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INTRODUCTION: The horizontal beam lateral (HBL) position technique for X-ray imaging has been used for nearly a century; however, this can be challenging for the patient and the practitioner, as it potentially compromises patient dignity. This study explores student radiographers' knowledge and experience of lateral hip positions and their impact on diagnostic quality and patient dignity. METHOD: A cross-sectional mixed-method online survey of undergraduate diagnostic radiography students was completed. Likert scale assessments, rank ordering questions, and free-test qualitative responses were utilised for questions on knowledge and experience of different positioning, ease to obtain, patient dignity, diagnostic quality, and need for repeats. Data analysis included descriptive statistics and cross-tabulation non-parametric analysis against variables of age, gender and year of study. RESULTS: Responses were received by n = 42/158 students, a response rate of 27%. The HBL position was the most commonly repeated image (76.6%); the qualitative themes included HBL image quality issues and difficulty in the HBL positioning for elderly or frail patients, often in discomfort and pain. Analysis of student responses to perceived patient dignity in positioning identified 73.8% found the HBL undignified, and 85.7% agreed the Clements-Nakayama (CN) position would be more dignified for patients. The diagnostic image quality of the HBL position (64.2%) was compared to the CN alternative axiolateral (66.6%). Comparison of ease of obtaining the correct position for HBL (47.6%) was higher than CN position (28.6%); this could be due to the lack of experience n = 3/42 (7.1%) of this position. CONCLUSION: Overall, student radiographers' experience and knowledge of various lateral hip positions observed in clinical practice was good. The CN position scored high for diagnostic image (66.6%) and dignity for the patient (85.7%), over the often repeated HBL position (76.6%), which scored lower for image quality (64.2%) and dignity (76.6%). IMPLICATIONS FOR PRACTICE: Radiographers should advocate for professional autonomy and explore alternative positioning techniques. Further investigation into the CN position's utilisation, image quality and radiation dose in England is recommended.

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INTRODUCTION: The World Health Organization (WHO) emphasizes the global issue of poor air quality, largely attributed to the release of pollutants by human activity. In a significant development, air pollution was officially recorded as a cause of death in the UK for the first time in 2021, prompting the creation of the Clean Air Bill and campaigns to reduce emissions. In light of these developments, this paper aims to map available literature on air pollution-related illnesses, with a specific focus on the role of radiographic imaging in their diagnosis. METHOD: A scoping review was conducted using the Scopus, Trip Medical Database, and CINAHL databases. Key terms such as "air pollution" and "imaging" and inclusion and exclusion criteria were applied. A critiquing framework assessed the quality, rigor, and transparency of research. Data from each study was extracted and extrapolated into a thematic matrix to display the results. RESULTS: A review of ten papers comprising four systematic reviews, four cohort studies, and two longitudinal studies found nine different pollutants implicated in various diseases. Seven papers focused on brain pathological changes, two on lung function, and one on cardiovascular changes. Eight studies used Magnetic Resonance Imaging (MRI), and two used Computed Tomography (CT) scans. CONCLUSION: The findings revealed nine different air pollutants were mentioned across a range of CT and MRI imaging modalities in the studies. Dementia was the most referenced illness. The results suggest that air pollution-related illnesses will continue to pose a significant health risk, impacting the general population and the clinical work of the radiography profession. IMPLICATIONS FOR PRACTICE: Given the diverse effects of air pollutants on health, it is important radiographers are educated on how patient's history may influence imaging findings.

