THE RACE TOWARDS THE UNIVERSAL HEALTH COVERAGE AND FACTORS INFLUENCING RADIOGRAPHERS CAREER CHOICE IN RURAL SETTLEMENTS IN NORTH-EASTERN NIGERIA

Background: There is a human resource crisis in the healthcare sector in Nigeria. This is because of the existing inequitable distribution of the available meagre workforce which is itself not helped by the increasing and currently trending brain drain. Purpose: This study aimed at assessing the factors that influence radiographers choice of career in rural settlements in Northeastern Nigeria. Methods: A cross-sectional study was conducted among Radiographers in Northeastern Nigeria. A 21-item, self-administered semi-structured questionnaire was distributed over a six (6) month period, where 130 questionnaires were distributed. The questionnaire consisted of two sections; a: on demography; b: on factors (attractors and detractors) for career choice in rural areas. Content analysis was used to analyze qualitative data; descriptive statistics were used to analyze quantitative data. Statistical Package for Social Sciences (SPSS) version 21.0 was used. Results: A total of 91 questionnaires were retrieved, giving a response rate of 70%. There were 56 (61.5%) males and 35 (38.5%) females. About 82 (90.1 %) had B.Sc and 9 (9.9 %) had M.Sc as their highest qualification. The major attractors for accepting rural jobs were improved remuneration 97 (86.8%) and opportunity for continuous professional development 72 (79.1%). While major detractors were, the cultural and traditional beliefs of the people in rural areas 23 (25.3%) and the lack of social amenities/poor infrastructure 22 (24.2%). Conclusion: The attractors for radiographers to rural areas in this study were; improved remuneration, availability of equipment, professional development, availability of social amenities and security among others. To recruit and retain radiographers in the rural areas, government, recruitment agencies and employers should in addition to good remuneration motivate the radiographers by providing adequate power, security, rural posting allowances, good functional equipment and a working and learning environment.

IMPACT OF ULTRASOUND AND SOCIODEMOGRAPHIC VARIABLES ON MATERNAL FOETAL ATTACHMENT IN TARABA STATE, NIGERIA

Background: Maternal foetal attachment is manifested in behaviours that demonstrate care and commitment to the foetus. Ultrasound decreases maternal anxiety and confers psychological benefits following a reassuring sonogram. Maternal-foetal attachment is affected by many socio-demographic factors which include maternal age, occupation, educational level, race, marriage duration, ethnicity, Religion, income status, pregnancy planning, and identification of the foetal gender Aim: This study was aimed at assessing the effect of ultrasound and sociodemographic factors on maternal foetal attachment during pregnancy. Method: A prospective study was conducted from November 2019 to March 2020. A convenient sampling method was employed and included 404 pregnant women aged 18-45 years old in their 2nd and 3rd trimesters. The data were collected using a maternal foetal attachment scale questionnaire. Descriptive and inferential statistics were carried out at a p-value < 0.05. Result: The score of the maternal foetal attachment scale was greater with post ultrasound than the pre ultrasound. There was a statistically significant difference between the pre and post ultrasound maternal foetal attachment scale (p=0.000). A statistically significant difference was observed in the maternal foetal attachment across the different ethnic groups (p=0.000), planned and unplanned pregnancy (p=0.000). Conclusion: This study revealed that ultrasound scan has an influence on maternal foetal attachment, planned pregnancy. Hausa, Bandawa and Jenjo were found to be more attached to their foetuses.

