Reasons for non-uptake and subsequent participation in the NHS Bowel Cancer Screening Programme: a qualitative study.

BACKGROUND: Screening for bowel cancer using the guaiac faecal occult blood test offered by the NHS Bowel Cancer Screening Programme (BCSP) is taken up by 54% of the eligible population. Uptake ranges from 35% in the most to 61% in the least deprived areas. This study explores reasons for non-uptake of bowel cancer screening, and examines reasons for subsequent uptake among participants who had initially not taken part in screening. METHODS: Focus groups with a socio-economically diverse sample of participants were used to explore participants' experience of invitation to and non-uptake of bowel cancer screening. RESULTS: Participants described sampling faeces and storing faecal samples as broaching a cultural taboo, and causing shame. Completion of the test kit within the home rather than a formal health setting was considered unsettling and reduced perceived importance. Not knowing screening results was reported to be preferable to the implications of a positive screening result. Feeling well was associated with low perceived relevance of screening. Talking about bowel cancer screening with family and peers emerged as the key to subsequent participation in screening. CONCLUSIONS: Initiatives to normalise discussion about bowel cancer screening, to link the BCSP to general practice, and to simplify the test itself may lead to increased uptake across all social groups.

Support line and tube visibility in chest examinations using computed radiography.

The visibility of support lines and tubes was compared in computed radiography (CR) and screen-film adult chest radiographs. Parameters investigated were radiation dose, image minification, and the use of unsharp mask enhancement. Five radiologists rated the visibility of support lines and tubes on a five-point scale ranging from 1 (entire course of line visible) to 5 (line not visible or only small portion seen). These CR results were compared with the visibility of support lines and tubes as assessed by the same readers for conventional screen-film radiographs (600 speed). Support line and tube visibility improved with image enhancement, image minification, and increasing radiation dose. At the same radiation exposure, support line and tube visibility of the screen-film combination was superior to that of standard CR images. Application of an unsharp mask enhancement algorithm to CR images, however, significantly improved support line and tube visibility in comparison to that obtained with the screen-film combination. It was concluded that unsharp mask processing is a valuable tool for improving the visibility of support lines and tubes in CR chest radiographs.

Picture archiving and communication system bandwidth and storage requirements.

The purpose of this work was to determine the requirements for image storage and network bandwidth for a total digital department in a moderate sized academic radiology department. Data from the radiology information system was combined with image production information to produce a model of image acquisition. Destinations of images to reading rooms were studied to determine the final distributions of film. All findings were used to model the flow of data that would be expected if the images in the department were completely digital. Using today's standards, the department would produce approximately 15.7 Gbytes of data per day or 3.5 Tbytes of data per year if all acquisitions were digital. The peak acquisition rate would be 1.8 Gbytes per hour with a sustained rate greater than 1 Gbyte per hour for most of the working day. The anticipated bandwidth for the total digital department exceeded the capabilities of the existing picture archiving and communication system equipment. A distributed networked archive solution was shown to optimize access to images by radiologists and referring clinicians.

Mottle on computed radiographs of the chest in pediatric patients.

PURPOSE: To investigate the relationship between radiation exposure and perceived mottle at bedside pediatric chest examinations performed with screen-film and computed radiographic techniques. MATERIALS AND METHODS: In a pediatric intensive care unit, chest radiographs were obtained with both computed radiography (60 radiographs) and a 600-speed screen-film system (14 radiographs). The relative radiation exposure was estimated by using the sensitivity value obtained in the processing of each computed radiograph. Five radiologists assessed the mottle present in the computed radiographs and screen-film images. RESULTS: For computed radiographs, the perceived level of mottle was inversely related to radiation exposure. For the same radiation exposure, the perceived mottle on computed radiographs was significantly higher than that on screen-film images (P < .001 for small cassettes; P < .01 for large cassettes). CONCLUSION: Pediatric computed radiography of the chest requires approximately twice the exposure of a 600-speed screen-film system to attain the same level of mottle.

Computed radiography and film digitizer inputs to an intensive care unit teleradiology system: an image quality comparison.

RATIONALE AND OBJECTIVES: We compared computed radiography (CR) with a film digitizer as an image input device for transmitting radiographs to intensive care unit (ICU) displays. METHODS: Limiting spatial resolution and low-contrast detectability performance were determined for a 600-speed screen-film combination and CR films. The same image data were transmitted to ICU displays directly from the CR or by digitizing the conventional film. RESULTS: CR resolution ranged from 2.5 to 3 line pairs per millimeter (Ip/ mm) depending on cassette size. Display station resolution for the CR image data was 1.5-1.9 lp/mm, but improved resolution could be achieved using display magnification modes. Film digitization resulted in a loss of resolution. Direct transmission of CR image data to display stations gave low-contrast detectability similar to that obtained with CR film. CONCLUSION: ICU teleradiology displays that use CR, rather than film digitizers, offer improved image quality and superior operational efficiency.

Maternity care monitoring: a contrast at two levels of health care delivery in Ibadan, Nigeria.

The obstetric performance of women delivering at two hospitals in Ibadan is compared in this study. The prevalence of high-risk pregnancies at the tertiary level hospital (University College Hospital) was higher than that of the secondary level hospital (Oluyoro Catholic Hospital). Consequently, the cesarean section rate of the UCH (21.8%) was higher than that at the OCH (2.3%). Similarly, the maternal mortality (3.5 per 1000) and perinatal mortality (60.2 per 1000) at the UCH were significantly higher than at the OCH, 2.0 per 1000 and 9.8 per 1000, respectively. The need for a national birth survey based on a representative sample of all the different types of health establishments in Nigeria was stressed.

PIP: The obstetric performance of women delivering at 2 hospitals in Ibadan, Nigeria, is compared in this study. The prevalence of high-risk pregnancies at the tertiary level hospital (University College Hospital) was higher than that of the 2ndary level hospital (Oluyoro Catholic Hospital). Consequently, the cesarean section rate of the UCH (21.8%) was higher than that at the OCH (2.3%). Similarly, the maternal mortality 3.5/1000) and perinatal mortality (60.2/1000) at the UCH were significantly higher than at the OCH, 2.0/1000 and 9.8/1000, respectively. The need for a national birth survey based on a representative sample of all the different types of health establishments in Nigeria was stressed.