Radiography

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A study of the effect on accuracy of the introduction of a bellyboard as an immobilisation device to the radical radiotherapy treatment of prostate cancer patients
(2012-09) McIlwraith, K. A.; Blyth, Christine
Ensuring reproducibility in any radiotherapy technique is vital to ensure that a geometric miss does not occur. Patient position and comfort play a major part in the reproducibility of setups. Purpose: To study the effect on accuracy of the introduction of a bellyboard to the existing prone technique used for radical radiotherapy treatment of prostate cancer. Materials and Methods: Thirty patients were treated using the bellyboard in the standard method. Portal images were compared with those of a control group of patients who had treatment with no rigid immobilisation. Patients in both groups were males with prostate cancer, who underwent radical radiotherapy treatment. Images were analysed using anatomy matching, and deviations from the isocentre were noted. Results: Statistical analysis of the results showed no statistical significance between the groups, though within the control group there were more deviations over 0.5 cm from the isocentre position than in the bellyboard group. Conclusions: Introduction of the bellyboard was seen to be equivalent to the use of the control technique. When the deviations from isocentre position were evaluated for each group, the control group had more deviations over 0.5 cm than the bellyboard group. 2011 Cambridge University Press.
Adopting a blended approach to learning: Experiences from Radiography at Queen Margaret University, Edinburgh
(Elsevier, 2009-08) Cockbain, M.; Blyth, C.; Bovill, C.; Morss, K.
The perspective of the radiography teaching team at Queen Margaret University (QMU) was that a transmission mode of programme delivery was sub-optimal in helping students to learn and make links between theory and practice. Programme redesign adopted a blended learning approach with both face-to-face and online learning aimed at enhancing the students' control over their own learning. Online tasks within Web Classroom Tools (WebCT) were used as an integral part of careful programme design, which resulted in a programme enabling synthesis of the skills, knowledge and competencies acquired in the academic and clinical environments. With the move towards a more learner-centred, blended educational experience for the students the lecturers' role shifted to that of facilitator with WebCT providing the tutor with a more transparent view of student learning. Lecturers plan learning activities that build upon the skills students have developed through learning in groups, online and in class. The explicit connections that now exist between the academic programme and the opportunities for applying knowledge in practice allow students to engage more deeply in their learning. 2008 The College of Radiographers.
An audit of a radiotherapy review clinic for breast cancer patients: a multi-disciplinary approach
(2008) Cameron, J. L.; Blyth, C.; Kirby, A.
Purpose: With the advent of multi-disciplinary team working in Oncology practice, this audit was designed to assess patient satisfaction with this approach within an on-treatment review clinic for breast cancer patients. It also aimed to look at conformity of reporting of treatment side effects between different staff groups. Patients and methods: A questionnaire was distributed to 230 radical breast cancer patients once a week after each review clinic. An oncologist and a radiographer or nurse reviewed the patients during weeks 1-4 of treatment. A review form was completed at each visit specifying any side effects noted. Results: Patients appeared satisfied with their clinic visits to both the radiographer and nurse with 84 and 85% confidence and trust in the members of staff compared to 73% with the doctor. There was disparity in the recording of side effects between non-medical and medical staff groups. Conclusion: This audit has provided good evidence to support the continuation of multi-disciplinary review clinics. A key benefit is the reduction in clinic waiting times for patients and a substantial time saving for the medics. It also supports role development for the radiographer and nurse involved. 2008 Cambridge University Press.
Anterior universal spine system for adolescent idiopathic scoliosis: a follow-up study using scoliometer, real-time ultrasound and radiographs.
(IOS, 2002) Burwell, R. G.; Aujla, R. K.; Cole, A. A.; Kirby, Alanah; Pratt, R. K.; Webb, J. K.; Moulton, A.; Grivas, T. B.