RADIOLOGICAL EVALUATION OF LEAD APRON INTEGRITY IN FIVE SELECTED HOSPITALS IN ABUJA, NIGERIA

Background: The general consensus is that any exposure to ionising radiation carries a risk. Diagnostic radiology is the largest (87%) contributor to man-made ionising radiation, therefore any economical and socially acceptable means of reducing dose without compromising the diagnostic value of the procedure must be worth implementing. Aim: This study is aimed at evaluating lead apron integrity in five selected Hospitals in Abuja, Nigeria. Methodology: The methodology approach includes the application of a large area beam for transmission measurement with the placement of OSLD before and behind the ten (10) lead aprons to determine the entrance and exit dose as well as the transmission factor. In this study, a lead apron consisting of 0.25mm and 0.35mm thickness were examined. Results: The result shows that the transmittance factor of the entrance and exit dose through the lead equivalent aprons is directly proportional to the age of the apron with NHA1 having the highest transmission factor (0.83) and oldest age (16 years). WGH2 has the lowest transfer factor (0.12) and the least age (1 year). Conclusion: Lead aprons loses their attenuation capability over time and should be replaced after 15 years at most for effective protection against ionizing radiation.

SONOGRAPHIC FEATURES OF RADIOLOGICALLY NON-FUNCTIONING KIDNEYS ON INTRAVENOUS UROGRAPHY (IVU) IN KANO METROPOLIS, NIGERIA

Background: Despite technological advancement in uroradiology, renal ultrasonography remains the imaging modality of choice for evaluating various pathological conditions affecting the urinary tract (GIT) system. Aim: This study was aimed at evaluating sonographic features of radiologically nonfunctional kidneys in Kano metropolis, Nigeria. Methods: A prospective study involving 94 subjects each from the diseased and control groups were conducted in Kano metropolis from January 2019 to January 2021. Renal scans were performed using a digital ultrasound imaging system; model DP-8800Plus fitted with a 3.5MHz curvilinear transducer. The maximum length, width, and thickness were measured. The renal echogenicity was assessed and graded. Data were analyzed using SPSS Version 22.0 Results: The mean values of the right and left renal volumes among adult patients was 400.5 ± 527.3 cm3 and 177.6 ± 174.3 cm3 respectively. For pediatric patients, it was 72.3 ± 308.6 cm3 and 241.6 ± 228.7 cm3 for the right and left kidney respectively. The renal parenchymal echogenicity of the right kidney among adult patients was scored as grade II 2 (5.3%), grade III 27 (71%), and grade IV 9 (23.7%), while those pediatric patients were Grade 0 (11.1%), and 8 (88.9%) as grade III. The adults left kidneys were scored grade II 2 (6%), and 16 (47%) each as grades III and IV, while the pediatric group scored 3 (25%) as grade II, and 9 (75%) as grade III. Conclusion: Increased renal volume, shrunken kidney, increased renal parenchymal echogenicity, and severe hydronephrosis were strong sonographic indicators of nonfunctional kidneys.

AN EVALUATION OF THE EVIDENCE OF BURNOUT AMONG ULTRASOUND PRACTITIONERS IN RIVERS STATE

Background: Occupational burnout has become a critical issue among ultrasound practitioners. Inappropriate management of occupational burnout can lead to serious health problems. Aim: To evaluate the evidence of burnout among ultrasound practitioners in Rivers State. Materials and methods: A survey of ultrasound practitioners in selected diagnostic imaging facilities in Port Harcourt and its environs was conducted between November 2018 and March 2019 to evaluate the evidence of burnout. A descriptive survey design was employed and selection of the facilities was done using a systematic sampling technique. 21 diagnostic imaging facilities were used. Ethical clearance was obtained from the Management of the facilities. Data were obtained from structured questionnaires administered to 50 ultrasound practitioners in these facilities, who accepted to participate in the study. The questionnaire surveyed basic demographic data, time to get to work, experiences, practices, the number of night shifts and other factors that predispose burnout. Data analysis was done using SPSS version 20. Results: The factors contributing to burnout among ultrasound practitioners are understaffing leading to work overload and excessive overtime work (41%), hostile interactions with patients' relatives (34%), interactions with colleagues (20%), and conflict with Boss/supervisor (5%). Burnout manifests differently among the practitioners as feelings of being worn-out and weary (46%), being sick (31%), being emotionally drained (23%). Conclusion: Ultrasound practitioners in Rivers State suffer a high level of burnout. Issues of understaffing and interpersonal communication skills should be addressed in order to minimize the incidence of burnout.