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INTRODUCTION: The 10 Kilovoltage (kV) rule was a historic exposure adaption technique designed for film screen X-ray imaging to reduce ionising radiation dose without loss of image quality. This study evaluates knee X-ray radiation dose and image quality between standard patient exposure factors, the historic 10 kV rule (-50 % Milliampere-second (mAs), and a modified 10 kV rule (-75 % mAs) using a digital radiography (DR) system. METHOD: Applying the exposure factors of 63 kV and 8 mAs (standard pre-set exposure), 73 kV and 4 mAs (historic 10 kV rule) and 73 kV and 2 mAs (modified 10 kV) to a phantom knee and recording entrance skin dose (ESD) using thermoluminescence dosemeters (TLDs). The ESD was analysed with a t-test. The image quality was assessed using a Likert 5-point Visual Grading Analysis (VGA) by (n = 3) independent observers. The ESD data was analysed with Analysis of Variance (ANOVA) for differences between the techniques. RESULTS: The ESD reduction for the historic 10 kV rule was 32.1-33.7 % (20.9 µGy; p = 0.00), and the modified 10 kV rule 81.5-81.8 % (42.1-43.7 µGy; p = 0.00) compared to the standard pre-set exposure technique. The historic and modified 10 kV exposure parameters image quality for the AP views knee X-rays scored higher (p = 0.00) than the standard preset exposure images. The VGA for the lateral knee view using the historic (-0.1 VGA; p = 0.02) and the modified 10 kV (-0.3 VGA; p = 0.00) were slightly lower than the standard preset image quality, related to the trabeculae pattern and cortical outlines. CONCLUSION: The findings suggest dose reductions could be made by modifying the exposure factors without reducing the quality of diagnostic images in the AP Knee position. The findings for the lateral knee X-rays indicate the image quality scored lower but was still within diagnostic range. Further research is required in laboratory conditions of exposure adaptations over a larger sample of anatomy thickness and applying a wider exposure (kV) range. IMPLICATIONS FOR PRACTICE: One of a radiographer's many roles are to optimise techniques to improve image quality of anatomy and reduce the radiation dose to the patient. The findings have shown there is potential for further research using the modified 10 kV rule.

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INTRODUCTION: Transgender patients have described negative healthcare experiences, including discrimination and feeling unwelcome. Additionally, these patients are at risk of inadequate or unsafe care due to healthcare providers being unable to obtain and record transgender patients' correct gender and assigned birth sex. This literature review aims to review radiology and radiographer articles published since 2018 about transgender healthcare issues and make recommendations that can be applied by diagnostic radiographers, their managers and diagnostic radiography programme providers. METHOD: A literature search used multiple databases containing peer-reviewed articles. Boolean operators and key words were utilised. Identified articles were searched to identify any articles not found by searching the databases. Themes and sub-themes from each paper were identified and discussed. RESULTS: Three key themes were identified: education, systems and environment. Education sub-themes were knowledge and awareness. Systems sub-themes were recording gender correctly and discriminating/stigmatising policies. Environment sub-themes were transgender-friendly symbols and environmental dysphoria. CONCLUSION: Transgender patients still face barriers to equitable care. Several recommendations were made based on the thematic discussion that could be applied by diagnostic radiographers, student radiographers, radiology managers, University training providers, and professional body organisations. Diagnostic radiography programmes should include training on both clinical topics and cultural competence. Radiology managers should display transgender-positive symbols in their departments and ensure their policies are non-discriminatory and non-stigmatising. Radiology hardware and software providers should provide the ability to record non-binary genders and birth-assigned sex. IMPLICATIONS FOR PRACTICE: Transgender patients have the right to receive equitable care from diagnostic radiographers during their imaging examination and radiology attendance, and that any risks relating to their transgender status should be correctly managed with appropriate sensitivity.

