Exploring the research domain of consultant practice: Perceptions and opinions of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice. Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question. Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload. Conclusion: Research is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain. This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work routinely. • Consultant radiographers allocate little protected time for research due to clinical demands. • Almost half of the consultant radiographers feel research should not be a core part of their roles.

Assessment of radiation protection practices among radiographers in Lagos, Nigeria.

Science.gov (United States)

Eze, Cletus Uche; Abonyi, Livinus Chibuzo; Njoku, Jerome; Irurhe, Nicholas Kayode; Olowu, Oluwabola

2013-11-01

Use of ionising radiation in diagnostic radiography could lead to hazards such as somatic and genetic damages. Compliance to safe work and radiation protection practices could mitigate such risks. The aim of the study was to assess the knowledge and radiation protection practices among radiographers in Lagos, Nigeria. The study was a prospective cross sectional survey. Convenience sampling technique was used to select four x-ray diagnostic centres in four tertiary hospitals in Lagos metropolis. Data were analysed with Epi- info software, version 3.5.1. Average score on assessment of knowledge was 73%. Most modern radiation protection instruments were lacking in all the centres studied. Application of shielding devices such as gonad shield for protection was neglected mostly in government hospitals. Most x-ray machines were quite old and evidence of quality assurance tests performed on such machines were lacking. Radiographers within Lagos metropolis showed an excellent knowledge of radiation protection within the study period. Adherence to radiation protection practices among radiographers in Lagos metropolis during the period studied was, however, poor. Radiographers in Lagos, Nigeria should embrace current trends in radiation protection and make more concerted efforts to apply their knowledge in protecting themselves and patients from harmful effects of ionising radiation.

European radiographers' challenges from mammography education and clinical practice - an integrative review.

Science.gov (United States)

Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

2017-06-01

This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Exploring the research domain of consultant practice: Experiences of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim of the overall study was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This second part of the study involved telephone interviews with twenty five consultant radiographers. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers. The principal barriers revealed were: lack of time; excessive clinical workload; lack of skills and confidence to undertake research; poor research culture; and lack of support. The main facilitators noted were: dedicated time, research training and up-skilling; mutually beneficial collaborations; managerial understanding of the research domain of the role; and research focussed on clinical demand. Conclusion: Fulfilling the clinical role is imperative and integral to the profession at consultant level; however, if it is undertaken to the detriment of the other domains then these practitioners may not be operating at ‘consultant’ level. Overall improvements must be made to ensure that the consultant radiographer role is delivering on current expectations and is safeguarded for the future of the next generation of radiographers. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work regularly. • Consultant radiographers allocate little protected time for research due to clinical demands.

Ultrasonic and radiographic evaluation of advanced aerospace materials: Ceramic composites

Science.gov (United States)

Generazio, Edward R.

1990-01-01

Two conventional nondestructive evaluation techniques were used to evaluate advanced ceramic composite materials. It was shown that neither ultrasonic C-scan nor radiographic imaging can individually provide sufficient data for an accurate nondestructive evaluation. Both ultrasonic C-scan and conventional radiographic imaging are required for preliminary evaluation of these complex systems. The material variations that were identified by these two techniques are porosity, delaminations, bond quality between laminae, fiber alignment, fiber registration, fiber parallelism, and processing density flaws. The degree of bonding between fiber and matrix cannot be determined by either of these methods. An alternative ultrasonic technique, angular power spectrum scanning (APSS) is recommended for quantification of this interfacial bond.

Armor Possibilities and Radiographic Blur Reduction for The Advanced Hydrotest Facility

International Nuclear Information System (INIS)

Hackett, M

2001-01-01

Currently at Lawrence Livermore National Laboratory (LLNL) a composite firing vessel is under development for the Advanced Hydrotest Facility (AHF) to study high explosives. This vessel requires a shrapnel mitigating layer to protect the vessel during experiments. The primary purpose of this layer is to protect the vessel, yet the material must be transparent to proton radiographs. Presented here are methods available to collect data needed before selection, along with a comparison tool developed to aid in choosing a material that offers the best of ballistic protection while allowing for clear radiographs

Radiographic changes of TMJ components with an advancement of TMJ internal derangement

International Nuclear Information System (INIS)

Kurita, Hiroshi

2006-01-01

Internal derangement (ID) of the temporomandibular joint (TMJ) relates to a mechanical and anatomical disturbance interfering with the smooth joint function. The ID usually develops in a benign and self-limiting fashion and does not always lead to progressing disorders. Radiographically visible degenerative changes occur with advancement of ID. It is thought that most of these changes closely correlate with the self-limiting nature of ID. In this report, a variety of radiographically visible degenerative changes were shown to develop with advancing ID. These changes, including a total and more anterior displacement of the TMJ disk, deviations in configuration of the TMJ disk, resorption of lateral pole of TMJ condyle, regression in horizontal size of the TMJ condyle, and flattening of the articular eminence, developed reflecting each other and might play an important role in an improvement of clinical signs and symptoms in the long run. It is also suggested that most of the acute and destructive radiographically visible degenerative changes were arrested or slowed in those patients whose symptoms and signs were successfully resolved or reduced. (author)

Characterization Of The Advanced Radiographic Capability Front End On NIF

International Nuclear Information System (INIS)

Haefner, C.; Heebner, J.; Dawson, J.; Fochs, S.; Shverdin, M.; Crane, J.K.; Kanz, V.K.; Halpin, J.; Phan, H.; Sigurdsson, R.; Brewer, W.; Britten, J.; Brunton, G.; Clark, W.; Messerly, M.J.; Nissen, J.D.; Nguyen, H.; Shaw, B.; Hackel, R.; Hermann, M.; Tietbohl, G.; Siders, C.W.; Barty, C.J.

2009-01-01

We have characterized the Advanced Radiographic Capability injection laser system and demonstrated that it meets performance requirements for upcoming National Ignition Facility fusion experiments. Pulse compression was achieved with a scaled down replica of the meter-scale grating ARC compressor and sub-ps pulse duration was demonstrated at the Joule-level

Radiographers' performance in chest X-ray interpretation: the Nigerian experience

Science.gov (United States)

Egbe, N O; Akpan, B E

2015-01-01

Objective: To assess the performance of Nigerian radiographers in interpretation of plain chest radiographs and to assess whether age, years since qualification and sector of practice are associated with performance. Methods: A test set of 50 radiographs containing 23 cases with no pathology (normal) and 27 abnormal cases (cardiopulmonary conditions) independently confirmed by 3 radiologists were presented to 51 radiographers in a random order. Readers independently evaluated radiographs for absence or presence of disease and stated the location, radiographic features and diagnosis. Readers self-reported their age, years since qualification and sector of practice. Receiver operating characteristic was used to assess the performance. Mann–Whitney U test was used to assess whether age, years since qualification and sector of practice were associated with performance. Results: Mean location sensitivity was 88.9 [95% confidence interval (CI), 0.787–0.980]. Mean sensitivity and specificity were 76.9 (95% CI, 0.658–0.864) and 79.8 (95% CI, 0.658–0.864), respectively. Age was not associated with performance (p = 0.07). Number of years qualified as radiographer (p = 0.005) and private practice (p = 0.004) were positively associated with performance. Conclusion: Nigerian radiographers can correctly report chest radiographs to a reasonable standard, and performance is associated with number of years since qualification and the sector of practice. Advances in knowledge: There are less than 300 radiologists serving a Nigerian population of about 170 million; therefore, X-ray interpretation by radiographers deserves consideration. Nigerian radiographers have potential to interpret chest X-ray in the clinical setting, and this may significantly improve radiology service delivery in this region. PMID:25966290

Formative feedback in the clinical practice setting: What are the perceptions of student radiographers?

International Nuclear Information System (INIS)

Fowler, P.; Wilford, B.

2016-01-01

The role of feedback to a learner's development has been well established. There is an absence of studies relating to student radiographers experience of gaining and applying formative feedback. This study investigated processes involved in gaining written formative feedback in the clinical practice setting as well as the impact feedback had on student radiographers learning. The data was collected from radiography students at two higher education institutions by electronic questionnaire comprising scaled and open questions. There was a response rate of 37% (n = 103/279). Scaled data was analysed using inferential statistics and the qualitative data helped explain the findings. The majority of students recognised radiographers were frequently busy; resulting in feedback that is generic and not always timely. There is strength of opinion 82.6% (n = 85/103) that student radiographers do not work with any one radiographer consistently enough to enable the provision of constructive and meaningful feedback. There appears to be difficulty in obtaining the comments but the evidence shows they are valued. The majority of students seek feedback that is specific and will clearly identify areas for development. They reflect on feedback as well as use self-criticism of their practice performance indicating the development of autonomous skills. The challenge of enabling consistent one to one working with radiographers, the need to maximise a learning culture within practice environments and ensuring full engagement by radiographers and students could be addressed by modification of the feedback system, a working group being formed from students, supervising radiographers and academic tutors. - Highlights: • Students value constructive criticism and on-going verbal feedback. • Written feedback is not always easy to obtain because of pressures on staff time. • Student radiographers are rarely able to work consistently with the same person. • Student and mentor

Case study: Solitary intra-cystic papilloma - Advances in consultant radiographic practitioner led ultrasound guided mammotome excisional biopsy

International Nuclear Information System (INIS)

Lawson, Sarah

2008-01-01

Working practices in Breast Radiology have changed and advanced in the past few years, resulting in an increase in the number of small, indeterminate, non-palpable breast lesions detected. One such lesion is the breast papillary lesion which is essentially an epithelial proliferation with an associate increased risk of breast carcinoma. The current management of an intra-cystic breast papilloma diagnosed by 14 g core biopsy is highly contentious as traditionally management is by surgical biopsy. Recent advances have demonstrated that excision by 8 or 11-gauge Ultrasound guided Mammotomy can be a safe alternative, allowing non-operative removal. The consultant radiographic practitioner role has been integral in establishing the policies needed to support and establish ultrasound guided Mammotome excisional biopsy

Do general radiographic examinations resemble a person-centred environment?

International Nuclear Information System (INIS)

Hayre, C.M.; Blackman, S.; Eyden, A.

2016-01-01

Aim and objective: It is argued whether general radiographic examinations adhere to a person-centred approach within the direct digital radiography (DDR) environment. General radiographic examinations continue to increase and constitute approximately 90% of all examinations undertaken in the clinical environment. This study explored the potential impact patients experience whilst undergoing general imaging examinations. Method: An ethnographic methodology provided insight of two general radiography environments in the United Kingdom (UK) using participant observation and semi-structured interviews. Findings: The findings highlighted an ‘in and out’ culture whereby patients are ‘hurried’ and ‘rushed’ out of X-ray rooms in response to increasing time pressures experienced by diagnostic radiographers. In addition, this study challenged that patients may begin to rank ‘speed’ and ‘waiting times’ above other elements of radiographic care thus presenting new challenges for radiographers within the clinical environment. Conclusion: It is asserted that radiographers should remain holistic healthcare professionals and not begin to resemble operators on the production line. Further, it challenges whether patients are beginning to rank aspects of radiographic care within contemporary practices. Advances in knowledge: Few studies have explored the radiographer–patient relationship within the DDR environment, yet this study provides insight of person-centred practices within contemporary practices. - Highlights: • Challenges whether the use of DDR conforms to a person-centred approach. • Challenges whether radiographers are ‘treating patients as persons’ using DDR. • Patients may begin to rank ‘speed’ and ‘waiting times’ above other aspects of radiographic care.

Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

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Guilherme dos Santos Trento

2015-12-01

Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

Cervical spine trauma radiographs: Swimmers and supine obliques; an exploration of current practice

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Fell, Michael, E-mail: michael.fell@mkgeneral.nhs.u [Milton Keynes General Hospital, Radiology Standing Way, Eaglestone, Milton Keynes, Buckinghamshire MK6 5LD (United Kingdom)

2011-02-15

The study objectives were: to investigate current cervical spine radiographic imaging practices in conscious adult patients with suspected neck injury; reasons behind variation and consideration of dose estimates were explored. Comparison with a previous survey has been made. Questionnaires were sent to superintendent radiographers responsible for accident and emergency X-ray departments in English trusts with over 8500 emergency admissions per year, with a response rate of 97% (n = 181/186). Departmental cervical spine imaging protocols were reported by 82% of respondents. None use fewer than the three standard projections; if the cervicothoracic junction (C7/T1), is not adequately demonstrated 87% use swimmers projections, 9% supine obliques, 3% CT alone. Following projectional radiography, 97% perform CT. A significant (p = 0.018) increase was found since 1999 in CT use once the swimmers projection fails; fewer now use obliques at this point, continuing with CT instead. No significant difference (p = 0.644) was found in choice of first supplementary radiographs; despite British Trauma Society's recommendation to undertake supine obliques, swimmers remain the most widespread technique. An 85% response rate (n = 103/121) completed a second questionnaire, exploring reasons behind the various practices. Several reported a perceived difficulty in interpreting oblique radiographs, some a concern over high dose of the swimmers. Numerous issues affect the acquisition of cervical spine radiographs. Patient radiation dose should be a major consideration in selection of technique. A potential need for training in interpretation of obliques is highlighted. Specific guidelines for optimum projections should be researched, and protocols issued to ensure best practice.

The radiographer's professional role in practical aspects of radiation protection

International Nuclear Information System (INIS)

Shrimpton, J.A.

1995-01-01

The subjects discussed were qualified radiographer definition, unnecessary x-rays exposure in x-rays examination and it's contribution in radiation protection practices, the improvement in procedures, and reviews of booklet called 'making the best use of a Dept of Clinical Radiology, UK

Reporting by radiographers: a policy and practice guide

International Nuclear Information System (INIS)

Paterson, Audrey M.; Price, Richard C.; Thomas, Adrian; Nuttall, Lorraine

2004-01-01

Reporting by radiographers and other non-medical staff has developed considerably in the past decade, and especially so since the College of Radiographers published its vision paper on reporting by radiographers, in 1997. It was felt necessary, therefore, to develop guidance to assist radiographers and others undertaking radiographic reporting. The guidance provided includes guidance on planning and implementing a reporting service using reporting radiographers; the education, continuing education and support required by reporting radiographers; quality and standards related to reporting; and the nature of a report. Broader issues that will need to be addressed as reporting by radiographers becomes the norm are also raised

Assessment of radiation protection practices among radiographers in Lagos, Nigeria

OpenAIRE

Eze, Cletus Uche; Abonyi, Livinus Chibuzo; Njoku, Jerome; Irurhe, Nicholas Kayode; Olowu, Oluwabola

2013-01-01

Background: Use of ionising radiation in diagnostic radiography could lead to hazards such as somatic and genetic damages. Compliance to safe work and radiation protection practices could mitigate such risks. The aim of the study was to assess the knowledge and radiation protection practices among radiographers in Lagos, Nigeria. Materials and Methods: The study was a prospective cross sectional survey. Convenience sampling technique was used to select four x-ray diagnostic centres in four te...

Advanced radiographic scanning, enhancement and electronic data storage

International Nuclear Information System (INIS)

Savoie, C.; Rivest, D.

2003-01-01

It is a well-known fact that radiographs deteriorate with time. Substantial cost is attributed to cataloguing and storage. To eliminate deterioration issues and save time retrieving radiographs, laser scanning techniques were developed in conjunction with viewing and enhancement software. This will allow radiographs to be successfully scanned and stored electronically for future reference. Todays radiographic laser scanners are capable Qf capturing images with an optical density of up to 4.1 at 256 grey levels and resolutions up to 4096 pixels per line. An industrial software interface was developed for the nondestructive testing industry so that, certain parameters such as scan resolution, number of scans, file format and location to be saved could be adjusted as needed. Once the radiographs have been scanned, the tiff images are stored, or retrieved into Radiance software (developed by Rivest Technologies Inc.), which will help to properly interpret the radiographs. Radiance was developed to allow the user to quickly view the radiographs correctness or enhance its defects for comparison and future evaluation. Radiance also allows the user to zoom, measure and annotate areas of interest. Physical cost associated with cataloguing, storing and retrieving radiographs can be eliminated. You can now successfully retrieve and view your radiographs from CD media or dedicated hard drive at will. For continuous searches and/or field access, dedicated hard drives controlled by a server would be the media of choice. All scanned radiographs will be archived to CD media (CD-R). Laser scanning with a proper acquisition interface and easy to use viewing software will permit a qualified user to identify areas of interest and share this information with his/her colleagues via e-mail or web data access. (author)

Can Australian radiographers assess screening mammograms accurately? First stage results from a four year prospective study

International Nuclear Information System (INIS)

Moran, S.; Warren-Forward, H.

2016-01-01

Introduction: Globally, the role of the radiographer is changing; some countries have developed advanced roles with specific scopes of practice. Other countries, like Australia, are in the process of this change. The aim of this research is to assess the diagnostic outcomes reported by the radiographers and compare them to those reported by current screen readers. Method: Six experienced radiographers were invited to participate in a prospective study conducted between 2010 and 2011. They were required to read 2000 mammograms each. Their results were compared with those of the radiologists. Statistical analysis of the results included overall cancer detection rates, recall rates, levels of agreement, kappa, sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results: A total of 9348 women were included in the study. The percentage of cancers detected by the radiographers ranged from 53% to 100% of the cancers detected by the radiologists. Radiologist recall rate ranged between 3.4% and 5.5% and the radiographers' range was 2.9%–9.8%. Level of agreement of the radiographers with the radiologists ranged from 90 to 96%. Conclusion: The potential for accuracy in screen reading by Australian radiographers is supported by the results of this study. Implementation of formal training is likely to result in an increase in the diagnostic accuracy of radiographers. - Highlights: • Radiographers prospectively read 2000 screening mammograms each. • These results support potential for accuracy in screen reading by radiographers. • Will advanced practice be introduced within BreastScreen Australia?.

ETA-II experiments for determining advanced radiographic capabilities of induction linacs

International Nuclear Information System (INIS)

Weir, J.T.; Caporaso, G.J.; Clark, J.C.; Kirbie, H.C.; Chen, Y.J.; Lund, S.M.; Westenskow, G.A.; Paul, A.C.

1997-05-01

LLNL has proposed a multi-pulsed, multi-line of sight radiographic machine based on induction linac technology to be the core of the advanced hydrotest facility (AHF) being considered by the Department of Energy. In order to test the new technologies being developed for AHF we have recommissioned the Experimental Test Accelerator (ETA II). We will conduct our initial experiments using kickers and large angle bending optics at the ETA II facility. Our current status and our proposed experimental schedule will be presented

A survey to assess audit mechanisms practised by skeletal reporting radiographers

International Nuclear Information System (INIS)

Jones, H.C.; Manning, D.

2008-01-01

Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies

A survey to assess audit mechanisms practised by skeletal reporting radiographers

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Jones, H.C. [Directorate of Radiology, Royal Liverpool University Hospital Trust, Prescot Street, Liverpool L7 8XP (United Kingdom)], E-mail: helen.jones@rlbuht.nhs.uk; Manning, D. [School of Medical Imaging Sciences, St. Martin' s College, Lancaster LA1 3JD (United Kingdom)

2008-08-15

Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies.

Consultant breast radiographers: Where are we now?

International Nuclear Information System (INIS)

Rees, Zebby

2014-01-01

Introduction: The aim of this study is to: • Evaluate the current role of the consultant breast radiographer. • Compare current practice with the four key components for consultant practice. • Gauge the support of radiologist colleagues. • Determine the other professional commitments involved with the role. This study could be the precursor for a macro study of all consultant radiographer practice in other specialities. Methodology: Methodology used was a comparative ethnographic study. Questionnaires to the 24 consultant breast radiographers currently in post, and consultant breast radiologists, who work with them, were conducted. Data collection was a qualitative thematic approach. Conclusion: Consultant breast radiographers provide high quality care to patients through excellent clinical practice, leadership and good communication. However, this study shows hospital Trusts emphasis for non medical consultants is for clinical practice first. Some radiologists are still a barrier to progression for consultant breast radiographers, and radiologists have a big influence in recruitment decisions. Consultant breast radiographer posts are well established, their numbers are increasing through recognition of the role and of their abilities and performance. Consultant breast radiographers state that becoming a consultant is the major achievement of their career, proving the Society of Radiographers' vision of the four-tier career structure has been well received by the radiography profession

An exploratory study of radiographer's perceptions of radiographer commenting on musculo-skeletal trauma images in rural community based hospitals

International Nuclear Information System (INIS)

Howard, Morag L.