TOXICITY EFFECT OF RADIOGRAPHIC DEVELOPER EFFLUENT ON GIANT AFRICAN SNAIL (Achatina fulica)

Background: The decline in the population of snails, a source of protein of people living in the high forest zone due to environmental pollution and the hazard caused by the disposal of radiographic developer effluent into streams, bushes or forests and public sewer systems makes the assessment of the effect on giant African snails (Achatina fulica) from environmental pollution due to radiographic developer effluent very important. Materials and Methods: Ninety 5 months old, 12 months old and 24 months old giant African snails were randomly divided into 6 groups of 15 snails for each age group based on the dose of developer effluent to be administered. One group from each age group was designated the control and the remaining, the experimental group. Range finding test was performed at effluent concentrations of 100 %, 50 %, 25 %, 12.5 %, 6.25 %, 3.125 %, 1.6 % and 0 % (control) in 150 ml of distilled water. The effluent solution was administered on the feed and soil of the experimental snails only. Results: Behavioural changes occurred between 0.2 – 1.0 % concentration and mortality at 24 – 96 hours exposure to the effluent solutions. The percentage (%) mortality of the giant African snails increased as the effluent concentration increased from 0.2 - 1.0 % and at an increased exposure time of 24 – 96 hours. The estimated 96 hours LD for the 5, 12 and 24 months old giant African snails were 0.20 - 0.23, 0.23 - 0.25 and 0.30 - 0.26 respectively. Conclusion: Radiographic developer effluent is harmful to the giant African snails, with the % mortality increasing with an increase in concentration and exposure time to the developer effluent. Legislation is recommended to ensure the safe disposal of radiographic developer effluents into the Nigerian environment considering the importance of giant African snails (Achatina fulica) to the ecosystem and the economy.

CAROTID DOPPLER INDICES WITH AGE AND BODY MASS INDEX IN A SAMPLED NIGERIAN POPULATION

Background: Carotid Doppler studies are frequently carried out to assess for possible stenosis resulting from the presence of carotid plaques. The carotid peak systolic velocity (PSV) and end-diastolic velocity (EDV) are key indices for determining the severity of the stenosis. However, normative values of these parameters may be dependent on anthropological variables like age and body mass index (BMI) Objective: The study was aimed at assessing the variations of PSV and EDV with age and BMI in a sampled Nigerian population. Materials and Methods: A total of 204 participants (72 males and 132 non-gravid females) aged between 20 and 70 years who were normotensive with no cardiovascular diseases were selected. Their ages, BMI, PSV and the EDV were measured using standard protocols for the four segments of the carotid artery: common carotid (CC), carotid bulb (CB), internal carotid (IC) and the external carotid (EC). Data obtained were presented using tables and line graphs while the analysis of variance (ANOVA) was used to determine the significant differences in measurement across the groups. Results: The mean PSV recorded were 88.25 ± 7.43 cm/s for the CC, 73.93 ± 6.23 cm/s for the IC, 51.01 ± 4.30 cm/s for the CB and 50.41 ± 4.25 cm/s for the EC. There was a steady increase of the PSV between 20 and 46 years from 74.91 cm/s to 98.78 cm/s for the CC, from 62.76 cm/s to 82.75 cm/s for the IC, from 42.80 cm/s to 56.43 cm/s for the EC and from 43.30 cm/s to 57.10 cm/s for the CB. The maximum EDV measured for the IC was (24.75 ± 2.11 cm/s). Others were 21.12 ± 1.8 cm/s for the CC, 19.38 ± 1.65 cm/s for CB and 16.92 ± 1.44 cm/s for the EC. The EDV also increased steadily between 20 to 46 years from 17.76 cm/s to 23.68 cm/s for the CC, from 21.04 cm/s to 27.75 cm/s for the IC, from 14.38 cm/s to 18.97 cm/s for the EC and from 16.48 cm/s to 21.73 cm/s for the CB. The PSV and EDV varied significantly with age (p > 0.05). Also, the PSV and EDV increased slightly with increasing BMI from 30 – 31.9 kg/m2. For a BMI of 20 kg/m2 to 32 kg/m2, the increase in PSV were from 79.48 cm/s to 90.75 cm/s for the CC, from 66.58 cm/s to 76.03 cm/s for the IC, from 45.40 cm/s to 51.85 cm/s for the EC and from 45.94 cm/s to 52.46 cm/s for the CV. Similarly, the PSV and EDV values decreased at a BMI of 30 – 31.99 kg/m2. Thus, the BMI was significantly associated with PSV and EDV across all segments of the carotid artery (p > 0.05). Conclusion: There are significant variations in carotid PSV and EDV with age and BMI. These variations should be taken into consideration when diagnoses on alterations in carotid artery flow are to be made using PSV and EDV values.