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INTRODUCTION: Obesity bias exists in healthcare professionals and students from numerous disciplines and negatively impacts the quality of care, outcomes, engagement, and satisfaction of their patients. With obesity rates continuing to rise in the United Kingdom (UK), more patients will be affected than ever, and it is becoming an increasingly important issue to tackle. This study aims to assess the attitudes to obesity of student diagnostic radiographers and determine if obesity bias exists in this population. METHOD: Student radiographers (n = 140) at a single university in the UK were invited to complete an online survey comprising measures designed to assess levels of bias and attitudes towards obesity, including the Attitude Towards Obese Persons (ATOP) scale. Likert-type scales were used to collect quantitative data, and data analysis included descriptive statistics, frequencies, and Spearman's rank correlation coefficient. RESULTS: Responses were received from n = 38 students. The mean ATOP score for participants was 70.37 (SD = 19.26). With 26 % (n = 10) scoring below 60, demonstrating strong negative attitudes towards obese individuals. Additionally, students (76.3 %; n = 29) indicated that they observed high levels of obesity bias whilst on clinical placement. There was a statistically significant correlation between levels of weight bias and students' confidence in working with obese patients (r(36) = 0.4, p 0.01). Students who are less confident working with obese patients had higher levels of obesity bias. CONCLUSIONS: Obesity bias exists in radiography students at levels comparable to those that have been found previously in other healthcare professionals and students. Furthermore, radiography students lacked confidence in their technical ability to work with obese patients and lower confidence levels were associated with higher levels of obesity bias. IMPLICATIONS FOR PRACTICE: The findings of this study provide preliminary knowledge upon which future research can be built.

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INTRODUCTION: Impostor Phenomenon (IP) includes feelings of being a fraud, which can be associated with high anxiety levels. Research suggests healthcare students on clinical placement report high levels of anxiety. This study aimed to explore radiography students' (diagnostic and therapeutic) IP traits within the United Kingdom (UK). METHODS: The pilot study used a mixed-method online survey, applying the Clance Impostor Phenomenon Scale (CIPS). Internal student recruitment used the university virtual learning environment (VLE), and external UK recruitment used social media with a convenience sampling method. The survey included demographic questions (gender, age, year of study, course). The statistical analysis used the Kruskal-Wallis test for the quantitative responses and content analysis of the qualitative responses. RESULTS: The survey received n = 92 responses; 77% were found to have frequent or intense IP traits. No significant differences were identified by age (p = 0.46) or radiography programme (diagnostic or therapeutic) (p = 1.00). The year of study demonstrated a significant difference (p = 0.01), with second-year students scoring a higher CIPS score (78.56) than first and third years (72.41 and 66.17, respectively). There was also a significant difference between males and females surveyed (p = 0.001). The thematic analysis highlighted that the clinical placement environment, prior IP knowledge, feelings of not belonging, and being an older/mature student increased IP feelings. CONCLUSION: Both therapeutic and diagnostic students returned a high CIPS score >70, demonstrating that IP traits were present in the sample of survey responses. Although being an older/mature student was a subtheme in qualitative responses, the quantitative data displayed no statistical difference amongst the CIPS scores by age. A significant difference between males and females surveyed (p = 0.001) and year of study (p = 0.01) was found with second years students scoring higher (mean CIPS score of 75.56) than first and third-year students (72.41 and 66.17, respectively). The qualitative responses further suggested as clinical placement experiences increased, feelings of IP decreased. IMPLICATIONS FOR PRACTICE: Educational intervention methods such as workshops may assist radiography students in identifying and coping with IP traits before their first clinical placement.

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INTRODUCTION: The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England. METHODS: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers. RESULTS: The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership. CONCLUSION: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.

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INTRODUCTION: Radiographers have been reporting Magnetic Resonance Imaging (MRI) examinations for over ten years, and there is an increasing body of evidence confirming the efficacy of this role expansion. However, little is known about the clinical scope of practice of radiographers undertaking this enhanced level of practice. The aim of this study was to investigate the clinical scope of practice of MRI reporting radiographers within the United Kingdom (UK). METHODS: MRI reporting radiographers who are actively reporting within the UK were invited to participate in a short online survey investigating the anatomical areas reported, clinical referral pathways and onward referral practices they routinely undertake. The survey was distributed via social media channels with snowball sampling encouraged. RESULTS: There were n = 14 responses received, with an estimated response rate of 21.5%. The majority (93% n = 13/14) practised in England, with one response from Scotland. All participants (n = 14/14) undertook reporting of general practitioner (GP) and community healthcare practitioner's referrals, with 93% reporting for outpatient referrers. There was statistically significant variation in the anatomical areas reported when compared against those qualified less than two years and those qualified over ten years (p = 0.003). No other statistically significant variation was seen. CONCLUSION: There was no statistical difference in the implementation of MRI reporting by radiographers identified. All participants indicated reporting for GP and community healthcare practitioner referrers which align well with the implementation of community diagnostic centre rollout across the UK. IMPLICATION FOR PRACTICE: This is believed to be the first study of its kind in the realm of MRI reporting. The study has suggested that MRI reporting radiographers are well placed to contribute to the rollout of community diagnostic centres within the UK.