2013-01-01

Aim: This study sought to explore the perceptions of community hospital based radiographers in North East Scotland regarding the practice of radiographer commenting on musculo-skeletal trauma images. Method: A purposive sample of radiographers (n = 8) were recruited from community hospitals throughout the North-east of Scotland. A qualitative, exploratory study was conducted employing semi-structured interviews consisting of one focus group and two individual interviews. The interviews were audio recorded and transcribed in full to allow thematic analysis of the data using a framework adapted from Pope and Mays (2006). Main findings: This study revealed that the practice of radiographer commenting in the community provides a valuable front line opinion on musculo-skeletal trauma image appearances to enhance diagnostic outcomes for patients and streamline their care pathway. The appreciation shown from inter-professional colleagues for this practice induced feelings of professional pride and job satisfaction in the sample group. All participants expressed a desire to undertake additional training to allow progression from radiographer commenting to radiographer reporting of musculo-skeletal trauma images. Perceived barriers to the practice of radiographer commenting were time constraints and a lack of support with regards to continuing professional development (CPD) opportunities and mentorship from radiology colleagues. Conclusion: The practice of radiographer commenting in the community setting should be supported by ongoing training, and radiologist involvement in mentoring could provide radiographers with a valuable support mechanism. The voice of all radiographers regarding this extended role must be heard by professional leaders to ensure that the skills and education required for radiographer commenting are provided and subsequent patient care is not compromised

Evaluating the fundamental qualities of a nuclear medicine radiographer for the provision of an optimal clinical service

International Nuclear Information System (INIS)

Griffiths, Marc; King, Simon; Stewart, Rob; Dawson, Gary

2010-01-01

The developing nature of nuclear medicine practice highlights the need for an evaluation of the fundamental qualities of a Radiographer working within this discipline. Existing guidelines appear to be in place for clinical technologists working within nuclear medicine. However, limited guidance has been provided for Radiographers practicing within this discipline. This article aims to discuss the fundamental qualities that are considered essential for optimal service delivery, following consultation with various stakeholders. Areas such as technical expertise and knowledge, appropriate use of imaging equipment and current models of safe working practice will be discussed. Patient care and ethical considerations will also be evaluated, along with some core recommendations for future advanced practice.

CT colonography: accuracy of initial interpretation by radiographers in routine clinical practice

International Nuclear Information System (INIS)

Burling, D.; Wylie, P.; Gupta, A.; Illangovan, R.; Muckian, J.; Ahmad, R.; Marshall, M.; Taylor, S.A.

2010-01-01

Aim: To investigate performance of computed-assisted detection (CAD)-assisted radiographers interpreting computed tomography colonography (CTC) in routine practice. Materials and methods: Three hundred and three consecutive symptomatic patients underwent CTC. Examinations were double-read by trained radiographers using primary two-dimensional/three-dimensional (2D/3D) analysis supplemented by 'second reader' CAD. Radiographers recorded colonic neoplasia, interpretation times, and patient management strategy code (S0, inadequate; S1, normal; S2, 6-9 mm polyp; S3, ≥10 mm polyp; S4, cancer; S5, diverticular stricture) for each examination. Strategies were compared to the reference standard using kappa statistic, interpretation times using paired t-test, learning curves using logistic regression and Pearson's correlation coefficient. Results: Of 303 examinations, 69 (23%) were abnormal. CAD-assisted radiographers detected 17/17 (100%) cancers, 21/28 (72%) polyps ≥10 mm and 42/60 (70%) 6-9 mm polyps. The overall agreement between radiographers and the reference management strategy was good (kappa 0.72; CI: 0.65, 0.78) with agreement for S1 strategy in 189/211 (90%) exams; S2 in 19/27 (70%); S3 in 12/19 (63%); S4 in 17/17 (100%); S5 in 5/6 (83%). The mean interpretation time was 17 min (SD = 11) compared with 8 min (SD = 3.5) for radiologists. There was no learning curve for recording correct strategies (OR 0.88; p = 0.12) but a significant reduction in interpretation times, mean 14 and 31 min (last/first 50 exams; -0.46; p < 0.001). Conclusion: Routine CTC interpretation by radiographers is effective for initial triage of patients with cancer, but independent reporting is currently not recommended.

Radiographic quality and radiation protection in general medical practice and small hospitals

International Nuclear Information System (INIS)

Williamson, B.D.P.; Le Heron, J.C.

1988-01-01

Radiation protection and image quality were assessed in a survey of 22 general medical practices (GP) and the 24 smallest hospitals with x-ray facilities. Limited radiography, usually of extremities for trauma, was being performed in these facilities since access to regular radiology services was restricted, mainly for geographic reasons. An anthropomorphic phantom foot and ankle with two simulated fractures of the lateral and medical malleoli was presented at each facility for radiography, and the resulting films assessed for radiographic technique and basic diagnostic usefulness. The x-ray equipment was adequate for the range of procedures performed. While the standard of radiographic techniques was lower than in regular x-ray departments, most films of the phantom ankle were still diagnostically useful and only four were rejected entirely. The principal deficiency in general practice x-ray was in darkrooms and x-ray film processing. Consultation in this regard with registered medical radiation technologists is recommended. Generally, the x-ray equipment and working procedures complied with the National Radiation Laboratory Code of Safe Practice for the Use of X-rays in Diagnosis (Medical). Radiation doses to the phantom ankle ranged widely for effectively the same procedure, although none was excessive. Improved x-ray film processing, and tighter x-ray beam collimation, would result in a narrower range of doses to patients. Personnel exposures to radiation were satisfactorily low and special shieldings are not required in general practice. (author). 7 refs., 4 figs., 2 tabs

Radiographic imaging. 4 ed.

International Nuclear Information System (INIS)

Chesney, D.N.; Chesney, M.O.

1981-01-01

This is a revised edition of the textbook previously entitled 'Radiographic Photography' and accords with the current syllabus of training for the Diploma of the Royal College of Radiographers. The aim is a non-mathematical approach to provide a guide for the student to the knowledge and understanding of the theoretical concepts which affect the quality of radiographic image; materials and practices are also reviewed, particularly in relation to the characteristics of the radiographic image, and to processing equipment and processing areas. The subject is dealt with under the following headings: the photographic process, film materials in x-ray departments, sensitometry, storage of film materials and radiographs, intensifying screens and cassettes, film processing, developing, fixing, rinsing, washing, drying, the processing area and equipment, systems for daylight film handling, the radiographic image, management of the quality, presentation of the radiograph, light images and their recording, fluorography, some special imaging processes, e.g. xerography, copying radiographs. (U.K.)

Brazilian young dental practitioners' use and acceptance of digital radiographic examinations

International Nuclear Information System (INIS)

Rovaris, Karla; De Faria Vasconcelos, Karla; Do Nascimento, Eduarda Helena Leandro; Oliveira, Matheus Lima; Freitas, Deborah Queiroz; Haiter-Neto, Francisco

2016-01-01

The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years. Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05). A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations. This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations

Brazilian young dental practitioners' use and acceptance of digital radiographic examinations.

Science.gov (United States)

Rovaris, Karla; de Faria Vasconcelos, Karla; do Nascimento, Eduarda Helena Leandro; Oliveira, Matheus Lima; Freitas, Deborah Queiroz; Haiter-Neto, Francisco

2016-12-01

The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years. Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05). A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations. This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

Radiographer interpretation of trauma radiographs: Issues for radiography education providers

International Nuclear Information System (INIS)

Hardy, Maryann; Snaith, Beverly

2009-01-01

Background: The role of radiographers with respect to image interpretation within clinical practice is well recognised. It is the expectation of the professional, regulatory and academic bodies that upon qualification, radiographers will possess image interpretation skills. Additionally, The College of Radiographers has asserted that its aspiration is for all radiographers to be able to provide an immediate written interpretation on skeletal trauma radiographs by 2010. This paper explores the readiness of radiography education programmes in the UK to deliver this expectation. Method: A postal questionnaire was distributed to 25 Higher Education Institutions in the UK (including Northern Ireland) that provided pre-registration radiography education as identified from the Society and College of Radiographers register. Information was sought relating to the type of image interpretation education delivered at pre- and post-registration levels; the anatomical range of image interpretation education; and education delivery styles. Results: A total of 19 responses (n = 19/25; 76.0%) were received. Image interpretation education was included as part of all radiographer pre-registration programmes and offered at post-registration level at 12 academic centres (n = 12/19; 63.2%). The anatomical areas and educational delivery methods varied across institutions. Conclusion: Radiography education providers have embraced the need for image interpretation education within both pre- and post-registration radiography programmes. As a result, UK education programmes are able to meet the 2010 College of Radiographers aspiration.

Advancing nursing practice: redefining the theoretical and practical integration of knowledge.

Science.gov (United States)

Christensen, Martin

2011-03-01

The aim of this paper is to offer an alternative knowing-how knowing-that framework of nursing knowledge, which in the past has been accepted as the provenance of advanced practice. The concept of advancing practice is central to the development of nursing practice and has been seen to take on many different forms depending on its use in context. To many it has become synonymous with the work of the advanced or expert practitioner; others have viewed it as a process of continuing professional development and skills acquisition. Moreover, it is becoming closely linked with practice development. However, there is much discussion as to what constitutes the knowledge necessary for advancing and advanced practice, and it has been suggested that theoretical and practical knowledge form the cornerstone of advanced knowledge. The design of this article takes a discursive approach as to the meaning and integration of knowledge within the context of advancing nursing practice. A thematic analysis of the current discourse relating to knowledge integration models in an advancing and advanced practice arena was used to identify concurrent themes relating to the knowing-how knowing-that framework which commonly used to classify the knowledge necessary for advanced nursing practice. There is a dichotomy as to what constitutes knowledge for advanced and advancing practice. Several authors have offered a variety of differing models, yet it is the application and integration of theoretical and practical knowledge that defines and develops the advancement of nursing practice. An alternative framework offered here may allow differences in the way that nursing knowledge important for advancing practice is perceived, developed and coordinated. What has inevitably been neglected is that there are various other variables which when transposed into the existing knowing-how knowing-that framework allows for advanced knowledge to be better defined. One of the more notable variables is

Clinical practice: new challenges for the advanced practice nurse.

Science.gov (United States)

Bartel, J C; Buturusis, B

2000-12-01

This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community?

Clinical education - place and part for becoming a practically trained radiographer

International Nuclear Information System (INIS)

Shangova, M.; Stavreva, E.; Panamska, K.; Bozhkova, M.

2015-01-01

Full text: The aim is to present the crucial role of clinical education for becoming a practically trained radiographer. It's been put on review and analysis the role of the clinic practice and pre-graduate practice into the education of the future specialist. It's presenting in detail every component of the program for study and the contribution of every module in it - image diagnostic, nuclear medicine and radiotherapy. the clinical education lasts six semesters in real working environment. The gradual increase of working hours creates conditions for higher educational quality. Students gradually master techniques, acquire skills and precision at working in an X-ray department, nuclear medicine units and radiotherapy, master communication techniques and acquire teamwork skills. the clinical education provides professional training, quick adaptation to realization and facilitates starting a job

Brazilian young dental practitioners' use and acceptance of digital radiographic examinations

Energy Technology Data Exchange (ETDEWEB)

Rovaris, Karla; De Faria Vasconcelos, Karla; Do Nascimento, Eduarda Helena Leandro; Oliveira, Matheus Lima; Freitas, Deborah Queiroz; Haiter-Neto, Francisco [Div. of Oral Radiology, Dept. of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo (Brazil)

2016-12-15

The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years. Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05). A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations. This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

Justification of radiographic examinations: What are the key issues?

Science.gov (United States)

Vom, Jason; Williams, Imelda

2017-09-01

Justification of radiographic examinations is the practice of evaluating requested radiological examinations to assess for clinical merit and appropriateness based on clinical notes and patient information. This implies that justification in radiography requires the evaluation of requested examinations, the justification of exposures being applied and determining whether patients fit the recommended criteria for the procedure. Medico-legal requirements by the professional registration body, the Medical Radiation Practice Board of Australia (MRPBA), identify justification as an advocated and obligatory practice for radiographers. Yet, justification remains an inconsistent practice implemented amongst Australian radiographers. This review aims to identify associated barriers inhibiting the consistent practice of justification and the hesitance by radiographers in practicing justification responsibilities. It also recommends a change in workplace culture which encourages radiographers to accept a more autonomous role that cultivates critical thinking, reflection and research-informed decision making as justification will ultimately benefit patients. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice

DEFF Research Database (Denmark)

Ornbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille

2013-01-01

radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated.RESULTS: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21......OBJECTIVES: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice.METHODS: Conventional radiographs (x......-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p0) in the DMARD period compared with 158 patients in the TNF-I period (p...

Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers

International Nuclear Information System (INIS)

Coleman, Liz; Piper, Keith

2009-01-01

Aim: To assess how accurately and confidently casualty officers, nurse practitioners and radiographers, practicing within the emergency department (ED), recognize and describe radiographic trauma within an image test bank of 20 appendicular radiographs. Method: The participants consisted of 7 casualty officers, 13 nurse practitioners and 18 radiographers. All 20 radiographic examinations selected for the image test bank had been acquired following trauma and included some subtle, yet clinically significant abnormalities. The test bank score (maximum 40 marks), sensitivity and specificity percentages were calculated against an agreed radiological diagnosis (reference standard). Alternative Free-response Receiver Operating Characteristic (AFROC) analysis was used to assess the overall performance of the diagnostic accuracy of these professional groups. The variation in performance between each group was measured using the analysis of variance (ANOVA) test, to identify any statistical significant differences in the performance in interpretation between these groups. The relationship between the participants' perceived image interpretation accuracy during clinical practice and the actual accuracy of their image test bank score was examined using Pearson's Correlation Coefficient (r). Results: The results revealed that the radiographers gained the highest mean test bank score (28.5/40; 71%). This score was statistically higher than the mean test bank scores attained by the participating nurse practitioners (21/40; 53%) and casualty officers (21.5/40; 54%), with p < 0.01 and p = 0.02, respectively. When compared with each other, the scores from these latter groups showed no significant difference (p = 0.91). The mean 'area under the curve' (AUC) value achieved by the radiographers was also significantly higher (p < 0.01) in comparison to the AUC values demonstrated by the nurse practitioners and casualty officers, whose results, when compared, showed no significant

PACS influence the radiographer's work

International Nuclear Information System (INIS)

Fridell, Kent; Aspelin, Peter; Edgren, Lars; Lindskoeld, Lars; Lundberg, Nina

2009-01-01

Radiological departments are changing rapidly due to the implementation of digital images and PACS (Picture Archiving and Communication Systems). The introduction of new technology seems to dissolve boundaries between the professions in the work environment where the technology is introduced. This process tends to change the organization and its routines. The aim of this qualitative study is to explore changes in radiographers' work with regard to skills, work practice and technology. The study used open-ended interviews to explore the radiographers' perceptions of such changes, and to identify problems and solutions pertaining to work practice. Inspiration is taken from grounded theory to explain the changes in work that were found. Respondents were selected from a total of 133 potential participants as a theoretical or purposive sample. The changing trends within the professional role indicated that radiographers, as image producers, shifted their focus from the ability to set the optimal exposure parameters in order to obtain the optimal image for diagnosis to become expert in exposure parameters, projection techniques and diagnostic practice, having multifaceted skills, as being the jack of all trades. When implementing PACS there was an obvious change in image production. At the start there were visions of new routines, and therefore the radiographers became early adopters to the new technology; in practice the organization was stacked in old routines, as the routines were inflexible and PACS work was pushed into old work routines. Although inflexible, this does not mean that they cannot change, and obviously in 2006 new routines had been implemented making it possible for the radiographers in finding new ways for collaborating with colleagues. The new technology immediately created a vision of improved service to the clinicians. In order to optimize the service the radiographers developed an insight into the need for a more comprehensive change in work using

Radiographers' and radiology practitioners' opinion, experience and practice of benefit-risk communication and consent in paediatric imaging

International Nuclear Information System (INIS)

Portelli, J.L.; McNulty, J.P.; Bezzina, P.; Rainford, L.

2016-01-01

Objectives: To investigate radiographers' and radiology practitioners' opinion, experience and practice of radiation benefit-risk communication and consent for paediatric imaging examinations. Methods: A cross-sectional survey was conducted amongst radiographers and radiology practitioners working at a primary paediatric referral centre in Malta, so as to acquire information about their interactions with paediatric patients and/or their parents, particularly their opinion and practice of communicating benefit-risk information and seeking consent for imaging examinations. Results: The return of 112 questionnaires provided a response rate of 66.7%. Findings revealed varied practice relating to the provision of benefit-risk information, whereby details concerning examination benefits and potential risks are not always conveyed. For 89% of participants, parental consent was sought for paediatric imaging examinations in their current practice. Only 36.7% of participants indicated that they were highly confident in their ability to communicate benefit-risk information. The study findings also revealed that parents can truly be worried about the associated radiation exposure, with some even refusing an imaging examination as a result of such concerns. Conclusions: The practice of communicating benefit-risk information to paediatric patients and/or their parents is varied. A possible gap in benefit-risk communication education and/or training was identified, which may impact radiographers' and radiology practitioners' confidence in conveying such information. Education/training activities for radiographers and radiology practitioners are therefore necessary to foster improved benefit-risk dialogues and help provide reassurance to parents/guardians about the benefits of appropriately indicated paediatric imaging examinations. - Highlights: • The practice of communicating radiation benefit-risk information to parents of paediatric patients is varied. �

Reflections on the role of consultant radiographers in the UK: What is a consultant radiographer?

International Nuclear Information System (INIS)

Booth, L.; Henwood, S.; Miller, P.

2016-01-01

Context: This paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK. Methods: A longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis. Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period. Findings: The data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures. The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery. Conclusions: The paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further. - Highlights: • This paper shows the variation in roles between consultant radiographers. • The commonality with medical roles is highlighted. • Problem solving is identified as a core skill in consultant radiography. • Consultants offered evidence of the roles developing service provision. • While all four domains of practice are covered, research is the least well supported.

Advanced midwifery practice: An evolutionary concept analysis.

Science.gov (United States)

Goemaes, Régine; Beeckman, Dimitri; Goossens, Joline; Shawe, Jill; Verhaeghe, Sofie; Van Hecke, Ann

2016-11-01

the concept of 'advanced midwifery practice' is explored to a limited extent in the international literature. However, a clear conception of advanced midwifery practice is vital to advance the discipline and to achieve both internal and external legitimacy. This concept analysis aims to clarify advanced midwifery practice and identify its components. a review of the literature was executed using Rodgers' evolutionary method of concept analysis to analyze the attributes, references, related terms, antecedents and consequences of advanced midwifery practice. an international consensus definition of advanced midwifery practice is currently lacking. Four major attributes of advanced midwife practitioners (AMPs) are identified: autonomy in practice, leadership, expertise, and research skills. A consensus was found on the need of preparation at master's level for AMPs. Such midwives have a broad and internationally varied scope of practice, fulfilling different roles such as clinicians, clinical and professional leaders, educators, consultants, managers, change agents, researchers, and auditors. Evidence illustrating the important part AMPs play on a clinical and strategic level is mounting. the findings of this concept analysis support a wide variety in the emergence, titles, roles, and scope of practice of AMPs. Research on clinical and strategic outcomes of care provided by AMPs supports further implementation of these roles. As the indistinctness of AMPs' titles and roles is one of the barriers for implementation, a clear conceptualization of advanced midwifery practice seems essential for successful implementation. an international debate and consensus on the defining elements of advanced midwifery practice could enhance the further development of midwifery as a profession and is a prerequisite for its successful implementation. Due to rising numbers of AMPs, extension of practice and elevated quality requirements in healthcare, more outcomes research exclusively

Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

Science.gov (United States)

Mick, D J; Ackerman, M H

2000-01-01

This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical

Advancing work practices

DEFF Research Database (Denmark)

Noesgaard, Signe Schack

2016-01-01

-executed instructional interventions will advance work practices. Design/methodology/approach The paper synthesizes contemporary social-psychological and educational research in the creation of a model of intervention-based change. In addition, the findings from an empirical study of online teacher professional......Purpose The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well...... development simultaneously inspire and exemplify the model. Findings The paper suggests that increased attention to individual motivational drivers is needed, especially post intervention, to help ensure meaningful learning transfer and sustainable behavior change. The importance of individualized on...

Post-graduate training in imaging diagnostics, nuclear medicine and radiotherapy for radiographers

International Nuclear Information System (INIS)

Petkova, E.; Velkova, K.; Shangova, M.; Karidova, S.