Nine patients with AIS treated surgically with anterior USS instrumentation were examined by several methods pre-operatively and at each of 8 weeks, 1 year and 2 years after surgery (mean age 14.6 years, girls 7, boys 2, thoracolumbar 7, lumbar 1, thoracic 1, left 7, right 2). The methods used were (1) Scoliometer to measure angle of trunk inclinations (ATIs) in the standing forward bending position at each of 10 levels and converted to 18 levels by a computer program, (2) real-time ultrasound in the prone position of laminal rotations at each of 1 8 levels from TI-SI, and (3) anteroposterior radiographs in the standing erect position measured for each of Cobb angle, segmental vertebral rotation (Perdriolle) and segmental vertebral translation from the Ti-Si line (horizontal translation of each vertebral centroid from the T1-S1 line). The findings were plotted graphically and segmentally for each of Scoliometer ATJs, ultrasound laminal rotations, and radiographic vertebral rotations and translations. Findings. Graphical representation of the data shows that the improvement brought about by surgery is most clearly and consistently evident for segmental vertebral translation. The statistical analysis shows that the radiological parameters (Cobb angle, apical vertebral rotation and apical vertebral translation) and ultrasound spinal (laminal) rotation do not change detectably in follow-up. The Scoliometer ATI findings show an increase from 4 degrees (at 8 weeks) to 7 degrees (at 2 years) which is statistically significant. The evidence from this small sample of patients is consistent with the view that the compared with posterior USS, anterior USS surgery for AIS results in (1) similar initial rib hump correction, and (2) less rib hump reassertion during follow-up. More data are needed to evaluate these views.
Anthropometry and allometry in girls with right thoracic adolescent idiopathic scoliosis (AIS).
(ISO Press, 1997) Cole, A. A.; Burwell, R. G.; Kirby, Alanah; Polak, F. J.; Webb, J. K.; Diab, K. M.; Sevastik, J. A.
Assessment of set-up discrepancies using daily portal imaging during radiotherapy treatment for patients with spine and bone metastases
(Cambridge Journals, 2012-12) Young, L.; Blyth, Christine
It is well established that patients with bone metastases get good pain relief from radiotherapy. The aim of treatment is to achieve maximum pain relief with minimum morbidity. Accuracy and reproducibility of the patient's position are fundamental to the successful delivery of radiation therapy. It has been recognised for many years, that the accuracy of patient positioning will improve the success of radiation treatment. A previous study carried out in the department showed that the use of only a single tattoo for the set-up of palliative patients resulted in poor accuracy. The aim of this study was to assess if the addition of extra skin marks improved the set-up accuracy of palliative patients being treated for spine and bone metastases. A protocol was implemented detailing the extra skin marks to be used. Daily portal images were acquired and analysed retrospectively using anatomy matching. The results obtained were then compared with those of the previous study. The use of extra skin marks resulted in a total of 45% of images within 5 mm tolerance compared with 36% of images in patients treated with a single centre tattoo. Also, the number of images with deviations greater than 15 mm was reduced by more than 50% with the addition of extra skin marks. This study has shown that extra skin marks do increase the set-up accuracy in palliative patients treated for spine and bone metastases. Therefore, the practice of using extra skin marks has become standard protocol for all palliative patients within the department.
Back shape assessment in each of three positions in preoperative patients with adolescent idiopathic scoliosis: evaluation of a 10-level Scoliometer method interpolated to 18-levels.
(IOS Press, 2002) Burwell, R. G.; Aujla, R. K.; Cole, A. A.; Kirby, Alanah; Pratt, R. K.; Webb, J. K.; Moulton, A.
A Scoliometer was used by one observer (RKP) to assess the reproducibility of angle of trunk inclinations (ATIs) in 13 preoperative patients with AIS (thoracic 7, thoracolumbar 6, mean Cobb angle 50 degrees, right 9, age 15.4 years, girls 10). Three positions were used namely standing forward-bending, (FB) sitting FB and prone. Readings of ATI on the back were obtained at each of 10 levels (T1-S1). The subject was repositioned after walking around the room and a second set of readings obtained (repeats). All readings were converted by a computer program to 18 levels and plotted. The readings from 18 levels were analysed by level, as well as summated and averaged both without and with correction for the side of the curve. Conclusions. Back surface asymmetry measured with a Scoliometer in these preoperative patients with AIS is less in the prone position than in each of the forward bending positions. The standing FB position has the best reproducibility which supports the practice of using this position to measure Scoliometer ATIs in preoperative patients with AIS.
