Student radiographers' attitudes toward the older patient: an intervention study

Purpose: To design, implement and evaluate the effect of an educational intervention on Norwegian student (diagnostic) radiographers' attitudes towards older people. Design: This study is part of a wider longitudinal study that will evaluate student radiographer attitudes towards the older patient as they progress through their training. In this phase an educational intervention, aimed at improving student radiographer attitudes towards the older person, was designed and implemented. What is reported here are the findings of a pre-test, post-test design that used the Kogan's attitudes towards older people scale to determine whether this intervention had any effect of student radiographer attitudes towards older people. Results: Overall students reported significantly more positive attitudes towards older people after intervention (p = 0.01). However, analysis of responses to individual questions reveals that this difference was not significant in all cases. Conclusion: The results of the present study suggest that an educational intervention can have a significant impact on student radiographer's attitudes towards older people. Whether this positive attitude remains throughout training, forms part of the wider basis for this study

Constraints faced by the Tribal Youth in Vocational Preference

Tribes are considered as primitive people and they are cut-off from the social and political structures of development. The present study identified the constraints faced by the tribal youth in The Nilgiris district, Tamil Nadu. Data were collected from the tribal youth through a structured interview schedule developed for the study. A majority of the tribal youth reported that insufficient credit facilities was the major constraint faced by them. Other major constraints faced by the tribal youth were lack of periodical training, land alienation and job insecurity

Therapeutic Drug Monitoring of Selected Drugs: An Approach to Drug Therapy Optimization

Therapeutic drug monitoring (TDM) is the process by which the treatment is optimized by ensuring that the plasma/blood drug concentrations lie within a therapeutic range, above which toxicity occurs and below which the drug is ineffective3. In other words it refers to the individualization of drug dosage, by maintaining plasma or blood drug concentrations within a targeted therapeutic range. The notion of a therapeutic range is more a probabilistic concept then an absolute entity which represents a range of drug concentrations within which the probability of a desired clinical response is relatively high and the probability of unacceptable toxicity is relatively low4. The concentrations above a previously determined target or therapeutic range are considered toxic or potentially toxic and levels below are subtherapeutic. The appropriate medical interpretation by TDM has a direct influence on drug prescribing procedures. The close relationship between plasma levels of the drug and the clinical effects is the basis of the concept of TDM. The measurement of plasma level is justified only when the information provided is of potential therapeutic benefit. Therefore, in TDM the drug levels are an adjunct to the clinical picture and doses should be modified according to the individual’s pharmacodynamic response (based on sound clinical judgement) using pharmacokinetic principles to aid titration of the dose to achieve the appropriate therapeutic end point or in other words optimal patient benefit. TDM demands knowledge of pharmacokinetics and the influencing factors and a knowledge of pharmacodynamic to assess the side effects and drug interactions which can result in apparent toxicity or lack of effect. In a nutshell the principle is that a stronger relationship exists between plasma concentration and effect (Ferguson principle) than between the dose and effect. TDM blends the knowledge of therapeutics, pharmacology, pharmacokinetics, laboratory technology, and clinical medicine and applies it to certain drugs that require determination of patient specific dosage regimens to maximize therapeutic effectiveness while minimizing toxicity

Student radiographers' attitudes towards the older patient: a longitudinal study

Purpose: To design, implement and evaluate the effect of an educational intervention on student radiographer attitudes across their educational tenure. Methods: In the first phase, an educational intervention that involved didactic lectures, reflective exercises and simulation suits, aimed at improving student radiographer attitudes towards the older person, was designed and implemented. Kogan’s attitudes towards older people (KoP) scale was administrated at five test points; pre-intervention; post-intervention; 6 months post intervention; 12 months post intervention and 24 months post intervention. At the final test point these quantitative data was supplemented with qualitative data for triangulation of the findings. Results: Students held positive attitudes towards older people pre intervention, these increased significantly post intervention (p=0.01). However, this increase in positive scores was not noted at 6 months and 12-months post intervention. At 24-months post intervention, although there was a slight increase in positive attitudes when compared to the 6 and 12 month scores, this increase was not found to be significant (p=.178) Conclusions: The results post-intervention suggested that an educational intervention can have a significant impact on student radiographer’s attitudes towards older people. However, the qualitative data suggests that experiences on initial clinical placement can be detrimental to attitudinal scores, particularly if the intervention does not include Dementia care strategies