2006-01-01

Full text: The application of new technologies in imaging diagnostics, as well as the use of digital processing and storing of information, has increased the quality and scope of imaging diagnostics. The potentials of therapeutic methods connected with imaging diagnostics and nuclear medicine, interventional therapeutic procedures (dilatation, embolism, stent, etc.), basins with radio-pharmaceuticals, etc., are constantly increasing. The constant training of radiographers in working with the new, advanced image-diagnostic equipment has become an established international practice in the process of training the human resources of the imaging-diagnostic departments and centers. Objectives: 1. Investigating the potentials of post-graduate training for monitoring the dynamics in the development of the principles, methods and techniques in imaging diagnostics; 2. The attitude of radiographers towards post-graduate training. Systematic approach and critical analysis of published data and mathematical-statistical methods with regard to the need of post-graduate training. The processed data of the survey on the necessity for post-graduate training conducted among 3rd year students in the last 3 years - 75 % consider post-graduate training mandatory, 11% deem it necessary, and 14% have no opinion on the issue; and among the working radiographers in the last 3 years the results are as follows: mandatory - 91%, necessary - 7%, no opinion - 2%. The improvement and advances in imaging diagnostic equipment and apparatuses have considerably outstripped the professional training of radiographers. The key word in the race for knowledge is constant learning and training, which can successfully be achieved within the framework of post-graduate training

Education of advanced practice nurses in Canada.

Science.gov (United States)

Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

2010-12-01

In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

Standard practice for determining relative image quality response of industrial radiographic imaging systems

CERN Document Server

American Society for Testing and Materials. Philadelphia

2007-01-01

1.1 This standard provides a practice whereby industrial radiographic imaging systems may be comparatively assessed using the concept of relative image quality response (RIQR). The RIQR method presented within this practice is based upon the use of equivalent penetrameter sensitivity (EPS) described within Practice E 1025 and subsection 5.2 of this practice. Figure 1 illustrates a relative image quality indicator (RIQI) that has four different steel plaque thicknesses (.015, .010, .008, and .005 in.) sequentially positioned (from top to bottom) on a ¾-in. thick steel plate. The four plaques contain a total of 14 different arrays of penetrameter-type hole sizes designed to render varied conditions of threshold visibility ranging from 1.92 % EPS (at the top) to .94 % EPS (at the bottom) when exposed to nominal 200 keV X-ray radiation. Each “EPS” array consists of 30 identical holes; thus, providing the user with a quantity of threshold sensitivity levels suitable for relative image qualitative response com...

Radiographers' preconditions for evidence-based radiography

International Nuclear Information System (INIS)

Ahonen, Sanna-Mari; Liikanen, Eeva

2010-01-01

Evidence-based practice (EBP) is essential in today's health care, but its establishment requires several preconditions from individuals and organizations (e.g. knowledge, understanding, attitudes, abilities, self-confidence, support, and resources). Previous studies suggest that radiographers do generate and use evidence in their work, but evidence-based radiography (EBR) is not yet used routinely as established practice, especially in terms of research utilization. This paper aims to describe radiographers' preconditions for EBR, and their participation in research activities. Main focus is on research utilization. Using an electronic questionnaire developed for this study, a survey was conducted: data collected from Finnish radiographers and radiotherapists (N = 438) were analysed both statistically and qualitatively. The final response rate was 39%. The results suggest radiographers' preconditions for EBR to consist of knowledge of research, significance of research activities, research-orientated way of working, and support. In addition, adequate resourcing is essential. Reading scientific journals, participation in research activities, a higher degree of education, and senior post seem to be significant promoters of EBR and research utilization. The results support the notion that EBR, and especially research utilization, are not yet well-established in Finland, and radiographers' viewpoints concerning the role and significance of research evidence and research activities still seem to vary.

Current role of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in modern departments

International Nuclear Information System (INIS)

Karidova, S.; Velkova, K.; Panamska, K.; Petkova, K.

2006-01-01

Full text: In the communication we set out to focus the attention of the medical staff and the public on the place and the constantly growing role (relative burden) of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in the field of modern medicine. The advanced radiographers level and rapid development of the contemporary equipment and apparatuses used in imaging diagnostics, nuclear medicine and radiotherapy, as well as the methods of their utilization, presuppose very good and constantly improving theoretical and practical training of the imaging technician. The radiographer fulfills responsible tasks under the guidance of the physician or independently and bears specific responsibilities. Having mastered the fundamentals of radiation protection, the imaging technician protects both himself and the patient from the impact of ionizing radiation. To be able to fulfill his/her constantly increasing duties and obligations, the imaging radiographer has acquired wide knowledge of general education subjects, subjects of general medicine and special subjects. The radiographer has a good knowledge of Latin and a modern foreign language, and he is also computer literate so as to be able to cope with the widely spread visualizing methods. The radiographer acquires additional post-graduate training to work in narrowly specialized fields as well as to improve his/her qualifications

Advanced Neutron Radiographic Equipment within the US Army

Science.gov (United States)

2014-01-29

The first of the two new neutron generators developed for ARDEC was built and delivered by Phoenix Nuclear Labs ( PNL ) located in Madison, WI...PRELIMINARY NEUTRON RADIOGRAPHS AND RESULTS During the hardware and software testing of the PNL neutron generator several test shots were

Assessment of radiation protection practices among radiographers ...

African Journals Online (AJOL)

Application of shielding devices such as gonad shield for protection was neglected mostly in government hospitals. Most x-ray machines were quite old and evidence of quality assurance tests performed on such machines were lacking. Conclusion: Radiographers within Lagos metropolis showed an excellent knowledge of ...

Assessment of the willingness of Australian radiographers in mammography to accept new responsibilities in role extension: Part two – qualitative analysis

International Nuclear Information System (INIS)

Moran, S.; Taylor, J.K.; Warren-Forward, H.

2013-01-01

Advanced practice in screening mammography has become widespread in the United Kingdom over the last 20 years, and Australian radiographers working in BreastScreen programs have shown interest in similar developments. Radiographers working in BreastScreen Australia were surveyed in order to capture their thoughts and perceptions on role extension. Questionnaires were circulated to radiographers working in BreastScreen Australia programs. Thematic analysis was used to analyze the open response questions to explore the advantages and disadvantages identified by the participants with respect to role expansion in screening mammography as well as any changes to their duties over the last decade. There were 253 responses to the survey and of those responses, 70% of radiographers shared their thoughts on role extension and 49% provided comments on changes in the workplace. The majority (61%) radiographers responding to the role extension question were concerned about potential problems associated with role extension; the biggest issues were that role extension should not be mandatory and that selection criteria for advanced practitioners should be stringent, with adequate time made available for training and study. The major change in the role of the radiographer has been the increased time dedicated to quality assurance tasks and administrative duties as well as more training required due to technological changes from film-screen to digital mammography. There is high interest in role extension by radiographers working in BreastScreen programs, provided that it is voluntary. The role of the radiographer within breast imaging in Australia is still evolving

Initial image interpretation of appendicular skeletal radiographs: A comparison between nurses and radiographers

International Nuclear Information System (INIS)

Piper, Keith J.; Paterson, Audrey

2009-01-01

, although differences in performance between the two groups remained, with the radiographer group achieving a better overall performance than the nurse group. As patients in MIUs and A/E receive treatment based on the initial interpretation of their imaging investigations by either nurses or radiographers, the improvement after training is encouraging but the difference in the overall performance is less so. More work is required to evaluate the performance of radiographers and nurses undertaking initial image interpretation as part of their normal practice

Can Australian radiographers assess screening mammograms accurately? Biennial follow-up from a four year prospective study and lesion analysis

International Nuclear Information System (INIS)

Moran, S.; Warren-Forward, H.

2016-01-01

Introduction: Globally, the role of the radiographer is changing; some countries have developed advanced roles with specific scopes of practice. Other countries, like Australia, are in the process of this change. This paper demonstrates the abilities of Australian radiographers in mammogram screen reading, highlighting some of their specific difficulties with different lesion types. Method: Six experienced radiographers participated in a prospective study, screen reading 2000 mammograms each between 2010 and 2011. This paper looks at the results of those same women at biennial re-screen. Analysis of the results included validation of normal results by negative follow-up screens and new cancers at biennial review; there is also analysis on the types of lesions detected and missed. Results: After biennial review, three cancers in 2013/2014 had been marked as abnormal by one radiographer two years prior, which increased her sensitivity from 64% to 85%. Sensitivity for the radiologists decreased from the assumed 100% to 95%. Radiographers appeared to be skilled in detection of calcifications and architectural distortions but had difficulty with non-specific densities. Conclusion: This study demonstrates the potential for Australian radiographers to enhance the accuracy of screen reading programs. - Highlights: • Radiographers have the potential to increase breast cancer detection rates. • Radiographers appear to be skilled at detecting calcifications. • Lesions commonly overlooked by radiographers could be targeted for training.

Radiation protection education and training of radiographers

International Nuclear Information System (INIS)

Elsakkers, P.

1995-01-01

The International Society of Radiographers and Radiological Technicians (ISRRT) is an international non-governmental organisation in official relationship with the World Health Organization. Over 50 countries are members of the ISRRT. The ISRRT encourages and facilitates communication between radiographers throughout the world. The ISRRT has produced several documents, e.g. ''The Role of the Radiographer in Europe''. The ISRRT has also done research and developed initiatives to analyse the quality of training of radiographers in the different member states of the EC. Research was done in the member states to analyse the efforts in the field of quality control. An extended study was performed on the current level of education in radiation protection in the European member states. The ICRP recommends in its publications the need of good training and continuing education for all radiographers. An important part of the basic training of radiographers should focus on the performance of radiation protection and quality control tests. Good daily practice can decrease patient dose in many ways. (Author)

Total elbow arthroplasty: a radiographic outcome study

Energy Technology Data Exchange (ETDEWEB)

Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

2016-06-15

Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

Radiographic caries diagnosis and restorative treatment decision making

International Nuclear Information System (INIS)

Mileman, P.A.

1985-01-01

This thesis is concerned with a single diagnostic technique: the bitewing radiograph, and the way it is used by dentists to decide on patient treatment need for interproximal caries. The variation in caries diagnosis and treatment decisions using bitewing radiographs is described and the radiographic criteria of choice for minimizing over and undertreatment according to a norm are investigated. Three possible diagnostic strategies in interproximal caries diagnosis using a decision analysis approach are described and evaluated, and the effect of the reported diagnostic behaviour and knowledge of practicing Dutch dentists in their use of bitewing radiographs for the diagnosis and treatment of interproximal caries is described and analyzed. (Auth.)

Optimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.

Science.gov (United States)

Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan

2016-09-01

The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.

Radiographer-led breast boost localisation – A service evaluation study

International Nuclear Information System (INIS)

Smith, S.; Comins, C.

2015-01-01

A radiation boost to the tumour bed as part of breast conserving therapy reduces the rate of local recurrence. Radiographer-led planning for tangential field radiotherapy has been the practice at our centre since 2007. The transition from conventional simulation to computed tomography (CT) and virtual simulation enhanced the radiographer's role in the breast planning process. Electron boost mark ups continued to be marked up freehand by doctors using available imaging to determine tumour bed. The paper reports on a service evaluation undertaken to establish a change in practice for electron breast boosts to be simulated using the virtual simulator by suitably trained radiographers. The retrospective simulation of ten patients confirmed the consistency of radiographer tumour bed localisation, followed by the prospective simulation of ten patients' boost fields. The introduction of a radiographer-led planning breast boost service has given greater autonomy and job satisfaction to individuals as well as resulting in a cost effective use of available resources. - Highlights: • A service evaluation study was undertaken to train a radiographer to perform breast boost planning. • Retrospective breast boost planning established proposed technique was workable. • Prospective planning by radiographer proved their competence. • Introduction of new technique provided job satisfaction and service improvement

Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing.

Science.gov (United States)

O'Connell, Jane; Gardner, Glenn; Coyer, Fiona

2014-12-01

This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. Data were sourced from electronic databases as described in the background section. As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education. © 2014 John Wiley & Sons Ltd.

Education and training for advanced practice: Principles of course design and assessment applied to a 'stereotactic needle core biopsy of the breast' module

International Nuclear Information System (INIS)

Dixon, Anne-Marie

2006-01-01

In order to realise the promise of the NHS Plan, radiographers are extending their practice to encompass tasks previously undertaken by radiologists and advancing their practice by taking responsibility for clinical decision-making and autonomous membership of multidisciplinary healthcare teams. In partnership with clinical service providers Higher Education Institutes are devising programmes of study to support such professional development. This article reviews the design of a 20 credit post-graduate (M level) module in stereotactic needle core biopsy of the breast. Particular consideration is given to underpinning educational principles of course design and assessment and how these are applied in order that teaching, learning and assessment have academic rigour and clinical competence of successful students is assured

Educational and experiential effects on radiographers' radiation safety behavior

International Nuclear Information System (INIS)

Tilson, E.R.

1982-01-01

Forty-four radiographers from 11 hospitals in Northern California were observed for radiation safety behaviors in six categories. A multiple regression analysis was performed to determine if there was a significant relationship between the six radiation safety behaviors and the radiographer's age, sex, type of professional training, years since completion of professional training, years of professional practice, time of day, and exposure frequency. The multiple regression analysis showed that there was a significant relationship between use of gonadal shielding and years since completion of professional training, years of professional practice, type of training, and age. The multiple regression analysis also showed that the number of repeated films due to technical error was significantly related to the type of professional training a radiographer received

Delineating advanced practice nursing in New Zealand: a national survey.

Science.gov (United States)

Carryer, J; Wilkinson, J; Towers, A; Gardner, G

2018-03-01

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

Role extension and role advancement - Is there a difference? A discussion paper

International Nuclear Information System (INIS)

Hardy, Maryann; Snaith, Beverly

2006-01-01

The terms 'extended' and 'advanced' practice are commonly used to describe clinical practitioner roles. However, these terms have not been clearly defined within the context of modern radiography practice despite their fundamental importance to establishing the 4 tier structure, implementing Agenda for Change and promoting a coherent clinical radiography career structure. This paper discusses the terms 'extension' and 'advancement' in relation to radiography practice and, using evidence from the debates of other health professions, attempts to offer some clarity to the terminology, presenting one interpretation of its possible application to the radiographer role in the United Kingdom

Radiographical measurements for distal intra-articular fractures of the radius using plain radiographs and cone beam computed tomography images

Energy Technology Data Exchange (ETDEWEB)

Suojaervi, Nora; Lindfors, N. [Helsinki University Central Hospital, Department of Hand Surgery, Helsinki (Finland); Sillat, T.; Koskinen, S.K. [HUS Helsinki Medical Imaging Center, Helsinki University Central Hospital, Department of Radiology, Helsinki (Finland)

2015-12-15

Operative treatment of an intra-articular distal radius fracture is one of the most common procedures in orthopedic and hand surgery. The intra- and interobserver agreement of common radiographical measurements of these fractures using cone beam computed tomography (CBCT) and plain radiographs were evaluated. Thirty-seven patients undergoing open reduction and volar fixation for a distal radius fracture were studied. Two radiologists analyzed the preoperative radiographs and CBCT images. Agreement of the measurements was subjected to intra-class correlation coefficient and the Bland-Altman analyses. Plain radiographs provided a slightly poorer level of agreement. For fracture diastasis, excellent intraobserver agreement was achieved for radiographs and good or excellent agreement for CBCT, compared to poor interobserver agreement (ICC 0.334) for radiographs and good interobserver agreement (ICC 0.621) for CBCT images. The Bland-Altman analyses indicated a small mean difference between the measurements but rather large variation using both imaging methods, especially in angular measurements. For most of the measurements, radiographs do well, and may be used in clinical practice. Two different measurements by the same reader or by two different readers can lead to different decisions, and therefore a standardization of the measurements is imperative. More detailed analysis of articular surface needs cross-sectional imaging modalities. (orig.)

Radiographical measurements for distal intra-articular fractures of the radius using plain radiographs and cone beam computed tomography images.

Science.gov (United States)

Suojärvi, Nora; Sillat, T; Lindfors, N; Koskinen, S K

2015-12-01

Operative treatment of an intra-articular distal radius fracture is one of the most common procedures in orthopedic and hand surgery. The intra- and interobserver agreement of common radiographical measurements of these fractures using cone beam computed tomography (CBCT) and plain radiographs were evaluated. Thirty-seven patients undergoing open reduction and volar fixation for a distal radius fracture were studied. Two radiologists analyzed the preoperative radiographs and CBCT images. Agreement of the measurements was subjected to intra-class correlation coefficient and the Bland-Altman analyses. Plain radiographs provided a slightly poorer level of agreement. For fracture diastasis, excellent intraobserver agreement was achieved for radiographs and good or excellent agreement for CBCT, compared to poor interobserver agreement (ICC 0.334) for radiographs and good interobserver agreement (ICC 0.621) for CBCT images. The Bland-Altman analyses indicated a small mean difference between the measurements but rather large variation using both imaging methods, especially in angular measurements. For most of the measurements, radiographs do well, and may be used in clinical practice. Two different measurements by the same reader or by two different readers can lead to different decisions, and therefore a standardization of the measurements is imperative. More detailed analysis of articular surface needs cross-sectional imaging modalities.

Industrial radiography on radiographic paper

International Nuclear Information System (INIS)

Domanus, J.C.

1977-11-01

An investigation was performed to compare the quality of radiographic paper with that of X-ray film, after a review had been made of the rather scarce literature on the subject. The equipment used throughout the investigation is described, and characteristic curves for Agfa-Gevaert and Kodak papers exposed with different intensifying screens in the low and intermediate voltage range are reproduced. The relative speed, contrast and exposure latitude were computed from these curves. The quality of the radiographic image was checked on U/Al blocks and plates, Al and Fe blocks, and fiber-reinforced composites. Exposure charts for Al and Fe were made for various paper and screen combinations. Both the sharpness of the radiographic image as well as the influence of processing on speed and contrast were checked. Examples are given of the practical application of the paper for radiography of castings, weldings, solderings, assemblies, etc. (author)

A survey of the radiographic cassettes disinfection of university hospitals in seoul

International Nuclear Information System (INIS)

Kweon, Dae Cheol; Park, Peom; Kim, Moon Sun; Kim, Dong Sung

2001-01-01

The purpose of this study is to prevent nosocomial infection in patients through contact of radiographic cassettes. Data were collected from radiographers working in 29 university hospitals in Seoul in February and March 2001. Radiographic cassettes were disinfected daily in 5 hospitals, weekly in 4 hospitals, monthly in 5 hospitals, bimonthly in 1 hospital and once every three months in another hospital. 12 other hospitals do not practice regular disinfections of radiographic cassettes. Gauze soaked in disinfectant solution is used in 7 hospitals while 11 hospitals used cotton and cloth soaked in disinfectant solution to clean the radiographic cassettes. 26 hospitals used 99% alcohol based disinfectant solutions while 3 hospitals used 75% alcohol based disinfectant, 26 hospitals use of intercourse cassettes outpatients and in patients. In 26 hospitals, all patients shared the same set of radiographic cassettes used in the hospitals, or in 26 hospitals, separate sets of radiographic cassettes are used for outpatients and inpatients. Separate sets of cassettes are used for ICU and inpatients in 6 others hospitals. 23 hospitals used the same sets of radiographic cassettes for all their patients. radiographic cassettes are cleaned in wash area in the study room of the radiographic department in 17 hospitals. 12 other hospitals do not have designated cleaning areas for the cassettes. All radiographers practiced hands washing with soap. All 29 hospitals surveyed have infection control committee. However, only 9 out of the 29 hospitals surveyed provided Infection · disinfections control education to radiographers. Only 3 hospitals have radiographers sitting in the infection control committee. Infection management education is conducted in 63 hospitals annually, twice a year in 1 hospital and once every 3 months in 2 hospitals

Radiographic evaluations

International Nuclear Information System (INIS)

Williams, J.L.

1988-01-01

The author describes how to: perform a systematic evaluation of a chest radiograph; state the classic radiographic description of hyaline membrane disease; list the conditions that cause hyperaeration and describe the radiologic feature of hyperaeration; describe the radiograph of a patient with a congenital diaphragmatic hernia; identify optimum placement of an endotracheal tube, gastric feeding tube, and umbilical artery catheter on a radiograph; differentiate between pulmonary interstitial air and hyaline membrane disease; select radiographic features that would indicate the presence of a tension pneumothorax; describe a lateral decubitus projection and state the type of problem it is most often used to identify; explain the procedure used in obtaining a lateral neck radiograph and list two problems that may require this view; and describe the radiograph of a patient with cystic fibrosis

Analysis instruments for the performance of Advanced Practice Nursing.