Interdisciplinary Collaboration among Health Professionals: A Panacea for effective and Evidence-based Health Care delivery

Introduction: Interdisciplinary collaboration (IDC) is important in health care settings as the complex nature and demands of the health care work environment requires the expertise and knowledge of different individuals or specialists working together to solve multifaceted and complex patient care problems. Objective: To assess the health professionals' attitude towards the development of an interdisciplinary collaborative approach to patient care in health institutions and to systematically review the impact of IDC as a panacea for effective health outcomes in Nigeria. Methodology: The research is a systematic review that provides various approaches for studying interdisciplinary teams. Fifty articles were selected from different search engines such as Google, google scholar, science direct and research gate with the search term Interdisciplinary collaboration among health care professionals. Articles were arranged based on most relevant, relevant and closely related articles. Result: The study revealed that IDC is pivotal in evidence-based care and contributes immensely to effective and efficient health outcomes. It puts the patient at the centre of the healthcare team's focus and allows all health professionals, with the patient, to collaboratively provide input, be part of the decision making, and improve outcomes. Although there are several obstacles to IDC, adopting this team-based culture of mutual respect and understanding is possible and, in fact, necessary. Conclusion: This study reveals that there are many benefits to IDC. It can improve safety and healthcare delivery, as well as reduce costs. The interprofessional team supports patient and personnel engagement, organizational efficiency and innovation.

Nigerian Radiographers Obligation to Diagnostic Reference Levels in Medical Imaging

Background Diagnostic reference levels (DRLs) help to identify unusually high dose levels in medical procedures involving radiation. This will subsequently, stimulate quality control. There are legislations and guidelines requiring the Member States of European Union to adopt DRLs. While about 72% of European countries, as well as the United States, have complied, and with subsequent reviews demonstrating significant dose reductions (16% – 30%), no evidence links any African country to replicating the same. Objective This work briefly reviewed the progress of Nigeria with regards to diagnostic reference levels (DRLs) and with particular attention to efforts by radiographers. Methods Google search was made with keywords of 'diagnostic reference levels' as well as 'radiation dose in Nigeria.' Over forty works were retrieved but only twenty-two which had specific relevance to the focus of the review were archived and read. The works were subsequently scrutinized to piece together the trend of DRLs globally, and locally. Results Publications on x-ray, mammography, fluoroscopy and computed tomography dose abound in Nigeria. Doses had wide variations in all modalities. There was no accessible evidence to indicate that any regulatory agency in Nigeria had keyed into the imperative of dose investigation, monitoring and reporting. Conclusion In conclusion, diagnostic reference levels in x-ray, mammography and computed tomography have been recommended by independent researchers in Nigeria. Regulatory agencies are urged to summon the will to give guidelines on implementation of these DRLs in order to improve optimization of protection for patients.