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INTRODUCTION: Clinical placement is an essential aspect of student radiographers' training. The Covid-19 pandemic proved challenging for diagnostic radiography students disrupting clinical placements. This study aims to explore the impact of Covid-19 on first and second year student diagnostic radiographers' in clinical practice during the Covid-19 lockdown periods and Covid-19 waves in England. METHOD: A cross-sectional online survey was used to attain quantitative attitudinal 5-point Likert and qualitative free-text response data. Descriptive and inferential statistics data analysis applied the Mann-Whitney U test and Kruskal-Wallis H test. The qualitative data were thematically coded and analysed for patterns of reoccurring themes. RESULTS: There were n = 85 responses from n = 9 different counties within England. Students reported missing between n = 1-14 weeks of placement. There was a lack of (41%; n = 35) or limited radiography staff (21%; n = 18) in the clinical departments and a lack of a range of X-ray examinations available (67%; n = 57) during the Covid-19 lockdowns, which affected completing practice assessments. Negative effects included stress, anxiety and worry (68%; n = 58); positive effects included team working (16.4%; n = 14), learning to work under pressure (12.9%; n = 11), and preparation for qualifying (8.2%; n = 7). CONCLUSIONS: This study identified that students needed more support in this critical aspect of their training. There were both positive and negative responses; notably, the results highlight how the Covid-19 lockdowns have strained the National Health Service (NHS) and adversely affected radiography students. IMPLICATIONS FOR PRACTICE: The findings underscore the need for university educators and student liaison radiographers within hospitals to have an awareness of the mental health and practical learning needs of the students they are instructing post-Covid-19 lockdown.

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INTRODUCTION: Communication issues can arise when deaf or hearing impaired individuals access National Health Service (NHS) radiology services if reasonable adjustments and inclusive services are not facilitated. This study aims to assess student diagnostic radiographers' attitudes and communication experience with service users who are deaf or hearing impaired. METHODS: An anonymous online survey was conducted on UK undergraduate diagnostic radiography students from a single university. The sample size of students invited to participate in the study was n = 156. The measurement scales and questions included quantitative attitudinal 5-point Likert and qualitative free-response questions. Statistical analysis included the Kruskal-Wallis H test, Mann-Whitney U test, pairwise comparisons of variables and thematic coding of qualitative data. RESULTS: n=48 students responded. The student's perceptions of communication experiences with deaf or hearing-impaired patients were positive (72.9%) but depended on the amount of experience whilst on clinical placement (first-year students had less clinical placement experience than years two and three). Overall confidence in communicating was 47.9% with no difference by gender (p = 0.87) but variance by age category (p = 0.03), with the 18-29 group less confident and first-year students having less experience to draw upon for responses (p = 0.04). Confidence in gaining consent (56.3%) demonstrated no variation by gender (p = 0.75) or cohort (p = 0.54), but variance by age category (p = 0.03) due to difference in unmatched sample sizes. Participants elaborated on positive service adaptations that can be facilitated for service users who are deaf or hearing impaired and issues that caused negative communication experiences. CONCLUSION: The study has produced data on the experience of student radiographers interacting with an understudied service user group who are deaf or hearing impaired. Qualitative responses discussed a range of resources to assist clinical practice communication and recommendations for further improvements and training opportunities. IMPLICATIONS FOR PRACTICE: The findings of this study can help to inform future research, policy, practice, and educational training.