Body mass index of girls in health influences menarche and skeletal maturation: a leptin-sympathetic nervous system focus on the trunk with hypothalamic asymmetric dysfunction in the pathogenesis of adolescent idiopathic scoliosis?
(2008) Burwell, R. G.; Aujla, R. K.; Kirby, Alanah; Dangerfield, P. H.; Moulton, A.; Cole, A. A.; Polak, F. J.; Pratt, R. K.; Webb, J. K.
Lower body mass index (BMI) and lower circulating leptin levels have been reported in girls with AIS. In this paper we evaluate skeletal sizes and asymmetries by higher and lower BMI subsets about the means for each of three groups of girls age 11-18 years: 1) normals, 2) school screening referrals, and 3) preoperative girls. Higher and lower BMI subsets, likely to have separated subjects with higher from those with lower circulating leptin levels, identify: 1) girls with relatively earlier and later menarche; 2) trunk width size greater in the higher than in the lower BMI subset, of all three groups; 3) abnormal upper arm length (UAL) asymmetries (right minus left) in the lower BMI subset of the preoperative girls; and 4) in thoracic AIS of screened and preoperative girls, Cobb angle and apical vertebral rotation each significantly and positively correlate with UAL asymmetry in the lower BMI subset but not in the higher BMI subset. In preoperative girls, the lower BMI subset shows the combination of relatively reduced pelvic width and abnormal UAL asymmetry, suggesting that both are linked to lower circulating leptin levels. An earlier puberty with hormonal changes provides a plausible explanation for the larger trunk width at the shoulders and pelvis especially at the younger ages in the higher BMI subsets. At the shoulders, this widening is driven by the ribcage which, in human evolution was acquired with decoupling of head and trunk movements required for efficient bipedal gait. The UAL asymmetry patterns within the groups and BMI subsets are not explained by hormonal mechanisms. It is hypothesized that 1) normal trunk widening of the thoracic cage by hormones in human adolescence is supplemented via the sympathetic nervous system under leptin-hypothalamic control influenced by energy stores (metabolic fuel); and 2) hypothalamic dysfunction with altered hypothalamic sensitivity to leptin through a SNS-driven asymmetric effect may create skeletal length asymmetries in upper arms, ribs, ilia and vertebrae, and initiate AIS. Additional mechanisms acting in the spine and trunk may be required for AIS to progress including 1) somatic nervous system dysfunction, 2) biomechanical spinal growth modulation, and 3) osteopenia.
Covert observation to find if patient hospital clothing saves radiotherapy treatment room time, and the issue of a questionnaire to find if this is detrimental to patients' experience of radiotherapy
(Cambridge Journals, 2013-12) Farnan, M.; Blyth, Christine
Background Radiotherapy departments are having to work more efficiently to cope with increasing demand for radiotherapy resources. Radiotherapy treatment room efficiency may be increased by the introduction of hospital clothing as this negates the need for patient changing in the treatment room. However, studies have shown that hospital clothing can have a negative effect on patient dignity. It is therefore important to balance potential time saving with any detriment to patients. Purpose This study examined the effect that hospital clothing had on the time patients spend in the treatment room and aimed to identify patients' opinions of the clothing. Materials and methods Potential time saving was determined by covertly timing patients currently undergoing radiotherapy treatment as they entered and exited the treatment room. A total of 348 patients were timed in their own clothing and 341 were timed when they wore hospital clothing. The timings of these two groups were compared to determine whether hospital clothing saved treatment unit time. Patient opinions of the clothing were examined by issuing a short questionnaire, designed to gather ordinal data, at the end of their course of treatment. Questionnaires were issued only to patients who had worn hospital clothing in the radiotherapy department. Results Introducing hospital clothing saved a significant amount of treatment room time and patients were generally positive about wearing the clothing. Conclusion It is suggested that hospital clothing is a welcome addition to the radiotherapy department to increase efficiency without detriment to patients. Copyright Cambridge University Press 2013.
