The Editor-in-chief, the Editor, the Editorial Board and the entire staff of the Institute of Radiography wish to express our delight in bringing this edition ofthejournal to the reading public. We congratulate ourselves for fulfilling our promise in the last edition not to delay this edition. We achieved this feat in spite ofenormous challenges. This is a good opportunity to congratulate the immediate past registrar of RRBN, Mr R. B. J . Babatunde who recently retired from service. We also congratulate Mr M.S. Okpaleke v'ho has been elex ated to the post ofActing Registrar. We z'ish both men the best.

We are saddened by the loss of Prof. B.C. Umerah who passed on recently. Until his demise, the late erudite scholar was an editorial adviser to this editorial board. May his soul rest in perfect peace. We are bold to say that you will find articles in this edition both interestin s and challengin s They were carefully selected to arouse the interest ofbi:dding authors. Should such intending authors require help or ads ice, they should not hesitate to call at the Institute ofRadiography. As we look forward to a new' year, we urge you to resolve to put together a manuscript for publication. We wish you a merry Christmas and a successful year ahead. The Ediinr

REVIEW ARTICLE

DIAGNOSTIC MEDICAL IMAGING: A REVIEW OF A CENTURY OF EVOLUTIONS 'Eze CU, 'Njiiku I, 'Aboiiyl L C, Department of Radiation Biology, Radiotherapy, Radi‹xliagnusis and Radiography, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Ishaga Road, Idi-Araba, Suritlere, LfiQos, N' 8eria,

ABSTRACT Background: Diagnostic medical imaging has continually undergone tremendous evolutions since the discovery ofx-ray in 1 P›95. While some modalities have been modified, some have been totally discarded, while new ones have also been introduced as knowledge and technology continued to advance. Objective: The objective ofthe study is to review and highlight the major events that defined the course of development of diagnostic medical imaging in the past century.

Methods: Available literature on the history of events and the princ iples behind major breakthroughs as well as on pioneers in the medical imaging sub specialty was reviewed. Summary: Photography, chemical processing of photosensiiive materials and fluorescence all preceded the discovery of X-rays by Roentgen and laid the foundation for the eventual discovery ofX-ray in 1895. Between 1595 and early 1970's, the application of X- rays in medicine, science and industry went far beyond the imagination of early researchers and medical imaging practitioners. This period is generally referred to as the analogue era. In the period, X-ray films, intensifying screens, image intensifl er and the rapid serial film changer were all introduced into diagnostic medical imaging. A major feature of this period was excessive radiation dose due to high exposure time that was required to produce diagnostic radiographs. The digital period, which commenced with the first clinical application ofcomputed tomography (CT) in the early 1970's, has continued till now. The main feature of this period is the modernization of x-ray equipment that culminated in drastic reduction ofradiation doses associated with diagnostic imaging. Other major breakthroughs in this era include magnetic Nigerian Jouro9l of I›fcdTeol laeglng ood RadleJJon Therapy

resonance imaging, single photon emission computed tomography and position emission tomography. Areas hitherto believed impossible such as metabolic, brain and soft tissue studying are now routinely studied with x-rays in the digital era. As knowledge and technology continue to advance, it is also expected that diagnostic medical imaging will witness even more evolutions in future. Keywords: Medical imaging, evolution, modalities, history. Eze, Cletua Uche

Departn ens nt-ItadiJtion Diology, RJdio‹l erapy Rad‹ndia¿l\ ‹J; i» \« J Rail i‹›¿r»pJ1 ¿. Faculcy nI”CIinicaI '›c fences, ('‹›]lc o ‹Jl” h1cJir inn. £/ itJ versiiy nt- Lagos, tsJ›aj}a Road, Idi-Araha. Svru-lere. Lagos, N igeria. E-n›a‹J : l”aine4 eze\ujyaltor›.con› ccze( unilag. edu ng Mnbite: ‹ 2341103243291 5.

INTRODUCTION Diagnostic medical imaging, also known as Radiology, became a well developed and recognized medical sub-specialty in the first decade after the discovery of x-ray in 1895 by Wilhelm Conrad Roentgen, becoming a recognized medical sub-specially in the United states ofAmerica only in 1900"'. The discoveries of photography and photographic materials preceded the discovery ofx ray and helped lay the foundation for the phenomenal growth seen in medical imaging". In fact, the discovery of xray occurred when a fluorescent screen (barium platinocyanide) emitted light when it was excited by radiation emerging from a Crooke's tube to produce an image on a photographic plate'. The development of medical imaging in the past century has been so rapid that it has presently assumed the status of one of the fastest growing and most technology-driven medical sub specialty'. With advancement in both knowledge V‹il. I No. 3. Nos’emher 201 2

iigiinxiir ?lfezfirrZ I.nraginp: A Rrrir›i' a„(d firiirzri)' z›JZIw›fiiziess

and technology, especially the advent of computerizaiion, medical imaging has evolved from the analogue era to the current digital systems presently used to obtain high resolution images of bulky objects and also used to characterize heterogeneous organic and inorganic materials to very minute details"'. It is important, therefore, to review some of the evolutions of diagnostic medical imaging immediately before and after the discovery ofx ray in 1895. THE REVIEW Although there is no clear dividing line, major discoveries and evolution s that brought diagnostic medical imaging to its present status can be reviewed under three periods. The period 1800 to 1895 is termed the photographic period, the analogue period is the period between 1895 and early 1970's whereas the digital era presumably came into prominence with the first Table 1:

I83P t8f› J 1871 1879

UhNicapbore Hiepce Leuia J.M. Doguerre William F. Tal(iot John Hgracbgl FreiJgri‹;k Scptt Aix;ber It.Jcbazd . Jvladdox

Williairi Conrad Rogntgen Williaiti Conrad Roe•lgen Cert ScHeuvner

clinical application of computed tomography (CT) in the early 1970’s andis stitlon going’. PHOTOGRAPHIC PERIOD The camera, photography and chemical development ofphotosensitive materials were all developed before the discovery ofx-rays in 1895. The camera was invented by J.N. Niepce who also took the first permanent photograph with a camera in 1826. While L. J. M. Doguerre perfected the an and science of chemical processing of photographic materials in 1839, J. Herschel was credited with coining the word ’photography' later in the same year'. It is interesting to note that it was the photographic property of x-rays that eventually lead to their discovery". Other important discoveries pertaining to photography made before and immediately after the discovery of x-ray are shown in table 1.

+H istorical Events Firgt Periaianent phptpgraph with camera Di$oovcrgd cbgmiral development ofa photoiensitive material Disoevergd negative-ppoitivg iagtlipd ofpbotngraphv Goined wpixJ tpgraphy” Oi$OOvcrgd wei colloFlian precept Invented plate ‹;›uating uiachi:rig Oivcovcred X-rayg Fiat Mgfiical RaiJiogr»ph lvlanufactuigtl tlig fw:I glasa platgs Our radiogmpby

Introduced first paper for x-mF purposes

1896 1896 1896

Tliquiax A. Ediscin Micbael Pupin May Levy

Recommended catciuiii tunxriaie for fluorogcnpic screens

Kodak Patierson Sc-Company

Introduced double emulsion film Manufactured fluprggcgnt int€aigifying screens with iinprpvgd cbaraclezigticg

Finl reported screen-film radiayraph Made radiograpb using double emulsion coated film

Kodak

1936

Patterson Screen Company

Introduced fluore:icent screens with protective

Kodak

Introduced film with ceUuli:tie acetate safeiv base

DuPont

Introduced azi x-rav filizi witb blug tinted bagg

Patterson Sc-Compa•F

Introduced Pattgrgon tier Speed Percent

Amen

Introduced a direct exposure x-my fifth Introduced automatic film praceeaor

Poke 1960

t966 I971 1972 1977

DuPoni Knbak Kodak

3M 3M Kodak

Introduced i:tiller transport precept Made firs lika on pelFester base Intraduc›eid rapid prpcws f90 gxx:aniJl film-iJevelooment gvgtgm Intrpdjicgd ultraviolgt gritting scregng which reduced light crp$8Dver in dOublc›-cUrveiJ paneled cassette liitrpducgd rare earth screens

Intrpduced low cresaovcr fik• Introduced tabular grain emulsion x-ray film with

+ Ada[›ted From RadioG raghicB 1989; 9 (d). 122 3

Nigerian Journal of hfedteal latagtng aad Radiation Tberaj›j'

Vol. I to. 3. f'fovem ber 26t2

ANALOGUE PERIOD It is generally assumed that the analogue period started with discovery of the camera, photography and chemical processing of films, but only becoming more prominent with Roentgen's discovery of x-rays. Included in this period are discovery of x-rays, x-ray films, cassettes, intensifying screens, the rapid film changer, the image intensifier, contrast medium, nuclear medicine and sonography.

This period was characterized by excessive radiation dose to the patient and poor quality

DISCOVERY OF X-RAY AND EARLY XRAY EXAMINATION

X-ray was in 1895 by a German scientist named Wilhelm Conrad Roentgen. The discovery was accidental as Roentgen was investigating the conductivity of electric current in an evacuated glass tube’. X-ray imaging, immediately alter Roentgen’s discovery, was quite simple. It involved creating an image by focusing an x-ray beam to the body part of interest, directing the emergent beam from the patient onto a single sided piece of film inside a box called the x-ray cassette that was physically held by the patient himself(Fig 1).

An x-ray examination ofthe skutl then could last up to 11 minutes' ' °. Since even small doses of radiation carry potential risks ofsomatic effect, it is then easy to understand why some early practitioners of the profession came down with radiation sicknesses while some even died in the proces l Such practitioners who paid the supreme price for pioneering work in the profession have a memorial erected for them in Hamburg, Germany". Earliest x-ray tubes were of the stationary anode, ’Coolidge' type, were characterized by low output hence they were restricted to the imaging ofextremities and other body parts that could be held still for quite a long time. Most modern x- units are now ofthe more powerful, rotating anode x-ray tubes that also safe both forthe operator and the patient . X - RAY F I L M5 , C A S S E T T E S , INTENSIFYING SCREENS AND FILM PROCESSING The year 1896 was quite eventful in the annals of medical diagnostic imaging. It was in that year that Carl Schleusner invented the first glass plates (the forerunner ofthe present x-ray cassettes) for plain radiography. While Kodak, a Japanese company, introduced the first x-ray paper (film), Thomas Edison, an American Scientist and inventor, also introduced calcium tungsiate (CaWO‹) intensifying screens in the same year'.

Nigerian Journal of hfedJeal Itaagtng aad Radiation Tberaj›j'

Vol. I ?4o. 3. Noxemher E6t2

u.»..i h4 ie liae I P ftp in re cc rded the first x — raw fi l in /i nte n s i fy i rig sc ree n c cmbmat i o n in radiography w li ile May Levy’ introduced dtatibl e s ided (diiplitized) emulsion films aI sta in l S9t›.

froth dev eloped and develop ing nations ‹at the w end.

It was in 10 1 t , how es er, that the Patterson Screen Coinpany tinde rtook the first comma re rat Juan ufacttire of intensif:'•s • c reens ‘. I i is n‹ateworthy that the first significant step tons ards reducti‹a n of patient radiation dnase ss as taken in 1916 ss it li the ctiiiiirercial i iiantifaeture of froth intensi fJ ing screens and d‹auh ie coated x—ray filiiis. Calcium tungstate of the intensi lying screens detects x—ray photons and cont erts them to light photons. Since the eirttlsion of the x—ray lili:i is more sens it ice to light than radiation, it then became pose it ie to deploy sinaI ler radiation doses to a chic s e ex en red It I ts". 1\4 odern technology has enabled x—ray exp‹asures to tirade in ni il I i seconds, thereby reducing patient dose in d iagnostic ex aostires to just 2%› of what it freed to be a century ap‹a“.