Science.gov (United States)

Sevilla-Guerra, Sonia; Zabalegui, Adelaida

2017-11-29

Advanced Practice Nursing has been a reality in the international context for several decades and recently new nursing profiles have been developed in Spain as well that follow this model. The consolidation of these advanced practice roles has also led to of the creation of tools that attempt to define and evaluate their functions. This study aims to identify and explore the existing instruments that enable the domains of Advanced Practice Nursing to be defined. A review of existing international questionnaires and instruments was undertaken, including an analysis of the design process, the domains/dimensions defined, the main results and an exploration of clinimetric properties. Seven studies were analysed but not all proved to be valid, stable or reliable tools. One included tool was able to differentiate between the functions of the general nurse and the advanced practice nurse by the level of activities undertaken within the five domains described. These tools are necessary to evaluate the scope of advanced practice in new nursing roles that correspond to other international models of competencies and practice domains. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Transfer of learning: Radiographers' perceptions of simulation-based educational intervention

International Nuclear Information System (INIS)

Aura, S.; Jordan, S.; Saano, S.; Tossavainen, K.; Turunen, H.

2016-01-01

Aim: The aims of this qualitative descriptive study were to 1) explore and define radiographers' competence in intravenous pharmacotherapy before and after a simulation-based education, 2) examine radiographer's perceptions of transfer of learning into clinical practice. Method: Sixteen diagnostic radiographers in one hospitals' Clinical Radiology Unit were individually interviewed before a multidisciplinary simulation-based pharmacotherapy education intervention in 2012 and fourteen were re-interviewed after the intervention 6–7 months later. Data were analyzed using qualitative content analysis. Results: Before education the participants reported uncertain competence in pain management during imaging procedures and acute situations. These weak competence areas identified were strengthened and self-confidence grew. The intervention improved the domains of pharmacotherapy-related patient safety; teamwork development and communication skills. In addition, the radiographers indicated that the iv. pharmacotherapy knowledge from simulation learning was transferred to routine work. Conclusion: The results of this study suggest simulation-based education is suitable for radiographers' pharmacotherapy learning. Adequate pain measurement and management are essential during invasive procedures and these skills can be realistically learned in simulations and transferred to clinical practice. - Highlights: • Simulation education is suitable for professionals' pharmacotherapy education. • Radiographers felt education empowered them to manage acute situations. • Skills in pain measurement, analgesia and patient monitoring enhanced. • Communication and teamwork skills were enhanced. • Simulation-based learning was transferred to clinical practice.

Use your good judgement - Radiographers' knowledge in image production work

International Nuclear Information System (INIS)

Larsson, W.; Lundberg, N.; Hillergard, K.

2009-01-01

It has been shown that the demand for radiography services has markedly increased and radiographers' work has become more complex as their role has changed. More specifically, it entails new activities, new ways of communicating and new responsibilities. This means that radiographers work in new ways and need new ways to learn. The knowledge needed in this learning process is still unexplored. The aim of this study is to identify and present how radiographers use knowledge in image production work using PACS. This is explored by studying how radiographers use their knowledge in practice. The study adopts a qualitative approach, using participant observation of and semi-structured interviews with radiographers at five Swedish hospitals. To identify properties of knowledge, Blackler's theory of knowledge components was applied. The results of this study show that radiographers use the knowledge components in different situations in their image production work. They use embrained knowledge in planning X-ray examinations and in viewing images. Encoded knowledge is required for the use of various kinds of documentation, such as manuals and protocols. Embodied knowledge is action-oriented and involves 'gut feelings'. The study also illustrates that radiographers use their knowledge at different levels as routine actors or as reflective actors, in a more static way or with a flexible attitude, more unreflectively or more as critical reflectors, and finally more as performing automatic action or problem-solving action. This study concludes that radiographers need more reflective actors in the image production process when working with PACS. The study also illustrates that radiographers need to be flexible in their work; there is little room for static work. In work they need to analyze images, it is not enough to 'check them off'; they cannot just read documents, you need to interpret them to optimize work performance. Overall, radiographers need to have a critical and

Clinical Experience in Advanced Practice Nursing: A Canadian Perspective.

Science.gov (United States)

Donnelly, Glenn

2003-01-01

The role of advanced practice (AP) nurses must be clearly articulated and defined and not overshadowed by medical functions. Consensus on their educational preparation and explication of the nature of expertise in advanced practice are needed if AP nurses are to realize the full scope of their practice. (Contains 35 references.) (SK)

An Academic-Practice Partnership to Advance DNP Education and Practice.

Science.gov (United States)

Howard, Patricia B; Williams, Tracy E

During the past decade, the growth of doctor of nursing practice (DNP) programs in the United States has been phenomenal, with most focusing on the preparation of advanced practice registered nurses. Simultaneously, academic-practice partnerships have been a frequent subject of discussion for nursing's leading academic, administrative, and practice organizations. Numerous reports about academic-practice partnerships concerning aspects of baccalaureate nursing education exist, but partnership accounts for DNP programs are essentially nonexistent. The purpose of this article is to describe the initial phase of an academic-practice partnership between a multisystem health care organization and a college of nursing in a public land-grant university in the southeastern United States. The 7-year partnership agreement between Norton Healthcare and the University of Kentucky College of Nursing was designed to prepare 5 cohorts of 20 to 30 baccalaureate-prepared staff nurses as DNP graduates for advanced practice registered nurse eligibility. The description of partnering institution characteristics frames an emphasis on elements of the partnership proposal, contractual agreement, and partner responsibilities along with the logic model evaluation plan. Lessons learned include the importance of proposals and contracts to sustain the partnership, frequent communication to build trust, and strategic analysis for rapid response to challenging situations. Copyright © 2016 Elsevier Inc. All rights reserved.

Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology

International Nuclear Information System (INIS)

Taljanovic, Mihra S.; Schwartz, Stephanie A.; Graham, Anna R.; Benjamin, James B.; Gmitro, Arthur F.; Krupinski, Elizabeth A.; Hunter, Tim B.; Resnick, Donald L.

2008-01-01

To correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA). The study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement. A spin echo (SE) sequence with four echoes and separate fast spin echo (FSE) proton density (PD)-weighted SE sequences of fat (F) and water (W) were acquired with water and fat suppression, respectively. T2 and water:fat ratio calculations were made for the outlined regions of interest. The calculated MRI values were correlated with the clinical, radiographic, and histopathologic findings. Analyses of variance were done on the MRI data for W/(W + F) and for T2 values (total and focal values) for the symptomatic and contralateral hips. The values were significantly higher in the study group. Statistically significant correlations were found between pain and total W/(W + F), pain and focal T2 values, and the number of microfractures and calculated BME for the focal W/(W + F) in the proximal femora. Statistically significant correlations were found between the radiographic findings and MRI values for total W/(W + F), focal W/(W + F) and focal T2 and among the radiographic findings, pain, and hip movement. On histopathology, only a small amount of BME was seen in eight proximal femora. The amount of BME in the OA hip, as measured by MRI, correlates with the severity of pain, radiographic findings, and number of microfractures. (orig.)

Role extension and role advancement - Is there a difference? A discussion paper

Energy Technology Data Exchange (ETDEWEB)

Hardy, Maryann [Division of Radiography, School of Health Studies, University of Bradford, Trinity Road, Bradford, West Yorkshire BD5 0BB (United Kingdom)]. E-mail: m.l.hardy1@bradford.ac.uk; Snaith, Beverly [Mid Yorkshire Hospitals NHS Trust (United Kingdom)

2006-11-15

The terms 'extended' and 'advanced' practice are commonly used to describe clinical practitioner roles. However, these terms have not been clearly defined within the context of modern radiography practice despite their fundamental importance to establishing the 4 tier structure, implementing Agenda for Change and promoting a coherent clinical radiography career structure. This paper discusses the terms 'extension' and 'advancement' in relation to radiography practice and, using evidence from the debates of other health professions, attempts to offer some clarity to the terminology, presenting one interpretation of its possible application to the radiographer role in the United Kingdom.

The lived experience of newly qualified radiographers (1950-1985): An oral history of radiography

International Nuclear Information System (INIS)

Decker, Sola

2009-01-01

The preparedness for practice of newly qualified healthcare professionals (including radiographers) has been the focus of attention in recent years as the practice environment continues to place great demands on its workforce. This paper reports an aspect of the findings from an oral history project on the career history of radiographers conducted as an academic research investigating the changes that have occurred in radiography and the impact these have had on the profession and the practice of radiography. The main focus of this paper is the lived experience of the informants of the oral history project as newly qualified radiographers. The findings are discussed in the context of current practice environment and developments in radiography. Analysis of the textual materials generated from informants' oral historical accounts, suggest radiographers trained in this time frame perceived their training as 'fit for purpose. The findings further suggest there is a general norm of 'get-on-with-it' as a coping strategy which is still prevalent in the profession today. The paper concludes by drawing on lessons that can be learned from the lived experiences of radiographers' oral historical accounts.

21 CFR 892.1920 - Radiographic head holder.

Science.gov (United States)

2010-04-01

...) Identification. A radiographic head holder is a device intended to position the patient's head during a... device is also exempt from the current good manufacturing practice requirements of the quality system...

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

Science.gov (United States)

Garrett, Bernard; Klein, Gerri

2008-08-01

The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless

An evidence based protocol for peer review of radiographer musculoskeletal plain film reporting

International Nuclear Information System (INIS)

Stephenson, Paul; Hannah, April; Jones, Helen; Edwards, Rosemary; Harrington, Kate; Baker, Sally-Anne; Fitzgerald, Nicole; Belfield, Jane

2012-01-01

Aims: Medical image interpretation by non-medically trained staff continues to court controversy. This article aims to show that any potential risks associated with radiographer reporting can be monitored and mitigated if a robust peer review system is introduced. A search of the evidence base illustrates a paucity of guidance on how reporting radiographers should be audited or how a peer review process should be implemented. A practical framework for designing a reporting radiographer peer review process is provided. Methods: Following a literature review, key issues faced when designing a peer review protocol were identified. The following questions are answered: How frequent should peer review take place? How many reports should be reviewed? How are reports selected for review? Who should peer review the radiographer reports? How should radiographer's reporting performance be measured? What standard of reporting is acceptable? Results: Details are provided of the process that has been used for over three years at a busy inner-city teaching hospital for auditing musculoskeletal plain film radiographer reporting. The peer review method presented is not intended to produce robust statistical data; it is a practical method of locally assessing the reporting competency. As such, our protocol should be viewed as part of a larger programme for continuing professional development. Conclusion: It is hoped that this practical protocol will encourage radiology departments to engage in a programme of peer review for reporting radiographers.

Epigenetics: An Emerging Framework for Advanced Practice Psychiatric Nursing.

Science.gov (United States)

DeSocio, Janiece E

2016-07-01

The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.

Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?

Science.gov (United States)

Craiovan, B; Weber, M; Worlicek, M; Schneider, M; Springorum, H R; Zeman, F; Grifka, J; Renkawitz, T

2016-06-01

The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was - 1.4° ± 3.9° for inclination and 0.8°± 7.9° for anteversion with excellent correlation for inclination (r = 0.81, p cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future. • Measuring acetabular cup orientation on anteroposterior radiographs of the hip after THA is a helpful procedure in everyday clinical practice as a first-line imaging modality• CT remains the golden standard to accurately determine acetabular cup position.• Future measuring on radiographs for cup orientation after THA should account for integration of the pelvic tilt in order to maximize the measurement accuracy. Citation Format: • Craiovan B, Weber M, Worlicek M et al. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?. Fortschr Röntgenstr 2016; 188: 574 - 581. © Georg Thieme Verlag KG Stuttgart · New York.

International Society of Radiographers and Radiological Technologists and radiation protection

International Nuclear Information System (INIS)

Yule, A.

2001-01-01

The ISRRT was formed in 1962 with 15 national societies and by the year 2000 has grown to comprise more than 70 member societies. The main objects of the organization are to: Improve the education of radiographers; Support the development of medical radiation technology worldwide; Promote a better understanding and implementation of radiation protection standards. The ISRRT has been a non-governmental organization in official relations with the World Health Organization (WHO) since 1967. It is the only international radiographic organization that represents radiation medicine technology and has more than 200 000 members within its 70 member countries. Representatives of the ISRRT have addressed a number of assemblies of WHO regional committees on matters relating to radiation protection and radiation medicine technology. In this way, the expertise of radiographers worldwide contributes to the establishment of international standards in vital areas, such as: Quality control; Legislation for radiation protection; Good practice in radiographic procedures; Basic radiological services. The ISRRT believes that good and consistent standards of practice throughout the world are essential

Reflections on the role of consultant radiographers in the UK: The perceived impact on practice and factors that support and hinder the role

International Nuclear Information System (INIS)

Henwood, S.; Booth, L.; Miller, P.K.

2016-01-01

Study context: This paper is the third paper arising from a two year long, in-depth case study exploring various components of the role of consultant radiographers in the UK. This paper focuses particularly upon the perceived impact of the role and factors that support and hinder the role in practice. Methods: A longitudinal case study method was used to explore the role of consultant radiographers. Interviewing was informed and guided by a phenomenological approach to promote a deeper understanding of consultants' experiences in the role. Eight consultant radiographers participated, with six involved throughout the whole study. Over an 18 month period each of those six consultants was interviewed three times. Two consultants only participated in the first interview; these interviews are also reported here. A total of 20 interviews were conducted. Findings: Interviews explored the impact of the consultant role as perceived by consultants themselves, and encouraged individual reflection on factors which had both supported and hindered success therein. Analysis demonstrated that there was substantial variation in the experiences communicated yet, and without any exception, all consultants reported that the introduction of their role had been beneficial to service delivery and quality of patient care. A number of obstacles were outlined, as well as a range of support mechanisms. Recommendations are thus made as to how the consultant role might be more effectively supported in the future. - Highlights: • The perceived impact of the consultant radiographer role in practice. • Reflections upon what supported the consultants in their role. • Reflections upon what hindered the consultants in their role.

CT colonography training for radiographers - a formal evaluation

International Nuclear Information System (INIS)

Haycock, A.; Burling, D.; Wylie, P.; Muckian, J.; Ilangovan, R.; Thomas-Gibson, S.

2010-01-01

Aims: To evaluate the efficacy of a new intensive 'hands-on' course designed to train small teams of radiographers in computed tomography colonography (CTC) technique and initial interpretation for patient triage. Materials and methods: The course comprised small-group lectures, active participation in the daily CTC service with practical technique and image interpretation training by experienced radiologists and radiographers. Evaluation was by assessment of knowledge using randomized sets of multiple choice questions (MCQ; pre/post-course), practical technique using checklists and expert global scores, and interpretation performance outcomes using randomized pre/post-course test datasets (five validated CTC examinations each). Paired t-tests were used to investigate change in performance for MCQ score and interpretation accuracy. Results: Thirteen courses with 49 participants were evaluated over 2 years. Practical skills were high, with mean (SD) checklist scores of 14/15 (0.85) and global scores of 26/30 (2.3). MCQ scores increased significantly from a mean of 59% pre-course to 69% post-course, p 10 mm) detection rates also improved significantly from 49% to 60%, p = 0.002. Conclusion: Structured training in CTC can significantly improve knowledge and interpretation skills of radiographers, while assessing safe procedural performance. Implementation of similar programmes nationally may help reduce performance gaps between centres.

Radiographers and trainee radiologists reporting accident radiographs

DEFF Research Database (Denmark)

Buskov, L; Abild, A; Christensen, A

2013-01-01

To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital....

Reliability of cervical lordosis measurement techniques on long-cassette radiographs.

Science.gov (United States)

Janusz, Piotr; Tyrakowski, Marcin; Yu, Hailong; Siemionow, Kris

2016-11-01

Lateral radiographs are commonly used to assess cervical sagittal alignment. Three assessment methods have been described and are commonly utilized in clinical practice. These methods are described for perfect lateral cervical radiographs, however in everyday practice radiograph quality varies. The aim of this study was to compare the reliability and reproducibility of 3 cervical lordosis (CL) measurement methods. Forty-four standing lateral radiographs were randomly chosen from a lateral long-cassette radiograph database. Measurements of CL were performed with: Cobb method C2-C7 (CM), C2-C7 posterior tangent method (PTM), sum of posterior tangent method for each segment (SPTM). Three independent orthopaedic surgeons measured CL using the three methods on 44 lateral radiographs. One researcher used the three methods to measured CL three times at 4-week time intervals. Agreement between the methods as well as their intra- and interobserver reliability were tested and quantified by intraclass correlation coefficient (ICC) and median error for a single measurement (SEM). ICC of 0.75 or more reflected an excellent agreement/reliability. The results were compared with repeated ANOVA test, with p  0.05). All three methods appeared to be highly reliable. Although, high agreement between all measurement methods was shown, we do not recommend using Cobb measurement method interchangeably with PTM or SPTM within a single study as this could lead to error, whereas, such a comparison between tangent methods can be considered.

Radiographers' commitment to continuing professional development: A single-centre evaluation

International Nuclear Information System (INIS)

Stevens, Barry J.

2016-01-01

Purpose: This study aimed to examine radiographers' commitment to continuing professional development (CPD), and to ascertain what types of activities are preferred so a model for provision of departmental activities could be developed. Methods: An online survey was used to obtain information from all departmental radiographers regarding their commitment to CPD. Statistical analysis, using Spearman's Rho and Chi-Square test, was utilised to investigate any associations. Results: All radiographers (n = 57) were invited via email. A response rate of 67% (n = 38) prevailed. Radiographers feel CPD is important and a positive correlation existed with feelings regarding compulsory CPD (r value = .718, P value = .001). Thirty-four percent had logged the SOR-recommended twelve or more pieces of CPD in the last 2 years. One to three hours a month is the preferred amount of own time radiographers are willing to dedicate. Negative correlations exist between the amount of own time radiographers are willing to commit to CPD activities and their feelings regarding compulsory CPD (r value = −.419, P value = .009), and HCPC audit (r value = −.509, P value .001). Conclusion: Although radiographers recognise the importance of CPD many spend less than four hours of their own time a month on CPD. Departmental activities should be free, short lasting, lunchtime presentations with theory presentation that encourage interaction and discussion with inclusion of practical elements. Further research investigating the barriers that prevent radiographers from partaking in CPD and the causes for insufficient CPD records is recommended. - Highlights: • The large majority of radiographers feel CPD is important or very important to them. • The majority had positive opinions regarding compulsory CPD and HCPC audit. • 50% of radiographers commit less than 4 h of their own time to CPD. • As radiographers get older they log less CPD and commit less time to CPD. �

Automated alignment of the Advanced Radiographic Capability (ARC) target area at the National Ignition Facility

Science.gov (United States)

Roberts, Randy S.; Awwal, Abdul A. S.; Bliss, Erlan S.; Heebner, John E.; Leach, Richard R.; Orth, Charles D.; Rushford, Michael C.; Lowe-Webb, Roger R.; Wilhelmsen, Karl C.

2015-09-01

The Advanced Radiographic Capability (ARC) at the National Ignition Facility (NIF) is a petawatt-class, short-pulse laser system designed to provide x-ray backlighting of NIF targets. ARC uses four NIF beamlines to produce eight beamlets to create a sequence of eight images of an imploding fuel capsule using backlighting targets and diagnostic instrumentation. ARC employs a front end that produces two pulses, chirps the pulses out to 2 ns, and then injects the pulses into the two halves of each of four NIF beamlines. These pulses are amplified by NIF pre- and main amplifiers and transported to compressor vessels located in the NIF target area. The pulses are then compressed and pointed into the NIF target chamber where they impinge upon an array of backlighters. The interaction of the ARC laser pulses and the backlighting material produces bursts of high-energy x-rays that illuminate an imploding fuel capsule. The transmitted x-rays are imaged by diagnostic instrumentation to produce a sequence of radiograph images. A key component of the success of ARC is the automatic alignment system that accomplishes the precise alignment of the beamlets to avoid damaging equipment and to ensure that the beamlets are directed onto the tens-of-microns scale backlighters. In this paper, we describe the ARC automatic alignment system, with emphasis on control loops used to align the beampaths. We also provide a detailed discussion of the alignment image processing, because it plays a critical role in providing beam centering and pointing information for the control loops.

Quality of radiograph

International Nuclear Information System (INIS)

Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail

2008-01-01

This chapter discussed on how to get a good radiograph. There are several factors that can make good radiograph such as density of radiograph, the contrast of radiograph, definition of radiograph, the present of artifact and backscattering. All of this factor will discuss detailed on each unit of chapter with some figure, picture to make the reader understand more when read this book. And at the end, the reader will introduce with penetrameter, one of device to determine the level of quality of the radiograph. There are two type of penetrameter like wire type or holes type. This standard must be followed by all the radiographer around the world to produce the good result that is standard and more reliable.

