Ionising radiation exposure from medical imaging – A review of Patient's (un) awareness

Introduction: Medical imaging is the main source of artificial radiation exposure. Evidence, however, suggests that patients are poorly informed about radiation exposure when attending diagnostic scans. This review provides an overview of published literature with a focus on nuclear medicine patients on the level of awareness of radiation exposure from diagnostic imaging. Methods: A review of available literature on awareness, knowledge and perception of ionising radiation in medical imaging was conducted. Articles that met the inclusion criteria were subjected to critical appraisal using the Mixed Methods Appraisal Tool. Results: 140 articles identified and screened for eligibility, 24 critically assessed and 4 studies included in synthesis. All studies demonstrated that patients were generally lacking awareness about radiation exposure and highlighted a lack of communication between healthcare professionals and patients with respect to radiation exposure. Conclusion: Studies demonstrate a need to better inform patients about their radiation exposure, and further studies focusing on nuclear medicine patients are particularly warranted. Implications for practice: Adequate and accurate information is crucial to ensure the principle of informed consent is present

Radiation exposure awareness from patients undergoing nuclear medicine diagnostic 99mTc-MDP bone scans and 2-deoxy-2-(18F) fluoro-D-glucose PET/computed tomography scans

INTRODUCTION: Medical imaging is on average the largest source of artificial radiation exposure worldwide. This study seeks to understand patient's awareness of radiation exposure derived from nuclear medicine diagnostic scans and assess if current information provided by leaflets is adequate. METHODS: Single-centre cross-sectional questionnaire study applied to bone scan and FDG PET/computed tomography patients, at a nuclear medicine and PET/computed tomography department over a 15-week period in 2018. Questionnaires on dose comparators were designed in collaboration with patients, public, and experts in radiation exposure. Qualitative data were analysed using thematic analysis and quantitative data using SPSS (V. 24). RESULTS: A total of 102 questionnaires were completed (bone scan = 50; FDG PET/computed tomography = 52). Across both groups, 33/102 (32.4%) patients reported having a reasonable understanding of nuclear medicine and 21/102 (20.6%) reported a reasonable knowledge of ionising radiations. When asked to compare the exposure dose of respective scans with common comparators 8/50 (16%) of bone scan patients and 11/52 (21.2%) FDG PET/computed tomography answered correctly. On leaflet information, 15/85 (17.6%) patients reported the leaflets do not provide enough information on radiation exposure and of these 10/15 (66.7%) commented the leaflets should incorporate more information on radiation exposure dose. CONCLUSION: More observational and qualitative studies in collaboration with patients are warranted to evaluate patients' understanding and preferences in communication of radiation exposure from nuclear medicine imaging. This will ensure communication tools and guidelines developed to comply with ionising radiation (medical exposure) regulation 2017 are according to patients needs and preferences

Associations between Age, Years in Post, Years in the Profession and Personal Experience of Mental Health Problems in UK Mental Health Nurses

Nurses' mental health is of paramount importance, both in terms of patient safety and the sustainability of the workforce. Age, years in the profession, in post and personal experience or exposure to mental health problems are relevant to the mental health nursing workforce crisis in the United Kingdom. This study aimed to determine the relationship between age, years in the profession and post and self-reported experience of mental health problems using an online cross-sectional survey of 225 UK mental health nurses. Number of years in post was inversely correlated with overall experience of mental health problems, particularly living with someone else with mental health problems. Those with experience of living with someone with mental health problems had significantly fewer years of professional experience than those without. This article discusses possible explanations for this phenomenon and makes the case for future research on the topic

Grip strength values and cut-off points based on over 200,000 adults of the German National Cohort - a comparison to the EWGSOP2 cut-off points

BACKGROUND: The European Working Group on Sarcopenia in Older People (EWGSOP) updated in 2018 the cut-off points for low grip strength to assess sarcopenia based on pooled data from 12 British studies. OBJECTIVE: Comparison of the EWGSOP2 cut-off points for low grip strength to those derived from a large German sample. METHODS: We assessed the grip strength distribution across age and derived low grip strength cut-off points for men and women (peak mean -2.5 × SD) based on 200,389 German National Cohort (NAKO) participants aged 19-75 years. In 1,012 Cooperative Health Research in the Region of Augsburg (KORA)-Age participants aged 65-93 years, we calculated the age-standardised prevalence of low grip strength and time-dependent sensitivity and specificity for all-cause mortality. RESULTS: Grip strength increased in the third and fourth decade of life and declined afterwards. Calculated cut-off points for low grip strength were 29 kg for men and 18 kg for women. In KORA-Age, the age-standardised prevalence of low grip strength was 1.5× higher for NAKO-derived (17.7%) compared to EWGSOP2 (11.7%) cut-off points. NAKO-derived cut-off points yielded a higher sensitivity and lower specificity for all-cause mortality. CONCLUSIONS: Cut-off points for low grip strength from German population-based data were 2 kg higher than the EWGSOP2 cut-off points. Higher cut-off points increase the sensitivity, thereby suggesting an intervention for more patients at risk, while other individuals might receive additional diagnostics/treatment without the urgent need. Research on the effectiveness of intervention in patients with low grip strength defined by different cut-off points is needed

