BACKGROUND: Radiographers provide imaging services in multiple healthcare settings, including emergency and trauma. Transitioning to a qualified radiographer is already a time of vulnerability - with the increasing complexity and unpredictable nature of the emergency and trauma healthcare environment, recently qualified radiographers may experience this environment distinct from other service delivery areas. OBJECTIVE: the study explored recently qualified radiographers' expectations and experiences in emergency and trauma imaging service delivery. METHODS: an inductive qualitative phenomenological approach with a purposive sampling technique recruited recently qualified radiographers (n=19) involved in the delivery of emergency and trauma imaging services. Transcribed semi-structured individual interviews were thematically analysed. RESULTS: Two themes and related categories were identified: 1. The multiplexity of diagnostic emergency and trauma imaging service delivery and 2. Approaching the complex nature of emergency and trauma imaging. CONCLUSION: the expectations and experiences of emergency and trauma imaging varied, aligned to previous exposure to emergency and trauma imaging. Even though emergency and trauma imaging was challenging, the fast pace, patient dynamics and multidisciplinary deliverance; the experience was considered rewarding and an opportunity to improve skills. Participants coped through debriefing and calming strategies; however, radiology-specific debriefing was recommended to further foster the recently qualified radiographers' well-being.

INTRODUCTION: Graduate radiographers entering their qualified positions need to orientate and familiarise themselves with a rapidly changing work environment to deliver a high standard of diagnostic imaging services. During this transitional phase, these newcomers also strive to meet self-expectations and workplace expectations. This study was performed to understand the work readiness perspectives and initial experiences of graduate radiographers on beginning their newly qualified roles. METHODS: the study used a qualitative phenomenological approach to collect data through individual semi-structured in-depth telephone interviews with 14 purposively sampled undergraduate and postgraduate radiographers. The rich data were transcribed verbatim and then thematically analysed. RESULTS: Four major themes emerged: (1) preparing to be 'work-ready', (2) initial encounters as qualified radiographers, (3) personal and professional challenges and (4) support strategies and advice for new graduates. CONCLUSIONS: New graduate radiographers face many personal and professional challenges but agree that they thrive in supportive collegial environments. Most participants had a high perspective of their work readiness strongly related to their clinical placements as students, workplace familiarity, support networks and coping strategies. Further review into individual workplace orientations by organisation leaders may benefit the immersion and enhancement of graduate radiographers' initial experiences in their new role.

INTRODUCTION: Paediatric patients differ from adult patients with respect to anatomy, examination factors, behaviour, and intellectual development, requiring dedicated specialised knowledge and expertise. In the absence of a formal dedicated paediatric medical imaging subspecialty, this study undertook to understand student radiographers' experiences and perspectives on paediatric medical imaging. METHODS: the study entailed a descriptive cross-sectional survey design entailed a 51-item closed and open-ended response questionnaire using a total sampling method. Data were collected from both under- and postgraduate student radiographers who undertook clinical placement. Data interpretation and analysis involved statistical analysis of close-ended questions and thematic analysis of open-ended questions. RESULTS: the overall response rate was 70%. Most participants acknowledged the importance of dedicated paediatric content as well as the theory content covered. The shortcoming in pre-placement practical component was overcome through varied approaches like observations and attempting through supervision whilst experiencing uncertainty, anxiety and felt unfair to risk the patient. As reported in literature like their qualified counterparts expressed similar challenges in technique adaptation, styles of interactions in gaining cooperation from both the children and parents. They also felt paediatric content and the practicals should be embedded throughout the course offering to not compromise the day-to-day service delivery. CONCLUSIONS: the study findings iterate the importance paediatric imaging in the service delivery context. The importance of undertaking these examinations reliant on experiential learning is insufficient to bridge the gap of preparation prior to placement. IMPLICATIONS FOR PRACTICE: Collaborative academic and clinical radiography education will ensure that radiography students' dedicated specialised paediatric imaging knowledge and experience are enhanced.

This editorial examines current collimation and cropping practices in general radiography. We critically reflect on whether we are concerned by the practice of collimation creep amongst radiographers. Discussions around policy, evidence‐based practice and potential hypocrisies are outlined in this editorial piece.