Does the Position of the Arm during Intravenous Contrast Administration alter Image Quality in Computed Tomography Pulmonary Angiography (CTPA)?
(2009-11-27) Wood, K.
Pulmonary embolism (PE) is the sudden blocking of a pulmonary artery, commonly by a blood clot.PE can be very difficult to diagnose clinically and is potentially fatal carrying a 30% mortality rate if untreated 1. In the UK 10% of all hospital deaths equating to 1% of all hospital admissions have been shown to be attributable to PE 2.
Endometrioid epithelial ovarian cancer: 20 Years of prospectively collected data from a single center
(American Cancer Society, 2008-05-15) Storey, D. J.; Rush, Robert; Stewart, Moira; Rye, Tzyvia; Al-Nafussi, Awatif; Williams, Alistair R.; Smyth, John F.; Gabra, Hani
Enduring the unseen battle: navigating the mental toll of long-term sports injuries.
(2024-03-22) Whitehill, Nicole
Etiologic theories of idiopathic scoliosis: enantiomorph disorder concept of bilateral symmetry, physeally-created growth conflicts and possible prevention.
(IOS Press, 2006) Burwell, R. G.; Freeman, B. J. C.; Dangerfield, P. H.; Aujla, R. K.; Cole, A. A.; Kirby, Alanah; Pratt, R. K.; Webb, J. K.; Moulton, A.; Dangerfield, P. H.; Uyttendaele, D.
The detection of anomalous extra-spinal left-right skeletal length asymmetries in the upper limbs, periapical ribs, ilia and lower limbs of subjects with adolescent idiopathic scoliosis (AIS) raises questions about skeletal bilateral symmetry of vertebrates in health and disorder, its origin and control. The vertebrate body plan externally has mirror-image bilateral symmetries that are highly conserved culminating in the adult form. The normal human body can be viewed as containing paired skeletal structures in the axial and appendicular skeleton as 1) separate left and right paired forms (eg long limb bones, ribs, ilia), and 2) united in paired forms (eg vertebrae, sternum, skull, mandible). Each of these separate and united pairs are mirror-image forms--enantiomorphs. Left-right asymmetries of growth plates (physes) may cause (1) in long bones length asymmetries, (2) within one or more vertebral physes putative growth conflict with distortion as deformity, and (3) between ribs and vertebrae putative growth conflict that triggers thoracic AIS suggesting preventive surgery on spine and ribs. There is evidence of a possible role for environmental factors in AIS development. Genes and the environment (nature/nurture) may interact pre- and/or post-natally to explain both the deformity of AIS and its association with widespread anomalous skeletal length asymmetries. If substantiated there may ultimately be a place for the prevention of AIS in some subjects.
Etiologic theories of idiopathic scoliosis: neurodevelopmental concept of maturational delay of the CNS body schema (body-in-the-brain)
(IOS Press, 2006) Burwell, R. G.; Freeman, B. J. C.; Dangerfield, P. H.; Aujla, R. K.; Cole, A. A.; Kirby, Alanah; Polak, F. J.; Pratt, R. K.; Webb, J. K.; Moulton, A.; Dangerfield, P. H.; Uyttendaele, D.
