A meningoencephalitis outbreak associated with echovirus type 18 (E18) in south-western Hungary in mid-2023.

Echovirus type 18 (E18) is a member of the genus Enterovirus of the family Picornaviridae. In this study, we investigated the characteristics of E18 infections in hospitalized adults with meningoencephalitis that occurred during an unusual epidemic in south-western Hungary in mid-2023. Five (6.1%) out of 82 cerebrospinal fluid specimens that were tested were positive for an enterovirus, four of which were E18 (OR372160 and PP861087-PP861090). Headache (100%), fever (75%), retrobulbar pain (50%), nausea (50%), joint/limb pain (50%), exanthema, photophobia, and vomiting were the most common symptoms. Sequence analysis showed that these viruses were related to unpublished emerging E18 strains from France (2022/2023) and China (2019/2020). Further study is necessary to monitor the circulation of epidemic/pandemic E18 variants over time.

Canine companionship as a resilience factor: a quantitative inquiry into the impact of pet ownership on burnout mitigation among radiologists and radiographers.

Background: The demanding nature of diagnostic imaging, coupled with the increasing workload and exposure to high-stress scenarios, underscores the pressing concern of burnout among radiologists and radiographers in modern healthcare settings. The objective was to investigate the interplay between family characteristics, workplace characteristics, pet ownership, and the occurrence of burnout. Methods: An online, quantitative, cross-sectional study with a non-random, purposive sampling method was carried out among Hungarian radiologists and radiographers from 1st of September to 1st of November 2022. Results: We examined the results of 406 responses predominantly from females (79.8%, n = 324), including 70.7% radiographers (n = 287). Cronbach's alpha values for depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA) were 0.74, 0.88, and 0.85, respectively. Average burnout scores were 8.35 (SD = 6.62) for DP, 26.26 (SD = 12.74) for EE, and 32.86 (SD = 9.52) for PA. DP demonstrated a balanced distribution (low: 35.7%, moderate: 27.3%, high: 36.9%). Conversely, EE and PA skewed towards high levels, with 52.5% (n = 213) and 49.5% (n = 201). Significant associations were found between gender and DP (p = 0.006), age (31-40 years) and DP/PA (p < 0.001; p = 0.004), absence of children and all burnout dimensions (p < 0.05), and pet ownership (p = 0.004) with lower EE, particularly for dog owners (p = 0.009). Occupation lacked a significant effect on burnout dimensions (p > 0.05). Employees without a second job had higher EE (p = 0.002) and lower PA (p = 0.008). Increasing healthcare experience correlated with decreased DP values (p = 0.001), while working over 40 h weekly negatively impacted all burnout dimensions (p ≤ 0.05). 15.5% (n = 63) exhibited signs of high burnout, with the age group 31-40 demonstrating the highest proportion (25.4%, n = 27) and significant associations with marital status, absence of children, pet ownership, private healthcare, 10-19 years in healthcare, and working over 40 h weekly. Conclusions: There is a pressing need for evidence-based strategies to alleviate burnout among radiologists and radiographers. There is a growing importance of recognizing the role of pets, especially dogs, as valuable companions for emotional support and stress relief. Implementing pet-friendly policies or therapy programs can contribute to a positive and supportive workplace, potentially mitigating burnout among essential frontline healthcare professionals.

Value of 11C-Methionine PET Imaging in High-Grade Gliomas: A Narrative Review.

11C-Methionine (MET) is a widely utilized amino acid tracer in positron emission tomography (PET) imaging of primary brain tumors. 11C-MET PET offers valuable insights for tumor classification, facilitates treatment planning, and aids in monitoring therapeutic response. Its tracer properties allow better delineation of the active tumor volume, even in regions that show no contrast enhancement on conventional magnetic resonance imaging (MRI). This review focuses on the role of MET-PET in brain glioma imaging. The introduction provides a brief clinical overview of the problems of high-grade and recurrent gliomas. It discusses glioma management, radiotherapy planning, and the difficulties of imaging after chemoradiotherapy (pseudoprogression or radionecrosis). The mechanism of MET-PET is described. Additionally, the review encompasses the application of MET-PET in the context of primary gliomas, addressing its diagnostic precision, utility in tumor classification, prognostic value, and role in guiding biopsy procedures and radiotherapy planning.