Studies on the method of producing radiographic 170Tm source

International Nuclear Information System (INIS)

Maeda, Sho

1976-08-01

A method of producing radiographic 170 Tm source has been studied, including target preparation, neutron irradiation, handling of the irradiated target in the hot cell and source capsules. On the basis of the results, practical 170 Tm radiographic sources (29 -- 49Ci, with pellets 3mm in diameter and 3mm long) were produced in trial by neutron irradiation with the JMTR. (auth.)

The role of a consultant breast radiographer: A description and a reflection

International Nuclear Information System (INIS)

Kelly, Judith; Hogg, Peter; Henwood, Suzanne

2008-01-01

Consultant radiographers are a relatively new concept within the British healthcare system, with them being first established in 2003. Consultant radiographer job roles are broad and include advanced clinical activities (often being similar in nature to those delivered by medical practitioners, e.g. radiologists), professional leadership, teaching and education and service improvement. Given their relative novelty almost no literature exists to describe in detail specific roles of consultant breast radiographers. Consequently, in this article we use a case study approach to describe and reflect critically upon the role of one consultant breast radiographer. The article commences with a general introduction about consultant radiographers; it then progresses to outline the context in which the case study of the breast consultant radiographer sits. Through description and reflective commentary we take the reader through the role of the consultant breast radiographer to highlight where the role has had perceived value and also to highlight where the role has been particularly challenging for the post holder. As a consequence of the case study approach taken, the article is written partly in the first person (taken from interview comments made by the consultant breast radiographer) and partly in the third person. The final element of the article is a reflective commentary given by the consultant radiographer regarding her feelings about her first few years as a consultant breast radiographer

Organizing a community advanced pharmacy practice experience.

Science.gov (United States)

Koenigsfeld, Carrie Foust; Tice, Angela L

2006-02-15

Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site.

Radiographer and radiologist perception error in reporting double contrast barium enemas: A pilot study

International Nuclear Information System (INIS)

Booth, Alison M.; Mannion, Richard A.J.

2005-01-01

Purpose: The practice of radiographers performing double contrast barium enemas (DCBE) is now widespread and in many centres the radiographer's opinion is, at least, contributing to a dual reporting system [Bewell J, Chapman AH. Radiographer performed barium enemas - results of a survey to assess progress. Radiography 1996;2:199-205; Leslie A, Virjee JP. Detection of colorectal carcinoma on double contrast barium enema when double reporting is routinely performed: an audit of current practice. Clin Radiol 2001;57:184-7; Culpan DG, Mitchell AJ, Hughes S, Nutman M, Chapman AH. Double contrast barium enema sensitivity: a comparison of studies by radiographers and radiologists. Clin Radiol 2002;57:604-7]. To ensure this change in practice does not lead to an increase in reporting errors, this study aimed to compare the perception abilities of radiographers with those of radiologists. Methods: Three gastro-intestinal (GI) radiographers and three consultant radiologists independently reported on a selection of 50 DCBE examinations, including the level of certainty in their comments for each examination. A blinded comparison of the results with an independent 'standard report' was recorded. Results: The results demonstrate there was no significant difference in perception error for any of the levels of certainty, for single reporting, for double reading by a radiographer/radiologist or by two radiologists. Conclusions: The study shows that radiographers can perceive abnormalities on DCBE at similar sensitivities and specificities as radiologists. While the participants in the study may be typical of a district general hospital, the nature of the study gives it limited external validity. As a pilot, the results demonstrate that, with slight modification, the methodology could be used for a larger study

Is the owner entitled to radiographs taken of his animal?

International Nuclear Information System (INIS)

Hartung, K.

1990-01-01

In the Federal Republic of Germany a veterinarian owns radiographs taken of animals in his practice. They have to be filed like any other results of diagnostic procedures. This is important, because evidence is required in the case of a law suit. On the other hand, it has to be stressed that taking radiographs is the subject of a free contract between owner and veterinarian. So it is possible to take the radiographs solely with the purpose of giving them to the owner, who may have them analysed by any other veterinarian of his choice. This is especially true in hip radiographs, which are evaluated and filed by an adjudicator of the breed association. In any case the radiologist has the obligation to lend the radiographs to another veterinarian on request for inspection. The second veterinarian has to give them back as soon as possible

Advancing Evaluation Theory and Practice in South Asia ...

International Development Research Centre (IDRC) Digital Library (Canada)

Advancing Evaluation Theory and Practice in South Asia: Community of ... evidence-based policy development, decision-making, and practice in South Asia. ... International Water Resources Association, in close collaboration with IDRC, ...

Radiographic analysis of ameloblastoma: A retrospective study

Directory of Open Access Journals (Sweden)

Chandramani More

2012-01-01

Conclusion: Radiographs are an important aid for the diagnosis of oral lesions of various types, especially those that involve bone. It is important for the practicing clinicians to know the salient features of ameloblastoma which are peculiar to the local population.

An Academic-Practice Partnership Model to Grow and Sustain Advanced Practice Nursing.

Science.gov (United States)

Williams, Tracy E; Howard, Patricia B

2017-12-01

The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study. The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing. An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program. Qualitative methods were used to explore pilot data at midpoint of cohort 1 student progression to determine learning outcomes and DNP projects with potential for impact on organization goals. Partnership implementation experiences indicate that contractual agreements and an established evaluation plan are keys to academic-practice partnership success. Pilot study findings suggest that curriculum core courses provide a foundation for designing DNP projects congruent with acute and primary care health system goals. Implementing an academic-practice partnership is a strategy for workforce development to increase retention of advanced practice nurses. Academic-practice partnerships can serve as a catalyst for a paradigm shift for changing models of care, thus enhancing workforce development succession planning for sustainable growth in healthcare systems.

Neonates do not need to be handled for radiographs

International Nuclear Information System (INIS)

Slade, Dawn; Alfaham, Mazin; Davis, Peter; Tuthill, David; Harrison, Sara; Morris, Susan; Guildea, Zoe

2005-01-01

The handling of sick neonates may have detrimental effects such as hypoxia or bradycardia. Such handling is inevitable due to the frequent need for practical procedures; however, minimising handling reduces these adverse events and may improve outcome. Radiography is one of the commonest procedures performed on neonates. Usually the infant is lifted and placed onto the radiographic cassette; however, modern incubators often incorporate a tray beneath the mattress in which the radiographic cassette can be placed without the need to disturb the infant. To compare the quality of chest radiographs taken using the standard direct contact method, with those taken using the under-tray technique. A series of chest radiographs taken over a 21-month period were analysed independently by two consultant paediatric radiologists unaware of the radiographic details. The position of the radiograph, i.e. direct contact or under-tray, was determined by the radiographer. Radiographic quality was scored on the following features: exposure, blurring, rotation, cut-off or coning, and side markers. A subjective score was also included. The results from each radiologist were analysed separately. Seventy chest radiographs were analysed - 25 standard method, 45 under-tray. A statistically significant advantage for the under-tray method was seen on two analyses - radiologist 1 for exposure, and radiologist 2 for cut-off. No other significant differences were noted. There were no differences in the infants' weights or radiation exposure. The under-tray method for taking radiographs may produce films of at least equivalent quality to the standard method. Since the standard method involves handling with potential desaturation and bradycardia, this technique should cease. (orig.)

Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

Energy Technology Data Exchange (ETDEWEB)

Creeden, Sean G.; Rao, Anil G.; Eklund, Meryle J.; Hill, Jeanne G.; Thacker, Paul G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

2017-03-15

Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy. To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures. We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management. We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam. Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold. (orig.)

Radiographic follow-up study of Little Leaguer's shoulder

International Nuclear Information System (INIS)

Kanematsu, Yoshiji; Iwase, Takenobu; Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi; Kashiwaguchi, Shinji; Iwame, Toshiyuki

2015-01-01

Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

Advancing Work Practices Through Online Professional Development

DEFF Research Database (Denmark)

Noesgaard, Signe Schack

The natural expectation for professional development courses is that they will improve a participant’s work performance, but do they? This PhD research challenges several assumptions underlying the design of online professional development courses, revealing that it is after such interventions...... was not effective and subsequently terminate change that could have advanced their practices. This underlines the need to think beyond the course format to make online professional development interventions continuous, committing, and contextual. The research suggests rethinking online professional development...... as adaptive “just-in-time” technologies and proposes a design theory called “situated online professional development,” entailing six design principles for advancing work practices....

Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice?

DEFF Research Database (Denmark)

Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille

2014-01-01

OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2...

Intraligamentary--intraosseous anesthesia. A radiographic demonstration.

Science.gov (United States)

Garfunkel, A A; Kaufman, E; Marmary, Y; Galili, D

1983-10-01

Intraligamentary dental anesthesia has become a widely accepted technique. The periodontal ligament seems to provide easy access to the tooth apex. In the present study, radiopaque material was injected into baboon monkeys. Serial radiographs during incremental injections showed clouding of the crestal bone. The material was seen gradually advancing through the alveolar bone crest, apically. The spread was noticed through the marrow spaces, unexpectedly avoiding the PDL route.

Assessment of the willingness of radiographers in mammography to accept new responsibilities in role extension: Part one - Quantitative analysis

Energy Technology Data Exchange (ETDEWEB)

Moran, S., E-mail: sheila.moran@uon.edu.au [BreastScreen New South Wales, Hunter New England Program (Australia); Warren-Forward, H. [Discipline of Medical Radiation Sciences, University of Newcastle, NSW (Australia)

2011-11-15

comply) was seen as a problem by only 15% of respondents. Conclusion: This study reports on the thoughts and perceptions of Australian radiographers on many aspects of role expansion within BreastScreen Australia and shows their support for advanced practice.

Assessment of the willingness of radiographers in mammography to accept new responsibilities in role extension: Part one - Quantitative analysis

International Nuclear Information System (INIS)

Moran, S.; Warren-Forward, H.

2011-01-01

comply) was seen as a problem by only 15% of respondents. Conclusion: This study reports on the thoughts and perceptions of Australian radiographers on many aspects of role expansion within BreastScreen Australia and shows their support for advanced practice.

Design and evaluation of learning strategies for a group of radiographers in radiostereometric analysis (RSA).

Science.gov (United States)

Muharemovic, O; Troelsen, A; Thomsen, M G; Kallemose, T; Gosvig, K K

2017-11-01

The purpose of this study was to design and evaluate a radiostereometric analysis (RSA) program aimed at radiographers in order to increase their cognitive and practical skills, thereby increasing image quality and minimizing exposure repetition. Twenty radiographers were randomized into two identically sized study groups. Training consisted of a theoretical and practical workshop using a phantom. Tests were performed to compare the effect of training to nontraining, and the effect of time duration on the maintenance of RSA skills. The effect of training was measured by a written test and three defined parameters influencing image quality. Group A reduced significantly (p RSA X-ray training program where radiographers significantly improve their theoretical and practical skills in centering the CP closer to the CCF, NB and RP. A duration of up to two months after training does not influence the quality of participants' performance. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Clinical history and physical examination skills - A requirement for radiographers?

International Nuclear Information System (INIS)

Snaith, Beverly A.; Lancaster, Anne

2008-01-01

Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

Transfer function analysis of radiographic imaging systems

International Nuclear Information System (INIS)

Metz, C.E.; Doi, K.

1979-01-01

The theoretical and experimental aspects of the techniques of transfer function analysis used in radiographic imaging systems are reviewed. The mathematical principles of transfer function analysis are developed for linear, shift-invariant imaging systems, for the relation between object and image and for the image due to a sinusoidal plane wave object. The other basic mathematical principle discussed is 'Fourier analysis' and its application to an input function. Other aspects of transfer function analysis included are alternative expressions for the 'optical transfer function' of imaging systems and expressions are derived for both serial and parallel transfer image sub-systems. The applications of transfer function analysis to radiographic imaging systems are discussed in relation to the linearisation of the radiographic imaging system, the object, the geometrical unsharpness, the screen-film system unsharpness, other unsharpness effects and finally noise analysis. It is concluded that extensive theoretical, computer simulation and experimental studies have demonstrated that the techniques of transfer function analysis provide an accurate and reliable means for predicting and understanding the effects of various radiographic imaging system components in most practical diagnostic medical imaging situations. (U.K.)

Online, directed journaling in community health advanced practice nursing clinical education.

Science.gov (United States)

Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

2004-04-01

The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education.

Profile of advanced nursing practice in Spain: A cross-sectional study.

Science.gov (United States)

Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

2018-03-01

In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

Establishing philanthropic funds for advanced practice scholarships.

Science.gov (United States)

Neumann, T

1997-01-01

Because of decreased tuition assistance at some hospitals, experienced nurses interested in advanced roles may quit rather than stay and expand their roles. This author describes how a hospital based philanthropic community group has helped provide scholarships for nurses interested in advanced practice and how to set up a similar scholarship program that will retain these experienced and motivated nurses.

Cardiac and pericardial calcifications on chest radiographs

Energy Technology Data Exchange (ETDEWEB)

Ferguson, E.C., E-mail: ecferguson@hotmail.co [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States); Berkowitz, E.A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States)

2010-09-15

Many types of cardiac and pericardial calcifications identified on chest radiographs can be recognized and distinguished based on characteristic locations and appearances. The purpose of this review is to emphasize the importance of detecting cardiac and pericardial calcifications on chest radiographs, and to illustrate and describe the various types of calcifications that may be encountered and how they may be differentiated from one another. Each type of cardiac and pericardial calcification is discussed, its location and appearance described, and its significance explained. Recognizing and understanding these calcifications is important as they are often encountered in daily practice and play an important role in patient care.

Systematic assessment of constipation on plain abdominal radiographs in children

International Nuclear Information System (INIS)

Bosch, Maurice van den; Graafmans, Doortje; Nievelstein, Rutger; Beek, Erik

2006-01-01

Constipation in childhood is common and its clinical assessment is often difficult. Plain abdominal radiography is simple and used to quantify constipation. Three scoring systems, those of Barr et al., Leech et al. and Blethyn et al., have been developed to quantify fecal loading on the abdominal radiograph. In order to determine which method is the most useful in clinical practice, we assessed the reproducibility of the three scoring systems. Plain abdominal radiographs from 40 clinically constipated children were retrospectively reviewed by two paediatric radiologists on two separate occasions. The radiographs were scored according to three different systems developed by Barr et al., Leech et al., Blethyn et al. Intraobserver variability and interobserver reproducibility were determined for each system. Kappa coefficients were calculated as indicators of inter- and intraobserver agreement for categorical outcome variables. The Leech score showed the highest reproducibility: the intraobserver agreement was high for both observers (κ values of 0.88 and 1.00, respectively, P<0.05). Furthermore, the interobserver agreement was also high: κ 0.91 in the first round and 0.84 in the second. The Leech score proved to be a highly reproducible tool for assessment of childhood constipation and is of value in clinical practice for systematic assessment of constipation on plain abdominal radiographs in children. (orig.)

Systematic assessment of constipation on plain abdominal radiographs in children

Energy Technology Data Exchange (ETDEWEB)

Bosch, Maurice van den; Graafmans, Doortje [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Nievelstein, Rutger; Beek, Erik [Wilhelmina Children' s Hospital, Department of Paediatric Radiology, Utrecht (Netherlands)

2006-03-15

Constipation in childhood is common and its clinical assessment is often difficult. Plain abdominal radiography is simple and used to quantify constipation. Three scoring systems, those of Barr et al., Leech et al. and Blethyn et al., have been developed to quantify fecal loading on the abdominal radiograph. In order to determine which method is the most useful in clinical practice, we assessed the reproducibility of the three scoring systems. Plain abdominal radiographs from 40 clinically constipated children were retrospectively reviewed by two paediatric radiologists on two separate occasions. The radiographs were scored according to three different systems developed by Barr et al., Leech et al., Blethyn et al. Intraobserver variability and interobserver reproducibility were determined for each system. Kappa coefficients were calculated as indicators of inter- and intraobserver agreement for categorical outcome variables. The Leech score showed the highest reproducibility: the intraobserver agreement was high for both observers ({kappa} values of 0.88 and 1.00, respectively, P<0.05). Furthermore, the interobserver agreement was also high: {kappa} 0.91 in the first round and 0.84 in the second. The Leech score proved to be a highly reproducible tool for assessment of childhood constipation and is of value in clinical practice for systematic assessment of constipation on plain abdominal radiographs in children. (orig.)

Monte Carlo simulation for radiographic applications

International Nuclear Information System (INIS)

Tillack, G.R.; Bellon, C.

2003-01-01

Standard radiography simulators are based on the attenuation law complemented by built-up-factors (BUF) to describe the interaction of radiation with material. The assumption of BUF implies that scattered radiation reduces only the contrast in radiographic images. This simplification holds for a wide range of applications like weld inspection as known from practical experience. But only a detailed description of the different underlying interaction mechanisms is capable to explain effects like mottling or others that every radiographer has experienced in practice. The application of Monte Carlo models is capable to handle primary and secondary interaction mechanisms contributing to the image formation process like photon interactions (absorption, incoherent and coherent scattering including electron-binding effects, pair production) and electron interactions (electron tracing including X-Ray fluorescence and Bremsstrahlung production). It opens up possibilities like the separation of influencing factors and the understanding of the functioning of intensifying screen used in film radiography. The paper discusses the opportunities in applying the Monte Carlo method to investigate special features in radiography in terms of selected examples. (orig.) [de

Is the frontal radiograph alone sufficient to evaluate for pneumonia in children?

International Nuclear Information System (INIS)

Rigsby, Cynthia K.; Strife, Janet L.; Johnson, Neil D.; Atherton, Harry D.; Kotagal, Uma R.; Pommersheim, William

2004-01-01

In our cost- and radiation-conscious environment, the feasibility of performing only a frontal radiograph for the diagnosis of pneumonia in children needs to be reassessed. To determine the diagnostic efficacy of the frontal radiograph alone in comparison to the frontal and lateral combined radiographs for the radiographic diagnosis of pneumonia in children. Three radiologists retrospectively and independently reviewed the frontal radiographs alone and separately reviewed the frontal and lateral radiographs of 1,268 children referred from the emergency room for chest radiographs. A majority interpretation of at least two radiologists for the frontal views alone was compared with majority interpretation of the frontal and lateral combined views for the radiographic diagnosis of pneumonia. ''Pneumonia'' was defined as a focus of streaky or confluent lung opacity. For the radiographic diagnosis of pneumonia, the sensitivity and specificity of the frontal view alone were 85% and 98%, respectively. For the confluent lobar type of pneumonia, the sensitivity and specificity increased to 100%. When the frontal view alone yields a diagnosis of confluent lobar pneumonia, this is highly reliable. However, nonlobar types of infiltrates will be underdiagnosed in 15% of patients using the frontal view alone. The clinical impact of these radiographically underdiagnosed pneumonias needs to be assessed prior to implementing the practice of using only frontal radiographs for diagnosing pneumonia. (orig.)

Is the frontal radiograph alone sufficient to evaluate for pneumonia in children?

Energy Technology Data Exchange (ETDEWEB)

Rigsby, Cynthia K. [Department of Radiology, Children' s Hospital Medical Center, 3333 Burnet Avenue, OH 45229, Cincinnati (United States); Department of Medical Imaging No. 9, Children' s Memorial Hospital, 2300 Children' s Plaza, IL 60614, Chicago (United States); Strife, Janet L.; Johnson, Neil D. [Department of Radiology, Children' s Hospital Medical Center, 3333 Burnet Avenue, OH 45229, Cincinnati (United States); Atherton, Harry D.; Kotagal, Uma R. [Department of Health Policy and Clinical Effectiveness, Children' s Hospital Medical Center, 3333 Burnet Avenue, OH 45229, Cincinnati (United States); Pommersheim, William [Department of Radiology, Children' s Hospital Medical Center, 3333 Burnet Avenue, OH 45229, Cincinnati (United States); Wake Forest University Baptist Medical Center, Department of Radiology, Meads Hall, 2nd Floor, NC 27157, Winston-Salem (United States)

2004-05-01

In our cost- and radiation-conscious environment, the feasibility of performing only a frontal radiograph for the diagnosis of pneumonia in children needs to be reassessed. To determine the diagnostic efficacy of the frontal radiograph alone in comparison to the frontal and lateral combined radiographs for the radiographic diagnosis of pneumonia in children. Three radiologists retrospectively and independently reviewed the frontal radiographs alone and separately reviewed the frontal and lateral radiographs of 1,268 children referred from the emergency room for chest radiographs. A majority interpretation of at least two radiologists for the frontal views alone was compared with majority interpretation of the frontal and lateral combined views for the radiographic diagnosis of pneumonia. ''Pneumonia'' was defined as a focus of streaky or confluent lung opacity. For the radiographic diagnosis of pneumonia, the sensitivity and specificity of the frontal view alone were 85% and 98%, respectively. For the confluent lobar type of pneumonia, the sensitivity and specificity increased to 100%. When the frontal view alone yields a diagnosis of confluent lobar pneumonia, this is highly reliable. However, nonlobar types of infiltrates will be underdiagnosed in 15% of patients using the frontal view alone. The clinical impact of these radiographically underdiagnosed pneumonias needs to be assessed prior to implementing the practice of using only frontal radiographs for diagnosing pneumonia. (orig.)

