As the length of the IMF increases, severity of skin reactions also increases; a positive correlation was identified between the two at both week three of radiotherapy and three weeks post radiotherapy (r = 0.401, n = 34, p = 0.05 and r = 0.671, n = 29, p = 0.00 respectively). Only one patient displayed grade 2 at eight weeks post radiotherapy (IMF length 7.5 cm). CONCLUSION The findings from this study would suggest that larger breasted patients do present earlier, and with more severe radiation-induced skin reactions. IMPLICATIONS FOR PRACTICE Changes to skin care practice could be considered for patients with larger breasts. This could be in the form of more frequent check-ups during treatment or proactive side effect management rather than reactive management. OBJECTIVES What are the risks of error as a result of out-of-hours work in health care that could be attributed to Shift Work Disorder; and what safety implications would this have for radiographers working with ionising radiation? To conduct a literature search of existing studies of Shift Work Disorder. To critically appraise appropriate studies for research rigour. To synthesize and discuss findings in the selected research articles. To investigate the impact of the results in relation to medical imaging and safety. KEY FINDINGS A systematic review of the literature was planned and executed to meet the above objectives. Narrative synthesis was used to describe the heterogeneous findings of the studies appraised. CONCLUSION Four of the five studies selected after critical appraisal suggested a positive correlation of error with increased mental and physical fatigue as a result of shift work or rapid shift rotation. No studies directly investigated medical imaging professionals. IMPLICATION FOR PRACTICE Considerations need to be made when optimising shift work for healthcare professionals so as to avoid Shift Work Disorder and consequential error; particularly in the context of ionising radiation. Research into environmental and lifestyle support should be pursued to study its effect as prevention or management. Further direct study with radiographers is recommended. INTRODUCTION Lumbar spine radiography is considered as having a high radiation dose compared to other planar radiography examinations. The aim of this study was to investigate the feasibility of replacing an antiscatter grid with an air gap technique to achieve dose reduction for lateral lumbar spine radiography while maintaining image quality on a direct digital radiography (DDR) system. METHODS In phase 1, an experimental study using an anthropomorphic phantom identified the optimal airgap technique. In phase 2, lateral projections of the lumbar spine were performed on 50 patients randomly assigned equally into a control group (using the antiscatter grid) and an experimental group (using the airgap technique). The dose area product (DAP) was recorded, keeping other variables constant. Image quality evaluation was performed by 5 radiologists performing Absolute Visual Grading Analysis (VGA) using an image quality score tool, with resultant scores analysed using Visual Grading Characteristics (VGC). RESULTS A 10 cm airgap in conjunction with a source to image distance (SID) of 121 cm was found as the optimal airgap technique. The clinical application of this technique resulted in a statistically significant (p  0.05). CONCLUSION Replacing the antiscatter grid with an airgap technique in lateral lumbar spine digital radiography, provides a significant dose reduction whilst still maintaining diagnostic image quality. IMPLICATIONS FOR PRACTICE The airgap technique is a simple and easy technique to implement and radiographers should find no difficulties in applying it, as It involves no additional cost and no additional equipment. INTRODUCTION There is an increasing demand on diagnostic imaging departments, a shortage of radiologists, and a backlog of images requiring a report across several trusts in the UK. A negative impact on performance can result in significant outcomes for the patient. The aim of this study is to ascertain whether decisions made under time pressure will affect the accuracy of the interpretation of conventional radiographs.  https://www.selleckchem.com/products/jnj-64619178.html  METHODS Final year undergraduate diagnostic radiography students were recruited [n = 21] and separated into three groups of seven at random, assigning time limits per image for a set of normal and abnormal conventional appendicular radiographs; 15 s (high pressure), 30 s (moderate pressure) and unlimited time (low pressure). Each image was assessed, and answers were recorded as normal or abnormal with an approximate location of the pathology. RESULTS The ANOVA test revealed no statistical significance amongst results. The mean accuracy was highest in the 15 s group (82.86%) and lowest in the unlimited time group (74.52%). The results also demonstrated a decrease in accuracy with increased image review times within the unlimited time group; with the quickest participant achieving 88.33% and the slowest, 56.67%. CONCLUSION The results demonstrated no statistical significance. However, it is recommended to conduct a similar study using sufficient reporting practitioners to enable direct parallels to be drawn with statistical significance. IMPLICATIONS FOR PRACTICE The results signify an importance for imaging departments to manage the number of staff and their workload. Subsequently, this aims to ensure reporting practitioners work at their optimum stress level for efficient work performance. INTRODUCTION In the Netherlands, Diagnostic Reference Levels (DRLs) have not been based on a national survey as proposed by ICRP. Instead, local exposure data, expert judgment and the international scientific literature were used as sources. This study investigated whether the current DRLs are reasonable for Dutch radiological practice. METHODS A national project was set up, in which radiography students carried out dose measurements in hospitals supervised by medical physicists. The project ran from 2014 to 2017 and dose values were analysed for a trend over time. In the absence of such a trend, the joint yearly data sets were considered a single data set and were analysed together. In this way the national project mimicked a national survey. RESULTS For six out of eleven radiological procedures enough data was collected for further analysis. In the first step of the analysis no trend was found over time for any of these procedures. In the second step the joint analysis lead to suggestions for five new DRL values that are far below the current ones.