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INTRODUCTION: Recent guidance from the British Institute of Radiology (BIR) and the American Association of Physicists in Medicine (AAPM) focuses on cessation of patient Lead-rubber (Pb) shielding placed within the Field of View (FOV) that may influence image exposure or quality. Furthermore, the BIR assert shielding organs greater than 5 cm from the primary X-ray beam will have a negligible effect to the received radiation dose. Bilateral hand X-rays are frequently and repeatedly requested for the diagnosis and ongoing management of arthritic conditions. There is a lack of literature regarding the effect of Pb shielding during bilateral hand X-ray examinations. This research aimed to investigate the scattered secondary radiation dose to the gonads during a bilateral hand X-ray, with and without the use of Pb shielding outside the FOV at a greater distance than 5 cm from the primary beam. METHODS: Using an anthropomorphic phantom and constructed upper limbs, radiation was recorded to the male and female gonads. Thermoluminescent dosimeters (TLD's) (⅛" x ⅛" x 0.15″ TLD-100H) were placed in groups of three upon the testes and within the left and right ovary to record the ionising radiation dose. Three collimated exposures were completed using a standard clinical practice hand X-ray protocol of 60 kVp and 2.5 mAs with a source to image distance (SID) of 100 cm. The mean and standard deviation of the radiation dose was calculated for both with and without Pb shielding. A paired two-sample t-test was conducted to determine statistical significance (p ≤ 0.05). RESULTS: Data analysis demonstrated dose measured to the testes of 5.3 µGy (SD 0.8) without Pb shielding and 2.3 µGy (SD 0.2) with Pb (reduction of 3 µGy; 56.6%). Left ovary doses measured 40.6 µGy (SD 1.2) without Pb shielding and 28.8 µGy (SD 1.7) with Pb (reduction of 11.9 µGy; 29.2%) and right ovary doses measured 39.5 µGy (SD 1.9) without Pb shielding and 26.6 µGy (SD 1.0) with Pb (reduction of 12.8 µGy; 32.4%). The paired two-sample t-test presented a statistically significant dose reduction (p = 0.0039). CONCLUSION: The study demonstrated dose limitation from scattered secondary radiation to the gonads when Pb shielding was used during a bilateral hand X-ray at distances greater than 5 cm from the primary X-ray beam on anatomy outside the FOV. IMPLICATIONS FOR PRACTICE: The use of Pb shielding over the gonad area during a bilateral hand X-ray examination aligns to ALARP best practice and provides prospects for patient (male and female) dose reduction.

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INTRODUCTION: COVID-19 is a highly contagious viral disease declared a global pandemic in March 2020. Throughout the pandemic, radiography students have been working in hospitals on the frontline. The review aimed to search for evidence of the impact COVID-19 has had on diagnostic radiography students and consider whether additional support and learning needs to be implemented. METHODS: A literature search strategy applied keywords, BOOLEAN search operators, and eligibility criteria on PubMed, Medline, and Google Scholar databases. Cormack's (2000) critique framework was chosen to methodologically appraise the mixed-method studies to evaluate the quality, validity and rigour. RESULTS: The search decisions were displayed in a PRISMA flowchart to evidence the process to identify the found articles comprised of two surveys, two semi-structured interviews and one case study. The findings identified common and reoccurring themes of personal protective equipment, mental wellbeing, accommodation and travel, assessments and learning, and transitioning to registration. CONCLUSION: The literature suggests that students felt positive impacts of the pandemic, such as being prepared for registration. However, negative effects included the fear of contracting the virus, anxieties of working with ill patients, impracticalities of accommodation and travel during clinical placement, and the adaption to online learning. IMPLICATIONS FOR PRACTICE: Clinical staff and universities need to work together to ensure students are mentally and physically supported during the pandemic. Regular meetings and agreed channels of communication with students will allow any issues to be brought to attention and addressed. In addition, employers should recognise that newly qualified radiographers will need extra support.