CT colonography training for radiographers - a formal evaluation

Energy Technology Data Exchange (ETDEWEB)

Haycock, A. [Intestinal Imaging Centre and Wolfson Unit for Endoscopy, St Mark' s Hospital, Imperial College London, London (United Kingdom); Burling, D., E-mail: burlingdavid@yahoo.co.u [Intestinal Imaging Centre and Wolfson Unit for Endoscopy, St Mark' s Hospital, Imperial College London, London (United Kingdom); Wylie, P.; Muckian, J.; Ilangovan, R.; Thomas-Gibson, S. [Intestinal Imaging Centre and Wolfson Unit for Endoscopy, St Mark' s Hospital, Imperial College London, London (United Kingdom)

2010-12-15

Aims: To evaluate the efficacy of a new intensive 'hands-on' course designed to train small teams of radiographers in computed tomography colonography (CTC) technique and initial interpretation for patient triage. Materials and methods: The course comprised small-group lectures, active participation in the daily CTC service with practical technique and image interpretation training by experienced radiologists and radiographers. Evaluation was by assessment of knowledge using randomized sets of multiple choice questions (MCQ; pre/post-course), practical technique using checklists and expert global scores, and interpretation performance outcomes using randomized pre/post-course test datasets (five validated CTC examinations each). Paired t-tests were used to investigate change in performance for MCQ score and interpretation accuracy. Results: Thirteen courses with 49 participants were evaluated over 2 years. Practical skills were high, with mean (SD) checklist scores of 14/15 (0.85) and global scores of 26/30 (2.3). MCQ scores increased significantly from a mean of 59% pre-course to 69% post-course, p < 0.001. Correct classification of CTC examination improved significantly from a mean of 55% pre-course to 71% post-course, p < 0.001. Cancer and large polyp (>10 mm) detection rates also improved significantly from 49% to 60%, p = 0.002. Conclusion: Structured training in CTC can significantly improve knowledge and interpretation skills of radiographers, while assessing safe procedural performance. Implementation of similar programmes nationally may help reduce performance gaps between centres.

The radiographic acromiohumeral interval is affected by arm and radiographic beam position

Energy Technology Data Exchange (ETDEWEB)

Fehringer, Edward V.; Rosipal, Charles E.; Rhodes, David A.; Lauder, Anthony J.; Feschuk, Connie A.; Mormino, Matthew A.; Hartigan, David E. [University of Nebraska Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Omaha, NE (United States); Puumala, Susan E. [Nebraska Medical Center, Department of Preventive and Societal Medicine, Omaha, NE (United States)

2008-06-15

The objective was to determine whether arm and radiographic beam positional changes affect the acromiohumeral interval (AHI) in radiographs of healthy shoulders. Controlling for participant's height and position as well as radiographic beam height and angle, from 30 right shoulders of right-handed males without shoulder problems four antero-posterior (AP) radiographic views each were obtained in defined positions. Three independent, blinded physicians measured the AHI to the nearest millimeter in 120 randomized radiographs. Mean differences between measurements were calculated, along with a 95% confidence interval. Controlling for observer effect, there was a significant difference between AHI measurements on different views (p<0.01). All pair-wise differences were statistically significant after adjusting for multiple comparisons (all p values <0.01). Even in healthy shoulders, small changes in arm position and radiographic beam orientation affect the AHI in radiographs. (orig.)

Radiographic film digitizing devices

International Nuclear Information System (INIS)

McFee, W.H.

1988-01-01

Until recently, all film digitizing devices for use with teleradiology or picture archiving and communication systems used a video camera to capture an image of the radiograph for subsequent digitization. The development of film digitizers that use a laser beam to scan the film represents a significant advancement in digital technology, resulting in improved image quality compared with video scanners. This paper discusses differences in resolution, efficiency, reliability, and the cost between these two types of devices. The results of a modified receiver operating characteristic comparison study of a video scanner and a laser scanner manufactured by the same company are also discussed

[Transparency regime: semiotics of radiographical images in urological diagnostics].

Science.gov (United States)

Martin, M; Fangerau, H

2012-10-01

Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

Fast radiographic systems

International Nuclear Information System (INIS)

Domanus, J.C.

1984-08-01

Industrial radiography can be performed with shorter exposure times, when instead of X-ray film with lead intensifying screens the radiographic paper with fluorescent screen is used. With paper radiography one can obtain lower material, equipment, and labor costs, shorter exposure and processing times, and easier radiation protection. The speed of the radiographic inspection can also be increased by the use of fluorometallic intensifying screens together with a special brand of X-ray film. Before accepting either of the two fast radiographic systems one must be sure that they can produce radiographs of adequate image quality. Therefore an investigation was performed on that subject using ISO wire IQI's and ASTM penetrameters. The radiographic image quality was tested for aluminium and steel up to 30 mm thick using various brands of radiographic paper and X-ray film with fluorometallic screens and comparing them with fast X-ray films with lead screens. Both systems give satisfactory results. (author)

Procedure competencies and job functions of the urologic advanced practice nurse.

Science.gov (United States)

Kleier, Jo Ann

2009-01-01

A 2-round modified Delphi study recruited a panel urologic advanced practice nurse experts to identify the procedure competencies and job functions unique to the role of the advanced practice nurse specializing in the care of urology patients.

Design and evaluation of learning strategies for a group of radiographers in radiostereometric analysis (RSA)

DEFF Research Database (Denmark)

Muharemovic, O; Troelsen, A; Thomsen, M G

2017-01-01

INTRODUCTION: The purpose of this study was to design and evaluate a radiostereometric analysis (RSA) program aimed at radiographers in order to increase their cognitive and practical skills, thereby increasing image quality and minimizing exposure repetition. METHODS AND MATERIALS: Twenty...... radiographers were randomized into two identically sized study groups. Training consisted of a theoretical and practical workshop using a phantom. Tests were performed to compare the effect of training to nontraining, and the effect of time duration on the maintenance of RSA skills. The effect of training...... after training group B had experienced overall significant improvement on a par with group A. CONCLUSION: It is realistic to implement an RSA X-ray training program where radiographers significantly improve their theoretical and practical skills in centering the CP closer to the CCF, NB and RP...

Doctor of Nursing Practice: The Role of the Advanced Practice Nurse.

Science.gov (United States)

Walker, Deborah Kirk; Polancich, Shea

2015-11-01

To explore the evolution and emerging roles of the Doctor of Nursing Practice (DNP) Advanced Practice Nurse (APN). Published peer reviewed literature, cancer-related professional resources, and Web-based resources. The DNP education has prepared the APN for process improvement initiatives, providing quality care, and evidence-based practice translation, which are critical with the emerging trends in this complex health care environment. DNP-prepared APNs have the opportunity to impact oncology care across the cancer trajectory, in various settings, and in various innovative roles as entrepreneurs. Copyright © 2015 Elsevier Inc. All rights reserved.

Establishing radiation therapy advanced practice in New Zealand

Energy Technology Data Exchange (ETDEWEB)

Coleman, Karen; Jasperse, Marieke; Herst, Patries [Department of Radiation Therapy, University of Otago, Wellington (New Zealand); Yielder, Jill [University of Auckland, Auckland (New Zealand); Department of Radiation Therapy, University of Otago, Wellington (New Zealand)

2014-02-15

Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

Establishing radiation therapy advanced practice in New Zealand

International Nuclear Information System (INIS)

Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

2014-01-01

Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board

Advance care planning for nursing home residents with dementia: policy vs. practice.

Science.gov (United States)

Ampe, Sophie; Sevenants, Aline; Smets, Tinne; Declercq, Anja; Van Audenhove, Chantal

2016-03-01

The aims of this study were: to evaluate the advance care planning policy for people with dementia in nursing homes; to gain insight in the involvement of residents with dementia and their families in advance care planning, and in the relationship between the policy and the actual practice of advance care planning. Through advance care planning, nursing home residents with dementia are involved in care decisions, anticipating their reduced decision-making capacity. However, advance care planning is rarely realized for this group. Prevalence and outcomes have been researched, but hardly any research has focused on the involvement of residents/families in advance care planning. Observational cross-sectional study in 20 nursing homes. The ACP audit assessed the views of the nursing homes' staff on the advance care planning policy. In addition, individual conversations were analysed with 'ACP criteria' (realization of advance care planning) and the 'OPTION' instrument (involvement of residents/families). June 2013-September 2013. Nursing homes generally met three quarters of the pre-defined criteria for advance care planning policy. In almost half of the conversations, advance care planning was explained and discussed substantively. Generally, healthcare professionals only managed to involve residents/families on a baseline skill level. There were no statistically significant correlations between policy and practice. The evaluations of the policy were promising, but the actual practice needs improvement. Future assessment of both policy and practice is recommended. Further research should focus on communication interventions for implementing advance care planning in the daily practice. © 2015 John Wiley & Sons Ltd.

Australian rural radiographers' perspectives on disclosure of their radiographic opinion to patients

International Nuclear Information System (INIS)

Squibb, Kathryn; Bull, Rosalind M.; Smith, Anthony; Dalton, Lisa

2015-01-01

The role of Australian rural radiographers in radiographic interpretation, communication and disclosure of their radiographic opinion with a specific focus on plain film radiography was examined in a two phase, exploratory interpretive study. Data were collected using questionnaires and interviews and analysed thematically. This reports one of the key themes identified in the thematic data analysis. ‘Disclosure of Radiographic Opinion to Patients’ comprises the three interrelated sub-themes Acting Ethically, Selective Disclosure and Filtered Truth. It is wholly concerned with the ways in which rural radiographers choose to disclose their radiographic opinion to patients. Without a clear picture of where they stand medico-legally, rural radiographers draw on experience and a strong ethical framework as the basis for these complex decisions. Rural radiographers frame their disclosures to patients in a manner that is governed by the diagnostic, therapeutic and emotional impact the information disclosed may have on the patient. Disclosure to patients was found to be selective, often diagnostically vague and ethically filtered

Radiographically Occult and Subtle Fractures: A Pictorial Review

International Nuclear Information System (INIS)

Jarraya, M.; Hayashi, D.; Roemer, F.W.; Crema, M.D.; Conlin, J.; Marra, M.D.; Guermazi, A.; Roemer, F.W.; Crema, M.D.; Diaz, L.; Conlin, J.; Jomaah, N.

2013-01-01

Radiographically occult and subtle fractures are a diagnostic challenge. They may be divided into (1) high energy trauma fracture, (2) fatigue fracture from cyclical and sustained mechanical stress, and (3) insufficiency fracture occurring in weakened bone (e.g., in osteoporosis and post radiotherapy). Independently of the cause, the initial radiographic examination can be negative either because the findings seem normal or are too subtle. Early detection of these fractures is crucial to explain the patients symptoms and prevent further complications. Advanced imaging tools such as computed tomography, magnetic resonance imaging, and scintigraphy are highly valuable in this context. Our aim is to raise the awareness of radiologists and clinicians in these cases by presenting illustrative cases and a discussion of the relevant literature.

Development of advanced nursing practice in China: Act local and think global

Directory of Open Access Journals (Sweden)

Frances Kam Yuet Wong

2018-04-01

Full Text Available This paper discusses the development of advanced nursing practice in China in the context of global development. The scope of nursing is evolving over time, with increasing demands for the management of complex healthcare situations at individual, community and system levels. These demands are aggravated by the specialization of medical practice, with advanced treatment plans and patients requiring care in focused areas. The qualifications and competencies of the initial entrants into nursing practice are not adequate to deal with these demands. Advanced nursing practice (ANP developed first in response to service demands, and education programs were introduced to prepare nurses for practicing at a higher level. This paper will first review the historical development of ANP in China, followed by a discussion of the differentiation of competence levels in nursing practice and the classification of specializations. It concludes by exploring how education in combination with experience protected by regulation of practice can support nurses to gradually evolve from registered nurse, specialty nurse to advanced practiced nurse.

A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

Science.gov (United States)

Hanley, Mary Anne; Coppa, Denise; Shields, Deborah

2017-08-01

For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

Instant radiography: a computerized support system for industrial radiographers

International Nuclear Information System (INIS)

Taiyus, M.K.; Sadique, J.

1995-08-01

This work describes an approach for systematic collection of information, organization of these information to create a database, which is based to create a user friendly software ( Instant Radiography). It helps to reduce the vagaries of radiographic practice and reduces the number of trials needed to get good radiographs. This software considers the interrelated and dependent parameters of radiography, e.g., quality of radiation, properties of films, source-to-film distance(SFD), processing conditions etc. and provides precise numerical values for exposure time and other parameters needed for field work. (author), 2 figs., 15 refs

Radiographic examination of the equine stifle

International Nuclear Information System (INIS)

Denoix, J.M.

1986-01-01

A radiographic technique is described for the equine stifle joint with the horse in the standing position or under general anaesthesia. The method with the animal anaesthetised in the dorsal recumbency and the leg extended was preferred because it gave greater flexibility with a better range of views and greatly reduced the safety hazards. In the standing position a useful practical tip for the lateral view was to raise and extent the limb caudally. This provides some flexion and ventral movement of the stifle allowing improved access for the cassette, a more accurate lateral view of the joint and a reduction in exposure. Some of the features of radiographic anatomy, from birth to adulthood, of this rather complex joint are described to form a basis for radiological interpretation in cases of suspected stifle lameness

Impact of postgraduate education on advanced practice nurse activity - a national survey.

Science.gov (United States)

Wilkinson, J; Carryer, J; Budge, C

2018-03-22

There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.

Strategic directions and actions for advanced practice nursing in China

Directory of Open Access Journals (Sweden)

Martha N. Hill

2017-01-01

Full Text Available There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs improve health care and outcomes. The China Medical Board (CMB China Nursing Network (CCNN began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system.

A radiographic study of mental foramen in intraoral radiographs

International Nuclear Information System (INIS)

Sohn, Jeong Ick; Choi, Karp Shik

1995-01-01

The purpose of this study was to evaluate the position and shape of mental foramen in periapical radiographs. For this study, periapical radiographs of premolar areas were obtained from the 200 adults. Accordingly, the positional and shape changes of mental foramen were evaluated. The authors obtained radiographs according to changes in radiation beam direction in periapical radiographs of premolar areas, and then evaluated the positional and shape changes of mental foramen. The following results were obtained: 1. Shapes of mental foramen were observed elliptical (34.3%), round or oval (28.0%), unidentified (25.5%) and diffuse (12.2%) type in descending order of frequency. 2, Horizontal positions of mental foramen were most frequently observed at the 2nd premolar area (55.3%), the area between the 1st premolar and 2nd premolar (39.6%), the area between the 2nd premolar and 1st molar (3.4%), the 1st premolar area (1.0%), the area between the canine and 1st premolar (0.7%) in descending order of frequency. 3. Vertical positions of mental foramen were most frequently observed at the inferior to apex (67.1%), and at apex (24.8%), overlap with apex (6.4%), superior to apex (1.7%) in descending order of frequency. 4. Shapes of mental foramen were more obviously observed at the upward 10 degree positioned periapical radiographs. And according to the changes of horizontal and vertical position, they were observed similar to normally positioned periapical radiographs.

Mentoring advanced practice nurses in research: recommendations from a pilot program.

Science.gov (United States)

Leung, Doris; Widger, Kimberley; Howell, Doris; Nelson, Sioban; Molassiotis, Alex

2012-01-01

Advanced Practice Nurses (APNs) need research skills to develop and advance their practice and, yet, many have limited access to research training and support following completion of their advanced degree. In this paper we report on the development, delivery, and evaluation of an innovative pilot program that combined research training and one-to-one mentorship for nine APNs in conducting research relevant to their practice. The program was organized within an academic institution and its affiliated hospitals in Toronto, Canada. Our experience with this program may assist those in other organizations to plan and deliver a similar program for APN research mentorship.

Advanced quantum mechanics a practical guide

CERN Document Server

Nazarov, Yuli V

2013-01-01

An accessible introduction to advanced quantum theory, this graduate-level textbook focuses on its practical applications and treats real-life examples to equip readers with an operational toolbox of theoretical techniques. It features case studies from different topics and 70 end-of-chapter problems, with solutions for instructors available online.

Harnessing competence and confidence: Dimensions in education and development for advanced and consultant practice

International Nuclear Information System (INIS)

Price, Richard C.; Edwards, Hazel M.

2008-01-01

Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge for expert practice but also strategic vision and interpersonal intelligence to facilitate leadership and practice innovation. A model for developing leadership skills for consultants focussing on competence, confidence and capacity is proposed

Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.

Science.gov (United States)

Schober, Madrean M; Gerrish, Kate; McDonnell, Ann

2016-06-01

To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.

Effectiveness Of Plain Shoulder Radiograph In Detecting Degenerate Rotator Cuff Tears.

Science.gov (United States)

Hussain, Adnan; Muzzammil, Muhammad; Butt, Faisal; Valsamis, Epaminondas Markos; Dwyer, Amitabh J

2018-01-01

Studies have demonstrated radiographic findings of sclerosis and cortical irregularity at the greater tuberosity can suggest a rotator cuff tear. Plain radiographs are the most easily attainable first-line investigations in evaluating shoulder injuries. This study determines the effectiveness in predicting degenerate rotator cuff tears by detecting radiographic changes on shoulder x-rays. Retrospective cross-sectional study with a consecutive series of patients conducted in Hinchingbrooke Hospital, Huntingdon, United Kingdom from January 2015 to June 2017. Anteroposterior shoulder radiographs of 150 symptomatic patients who underwent shoulder arthroscopy were independently analysed by surgeons who were blinded from the arthroscopic results. Patients aged fewer than 30 and over 70 years were excluded. Patients with advanced osteoarthritis and cuff tear arthropathy evident on x-rays were also excluded. Sixty-five patients included in the study had rotator cuff tears on arthroscopy. Radiographic changes were correlated with arthroscopic findings to determine this test's ability to predict degenerate rotator cuff tears. When both cortical irregularity and sclerosis were present on the plain radiograph, these signs had a sensitivity of 78.8% [95% CI 65.7, 87.8%] and specificity 77.4% [95% CI 67.2, 85.0%] with a positive predictive value of 68.3%, using contingency table analysis. The presence of cortical irregularity was found to be a better predictor of a tear as compared to sclerosis. This study concludes that plain radiograph are good modality for initial evaluation of rotator cuff tears and detecting when both cortical irregularity and sclerosis. Consideration of these radiographic findings serves as a useful adjunct in diagnostic workup and can guide subsequent investigations and treatment when evaluating rotator cuff tears of the shoulder.

A survey on the research awareness and readiness among radiographers in Singapore General Hospital (SGH)

International Nuclear Information System (INIS)

Ooi, Chin-Chin; Lee, Sally Hsueh-Er; Soh, BaoLin Pauline

2012-01-01

Aim: Research is a key component of evidence-based medical imaging. Good knowledge and attitude towards research is important in implementing the paradigm shift from the traditional model of practice to evidence-based practice. The aim of this study was to ascertain the attitude, level of awareness and knowledge of radiographers about research. Potential barriers might also be identified so that programmes and schemes could be developed to raise the profile of research in clinical practice. Methods: A 20-item scale self-completion questionnaire was designed and distributed to radiographers in the Department of Diagnostic Radiology, SGH. The questionnaire consisted of questions pertaining to years of working experience, specialization of practice, role/involvement in any research, training needs and identification of potential barriers to research. Results: The final response rate was 67% (N = 114). Although the involvement in research is 39% (N = 44), the radiographers strongly believed that it is essential for them to participate in research to develop themselves and the profession, as well as to improve the quality of care delivered to patients. The main identified perceived barriers to research included lack of time, resources and heavy clinical workload. Sixty-four percent (N = 73) of participants indicated that provision of courses would improve their research skills, such as research methodology, biostatistics, literature critique, and a lack of these could be some of the reasons for low research involvement among radiographers. Conclusions: The data suggest that positive attitudes, institutional support and provision of research related courses are needed to increase radiographers' involvement in research.