Effects of Increased Pork Hot Carcass Weights. II: Loin Quality Characteristics and Palatability Ratings

The objective of this study was to evaluate the effects of increased pork hot carcass weight on loin quality and palatability of top loin chops. Pork loins (N = 200) were collected from 4 different hot carcass weight groups: A light weight (LT; less than 111.8 kg), medium-light weight (MLT; 111.8 to 119.1 kg), medium-heavy weight (MHVY; 119.1 to 124.4), and a heavyweight group (HVY; 124.4 and greater). Following fabrication, chops were assigned to fat and moisture analysis, Warner-Bratzler shear force (WBSF), consumer sensory panels, or trained sensory panels. Chops from the HVY group were rated as more (P 0.05) consumer flavor liking ratings. Hot carcass weight treatment did not contribute (P > 0.05) to the percentage of chops rated acceptable for flavor and overall liking. The greatest (P 0.05), with greater (P < 0.05) overall tenderness ratings compared to chops from LT carcasses. These results indicate chops from heavier weight carcasses may have improved tenderness and juiciness compared to chops from lighter carcasses

Effects of Increased Pork Hot Carcass Weights. I: Chop Thickness Impact on Consumer Visual Ratings

The objective of this study was to evaluate the effect of increased pork hot carcass weights on consumer visual acceptability and purchase intent ratings of top loin chops cut to various thicknesses in a price labeled versus unlabeled retail display scenario. Pork loins (N = 200) were collected from 4 different hot carcass weight groups: light weight (LT; less than 111.8 kg), medium-light weight (MLT; 111.8 to 119. kg), medium-heavy weight (MHVY; 119.1 to 124.4 kg), and a heavy weight group (HVY; 124.4 kg and greater). Loins were fabricated into 4 pairs of chops of specified thicknesses (1.27, 1.91, 2.54, and 3.18 cm). One chop from each pair was assigned to be packaged with or without a label. Consumers assessed chops for appearance, desirability, and purchase intent. For both appearance and purchase intent ratings, chops from HVY carcasses were given more desirable (P < 0.05) ratings compared to LT chops. Consumers gave greater (P < 0.05) appearance ratings to thicker cut chops. There was a hot carcass weight × chop thickness interaction (P < 0.05) for the percentage of consumers that indicated the chop was desirable overall. Regardless of hot carcass weight group, chops with a thickness of 1.27 cm had the lowest (P < 0.05) percentage of consumers indicate they were desirable overall. A greater (P < 0.05) percentage of consumers indicated “yes” they would purchase chops cut to a thickness of 2.54 cm compared to all other thicknesses. Additionally, there was a greater (P < 0.05) percentage of consumers who indicated they would purchase unlabeled chops compared to labeled chops. These results, within the population sampled, indicate that carcass weight and chop thickness can affect consumer preference and thus should be considered by retailers when marketing fresh pork loin chops

Sarcopenia - Endocrinological and neurological aspects.

Sarcopenia in geriatric patients is often associated with or even caused by changes of the endocrine and nervous system. The multifactorial pathogenesis of sarcopenia and additional multimorbidity in geriatric patients makes it difficult to study distinct pathogenic pathways leading to sarcopenia. Patients suffering from diabetes, Cushing&#39;s syndrome, chronic kidney disease, Klinefelter&#39;s syndrome or motor neuron diseases, such as amyotrophic lateral sclerosis for example are known to have impaired muscle property and reduced physical performance. These patients are typically younger and suffer from conditions caused by a known molecular disease mechanism and a peculiar sarcopenic phenotype. Therefore, these sequelae can serve as prototypic disease models to study isolated endocrinological and neurodegenerative causes for sarcopenia. This review focuses on diseases whose etiopathogenesis of muscle impairment is known. The idea is to use these diseases as proof of principles to develop a classification algorithm of sarcopenia in the elderly to make a more mechanism-oriented therapy be possible