetes and kidney disease, there are no data to suggest a similar decline for liver disease. This review highlights the common causes of liver disease affecting Aboriginal and Torres Strait Islander people, which include hepatitis B, hepatitis C, alcohol related liver disease, metabolic dysfunction-associated fatty liver disease, and cirrhosis and its complications including hepatocellular carcinoma. Current treatments including liver transplantation as well as suggestions for improving detection, treatment and access to liver care will also be discussed. Recent revolutions in the detection and treatment of liver disease make efforts to improve access to treatment and outcomes an urgent priority for Aboriginal and Torres Strait Islander people

Dangers of Peripheral Intravenous Catheterization: The Forgotten Tourniquet and Other Patient Safety Considerations

Intravenous catheterization is a widely used invasive procedure, with applications in both ambulatory and hospital settings. Due to its inherently invasive nature, intravenous (IV) therapy is associated with a number of potential complications, many of which are directly relevant to patient safety (PS). PIV-related morbidity may be due to mechanical or nonmechanical factors. The most frequent nonmechanical peripheral venous catheterization adverse events (PVCAEs) include insertion site pain, phlebitis, hematoma formation, and infusate extravasation. The most common mechanical PVCAE is catheter obstruction/occlusion and dislodgement. Significant complications can also occur with the administration of incorrect type or wrong amount of IV fluids. Moreover, simultaneous infusion of incompatible medications can result in infusate precipitation. Finally, less frequent but significant complications have been reported, including bloodstream and local infections, air embolization, nerve damage, arterial puncture, skin necrosis associated with vasopressor infusions, and limb-threatening forgotten tourniquet events. Taken together, the above complications can lead to substantial patient discomfort, unnecessary or prolonged hospitalization, increased costs, and additional downstream morbidity. Efforts to prevent PVCAEs and improve patient outcomes should involve thorough provider education, clinical vigilance by all involved healthcare providers, health service level strategies, as well as the proactive participation of all stakeholders, including patients and their families

Evaluation of a Theory-Informed Implementation Intervention for the Management of Acute Low Back Pain in General Medical Practice: The IMPLEMENT Cluster Randomised Trial

Introduction: This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice. Methods: General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavioural predictors (e.g. knowledge, attitudes and intentions) and fear avoidance beliefs. We were unable to recruit sufficient patients to measure our original primary outcomes so we introduced other outcomes measured at the general practitioner (GP) level: behavioural simulation (clinical decision about vignettes) and rates of x-ray and CT-scan (medical administrative data). All those not involved in the delivery of the intervention were blinded to allocation. Results: 47 practices (53 GPs) were randomised to the control and 45 practices (59 GPs) to the intervention. The number of GPs available for analysis at 12 months varied by outcome due to missing confounder information; a minimum of 38 GPs were available from the intervention group, and a minimum of 40 GPs from the control group. For the behavioural constructs, although effect estimates were small, the intervention group GPs had greater intention of practising consistent with the guideline for the clinical behaviour of x-ray referral. For behavioural simulation, intervention group GPs were more likely to adhere to guideline recommendations about x-ray (OR 1.76, 95%CI 1.01, 3.05) and more likely to give advice to stay active (OR 4.49, 95%CI 1.90 to 10.60). Imaging referral was not statistically significantly different between groups and the potential importance of effects was unclear; rate ratio 0.87 (95%CI 0.68, 1.10) for x-ray or CT-scan. Conclusions: The intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant changes in actual behaviour. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN01260600009853