Radiographers' perception of patient safety culture in radiology.

INTRODUCTION: Radiographers play a central role in patient safety because of their knowledge of and responsibilities in relation to the imaging process. To maintain safe care, the workplace must create a safety culture that enables sustainable safety work. AIM: This study aims to describe radiographers' perceptions of the patient safety culture in radiology units in Sweden. METHODS: The Swedish Hospital Survey of Patients' Safety Culture (S-HSOPSC) was used to gather descriptive data from 171 Swedish registered radiographers working in five radiology clinics distributed across 15 units. Fifty-one questionnaire items and one open-ended question were analysed, comprising perceptions of the overall safety grade, the frequency of number of reported risks and events, and 14 composites regarding patient safety dimensions. RESULTS: The radiographers' concerns surrounding the patient safety culture in their workplaces related to weaknesses regarding the safety dimensions "Staffing", "Frequency of error reporting", "Organizational learning - continuous improvement" and "Executive management support for patient safety". They perceived "Teamwork within the unit" to be a strength. CONCLUSION: Despite some weaknesses in the patient safety culture, the radiographers perceived that the overall patient safety level was good, in part because of their ability to spot risks in time. The executive management, however, needed to improve their feedback on safety measures; and another reason for some weaknesses in the patient safety culture could be staffing issues such as lack of time for meetings for continuous improvement. Managers and leaders have a great responsibility to establish a patient safety culture through support and good leadership. IMPLICATIONS FOR PRACTICE: An understanding of what creates a safety culture is important to prevent patient safety incidents.

Radiographers' academic development in Sweden: Towards and after a doctoral degree.

INTRODUCTION: Radiography is a young discipline and having radiographers with a doctoral degree is central for its development. Academic development of this field in Sweden has been evolving. This study explored the diagnostic radiographers' prerequisites for doctoral studies, post-doctoral employment and research activities. METHODS: Data were collected through a questionnaire designed to give insight into doctoral radiographers' qualification paths, funding, doctoral status, employment and basic demography. Sixteen radiographers participated. A conventional content analysis was used. RESULTS: The median age at dissertation defence was 53 for doctorates and 60 for licentiates. This indicates that after receiving the doctorate, there is short time left in the profession, increasing the challenge to develop the field. Most doctorates were employed within educational establishments. Unfortunately, few had supervised doctoral students, but those employed within academia contributed significantly to academic research. CONCLUSION: Compared to other Nordic countries, Sweden is at the forefront with a positive development in obtained high academic degrees. Nevertheless, there is an urgent need for post-doctorate radiographers in order to maintain the workforce to meet current and future demands. Radiographers with doctorates need to be consulted when planning research projects to establish a clear radiographic perspective. Swedish radiographers with a doctorate or licentiate have limited research time, indicating that Sweden may not invest enough in radiographic research. IMPLICATIONS FOR PRACTICE: There is a need for more doctoral positions and doctorates radiographers to supervise doctoral students. Clinical departments should recognise the benefits of having radiographic clinical research.

Radiographic research in Sweden - A review of dissertations.

INTRODUCTION: Radiographers have performed research since 1988 in Sweden. The amount of doctoral and licentiate dissertations written by registered diagnostic radiographers has increased considerably since 2000. How this new field of research was established and developed has facilitated understand of the boundaries that strengthen the professional evidence base. The aim of this dissertation review was to explore the nature and the current state of radiographic research, written by registered diagnostic radiographers in Sweden. METHODS: Dissertations published between 1988 and 2017 were analysed both deductively and inductively with content analysis. RESULTS: Radiographic research focused on structural factors, clinical radiography, radiographic technology and pedagogical approaches. The findings indicated a large interest in advancing patient information, wellbeing and care during examinations. The participants were predominantly clinical patients, followed by radiographers, adults/children and the general public. The most common study designs were descriptive with a trend towards interventional studies. Interviews and questionnaires were the most common data collection methods followed by clinical examinations and documents. CONCLUSION: The analyses demonstrate that the current radiographer research has its roots in clinical practice, focusing on pragmatic aspects and applied knowledge. The findings suggest that radiographer's dissertations meet the challenges of new technologies and working practise. If the knowledge is connected to the radiographic framework, radiography can be viewed as an independent discipline with its own philosophical base. When radiographers are encouraged to conduct research, evidence based knowledge increase which strengthens the profession. Radiography, as a scientific discipline is evolving in Sweden.