The purpose of this work is to present a computer assisted diagnostic tool for radiologists in their diagnosis of Alzheimer's disease. A statistical likelihood-ratio procedure from signal detection theory was implemented in the detection of Alzheimer's disease. The probability density functions of the likelihood ratio were constructed by using medial temporal lobe (MTL) volumes of patients with Alzheimer's disease (AD) and normal controls (NC). The volumes of MTL as well as other anatomical regions of the brains were calculated by the FreeSurfer software using T1 weighted MRI images. The MRI images of AD and NC were downloaded from the database of Alzheimer's disease neuroimaging initiative (ADNI). A separate dataset of minimal interval resonance imaging in Alzheimer's disease (MIRIAD) was used for diagnostic testing. A sensitivity of 89.1% and specificity of 87.0% were achieved for the MIRIAD dataset which are better than the 85% sensitivity and specificity achieved by the best radiologists without input of other patient information.

Introduction: Cultural competency and safety are essential components to consider in the provision of person-centred equitable healthcare. Therefore, student radiographers' learning should include the necessary knowledge, skill sets and competence to recognise the patient's unique characteristics to enable culturally competent and safe medical imaging services. Therefore, this study explored undergraduate and postgraduate diagnostic radiography students' perspectives on cultural competency and safety. Methods: a qualitative phenomenological design with a hermeneutic phenomenological approach was followed to explore student perspectives. Student radiographers (second and third-year undergraduate and first and second-year postgraduate) from the study site were purposively and conveniently recruited to participate in focus group interviews. Fifteen focus group interviews were conducted, recorded and transcribed verbatim before undergoing thematic analysis. Results: Thematic analysis identified two themes. Theme one centred around the cultural competence and safety learnt by student radiographers at university and the second theme cultural competence and safety learnt in workplace learning. Conclusion: This study demonstrated the importance of cultural competence and safe practice in examining patients of different cultures. It highlights the importance of creating awareness among students of their own abilities and capabilities of cultural sensitivity and safe practice as part of their learning. Future health professionals should be empowered to address and respond to patients’ unique needs in a competent, safe and professional manner to reduce health disparities. Implications for practice: Cultural competence and safety are integral to person-centred care. Including these concepts in radiography education is therefore vital to ensure optimal patient outcomes.

INTRODUCTION: Interprofessional education (IPE) in medical radiation education is designed to enhance both student and longer-term patient outcomes. This scoping review aims to provide an overview of the available evidence and examine the effectiveness of IPE strategies used to enhance the development of medical radiation science (MRS) students. METHODS: Medline, CINAHL, Cochrane Library and Emcare were searched for articles which employed an experimental study design to quantitatively assess the effectiveness of IPE for MRS students. Two reviewers screened and extracted relevant data independently. Critical appraisal was conducted using the JBI critical appraisal tool. RESULTS: Eighteen studies were included in this review. Diverse approaches to IPE were discovered, particularly in terms of the method of delivery, setting and duration of interventions. MRS students interact with many professions, particularly medical doctors and nurses. All studies which employed a control arm demonstrated statistically positive findings favoring IPE intervention(s). In pre-post studies, most IPE interventions reported significant positive differences after IPE was implemented. This entailed an enhanced perceived knowledge and understanding of other professions, and ability to undertake their role in the team. CONCLUSION: IPE was shown to be effective in enhancing students' perceptions and attitudes and to a limited extent, improve knowledge acquisition. Future research should assess long-term effects and patient-related outcomes. IMPLICATIONS FOR PRACTICE: IPE in a variety of formats demonstrates positive results for MRS students; however, interventions which are longer-term, conducted in small groups, and performed earlier in the educational pathway, may demonstrate greater effectiveness.

Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been reported, but the reasons for these practices and suggestions to improve practices were lacking. Therefore, this study explored radiation protection among South African diagnostic radiographers. This study used an explanatory, sequential, mixed-method approach. Data were collected in three phases. Phase I, the quantitative phase, used an online questionnaire and respondents from Phase I interested in participating in Phase II, the qualitative phase, were interviewed, yielding 13 in-depth semi-structured telephone interviews. In Phase III, eight radiography managers co-constructed change strategies to optimize radiation protection in South Africa in two focus group interviews. Radiation protection was suboptimal despite diagnostic radiographers having a good attitude, subjective norm and perceived behavioral control toward radiation protection and optimal radiation protection knowledge. Varying attitudes to radiation protection, lack of resources, and support from radiography management and healthcare teams contributed to suboptimal radiation protection practices. Radiography managers suggested increasing radiation protection awareness, ameliorating the diminished stature of the radiographer in the healthcare team, and increasing the availability of optimal quality resources. South African diagnostic radiographers' radiation protection knowledge was optimal, but the implementation of radiation protection varied and was influenced by multiple factors. A radiation protection culture supported by management is advocated to optimize radiation protection. However, ultimately radiation protection practices are incumbent on the individual radiographers' choice to practice radiation protection.

