Ionising radiation is a modality used in diagnostic and therapeutic medicine. The technology has improved and resulted in lower dose exposure but there has been an escalation in the quantity of procedures, their duration and complexity. These factors have meant increased occupational radiation exposure for interventionalists. Ionising radiation exposure can have detrimental health effects and includes radiation skin burns, various carcinomas, genetic and chromosomal aberrations and cataractogenesis of the lenses of the eye. The lenses of the eye are of the most radiosensitive organs and the risk of cataracts is high despite low radiation dose exposures. The use of personal protective equipment (PPE) is a method that can be used to mitigate the risk for developing lens opacifications. The consistent and effective utilisation of PPE is marred by availability, proper fit and ease of use when performing procedures. Radiation safety training is imperative to enforce a culture of radiation safety among interventionalists. The aim of this study was to quantify and describe cataracts among South African interventionalists and to understand their radiation safety practices. For this purpose, a cross sectional study was designed using multiple methods. A survey was conducted to determine the demographics and the risk factors of doctors exposed to radiation to doctors not exposed. The radiation workload and radiation safety practices of interventionalists were explored. Both groups had slit lamp examinations. The data were analysed analytically and a regression model developed looking at the outcomes and the risk factors. Qualitative in-depth interviews and group interviews were conducted to explore the perceptions of interventionalists regarding radiation safety. Deductive and inductive thematic analysis was done. Interdisciplinary research is challenging but offers tremendous opportunity for exploring and tackling complex issues related to securing a safe radiation work environment.

Background: Ionising radiation (IR) is an occupational hazard for interventionalists. Dry eye syndrome may develop. There may be damage to the corneal epithelium, causing irritation and ulceration. Radiation-induced cataracts commonly develop in the posterior sub-capsular (PSC) region of the lens and are more common in the left eye. Aim:The aim of this study was to describe the ophthalmological findings in South African interventionalists occupationally exposed to IR.Setting: This study was conducted in South Africa. Methods:A prospective cross-sectional study was conducted. Interventional radiologists ( 25), adult cardiologists (42) and paediatric cardiologists (31) were recruited at conferences and included in the study. Convenience sampling was used. Participants completed a survey that collected data on their demographics, their cataract risk factors and co-morbid diseases, their occupational history, their radiation safety practices and their training in occupational history. Participants' eyes were examined using a slit lamp after dilation of the eyes. Ethics clearance was obtained and each participant gave informed consent. A descriptive analysis was done. Results:The median age of the 98 interventionalists screened was 43.5 years. They worked with radiation for a median of 7.5 years. Cataracts occurred in the left eye of 17 (17.3%) participants and in the right eye of nine (9.2%). There were five (5.1%) PSC cataracts in the left eye and one (1%) in the right eye. The vitreous was abnormal in 19.4% of participants. The tear break-up time was abnormal in 48% of participants. Conclusion:Ionising radiation is an occupational hazard posing a risk to interventionalists' eyes. They are at increased risk of cataracts and dry eye syndrome, which can affect their occupational performance and quality of life. Education can positively influence the radiation safety practices of interventionalists that could reduce the detrimental effects of IR on their eyes.

Contents 1. Introduction 2. Aim 3. Review of literature 3.1 Bureaucratic context 3.2 Typical human issues 3.3 Towards a theoretical model 4. Research design and methodology 4.1 Questionnaire design and validation 4.2 Measurement issues 4.3 Data collection 5. Results 5.1 User categorization 5.2 User attitudes 5.3 User perceptions 5.4 Users' opinion of the questionnaire 6. Discussion 7. Conclusion 8. References 9. Appendix A

Background: Occupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes.Objectives: This study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors.Method: A cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3.Results: The study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance.Conclusion: The findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting.Contribution: The research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.

Any situation on the brink of change requires guides to assist in navigating such a new shared social space. Journalism is one such form of guidance. However, just as societal conditions are constantly in flux, so are the conditions under which journalism is practised. This is particularly true for the current generation of journalists with the lines between mainstream and alternative forms of journalism almost completely obscured. While the journalistic landscape is fluid, lessons for navigating this world can be found in the work of journalists from previous eras. This article places the work of South African journalist Nat Nakasa, a member of the 1960s Drum Generation, in conversation with the ideas of existentialism to further an understanding of existentialism in a South African context, and for South African journalism. This is achieved by identifying themes in Nakasa's work and linking these to some of the ideas of existentialism. The article argues that maintaining a public sphere within a democratic society requires a media sphere with space for mainstream and unconventional journalism. At the hand of an analysis of Nakasa's work, the article presents a possibility of how unconventional journalism can be a vital element to a pluralistic media environment and to guide society through any period of change.