The rapid film changer w as ins'ented fry €ieorpe Schoenander in l94f›. It s› as soon discos ered that ph ve ie ia n s c ould observe images on t he fluorescent screens a li ile exposures w'ere being made, th us ttshering in (albe it in its crudest foriii), the ads antage of real-truce studies'. The pr‹ableiii is itli that ve as that physicians were, 'loot:ing directly at x-rays” ss li ich seas rather disastr‹a tts as irany early practitioners died ofradiation induced illnesses'. The rapid film changer is a be.x v.’hich allows ed a series ofcassettes to be exposed at a fast rate the so called inns ie rate) of two cassettes per second. The technique vx'as later impr‹as ed in l9 f3 to aI low the exp‹asure of up to six cassettes per second'. This aflows ed manv films to be exposed in quick s accessions. s‹a it was no longer necessary for Physicians tta stare directly at .x—

F ilir processing ss itnessed a iiiajor breakthrough in 1 965 with the introduction of the automatic fi I ir process ta r fry Kta dak'. 5e to re that hreaktliroti gli, all x—ray fi tins ss ere manual I y processed in the dark rotrr. The atito processor is a 9 0 —sec o nd rap id i:tee ha niea I,’ e lectron i c processing unit in is li ich processing chemicals, new filth emulsi‹a ns, rel ler transport of fi firs and high des elopirent temperature permitted the c‹vnpleti‹a n the pr‹acesses ‹at fi liii processing (des elopment, rinsing, fixing is ash ing and drv i ug) to be completed is itli in 90 seconds. With this, it then became possible to process ftp to tw'o h undred 3 5 x 3 5 cir filters in one he ur, thtis increasing the thro •shptit of processed fi lins in shorter intern all. A n o t li e r in i I e s t o we t h a t s i g n i fi e a n t I y rex olutionized i iiedical dia s n‹astie i iliaging w as the introductitan of daylight filiii processing in l 9t›0 hv €i nuther Scliiiiidt . Follows ing Seiiiidt' s d is em ery, t he 'P rod ttct in ii Cont pan y' in col I aborati‹a n wit h EiiiPont, match lectured the first dav light processor later the same year'-. This cotild he regarded as the fore runner of present time digital fi lm processing which is fast rep lacing traditional darkrooi:i fi tin processing in

THE RAPIDF1L54CHANGER

THE I NI.4€i E I NTENSI FI ER The image intens ifier was intr‹adtieed into diagnostic imaging in 1 955. it all ‹aised the pick tip and display of rapid I y acquired x—ray images Its ing a coiiihination of telex ision camera and monit tar. Mest popttlar among early intake inte n s ifie rs w e re t lie iir •s e s'id ie ‹an a nd ort h i c on ' ’. • s e in te n s i lie ts re place d fluorescent screen image viewing in the twiddle of the 19 ›0's.

CONT14ST hI ED!.* A contrast medium is a substance that the ability to ahsorh radiation higher or lower than surrounding tissue and is therefore freed to enhance the visualization of internal structures in the bodv during medical imaging. The first recognized contrast need i iim used in medics I i iii °s ing was a thin w ire inserted into the tireter by Tattier in 18 9 7 ss li ich enabled the shadow' of the tireter to he seen in the radi‹agraph''. The first in din ate d, w a ter so I tit ie, li igh os in ofar, intrax en‹atis contrast medium known as Itapax I odtapy ridone sodiuir— N— acetic acid l was introduced in 1925 bv a group led fry prof.

»...‹ Liechw itz''. lopax, hecause ‹at its li igh ‹asm‹a lali ty, caused p‹ast inject ion reacti‹a ns such as nausea, s ‹rriting and rashes. In I 9t›9. Ion osmolar, indicated contrast i iiediuir was introduced fry Nr T. Alinen”.

knoss’n as radioisotope scannin s •° radiontic I ide imaging) was intr‹aduced intta medical im °s ing in the 19 f0's. It requires the ftse of special paiiiiiia caiiieras’. A radiopliarmaceutical c‹antaininp a suitable rad in isotope is usually introduced into the body and is concentrated fry the target organ. The faint radiation energy emitted fry the radioistatope is detected and measured by the gainira camera. The camera then hses the detected signal s to btiild 2—Dimensional spatial distrihtition of the radio istatope in the organ. Radioisotope scannin s is whore sensitis e than plain x—ray examination in detecting iretastatic let in us h ut is, hev. e s’ er, non— s pec ifie in discriminating betiseen primary and secondary ttti iiours'’. This m‹ada I ity was not fotind wide spread appl mation especial I y in des'e loping nations I ike N i peria. SONOGR t PH1’ fi tanogiapliy (also kn‹av. n as ultrasono s••phy) is medical i i iiapin s v.'hich uses sound of sey h 'sh frequency (statind that is inaudible to titan and is from 20 KHz and ahome) fear the creati‹a n ‹at images oftissues for dia s•••°' s. In the l 9fi0' s, use of sound in diagnostic medical i iiiaging v. as introduced. It ins oI s ed placing the transducer aga inst the skin of the patient near the •••sa n of interest. The transducer generates the h ' sh frequency sound waves v. hich penetrate the body, htatinces off the interna I organs and echoed back. The transducer °sain receis es the rettirninp echoes and feeds the signal intta the In trasound machine. \Vitli the aid eta coiiiputer. the si s nal is turned into real —time images' '. Sontagraphv is ins aluah ie in obstetric, abdominal, pet s ic and cardiac studies. It is also pain less, non ins asis’e and dtaes not ins olx e the use of i onizing radiation but is rather less sensiti se than such i iiodalities as ctiiiiputed to •s••phy and i iiapnetic resonance

DICITAL ER.1 This peri‹ad is characterized by eoriiputer based

i nia s ing modalities des igned to acliies e the same high qualitv images at less radiation doses‘ Otitstandin s discoveries in the period inclttde c maputed tomography, magnetic re sonance i i iiag ing, s ing ie—photon emission computed tomtagraphv and position emissi‹an t ‹ai iiopraphJ. in this period also, training ‹at professionals invols ed in the dia s nostic medical imaging stib— spec ia lty because iiiore ads anced. The computed tomtagraphv (CT) scanner was invented in 1 972 fry an EngI ish Sc i entist named Godfrey Heunsfie Id ' . in earlier trials, he first used s• • rays, then x—rays and an array ‹at detectors mounted on a rotatin s frame. As the pantry rotated, different portitans of the organ are exposed t‹a radiation. The arrav of detectors w’il l detect the radiation signa Is emerging fr‹vn the patient and feed theirs tta a ctrrptiter wli ich tums the sipna Is intta cross sectional (slices) images of the organ “. The first CT scanner was a head scanner u’hich track hours to acquire a single slice image and iiiore than to enty— four h‹aurs to complete a head CT examination'. Present generatitans taf C’T scanners are irtich faster and can coiiiplete CT exaininati‹a n ‹af the whole body in a matter of seconds’. CT Scanning allow s discrimination to he tirade beta een tissues ofonly slight density difference. This allowe somali lesions v. ithin the eranitini to be studied i s weater details. Radiation dose from CT is comparable to that from c‹anv enti‹a nal radiography, though the CT mach ine is costlier t‹a acqtii re''. For ins entin s the CT. Prof. Heuristic Id is as awarded the Nobel Prize in physiology ‹ar medicine'.

M4CWETIC RESONANCE I ACI WC Magnetic resonance i i nagin s became a clinical diagnostic tool in 1973 is hen the first h4 Rl sttidy on a htiiiian was performed. Pati I Latiterhur ‹at the Unit ersity of I I l inois at Urbana Chaiiipaipn, L SA and Sir Peter Maiisfie Id of the L nis ers ity of Nottinpham, England w on the 2003 Nobe I Prize in phvsi •• •• s› • r Medicine for ins'entinp the MRI

o... h4apnetic resonance imaging s i stializes both the strttcture (anatoiiiv) and functi‹a n of an organ in i nhI tiple planes. Pos erfu I n••s netic fields are freed to align the nuclear magnetization taf hydrogen atoms in is ater of the h‹adv. Then Radio fret uenc y ( RF) lie I de are used to systematical I y alter the nuclear irapnetizatitiii, catisin s the fry dr•• sen n uclei t‹a prodttce a rotating magnetic field. This lie Id is detected by the scanner and fed as a signa I tta a ctiiiiputer ss hic li then constructs an image front the s i pnals ,. Spatial reso I tition taf hl RI is comparable w itli C’T. Contrast detai I is, lion. es er, better with h4 Rl hecatise ofthe c‹rrplex I ibrary ofptil se sequences and ahtindant hydrogen attains that can be opti i iiized t‹a proc ide better eontrast' ‘.

SINCLE

PHOTO? E 51 ISS1ON

COMPLTED TO?IOCI RAPH4’(fiPECT) David Edss ards and R‹ay Rul I were created ss ith ins entin s the SPECT Scanner in the l 050's, tho•sh the moda I ity only gained vi ide clinical acceptance iii the last thirty years . SPECT hses pdI lltl2fl ffl V5 flfld II )d122122 d C8122e ffl I tJ (I fCi V ldc title

3 —Dimensional inforiiiation. The camera acquires in It I tiple 2—Dimensional images frtrr multiple angles and feeds them as signals to a eoiiiputer. The c ta ir p ute r t he n hses a tom tagrap li ie reconstrueti‹a n a I gorithir t‹a reconstruct the ni u I tiple 2—D images to 3 —D images. 3—D spatial resolution ‹at 5 PECT is hetter than CT or II RI and is very stiitah ie for the sttidy oftumours, bra in and cardiac functions. L‹anp scanning time and h 'sh level ta f image att ifacts are, hois ev er, some of the major lim stations ofthe niodalitv .

BOSITRON EM!SfON TONIOCRAPHY (PET) Ptasitron emission ctaiiiputed tom‹agraphy (P ET) made its entry as an im °s ing mtadality in the l 9fi0's. it uses short—listed raditaisotopes to produce 3 —D coloured im °s•* • f functitaninp organs in the body, thtis proc iding information afront the body's metabolic actin ities. PET is sey seiisitis e in detecting actis' e tumours hut it cannot be used to estimate the size ‹at such tumours, unlike CT or MR[ .

The earliest practitioners in the diagnostic medical profess ion u ere physicists and electrical engineers hef‹v e physicians foll ‹ais ed suit. \Vli ile Pr‹af. R‹aentpen a phy sicist, made the first radi‹agraph of a human heink figure 2), Dr. John Macintvre , an electrical engineer, is believed to haste set tip the first dedicated radioltagy department in the ss end at the €i lasgoss Royal infirmary, Sctatland to provide i iiedical dia s••astic i iiia s ing serf ices to patients'. The Roentgen society bthe predecessor of the British institute of Radio logy w'as established in 1 597 u’hi ie the American Roentpen society ssas established 1900. Presently, s‹rre ‹at the professionals ins cfs ed in i iiedieal imaging are radiolopists, raditagraphers. medical pliy sieists and other scientists pure I y ins'ols ed in research. it is not very clear when diagnostic medical i iiiaging took off as a i iiedical Hit specialty Nigeria. The of radiographers in the country, litais ev er, started around 194 7 in the country . From hospital based ap renticeship ty pe of training, most professionals in the diagnost ie medical inn a s' s °• b—specialty undergo rip‹r ‹a tis training. €i l obal I v, the current training of Stich professionals has bectrre Unnersity hased degree p •••s•• •iines and in some c ‹a tintrie s like N i pe ria, post qua l i ticat ion internship t ra in i n to r red in I ‹a gi sts a nd radiographers is also required.

CONCL[SON

o. ...

‹

In spite ta f technological ads ancement and digitizati‹a n, no newer i iiodalitv appears able to successfully replace the one preceding it. h4 est taf the moda I ities play complementary roles tta each other. Since kn‹awledpe and teehn‹a l ‹agv are always changing, it is not di ffietilt to pred i ct that diagnostic medical iirag trip i s po ised to experience even greater es ol utions in the near ftittire.

€ioI dstein I, Nexvbtiry D. Joy D, Lyman C’E, Echlin P, Li fshin E, San. yer, L, Michae I R. Scannin s electron i nier‹ascopy and x—ray i iiicroanal ysis. Http:/ 'u’wu’.sprinter. c‹am,'iiiaterials.'charace rizati‹a n+%›2fi+es a I uation,*hook,'97S —0—306— 47202—3.

9

REFERENCES l.

2.