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INTRODUCTION: Deterioration of visual acuity (VA) and visual impairment has been linked to age-related subtle changes, gender, and a correlation to socioeconomic status. This study aimed to assess first-year diagnostic radiography students' visual functional abilities by applying the International Classification of Impairments, Disabilities and Handicaps (ICIDH) recommendations of functional VA screening and health-related quality of life questionnaire (HRQOL). METHODS: The design followed the World Health Organisation (WHO) electronic VA testing of monocular sight using LogMAR charts and binocular vision using Snellen charts, and an HRQOL questionnaire assessing for reduced ability of visual-based tasks in activities of daily living (ADL). The data was evaluated in correlation to the participant's visual correction, age, gender, and socioeconomic background. RESULTS: Seventy students were recruited, all meeting the WHO standard level for visual ability, with 100% (n = 70/70) met or achieved above normal binocular vision, correlating to expected normal population results from published studies for age. The monocular vision demonstrated 74% (n = 52/70) for the right eye, and 80% (n = 56/70) for the left eye for normal vision levels. The results did not differ significantly between each eye (p = 0.21), gender variations between the left eye (p = 0.27) and the right eye (p = 0.10) results were affected by sample ratio of females (80%; n = 56/70) to males (20%; n = 14/70), the visual correction did not impair binocular VA. The HRQOL assessment indicated no significant functional VA issues in the study sample. The study demonstrated no association between the participant's socioeconomic background that may influence their VA ability. CONCLUSION: The results provided normative binocular and monocular data on visual function in a sample of student radiographers and indicated that their thresholds align to normal (or near-normal) VA standards. IMPLICATIONS FOR PRACTICE: The visual health data was reviewed for subgroup comparison and trend analysis, and did not identify risk factors within this sample group that their VA and visual functioning would impact upon radiography clinical placement tasks and activities. The sample is not generalisable to the wider population; further studies are recommended.

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INTRODUCTION: This study investigated the scope of practice of CT head reporting radiographers in the UK, and to compare adherence to professional body standards. METHODS: An online questionnaire was utilized applying both multiple-choice and response (closed questions), and qualitative open question free-text responses. The 30 questions covered four key areas of demographics, the scope of practice, referrals, and ongoing competence, as described in professional body national guidance standards. The questionnaire was disseminated (convenience sampling) via Twitter and email to the National CT Head Reporting Special Interest Group. Responses were transcribed and coded; the results applied descriptive statistics to summarise observations of the study sample. RESULTS: The sample of participant response data analysed was n = 54. Most respondents were from England, with a postgraduate certificate award in clinical reporting, and a mean length of 8.3 years of reporting experience. The accepted referral pathway included a wide range of medical and surgical specialities, including both in and outpatients and acute and chronic pathways. Furthermore, 96.2% of the sample had a scope of practice that authorised referral recommendations to a broad and inclusive group of medical and surgical teams, and if required further or repeat diagnostic imaging. To maintain quality and evidence of ongoing competency, all radiographers were involved in audit cycles. CONCLUSION: The data collected confirmed the reporting practice within this sample group aligns to national recommended guidance. The data provided key information on the range and variation of individuals scope of practice within age restrictions of patients, examination types, referral teams, and ongoing competency practices. IMPLICATIONS FOR PRACTICE: This paper details the scope of practice of CT head reporting by radiographers and the contribution made to the healthcare sector.

