Cut-off value for a normal posterior tibial nerve to diagnose tarsal tunnel syndrome amongst people of different race in Pretoria, South Africa.

INTRODUCTION: Posterior tibial nerve (PTN) cross-sectional area (CSA) reference values for the diagnosis of tarsal tunnel syndrome (TTS) using ultrasound imaging exist in several countries but not in South Africa (SA). Therefore, the objective was to measure the CSA reference values for PTN in SA. METHODS: Ultrasound CSA measurements of PTN in both ankles on 112 participants were performed, the mean measurement was recorded, and the effect of race, age, gender, and body mass index (BMI) were recorded. RESULTS: In this study, the primary variables age and BMI affect the CSA measurement of the PTN. A positive correlation was found between PTN asymptomatic size and age (r = 0.196, P < 0.05), size and BMI (r = 0.200, P < 0.05). Age (categories) had a mean value of 3.17 for the age group 36-45 years (95% confidence interval (CI) 2.9-3.4). The mean BMI was 30.0 kg/m2 (CI 28.57-31.08). As for the asymptomatic PTN, a mean CSA reference value of 0.10 cm2 was obtained. CONCLUSION: With increase in age and BMI, a greater PTN measurement will occur. Race appears to be a contributing factor, but further research is needed in this regard. The reference CSA value for normal PTN should be set at 0.10 cm2 for all racial groups for a basic musculoskeletal ultrasound exam protocol in South Africa.

Radiographer experiences of personal protective equipment during COVID-19 in Gauteng, South Africa.

INTRODUCTION: Amidst the COVID-19 pandemic, healthcare workers (HCWs) were found to be at a greater risk of becoming infected with severe acute respiratory syndrome (SARS-CoV-2). This disease is highly contagious and is for the most part preventative if correct Personal Protective Equipment (PPE) is used while attending to patients. Subsequently, a lack of PPE in South Africa was putting the lives of health care workers at risk impacting on the functioning of the healthcare system. METHODS: This exploratory, descriptive, qualitative study used purposeful sampling to obtain data saturation. The study comprised twelve individual interviews with radiographers from both private and government hospitals in Gauteng, South Africa who worked in x-ray departments during the COVID-19 pandemic. Online video interviews were conducted. The transcripts of the interviews were further coded into themes and categorised using thematic analysis and verified by an independent coder. RESULTS: The radiographers' experiences of PPE during COVID-19 in Gauteng, South Africa generated 3 themes: radiographers' experiences with PPE supplied during COVID-19, workplace practices and procedures for PPE during COVID-19 and emotional challenges faced during PPE shortage. DISCUSSION: While there was an understandable fear of contracting the COVID-19 virus during the height of the pandemic. The researcher also believes that radiographers would benefit greatly by receiving training on how to use PPE correctly for infection control in highly stressful situations. Education is required for use of PPE when supply is scarce and the number of infected patients outweighs the quantities of PPE available. This study further found that there needs to be more support given to healthcare workers (HCW's) to assess their mental health and emotional stress experienced when facing a pandemic. CONCLUSION: While COVID-19 has started to settle, the lessons learnt should inform recommendations on PPE use, regarding procurement and preservation. In addition, mental health assessments can be considered for radiographers during future pandemic.

Diagnostic radiographers' perceptions of professional identity in Johannesburg, Gauteng, South Africa.

INTRODUCTION: The study explored and described the professional identity of diagnostic radiographers in Johannesburg, Gauteng, South Africa. METHODS: The methodology employed for the study was qualitative, exploratory and descriptive design. Face-to-face interviews were conducted with thirteen diagnostic radiographers from private, public practices and individually owned practices. Semi-structured interviews were conducted, and the responses underwent thematic analysis and used Braun and Clarke's six steps for analysing qualitative data. RESULTS: The thematic analysis revealed three themes and six categories. The three themes identified were: perceptions of identity, environment influences and organisational institutions. CONCLUSION: This study provided an insight into the current perspectives of the professional identity of diagnostic radiographers in Johannesburg, South Africa, which reflected a positive professional identity. The three themes identified could inform guidelines for education in diagnostic radiographers' professional identity in the future.

Radiography students' perceptions of the attributes required for clinical educators.

INTRODUCTION: A clinical educator (CE) is responsible for the clinical training and supervising of students to acquire skills and knowledge during Work Integrated Learning (WIL). The CE can have a positive or negative influence on students depending on their clinical and interpersonal attributes. The purpose of this qualitative exploratory-descriptive and contextual study was to explore and describe students' perceptions regarding the attributes of their CEs upon the successful implementation of the degree programme at the HEI. METHODS: Eighteen radiography students studying at the HEI in South Africa, from 4 disciplines namely, diagnostic radiography, nuclear medicine technology, diagnostic ultrasound and radiation therapy participated in the study. The data collection tool was unstructured interviews. Data was collected through in depth in-person and online interviews and was analysed using thematic analysis. RESULTS: The study revealed four themes highlighting the students need for CEs who possess personality traits that foster and enhance their performance. These CEs should establish an environment conducive to productive learning for students, encourage learning within the context of workplace-based learning, seamlessly integrate theoretical knowledge into clinical practice and consistently exhibit professional attributes. CONCLUSION: The findings from the study emphasize how the attributes and personality of CEs can significantly influence students experiential learning (WIL). The presence of a strong moral connection between students and CEs was considered a crucial aspect for successful clinical learning.