Complex Diagnostic Challenges in Glioblastoma: The Role of 18F-FDOPA PET Imaging.

Glioblastoma multiforme (GBM) remains one of the most aggressive and lethal forms of brain cancer, characterized by rapid proliferation and diffuse infiltration into the surrounding brain tissues. Despite advancements in therapeutic approaches, the prognosis for GBM patients is poor, with median survival times rarely exceeding 15 months post-diagnosis. An accurate diagnosis, treatment planning, and monitoring are crucial for improving patient outcomes. Core imaging modalities such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are indispensable in the initial diagnosis and ongoing management of GBM. Histopathology remains the gold standard for definitive diagnoses, guiding treatment by providing molecular and genetic insights into the tumor. Advanced imaging modalities, particularly positron emission tomography (PET), play a pivotal role in the management of GBM. Among these, 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-FDOPA) PET has emerged as a powerful tool due to its superior specificity and sensitivity in detecting GBM and monitoring treatment responses. This introduction provides a comprehensive overview of the multifaceted role of 18F-FDOPA PET in GBM, covering its diagnostic accuracy, potential as a biomarker, integration into clinical workflows, impact on patient outcomes, technological and methodological advancements, comparative effectiveness with other PET tracers, and its cost-effectiveness in clinical practice. Through these perspectives, we aim to underscore the significant contributions of 18F-FDOPA PET to the evolving landscape of GBM management and its potential to enhance both clinical and economic outcomes for patients afflicted with this formidable disease.

Confirmed Case of Autochthonous Human Babesiosis, Hungary.

We report a case of autochthonous human babesiosis in Hungary, confirmed by PCR and partial sequencing of the Babesia spp. 18S rRNA gene. Babesiosis should be considered during the differential diagnosis of febrile illnesses, and peripheral blood smears to detect Babesia spp. should be part of the routine clinical workup.

Encapsulation protocol for fecal microbiota transplantation.

Introduction: Clostridioides difficile infections (CDI) continue to pose a challenge for clinicians. Fecal microbiota transplantation (FMT) is an effective treatment option in CDI. Furthermore, recent and ongoing studies suggest potential benefits of FMT in other diseases as well. Methods: We would like to present a novel protocol for encapsulation of lyophilized fecal material. Our method provides with better compliance as well as improved flexibility, storage and safety. Results: FMT was conducted in 28 patients with an overall success rate of 82,14% using apsules containing lyophilized stool. 16 of patients were given capsules with lessened bacteria counts. The success rate in this group was 93,75%. Discussion: The results highlight the still unanswered questions about the mechanism of action and contribute to a wider use of FMT in the clinical praxis and in research.

Detection of Arrhythmias Using Smartwatches-A Systematic Literature Review.

Smartwatches represent one of the most widely adopted technological innovations among wearable devices. Their evolution has equipped them with an increasing array of features, including the capability to record an electrocardiogram. This functionality allows users to detect potential arrhythmias, enabling prompt intervention or monitoring of existing arrhythmias, such as atrial fibrillation. In our research, we aimed to compile case reports, case series, and cohort studies from the Web of Science, PubMed, Scopus, and Embase databases published until 1 August 2023. The search employed keywords such as "Smart Watch", "Apple Watch", "Samsung Gear", "Samsung Galaxy Watch", "Google Pixel Watch", "Fitbit", "Huawei Watch", "Withings", "Garmin", "Atrial Fibrillation", "Supraventricular Tachycardia", "Cardiac Arrhythmia", "Ventricular Tachycardia", "Atrioventricular Nodal Reentrant Tachycardia", "Atrioventricular Reentrant Tachycardia", "Heart Block", "Atrial Flutter", "Ectopic Atrial Tachycardia", and "Bradyarrhythmia." We obtained a total of 758 results, from which we selected 57 articles, including 33 case reports and case series, as well as 24 cohort studies. Most of the scientific works focused on atrial fibrillation, which is often detected using Apple Watches. Nevertheless, we also included articles investigating arrhythmias with the potential for circulatory collapse without immediate intervention. This systematic literature review provides a comprehensive overview of the current state of research on arrhythmia detection using smartwatches. Through further research, it may be possible to develop a care protocol that integrates arrhythmias recorded by smartwatches, allowing for timely access to appropriate medical care for patients. Additionally, continuous monitoring of existing arrhythmias using smartwatches could facilitate the assessment of the effectiveness of prescribed therapies.

