Equality,diversity and career progression: Perceptions of radiographers working in the National Health Service

This study evaluated radiographers' perceptions of equality, diversity and career progression in the National Health Service (NHS) by means of a quantitative national survey in which 120 radiographers responded. The findings were assessed in relation to the participants’ own beliefs about equality and diversity. Key findings included that despite the fact that the NHS is actively attempting to address equality and diversity issues, radiographers working within the NHS still perceive that problems exist. This is apparent from the findings that 55% of participants thought that women generally experience some barriers to career progression. Sixty-seven percent perceived that people with disabilities experienced barriers to career progression and 49% felt that the profession did not reflect the community that it served. Reassuringly, policy and procedures are felt to be making a difference and worthwhile. In the light of the introduction of the Single Equality Scheme and Equality Impact Assessments, it is important that radiographer's perceptions of equality and diversity are evaluated and that incorrect beliefs are challenged.     

Molecular identification of novel intermediate host species of Angiostrongylus vasorum in Greater London

Angiostrongylus vasorum is a parasitic nematode that can cause serious and potentially fatal disease in dogs and other canids. The aim of this study was to determine the intermediate slug species infected in nature by sampling sites in Greater London and Hertfordshire located within a known hyperendemic region. Overall, A. vasorum larvae were recovered from 6/381 slugs (1.6 %) by tissue digestion, and their identity was confirmed by PCR. Infected slugs originated from three different sites in the Greater London area: one in Waltham Forest and two in Bromley. Slugs parasitised by A. vasorum were identified by a combination of external morphological characteristics and molecular techniques and belonged to three different families: the Arionidae, the Milacidae and the Limacidae. This includes two new host records for the parasite: Arion distinctus and Tandonia sowerbyi. This is the first record of A. vasorum in the family Milacidae, indicating that the parasite has a broader intermediate host range than previously recognised.     

Outcomes and complications of trans-vaginal mesh repair using the Prolift™ kit for pelvic organ prolapse at 4 years median follow-up in a tertiary referral centre

Purpose

To evaluate the anatomical, functional and post-operative outcomes of polypropylene mesh (Prolift?) in the surgical management of pelvic organ prolapse (POP).

Methods

A single-centre observational study of 106 successive patients, who underwent Prolift? mesh repair (POP ≥ 2) with a median follow-up of 4 years, was performed. Outcomes of interest measured included patient demographics, intra and post-operative complications, concomitant procedures for POP or urinary incontinence. Using the Baden–Walker classification, grade ≥2 prolapses in the operated compartment were deemed as surgical failure. Validated questionnaires including ICIQ-VS and ICIQ-UI were used to assess functional outcome.

Results

Of the 106 patients, 56 had an anterior, 36 a posterior and 14 a total Prolift?. 101 patients were available for follow-up (median 4 years). 82 women underwent a clinical follow-up whilst 19 underwent a telephonic follow-up. Peri-operative bladder injury was noted in 2 (1.9 %) cases. Six (5.6 %) patients developed mesh exposure post-operatively. Re-operation rates for recurrent prolapse in the operated compartment were 2.8 % (n = 3). At follow-up, prolapse recurrence in the operated compartment was noted in another 7.3 % (n = 6) patients. Combining re-operations for POP and recurrences noted during follow-up, the revised failure rate was 10.1 % (n = 9). De novo prolapse in the non-operated compartment occurred in 19.5 % (n = 16) women.

Conclusion

Our study demonstrates that Prolift? vaginal mesh surgery offers anatomical cure rates of 89.9 %. A higher rate of de novo recurrence in the non-operated compartment was noted suggesting that surgical correction in one compartment may exacerbate recurrence in other compartments.     

Higher Habitual Nuts Consumption Is Associated with Better Cognitive Function among Qatari Adults

The association between nuts intake and cognitive function is inconclusive. We aimed to investigate the association between habitual nuts consumption and cognition among Qatari adults. Data from 1000 participants aged >20 years who attended Qatar Biobank (QBB) were used. Nuts consumption was assessed by a food frequency questionnaire (FFQ). Blood samples were measured for magnesium, lipids and glucose. Mean reaction time (MRT) was used as an indicator of cognitive function. Linear regression was used to assess the association. A total of 21.1% of the participants reported consuming nuts ≥4–6 times/week (high consumption) while 40.2% reported consuming ≤1 time/month (low consumption). The mean MRT was 715.6 milliseconds (SD 204.1). An inverse association was found between nuts consumption and MRT. Compared to those with a low consumption, high consumption of nuts had a regression coefficient of −36.9 (95% CI −68.1 to −5.8) after adjusting for sociodemographic and lifestyle factors. The inverse association between nuts and MRT was mainly seen among those >50 years. There was an interaction between nuts consumption and hypertension. The association between nuts consumption and MRT was not mediated by hypertension, diabetes, or serum magnesium. Habitual higher consumption of nuts is positively associated with cognitive function, especially among old adults.     