Hta I ities GA’. American Radio l ogv: Its contribution to dia s••°' s and treatment of diseases. Journal of American Medical Association 1947; 13 I 6): 327—330. Hans AG, Cull i na n JE. Sc reen fil m pr‹acessin s •ysteins for medical radiography: A li istorical revieis. Radio€iraphics 1989, 9J 6): 1203 — 1224. €iray JE. Orton C€›. Medica I Physics: Seine recollections in diagnostic X—ray im °s' and therapeutic radio logy. Radiol •sy 2005; 21 7: 6 1 9 ›2 f.

Knou’led se of Shadow.' s: the introduction of X—ray images in Medicine. Soc i olopy of health and illness 1959; 11(4): 360 3 8 l .

Hay GA, Htighes D, X—raw. In: First year phys ice for radi‹agraphers 2nd ed. London, Bai l lere Tindall 1 979; pp. 123— l3 6. Mtih‹agora \VE, Nyanda AI\4, Ngaile .IE, Leifa U S. Film reject rate studies in i iiajor diagnostic x—ray facilities in Tanzania. 20 10: Availahle at: L M- R EI EC T— RAT E— I U— 5 E L EC TE D— DIAL NOSTIC —X— RAY—FAC IUTI E5— ID — TAfiZAN I AAccessed on Jan uary 20, 20 1 1. Calder I F. The history of radiology Scot I and: l 596—2 000. British jo urna l txt Radiology 2003: 7é : 283

\ 2. Leonard P, Schieb MC’. The day light system. Australian Radio low 1981; 25d 3 l: 29t›—31l

Terras R. The life of Ed. C’. German: a h red or ica I pers pect i s e . As ai la h I e at http:/ 'ss'xvu’.nehi. nlni . ni li .pos,*ptibnied,' 7644 607. Accessed on 3 l May, 20 12 C Ires ne y Li N , C free ne y MO. I ni a ge l ntensifiers. In: Equipment for rad i ographers 2nd ed; London: 5l ackwel l scientific publieati‹a ns 1075: 309-43 S.

H o w' M R I u’ o r k s . A› a i l a b l e a t http : /,'w ss ss. lion. sttiff›s ‹arks.coni,’mti . html.'pr notable. Accessed on 1 5th Jantiary, 20 12

18.

19. London: f' bSnunderaCo. l 99G: l7 37.

20.

21.

22.

S'ige ria ri d ‹tu i nal ‹if .\3 cdical i mayin g and lladiat ion The rapy

Pos itron e ni ise ion toni ograph v (P ET): ge n e ra l i n to r iii a t io ri . As a i I a h le at http:,'/ s ‹s ss . rah .sa.ges . au,'n united.'P ET,' et info.htiii. Accessed on 0 l Jtine. 20 12

QUALITV hJANAGEMENT: A PANACEA FOR PATIENT RADTATION DOSE OPTIMIZATION IN HADIOLOGY .-SRI IU IE C.O.D.

I NTRODUC’ TION

\\’here as reject analysis iiiay be conducted to deteriii inc the fete I and causes taf fi I in wastage tar as a qtiantiiatis e index of a qtia I ity assurance programme, it is necessary to ens ure that the analys is is sensitive to aI l the parameters is hic li impact on the cv oral I reject rate'. Reject,’re heat analys is resti Its, in themselves, cann‹a t pr‹aduee the desired outcome. They remain mere audits taf sources ‹at resource wastages and pointers to the sources of additional radiation exposttre to the atient until thev are tit i l ized and managed hv those concerned, in the e.xpectation of achies ing the des ired otitc‹rre. it ss as the urpose of this studv to evaluate the use of reject.'repeat analysis in aticnt radiation dose opt i in i z at i ‹a n a nd t o u nders c ore q u al it v i iianage ment as a mean s oI guarantee ing opti ir mation of intake qttalitv and patient radiati‹a n dose in Raditalt•s›

MATER!ALStND h4ETHODS

The ana I vets of data ss as done tie ing SPSS I 6.0 statistical package. The decision criteria fear the test taf significance s as to accept the null hyptathesis, H‹ : p› — p. = 0 if the t— ratio ohta ined is less than the critica I t— ratio for 11 df at Ct 5 %›l 0.05) front the statistical tahle of t— rati‹a s; 2— ta iled test, v. here pi and p. are the reject rates for the t ›s ta l 2ss eek periods respect ix ely. RESULTh The total ii umher of radi‹agraphs done, and rejects for the fitst and second 1 2 w eek periods are presented in table l . During the first 12 ss eek peri‹ad. a total of 2,093 radi‹apraphs w ere taken and a ttatal taf 274, representing l 3.00%› w ere rejected. In the second 12 v›'eei: erred, when instructions on how to achic e the desired rms ult v. as gis en hefore each rejected radiograph seas re eated, a total of 2,206 radiopraplis « ere taken tatit else li ich 201, representing 9. l l ° ‹ v. ere

rejected. The SPSS output for the iiiean reject rates for the first and second periods are ( I 3.0592

r.aces f€if All the exaniin.Orions in the second period. C’hest X—rays had the highest repeat note of 13.64

respecti ely. The overall mean reject rate for the 2* week period was 11 .0529 + 2.2766) .

the least repe‹9t fdté CIf (3.75 _ fi.52)%». In the second period, pelv'ic x-rays also had the least repeat rate off 1. 57 _5. 77 )°\ w'hi ie the extremities

Table 2 shows the feject r.ate per type of examination for the first sand second 12 w'eek periods. There z.as .a general drop in the reject

‹e »‹ded the h›,he» repeat rate of ( { o. 24 _ . 19)°fi .

TABLE 1 WEEKLY RECDRD OF THE NUMBE R OF CASES DONE AND (RE JECTS) TYPE OF EXAMINATION \§ [E [E g Chest Abd. Pelvis Sk ul ! / PNS NeCk/ Spi ne Extre- TOTAL Reject Fac. 5 . PostNS mities rate 1 120 (15) 5 (0) 4 (0) 13 (3) 3 (1 ) 5 (1 ) 15 (1 ) 22 (3) 187 (24) 12.83 2 121 (17) 3 (0) 3 (0) 15 (1) 5 (1 ) 2 (0) 13 (2) 18 (2) 180 (23) 12.78 3 96 (13) 11 (1) 1 (0) 13 (2) 2 (0) 3 (0) 14 (1) 20 (2) 160 (19) 11.88 4 131 (19) 1 (0) 0 (0) 14 (2) 6 (1 ) 11 (2) 18 (2) 11 (1 ) 192 (27) 14.06 5 119 (16) < (1) 1 (0) 14 (2) 4(0) 2 (0) 12 (1) 17 (3) 173 (23) 1 3.29 6 113 (15) 0 (0) 1 (0) 12 (1) 7 (2) 5 (1 ) 13 (2) 20 (4) 171 (25) 14.62 7 109 (13) 3 (0) 1 (0) 10 (2) 3 ’0) 6 (1 ) 16 (1 ) 21 (3) 169 (20) 11.83 8 98 (13) 3 (0) 2 (0) 13(1) 1 ’0) 0 (0) 17 (2) 22 (2) 156 (18) 11.54 9 104 (18) 0 (0) 5 (1 ) 11 (1) 7 (1 ) 9 (1 ) 15 (1 ) 23 (2) 174 (25) 14.37 10 124 (15) 6 (1) 4 (1) 12(1) 2(0) 4(1) 13 (2) 13 (1) 178 (22) 11 113 (16) 1 (0) 2 (0) 12 (2) 6 (1) 5 (1) 10 (0) 18 (2) 167 (22) 1 3.17 12 125 (17) (1 ) 3 (0) 11 (2) 1 (0) 5 (1 ) 17 (2) 20 (3) 186 (26) 1 3. 98 TOTAL 1373(187) 1 (4) 27(2) 150(20) 47(7) 57(9) 173(17) 225(28) 2093 (274)

13 128 (14) 14 142 (13)

2 (0) 3 (0)

3 (0) 5 (1)

11(1) 13(2)

3 (0) 1 (0)

5 (0) 2 (0)

13 (1) 11 (1)

19 (1) 18 (3)

184 (17) 195 (20)

9.24 10.26

15 121 (10)

6(1)

1 (0)

9 (0)

7 (1 )

5 (1 )

14 (2)

20 (2)

183 (17)

9.29

16 111 (13)

<(1)

0 (0)

15 (2)

5 (1)

3 (0)

17 (2)

23 (1)

178 (20)

11.24

17 117 (11 ) 18 103 (9)

1 (0) 0 (0)

2 (0) 3 (0)

16 (2) 12 (1)

8 (0) 2 (0)

7 (1 ) 9 (2)

15 (1 ) 16 (1)

23 (4) 25 (2)

189 (19) 170 (15)

10.05 8.82

19 110 (12) 20 133 (10)

< (0) 7 (0)

1 (0) 4 (0)

14 (1) 7 (0)

3 (0) 9 (1)

3 (0) 6 (0)

15 (1 ) 12 (2)

21 (2) 19 (2)

171 (16) 197 (15)

9.36 7.61

21 125 (12)

2 (0)

1 (0)

10 (0)

4 (0)

4 (0)

18 (1 )

25 (3)

189 (16)

8.47

22 119 (9)

3 (0)

2 (0)

11 (0)

6 (1)

4 (1)

9 (0)

14 (1)

168 (12)

7.14

23 147 (12) 24 151 (11 )

1 (0) 3 (1)

0 (0) 1 (0)

13 (1) 8 (2)

2 (0) 1 (0)

1 (0) 3 (1 )

7 (1 ) 10 (1 )

21 (3) 13 (1 )

192 (17) 190 (17)

8.85 8.95

TOTAL 1507(136) 36(3)

23(1)

139(12) 51(4) 52(6)

157(14) 241(25) 2206 (201)

I 1.7 l

Tshlc 3: Percentage distrihutini› nf rejects according tn Benson

Mntini›al hl rirring

The test of significance fear di fferenee in the reject rates observed for the two periods sli ois ed that the difference is significant at p 0.Of. The t— ratio at df I I front the SPS5 output is I 0.fi63. This is greater than the critical t— ratio (t, , „ „,) = 2.20 l . Hence, we reject the nu I thy pothesis, H„ : p, — p, = 0. DISCU fiSI ON Otir findings on reject rates, and rea » r» the rejects are in agreement witli earlier studies reported in the I iterature htit, o ur finding on the impact oftraining and supervision on reject rates reduction is quite res ealin . We di so» ered that t li e s t u dy groti ps , ni ade ti p o I in ter n radiopra liers, trade varying degree ofchallenges regard ing the raditagraphie technique for skull,

sintises, post nasal space and extremities ofbabies in particulaf. For chest radiography, quite a Fl £lHlher of them have problem of c leering the *C8(ILl l ae off the lungs fields. The test of Hl HifUance show. ed that the reducti‹a n in the reject rate achieved was not c‹aincidental but real lhD *. s l $’ 1n@ Ufédence to training and super ision 85 8 IfledtlS Ci f tl sstirin s irriape q ualitv and patient dose opt imization.

CONCLUlON

5. rejects.'retakes — Radi‹agraphic chal l enges. (http:/ 'rpd. oxfordjournals.org 20 I 0/02 ' 16 l

\\’atl: inson, S. : Moores, B. Ivl .; and Hill, S.J. Reject ana lysis: its role in quality assurance. Radi‹•s••phy 1954; IO: I S9— 194. 2.

3.

4.

Tabari. A. M. and €iarha, [ . Use of reject— repeat analysis in patient radiation dose optii iiization in diagn‹asiic rad in logy. \\’est African J‹atirna I of Radiology 2009; 16: 7— 10. Schandorf, C’. and Tetteh, G.K. Aiialy his of the status of X—ray diagn‹asis in €ihana. Britisli .l otirnal of Radi‹al •• s› 1098; 7 l : l 040— 1048. Zendeneh, D.; Teferi, S. and Adniassie, D. X—ray reject analysis in Tiktir, Anthemsa and Bethzatlia hospitals. Ethiopia Journal of Health Des. 2005; 22( 1): t›3 —é7

Pugin. .l . The control of phototimers. in: Qua I i t y a s s u ra nce in rad i •s •° phv. Radiography 1 985; 5 I : 14 l - 142. \\’atkinson. S.A. Econoiiiic aspects of quality assurance. Radi‹agraphy 1085: 5 l : 133 - 140. Russell, J .G. B. and \\’ri s lev, .l . Population room dose in radi‹adiapnosis: its assessment and importance. Raditagtaphv 1986; 52: l l — 13. Lais s, P. X—rays: more harm than p‹aod’? Rodale Piess, Eminane, P.A. 19 77: 202—203.