Conventional and digital radiographic methods in the detection of simulated external root resorptions: A comparative study

Directory of Open Access Journals (Sweden)

C J Sanjay

2009-01-01

Full Text Available Objective : To evaluate and compare the efficacy of conventional and digital radiographic methods in the detection of simulated external root resorption cavities and also to evaluate whether the detectability was influenced by resorption cavity sizes. Methods : Thirty-two selected teeth from human dentate mandibles were radiographed in orthoradial, mesioradial and distoradial aspect using conventional film (Insight Kodak F-speed; Eastman Kodak, Rochester, NY and a digital sensor (Trophy RVG advanced imaging system with 0.7mm and 1.0mm deep cavities prepared on their vestibular, mesial and distal surfaces at the cervical, middle and apical thirds. Three dental professionals, an endodontist, a radiologist and a general practitioner, evaluated the images twice with a one-week time interval. Results : No statistical significance was seen in the first observation for both conventional and digital radiographic methods in the detection of simulated external root resorptions and for small and medium cavities but statistical difference was noted in the second observation (P< 0.001 for both the methods. Conclusion : Considering the methodology and the overall results, conventional radiographic method (F-speed performed slightly better than the digital radiographic method in the detection of simulated radiographic method but better consistency was seen with the digital system. Overall size of the resorption cavity had no influence on the performance of both methods and suggests that initial external root resorption lesion is not well-appreciated with both the methods as compared to the advanced lesion.

Defining and assessing critical thinking skills for student radiographers

International Nuclear Information System (INIS)

Castle, Alan

2009-01-01

Developing critical thinking skills is a key aim of higher education and is important in preparing student radiographers for their future careers in clinical practice. The aim of this paper was to attempt to devise and assess six key components of critical thinking appropriate for radiographic practice. Each of the six components was divided into three dimensions and a Critical Thinking Skills Scoring Chart (CTSSC) devised to assess students' written performance against each dimension. Scores revealed that approximately 30% of students were rated as good and approximately 10% of students were rated as poor in each component, although there was some variability between different dimensions. It is suggested that educators need to encourage and support students to develop their critical thinking skills by reviewing their curriculum to clearly define specific skills and ensure that they are appropriately taught and assessed

Advances in direct radiographic magnification technique: First studies with a 1μ focal spot tube

International Nuclear Information System (INIS)

Huettenbrink, K.B.; Schadel, A.

1986-01-01

A direct radiographic enlargement technique mainly depends on the size of the focal spot. Up to now, its reduction was limited for physical reasons; therefore only minor degrees of magnification were applicable. With the new 1 μ focal spot tube, structures of microscopic dimensions can be visualized for the first time in a direct radiographic magnification of up to 100 diameters. First studies in isolated middle ear ossicles and a phantom soft-tissue-skull are demonstrated. Clinical usefullness seems to be limited, whereas its application for experimental research looks promising. (orig.) [de

Radiographic features of tuberculous osteitis in greater trochanter and lschium

International Nuclear Information System (INIS)

Hahm, So Hee; Lee, Ye Ri; Kim, Dong Jin; Sung, Ki Jun; Lim, Jong Nam

1996-01-01

To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis

Radiographic features of tuberculous osteitis in greater trochanter and lschium

Energy Technology Data Exchange (ETDEWEB)

Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

1996-11-01

To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

Measuring the impact of the advanced practitioner role: a practical approach.

Science.gov (United States)

Neville, Lillian; Swift, Juliette

2012-04-01

This paper aims to illuminate difficulties in evaluating the advanced practitioner role and to offer a practical solution. The advanced practice role has been part of the workforce strategy in the Northwest of England since 2005. However capturing hard evidence of the impact of this role has been problematic. Current restrictions on resources require the provision of evidence of the value of roles and services. Critical analysis of literature has identified challenges in evaluating the advanced practice role. The case study design takes account of current policy initiatives, notably QIPP. There is no common approach to evaluating the role of advanced practitioners. The case study has the potential to be a useful tool to organise evidence of the impact of advanced practitioner roles. Advanced practitioners need to have appropriate knowledge and skills to provide evidence of the impact of their role. There is potential for this work to be applied to other roles across the NHS. Managers need to work in partnership with workforce planners and educationalists to support advanced practitioners to utilise their skills in methods of providing evidence that they do work of value. Clear strategic direction for advanced practitioners is advised as part of the workforce strategy. © 2012 Blackwell Publishing Ltd.

Can skeletal image reporting be taught online: Perspectives of experienced reporting radiographers?

International Nuclear Information System (INIS)

Leishman, Lesley

2013-01-01

Background: Image interpretation relies upon expert clinical skill and comprehensive knowledge and understanding of the theories and concepts that underpin clinical practices. Traditionally, radiographer reporting education has been delivered using a blend of classroom based learning combined with workplace clinical practice. The direct and indirect costs of staff development and maintenance of the service has seen the incorporation of e-learning into courses in other health professions. Yet, despite its proven success, in the UK radiography has been resistant to progression into e-learning for reporting. This study aims to explore the perceptions of reporting radiographers to interactive online delivery of skeletal image reporting education. Method: Invitations to participate in the study were sent to 80 radiology departments in the UK. Reporting radiographers were asked to complete an online questionnaire to detail their reporting education experiences and to consider whether online delivery was a viable option. Results: A total of 86 radiographers participated in the study. They could see potential benefits of online delivery but agreed it would only be suitable for delivery of theoretical subjects, and that development of practical/clinical skills required interaction with experts in the field to enhance learning. Conclusion: Image reporting education is not suitable for entirely online delivery, and a blended learning solution, where online classroom based learning is combined with work based learning is more appropriate as it allows for interaction with experts in the field of reporting to facilitate the development of reporting skills enhance the overall learning experience

Radiographic progression with nonrising PSA in metastatic castration-resistant prostate cancer: post hoc analysis of PREVAIL.

Science.gov (United States)

Bryce, A H; Alumkal, J J; Armstrong, A; Higano, C S; Iversen, P; Sternberg, C N; Rathkopf, D; Loriot, Y; de Bono, J; Tombal, B; Abhyankar, S; Lin, P; Krivoshik, A; Phung, D; Beer, T M

2017-06-01

Advanced prostate cancer is a phenotypically diverse disease that evolves through multiple clinical courses. PSA level is the most widely used parameter for disease monitoring, but it has well-recognized limitations. Unlike in clinical trials, in practice, clinicians may rely on PSA monitoring alone to determine disease status on therapy. This approach has not been adequately tested. Chemotherapy-naive asymptomatic or mildly symptomatic men (n=872) with metastatic castration-resistant prostate cancer (mCRPC) who were treated with the androgen receptor inhibitor enzalutamide in the PREVAIL study were analyzed post hoc for rising versus nonrising PSA (empirically defined as >1.05 vs ⩽1.05 times the PSA level from 3 months earlier) at the time of radiographic progression. Clinical characteristics and disease outcomes were compared between the rising and nonrising PSA groups. Of 265 PREVAIL patients with radiographic progression and evaluable PSA levels on the enzalutamide arm, nearly one-quarter had a nonrising PSA. Median progression-free survival in this cohort was 8.3 months versus 11.1 months in the rising PSA cohort (hazard ratio 1.68; 95% confidence interval 1.26-2.23); overall survival was similar between the two groups, although less than half of patients in either group were still at risk at 24 months. Baseline clinical characteristics of the two groups were similar. Non-rising PSA at radiographic progression is a common phenomenon in mCRPC patients treated with enzalutamide. As restaging in advanced prostate cancer patients is often guided by increases in PSA levels, our results demonstrate that disease progression on enzalutamide can occur without rising PSA levels. Therefore, a disease monitoring strategy that includes imaging not entirely reliant on serial serum PSA measurement may more accurately identify disease progression.

Practical Implementations of Advanced Process Control for Linear Systems

DEFF Research Database (Denmark)

Knudsen, Jørgen K . H.; Huusom, Jakob Kjøbsted; Jørgensen, John Bagterp

2013-01-01

This paper describes some practical problems encountered, when implementing Advanced Process Control, APC, schemes on linear processes. The implemented APC controllers discussed will be LQR, Riccati MPC and Condensed MPC controllers illustrated by simulation of the Four Tank Process and a lineari......This paper describes some practical problems encountered, when implementing Advanced Process Control, APC, schemes on linear processes. The implemented APC controllers discussed will be LQR, Riccati MPC and Condensed MPC controllers illustrated by simulation of the Four Tank Process...... on pilot plant equipment on the department of Chemical Engineering DTU Lyngby....

Radiographic follow-up study of Little Leaguer's shoulder

Energy Technology Data Exchange (ETDEWEB)

Kanematsu, Yoshiji; Iwase, Takenobu [Tokushima National Hospital, Department of Orthopaedic Surgery, Tokushima (Japan); Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi [University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Bioscience, Tokushima (Japan); Kashiwaguchi, Shinji [Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Department of Orthopaedic Surgery, Tokyo (Japan); Iwame, Toshiyuki [Tokushima Prefectural Central Hospital, Department of Orthopaedic Surgery, Tokushima (Japan)

2015-01-15

Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

Do we really need radiographic assessment for the diagnosis of non-specific heel pain (calcaneal apophysitis) in children?

Energy Technology Data Exchange (ETDEWEB)

Kose, Ozkan [Diyarbakir Education and Research Hospital, Orthopaedics and Traumatology Clinic, Diyarbakir (Turkey); Diclekent Bulvari, Ataslar Serhat Evleri, Diyarbakir (Turkey)

2010-04-15

Non-specific heel pain (calcaneal apophysitis) is a common disorder, particularly in physically active growing children. Foot radiographs are usually obtained as part of the clinical evaluation in routine orthopaedic practice. However, there is still controversy about the specific findings on radiographs, and it is unclear what information is present on radiographs that may alter the diagnosis and management. The purpose of this study was to review a consecutive series of patients with the diagnosis of calcaneal apophysitis to assess the yield of routine radiographs of the foot. A prospective study was performed on 61 consecutive patients with a diagnosis of calcaneal apophysitis in a single-surgeon practice. Standard anteroposterior and lateral weight-bearing foot radiographs were obtained for each patient. Seventy-one sets of foot radiographs were reviewed to determine whether radiographs had an impact on diagnosis and management. Patients with antecedent trauma, penetrating injury, foot deformity, achilles tendonitis, bursitis and infections were excluded from the study. Seventy foot radiographs were considered to be normal. The radiographs changed the diagnosis in only one patient, in whom a simple bone cyst of the calcaneous was seen. Calcaneal apophysitis is a self-limiting disease, and patients can be treated conservatively. Neither the sclerosis nor the fragmentation of the apophysis could be used to establish the diagnosis of calcaneal apophysitis. Therefore, obtaining radiographs as an initial step in their evaluation does not seem to be justified. (orig.)

Do we really need radiographic assessment for the diagnosis of non-specific heel pain (calcaneal apophysitis) in children?

International Nuclear Information System (INIS)

Kose, Ozkan

2010-01-01

Non-specific heel pain (calcaneal apophysitis) is a common disorder, particularly in physically active growing children. Foot radiographs are usually obtained as part of the clinical evaluation in routine orthopaedic practice. However, there is still controversy about the specific findings on radiographs, and it is unclear what information is present on radiographs that may alter the diagnosis and management. The purpose of this study was to review a consecutive series of patients with the diagnosis of calcaneal apophysitis to assess the yield of routine radiographs of the foot. A prospective study was performed on 61 consecutive patients with a diagnosis of calcaneal apophysitis in a single-surgeon practice. Standard anteroposterior and lateral weight-bearing foot radiographs were obtained for each patient. Seventy-one sets of foot radiographs were reviewed to determine whether radiographs had an impact on diagnosis and management. Patients with antecedent trauma, penetrating injury, foot deformity, achilles tendonitis, bursitis and infections were excluded from the study. Seventy foot radiographs were considered to be normal. The radiographs changed the diagnosis in only one patient, in whom a simple bone cyst of the calcaneous was seen. Calcaneal apophysitis is a self-limiting disease, and patients can be treated conservatively. Neither the sclerosis nor the fragmentation of the apophysis could be used to establish the diagnosis of calcaneal apophysitis. Therefore, obtaining radiographs as an initial step in their evaluation does not seem to be justified. (orig.)

The radiographic image: A cultural artefact?

International Nuclear Information System (INIS)

Strudwick, Ruth M.

2014-01-01

This article looks at the role of the radiographic images produced by diagnostic radiographers. An ethnographic study of the workplace culture in one diagnostic imaging department was undertaken using participant observation for four months and semi-structured interviews with ten key informants. One of the key themes; that of the radiographic image as a cultural artefact, is explored in this article. The radiographic image is a cultural artefact which radiographers are protective of and take ownership of. Radiographers are conscious of the quality of their images and the images are an important aspect of their work. Radiographers take criticism of their images personally. The radiographic image is a record of the interaction that occurs between the radiographer and the patient. The way in which radiographic images are viewed, used and judged is an important aspect of the role of diagnostic radiographer

Developing advanced clinical practice skills in gastrointestinal consequences of cancer treatment.

Science.gov (United States)

Gee, Caroline; Andreyev, Jervoise; Muls, Ann

2018-03-08

This article explores the transition from a clinical nurse specialist (CNS) towards developing advanced clinical practice skills within a gastrointestinal consequences of cancer clinic. It presents data on the first 50 patients assessed by the CNS from a prospective service evaluation, demonstrating how this informed the nurse's future learning. There is high demand for advanced clinical practice skills to address unmet health needs and improve the quality, efficiency, and sustainability of healthcare services. However, a literature review found no literature on developing advanced clinical practice skills in this setting. Emerging themes from the service evaluation focused on barriers and enablers, ongoing support, organisational commitment and working in a multidisciplinary team. Blended learning provided both structured and opportunistic learning, embedding both formal and tacit knowledge, as roles require increasing flexibility. Clinical supervision and reflective practice were key in maintaining professional and peer support.

[Competencies and professional profile of the advanced practice nurse].

Science.gov (United States)

del Barrio-Linares, M

2014-01-01

The advanced practice nurse can foster the development of innovative approaches in the design of patient, families and community care. This study has aimed to explain the importance of the advanced practice nurse, especially that of the clinical nurse specialist (CNS), within the care setting and to go deeper into the knowledge of this nursing profile. A review of the literature. The following databases were used: CINAHL, PubMed and Medline. Search terms were 'clinical nurse specialist,' 'implementation,' and 'advanced practice nursing.' The sample included 24 publications. A synthesis of the findings generated a summary of the competencies of CNS and their definitions, with some examples in their daily practice and the outcome on its 3 spheres of influences: patients and families, staff and organization. CNS emerges in the health systems in order to improve the outcomes in the patients, staff and the organization per se because of its competence as an agent of change and transformational leader National policies and national strategies are needed to implement CNS on the Master's level in the Spanish National Health System given the evidence-based improvement in the care standards. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.

Implementing radiographic CT head reporting: The experiences of students and managers

International Nuclear Information System (INIS)

Clarke, Ruth; Allen, David; Arnold, Paul; Snaith, Beverley

2014-01-01

Introduction: In the face of growing demand in radiology, skill mix initiatives have sought to improve and expand service provision. Within the UK radiographer reporting is now widespread, although the growth in computerised tomography (CT) head reporting has not been as rapid as anticipated. The literature in this area is limited, but case studies have highlighted the successful implementation of this training through new radiographer roles in practice. Method: A cross-sectional survey was developed to elicit information from radiographers and managers on their experiences before, during and after post-graduate training in CT head reporting. Results: Seventy one responses were received comprising 48 past students (n = 48/111; 43.2%) and 23 service managers (n = 23/67; 34.3%). Key factors for the development were personal continual professional development for students and departmental need for managers. Challenges during training included a lack of study time due to staff shortages and access to radiologist mentors. Only 48.8% of students responding have gone on to use the new skills in practice cited reasons include staff shortages, resistance from radiologists and increase in radiological staffing. Conclusions: This qualitative study has demonstrated that those trusts who have implemented CT head reporting have evidenced perceptible benefits for both the department and individuals. Those radiographers who are successfully reporting have shown themselves to be highly motivated and persistent in their development

Radiographers and trainee radiologists reporting accident radiographs: A comparative plain film-reading performance study

International Nuclear Information System (INIS)

Buskov, L.; Abild, A.; Christensen, A.; Holm, O.; Hansen, C.; Christensen, H.

2013-01-01

Aim: To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital. Materials and methods: Plain radiographs of the appendicular skeleton from 1000 consecutive emergency room patients were included in the study: 500 primarily reported by radiographers and 500 by trainee radiologists. The final reporting was subsequently undertaken by a consultant radiologist in consensus with an orthopaedic surgeon. Two observers classified reports as either true positive/negative or false positive/negative based on the final report, which was considered the reference standard. To evaluate the severity of incorrect primary reports, errors were graded into three categories concerning clinical impact and erroneous reports graded as the most severe category were subsequently analysed. Mann–Whitney and Chi-squared tests were used to compare differences and associations between radiographers versus trainee radiologists regarding film reporting. Results: The sensitivity for correct diagnosis was 99% for reporting radiographers and 94% for trainee radiologists. The specificity was found to be 97% for reporting radiographers and 99% for trainee radiologists. Radiographers missed significantly fewer fractures (n = 2) than trainee radiologists (n = 14; p = 0.006) but had a higher, but not significant, degree of overcalling. No significant difference was found between groups regarding clinical impact of incorrect reporting. Conclusion: Trained radiographers report accident radiographs of the extremities with high accuracy and constitute a qualified resource to help meet increasing workload and demands in quality standards.

Radiographic constant exposure technique

DEFF Research Database (Denmark)

Domanus, Joseph Czeslaw

1985-01-01

The constant exposure technique has been applied to assess various industrial radiographic systems. Different X-ray films and radiographic papers of two producers were compared. Special attention was given to fast film and paper used with fluorometallic screens. Radiographic image quality...... was tested by the use of ISO wire IQI's and ASTM penetrameters used on Al and Fe test plates. Relative speed and reduction of kilovoltage obtained with the constant exposure technique were calculated. The advantages of fast radiographic systems are pointed out...

Win-win-win: collaboration advances critical care practice.

Science.gov (United States)

Spence, Deb; Fielding, Sandra

2002-10-01

Against a background of increasing interest in education post registration, New Zealand nurses are working to advance their professional practice. Because the acquisition of highly developed clinical capabilities requires a combination of nursing experience and education, collaboration between clinicians and nurse educators is essential. However, the accessibility of relevant educational opportunities has been an ongoing issue for nurses outside the country's main centres. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) developed between Auckland University of Technology and two regional health providers is one such example. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This paper provides an overview of the structure and pr month, distance education course focused on developing the context of critical care nursing.

Knowledge of practising radiographers of the supraspinatus outlet projection for shoulder impingement syndrome in the Eastern Cape, South Africa

International Nuclear Information System (INIS)

Williams, R.; Morton, D.G.

2016-01-01

Background/Aim: There are many projections in plain film imaging to demonstrate the specific aspects of the anatomy of the shoulder. However, reproducing the required projections can be challenging especially if radiographers are not familiar with the projections and their evaluation criteria. The aim of the study was to explore and describe the knowledge of practising radiographers regarding the supraspinatus outlet projection for shoulder impingement syndrome. Method: A quantitative, exploratory and descriptive design was followed. The population served as the sample and included all the practising radiographers in the public and private hospitals of a metropolitan municipality in the Eastern Cape, South Africa. A total of 84 respondents completed the structured, self-administered questionnaire. Results: The data revealed that in many cases, the majority of radiographers in the study, due to inadequate knowledge levels would not be able to produce an optimal radiographic image of the supraspinatus outlet. The results of the chi-squares indicated statistically significant differences (p < 0.05) between public and private hospitals regarding certain aspects of the scapular Y projection and SOP. Conclusion: It was found that the radiographers in the study had inadequate knowledge of scapular Y projections and SOPs in relation to SIS. Therefore, it is essential to ensure that radiographers are updated on their knowledge of radiographic practice on a continuous basis. - Highlights: • Many radiographers unable to produce an optimal image of the supraspinatus outlet. • Radiographers had poor knowledge of scapular Y and supraspinatus outlet projections. • It is essential that radiographers update their knowledge of radiographic practice.

Poor Utility of Gonadal Shielding for Pediatric Pelvic Radiographs.