Alinity hq platelet count is not impacted by severe microcytosis

BackgroundImpedance technology has been shown to overestimate platelet (PLT) count in samples with microcytes, while the optical‐fluorescence PLT count (PLT‐F) by Sysmex has been suggested to be unaffected by microcytosis. The Abbott Alinity hq analyzer employs multi‐dimensional optical PLT counting. Our goal was to assess the accuracy of this technology in microcytic samples.MethodsPlatelet measurements were performed by Alinity hq and the impedance (PLT‐I) and PLT‐F methods on a Sysmex XN‐3000 analyzer on 464 samples. PLT concentration range was 6.56–947 × 10⁹/L and mean cell volume (MCV) 40.9–123.0 fL. Samples were categorized into normocytic (MCV > 80 fL), microcytic (MCV 65–80 fL), and severely microcytic (MCV < 65 fL) groups.ResultsAlinity hq PLT count showed excellent agreement with PLT‐F (r = 1.00). Sysmex PLT‐I data showed somewhat weaker correlation with both PLT‐F and Alinity hq (r = 0.98). Increasing bias between Sysmex PLT‐I and PLT‐F was seen with decreasing MCV values, with mean bias of 35.2 × 10⁹/L in severe microcytosis. An inverse relationship was demonstrated between the PLT‐I versus PLT‐F bias and MCV (p < 0.0001). Consistent mean bias was observed between Alinity hq and PLT‐F across all MCV ranges.Mean platelet volume was suppressed or flagged by Sysmex XN in 50% of the samples in the severely microcytic group, and markedly higher red cell distribution width (RDW) was reported compared to Alinity hq (18.1% vs 13.7%, p < 0.0001).ConclusionThe Sysmex PLT‐I method overestimated the PLT count in samples with severe microcytosis. Alinity hq provided PLT counts and PLT and RBC indices that were not impacted by microcytosis.     

Factors associated with mortality and morbidity among pediatrics with burn injuries in Riyadh,Saudi Arabia

Objectives:To describe characteristics, mechanism, and factors associated with morbidity and mortality of pediatrics with burn injuries.Methods:This cross-sectional retrospective study examined all pediatrics with burn injuries carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia, from 2015-2020. Collected data included demographics, mechanism of burn, total body surface area (TBSA) burned, body region burned, incidence of infection, renal failure, scars, and respiratory events.Results:The study included 370 patients. Approximately 47.0% were aged ≤2 years, and 61.0% were males. The most common burn mechanism was scald burn (54%), 59.2% had a TBSA of 0-10%, and 60.3% had regional burns on the upper limbs. During follow-up, 5 patients died (incidence rate [IR]=1.60/100 patient/years [PYs]). Morbidity events included blood/sepsis infection (IR=2.87/100 PYs), urine infection (IR=8.30/100 PYs), wound infection (IR=21.72/100 PYs), renal failure (IR=0.96/100 PYs), and respiratory infections (IR=1.60/100 PYs). In a multivariate Cox regression analysis, factors independently associated with combined hazard of morbidity and mortality were female gender (hazard ratio [HR]=1.64, 95% confidence intervel [CI]: [1.01-2.67], p=0.047), TBSA (HR=3.20, 95% CI: [1.828-5.585], p<0.0001), and length of hospital stay (HR=3.14, 95% CI: [1.91-5.17], p=0.000).Conclusion:This study identifies certain characteristics suggestive of poor outcomes of pediatric burn injuries that are relevant to clinical management and prevention programs. Larger multicenter studies are required to fully characterize pediatric patients with burn injuries and to identify factors that adversely affect their prognosis.     

A case of spontaneous resolution of a scrotal ventriculoperitoneal shunt migration

Ventriculoperitoneal (VP) shunt catheter migration remains a rare but documented complication seen in one in 1000 patients who receive a VP shunt. Migration of the VP shunt into the scrotum is even more uncommon and requires surgical treatment. We report a unique case of a 6-month-old preterm male who developed right scrotal migration of his VP shunt. However, the tip of the VP shunt spontaneously reduced to its normal position, and repeated imaging months later showed no recurrence.     

Differences in automated depolarization patterns of Plasmodium faiciparum and P. vivax malaria infections defined by the Cell-Dyn® CD4000 haematology analyser

Of 1014 samples submitted for full blood count analysis and malaria screening, 854 were designated malaria-negative by blood film microscopy, 79 were unequivocally identified as Plasmodium vivax and 81 as P. falciparum. All samples were additionally analysed with the Abbott Cell-Dyn® CD4000 haematology instrument, and leucocyte differential plots of 90° polarized vs. 90° depolarized (NEU-EOS plot) and 90° depolarized vs. 0° light (EOS I plot) scatter were specifically examined for abnormal depolarization patterns. Depolarization pattern types were correlated with microscopy (species) results, and these correlations were consolidated by polymerase chain reaction analysis. All 854 microscopically-designated malaria-negative samples showed a type 1 (normal) CD4000 depolarization pattern. Abnormal pattern types 2, 3a and 3b were entirely restricted to one of the two malaria categories. Plasmodium falciparum malaria showed two CD4000 pattern types only; a ‘normal’ type 1 pattern was seen in 36/75 (48%) cases and the remaining 39 cases were all abnormal pattern type 3a. In contrast, most (79/85) P. vivax malaria cases showed a distinctive clustered EOS I population (types 2 and 3b patterns) that was not seen with P. falciparum. Automated depolarization analysis provides an effective means of detecting malaria-associated haemozoin, and the patterns of intracellular haemozoin further appear to provide species differentiation between P. falciparum and P. vivax.