Recurrence Patterns after Radiotherapy for Glioblastoma with [(11)C]methionine Positron Emission Tomography-Guided Irradiation for Target Volume Optimization.

11C methionine (11C-MET) is increasingly being used in addition to contrast-enhanced MRI to plan for radiotherapy of patients with glioblastomas. This study aimed to assess the recurrence pattern quantitatively. Glioblastoma patients undergoing 11C-MET PET examination before primary radiotherapy from 2018 to 2023 were included in the analysis. A clinical target volume was manually created and fused with MRI-based gross tumor volumes and MET PET-based biological target volume. The recurrence was noted as an area of contrast enhancement on the first MRI scan, which showed progression. The recurrent tumor was identified on the radiological MR images in terms of recurrent tumor volume, and recurrences were classified as central, in-field, marginal, or ex-field tumors. We then compared the MET-PET-defined biological target volume with the MRI-defined recurrent tumor volume regarding spatial overlap (the Dice coefficient) and the Hausdorff distance. Most recurrences occurred locally within the primary tumor area (64.8%). The mean Hausdorff distance was 39.4 mm (SD 32.25), and the mean Dice coefficient was 0.30 (SD 0.22). In patients with glioblastoma, the analysis of the recurrence pattern has been mainly based on FET-PET. Our study confirms that the recurrence pattern after gross tumor volume-based treatment contoured by MET-PET is consistent with the FET-PET-based treatment described in the literature.

Downside of Helping Professions: A Comparative Study of Health Indicators and Health Behaviour among Nurses and Early Childhood Educators.

The activities of health care workers and early childhood educators have received increased attention both in lay public discourse and in scientific discourse. These professional groups play a significant role in shaping the health behaviours of those they interact with; thus, understanding the patterns they convey is of paramount importance. The aim of our study is a comparative analysis of health conditions and health behaviours of professionals working in Hungarian early childhood education and nurses working in the healthcare system (n = 1591). We carried out our quantitative, cross-sectional research using convenience sampling among healthcare professionals working in nursing job positions (n = 581) and as early childhood educators (n = 1010), in south-west Hungary. Diagnosed chronic illnesses affect early childhood educators at a significantly higher rate (p < 0.05): the prevalence of musculoskeletal disorders is particularly high among them, as a result of which they reported a significant degree of physical limitation in relation to work. In the context of mental health, comparing the professional groups, nurses' indicators were significantly (p < 0.001) more unfavourable in all examined dimensions. Moreover, the comparison in terms of educational attainment directed attention to the worse indicators of non-graduates. In this context, early childhood educators are less affected by all three dimensions of burnout (p < 0.001). As for health behaviour, the smoking habits of nurses are more unfavourable (p < 0.05). Regarding screening tests, participation in cytological testing was significantly higher among nurses, whereas early childhood educators showed increased participation in mammography (p < 0.001). Our findings draw attention to the fact that early childhood educators are primarily affected by chronic musculoskeletal disorders, while healthcare workers are more affected by problems related to mental health. Mental well-being can be further endangered by the fact that both professional groups perceive low social appreciation for the work they carry out.

The Occurrence of Anxiety, Depression, and Distress among Professionals Working in Emergency Care.

Maintaining mental health is essential for professions with higher stress levels and challenging environments, including emergency specializations. In this study, the occurrence of distress, anxiety, and depression among a group of ambulance and hospital emergency care professionals was assessed (n = 202). A cross-sectional, quantitative, descriptive online survey was conducted, including the internationally validated Beck depression inventory (BDI), the perceived stress scale (PSS-14), and the State-Trait Anxiety Inventory (STAI). Statistical analyses involved descriptive statistics, the χ2-test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, logistic regression (LR), Cramer coefficient (Cramer's V), Kolmogorov-Smirnov test, and Spearman's rank correlation coefficient (rs). Based on the results, female professionals are more likely to have depressive symptoms (OR = 2.6, 95% CI = 1.3-5.1), perceived stress (OR = 1.2, 95% CI = 1.2-4.1), and anxiety (OR = 2.1, 95% CI = 1.0-4.1) than male professionals. Perceived stress levels decreased proportionally with increasing years spent working in healthcare (OR = 7.4, 95% CI = 7.1-8.3). Extended work shifts of 12 or 24 h increase the risk of perceived stress and anxiety in emergency care workers (p = 0.02). Customized stress management interventions are needed to mitigate the amplified mental strain associated with gender, working years, and longer shifts in the emergency care sector to sustain their mental health and well-being.