INTRODUCTION: Patient positioning is an essential consideration for the optimisation of radiation dose during CT examinations. The study objectives seek to explore the effects of vertical off-centring, localiser direction (0° and 180°), and phantom positioning (supine and prone) on radiation dose, using three different tube voltages in multidetector computed tomography (MDCT) imaging. METHODS: the trunk of a PBU-60 anthropomorphic phantom was imaged using a Discovery CT750 HD - 128 slice (GE Healthcare). Images employing 0° and 180° localisers were acquired in supine and prone orientation for each combination of vertical off-centring (±100, ±60 and ±30 mm) and different tube voltages (80, 120 and 140 kVp), using the system's automatic tube current modulation (ATCM) function. The displayed volume CT dose index (CTDIvol ) and dose length product (DLP) were recorded. RESULTS: with incremental table off-centring of ±100 mm, the dose at 120 kVp in the supine position ranged from 63% to 196% (0° localiser) and from 66% to 191% (180° localiser) as compared to iso-centre. While in the prone position, the dose ranged from 62% to 195% (0° localiser); and 62% to 193% (180° localiser), with a notable dose increase at higher tube voltages. Dose variation and vertical off-centring showed a significant relationship for both 0° and 180° localisers (r = 0.94 and 0.96, respectively, P 

INTRODUCTION: Forensic imaging plays a pivotal role regarding medico-legal issues by investigating the cause(s) of injuries to living or deceased individuals. There is currently a gap in the literature on forensic imaging due to limited national and international guidelines, protocols and scope of duties and responsibilities of radiographers undertaking forensic imaging. Thus, this study aimed to investigate the gap by exploring the experiences and perspectives of radiographers on forensic imaging in Australia. METHODS: a qualitative approach collected data from fifteen purposively sampled qualified Australian radiographers through individual in-depth interviews. The verbatim transcribed data were thematically analysed. RESULTS: Two themes were identified: 1) Radiographers' experiences of forensic imaging; 2) Radiographers' perceptions of forensic imaging within the job scope of a qualified radiographer. CONCLUSIONS: Participants' experiences of forensic imaging ranged from anxiety to a positive experience, and others posed ethical and situational dilemmas heightened by the lack of dedicated forensic imaging protocols. While some radiographers expressed that every radiographer should conduct forensic imaging, others felt it was not mandatory. IMPLICATIONS FOR PRACTICE: Radiographers' shared subjective experiences, thoughts and feelings provided insight into forensic imaging and the need for more significant support from educational and governing bodies.

Introduction: Radiation protection is multifarious, and consequently, a radiographers' application of radiation protection is multifaceted. Studies have shown varying radiation protection practices among radiographers. The first quantitative phase of this explanatory, sequential mixed-method study used the theory of planned behaviour to explore South African radiographers' radiation protection behaviour. Overall, South African radiographers' attitudes to radiation protection, subjective norm, perceived behavioural control, and radiation protection intention was high. This second phase of the study aimed to explore the reasons for South African radiographers' radiation protection practices. Methods: This study used an exploratory and descriptive qualitative approach. Data was collected through 13 in-depth semi-structured telephone interviews. Thematic analysis was used in order to uncover original phenomena. Data saturation was achieved and the study adhered to trustworthiness and ethical measures. Results: Thematic analysis identified two themes. The participants had the appropriate radiation protection knowledge, but radiation protection compliance remained a personal choice. Impediments such as feeling rushed during imaging of trauma and challenging patients, patients knowledge of radiation protection, resources, imaging referrals, inadequate training when transitioning from analogue to digital radiography and managerial support contributed to radiation protection compliance. Strategies such as further education, research and a change in mindset were suggested to further foster radiation protection compliance. Conclusion: Even though participants' knowledge of radiation protection aligned with the legislated guidelines, limited internalising of the knowledge resulted in compliance being a personal choice. Participants reflected on their insouciant attitude and observed a similar attitude in their radiographer colleagues. Patient and work-related impediments were identified to contribute to radiation protection compliance. Strategies to further foster compliance were suggested. Implications for practice: Understanding the reasons for radiographers’ choice in radiation protection will allow the development of strategies that foster optimum application of radiation protection practises. Developing a radiation protection culture that enhances personal compliance supported by education and evidence should be considered.