INCIDENCE AND AGE DISTRIBUTION OF FIBROIDS AT FEDERAL MEDICAL CENTRE OWERRI, NIGERIA

ABhTRACT AI1\1: The sttidy seas carried out at the Radiol •si' Liept, Federal Medical Centre, Ovverri, in order to deteriiiine the distrihtit ion and pre v alenee oftypes offihroids across s armors age brackets. hi ETHOD: 586 patients ‹at age bracket {2 I -50 vrs) w ere scanned for fibre id and other related pet v ie masses. The age brackets w ere grouped in to Earl y adli l th‹aod. Preiren opausal and Periirentapattsal apes. Findin s• a'ere soured according tta age, l oeatitan and tvpe of fibrtaid. REfiU LTfi : 1 8. l %› ( 106) had fihroid u'ith Pre menopati sa I ape gro u p, 3 l — 40y re) c‹anstituti ng the hi shest fibr‹a id incidence of 39. fi%f 42) The least incidence was rec‹arded i n peri iren‹apausal age group (4 I —50vrs) is ith 2S. 3%f (30). 7 f. 5fi« (50) severe single—type wli i le 24.5 %») (26) were multiple type. 5ubserotis fihroid is the single—type is hich had the hi s est incidence amongst a I I the single—types is itli 22. t›%» 24) and is most I y seen i n the prenienopausal age. The least forms of fihrtrd were Stibniucous and Cersocal found in 7. t›°‹ (5) and 7.6%» 5) respectis ely of the total population of fihroi d patients N= 106 and w it h highest inc i dence in the Early adulthood 11. S° ‹ (4) and preiren‹a pausal 11 .0%» 5). COI'tCLUStOIi : It is therefore proposed that pres alence ‹at fibr‹a id—type may str‹anpIy he dependent on age. Keywords: F ih re ids, t ypes ; distrih tit ion; pres alenee; age.

been attributed to increased incidence offibroids'

said, not be prone to has ing fibre ids because the desopestrel pi I l s present cx ulat ion bv inliihi tin s estrogen formation fry the ‹as cries‘ Fibrtaids are generally c l assifi ed according to their location’. Such classification results in the fib re ids be ing des e r ibed as 1 nt ra ir ura I, Stibintico usal, 5tihserousa l and Cers’ieal. A fihroid may also he Pedtinctilated if it des’e lope a pedicle which attaches itse If tta the uterine wal I and grows external I v into the peritoneal cas ity' ’ " The aims of this studv is to deteriiiine the distribution and prevalence of fibre id—type s l in different reprodtieti s e ape groups and the l ‹acality because ofpaucity ofdata in the locality.

The patients' ages n ere grouped intti : €irotip I - Early Adtilthtiod ape 2 I -30yrs €irotip 2 - Prenienopatisal age 3 I -*Oyrs €irotip 3 - Pert i nenopatisal ape 4 I -50vrs

Out tifthe what miniher taf patients studied N=556,

diagnosed of fibrt»id. The age srotip that had the highest incidence is Pren entipatisal (3 I -40) u ith 39.6%, (42). Otit of the ttital patients sc-anned N=586, 289 (49. 3%n) are

from e.ccli scan v.’as categorized as follows: Peduncti lated suhserotis

=

With reference to tables ii and ii i, single and multi ple ccc urring flirte ds v’efe recnrded

A

Total Number of Vuml›er ‹›F Patients Number of Patients Patients ›tudied without Fihroid with Fibrnid fi-5/J6 fi-4/J0 N-J 0d %u 188 154 34 32. 1 %

Number ‹›F Vumher of Cravir F«ra+id Patients Patients with fi-2/J9 ° Fibroid N-23 °» 149 51 •z4 13 5.7%›

190 (3 1 — 4flyrs)

1 t›ti 480

(BI .9fi+)

108

(I It. I •fi)

2119

23

(fi.0%«}

TABLE 2: XCiE AND FI BROID TO’P E IN OISTRI BUTION 1 A B C Pedunculatetl Iniriimural huhsernus fi ubserii us %« • «' •

D .hubmuciius

Tol*l N-I 06

E Cervical '«

%

Eurlv Adul thtitid

22 Total

26

(JB.9° »)

20

(JO.9° )

For single fibroid, Pedtinc-til aied Stibserous was the li ighest incidence in the Periiiien‹apausal age

24

(22.d° )

8

(7.é° »)

B

(7. /e/mJ

X0

witli 3 6. 7%t( I I ) termite least in Earlv adulthood S. 8°?(3).

.adti1thnod 1 1. 81s(*) Cert ical f*. ‹acctirred highest in Premenopausal pro up u'ith I I .0%»(5) and

T.ah1e iii depicts the ‹occurrence of i iiti It ip ie-type in different as• srotips.

TABLE 3: DISTRIBUTION OF T8’PES OF FI BROID ACCORDINR TO .1C E CROUP Age €i roup

AA B

E:iri v Adulilio‹›d

B D E

.4 & C

A& D

A& E

B&C

B&D

BAE

A TOE

TGT.8L

Stihmucous fibroid may he one of the c‹aiiiironest causes of abnormal bleedin s per s agina in yoting w tviien. Seek W. " C’ervieal fihroid was seen highest in Preiiienopatisal u'ith an incidence of 11 . 9° ‹ ( 5). Early adtilli o‹ad recorded 3(8. 5°.‹ ) w hile nil was rectarded in Perimenopausa l . This could be Interpreted as. cervical fibroid not commonly seen in the perinienopausal age.

It is kn‹ais n that fihroids can be solitay or ocetir in multiples and in types. I n tab Ie2.the stibsei ous single type fibroids had the highest taccurrence in all the age groups u ith 22. t›fit (24) representing the coiniiionest ty pe. Premenopausa I grtatip had the highest incidence u’ith 2 ›.2%› I I), while Perii nenopattsal grtatip recorded ( I 6.7%› )(5). The modal age for the highest incidence offibrtaid is 3 4. 3yrs. I ntrairtiral fibr‹a id had l•'s iest frequency in Early adulthood group u'ith 26. 5%t(9 ), least in €iroup 3 v.'ith 13.3 %»(4). This was established fry €ios'an et a I‘ v. he said the grois th of a fihroid starts intrairtirally fr‹aiii the iryometriui n and as use ad v a nc es it gro is s to he en hsero us a nd stibsequentlv fi 11s the entire literate. Sttidy slims s that statue remain intraiiitiral and become calcified or degenerated. €ios an ct at“ Peduncti lated subser‹a tis fibr‹a ids are ti sual I y extrauterine with attachment (pedicle) to the p e r i in e t r i It ni . I t w' as s e e n ir ‹a st I y i n Perii iienopatisal w'it h 3t›.7%» ( I I ) while 5.5%»(30 l seen in Early adulthood. Subinticoti s fihroid is as best dem‹anstrated with 5H€i tieing normal saline as c‹rrpared to TVS only. This finding collaborates tlitise reported fry Becker et al". 11. S°i (4) ofyottnp a onien had the highest incidence of Suhniueous fibre id v. hi ie premenopa ti sa I and perimeno ausal haste the same degree of incidence.

Large cervical fi hroids are known to catise dystonia in pregnancy'' In irttltiple fibroid incidence, it could be seen that tw'o—type incidence has t • 'sheet new urrenee. AI I —tvpes inc ide rice is in est I y fo und in Preirentapatisal age. There is rarity of three and to ur—tvpes seen simultaneo uslv. 80(75. 50,'0) of fibroids are fotind sin s le while 24. f%»(26 ) are in ultiple—type. This is in disagreement with €i tipta et al " report ss hich says that multiple tvpe fihroid ‹acctir whore than single—type fihroids.

In conclusion, it c‹atild be seen that the tvpe of fibroid inc idence depended on age. At the Grindal use of 34, one i iiay forecast that the ty pe taf fihroid a patient may li l: ely haste is Stihserous and when i iiti l tip ie it irav either be tw'o—type form ‹ar a 11—type fort:i w it h an incidence ratio of2: 1 The sttidy ctati l d be used as a predictive tool to knots ss liat type of fi hroid a patient may likely have at a part ictilar age pro up preced in s ultrasound examination in order to aid good and effective management.

1.

Tstida F and Ktipesic 5: Clinical predictors in the natural li istory of uterine leioniJ onta: pre l iirinary study. J . tiltiasound Med. 1998: 17: I 7—20.

2.

Danftartli D: t3bstetrics & Gyneco logo, 9t1i Editi‹a n, JS. Lippincott Co. Philadelphia 1999; pp 50 I —556.

€iross 5 and McCartliy 5: Son‹agraphie features of Uterine Lei‹rryomas: Aiialy Eis of 4 l prof en cases. J . L l trasound Ivled. 1083; 2: 40 1 —406. €i e a ii ; Mac far le ne : a nd c al le nder : Patlio l ogy il l tistrated, 2nd Edition, €ilaspow, C’htirchi l l Liv in setene 1 956; p 178, 693.

Beek W' Ohstetries €iyneeolo y, 4th Edition, \\’i l liams & W'ilkins, Battiti ore 109 7: pp 4 12— 4 14. Sche art LB; €loldstein Sr: and Achtraan: hee of Thans s aginal tiltrason‹•s•»phy to iii onitor t lie Effects of Tamcx ife ii on u te rine L e io in yoiii a s i z e a n d Os ar ia ii c j st ftarmat inn. J . U l trasound 1\ted. 1 995; 17 :699— 703. €itipta LG: t›upta Ahhitahh: X—ray Diagnosi s and i niaging: ultrastanogra hy. 3 rd edit ion, Javpee, Ness, belli i 1098, pp 449—4 50.

ORI€i INAL ARTICLE

PERCEPTION AND ATTITUDE OF NIGERIAN SCHOOL CHILDREN TOWARDS RADIOGRAPHY PROFESSION 'C.C. Ohagwu., ‘C.C. Nvq ankivo., ’C.U. Eze. ' Dc)iartinent of Radiography' and Radiolog i caI Sciences Nniiindi Azikiuc Univarsity Nnciv i Cani)iris .Anumbru State. Niycri ii

ABSTRACT

BACKGROUND: Shortage of manpower is a worldwide problem in radi s•»phy and is attributable to the ne sative perception of the profession by youn s people. AIM: To assess the level of awareness, perception and attitude of young Nigerian school children towards radiography profession and determine the effect of career talk on their perception and attitude towards it. METHODOLOGY: A tu' •-sroup study which targeted final-year science-inclined students of four selected secondary schools was conducted. The respondents numbering 39f were divided into two groups; l and 2. €iroup 1 received detailed career talk on radiography v.'hile sroiip 2 did not. The data collection instrument was a 26i te in se in i - st r uc t ure d s e l f- c o in p I e t i o n questionnaire designed to elicit the awareness level, perception and attitude of the tw o groups towards radlOhfaphy profession. REfi U LTS: The aware ness teste I of t he respondents about radio sraphy profession was 76.6
x arious attributes of radio sraphy profession and radiographers between the tw o groups (P < 0.05). The respondents who received career talk were more willing to take up radiography as a career than those who did not receive career talk. CONCLUii I OIi : Young Niberian schoo I c hi I dre n' s aware ness ab or: t rad i ogra phy profession is generally encouraging but they lack in-depth know ledge of the profession to make in formed cho ice. Their perception of the profession and attitude towards it is ••s»tive and can be improved by career talk. KEVWORDS : Radio s•» phy profess ion Awareness -Attitude Perception Ohagwu Christopher Chukivucmcka