Several workers consider that the etiology of adolescent idiopathic scoliosis (AIS) involves undetected neuromuscular dysfunction. During normal development the central nervous system (CNS) has to adapt to the rapidly growing skeleton of adolescence, and in AIS to developing spinal asymmetry from whatever cause. Examination of evidence from (1) anomalous extra-spinal left-right skeletal length asymmetries, (2) growth velocity and curve progression, and (3) the CNS body schema, parietal lobe and temporoparietal junction, led us to propose a new etiologic concept namely of delay in maturation of the CNS body schema during adolescence. In particular, the development of an early AIS deformity at a time of rapid spinal growth the association of CNS maturational delay results in the CNS attempting to balance a lateral spinal deformity in a moving upright trunk that is larger than the information on personal space (self) already established in the brain by that time of development. It is postulated that the CNS maturational delay allows scoliosis curve progression to occur - unless the delay is temporary when curve progression would cease. The putative maturational delay in the CNS body schema may arise (1) from impaired sensory input: (2) primarily in the brain; and/or (3) from impaired motor output. Oxidative stress with lipid peroxidation in the nervous system may be involved in some patients. The concept brings together many findings relating AIS to the nervous and musculo-skeletal systems and suggests brain morphometric studies in subjects with progressive AIS.
Etiologic theories of idiopathic scoliosis: the breaking of bilateral symmetry in relation to left-right asymmetry of internal organs, right thoracic adolescent idiopathic scoliosis (AIS) and vertebrate evolution.
(IOS Press, 2006) Burwell, R. G.; Dangerfield, P. H.; Freeman, B. J. C.; Aujla, R. K.; Cole, A. A.; Kirby, Alanah; Pratt, R. K.; Webb, J. K.; Moulton, A.; Dangerfield, P. H.; Uyttendaele, D.
In the search to understand the etiology and pathogenesis of adolescent idiopathic scoliosis (AIS) some workers have focused on mechanisms initiated in embryonic life including a disturbance of bilateral (left-right or mirror-image) symmetry highly conserved in vertebrates. The normal external bilateral symmetry of vertebrates results from a default process involving mesodermal somites. The normal internal asymmetry of the heart, major blood vessels, lungs and gut with its glands is also highly conserved among vertebrates. It results from the breaking of the initial bilateral symmetry by a binary asymmetry switch mechanism producing asymmetric gene expression around the embryonic node and/or in the lateral plate mesoderm. In the mouse this switch occurs during gastrulation by cilia driving a leftward flow of fluid and morphogen(s) at the embryonic node (nodal flow) that favors precursors of the heart, great vessels and viscera on the left. Based on the non-random laterality of thoracic AIS curves, the hypothesis is suggested that an anomaly of the binary asymmetry switch explains the excess of right/left thoracic AIS. Some support for this hypothesis is the prevalence of right and left scoliosis curve laterality associated with situs inversus. There is recent evidence that vertebrates within their bilateralised shell retain an archaic left-right asymmetric visceral body organization evident in thoracic and abdominal organs.
Evaluation of a new real-time ultrasound method for measuring segmental rotation of vertebrae and ribs in scoliosis.
(IOS Press, 1999) Kirby, Alanah; Burwell, R. G.; Cole, A. A.; Pratt, R. K.; Webb, J. K.; Moulton, A.; Stokes, I. A. F.
Evaluation of vertebral rotation by ultrasound for the early detection of adolescent idiopathic scoliosis (AIS).
(IOS Press, 1998) Burwell, R. G.; Kirby, Alanah; Aujla, R. K.; Kirk, E. L.; Pratt, R. K.; Bailey, M. A.; Webb, J. K.; Stokes, I. A. F.