Background: This study investigates the effects of vertical off-centring, localiser direction, tube voltage, and phantom positioning (supine and prone) on computed tomography (CT) numbers and radiation dose. Methods: an anthropomorphic phantom was scanned using a Discovery CT750 HD—128 slice (GE Healthcare) scanner at different tube voltages (80, 120, and 140 kVp). Images employing 0° and 180° localisers were acquired in supine and prone positions for each vertical off-centring (±100, ±60, and ±30 mm from the iso-centre). CT numbers and displayed volume CT dose index (CTDIvol) were recorded. The relationship between dose variation and CT number was investigated. Results: the maximum changes in CT number between the two phantom positions as a function of vertical-off-centring were for the upper thorax 34 HU (0° localiser, 120 kVp), mid thorax 43 HU (180° localiser, 80 kVp), and for the abdominal section 31 HU (0° localiser, 80 kVp) in the prone position. A strong positive correlation was reported between the variation in dose and CT number (r = 0.969, p < 0.001); 95% CI (0.93, 0.99). Conclusions: Patient positioning demands an approach with a high degree of accuracy, especially in cases where clinical decisions depend on CT number accuracy for tissue lesion characterisation.

INTRODUCTION: This experimental study explored the effect of vertical off-centring on computed tomography (CT) numbers in combination with various tube voltages and phantom sizes for two CT units. METHODS: CIRS Model 062 Electron Density and system performance phantoms were imaged on Siemens Emotion 16-slice CT and GEMINI-GXL scanners, respectively. Uniformity and accuracy were evaluated as a function of vertical off-centring (20, 40, 60, and 80 mm above the gantry isocentre) using different water phantom sizes (18, 20, and 30 cm) and tube voltages (80, 90, 110, 120, 130 and 140 kVp). RESULTS: Vertical off-centring and phantom size accounted for 92% of the recorded variance and the resultant change in CT numbers. The uniformity test recorded maximum changes of 14 and 27.2 HU for peripheral ROIs across the X- and Y-axes for an 80 mm phantom shift above the gantry isocentre on the GEMINI GXL and Siemens scanners, respectively. The absolute CT number differences between the superior and inferior ROIs were 13.7 HU for the 30 cm phantom and 4.8 HU for the 20 cm phantom for 80 mm vertical off-centring. The largest differences were observed at lower tube voltages. CONCLUSIONS: it is essential to highlight the significance of CT number variation in clinical decision-making. Phantom off-centring affected the uniformity of these numbers, which were further impacted by the ROI position in this experimental study. CT number variation was more evident in peripheral phantom areas, lower tube voltages and larger phantom sizes. IMPLICATIONS FOR PRACTICE: CT number is observed to be a variable under certain common conditions. This significantly impacts several applications where clinical decisions depend on CT number accuracy for tissue lesion characterisation.

BACKGROUND AND PURPOSE: Although it is fundamental for optimal scanner operation, it is generally accepted that accurate patient centring cannot always be achieved. This review aimed to examine the reported knowledge of the negative impact of patient positioning on radiation dose and image quality during CT imaging. Furthermore, the study evaluated the current optimisation tools and techniques used to improve patient positioning relative to the gantry iso-center. METHODOLOGY: a comprehensive search through the databases PubMed, Ovid, and Google Scholar was performed. Keywords included patient off-centring, patient positioning, localiser radiograph orientation, radiation dose, and automatic patient positioning (including synonyms). The search was limited to full-text articles that were written in English. After initial title and abstract screening, a total of 52 articles were identified to address the aim of the review. No limitations were imposed on the year of publication. RESULTS: Vertical off-centring was reported in up to 95% of patients undergoing chest and abdominal CT examinations, showing a significant influence on radiation dose. Depending on the scanner model and vendor, localiser orientation, bowtie filter used, and patient size, radiation dose varied from a decrease of 36% to an increase of 91%. A significant dose reduction was demonstrated when utilising an AP localiser, aligning with the trend for radiographers to off-center patients below the gantry iso-centre. Utilizing a 3D camera for body contour detection allowed for more accurate patient positioning and promoted further dose reduction. CONCLUSION: Patient positioning has shown significant effects on radiation dose and image quality in CT. Developing a good understanding of the key factors influencing patient dose (off-centring direction, localiser orientation, patient size and bowtie filter selection) is critical in optimising CT scanning practices. Utilising a 3D camera for body contour detection is strongly recommended to improve patient positioning accuracy, image quality and to minimise patient dose.

