SEED Program: The development of a program that has enabled the learning and growth of staff in the response to a community crisis.

This paper aims to share a program that took a whole-hospital approach in considering the wellbeing of staff at a time of recovery following the 2019–2020 bushfires. The SEED Program enlisted a person-centred participatory methodology that was embedded within a transformational learning approach. This methodology included collaboration, authentic participation, critical reflection, critical dialogue and listening where the staff voice was the driving factor in the development of strategies for recovery. The SEED Program resulted in the development of five initiatives that included four strategies and a celebration event where staff celebrated their New Year’s Eve in February 2020. The four strategies included the establishment of a quiet room, coffee buddies, Wellness Warriors and 24/7 Wellness. The outcomes from the SEED Program resulted in the development of a more person-centred culture and transformation of staff perspectives in how they understood their role in their learning and learning of others in recovery and support at a time of crisis. The key learnings were the effect of authentic collaboration, the benefit from enabling authentic leadership at all levels within a hospital, and the power of a staff connection to the ‘CORE’ values of the hospital and Local Health District. In conclusion, the staff involved hold the hope that others may benefit from their experience of transformational learning in creating more person-centred workplace cultures while supporting each other to move forward during a crisis. The limitation of the SEED Program was that it was a bespoke practice innovation designed in the moment, responding to an identified need for the staff following a crisis in the local community rather than a formal research approach to meeting the needs of this group of staff

Collaborate or thread the eye of the needle

Abstract: Th

A clinical audit of reporting radiographers and consultant radiologists’ ability to correctly identify suspected lung cancer on a chest X-ray image and to determine the effectiveness of the referral system.

Introduction NICE recommend for a chest X-ray (CXR) to be the initial diagnostic test to assess for lung cancer. People with known or suspected lung cancer must be offered a CT thorax with contrast to aid in confirming or ruling out a cancer diagnosis. This clinical audit evaluated a departmental CXR alert system for suspected lung cancer. Alerting was undertaken by radiologists and reporting radiographers who attempted to identify lung cancer from CXRs. The accuracy of the fast-track system and ability of each reporting group were explored. Method 846 cases with lung alerts were analysed and 545 CXRs were audited. The CXRs were split into two groups, the images reported by the radiologists (168) and the images reported by the reporting radiographers (377). Data was collected through PACS and Cerner computer systems to identify if the patient was “positive or “negative”, gfor liung cancer or had “other findings” as determined by a CT thorax . Results The Chi square statistical test showed no significant difference between the two reporting groups in their ability to identify lung cancer on CXRs. 27% of CXRs highlighted by radiologists and 35% by reporting radiographers were positive for lung cancer. The percentage of negative results from both groups highlights the need for continued professional development. Conclusion This clinical audit indicates that reporting radiographers and radiologists are not statistically significantly different in terms of their ability to identify lung cancer on CXR images and use the fast-track system. This audit supports the fast-track system’s efficacy in reducing diagnostic delay and supports the use of trained radiographers to increase the NHS’s imaging reporting resources

Diagnostic Radiography Students’ Attitudes towards Gender Inclusive Pregnancy Status Checks

Background The responsibility for protection of foetuses against ionising radiation lies with radiographers under IR(ME)R17. Previously, only females were screened for pregnancy prior to a pelvic X-ray, however amendments to IR(ME)R17 and new guidance from the Society of Radiographers recommends all individuals of childbearing potential must be screened. This means screening both male, females, transgender, intersex (put full list in) There is a lack of literature exploring radiographers views about gender inclusive pregnancy status checks. Method A qualitative study was conducted with nineteen third-year students on the BSc Diagnostic Radiography degree programme at a University in the North west of England. Focus groups were conducted including open-ended questions to gain insight into how IPS checks are conducted at each of the seven NHS Trusts attended as clinical placement. Students were also asked about their opinions and attitudes towards conducting IPS checks. Results A thematic analysis yielded four main themes: (1) education, (2) standardisation, (3) fear of reaction, and (4) placement involvement. Barriers to conducting the IPS check include a lack of staff encouragement due to the guidance being enforced at the discretion of the employer, as well as a general lack of awareness around gender inclusivity. All students showed a willingness to conduct the IPS checks despite this. Conclusion For service users and providers to welcome IPS checks, more training and awareness should be enforced surrounding LGBT+ issues in healthcare. Age and experience range of participants were limiting factors. Students generally feel well-prepared to conduct IPS checks due to experience on placement, however IPS checks should be standardised across all placement sites to ensure equal learning opportunities

Monitoring feeding of great whales by ingested acoustic temperature transmitter

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Compression force behaviours: An exploration of the beliefs and values influencing the application of breast compression during screening mammography

This research project investigated the compression behaviours of practitioners during screening mammography. The study sought to provide a qualitative understanding of ‘how’ and ‘why’ practitioners apply compression force. With a clear conflict in the existing literature and little scientific evidence base to support the reasoning behind the application of compression force, this research project investigated the application of compression using a phenomenological approach. Following ethical approval, six focus group interviews were conducted at six different breast screening centres in England. A sample of 41 practitioners were interviewed within the focus groups together with six one-to-one interviews of mammography educators or clinical placement co-ordinators. The findings revealed two broad humanistic and technological categories consisting of 10 themes. The themes included client empowerment, white-lies, time for interactions, uncertainty of own practice, culture, power, compression controls, digital technology, dose audit-safety nets, numerical scales. All of these themes were derived from 28 units of significant meaning (USM). The results demonstrate a wide variation in the application of compression force, thus offering a possible explanation for the difference between practitioner compression forces found in quantitative studies. Compression force was applied in many different ways due to individual practitioner experiences and behaviour. Furthermore, the culture and the practice of the units themselves influenced beliefs and attitudes of practitioners in compression force application. The strongest recommendation to emerge from this study was the need for peer observation to enable practitioners to observe and compare their own compression force practice to that of their colleagues. The findings are significant for clinical practice in order to understand how and why compression force is applied

The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent

Aims: The data regarding the associations of body mass index (BMI) with cardiovascular (CVD) risk, especially for those at the low categories of BMI, are conflicting. The aim of our study was to examine the associations of body composition (assessed by five different measures) with incident CVD outcomes in healthy individuals. Methods and results: A total of 296 535 participants (57.8% women) of white European descent without CVD at baseline from the UK biobank were included. Exposures were five different measures of adiposity. Fatal and non-fatal CVD events were the primary outcome. Low BMI (≤18.5 kg m−2) was associated with higher incidence of CVD and the lowest CVD risk was exhibited at BMI of 22–23 kg m−2 beyond, which the risk of CVD increased. This J-shaped association attenuated substantially in subgroup analyses, when we excluded participants with comorbidities. In contrast, the associations for the remaining adiposity measures were more linear; 1 SD increase in waist circumference was associated with a hazard ratio of 1.16 [95% confidence interval (CI) 1.13–1.19] for women and 1.10 (95% CI 1.08–1.13) for men with similar magnitude of associations for 1 SD increase in waist-to-hip ratio, waist-to-height ratio, and percentage body fat mass. Conclusion: Increasing adiposity has a detrimental association with CVD health in middle-aged men and women. The association of BMI with CVD appears more susceptible to confounding due to pre-existing comorbidities when compared with other adiposity measures. Any public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged