Children with CHDs are exposed to ionising radiation during diagnostic and interventional cardiac catheterisation procedures. Data regarding radiation doses a child is exposed to during these procedures are scarce. We aimed to investigate the radiation dose and other related parameters for paediatric cardiac catheterisation and propose these as local reference levels.

We collected radiation exposure data for all diagnostic and interventional cardiac catheterisation cases (excluding electrophysiology procedures) utilising fluoroscopy at “Anonymized for review” between January 1, 2021 and November 30, 2021. Direct measures of radiation usage, i.e. fluoroscopy time, dose-area product value, and air kerma, were reported for each case by the INNOVA 2100 manufactured by Wipro GE Healthcare. The absorbed radiation dose was measured using a Bhabha Atomic Research Centre dosimeter, which was placed directly on the patients’ chests. Differences in measures of radiation exposure across procedural and interventional types were tested using the normality of continuous data by Kolmogorov–Smirnov test. Spearman’s correlation coefficient was calculated when the data violated normality.

The overall median dose-area product, fluoroscopy time, air kerma, and absorbed dose measured using a Bhabha Atomic Research Centre dosimeter were 300 mg.m2, 10.5 mins, 37 mGy, and 2.4 mSv, respectively. We have further categorised the median exposure parameters into 5 age groups and propose them as local dose reference levels. There was a strong correlation between fluoroscopy time with the absorbed radiation dose (Rho = 0.942). Fluoroscopy time showed fair correlation with air kerma (Rho = 0.65) and dose-area product (Rho = 0.59). Absorbed radiation dose showed fair correlation with dose-area product ( Rho = 0.56).

Fluoroscopy time alone is not a sufficient metric to monitor radiation exposure. Even when fluoroscopy times were comparable, air kerma and dose-area product levels were quite different. Therefore, the local dose reference levels proposed can be used as a benchmark for future studies aimed at process optimisation and further reducing the radiation exposure in paediatric patients.

This study aimed to compare long-term audiological outcomes of diode laser stapedotomy, microdrill stapedotomy and combined potassium titanyl phosphate laser–microdrill stapedotomy, and to identify predictors of surgical success.

Surgical, audiological and complications data were collected. Surgical success was analysed via the measurement of post-operative air–bone gap, air conduction gain.

A total of 615 patients were included; median follow-up was 16 months (range 1–1319). Overall, the 94.3 per cent achieved surgical success (air–bone gap < 15 dB). Median air–bone gap closure was 5 dB (interquartile range: 2.50–8.12), and median air conduction gain was 27.5dB (interquartile range: 19.37–36.25).

Compared across techniques, success rates were similar; however, post-operative air–bone gap was significantly better with laser techniques than with microdrill alone (p = 0.016). Longer prostheses were associated with improved outcomes.

All the examined techniques showed excellent audiological results. Laser use was associated with better post-operative air–bone gap than stapedotomy with microdrill only.

Early placement of a ventricular access device (VAD) in premature post-hemorrhagic ventricular dilatation based on ventricular size criteria, coupled with an aggressive tapping regimen to control ventricular size, may improve developmental outcomes. As this treatment paradigm represents a significant departure from traditional care, we present results of an institutional quality improvement protocol implementation study focusing on safety and resource use for those seeking to implement a similar care pathway.

Infants treated under the new ventricular size-driven protocol were retrospectively compared to a historical cohort managed according to clinical symptomatology. Process and compliance measures related to protocol implementation were tracked, as were complications and measures of resource use.

Ventricular access device (VAD) placement occurred earlier and at a smaller ventricle size, but beyond the protocol-mandated timeframe. Although more resource-intensive than customary care, compliance with protocol-directed screening ultrasounds and VAD aspirations by trained clinicians was high. Intensive ultrasound surveillance altered the management of only one infant during their treatment course. An increased rate of complications related to earlier and more aggressive treatment in these fragile infants was not observed.

Protocol compliance was satisfactory and no safety issues were noted. Although VAD placement occurred sooner, a majority of infants received intervention outside of the mandated timeframe and at a ventricular size above the desired intervention threshold. Minimizing transfer delays from peripheral neonatal intensive care units and improving access to the operating room were identified as areas for improvement. It appears possible to decrease the frequency of ultrasound surveillance without compromising safety.

Community crime against older people is of increasing concern but the relationship between safety-seeking behaviours and continued psychological distress has not been examined. As existing assessment tools have limited validity, we aimed to investigate this by designing a novel person-reported safety-seeking behaviour measure (PRSBM) and conducting preliminary evaluation of its wider applicability.

We collected mixed-methods data from n=100 initially distressed older victims at 3 months post-crime, using the PRSBM. This asked older victims how often they engaged in six behaviours (checking, reassurance-seeking, rumination, avoidance, rituals, hypervigilance), what these were, how often, and how much they had changed since the crime. We measured continued distress using the two-item General Anxiety Disorder and Patient Health Questionnaires. We analysed qualitative behaviour data using codebook thematic analysis, quantitative data on behaviour frequency and change using logistic regression adjusted for gender, age and crime type, and explored the PRSBM psychometric structure using unique variable analysis.

Older victims reported a wide range of safety-seeking behaviours conceptually consistent with their experiences. Some were highly restrictive; others may help maintain independence. The frequency of checking, avoidance, and hypervigilance, and a change in avoidance, were most strongly associated with continued distress. The PRSBM was acceptable, comprehensive, and captured differences and commonalities in safety-seeking.

As older victims identified as avoidant appear at risk of losing their independence, referral for treatment is recommended. The PRSBM appears promising as a research and clinical tool in a range of settings, suggesting further testing in different populations would be worthwhile.

Due to frailty, chronic health issues, limited mobility, dependence on assistive devices, and polypharmacy, the geriatric population is more susceptible to the adverse effects of earthquakes. The aim of this study was to determine the factors affecting the quality of life of older adults who experienced the Kahramanmaraş-centered earthquakes in Türkiye on February 6, 2023.

This cross-sectional interview-based study was conducted with 340 older adults who experienced the earthquakes on February 6, 2023, and visited outpatient departments in Gaziantep. Data were gathered using a demographic form, Modified Fried Frailty Index, and WHO Quality of Life Instrument for Older Adults.

Participants’ average age was 71.37 ± 6.56 years, and 56.6% were women. Among them, 20.9% lost a first-degree relative, 15.3% were injured, and 45.3% were displaced. WHOQOL-OLD scores differed significantly by age, marital status, education, chronic illness, polypharmacy, living arrangements, and frailty.

This study highlights the factors influencing the quality of life of older adults in Türkiye after an earthquake. Living with a spouse and having primary or secondary education improved quality of life, while chronic illnesses and displacement had negative impacts. These findings emphasize the importance of considering the specific needs of older adults in disaster preparedness and response.