BACKGROUND AND PURPOSE: the purpose of this review was to examine the reported factors that affect the reliability of Computed Tomography (CT) numbers and their impact on clinical applications in diagnostic scanning, dental imaging, and radiation therapy dose calculation. METHODS: a comprehensive search of the literature was conducted using Medline (PubMed), Google Scholar, and Ovid databases which were searched using the keywords CT number variability, CT number accuracy and uniformity, tube voltage, patient positioning, patient off-centring, and size dependence. A narrative summary was used to compile the findings under the overarching theme. DISCUSSION: a total of 47 articles were identified to address the aim of this review. There is clear evidence that CT numbers are highly dependent on the energy level applied based on the effective atomic number of the scanned tissue. Furthermore, body size and anatomical location have also indicated an influence on measured CT numbers, especially for high-density materials such as bone tissue and dental implants. Patient off-centring was reported during CT imaging, affecting dose and CT number reliability, which was demonstrated to be dependent on the shaping filter size. CONCLUSION: CT number accuracy for all energy levels, body sizes, anatomical locations, and degrees of patient off-centring is observed to be a variable under certain common conditions. This has significant implications for several clinical applications. It is crucial for those involved in CT imaging to understand the limitations of their CT system to ensure radiologists and operators avoid potential pitfalls associated with using CT numbers as absolute values for diagnostic scanning, dental imaging, and radiation therapy dose calculation.

INTRODUCTION: the use of ionising radiation in medicine accounts for the majority of radiation exposure from artificial sources. Therefore, all measures to safeguard against unnecessary radiation exposure must be taken. As radiographers are central to radiation protection, this study aimed to determine South African radiographers' attitude towards radiation protection, subjective norm and perceived behavioural control concerning radiation protection. METHODS: This quantitative cross-sectional study used an online theory of a planned behaviour radiation protection questionnaire shared through social media platforms from August 2019 to February 2020. Diagnostic radiographers registered with the Health Professions Council of South Africa and employed at radiology departments in South Africa were invited to participate in the study. RESULTS: Four hundred and seventeen radiographers in South Africa responded to the questionnaire. The majority of respondents (90%, n = 376) plan to use radiation protection; however, only 16% continuously used radiation protection in the past. Respondents felt that using radiation protection was extremely good (72.2%), pleasant (47%), beneficial (74.1%), rewarding (55.2%) and worth the time (52.5%); 57% of respondents indicated that using radiation protection takes longer to complete the examination. Respondents report that approval from patients (43.5%), patients' family (32%), radiographer coworkers (31%), radiology managers (47%) and radiologists (43.9%) is very much important to them. CONCLUSION: the study shows that even though fewer respondents use radiation protection at present, most respondents plan and intend to use radiation protection measures. Respondents felt that radiation protection was good and beneficial, with some respondents feeling that radiation protection is not worth the time, which coincide with lengthening the examination. Overall, South African radiographers' attitudes towards radiation protection, subjective norm, perceived behavioural control and radiation protection intention were high.

Introduction: the dose creep phenomenon is now a widely recognized concept in diagnostic radiography in light of recent technological advancements transnationally. However, this still remains underexplored amongst radiography students preparing to enter the radiography profession. In response, this study explores the perceptions of dose creep amongst undergraduate student radiographers. Methods: the methodological approach utilized in this research study was grounded theory. The qualitative approach aimed to uncover findings from a higher education institution in Australia. Six students were recruited and took part in semi-structured interviews. This enabled the exploration of previously uncovered data, leading to the construction of original theory within the clinical and academic environment. The data analysis employed was constant comparative analysis (CCA). Results: a number of insights emerged from the qualitative data set. For instance, the radiography students understanding of the term ‘dose creep’ and decision making leading to dose creep in the clinical environment is captured. This is further supported with assessment of image evaluation determining appropriate exposure factor selection and future impact upon graduation as diagnostic radiographers. The findings identify some important learning needs and actions for both clinical and academic settings which may help foster good use of X-ray exposures. Conclusion: This paper concludes by affirming some challenges surrounding optimal exposure selection and the known phenomenon, dose creep. Further, this study identifies the importance of learning and teaching in the clinical environment whereby learned behaviour leads to suboptimum practices. Implications for practice: This study advances the existing evidence base by providing a unique lens into the knowledge and understanding of dose creep amongst radiography students in both academic and clinical contexts. It is anticipated this paper will help practitioners and educators better understand potential instances of dose creep within the clinical environment.