Stereotactic body radiotherapy in lung cancer: a contemporary review.

The treatment of early stage non-small cell lung cancer (NSCLC) has improved enormously in the last two decades. Although surgery is not the only choice, lobectomy is still the gold standard treatment type for operable patients. For inoperable patients stereotactic body radiotherapy (SBRT) should be offered, reaching very high local control and overall survival rates. With SBRT we can precisely irradiate small, well-defined lesions with high doses. To select the appropriate fractionation schedule it is important to determine the size, localization and extent of the lung tumor. The introduction of novel and further developed planning (contouring guidelines, diagnostic image application, planning systems) and delivery techniques (motion management, image guided radiotherapy) led to lower rates of side effects and more conformal target volume coverage. The purpose of this study is to summarize the current developments, randomised studies, guidelines about lung SBRT, with emphasis on the possibility of increasing local control and overall rates in "fit," operable patients as well, so SBRT would be eligible in place of surgery.

LINAC-based SBRT in treating early-stage NSCLC patients-single institution experience and survival data analysis.

Aim: This single institute prospective study aimed to evaluate the feasibility of LINAC-based stereotactic body radiotherapy (SBRT) in treating patients with early-stage non-small cell lung cancer (NSLSC). We focused on the survival data with the local and distant control profiles and the cancer- and non-cancer-specific survival. Treatment-related side effects were also collected and analyzed. Methods: Patients with early-stage NSCLC between January 2018 and October 2021 were included in our prospective study; a total of 77 patients receiving LINAC-based SBRT were analyzed. All patients had pretreatment multidisciplinary tumor board decisions on SBRT. The average patient age was 68.8 years (median: 70 years, range: 52-82); 70 patients were in ECOG 0 status (91%), while seven patients were in ECOG 1-2 status (9%). 52% of the patients (40) had histologically verified NSCLC, and the other 48% were verified based on PETCT results. We applied the SBRT scheme 8 x 7.5 Gy for central tumors (74%) or 4 x 12 Gy for peripheral tumors (26%). Results: The mean follow-up time was 25.4 months (median 23, range 18-50). The Kaplan-Meier estimation for overall survival in patients receiving LINAC-based SBRT was 41.67 months. Of the 77 patients treated by SBRT, death was reported for 17 patients (9 cases cancer-specific, 8 cases non-cancer specific reason). The mean local tumor control was 34.25 months (range 8.4-41), and the mean systemic control was 24.24 months (range 7-25). During the treatments, no Grade I-II were reported; in 30 cases, Grade I non-symptomatic treatment-related lung fibrosis and two asymptomatic rib fractures were reported. Conclusion: In the treatment of early-stage NSCLC, LINAC-based SBRT can be a feasible alternative to surgery. Although we reported worse OS data in our patient cohort compared to the literature, the higher older average age and the initial worse general condition (ECOG1-2) in our patient cohort appear to be the reason for this difference. With the comparable local control and survival data and the favorable side effect profile, SBRT might be preferable over surgery in selected cases.

Occupational Stress Levels among Radiologists and Radiographers in Hungary during the COVID-19 Era.

The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. A cross-sectional survey was conducted between September and November 2022, with participants comprising radiographers and radiologists affiliated with the Hungarian Society of Radiographers and the Hungarian Society of Radiologists. The online survey collected socio-demographic and COVID-19 data, and the participants completed an effort-reward imbalance questionnaire. The analysis of 406 responses revealed significantly higher effort-reward imbalance (ERI) levels among the radiologists compared to the radiographers (p < 0.05). The healthcare professionals with over 30 years of experience exhibited significantly lower ERI levels than those with 1-9 years, 10-19 years, or 20-29 years of experience (p < 0.05). Additionally, the individuals aged 31-40 demonstrated higher ERI levels compared to their counterparts aged 19-30, 41-50, and over 51 (p < 0.05). The respondents cohabiting with a spouse/partner reported significantly higher stress levels than their single colleagues (p < 0.05), while the dog owners exhibited significantly lower ERI levels (p < 0.05). Elevated occupational stress highlights specific groups requiring targeted interventions to reduce stress and mitigate burnout among radiologists and radiographers.