INTRODUCTION Radiography is a very important arm of modem medical practice and has •s been rec •snized in many countries as one ofthe professions allied to medicine. A decree was promulgated bv the military gos eminent in N 'seria in 1975 to regulate the actis ities of some professionals in public serv ice that included Radiography'. In 1987, decree No. 42 was promi:lgated which accorded radiography full professional status like medicine, midwifery, nursing, pharmacy, and law' \'ot. I No. .3, Nns't iii fit r 2 0I 2

3'c'Ji u 1 £.'Ii/1fl vu Jn t « fi

Rad i ograph y is a pr‹a tension trad it iona I I j’ c‹ancerned with creatin s x ray im •s•• • f patients to r p urp ones of d ia n ose s (d tag n ‹Est i c radiography) and treatment of tumors tieing x arious types of ionizi ng radiations (therapy radiogiapliy). \\’it h rapid advances in techno •• sy s astly improved trainin s and education, the scope of radiography has in the past two decades or tliereabo uts expanded in many countries. The male of radit•s••phers has c1ian s• d significantly as the dei:i and for radiography serf ices has increased markedly and the work a l s‹a bectrre nitare e‹ai iiplex-. The competence of radiographers rios c‹»s eis onset medical ii aping i odaliiies such a:> computed toiiiography. magnetic resonance imaging, ultrasonography, nuclear i iiedicine, and thermograpli y. The expandi •s r‹ant iers t«f radiography practice trade ensured that the role of radio s•• phers does not stop at oStaining diagnostic images hut also inc I side iiiakin s ° seftil c I inical interpretation of the images. Eiespite being a profession in tipis ard sv.'inn radiography is failing to attract v‹ating Niberian scho‹ l chi I dren t‹a i iiake career in it. This can be deduced front the number of radi •• sraphers registered i‹a praet ice the prtafession in Nigeria as ptihli shed bj’ the regti latory authority. According tta the Radiographers Registration Board of Ui geria ( R RBU ) ' pti h I ie at i ‹a n on t lie re is tere d rad i ographers in Nigeria updated on the 22nd Augtist, 20 l I, on I y l , 0fS radiographers are registered to practice raditagraphy in Ni geria. This number inc I sides those w'ho registered and ni i grated abroad for greener pastures, and those v.’h‹a iiii s it has e died. Ni peria is a s ery poptiloos c‹atintry with about a hundred and fifty iii I lion people and radiography serv ices are proc ided by this sirall ntiniher ofradiographers.

The a inn of this study was to assess the fete I of awareness, perception and attitude ‹at yoting

effect of career talk on their perception and attitude tow'ards the profession. LI TERATURE REVI EW Although there is patieitv of local I iterature on av. areness, perce ations and attitudes of school chit dren tow ards iredi cal radiohf8(Il1y, the problem ofacute shorta se ofradio s•°phers is w'el l rectagnized. Eze ct

a 1‘.

identifiéd

8DWD dIl£ii U3£l £fi USA

detractors of radi‹•s•»phy as a career. The att ract o re in e I u de read il y ax a i lab Ie j ‹a b opportunities, extension of radiography career ladder, role extension, introduction of internship for fresh had itapraphy s• ad rate s, r••s°° technol •s ieaI adv ancenients and opportunity for self employment. The inn es 'sators li ighlighted job opportunities b‹ath within and outside the country as the m‹ast imp‹artant attractor, since no radiographer w'ho is i slies tta practice in Nigeria is unenip loyed. The identified detractors include poor societal rec •s• ition of radiography, lack of professional title and radiation hazard. Radiation hazard was rated as the highest detractor. Poor societa I recogniti‹a n ofrad i ographers cottld be due to polar professional image ‹at radiography, a problems identified in an earlier study“. C’areer choice is influenced fry both psycho logical and socia I faettars. This is reflected iii the u’ay an indie id ual percei s es a prospect is e career. I n a study to compare the perceptions ‹at an ideal career with perceptions six other health careers, all the six health professions were pereeis ed as significantly less desirable than the ideal career in the areas of ”heing respected” and "working ss it h high technology.” ”Care for people" ss’as fotind to be the third li ighest ranked attribute of an ideal career, and pharmacy and radiation technology (radiography') were found to he signi r«»‹l

.. ‹

... ..t..«.

looser in this area". Joh sec urity was another attribute ta f ideal career ins estigated and only nursing w'as perceived as has ing job see urity that matched the ideal career, with other professions perceis ed as offering significantly less joh sec urity than the ideal profession‘ lnftarmation av ailahle to y cling people about a profession to a very large extent influence their perception ofthe profession and attit ude towards it. f'oor quantity and q ua l ity ‹a f information ahotit a profess ion coli Id instigate negati s e perce ti on and attitude fry young peep ie. A sttidy had reptarted tha I the qttantity and qttal ity o I informat ion ‹an internet u ehsites afront the career of radiography was not of satisfactory standard and m‹are attention from both the s•verniiient and professional hodies is needed if the profess ion is to sain attention, and the staffshortage problem is to be stat red'. It u'il I be an understatement to say that inadequate information on radiography or information xvli ich lack quality on the net affect the profess ion negati els' and the ads ice of the researchers shottld be taken Serv seriously tta ens ure that the profession grow s in an expected w ay. Another sttidy reported Unit ersity of Salford's website as coining traps in tens of information content on radiography . The sttidy e sa l tiated iranj tether v. ehsites. Althtatiph these u chs ites on radiography ex ist. the problem still reiiia ins that very few. 's• rian sectandary school students haste adequate kn‹ass ledpe of c‹rrptiter, and have access to one and know. lion. t ‹a search the ss eh. Radiography is not the on I v health profession facing this negative attitude and perception frtaiii y otingsters. A study o I attitudes of Hon s Kong high school students towards the n urs ing profession reported that students v'ere generally knees' l edgeahle about nurs ing h ut ss ere re I tictaiit to pursue nurs ing as a career. Htaxsex er, students v. lima were s‹acial l y act tiainted w ith n urses demonstrated a slightly mtare pos iti e attitude too ards ntirs inn and s I i ghtly lii s ier intention t‹a p ursoe ntirsinp career eoiiipared to those si’hta has e rita social acquaintance ss it li n urges". The way an individual feels ahtatit a profession seems to play an i i iiptartant part in the se leetion of a profession as a career"'

Front the red iew ed literature, certain things can be deduced, and their importance t‹a the progress of r a d i ‹a g r a p h y p r o fe s s i o n e a n n o i h e underestimated. These include i i iiptos ing on the attracts re ‹at t li is pro less ion, re dtie inn tar e I iirinatin s those things that detract vounp aeople front tak inn tip this career, publishing whore articles about the profess ion tan the internet and creating m‹are a‹s areness afront the profession to the voting people wlie pose it I y cottld take to this profession in the ftittire. RESEARCH hi ETHODh A tv. ta—gi ottp desi s as admited fear this study. The target ptapu lation u as the students in the senior sec‹a ndarj scho‹al final year c lass. The students w ere those offering science stihjects and are thought to he I ike IJ tta take to science and technol •ss * as ed careers. A cons'enienee sample of 3 9f students from fotir selected secondary scli‹aols in Anaiiihra state, Nigeria ss ere enlisted into the stttdy. This coiiiprised 20 I whales and 194 ferna let. They were dis ided to ta pro ups. €iroup I was made tip ‹at students ‹at Saint Charles' Specia I Science Sch‹aol , Onitsha and Special Science Schotal, AMagama who recei s ed detai led career talk on radi‹•s•»phy profession. €iroup 2. was tirade tip students of Lorreto Specia I Science Scliotal, Adazi—Nnttkw u and 1\4 enchant of Li s ht Special Science Scho‹a l, Oha. This grtatip did not receive any career on radi‹agraphy profess ion. Prior to ctaiiiiiiencement of data ctrl l eet ion, perm ission w as sought and edta ined fi oir the prime ipals of the fotir schoo Is invols ed in the studv for tie to speak tta the ir students and adiiiinister questionnaires. The purptase o I the study v. as clearly explained to the principals and d(I[ISO Y d15 tO Oflff)’ OLI I I he 5 lttd y \\ €f€ @1 V€11

v erha l ly. The data eoll ectitaii instrument vs’as a se in i —st rtict ured 2 6 — ite ir s e I f— c ta in p let ita n questionnaire vvli ich is a irodi fied adaptati‹a n of the questionnaire heed iii the study o I Pa I umho et a I ". (see ap endix 1. The modification w'as done to shit the objectives of the present sttidy. The questionnaire u’as divided into three parts. The first part consisted of qtiestitans tan the socio— deiiioprapli ie characteristics of the resptandents.

heatd ahotit radiopraphJ rofessi on before the questionnaire is as adiiiinistered to theirs. For group 2, no career talk was gis en in order to assess how irtieh of this professi ‹a n twat thej already knees . The questionnaire was distributed w it h instruction that items 14 — 26 should not be fil led out by students realm trade not heard ahotit rad iographj. The qtiesti‹a nnaire spas administered to the students hJ direct issuance and prim acy of the students w as rna intained by ensuring that natives were not included in the questionnaire and rio identification marks were tag ed to indie id ua l students except it » as A or B tta identify the location. The data collected were ana I y zed using Statistical Pact:age for Social Sciences Version (SPSS) I 4.0. Descriptix e and in ferential statistics w ere carried out. Statistical significance ss as considered at p -: RESULTfi

The respondents es at uated in the stttdy were 395 students in four selected Special Science Sehotals in Anainbra State, Ni geria. They comprised of 50. 9° ‹ (n = 201) males and 49. I %› (n = 1 94) tenta let dw ided into two gr‹atips as shown in table Tahlc I: Distrihution nf the students acrnss the scI›nnls TOTAL FE83.ELE 237

194 J49. 1 %›)

The respondents were’aged between 14 and 19 years (mean 16.9 1.1 years) for group l ; and between 15 and 20years (mean 17. l 0.9 years)

for group 2. The respondents' parents' formal educational qualification is as shown in table 2.

TsbJe 2: Pareot&' highest fotmsl educational qualiftCatione Qualification

Group 1

Group 2

Ph. D or equivalent

8.9•Z» (n = 2 I )

l 2.7’Z» (u = 20)

Master’s degree

5. 5•Z» (n = 13)

95%» (n =I S)

Bachelor's degree

52.3%o (n = 124)

48 U4°,(n =76)

0' level

26.6%o (n = 63)

2S B4 (n = 4 I )

First School Leaving Certificate

4. 2°Ze (n = 10)

2. 5fi» (n = 4)

No formnl education

0.4°Z» (n = l )

0% (n = 0)

No response

2. I "to (n = 5)

l .3%o (n = 2)

Tbtal

1II4l°Ze (n = 237)

100•Z» (n - 158)

The predominant parents' occupational groups for group 1 were private business (38.4%, n = 91) and teaching (24. l %«, n = 57). For group 2, the predominant parents' occupational groups were

private business (32 . 9%«, n == 52), teaching (24. l %, n = 38) and civil service (13.3%, n = 21). The respondents' role models' occupational groups are show» in table 3.

Table 3: Respondents’ role models’ occupational groupa

Acoountaiv:y AgnculNre AtLleiicz

1.3°A (n - 2)

Banking

06’% (n - I )

Buzinexs

13°4 (n - 2) II.6•o (n - I )

Eng;\neenng;

5.7°A (n - 9)

Entertainment

3.2°4 (n - 5)

Geolo

& Mining

Uaboiaiory medicine Medicine

34.2W« (n - 54)

Nursing

4.4°A (n - 7)

Pharmacy

7.0°A(n - 11)

Physiotherapy

1.3°4 (n - 2)

Politics

0.6°A(n - 1)

Priesthood

0.6°A(n - 1)

Natural science

1 .9°A(n - 3)

Undergraduate zNdentz

20.99’qn - 33)

Teaching

5. I %(n - fi )

Architecture

0.49’« (n - 1)

Aviation

0.49’« (n - 1)

Script writing

0.49’« (n - 1)

Radiography

5.59’» (n - 13 )

Military

0.49’» (n - 1)

No mle model

I .79’» (n - 4)

Total

1if0•A (n - 237j

Nigeria n Journal of hledieaf Imaging and Radiation Therapy'

34

Tnhlc 4- Rcspondcnts ' level rif aii’arcncss atiout radiogi aphy

T‹›txl

Talilc 5: Sourccs of rcspondcnts' kiinu lcclgc rind nwai cncss of i adingraplis’ profession

’Fatilc 6: Test of kiiou’1cdgc ahout raclingraphy' profession Knowledge

Remarks

P — 0.07 P — 0.07 Totiil

For group I , 85. 7°¥i ('n‘= 203) consider radiography a good career but only 42.6%i - 101) think they may take it up eventually. For group 2,74.4%i (n - 118) think it is agood career but only

14.6% (n - 23) think they may eventually take it up. The respondents’ ideal career choices are shown in table 7.