Introduction: This article explores the application of personalized medicine (PM) within the academic environment in the United Kingdom. There is a growing acceptance of the utility of PM in health care and the role medical imaging can play. In response, this article explored the views and opinions of diagnostic and therapeutic academics and the utilization of PM in education. Methods: This study primarily adopted a quantitative approach using an online survey. However, participants were also encouraged to provide qualitative comments in response to open-ended questions. The survey was distributed to radiography and radiotherapy academic departments, which received a response rate of 29%. Results: the findings identify some important considerations. On the one hand some participants reported teaching PM on their programmes (24%, n = 16), whereas 30% (n = 20) did not. Importantly, the remaining academics (46%) were either unsure or did not know what PM was. This finding, coincided with qualitative commentary, highlights some discrepancies linked to knowledge and understanding of PM within higher education and highlights areas where academics may need additional support. Conclusion: This article concludes by recognizing the challenges of delivering PM by some academics. It is noted that although the findings cannot be fully generalized, it does highlight fragmented understanding of PM among academic staff. This is important to reflect upon following the increasing requirements for radiography to become “more personalized.”

Introduction: the purpose of this experiment was to explore the direction of scattered secondary ionizing radiation to a patient. A left lateral radiographic examination of the elbow was deemed appropriate due to its close proximity to radiosensitive organs and record dose limiting opportunities upon wearing a lead-rubber apron. Methods: an anthropomorphic phantom and lead-rubber apron (Pb 0.35 mm) was used with a 15 cc ionization chamber (model 10,100 AT TRIAD) to measure scattered radiation to radiosensitive organs. Dose readings were recorded before and after in order to quantify dose reduction. Pearson's correlation, linear regression, t-test and one way analysis of variance (ANOVA) statistics were used to affirm how likely dose limitation was attributed to chance (p < 0.05). Results: the lead-rubber apron offered dose reduction to most radiosensitive organs. Notably, ionizing radiation was significantly reduced to the left breast 0.0083 μGy (98%), right breast 0.0000 μGy (99.9%) and spleen 0.0262 μGy (99.9%). No empirical benefit was recorded for testes and ovaries. Interestingly, the thyroid recorded an increase in dose (0.1733 μGy; p = 0.01). This was later mitigated using a thyroid collar but identifies increased stochastic risks if lead-aprons are worn alone. Scattered radiation was also reduced to both eyes, which were not directly covered. Conclusion: Lead-rubber aprons are generally utilized to limit ionizing radiation, yet this article offers insight whereby increases to ionizing radiation to the thyroid are plausible when wearing a lead-rubber apron alone. Whilst these findings cannot be generalized to other radiographic examinations it provides insight into a potential increase risk of scatter to a radiosensitive organ. Implications for practice: This paper has implications because it identifies that lead-rubber has an impact on scattered ionizing radiation to radiosensitive organs for a lateral elbow examination. Further, it identifies the potential for ionizing radiation to be increased to the thyroid upon wearing a lead-rubber apron alone.

In recent years, ethnography has become a methodology of choice for exploring radiographic practices. This article adds to the existing evidence base by providing detailed methodological accounts of two experienced researchers. It aims to provide a critical methodological lens to prospective researchers who may also use ethnography as their methodology of choice. The author's reflect on their experiences of utilising ethnography as a methodological approach. Here, accounts of the original tools aligned to undertaking ethnographic research in radiography are discussed and how these can be used to uncover original phenomena. The article identifies the researchers' own positionality and reflexivity as researchers and how this impacted on data collection. In short, this article provides a detailed account of undertaking ethnography as a methodological approach within diagnostic radiography. The experiences documented can provide prospective researchers an insight of the researchers' position within the fieldwork.