Why do women refrain from mammography screening?

INTRODUCTION: Breast cancer is the leading cause of death for middle-aged women in Sweden. Approximately 600,000 women are surveyed annually within the national screening program. However, 20% of Swedish women do not participate in mammography screening. Participation in mammography screening is a complex phenomenon that has many dimensions. The aim of this study was to explore the reasons why women refrain from mammography screening from the perspective of non-attending women. METHOD: A qualitative approach was chosen, and 10 women were interviewed. The interviews were analysed using qualitative content analysis. RESULTS: Two categories were identified: individual needs and absence of active promotion. "Non-personalized system" was the main theme that emerged from the analysis. CONCLUSION: The mammography screening does not adapt to the needs of each individual. This may be the reason why some women refrain from mammography screening.

Trends that have influenced the Swedish radiography profession over the last four decades.

INTRODUCTION: The expansion of the radiography profession in recent decades has widened the scope of radiographic practice. This has raised questions about which trends have had an impact on the profession over the years. The study aim was to explore trends that have influenced the radiography profession over the last four decades. METHODS: A qualitative design was used. Eleven focus group interviews inspired by the Scenario Planning Method were conducted at 11 diagnostic radiology departments in public hospitals in Sweden. The target group consisted of 48 registered radiographers. To analyse the data, qualitative content analysis was used. RESULTS: Thematic data analysis revealed three broad categories; technological development and radiation doses, current status of the radiography profession and specialisation leading to expert knowledge. Each category derived from two or three sub-categories. CONCLUSION: The results demonstrate significant trends of influences on the radiography profession in Sweden over the last four decades. New methods and technology and control of radiation doses have had a favourable effect on the development of the radiography profession. Nevertheless, current status such as shortage of radiographers has had an adverse way. Specialisation leading to expert knowledge has an influence on career advancement and a specialist education regulated by the law, might be a prerequisite for the development of the radiography profession.

Professional development for radiographers and post graduate nurses in radiological interventions: Building teamwork and collaboration through drama.

INTRODUCTION: The rapid development within Interventional Radiology presents new challenges. Hybrid operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic resonance imaging and other techniques. This means that several disciplines and professionals need to work in new constellations creating a multidisciplinary team around the patient. In accordance with this development, higher professional education must provide new pedagogic strategies to successfully address the knowledge expected in today's complex working life. AIM: To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to foster team work and collaboration in the field of radiography and learning. METHODS: A qualitative approach, closely related to Ethnography, was utilized. RESULT: The Drama Workshop utilising Forum Theatre created a dynamic learning environment and enabled the participants from three professions to understand each other's priorities better. The use of drama within health care education allows the students to take different roles in order to find the best way to co-operate. CONCLUSION: Forum Theatre is a useful learning medium in order to promote teamwork and collaboration in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to engage the participants at a deeper level and to experience various communication strategies and how the outcome changed depending on the approach. This can lead to improved teamwork and collaboration.

Capture efficiency of cooking-related fine and ultrafine particles by residential exhaust hoods.

Effective exhaust hoods can mitigate the indoor air quality impacts of pollutant emissions from residential cooking. This study reports capture efficiencies (CE) measured for cooking-generated particles for scripted cooking procedures in a 121-m3 chamber with kitchenette. CEs also were measured for burner produced CO2 during cooking and separately for pots and pans containing water. The study used four exhaust hoods previously tested by Delp and Singer (Environ. Sci. Technol., 2012, 46, 6167-6173). For pan-frying a hamburger over medium heat on the back burner, CEs for particles were similar to those for burner produced CO2 and mostly above 80%. For stir-frying green beans in a wok (high heat, front burner), CEs for burner CO2 during cooking varied by hood and airflow: CEs were 34-38% for low (51-68 l/s) and 54-72% for high (109-138 l/s) settings. CEs for 0.3-2.0 µm particles during front burner stir-frying were 3-11% on low and 16-70% on high settings. Results indicate that CEs measured for burner CO2 are not predictive of CEs of cooking-generated particles under all conditions, but they may be suitable to identify devices with CEs above 80% both for burner combustion products and for cooking-related particles.