Table 7: Respondents' Ideal Career Ideal Career Architecture Banking Biochemistry Economics

10.8 (n=17)

Engineering theology

Information technology Law Medicine

Microbiology

l'fo career choice yet Nursing Pharmacy

Physiology Physiotherapy Aviation Politics Priesthood Radiography Teaching Agriculture

Laboratory medicine Totsl

36

YoI. * N‹r3. No*ember2G*2

The perception ofthe student about various attributes ofradiography profession and radiographers are shown in table 8. Table 8: Perceptions of tLe respondents rerception rating

rercepoon rating

Radiography is humanitarian

4.35 + 0.93

P- 0.000*

Radiograpliers are highly respected

4.22 + 0.81

3.80 + 0.93 3.52 + 0.96

P- 0.000*

Andhun*

P- 0.000*

Radiography is invaluable III modem medical practice

4.31 + 0.98

Radiograpliers are brilliant

4.33 + 0.87

l63+ 115 4.09+0.97

4.66 0.70

4.3 J

0.96

P- 0.000*

peak of academics

4.49 * 0.73

4.30 + 0.93

P-0.000*

Radiograpliers are well paid

4.45 + 0.81

3.86 + 0.92

P- 0.000*

4.12 + 0.97

3.32

0.96

P- 0.000*

4.49 * 0.67

4. I7

0.94

P- 0.000*

3.92 + 1. 15

3. 12

1.08

P- 0.000*

4 W+0 M

3.70 + 1.14

P- 0.000*

3.79 * 1.10

3. 10

P- 0.000*

P- 0.000*

Radiograpliers work with hi—tech equipments Radiograpliers can get to the

Radiograpliers can attain the

highest level in their profession Radiograpliers can become specialists III many areas oftheir

profession Radiograpliers do not experience unemployment Radiograpliers are well shielded against tadiaticin at work place Radiograpliers make decisions about their work independently

1.00

On a visual analogue scale, the respondents rated their overall willingness to take up radiography profession as shown in table 9.

Table 9: Respondents overall willingness to take up radiography career Rstlng

Remarks

6.43 + 3.09

P - 0.0O0•

4.46 + 2.64

DISCUSSION Acute shortage of iadiographers is a world-wide problem in the health care sector and ways to eliminate it have been suggested but muchhas not been said about awareness of on « •chool this even students about profession, though they are potential new entrants into mdiography. The attitudes and perceptions ofthese youngsters have not been assessed to knowthose things that Nigerian 4ouraal of hledieaf Imaging and ttadlation Therapy'

possibly deter them from taking up this f si n. Ascertaining their perception of various attributes of radiography profession and tj1 graphers will help in identifying the aspects of radiography career that are positively or negatively perceived. This information will be to career guidance counselors in shaping Wrights of these young people positively ds mdiography career and disabusing their VoT. I No. 3. f/ovember I¥12

ofthe profession but the level of their know. ledge v.'as indeed every poor even anitinp those v.’hta received career taI k on radiography. Only x erj' few of aI I the respondents from the both groups were able t‹a demonstrate in—depth knowledge of the profession.

From the resptandents' ansisers on how they heard of the profession, career talk pressed to be a very important means ofcreating aw’areness about this profession. It is also a orthy of note that radiographers have a that to do if the level of awareness abotit this profession is to be increased. From the resptanses, it v.as obsers ed that many of the respondents in group I and about halfofall the respondents in s••• p 2 either heard of the profession through career ta I k deli s ered bv a radiographer or through a radi‹•s••pher they rivet at one time or the other in their life. done of the respondents indicated has ing heard of this profession front their career guidance counselor, and this indicates that the level of awareness of this career may even be low aiiiong the career guidance counselors and educators. Although, the findings in the study 'The career ofradiography: I nforination on the v. eb ' shows t fiat the information available on the net ab‹aut the career of dia s• ostic radi‹•s••phy was not of satisfactory heath in quantity and qtia I ity, the Nigerian sectandary school student hardly has access to the internet. Es en when he has, the l es'el of information technology IT) training he has is often not enough to enable him sticcessftil ly nan igate the relevant sites. This situation leaves the v.’ork on creating av. areness atout the profess ion to the career s•idance counselors, educators and radi‹•s••phers as they meet and interact with these youn s people in course oftheir

duty. The fact that mtast of the respondents heard about radiography within the last t v. o years is indeed a thing of great concern. This shows that the pr‹afession is very unpopular. One may w’onder why the respondents have not heard of rad iograpliy even when they have heard of med i cine, p harinac y, n urs ing, and ct her professions and would like to pursue careers in any of them as shown by the res ults ‹obtained. This cotild be because rad1OhP8Qhers are neat seen as very important iiiembers of the wealth care teams. Perhaps, these young people would not want to take up a career v. here they v. otild not be regard v.’ith high degree of importance. This also show s twat although there are v.'eb inforrriation ahotit radiography, the respondents do not have access to these information, For those v. ho have heard of the profession, roost of them do not consider it a nice career choice because all thej' may possibly hear abotit it is the dances ilhsticiated v.' ith working v.'it li ionizing radiati‹a ns and this indeed scares their asav from it. But is there anj' career w’ithout associated hazards? it is doubtful if there 1s aLly.

Although the respondents' les el of awareness is high, they still do not want to take up radio s••phy as a career. Twis is in line w’ith the find ings of a similar study on attitudes of Hong Kong hihh school students tois' ards the nursin s r•• fession. The sttidy sh‹awed that students a ere generally know’led seable abotit nursing but a'ere re I uctant to pursue nursing as a career". One of the most important factor clans idered in ‹a ur target p‹apu lation was their in—depth know ledge of the profession. This v. as generally very low and this implies that the respondents may have heard of the profession without actual I y know ing what the profession is all about. Therefore, career talks are very essential in other to chan s• this •s ly situation and enhance secondary school students' knoz’led se ‹at radi •s••phy profession and career. Career talk was fotind to haste great effect on the respondents. It should also be noted that the career talk had direct effect on their attitudes and perceptions. The effects of career tal ks cannot be underestimated if the scarcity of radiographers w’orld—aside is to be reduced or eliminated.

‹ .« ... Therefore, all orpanizat ions that are connected t‹a radiography profession slititild take it upon t he mseI s es to see that t his patic ity oI radiograpliers is eradicated as soon as possible hj' organizing regular career talks on radiography for the yotin s r• ople, especia I l y those about to begin their higher studies in the fruit ersity. Only t w‹a respondents chose radiography as their ideal career. Many of their v. he receis ed career talk think that it is a good career to take up and about a half taf theirs think thej maj es entually take up radiography as a career. For those antic did not receive career ta I k, alth‹atigh many ‹at the respondents th ink that radiography is a nice career, on I y very few of them think they cotild take tip radio s••phy as career later in life and this low ntiiiiher could be attributed to poor public image of radio s••phy and radi‹agraphers. Thej' may have thought it to be a good career because they know it has stiinetli inn tta do is ith caring for peep ie and sae inn I ife. The perceptions ‹af the respondents abotit x ariotis attributes ‹a I red i •s rap h y profess ion and rad iograpliers were general I y positive. Perception of those that received career taI k was better and this could be attributed to better information v.’hich thev received. This was also evident in the ratin s •f their nepcraft willingness to take tip the profession, as iiiore respondents from group that receis ed career taI k showed more willingness than those in the group that did not receive career talk. Slime ofthe students heard of radio s•°phy in their physics or chemistry c lasses. Their attitude show s that litt ie or nothing is Rein s d‹ane by the teachers to show theirs that radit•s••phy eotild be a wonderftil career to take tip. It is possih ie that career guidance counselors and educators e it her do not know’ ahotit this profession or that thej' know’ every I ittle abotit it. This is because the students are supposed to trade heard of it from them. Es en ifthey are aware ‹aftlie profession, it is obj i ous that they do not kn‹ais much about it. This may be the reason for most ofthe resp‹a ndents not deironstrati •s i n—depth knowledge oI the profession.

The results ofthis study sh‹av.'s that majority ofthe respondents' parents are v. elf educated. Althotiph these parents are well educated, it was also fotind that most of the resp‹a ndents do not relish to take after their parents' career. This wieans that the parents' acadeiiiie status and profession do not haste nitich effect tan their choice of career. Role models appear to lias’e influence on the career choice of these yoting people. Some of theirs would ss ant to take up the careers of their role models. It is pertinent to mate that verv few of the students have radi‹•s•»phers as their role model. This could be as a result of some of the detractors of radio s••phy profess ion identified in a pres' ious sttidv fry Eze et a I ‘. One of the detractors is poor societal recognition of radioprapliers which could be due t ta poor pro fe s s in nal trna ge oI radiographers’. This also could be a reason for most ‹at the students not has inn radi‹agraphers as their re Ie in ode 1s. Pract it in ners oI ct tier p r ofe s s i ta n s s tic h in e d ie i we , p li arniac y, engineerin s. n ursin s and teaching have inII hence on these young people in making their career choices. Eze ct al‘ had opined that lack of professional pride and confidence, poor dressin s habits and mannerism, and poor life sty let of practicing rudiographers ctatild discotirape a student from pursuing a career in radiography. RECOI¥I MENDATIONS: l.

Efforts should be tirade to improx' e public awareness of this professi‹a n especia I l y anion s y••••s people seeking admission into the fruit ersity to study iiiedicine or other courses allied to medicine. Radio s••phy is eg ual l y rew’ard in g a nd inte l l ect ua I l y stimulating as medicine and other medical related courses. Also, like i iiedicine and other allied liea l t li profess ions, it is concerned with earm s people and fulfill the requirements ofthose ss'h‹a se life peals are to pursue career concerned v. itli providin s c are for people.

2.

Forum to educate the public on effects of i onizing radiation and protection iiieasures taken tta pres ent there shtati ld be created. This is sta as to re—orientate them, since must of

i ‹/+a is.r..v

3.

4.

f.

therri have concluded that v.'orking v. ith i onizing radiation is like 'a suspended death sentence'. Radiograpliers should try and iinpr‹as e on their ptih I ie ima se. ln doing this, their mentorin s of younh [I€ople i\’ ho may want to pursue a career in radiography con Id become effectis'e. Radiographers should become more forceful and independent in their rework to be regarded as important members of the health care tears. Being forceful and independent means properly re s• l ating the profession and de finin s the duties and c‹aiiipetence expected ofradiographer. M‹are radi‹•s••phers shou Id studv for higher degrees like M Sc and Ph. D in other to attract the academic iiiinded yotin s• • rs to the profession. These prospectis e new entrants into radiography a'ou Id definitely not like t‹a have a stunted academic self—improvement. Vast iiiipros einent in acaderri ic status of Nigerian radio s••phers in the past one decade and half has redefined the practice radi‹agraphy in ltte country.

REFERENCEh l.

Utin CT. Professional ivm in radi‹•s•»phy: the IÜ1hé£1 äf1 eXQerience. X — rays: Journal of the Assoc iation of Radioprapliers of Nigeria 1993, 19 ( l ). 2 5—30.

2.

Brown A. Professionals under pressure: contextual in fl tiences on learning and dev elopment of radi0hfaphers in E •s land. Learning in Health and Social Care 2004; 3 (4): 2 13 —222.