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INTRODUCTION: The study evaluated the performance of a cohort of healthcare professionals in image interpretation of appendicular radiographic examinations following a preliminary clinical evaluation (PCE) course. METHODS: A systematic review and meta-analysis of image interpretation performance by non-medical staff was undertaken. Thirty three participants (seven radiographers, nineteen nurses, five paramedics, and two physiotherapists) completed an image based Objective Structured Examination (OSE) following a short course on PCE of appendicular radiographs. The case bank comprised 25 appendicular radiographic examinations. Prevalence of abnormal examinations approximated 52% (traumatic conditions). The OSE test scores were analysed with Alternative Free-response Receiver Operating Characteristic (AFROC) calculation of Area Under the Curve (AUC), sensitivity, specificity, and Cohen's Kappa (k) for multi-reader agreement. Professional subgroup results were compared with Analysis of Variance (ANOVA), and compared to the literature review. RESULTS: The participant subgroup results for radiographers were sensitivity 79.7%, specificity 92.9%, k = 72; AUC 86.5. Nurses sensitivity 76.2%, specificity 80.4%, k = 56; AUC 78.3. Paramedics sensitivity 80.3%, specificity 81.6%, k = 61; AUC 81.5. Physiotherapists sensitivity 90.4%, specificity 91.6%, k = 82; AUC 91.8. ANOVA Samples scores (f = 1.5; p = 0.23), sensitivity (f = 0.5; p = 0.65), specificity (f = 2.8; p = 0.05). The comparison of the radiographers and nurses results to the published literature were encouraging (SROC AUC 93.1 and 91.2, respectively). The paramedics and physiotherapists results could not be compared to published standards or abilities on the task due to a lack of literature available. CONCLUSION: The study results of image interpretation and commentary of appendicular radiographs in an academic environment by this multi-professional sample were to a high standard, further work is recommended on a larger sample.

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INTRODUCTION: The study aimed to analyse the results of radiographer's image interpretation of nuclear medicine (NM) examinations following a nine-month postgraduate module. METHODS: Twenty participants completed 60 summative image commentaries each at the end of the module from prospective NM worklists in England. Each submitted a mixed selection of examinations in bone, lung, renal, and thyroid scans. Prevalence of abnormalities was 51% incorporating acute and chronic pathology, normal variants and incidental findings. Every commentary was marked against reference standard radiologist definitive reports. Statistical analysis included Kappa (k), intraclass correlation coefficient (ICC) and Spearman's rank correlation coefficient (RS). RESULTS: Bone scan sensitivity and specificity was 93% (95% CI 91.3-95.6) and 88% (95% CI 84.3-90.9) respectively, accuracy at 91.5% (95% CI 88.6-93.7), with k = 0.82, ICC = 0.904, RS = 0.826. Lung scans demonstrated a sensitivity of 92.6% (95% CI 85.7-96.8), specificity was 92.1% (95% CI 88.7-94.1), accuracy 92.3% (95% CI 87.7-95.0), k = 0.83, ICC = 0.910, RS = 0.835. Renal scan sensitivity was 95% (95% CI 91.0-97.3), with 95.2% specificity (95% CI 91.8-97.3), accuracy were 95% (95% CI 91.4-97.3), k = 0.90, ICC = 0.948, RS = 0.907. Thyroid scans sensitivity was 88% (95% CI 83.1-91.4), with 93% specificity (95% CI 85.9-96.8), accuracy were 90.2% (95% CI 84.3-93.8), k = 0.80, ICC = 0.897, RS = 0.813. CONCLUSION: In this small pilot study, the image interpretation ability in assessing prospective NM examinations in a clinical environment displayed encouraging results. Further work is recommended to evaluate a larger sample and case selection.