Analysis of JC virus DNA in NPSLE patients treated with different immunomodulatory agents.

OBJECTIVE: The objective of this report is to assess the presence and viral load of JC polyomavirus (JCV) DNA in cerebrospinal fluid (CSF) and plasma from neuropsychiatric systemic lupus erythematosus (NPSLE) patients in comparison to controls and to investigate if different types of immunosuppressive treatments were correlated to detection and viral load of JCV DNA in SLE. BACKGROUND: Reactivation of a latent JCV infection with subsequent development of the fatal disease progressive multifocal leukoencephalopathy (PML) has become an increasing problem in patients with autoimmune diseases treated with newer immunosuppressants. Accumulating data point out that SLE patients are at particular risk for PML compared to patients with other rheumatic diseases. METHODS: CSF samples (n = 69) and plasma samples (n = 51) from 71 SLE patients and 58 controls (53 CSF samples and 50 plasma samples) with other non-inflammatory neurological disease (OND) were analyzed for JCV DNA with a quantitative PCR method. RESULTS: All CSF and plasma samples from NPSLE patients and controls were negative for JCV DNA. CONCLUSION: JCV DNA was absent in CSF and plasma in NPSLE patients and controls and consequently we were not able to identify any correlation between the occurrence of JCV DNA and type of immunosuppressive medication.

Intensive use of intravascular ultrasound during coronary angioplasty. A six-month campaign.

BACKGROUND: Compared to coronary angiography, intravascular ultrasound (IVUS) gives additional information important for the percutaneous transluminal coronary angioplasty (PTCA) procedure, but is time-consuming and may cause complications. AIM: To evaluate, during a period of intensive use of IVUS, the impact of IVUS on the final decision on balloon/stent diameter, consumption of devices, time-consumption and IVUS-related complications. METHOD: During a 6-month period, IVUS was contemplated in all PTCA procedures and the reason for not using IVUS was specified. We used CVIS during the first, and Endosonics during the last 3 months, and both periods started with 1 week of hands-on practice. All procedures were to be planned according to an initial quantitative coronary angiography (QCA), and the finally achieved result, material used and complications were registered. RESULTS: The proportion of IVUS/PTCA was 37% during, 8% 6 months before and 12% 6 months after the study period. Three hundred and twenty-three patients were included in the study (57% of all patients), 199 of them were subjected to IVUS. The indications for PTCA during the study period were stable angina (58%), unstable angina (32%) and acute myocardial infarction (10%). The main reasons for not doing IVUS were use of 6F guiding catheter (13%), urgent procedure (12%) and occluded vessel (11%). Initial QCA detected 253 stenoses in 199 patients and 64 additional stenoses were treated, most of them probably detected by IVUS. QCA systematically underestimated vessel size, particularly in small vessels. There was a non-significant trend to more accurate estimations towards the end of the study in small vessels. Dissection, probably due to IVUS, occurred in two cases (1%). There were no significant differences in the number of devices used in IVUS compared to non-IVUS patients. The procedural time was 24 min longer in IVUS than in non-IVUS cases and more stenoses were treated per procedure in the IVUS group. CONCLUSION: Coronary angiography often underestimated balloon/stent size but in an unpredictable way, with a substantial proportion of significant stenoses being undetected. IVUS had few serious complications, did not increase device consumption but prolonged procedural time.

Evidence for a function of core protein in complex III from beef-heart mitochondria.

Puried complex III ) ubiquinol-cytochrome c reductase) from beef heart mitochondria was alkylated with iodol [1-14C]acetamide. After 6-8 h of incubation with iodo[1-14C]acetamide, duroquinol and ubiquinol-2-cytochrome c reductase activites were inhibited approximately 50%. During this time 4.5 +/- 1.6 nmol of iodo[1-14C]acetamide reacted per mg of complex III protein. Experiments carried out over 24 h indicated that enzyme activity could be inhibited to 70% and the alkylation of complex III was proportional to inhibition. The rates of cytochrome b and c1 reduction by duroquinol are also decreased upon treatment of complex III with iodoacetamide. Separation of the peptides of complex III by electrophoresis in sodium dodecylsulfate shows that all of the radioactivity is located in a single peptide of 50 000 molecular weight, which has been identified as one of the two core proteins. The possible functions of core protein are discussed.