Eze C. U. , Okaro A. O. , Ochie K. The attractors and detractors of radiography as a career ch‹aiee: a studv in Enugu Southeast Nigeria. American Journal of Scienti fic Research 20 10; 5: l 2— 17. Milbtirn P. The professional intake of radi‹agraphy. Radiography Todav 1992; f8 (660). 19— 20. Paltimho M. V. , Raiiihur B. , Me[ntosli B. , Natid S. Perceptions clan ideal career versus perceptions of six health careers. J. Allied Health 2005; 3 7: 8 - 1 5. tennie E. , Kirhy A. The career ‹at radiography: in format i ‹a n on the web. Journal of Diagnostic Radiography and Imaging 2006; 6: 25—33.

Rosettes J. C., Fotanp A. , Chan P.T. Attitudes of Heng Kong high school students tow’ards ntirsinp pr‹afession. Nurse Education T‹aday 1 999: 19 (6): 454—47 l . 10. Wilbtir H. D., Ex'an R.K. Attitude towards teachin s: how. high school students feel afront teaching as a profess ion. Journal of Teacher Education l 9é I : 12 (2): 1 55 — 17 l .

APPENDIX

SECTION A: PERSONAL DATA Name ofSchool:..

2

Age:...

3.

Gender:..

4.

Parents' highest education qualification:..

5.

Parents' occupation:..

6.

What is the occupation ofyour role model?.... SECTION B: (AWARENESS) Please tick (I) where appropriate.

7.

Have you heard ofradiography profession?

a) Yes

b) No

8.

Ifyes, when did you hear about it?....

9.

How did you hear about it? a) In a career talk. b) In the media. C)Through a radiographer I met. D) Others, explain

how... 10. What does a radiographer do in his/herjob?....

SECTION C: (ATTITUDE AND PERCEPTION) 11. Do you consider radiography a nice career to take up?

a) Yes

b) No

12. Would you like to become a radiographer in future?

a) Yes

b) No

13. If "NO", what alternative is your ideal career choice?

Below are eiateinents deecribing the attributes of radiography profeesion and radiographers. Mark(X) against the option that beat fits how you feel about eacb attribute. 41

14. [ ] Strongly agree ( ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly dis °s ree 15. Radiographers are highly respected in the s‹aciety. [ ] Strongly °sree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly dis °s ree

M‹aderii medicine cannot achieve much a itli otit radiography. lt is the eye ofmodern medical practice. [ ] Strongly agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly disagree

17. Radiograpliers are very drill rant people and i iiake use taftheir drain a lot.

18. Rad iograpliers work w it h high technology equipment. [ ] Strtangl v agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly disagree

19. [ ] Strongly agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly dis •sree

20. Radiograpliers are well paid and make a lot ofmoney.

21. Radiography career structure allow' ‹one to attain the highest level in the profession [ ] Strongly agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly disagree

22. Radiography has mans’ areas ofspecia I ization and radiopraphers can become specialists in their fields. [ ] Strongly agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly dis •sree 23.

24. Rad i ographers are w elf protected against radiation and work in a safe emimminent. [ ] Str‹a nglv agree [ ] Agree [ ] Uncertain [ ] Disagree r ] Strongly dis °sree 25. [ ] Str‹angly agree [ ] Agree [ ] Uncertain [ ] Disagree [ ] Strongly disagree

2G. On a ten po int scale heloss, rate your overall w i l lingness to take up radiogrnphj' as your first choice career. (L‹aw score means unw i I lin s ness and high score means wi I l in s• ess). IJnv'ilJingncss

THANKYOU!

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TRAINING AND SKILL ACQUISITION FOR MANPOWER DEVELOPMENT SOLONlON t.4DEBOL.*, Ph.D

INTRODUCTION The stihjeet of des elo i iient and training is one that has often heen i iiistindersto‹ad hv many indi s iduals and corporate h‹adies, employees and e nip I ‹Myers alike in heath t lie scre ice and manufacturing industrial sectors of the economic. One incli sputahle fact taf life is that the process of team ing is one reality of an indie ideal's life that

Egh tij i (2002 : 3 6 ) defined Tra ining a nd Dene l opirent as “a planned efftart to faci I itate empl‹ayee learning ‹at joh—re laced deltas i otirs in order to i iiipros e eiiiplovee perforiiianc e". N«’aochei 1 907), in his mean atteiiipt, defined

A sim ilar de Smitten offered hv the I ii stitttte of Personne I 1\4 anagement ofNi geria, as restated by Obikova 2002: 2 I ) runs thtts, "Trainin s '• the process of des eloping a s orkerfis know. ledge, s k i 11s, a nd att itude th re • s h in strtie I tonal demonstration, praet ice and alanned ex aetience to meet the present and ftittire neecls taf the Otis iness" The terms "training” and "deme I mrrent" are often ti sed interclianpeahlJ, and often in a confused iiianner. \Vli ile the tv. o words inaj neat exactly tire an the sauce thing. the diet inction hetis een their is not very clear, as they tend to overlap considerably. froth in ftse and in contextual meaning. I n the opini‹a n of Egg uji t 2005), while trainin s re l ates to t he ac qIt is it i on oI kn or' ie dye and skills for the purposes of an occupation or task. devel‹apiiient is concerned i iiore with changes in attit ttde, hehas in ur and employee potential than is itli i i iiiiiediate skill. For the sake of clarity I w'ould li i: e to define training as the "aeqttisition of kn‹ass ledge. in forirati‹a n and skill by an individtia I. throtiph eitliei a f‹arnial or an infori iial procedttre", vvli ile dev elopnient is descrihah ie as "the concern it ant res ult of trainin s v. hich manifests in the e nha n e e ment ‹a I i lie ind i s id u al 's in nate competence and competency, th us yie I ding higher dis idends in rtaduetis itv tow ard a desired goal”. These concepts haste been compressed in v. hat I ex ress as the Trainin s' Develtapnient Tree in figure I helm..

figure l he low.

THE I II PORTANCE OF TR.HNI NCi AND DEI'E TOPh4 ENT h4any ‹arganizati‹a ns see staff as a r=•’i •se fear empl‹ayees, rather than as a means tow ards des elopiiient for the organization. For such organizations, in the event of a c‹arporate eeonoiiiic downturn, the first subliead t‹a receive the s ledge haiiiiner in a hudget cut is the Staff Training Stidget. L nf‹a rtunately, such corporate S‹adied forget that today's competent employees may neat necessarily reinain competent toiiiorr‹asv, as skills are subject to deterioration, and often become obsolete w'ith truce. The need for training and des'eIopirent can not be overeirphasized. The numerous benefits a c‹arporate body can derive from training ofits staff, include the following: 1.

3.

It affords employ ees the ability tta achieve the corporate ta gset in quality and qtiantitv of prtadtiction.

Training he lps t‹a ensure ava i l ahi l ity ‹at human restatirces that are needed for

4.

5.

e‹arporate expansion into nets pr‹adtict lines, and t‹a adopt and adjust for advances in techn‹a l •sy Staff training and dev elopnient v. ill help to ensure a i iiore cost effect ice and efficient resource tisage for the organization. Staff training he I ps tta iriniiiiize rework errtars, and to reduce industrial accidents and their attendant individual and corporate legal and financial liabilities. Training u ill ustial I y enhance the values of the indis'idual staff in the labour market, thus enhancing li is/tier morale and performance. Training usually increases the is orkerfis x ersatility, hv is idening his expertise for refer ance es'en in otherjob functions. An organization that is reputed for proc idin s ptaod trainin s will attract and retain a shod quality workforce which v. ill eventually lead to an enhanced corporate image, coi porate productis'ity and a °•ser market share for its products and services. Staff trainin s w'i l l tie ually help to create a read i l y as ailahle pool of wotk force as rep l aeement fear aging or existing staff.

I DENTlFYfNCTHETRt

INCNEEDS

Staff trainin s often comes as a reacti‹a n to an exist ing situation throtiph tis o major a aproaches, the Reactive and the Proact ice approaches. The Reactis' e ap roach to training tries to identify and seek so I titions to current needs and pr‹ableiiis ‹at the organization. These problems may inc I ude res‹atirce ttsage is astage, I csv pr‹adtict quality, or es en inereas inn inc idents of indti sttial ace idents in the orpanizat ion. The Proacti e a aproaeh on the other hand, is an approach that is to ni ard I oo k i n p. sv h ere by t ra i n i n g i s e‹anducted in anticipation of ftittire needs fear the o rg a ni z at in n . F or e xample . t he ads e n t of coirptiterization has posed challenges to nianv c ta operate bead ie s to t ra in t lie ir sta If i n ••• ••r• •• •••se. 1 w i I I imagine even now. that e xpected ii e w de s e I ‹a pine nt in Rad ia t i ‹a n and Enraging medical pr‹acedures wi I l aI so necessitate the t ra in ing and retraining of iii emhers of this noble rofessi onal hody ‹at Radiographers and Radiologists.

Training needs can he identified at a coiiipanv' s three Ie tels, the organizational general fete I. the group or departmental les el, and the indie idtial staff let el. Usual teeliniqttes for the training needed identification are along the to l l owing forumat:—

In identifyin s training needs foi staff, and arranging to meet those needs. there is ttsttal ly a unit of the organization that is charged v. itli the resp‹a nsihi l ity. The size or compos i titan of an organization training department ss i I I every often s arv from one organization to an‹ather. The functions of the Training Eiepariment ss il I from ester, restrain the same, i.e. To cl ev elop stafffor organ izat nana I corporate grou’th. The staff train inn needs that have been identified, as specified ahose, can he categorized into t s o major dis isions and pro ups: hl iero and hl acre Training Needs. \\’hi ie II ie re tra ining needs are targeted at the indie idtia I is orker septic may need to improve perforiiiance by adapting into a new job description, a macro training need is often designed for the larger s•otip in the organization, due to changes in or projected product lines or standards. POSTTR lI NI N€: EVALUATION There is a general need to es altiate the impact taf a training programs. to errs urc that organizational se als are heinp rivet fry s uch training r••s•° •iiiies. Adent i (2002) recommended the foal low inn p‹ast tra ining ev al nation arocesses: 1.

2.

Determ inc the perf‹ariiiance ohjecti es based on the c urrent j oh descripti‹a n of the staff, and « hat lie is expected to he com aetent in, ttp‹a n the completion ofthe traini •r r••s•° iiiiie. Deteriiiine perforiiiance ind icat‹a rs, and ci iteria for measuring fruit cfsork per hour.

per dav, or per such fruit of permed that the ‹organization may ch‹aose. This i iiay eqtial lv include performance indicators like x chute of sales, amount cfsaate i iiaterial generated, etc. Data gatherin s *•• rmats and irechanisiiis should be des inned to capture feedback from training panic ipants. A11 rele v ant data collected should he analyzed and a forum I rep‹a rt presented on the trained staff.

5.

I I the need arises, frtvn the resttlt of the post— trainin s ••° l tiation, the training foriiiat, type, mode or place could he modified.

The training cycle, trot:i the c‹ancepti‹a n of train inn need to the post training es a l tiation can be simply portrayed thrtatigh the system trainin s and development iiiodel shown in fs• re 2 beloss :

Training Needs Assessiiient Instructional Objectis es

Transfer Validity

Post tra ining Ex aluatitan

Training

TO’PES ANDTECHNIQU ES OFTRAINING The s ari‹a ti s types ‹at training include the

I I. 5UPERVI hED ON-THE -JOB

TRt

INC

follow'in s:

K

! KDUCTlONTRt

lNC

lnducti‹a n training is an organized sy stei:i b

inte, and faini I iarize v. itli their v. ‹ork, new jets, ne u’ zoo le ef vv er k, ne is sc he d u les ef v.'ork, and new' v. ork colleapues. it is tisual ly a short terni fornial induet ion cereirony.

in the job perforrriance, and being s upers ised fry a whore experienced operator in the same job

I II OFF-THE-JOB TRAINI NCl This is carried clit with the employee attendin s ° training programme while be ink awav front the immediatejob environment ofthe eiiiploy er.