Investigation of radiation protection and safety measures in Rwandan public hospitals: Readiness for the implementation of the new regulations.

BACKGROUND: An essential concept that all radiographers are required to implement is the use of techniques and the provision of protective devices to minimize radiation to patients and staff. Methods to achieve this could include good communication, immobilization, beam limitation, justification for radiation exposure, shielding, appropriate distances and optimum radiographic exposures factors. PURPOSE: The aim of this study was to assess the availability and utilization of radiation protection and safety measures by medical imaging technologists (MITs) in Rwandan hospitals. METHODS: A quantitative, non-experimental descriptive design was used and data collected by means of a self-designed questionnaire. One hundred and sixteen MITs (n = 116) representing 96.67% of the total population participated in the study. RESULTS: The study found radiation safety measures were not adequately implemented in government hospitals. Only 58.62% of MITs had radiation-measuring devices, with 29% receiving dose readings inconsistently. Lead rubber aprons were available at 99.13% of the hospitals; however, 59% of the participants had never checked the integrity of the aprons. Lead rubber aprons and lead equivalent barriers were most prevalent in the facilities. CONCLUSION: The study found there was a lack of adequate radiation safety equipment. Exposure charts and immobilization devices were not adequately implemented in the hospitals. The level of education and experience of the MITs did not appear to influence the radiation safety practice significantly. There is a need for concerted efforts between the Rwanda Utilities Regulatory Authority (RURA), Ministry of Health, University of Rwanda and hospital management to improve the radiation safety culture, especially in view of the law governing radiation protection that was recently promulgated.

Methods Used by General Practitioners to Interpret Chest Radiographs at District Hospitals in the City of Tshwane, South Africa.

INTRODUCTION: A chest radiograph is one of the first-line diagnostic tools for general practitioners (GPs) to diagnose, monitor treatment, and predict the outcomes of diseases. In district hospitals, after clinical examination, GPs refer patients for imaging in the X-ray department. Radiologists specialize in interpretation of radiographs and provide a gold standard radiologist report to help diagnose support and influence patient management. A shortage of radiologists restricts continuity in radiology services and causes a delay in diagnosis, compromising the overall quality of service to patients. GPs are mandated to perform image interpretation on all chest radiographs taken at district hospitals and they sometimes request assistance from radiographers. AIM: The aim of this study was to explore methods used by GPs to interpret chest radiographs at district hospitals in the City of Tshwane, in South Africa. METHODS: A qualitative, exploratory, and descriptive case study method of inquiry, with convenience sampling was used. Under discussion, the case studies were reconstructed in terms of themes. Recurring themes in these case studies were expounded and linked within the literature. RESULTS: Results obtained from a sample of 15 participants showed that GPs used a free global search to scan radiographs without a preconceived orderly pattern. Their only training on image interpretation occurred during undergraduate education and training. CONCLUSIONS: It was concluded that the methods used by GPs for interpretations of chest radiographs were not systematic in approach, resulting in omission in identifying abnormalities in some structures of the chest/thoracic region. The researcher recommends that all GPs need continuous in-house training to acquire the knowledge of the systematic method of evaluating chest radiographs.

The Influence of Image Interpretation Training on the Accuracy of Abnormality Detection and Written Comments on Musculoskeletal Radiographs by South African Radiographers.

INTRODUCTION: The study was conducted in two government hospitals in Johannesburg, South Africa, investigating the extent to which image interpretation and relevant terminology training would improve the accuracy and descriptive comments provided on musculoskeletal images by South African radiographers. METHODS: Nine radiographers interpreted an image bank comprised of 100 skeletal radiographs (50% abnormal) both before and on completion of a tailored education program in image interpretation. Radiographer comments were compared with the reference standard diagnosis (single experienced radiologist) and deemed to be correct, partially correct, or incorrect. The radiographers were assessed for sensitivity, specificity, and accuracy on the image bank pre- and postintervention. After testing for normality of the data, a Wilcoxon signed rank test was used for nonparametric paired data. RESULTS: Radiographer accuracy (from 71.04% to 78%), sensitivity (from 83.73% to 87.28%), and specificity (from 59.62% to 70.34%) all improved after the education program. A statistically significant improvement was noted in the accuracy (Wilcoxon value, z = -2.66, P = .008). Incorrect radiographer comments also decreased (from 24.1% to 17.78%, Wilcoxon value, z = -1.96, P= .05). Radiographer vocabulary used when describing abnormalities was more in line with the reference standard diagnosis after training. CONCLUSIONS: This study has shown that training in pattern recognition and construction of a comment could enable diagnostic radiographers to improve their accuracy and the ability to provide a descriptive comment on an image. Future work should include assessing accuracy and commenting in the clinical environment and whether the improvement in commenting is maintained over time.