Introduction: This article explores two phenomena in the general radiography environment—the increasing use of digital side markers (DSMs) by radiographers and the possibility for radiographers to “crop” radiographs post-exposure. This article offers originality by identifying the rationales of radiographers when using digital equipment. Methods: This study formed part of a larger ethnographic study undertaken in the United Kingdom (UK). Participant observation and semi-structured interviews were used. Overt participant observation identified cropping and DSM placement within the X-ray room. Semi-structured interviews later supported and/or refuted the rationale for DSMs and cropping clinically. Results: Two themes are discussed. First, radiographers support the use of DSMs by suggesting that mistakes will happen regardless of using an ASM and/or DSM. Furthermore, it is proposed that ASMs and DSMs can be interchangeably used in practice. Second, radiographers acknowledge the use of cropping ensuring their radiographs resemble “a textbook image.” This leads to question the optimum use of collimation in the clinical environment and how it may go unnoticed. Conclusion: This article concludes by recognizing some challenges digital radiography currently provides. The rationale and continuing use of DSMs and cropping of radiographs by radiographers highlights alternate complexities with digital technology in the clinical environment and how we may best overcome such challenges that influence the profession.

Introduction Since the discovery of X-rays by Rontgen in 1895, lead (Pb) has been used to limit ionising radiation for both operators and patients due to its high density and high atomic number (Z = 82). This study explores the attitudes and perceptions of diagnostic radiographers applying Pb protection during general radiographic examinations, an area underexplored within a contemporary radiographic environment(s). Methods This paper presents findings from a wider ethnographic study undertaken in the United Kingdom (UK). The use of participant observation and semi-structured interviews were the methods of choice. Participant observation enabled the overt researcher to uncover whether Pb remained an essential tool for radiographers. Semi-structured interviews later supported or refuted the limited use of Pb protection by radiographers. These methods enabled the construction of original phenomena within the clinical environment. Results Two themes are discussed. Firstly, radiographers, underpinned by their own values and beliefs towards radiation risk, identify a dichotomy of applying Pb protection. The cessation of Pb may be linked to cultural myths, relying on ‘word of mouth’ of peers and not on the existing evidence-base. Secondly, radiographers acknowledge that protecting pregnant patients may be primarily a ‘personal choice’ in clinical environments, which can alter if a patient requests ‘are you going to cover me up?’ Conclusion This paper concludes by affirming the complexities surrounding Pb protection in clinical environments. It is proposed that the use of Pb protection in general radiography may become increasingly fragmented in the future if radiographers continue rely on cultural norms.

INTRODUCTION: This article investigates a practical method of reducing the impact of scattered radiation during a lateral radiographic projection of the elbow. The light beam diaphragm (LBD) is generally accepted to limit ionising radiation using horizontal and longitudinal lead shutters, yet this article evidences further dose limitation by placing lead-rubber inferolateral to the LBD device. METHODS: Using an anthropomorphic phantom and arm construction scattered radiation was recorded at multiple radiosensitive organs. A 15 cc ionisation chamber (model 10100 AT TRIAD) was placed on each radiosensitive organ (eye, thyroid, breast, testes, spleen and ovaries) measuring exposure rate (μGy/s). Dose readings were recorded before and after the placement of lead-rubber inferolateral to the LBD. A paired two sample t-test was undertaken affirming how likely dose limitation was attributable to chance (p 

This commentary offers a contemporary perspective on personalised medicine (PM) within diagnostic radiography. PM refers to the use of a person's genetic information in tailoring strategies for the detection, treatment, or prevention of disease. Some key issues are raised in light of this new specialty and how it may affect diagnostic imaging. First, technological and commercial drivers are outlined, supported with ethical considerations. The authors then offer some future challenges that remain evident within the literature. The aim of this article is to begin to acknowledge the importance of PM, but most importantly, identify aspects where diagnostic imaging plays a pivotal role.

Introduction: This experimental study compares the appropriateness of direct digital radiography (DDR) and ultrasonography at detecting soft-tissue wooden foreign bodies (FBs) in extremities. Methods: Varying wooden FB splinters (2 mm, 5 mm and 10 mm) were inserted into eight porcine feet to simulate a patient presenting with a soft-tissue FB injury. Each of the FBs was placed in muscle distant, behind and near bone in the porcine feet. Control groups were used to check for false-positive diagnoses and, based on the presence of FBs; images were given a score depending on the level of visibility by the researcher. Results: a higher detection rate was achieved for all FBs in muscle distant from bone using ultrasound. All of the 2 mm and 5 mm wooden FBs were not detected using DDR. The sensitivity in detecting the FBs was 5.8% and 30% in DDR and ultrasound respectively. Conclusion: Poor sensitivities and specificities were identified in this study. However, this study shows that ultrasound remains superior to DDR at identifying small foreign body objects. This study demonstrates that ultrasound can be a clinically effective tool for detecting suspected wooden FBs >5 mm in the foot and thus should be considered as the primary imaging modality of choice for referring clinicians.