The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients.

Pain continues to be a significant problem for cancer patients, and the impact of a population-based strategy on their experiences is not completely understood. Our study aimed to determine the impact of palliative care on mitigating pain and its associated effects in determining the quality of life (QoL) among colon cancer outpatients. Six collection databases were used to perform a structured systematic review of the available literature, considering all papers published between the year 2000 and February 2023. PRISMA guidelines were adopted in our study, and a total of 9792 papers were evaluated. However, only 126 articles met the inclusion criteria. A precise diagnosis of disruptive colorectal cancer (CRC) pain disorders among patients under palliative care is necessary to mitigate it and its associated effects, enhance health, promote life expectancy, increase therapeutic responsiveness, and decrease comorbidity complications. Physical activities, the use of validated pain assessment tools, remote outpatient education and monitoring, chemotherapeutic pain reduction strategies, music and massage therapies, and bridging social isolation gaps are essential in enhancing QoL. We recommend and place a strong emphasis on the adoption of online training/or coaching programs and the integration of formal and informal palliative care systems for maximum QoL benefits among CRC outpatients.

Reduced burnout in medical and health science students during the pandemic COVID-19 - a follow-up study of a single institution in Hungary.

BACKGROUND: The coronavirus pandemic has significantly impacted lives worldwide, especially of medical and health science students. In Hungary, education has been relegated to the online space, with a substantial proportion of students having to attend medical secondments. Increased stress, uncertainty, and the presence of medical secondments can have an impact on students' premature burnout. METHODS: In 2021, we conducted a follow-up survey among students of the University of Pécs studying medicine and health sciences in two data collection periods (from March to May and September to November). Our online questionnaire consisted of the Maslach Burnout Inventory General Survey for Students and our self-designed questionnaire. We used descriptive and paired two-sample t-tests for data analysis at a 95% confidence interval (p ≤ 0.05). RESULTS: We excluded from our survey respondents whose data we could not follow-up; finally, 183 students' responses were analyzed. The majority of students were female (n = 148; 80.9%). Overall, there was a significant decrease in both exhaustion (EX) and cynicism (CY) scores (p = 0.001; p = 0.004). Female respondents had higher EX scores, but a significant decrease was observed for both genders (p ≤ 0.05). Excluding paramedic students, a significant decrease in EX scores was observed for the specialties we studied (p ≤ 0.05). General medicine students' CY scores decreased; physiotherapy students' profesisonal efficacy (PE) scores increased significantly (p ≤ 0.05). Students who were on medical secondments (n = 127; 69. 4%) were found to be more affected by burnout, but in all cases, these scores significantly improved (p ≤ 0.05). Students serving in the National Ambulance Service (n = 76; 41.5%), Hospitals (n = 44; 24.0%), or both (n = 7; 3.8%) had a significant decrease in their burnout score (p ≤ 0.05). Students who served in either a hospital or a hospital and National Ambulance Service had significantly improved CY and PE scores (p ≤ 0.05). Students concerned about their health had elevated EX and CY scores, which also improved (p ≤ 0.05). CONCLUSIONS: In conclusion, medical secondments positively affected student burnout scores for medicine and health sciences students at our institution. This fact implies that it is necessary to have more internships in real-life settings during the training. TRIAL REGISTRATION: Our survey has been approved by the Medical Research Council (Case No IV/4573-1/2021/ECU).

Serum Total Antioxidant Capacity (TAC) and TAC/Lymphocyte Ratio as Promising Predictive Markers in COVID-19.