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INTRODUCTION: The aim of the study was to evaluate the performance of radiographers in image interpretation of magnetic resonance imaging (MRI) brain, spine and knee examinations following a nine-month work based postgraduate MRI module. METHODS: Twenty-seven participants each submitted 60 image commentaries taken from prospective clinical workloads. The image interpretations (n = 1620) comprised brain, spine, and knee MRI examinations. Prevalence of abnormal examinations approximated 53% (brain), 74% (spine), and 73% (knee), and included acute and chronic pathology, normal variants and incidental findings. Each image interpretation was graded against reference standard consultant radiologist definitive report. RESULTS: The radiographer's performance on brain image interpretations demonstrated mean accuracy at 86.7% (95% CI 83.4-89.3) with sensitivity and specificity of 84% (95% CI 80.9-86.4) and 89.7% (95% CI 86.2-92.6) respectively. For spinal interpretations the mean accuracy was 86.4% (95% CI 83.4-89.0), sensitivity was 90.2% (95% CI 88.2-92), mean specificity was 75.3% (95% CI 69.4-80.4). The mean results for knee interpretation accuracy were 80.9% (95% CI 77.3-84.1), sensitivity was 83.3% (95% CI 80.8-85.5), with 74.3% specificity (95% CI 67.4-80.4). CONCLUSIONS: The radiographer's demonstrated skills in brain, spine and knee MRI examination image interpretation. These skills are not to replace radiologist reporting but to meet regulating body standards of proficiency, and to assist decision making in communicating unexpected serious findings, and/or extend scan range and sequences. Further research is required to investigate the impact of these skills on adjusting scan protocols or flagging urgent findings in clinical practice.

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INTRODUCTION: Magnetic Resonance Imaging (MRI) is a commonly used for diagnosing metastatic liver disease. When patients are unable to achieve the necessary arrested respiration required during image acquisition, image artefacts occur that affect image quality and diagnostic value. The main contribution of this study is the evaluation of a novel prototype technique that allows a specific sub-group of patients to breathe freely throughout the acquisition of dynamic contrast enhanced equilibrium phase MRI of the liver. METHODS: The study compared a traditional single phase of arrested respiration T1-weighted (T1W) fat saturated (FatSat) volumetric interpolated breath-hold sequence (VIBE) with a novel free-breathing T1W 3D Radial VIBE prototype sequence. A cohort of patients (n = 30) with known hepatic metastases who demonstrated difficulty in complying with the instructions for arrested inspiration were scanned. Both sets of data were compared for diagnostic quality using a Likert scale questionnaire by specialist Oncology Radiologists (n = 2). RESULTS: Higher scores for all image quality criteria, including the presence of artefact (2.6 ± 0.57; p < 0.001), lesion conspicuity (2.9 ± 0.35; p < 0.001) and visibility of intra-hepatic vessels (2.8 ± 0.37; p < 0.001) were found using the free-breathing sequence (13.5 ± 1.94; p < 0.001 t = 13.31; df 29; p < 0.001) than the breath hold phase (8.1 ± 2.06), confirmed with kappa (k-0.023; p-0.050). CONCLUSIONS: The results demonstrated a 39.5% improvement in overall image quality using the T1W 3D Radial VIBE prototype sequence, and have the potential to improve patient experience and reduce image artefacts during MRI imaging of this sub-group of patients.

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Several studies suggest that light in the UVA range (320-400 nm) activates signaling pathways that are anti-inflammatory and antioxidative. These effects have been attributed to Nrf2-mediated upregulation of "phase 2" genes such as heme oxygenase-1 (HO-1) that neutralize oxidative stress and metabolize electrophiles. Proteomics analysis previously had shown that small doses of blue light (400-500 nm) increased levels of peroxiredoxin phase 2 proteins in THP-1 monocytes, which led to our hypothesis that blue light activates Nrf2 signaling and thus may serve as an anti-inflammatory agent. THP-1 monocytes were treated with doses of blue light with and without lipopolysaccharide (LPS) inflammatory challenge. Cell lysates were tested for Nrf2 activation and HO-1 production. Treated cells were assessed for viability/mitochondrial activity via trypan blue exclusion and MTT assay, and secretion of two major pro-inflammatory cytokines, interleukin 8 (IL8) and tumor necrosis factor alpha (TNFα) was measured using ELISA. Blue light activated the phase 2 response in cultured THP-1 cells and was protective against LPS-induced cytotoxicity. Light pre-treatment also significantly reduced cytokine secretion in response to 0.1 µg ml-1 LPS, but had no anti-inflammatory effect at high LPS levels. This study is the first to report these effects using a light source that is approved for routine use on dental patients. Cellular responses to these light energies are worth further study and may provide therapeutic interventions for inflammation.

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