Objective This article explores image acquisition with DDR. General radiographic technology continues to advance therefore it remains paramount to continually reflect on DDR hardware and software amongst radiographers in an imaging modality that constitutes approximately 90% of all radiological examinations. Method This article reports findings from a wider ethnographic study of two general radiography environments in the United Kingdom (UK). Participant observation and semi-structured interviews were the methods used to uncover original data. Results Two key themes are discussed. Firstly, ‘the extent of DDR knowledge’ amongst radiographers is examined. The findings uncover that not all radiographers have an adequate knowledge base with DDR technology. Secondly, ‘pitfalls and near misses with DDR’ is discussed. This theme highlights the potential danger of radiographers ‘over-repeating’ X-ray examinations, coincided with the occurrence of radiological incidents whereby a patient is exposed to ionising radiation with no added benefit. Conclusion This paper concludes by challenging the current ‘skill base’ to operate DDR equipment. In addition, new pitfalls and near misses are highlighted, which may help forestall radiation incidents in the future. Dose and image optimisation remain central tenets to the role of the radiographer. Advances in knowledge Few studies have challenged image acquisition with DDR. This study adds to existing knowledge by uncovering original phenomena that may initiate discussions within the radiography community and continually enhance healthcare delivery.

This article explores the use of X-ray exposures following the introduction of direct digital radiography (DDR). Radiographers are central to delivering optimum levels of ionising radiation whilst maintaining sound image quality for radiological interpretation. Yet do radiographers utilise X-ray exposures appropriately? an ethnographic methodology provides insight of two general radiographic environments in the United Kingdom (UK) using participant observation and semi-structure interviews. A central theme uncovered as part of a Doctorate of Philosophy (PhD) study was the lack of autonomy concerning X-ray exposures within the general imaging environment. The findings highlight 'how radiographers behave'. For example, some radiographers do not alter 'pre-set' X-ray exposures, arguably failing to produce images of optimum diagnostic quality. Secondly, radiographers acknowledge 'whacking up', 'cranking up' and 'bumping up' X-ray exposures ensuring image production. In conclusion this article provides an original insight into the attitudes and behaviours of radiographers regarding X-ray exposures in contemporary practices using DDR. Dose and image optimisation are central tenets of radiographic practice that may be hindered in contemporary practices.

Objective: This article challenges whether diagnostic radiographers are image acquisition experts after the introduction of direct digital radiography (DDR). Method: an ethnographic methodology provides insight into two general radiography environments in the United Kingdom using participant observation and semi-structured interviews. Results: a central theme uncovered as part of a Doctorate of Philosophy study was the lack of theoretical knowledge and understanding of DDR among radiographers when undertaking radiographic examinations. It was found that some radiographers lack critical knowledge and understanding of DDR, which arguably may impact the autonomy of radiographers in the clinical environment. Conclusions: This article concludes by challenging whether radiographers have a basic level of knowledge and understanding to acquire images of diagnostic quality. Dose and image optimization are central tenets to the role of the radiographer, which is concluded to be problematic in contemporary practices. Advances in Knowledge: Few studies have questioned the skill base of diagnostic radiographers after recent advances in technology and professional roles. This study argues that diagnostic radiographers may be becoming deskilled within the general radiographic environment.

Aim and objective it is argued whether general radiographic examinations adhere to a person-centred approach within the direct digital radiography (DDR) environment. General radiographic examinations continue to increase and constitute approximately 90% of all examinations undertaken in the clinical environment. This study explored the potential impact patients experience whilst undergoing general imaging examinations. Method an ethnographic methodology provided insight of two general radiography environments in the United Kingdom (UK) using participant observation and semi-structured interviews. Findings the findings highlighted an ‘in and out’ culture whereby patients are ‘hurried’ and ‘rushed’ out of X-ray rooms in response to increasing time pressures experienced by diagnostic radiographers. In addition, this study challenged that patients may begin to rank ‘speed’ and ‘waiting times’ above other elements of radiographic care thus presenting new challenges for radiographers within the clinical environment. Conclusion it is asserted that radiographers should remain holistic healthcare professionals and not begin to resemble operators on the production line. Further, it challenges whether patients are beginning to rank aspects of radiographic care within contemporary practices. Advances in knowledge Few studies have explored the radiographer–patient relationship within the DDR environment, yet this study provides insight of person-centred practices within contemporary practices.