ID' F¢JIt51AL/£JPER.1TT 1’E TR tI h INR

settee are computer app I ications. lt is a condition method taf training sv lien and ss here h uiiian I is es and expensis e machineries are ins cfs ed. It is a fas orite niethtad fear initial training of a ir cia ft il ots and also in rad iotli era y alannin s

d)

JOB ROT.4TIO NS

in this case, a tra inee is made to mtas e from one jtah schedule to aiitather in the same organization. in this way, the trainee is proc ided ss it h a hroad spectrtii ii of experience on the v arious jet› schedules iii the organ ization. A t5 pical exam ale of ss here this method is applied is the Want:ing indtistrv. c)

.tPPRENTIC EfiH I PS

This is a commtan method of tra ining on the joh ss here a trainee is attached, or ap rcntieed, to an ex aerieneed hand in a artieti larj‹ah sc li edti ie. ft

I NTERNhHI P

This tta iii inn i iietliod iii v ‹al sues the attachment o f a ari qtia I i fied pr‹a fessitana I tta a refer ant institution of profess ional ctaiiipetence. so that he can be proc ided is ith an extensi s e aractiea I kn‹aw ledge and practice of ss fiat lie had earlier learnt m‹astly theoretica I l y. This is a condition form of training fresh pradtiates in the i iiedieal anal a I lied fields.

CONFEREKCES ANDSEIMNARS

h)

C.USE STUDIES

The choice of exotic training x enties. This can sometimes pushed—tip tra ining coasts unnecessari lv, is itlitatit addin s any x alue to know ledge gained. A training is orkshop fear wParkers in the supervisory operatic e cadre, scheduled for a 5 —star home I, for instance, is und‹atihtedly a financial ss aste or even recklessness fry the employ er. it is ads ised that such workshtap should be as oided. Manageiiient corrupt practices. There have been re orts of hackdoor dealin s where hv packages are del iherate I y over inn oiced, so as to at loss a margin offinancial returns as P/R for the Training Manager of the spoiisorin s •rpanization. S rich c‹arrtipt practices Patten lead to expensi v e costs. w ithout adding s altie to know.’ledge gained fry participants.

d)

Poor costing methods. Sometimes, training costs tias'e heen fixed arbitrarily hJ learning ‹atitfits and consultants, dtie to an application ‹af a poor coasting techniq ue. t3rdinarily, the cost of trainin s can be computed sinip IJ as to I lows:

CONCLLDlNC REMARKS

REFERENCE Adeoti K.O. (2002), “The lmpact of Training Methodologies on Organisational Corptarate Development”. Babcock Journal of Management and Social Sciences Vol. I No. 2. Eghtiij i J.O. (200f) "The Effect of Troinin s

€irou th” Sahcock Journal of »••s• ment and Socia I Sciences Vol. 3 No. 2. March 3.

C’ost per participant = feel € uui

Ve riah Ie € urt er e rtici ant

Velit liar i s » ft re re « tit fi

4.

Nu'ochei B.N. ( 1 997 l “fretting The Best Otit oI Yotir Training Bwidget”. .Iotirna I of Nigerian Institute ‹at Mana s• ment, Vaal. 33, No. l January — h4 arch Pg. 25 — 30.

5.

Ohil:ova J . O (2002) “The Foundation of Hmean Resource 1\4 anageirent” ljebu—ode, Piti s Debo (U i g1 Press.

The fixed cost here u'ill normally include the men ue, rental, awhile the variable coast will include cost of tea hreaks, and is orkshop materials.

CAhE REPORT

DIVERTICULAR DISEASE OF THE COLON PRESENTING WITH RECTAL BLEEDING IN AN ELDERLY AFRICAN: A CASE REPORT

OBJECTII'E: T‹a re—emphasize the role of raditalogical ex al uation in the diagnosis of di s ertictilar disease. RESUIT: Mtilt ip ie outptinehinp is ere seen in descendin s and sigmoid colon in dtatih ie ctantrast barium enemaa films CONCLU fi I ON : The i in porta nt rta le ef radi‹a l o s ical ex al uation in the diagnosis of di e ertictilar disease v.'as ctanfirired usino bariui n menta sttidy. Kcyss'ords:

Dis ertictil ar disease, li erniation, outpoticli inn, barium enema.

I RURHE, NK

I n the United States, dix erticu l ar disease taccurs frequently, especial I y amtanp e l derlv patients. One third of the general population develops dis erticti l ae bv the age of 45 years and two thirds fry the age 85 vears. The disease is considered to be a disease of the western u orld, and rare ain••s Africans' ‘. Though it has been increasin s ly reported in the Africans wlita listed in tirhan sites and those whoa once lived in the w estem wotld'. The disease increases w ith ape and rare in people less than 40vears." ' The pres alenee rate is 5 per 100,000 Africans awhile the studv d‹ane in I hadan show. ed pres'aI ence rate in Ui geria as 1.8 5fit’". This case is be ing reported hecatise the patient had rectal bleed inn and the c I inician suspected colorectal carcinoiiia but di v erticu l ar disease was dia s u sed after radiological es at nation. C.4S E REPORT

INTRODUCTION Dis'ertieular disease is a common disorder in the v.’estern wtend, 5 ct it w as not recognized as a pathological entity tintil the iiiid— 1 9th centtirv' The disease i iiay ins tale e any part of the pastr‹a intestioiial tract and typical I y acquired htit may he congenital. such as Meekel iliae dis ertictil tim ( rare)'. Divert iculae are lierniations of the irtictasa and shh notices a or the entire v.'a I I thickness through the mtiscularis mucosa as seen in congenital divertictil a. The sigmoid cc Ion is the most affected htawes er, dix ertic ular disease also can ins olx e the descending, ascendin s and trans erse colon as w elf as the jejunum, iletini and duodeii um.’

A t›3 —year—old African business exectitis e vx as referred to the surgical out patient tinit in L °s•* Uni v ersity Teaching Hospital (LATH) on account of abdominal pain, flatu l ence, weight loss, and hmod mixed w ith faeces and stvretimes passage of frank blood pei rectum, altered bowel habit with constipation a I ternatinp with diarrhea for over 9 mtantli s before resentati‹a n. He had heen on different i nedicati‹a ns including herbs ( local concortion) without satisfactory result. He presented ss itli nausea and x oiiiitinp and a sttdden bottt of bltaody stool, he then went to his coiiipanv' s clinic where he was referred tta LUTH. Before presentatitan at LATH he had to o whore episodes of bloody sto‹al, he d‹aes neat smoke btit drini:s a l etaliol moderately and eats in restaurants regularly, he is ssell trade fled and eats a lot of

Clinical examination mvealed an elderly, anxious looking man, not pale nor dehydrated, without peripheral lymaphadenopathy. Pulse rate was 78/min, blood pressure was 140/fi0 mmHg.

There was vague tenderness on abdominal examination, the abdomen moved with respiration and there was no abdominal mass felt. Rectal examination showed normal rectal mucosa and anal orifice. The gloved finger was stained

with bloody stoot, other systems were essentially normal. A provisional diagnosis of colorectal carcinoma was made. Apart from the PCV which was 28% other blood parameters were within normal limits, however there was occult blood in the stool. The ultrasound examination report was normal. The double contrast barium enema showed multiple rounded out pouching from the walls of the large bowel, mainly in the sigmoid and descending colon (Figs. 1 &2). Adiagnosis of diverticulai disease of the colon was then made. Patient was then managed conservatively and he improved clinically overtime.

DISCUSSION Diverticular disease of the colon is common in developed countries, prnbably due to diets poor in fibre ,. The disease that was previously believed to be rare among Africans is now an emerging disease entity in many areas of African tropics ”"'. The precise etiology of the disease is unknown however there are some theories, one of them is that high intraluminal pressure and aweak colonic wall at the sites of nutrient vessel penetration into the mzecuIcis may lead to hemiation. The condition also may be caused by abnormal colonic motility, defective muscular structure, defects in collagen consistency (i.e. increased cross-linking of collagen), and aging*’*"

Diverticular disease is asymptomatic in most cases though the disease is usually discovered as an incidental finding in most patients . The symptomatic patient commonly presents with abdominal pain, altered bowel habit and rectal bleeding. There is usually hisKiry oflow fibre diet. In the reported case the patient complained of abdominal pain, rectal bleeding and gloved finger was stained with bloody stool. Studies shows that rectal bleeding is the main presenting feature of

diverticular disease of the colon in blacks, bleeding was a major feature in the reposed case. Other symptoms may include, nausea, vomiting, constipation, diarrhéa, teilesmus, symptoms could also be associated with complications e.g. 2 fever, dysuria and vaginal discharge & 1 Figure I : Ba— Enema study - oblique v iew showJng mu Itiple colonic oucpunc hi 1t 8 I +h i£e 8fY0W9).

Pig u ze 2: Ba-Enema study { posc evac uation) AP view show ing muiti pie outpunch ing in the r igmoJd and descending colon (artows]

f4lgerlao Journal of hfedJeal latagtng aad Radiation Tberaj›j'

Diagnosis of diverticular disease is entirely radiological with double contract barium enema, diverticula appear as flask like or round outpunching from the bowel walls. Similar appearance was seen in the barium enema films of the reported case. The muscular change in the sigmoid colon, produces the concertina like or serrated appearance of the affected area. Other imaging studies that could be done are computed tomography, colonography, ultrasonography and magnetic resonance imaging.' Diveriicular disease predominantly affects the sigmoid colon and descending colon sn the western world and At?ic 2 l2

Vol. I ?4o. 3. November E6t2

Oirojola M.F., Man se e E: Div erticu la of the colon in three Nigerian siblin s° . Trop €ieogr Med. 1955: 40( l ): 54—5 7. +s•nbiyi O.A: Divertictilar disease of the colon in lbadan, Nigeria. Afr I Med Sci. 1959: I 8(4): 24 1-244. *Complications such an dis’eriiculitis, pericol ic abscess, perforation, color esicular fistula and peritonitis can occtir. Patient is tisual l y mana sed c‹anservatis'eI y with diet and drugs as it is with the reported case and ifthere is comp fixation, surgical intervention tray be required. REFERENCEii

2.

4.

Madiba T. E. , Mokoena T: Pattern of diverticular disease among Africans. East Afri Med J. 1994; 7 1( 10 l: 644—546. 9.

Bernades P: (natural history of divertictilar disease of the colon) Ann €iastroenterol Hepatol (Paris). 1956; 22(4 l: 209-2 11.

Jones D.I: ABC of colorectal disease. Div erticular disease. Brit. Med. J. 1992 30; 304(6839): I 435- 143 7.

10. McCarthy D.W, Bumpers H. L., Hoover E. L: Etio l ogy of dis ertictilar disease w’ith classic usually illustrations. I Nat I MedAssoc. 1995; 88(6). 389 3 90.

McCarthy D.W., Bumpers H. L., Hcover E. L: Etiology ‹af dis ertictilar disease v.’ith classic illustrations. I Natl Med Assoc. 1906; SS(6): 359-3 90.

Mokoena T. , Madiba T.E: Haemorrhage — the main presenting feature of dis ertictilar disease of the colon in blacks. S. Afr Med J. 1994: 84(2): 83-5 f .

Place R.J., Simmang C. Y: Dic eriic ular disease. Best Pract Res Clin Gastroenterol. 2002: 1 6( l ): 1 3 f- 138.

12. Segal 1., Solomon A., Htint I.A: Emergence of dis ertictilar disease in the urban South African black. Ciastroenterology. 19 7 7; 72(2): 2 l 1-2 19.

Painter N.S: Diverticular disease of the colon. The first of the 4’estern diseases shea n to be due to a deficiency of dietary fibre. S Afr lVl ed J . 1982; 6 I (25): 10 116— 10120. [hekwaba F.N: Diverticular disease of the colon in black Africa. I R Col l Surg Edinb. 1992: 3 7(2): 107— 109.

13. Stipihara K. , Mtito T. , Morioka Y. , Asano A. , Yamamot‹a T: Dis'eriicular disease of the co lon in Japan. A res'iew of 6 1 5 cases. Dit Colon Rectum. 1984: 2 7(8): 531 —f3 7. 14. Boxa J .G, Hopens T. A, €loldstein H.M: Diverticulitis of the ri s ht co lon. Dit Dis Sci. 1954: 29(2): l 50-155.