Nurses', physicians' and radiographers' perceptions of the safety of a nurse prescribing of ionising radiation initiative: A cross-sectional survey

Background: A new initiative was introduced in Ireland following legislative changes that allowed nurses with special training to prescribe ionising radiation (X-ray) for the first time. A small number of studies on nurse prescribing of ionising radiation in other contexts have found it to be broadly as safe as ionising radiation prescribing by physicians. Sociological literature on perceptions of safety indicates that these tend to be shaped by the ideological position of the professional rather than based on objective evidence. Objectives: To describe, compare and analyse perceptions of the safety of a nurse prescribing of ionising radiation initiative across three occupational groups: nursing, radiography and medicine. Design: A cross-sectional survey design. Settings: Participants were drawn from a range of clinical settings in Ireland. Participants: Respondents were 167 health professionals comprised of 49 nurses, 91 radiographers, and 27 physicians out of a total of 300 who were invited to participate. Non-probability sampling was employed and the survey was targeted specifically at health professionals with a specific interest in, or involvement with, the development of the nurse prescribing of ionising radiation initiative in Ireland. Methods: Comparisons of perspectives on the safety of nurse prescribing of ionising radiation across the three occupational groups captured by questionnaire were analysed using the Kruskal–Wallis H test. Pairwise post hoc tests were conducted using the Mann–Whitney U test. Results: While the majority of respondents from all three groups perceived nurse prescribing of ionising radiation to be safe, the extent to which this view was held varied. A higher proportion of nurses was found to display confidence in the safety of nurse prescribing of ionising radiation compared to physicians and radiographers with differences between nurses’ perceptions and those of the other two groups being statistically significant. Conclusion: That an occupational patterning emerged suggests that perceptions about safety and risk of nurse prescribing of ionising radiation are socially constructed according to the vantage point of the professional and may not reflect objective measures of safety. These findings need to be considered more broadly in the context of ideological barriers to expanding the role of nurses

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Nurses', Physicians' and Radiographers' Perceptions of the Safety of a Nurse Prescribing of Ionising Radiation Initiative: A Cross-Sectional Survey

Background: A new initiative was introduced in Ireland following legislative changes that allowed nurses with special training to prescribe ionising radiation (X-ray) for the first time. A small number of studies on nurse prescribing of ionising radiation in other contexts have found it to be broadly as safe as ionising radiation prescribing by physicians. Sociological literature on perceptions of safety indicate that these tend to be shaped by the ideological position of the professional rather than based on objective evidence. Objectives: To describe, compare and analyse perceptions of the safety of a nurse prescribing of ionising radiation initiative across three occupational groups: nursing, radiography and medicine. Design: A cross-sectional survey design. Settings: Participants were drawn from a range of clinical settings in Ireland. Sample: Respondents were 167 health professionals comprised of 49 nurses, 91 radiographers, and 27 physicians out of a total of 300 who were invited to participate. Non-probability sampling was employed and the survey was targeted specifically at health professionals with a specific interest in, or involvement with, the development of the nurse prescribing of ionising radiation initiative in Ireland. Methods: Comparisons of perspectives on the safety of nurse prescribing of ionising radiation across the three occupational groups captured by questionnaire were analysed using the Kruskal Wallis H test. Pairwise post hoc tests were conducted using the Mann Whitney U test. Results: While the majority of respondents from all three groups perceived nurse prescribing of ionising radiation to be safe, the extent to which this view was held varied. A higher proportion of nurses was found to display confidence in the safety of nurse prescribing of ionising radiation compared to physicians and radiographers with differences between nurses’ perceptions and those of the other two groups being statistically significant. Conclusion: That an occupational patterning emerged suggests that perceptions about safety and risk of nurse prescribing of ionising radiation are socially constructed according to the vantage point of the professional and may not reflect objective measures of safety. These findings need to be considered more broadly in the context of ideological barriers to expanding the role of nurses.Health Service Executiv

A Genome Scan in Families from Australia and New Zealand Confirms the Presence of a Maternal Susceptibility Locus for Pre-Eclampsia, on Chromosome 2

Epidemiological studies have shown that genetic factors contribute to the etiology of the common and serious pregnancy-specific disorder pre-eclampsia (PE)/eclampsia (E). Candidate-gene studies have provided evidence (albeit controversial) of linkage to several genes, including angiotensinogen on 1q42-43 and eNOS on 7q36. A recent medium-density genome scan in Icelandic families identified significant linkage to D2S286 (at 94.05 cM) on chromosome 2p12 and suggestive linkage to D2S321 (at 157.5 cM) on chromosome 2q23. In the present article, the authors report the results of a medium-density genome scan in 34 families, representing 121 affected women, from Australia and New Zealand. Multipoint nonparametric linkage analysis, using the GENEHUNTER-PLUS program, showed suggestive evidence of linkage to chromosome 2 (LOD=2.58), at 144.7 cM, between D2S112 and D2S151, and to chromosome 11q23-24, between D11S925 and D11S4151 (LOD=2.02 at 121.3 cM). Given the limited precision of estimates of the map location of disease-predisposing loci for complex traits, the present finding on chromosome 2 is consistent with the finding from the Icelandic study, and it may represent evidence of the same locus segregating in the population from Australia and New Zealand. The authors propose that the PE/E-linked locus on chromosome 2p should be designated the “PREG1” (pre-eclampsia, eclampsia gene 1) locus

An evaluation of the HSE guiding framework for the implementation of nurse prescribing of medical ionising radiation (X-Ray) in Ireland.

FOREWORD The introduction of Nurse Prescribing of Medical Ionising Radiation (X-ray) in Ireland is a significant initiative in the Irish health service which has positive implications for patients in terms of improved access to radiology services and simplification of their journey. Up to July 2014 the overall number of students who commenced the x-ray prescribing course was 171 and the number of x-ray prescriptions written by them totalled 92,575. It gives me great pleasure to publish the national ‘Evaluation of the HSE Guiding Framework for the Implementation Nurse Prescribing of Ionising Radiation (X-Ray) in Ireland 2014’ which is an extensive independent evaluation of the implementation of nurse prescribing of medical ionising radiation (X-ray) undertaken by researchers from UCD in partnership with UCC led by Professor Jonathan Drennan and which was commissioned by the Office Nursing & Midwifery Services, HSE. The evaluation clearly identifies that the introduction of nurses prescribing of ionising radiation has had a positive impact on patient care. The report highlights that nurses have been well prepared for their professional role and are prescribing ionising radiation effectively and appropriately. The greatest benefit of the initiative has been the impact it has had on facilitating patient access to treatment and care in an equitable and timely manner. I wish to acknowledge the support, advice and expertise of Professor Jonathan Drennan who expertly led the research team from University College Dublin / University College Cork in partnership with my office and our multi-disciplinary governance and advisory group which is representative off all key stakeholders engaged with assuring the safety and quality of Nurse Prescribing of Medical Ionising Radiation (x-ray) through out the various health services. The results of this report will be used to further develop, expand and support nurse prescribing of medical ionising radiation (x-ray). Registered nurses in Ireland have a choice about how they practice nursing. As Ellis and Anderson say, “It is only when we take responsibility for our choices that we begin to realise we truly are the masters of our fate.” I encourage nurse prescribers of Medical Ionising Radiation (X-ray) to take responsibility for your practice and to make a difference each and every day for our patients. There is no better way to build a foundation for leaving your footprint and your legacy for the future. Dr Michael Shannon Nursing and Midwifery Services Directo