SARS-CoV-2 infection might cause a critical disease, and patients' follow-up is based on multiple parameters. Oxidative stress is one of the key factors in the pathogenesis of COVID-19 suggesting that its level could be a prognostic marker. Therefore, we elucidated the predictive value of the serum non-enzymatic total antioxidant capacity (TAC) and that of the newly introduced TAC/lymphocyte ratio in COVID-19. We included 61 COVID-19 (n = 27 ward, n = 34 intensive care unit, ICU) patients and 29 controls in our study. Serum TAC on admission was measured by an enhanced chemiluminescence (ECL) microplate assay previously validated by our research group. TAC levels were higher (p < 0.01) in ICU (median: 407.88 µmol/L) than in ward patients (315.44 µmol/L) and controls (296.60 µmol/L). Besides the classical parameters, both the TAC/lymphocyte ratio and TAC had significant predictive values regarding the severity (AUC-ROC for the TAC/lymphocyte ratio: 0.811; for TAC: 0.728) and acute kidney injury (AUC-ROC for the TAC/lymphocyte ratio: 0.747; for TAC: 0.733) in COVID-19. Moreover, the TAC/lymphocyte ratio had significant predictive value regarding mortality (AUC-ROC: 0.752). Serum TAC and the TAC/lymphocyte ratio might offer valuable information regarding the severity of COVID-19. TAC measured by our ECL microplate assay serves as a promising marker for the prediction of systemic inflammatory diseases.

Migraine as a Disease Associated with Dysbiosis and Possible Therapy with Fecal Microbiota Transplantation.

Migraine is a painful neurological condition characterized by severe pain on one or both sides of the head. It may be linked to changes in the gut microbiota, which are influenced by antibiotic use and other factors. Dysbiosis, which develops and persists as a result of earlier antibiotic therapy, changes the composition of the intestinal flora, and can lead to the development of various diseases such as metabolic disorders, obesity, hematological malignancies, neurological or behavioral disorders, and migraine. Metabolites produced by the gut microbiome have been shown to influence the gut-brain axis. The use of probiotics as a dietary supplement may reduce the number and severity of migraine episodes. Dietary strategies can affect the course of migraines and are a valuable tool for improving migraine management. With fecal microbiota transplantation, gut microbial restoration is more effective and more durable. Changes after fecal microbiota transplantation were studied in detail, and many data help us to interpret the successful interventions. The microbiological alteration of the gut microflora can lead to normalization of the inflammatory mediators, the serotonin pathway, and influence the frequency and intensity of migraine pain.

Burnout and occupational stress among Hungarian radiographers working in emergency and non-emergency departments during COVID-19 pandemic.

INTRODUCTION: The increased workload caused by the coronavirus pandemic may have had a significant impact on the mental health of radiographers. The aim of our study was to investigate burnout and occupational stress in radiographers working in emergency departments (ED) and non-emergency departments (NED). METHODS: Quantitative, cross-sectional, descriptive research was carried out among radiographers working in the public health sector in Hungary. Due to the cross-sectional nature of our survey, there was no overlap between the ED and NED groups. For data collection, we used simultaneously the Maslach Burnout Inventory (MBI), the Effort-Reward Imbalance questionnaire (ERI), and our self-designed questionnaire. RESULTS: We excluded incomplete questionnaires from our survey; finally, 439 responses were evaluated. Significantly higher scores for depersonalisation (DP; 8.43 (SD = 6.69) vs. 5.63 (SD = 4.21) and emotional exhaustion (EE; 25.07 (SD = 11.41) vs. 19.72 (SD = 11.72)) were observed in radiographers working in ED (p = 0.001; p = 0.001) when compared to NED. Male radiographers working in ED aged 20-29 and 30-39 years with experience of 1-9 years were more affected by DP (p ≤ 0.05). Worrying about one's own health had a negative effect on DP and EE (p ≤ 0.05). Having close friend with a COVID-19 infection had a negative effect on EE (p ≤ 0.05); not being infected with coronavirus, not being quarantined and relocating within the workplace had a positive effect on personal accomplishment (PA); radiographers who were 50 years or older with 20-29 years of experience were more affected by depersonalisation (DP); and those who worried about their health had significantly higher stress scores (p ≤ 0.05) in both ED and NED settings. CONCLUSION: Male radiographers at the beginning of their careers were more affected by burnout. Employment in EDs had a negative impact on DP and EE. IMPLICATIONS FOR PRACTICE: Our results support the implementation of interventions to counter the effects of occupational stress and burnout among radiographers working in ED.