Examining the Impact of Cancer Treatment on Personhood: A Participatory Research Investigation into the Unique Experiences of Lesbian, Gay, and Bisexual Individuals
(Elsevier, 2024-11-14) Hill, Gareth; Bulley, Catherine
Purpose Cancer incidence is growing in the UK population and will affect half of all individuals in their lifetime, with most new diagnoses occurring over the age of 60 years old. Despite legal reforms and liberation of LGBTQ people’s rights in recent years, many LGBTQ people affected by cancer will have faced significant societal discrimination in their lives. The aim of this research was to explore how cancer treatment impacts on the personhood of LGB people, and to increase understanding of social issues specific to this community. Methods Underpinned by person-centred principles and Critical Social Theory, a community-based participatory inquiry was carried out with nine LBG people who had been affected by cancer. In two subsequent sessions, participants created an identity map and then reflected on how cancer and care experiences had impacted their identity. Initially, content analysis of transcripts was informed by Mezirow’s perspective transformation, followed by inductive thematic analysis within each data framework category. Participants were invited to provide feedback on the identified themes. Results The processes of coming out and facing a cancer diagnosis emerged as significant crises, leading to personal transformation. Factors such as past experiences of homophobia, duration of being openly out, and confidence in embracing altered identities influence interactions with healthcare providers and the level of support received. Conclusions This research makes a unique contribution by shedding light on the unreported support needs of LGB individuals affected by cancer, suggesting the need for additional assistance.
Experiences of learning through collaborative evaluation from a masters programme in professional education
(Taylor and Francis, 2010-06) Bovill, Catherine; Aitken, Gillian; Hutchison, Jennifer; Morrison, Fiona; Roseweir, K.; Scott, Alison; Sotannde, S.
This paper presents findings from a collaborative evaluation project within a masters programme in professional education. The project aimed to increase knowledge of research methodologies and methods through authentic learning where participants worked in partnership with the tutor to evaluate the module which they were studying. The project processes, areas of the course evaluated and the data collection methods are outlined. The findings focus on key themes from evaluating the effectiveness of using a collaborative evaluation approach, including: enhanced student engagement; creativity of the collaborative evaluation approach; equality between the tutor and students; and enhanced research skills. Discussion focuses on the outcomes and effectiveness of the project and tutor reflections on adopting a collaborative approach. This paper highlights lessons from the project relevant to those interested in staff-student partnership approaches and those facilitating postgraduate learning and teaching programmes and educational research courses. 2010 Taylor & Francis.
Help me to come out gracefully! Working with lesbian, gay, and bisexual, people affected by cancer to develop a national practitioner guide supporting inclusive care
(Elsevier, 2023-02-23) Hill, Gareth; Bulley, Catherine
Introduction: The healthcare support needs of the lesbian, gay, bisexual (LGB) and transgender community are becoming an emerging area of healthcare research. Providing person-centred care is World Health Organisation policy and as such it is important that Radiography services can demonstrate areas in which they are working with people to design, develop and feedback on the services that they receive. This research aimed to establish how cancer treatment impacted on the identities of LGB people, their experiences of care, and their engagement with developing a practitioner guide. Methods: This cooperative inquiry is underpinned by person-centred philosophy and participatory research principles. Participants were nine lesbian, gay, and bisexual people affected by cancer. Each engaged in two facilitated, audio-recorded conversations to explore their experiences of cancer care. An analytical framework based on Mezirow's Transformational Theory was used to organise the data, followed by detailed content analysis to develop themes. Results: Participants included men and women, aged 45–68, who had experienced different cancers. They explored how cancer treatment had impacted on them, and worked with the researcher and stakeholders to establish a seven-recommendation practitioner guide aimed at improving LGB people's care experiences. Their accounts revealed a broad range of issues that both corroborate and build on existing evidence. Themes highlighted expectations and experiences of both assumptions and prejudice in healthcare interactions. These experiences, along with misinterpretation of relationships with significant others, led to feelings of discomfort and reserve about self-expression. Findings of the research are presented in the following key areas: Dilemmas of attending oncology appointments; Inclusive experiences of care; and Formulation of the practitioner guide. Conclusion: The research findings enabled development of a national practitioner guide with the participants and key stakeholders to raise awareness of the needs of LGB persons affected by cancer and support better care. Implications for practice: By providing real-life accounts this research adds to understanding of how LGB persons interact with services, developing evidence to support cultural competence within the profession of Radiography and oncology services more broadly. © 2023 The Author(s)