Managing discomfort and developing participation in non-emergency MRI: children's coping strategies during their first procedure

Introduction: Building on existing work, this paper aims to develop a detailed analysis of the practical coping strategies developed by children who had not previously experienced an MRI, regarding a non-emergency examination of the brain. Methods: Semi-structured interviews with 22 children, aged between eight and sixteen years, were conducted immediately post-procedure. Emergent data were thematically analysed in line with the core precepts of Grounded Theory, and triangulated against interview data with their parents where pertinent. Results: The primary concern among interviewees related to how they had coped with the discomfort of an unfamiliar medical procedure; this was recurrently managed through a process herein termed Participation Development. This comprised three phases. The first, preparative participation, describes the children’s reported attempts to ready themselves for the examination (with parents) ahead of arriving in hospital. The second, enabling participation, describes how the children (with input from parents and radiographers) endeavoured to understand what was to come, and select viable distraction techniques. Finally, sustaining participation describes the children’s reports of actualizing their preparations during the examination itself. Where the overall process of participation development was successful, the children reported a sense of mastery, growth and even joy. Conclusion: While much work in the domain portrays children as relatively ‘passive’ agents’ during an MRI procedure, the findings herein point to how they can (with varying degrees of success) actively and constructively work with others. This, it is contended, has direct import for the improvement of support, both prior to and within a procedure itself

Managing discomfort and involving participation in non-emergency MRI: children’s coping strategies during a first procedure

Purpose: Building on existing work, this paper aims to develop a detailed analysis of the practical coping strategies developed by children who had not previously experienced an MRI, regarding a non-emergency examination of the brain. Materials and Methods: Semi-structured interviews with N=22 children, aged between eight and sixteen years, were conducted immediately post-procedure. Emergent qualitative data were thematically analysed in line with the core precepts of Glaserian Grounded Theory. Results: The primary concern among interviewees related to how they had coped with the discomfort (prospective and extant) of an unfamiliar medical procedure; this was recurrently managed through a process herein termed Involving Participation. This comprised three phases. The first, participation preparation, describes the children’s reported attempts to ready themselves for the examination (with parents) ahead of arriving in hospital. The second, enabling participation, describes how the children (immediately before examination, with input from parents and radiographers) endeavored to understand what was to come, and select viable distraction techniques. Finally, sustaining participation describes the children’s reports of actualizing their preparations during the examination itself. Where the overall process of participation development was successful, the children reported a sense of mastery, growth and even joy. Conclusion: While much work in the domain portrays children as relatively ‘passive’ agents during an MRI procedure, the findings herein point to how they can (with varying degrees of success) actively and constructively work with others. This, it is contended, has direct import for the improvement of support, both prior to and within a procedure itself

Student radiographer attitudes towards the older patient: a longtitudinal study

Background: The ageing population is creating greater pressure on health care services; radiology is no exception. Care of the older population has been reported as inadequate and as a consequence of the Mid-Staffordshire enquiry, care of the older patient has become a central feature of education and training. However little evidence exists as to the effectiveness of this education in the radiography arena. Method: This longitudinal study evaluated student radiographer attitudes towards older people. In the first phase an educational intervention, aimed at improving student radiographer attitudes towards the older person was designed and implemented. Attitudes were measured pre and post intervention using Kogan's attitudes towards older people scale (KoP). Students were then followed throughout their training to determine any changes in attitudes. Results: Students held positive attitudes towards older people pre intervention, which increased significantly post intervention (p=0.01). This significance was not noted at 6 and 12 months' post intervention; here average scores reduced to an almost identical level to those found pre-intervention. At 24 months' post intervention attitudinal scores increased, though this was not found to be significant. Conclusion: The initial results suggested that an educational intervention can have a significant impact on student radiographer's attitudes towards older people. However, the six and twelve months' post intervention scores suggest that these positive attitudes do not endure. Though the 24 months' post intervention findings demonstrate an increase in positive attitudes, these were still lower than the immediate post-intervention