Science.gov (United States)

Lee, Mark C; Lloyd, Jessica; Solomito, Matthew J

2017-07-01

Plain pelvic radiographs are commonly used for a variety of pediatric orthopedic disorders. Lead shielding is typically placed over the gonads to minimize radiation exposure to these sensitive tissues. However, misplaced shielding can sabotage efforts to protect patients from excessive radiation exposure either by not covering radiosensitive tissues or by obscuring anatomic areas of interest, prompting repeat radiographic examinations. The goal of this study was to determine the incidence of misplaced shielding for pelvic radiographs obtained for pediatric orthopedic evaluation. Children 8 to 16 years old who had an anteroposterior or frog lateral pelvic radiograph between 2008 and 2014 were included. A total of 3400 patients met the inclusion criteria, and 84 boys and 84 girls were randomly selected for review. For both boys and girls, the percentage of incorrectly positioned or missing shields was calculated. Chi-square testing was used to compare the frequency of missing or incorrectly placed shields between sexes and age groups. Pelvic shields were misplaced in 49% of anteroposterior and 63% of frog lateral radiographs. Shielding was misplaced more frequently for girls than for boys on frog lateral radiographs (76% vs 51%; P<.05). Pelvic bony landmarks were often obscured by pelvic shielding, with a frequency of 7% to 43%, depending on the specific landmark. The femoral head and acetabulum were obscured by shielding in up to 2% of all images. The findings suggest that accepted pelvic shielding protocols are ineffective. Consideration should be given to alternative protocols or abandonment of this practice. [Orthopedics. 2017; 40(4):e623-e627.]. Copyright 2017, SLACK Incorporated.

From challenges to advanced practice registered nursing role development: Qualitative interview study.

Science.gov (United States)

Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

2015-12-01

The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

The ethical commitment of Australian radiographers: Does medical dominance create an influence?

International Nuclear Information System (INIS)

Lewis, Sarah; Heard, Robert; Robinson, John; White, Karolyn; Poulos, Ann

2008-01-01

There is a lack of awareness and openness surrounding ethical debate in Diagnostic Radiography literature and culture, perpetuated in part by the historical growth of the technical realm of radiography, radiology and medicine. Hence, the impact of Australian radiographers' current level of professional autonomy, combined with the influence of medical dominance and radiographers' ethical commitment was undocumented. This study investigated the role, importance and attitudes of Australian radiographers towards ethics through a qualitative study following a grounded theory approach. Semi-structured interviews were conducted with 25 Australian. A conceptual framework mapping the causal conditions affecting the ethical commitment was developed. This study argues that a number of internal and external variables weave an intricate fabric of poor identity, subservience and negative workplace culture. Australian radiographers, whist attempting to set a standard of ethical commitment, are hindered by difficulties of medical dominance, relatively poor professional autonomy and difficulty in accepting responsibility. The presence of private radiology enterprise and the association between patient referral and money has eroded the radiographer-patient relationship and introduced the potential for unethical practice in the radiographer-radiologist-referring practitioner relationship

The ethical commitment of Australian radiographers: Does medical dominance create an influence?

Energy Technology Data Exchange (ETDEWEB)

Lewis, Sarah [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: s.lewis@fhs.usyd.edu.au; Heard, Robert [School of Behavioural and Community Health Science, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); Robinson, John [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); White, Karolyn [Centre for Values and Ethics and the Law in Medicine, Faculty of Medicine, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); Poulos, Ann [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia)

2008-05-15

There is a lack of awareness and openness surrounding ethical debate in Diagnostic Radiography literature and culture, perpetuated in part by the historical growth of the technical realm of radiography, radiology and medicine. Hence, the impact of Australian radiographers' current level of professional autonomy, combined with the influence of medical dominance and radiographers' ethical commitment was undocumented. This study investigated the role, importance and attitudes of Australian radiographers towards ethics through a qualitative study following a grounded theory approach. Semi-structured interviews were conducted with 25 Australian. A conceptual framework mapping the causal conditions affecting the ethical commitment was developed. This study argues that a number of internal and external variables weave an intricate fabric of poor identity, subservience and negative workplace culture. Australian radiographers, whist attempting to set a standard of ethical commitment, are hindered by difficulties of medical dominance, relatively poor professional autonomy and difficulty in accepting responsibility. The presence of private radiology enterprise and the association between patient referral and money has eroded the radiographer-patient relationship and introduced the potential for unethical practice in the radiographer-radiologist-referring practitioner relationship.

Visual simulation of radiographs

International Nuclear Information System (INIS)

Laguna, G.

1985-01-01

A method for computer simulation of radiographs has been added to the LLNL version of the solid modeler TIPS-1 (Technical Information Processing System-1). This new tool will enable an engineer to compare an actual radiograph of a solid to its computer-generated counterpart. The appearance of discrepancies between the two can be an indication of flaws in the solid object. Simulated radiographs can also be used to preview the placement of x-ray sources to focus on areas of concern before actual radiographs are made

Development of a Dynamic Spot Size Diagnostic for Flash Radiographic X-Ray Sources

International Nuclear Information System (INIS)

Droemer, D. W.; Lutz, S.; Devore, D.; Rovang, D.; Portillo, S.; Maenchen, J.

2003-01-01

There has been considerable work in recent years in the development of high-brightness, high-dose flash x-ray radiographic sources. Spot size is one of several parameters that helps characterize source performance and provides a figure of merit to assess the suitability of various sources to specific experimental requirements. Time-integrated spot-size measurements using radiographic film and a high-Z rolled-edge object have been used for several years with great success. The Advanced Radiographic Technologies program thrust to improve diode performance requires extending both modeling and experimental measurements into the transient time domain. A new Time Resolved Spot Detector (TRSD) is under development to provide this information. In this paper we report the initial results of the performance of a 148-element scintillating fiber array that is fiber-optically coupled to a gated streak camera. Spatial and temporal resolution results are discussed and the data obtained FR-om the Sand ia National Laboratories (SNL) RITS-3 (Radiographic Integrated Test Stand) accelerator are presented

Radiographic examination of the equine foot

International Nuclear Information System (INIS)

Park, R.D.

1989-01-01

A complete radiographic examination of the equine foot consists of properly exposed, processed, and positioned radiographs. For radiographic interpretation, in addition to knowing radiographic signs of disease, a knowledge of normal radiographic anatomy and possible insignificant anatomic variations is necessary

The radiographic examination of the colon

International Nuclear Information System (INIS)

Hendrix, T.R.; Saba, G.P. II.

1980-01-01

To provide medical and scientific background on certain selected technologies generally considered to be of particular significance, the National Center for Health Care Technology commissioned a series of overview papers, one of which is entitled 'The Radiographic Examination of the Colon.' These overviews are likely to be of most immediate interest to clinicians and biomedical scientists; they also may provide valuable background for assessments undertaken by the Center and for exploring the broad societal implications of health care technologies. Barium enema is the most available and widely used technique for examining the colon. It is often a routine part of the gastrointestinal work-up regardless of the suspected basis, anatomical or functional, of the patient's symptoms. Indeed, common practice is not to entertain a diagnosis of functional disorder before excluding all reasonable possibility of an anatomical abnormality. Barium enema is one of the most frequently ordered radiographic examinations

Radiographic testing

International Nuclear Information System (INIS)

Kuster, J.

1978-01-01

In view of great differencies in X-ray transmission it is more difficult to get optimum radiographs of plastics and especially of reinforced plastics than for example of metals. A procedure will be reported how to get with little effort optimum radiographs especially also in the range of long wave-length radiation corresponding 10 to 25 kV.P. (orig.) [de

Assessment of Radiographic Image Quality by Visual Examination of Neutron Radiographs of the Calibration Fuel Pin

DEFF Research Database (Denmark)

Domanus, Joseph Czeslaw

1986-01-01

Up till now no reliable radiographic image quality standards exist for neutron radiography of nuclear reactor fuel. Under the Euratoro Neutron Radiography Working Group (NRWG) Test Program neutron radiographs were produced at different neutron radiography facilities within the European Community...... of a calibration fuel pin. The radiographs were made by the direct, transfer and tracketch methods using different film recording materials. These neutron radiographs of the calibration fuel pin were used for the assessement of radiographic image quality. This was done by visual examination of the radiographs...

A survey of radiographers' confidence and self-perceived accuracy in frontline image interpretation and their continuing educational preferences

Energy Technology Data Exchange (ETDEWEB)

Neep, Michael J [Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Queensland (Australia); Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland (Australia); School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland (Australia); Steffens, Tom [Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Queensland (Australia); Owen, Rebecca [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane, Queensland (Australia); Faculty of Health, Queensland University of Technology, Brisbane, Queensland (Australia); McPhail, Steven M [Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland (Australia); School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland (Australia); Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Queensland (Australia)

2014-06-15

The provision of a written comment on traumatic abnormalities of the musculoskeletal system detected by radiographers can assist referrers and may improve patient management, but the practice has not been widely adopted outside the United Kingdom. The purpose of this study was to investigate Australian radiographers' perceptions of their readiness for practice in a radiographer commenting system and their educational preferences in relation to two different delivery formats of image interpretation education, intensive and non-intensive. A cross-sectional web-based questionnaire was implemented between August and September 2012. Participants included radiographers with experience working in emergency settings at four Australian metropolitan hospitals. Conventional descriptive statistics, frequency histograms, and thematic analysis were undertaken. A Wilcoxon signed-rank test examined whether a difference in preference ratings between intensive and non-intensive education delivery was evident. The questionnaire was completed by 73 radiographers (68% response rate). Radiographers reported higher confidence and self-perceived accuracy to detect traumatic abnormalities than to describe traumatic abnormalities of the musculoskeletal system. Radiographers frequently reported high desirability ratings for both the intensive and the non-intensive education delivery, no difference in desirability ratings for these two formats was evident (z = 1.66, P = 0.11). Some Australian radiographers perceive they are not ready to practise in a frontline radiographer commenting system. Overall, radiographers indicated mixed preferences for image interpretation education delivered via intensive and non-intensive formats. Further research, preferably randomised trials, investigating the effectiveness of intensive and non-intensive education formats of image interpretation education for radiographers is warranted.

A survey of radiographers' confidence and self-perceived accuracy in frontline image interpretation and their continuing educational preferences

International Nuclear Information System (INIS)

Neep, Michael J; Steffens, Tom; Owen, Rebecca; McPhail, Steven M

2014-01-01

The provision of a written comment on traumatic abnormalities of the musculoskeletal system detected by radiographers can assist referrers and may improve patient management, but the practice has not been widely adopted outside the United Kingdom. The purpose of this study was to investigate Australian radiographers' perceptions of their readiness for practice in a radiographer commenting system and their educational preferences in relation to two different delivery formats of image interpretation education, intensive and non-intensive. A cross-sectional web-based questionnaire was implemented between August and September 2012. Participants included radiographers with experience working in emergency settings at four Australian metropolitan hospitals. Conventional descriptive statistics, frequency histograms, and thematic analysis were undertaken. A Wilcoxon signed-rank test examined whether a difference in preference ratings between intensive and non-intensive education delivery was evident. The questionnaire was completed by 73 radiographers (68% response rate). Radiographers reported higher confidence and self-perceived accuracy to detect traumatic abnormalities than to describe traumatic abnormalities of the musculoskeletal system. Radiographers frequently reported high desirability ratings for both the intensive and the non-intensive education delivery, no difference in desirability ratings for these two formats was evident (z = 1.66, P = 0.11). Some Australian radiographers perceive they are not ready to practise in a frontline radiographer commenting system. Overall, radiographers indicated mixed preferences for image interpretation education delivered via intensive and non-intensive formats. Further research, preferably randomised trials, investigating the effectiveness of intensive and non-intensive education formats of image interpretation education for radiographers is warranted

Observer variation in grading sacroiliac radiographs in HLA-B27 positive individuals

International Nuclear Information System (INIS)

Hollingsworth, P.N.; Cheah, P.S.; Dawkins, R.L.; Owen, E.T.; Calin, A.; Wood, P.H.N.

1983-01-01

This study attempts to reconcile the apparent differences in the reported frequency of ankylosing spondylitis and radiological sacroilitis in HLA-B27 positive individuals. Pelvic radiographs from 125 Busselton subjects were mixed with 81 other films selected to illustrate the possible range of sacroiliac changes and were graded by observers who were involved in 2 of the conflicting studies and by a 3rd independent observer. Concordance was high for advanced bilateral disease but not for unilateral and milder changes. Variation between observers and the interpretation of sacroiliac radiographs is sufficiently large to account for much of the disagreement between frequency estimates

Radiographic Test

Energy Technology Data Exchange (ETDEWEB)

Lee, H.J; Yang, S.H. [Korea Electric Power Research Institute, Taejon (Korea)

2002-07-01

This report contains theory, procedure technique and interpretation of radiographic examination and written for whom preparing radiographic test Level II. To determine this baseline of technical competence in the examination, the individual must demonstrate a knowledge of radiography physics, radiation safety, technique development, radiation detection and measurement, facility design, and the characteristics of radiation-producing devices and their principles of operation. (author) 98 figs., 23 tabs.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

Science.gov (United States)

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

Children’s experience of going through an acute radiographic examination

International Nuclear Information System (INIS)

Björkman, B.; Almqvist, L.; Sigstedt, B.; Enskär, K.

2012-01-01

Children’s experience of radiographic examinations remains largely unexplored, although most radiographers examine children on a daily basis. In order to provide the high quality care that meets the needs of patients it was considered important to undertake research focused upon the patients’ experience of radiographic practice. The aim of the study was to investigate children’s experiences undergoing a radiographic examination for a suspected fracture. Inclusion criteria were Swedish-speaking children between 3 and 15 years of age who were submitted for a radiographic examination with an acute condition of the upper or lower extremity. Patients were informed of the study and together with the escorting parent or relative asked for consent to participate. During the examination the child was videotaped and immediately after, the child was interviewed in a nearby facility. The interview contained open-ended questions and was conducted while watching the videotape together with the child and their parent or relative and the researcher. Qualitative content analysis was used in analyzing the collected data. The analysis resulted in two categories – “feeling uncomfortable” and “feeling confident”. The subcategories contained in these categories were “pain in relation to injury and examination”, “the waiting time is strenuous”, “worries for the future and consequences of the injury”, “confidence in parental presence”, “confidence in radiographic staff and examination procedure”, and finally “recognition entails familiarity”. The results revealed that for the younger children, the experience of undergoing an acute radiographic examination was associated with pain and anxiety, but for the older children, the anxiety was more connected to whether the injury had caused a fracture and any anticipated future consequences or complications.

Research in medical imaging and the role of the consultant radiographer: A discussion

International Nuclear Information System (INIS)

Reeves, Pauline J.

2008-01-01

This article examines the need for research in radiography as a means to provide the evidence base for radiographic practice. The review examines the role of the consultant radiographer in providing potential research leadership and outlines possible avenues for research. The article uses three main themes to set out its proposals: - The need for patient focus. - The need for a greater mix of research methods and, specifically, more studies which utilise qualitative methods. - The need for consultant leadership in research and some potential studies. The article concludes by arguing the need for a greater academic community in radiography with consultant radiographers stepping up to play their part in that community

Image processing for the Advanced Radiographic Capability (ARC) at the National Ignition Facility

Science.gov (United States)

Leach, Richard R.; Awwal, Abdul A. S.; Lowe-Webb, Roger; Miller-Kamm, Victoria; Orth, Charles; Roberts, Randy; Wilhelmsen, Karl

2016-09-01

The Advance Radiographic Capability (ARC) at the National Ignition Facility (NIF) is a laser system that employs up to four petawatt (PW) lasers to produce a sequence of short-pulse kilo-Joule laser pulses with controllable delays that generate X-rays to provide backlighting for high-density internal confinement fusion (ICF) capsule targets. Multi-frame, hard-X-ray radiography of imploding NIF capsules is a capability which is critical to the success of NIF's missions. ARC is designed to employ up to eight backlighters with tens-of-picosecond temporal resolution, to record the dynamics and produce an X-ray "motion picture" of the compression and ignition of cryogenic deuterium-tritium targets. ARC will generate tens-of-picosecond temporal resolution during the critical phases of ICF shots. Additionally, ARC supports a variety of other high energy density experiments including fast ignition studies on NIF. The automated alignment image analysis algorithms use digital camera sensor images to direct ARC beams onto the tens-of-microns scale metal wires. This paper describes the ARC automatic alignment sequence throughout the laser chain from pulse initiation to target with an emphasis on the image processing algorithms that generate the crucial alignment positions for ARC. The image processing descriptions and flow diagrams detail the alignment control loops throughout the ARC laser chain beginning in the ARC high-contrast front end (HCAFE), on into the ARC main laser area, and ending in the ARC target area.

Advancing practice relating to SEA alternatives

International Nuclear Information System (INIS)

González, Ainhoa; Thérivel, Riki; Fry, John; Foley, Walter

2015-01-01

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary

Advancing practice relating to SEA alternatives

Energy Technology Data Exchange (ETDEWEB)

González, Ainhoa, E-mail: agonzal@tcd.ie [School of Natural Sciences, Trinity College Dublin, Dublin 2 (Ireland); Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop [Levett-Therivel Sustainability Consultants (United Kingdom); Fry, John, E-mail: john.fry@ucd.ie [School of Agriculture and Food Science, University College Dublin, Dublin 4 (Ireland); Foley, Walter, E-mail: walterfoley@gmail.com [School of Geography, Planning and Environmental Policy, University College Dublin, Dublin 4 (Ireland)

2015-07-15

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.

Radiographers' opinions on radiography research in Norway – A national survey

International Nuclear Information System (INIS)

Vikestad, K.G.; Hafskjold, L.; Kjelle, E.; Sebuødegård, S.; Hofvind, S.

2017-01-01

Objective: The objective of the Norwegian Radiography Research Group is to establish a strategy for radiography research in Norway. A survey investigating radiographers' opinions on research was conducted to establish a basis for this strategy. Methods: A questionnaire was sent to all members of the Norwegian Society of Radiographers using the society's e-mail list from May 2014 (n = 2273). The respondents, 31% (n = 697), were divided into six groups; general radiographers (n = 392), specialised radiographers (n = 124), managers (n = 74), radiation therapists (n = 59), professors (n = 13), and others (n = 35). The questionnaire included four parts: introduction, participation in research, research performed at the respondent's work place, and opinions on radiography research. The first parts consisted of close-ended questions, while the fourth part also included a Likert scale. Results: Among all respondents, 63% respondents agreed that there is a need for radiography research and 50% agreed that general radiographers/radiation therapists should be the principal investigators of such research. However, only 19% reported participation in a research project during the last five years, and of those, 50% knew how the results of their research had been communicated. Conclusion: The majority of radiographers agreed that there was a need for radiography research and that radiographers/radiation therapists should take a leading role in such work. The results indicate that radiographers/radiation therapists would benefit from training in informal and formal research skills. - Highlights: • Two in ten radiographers took part in research activity in Norway. • Six in ten agreed that there is a need for radiographic related research in Norway. • Evidence-based practice, informal and formal research training represent the main aim to reach in the first strategy for radiography research in Norway.

Establishing advanced practice for medical imaging in New Zealand

International Nuclear Information System (INIS)

Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

2014-01-01

Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ

Establishing advanced practice for medical imaging in New Zealand

Energy Technology Data Exchange (ETDEWEB)

Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

2014-02-15

Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

Attitudes of radiographers to radiographer-led discharge: A survey

International Nuclear Information System (INIS)

Lumsden, Laura; Cosson, Philip

2015-01-01

Background: The traditional role of the Diagnostic Radiographer in image acquisition has gradually been extended through skill-mix, particularly to include abnormality detection. Aims: This research focused on the attitudes of Radiographers to Radiographer-led Discharge (RLD), where Radiographers discharge patients with minor injuries and perform tasks previously undertaken by Accident and Emergency staff. The effects of job role, hospital type, experience and whether RLD was used in the participant's trust were examined. Method: A multiple-indicator online questionnaire assessed attitudes to RLD. Snowball sampling was used with advertisement via emails, posters and cards, containing Quick Response (QR) codes. Statement responses were coded, with reverse coding for negative statements and total scores were calculated. A higher score represented a more positive attitude. Results: 101 questionnaires were completed (an estimated 30% response rate) and the mean total score was 84/115. 95% of participants supported radiographer involvement in abnormality detection, with 46.5% selecting RLD as the preferred system for minor injuries patients vs 48.5% preferring commenting alone. Discussion: Participants were positive about extending their role through RLD and felt confident in their image interpretation abilities, though expressed concern for the legal consequences of the role and adequate pay. Generalization of the results is limited due to the possible low response rate. Conclusion: Overall, participants demonstrated positive attitudes towards RLD but they also indicate the need for appropriate payment for any additional responsibility. These findings are promising for successful implementation of RLD, though larger-scale research including radiologists, business managers, A and E staff and patients would be beneficial. - Highlights: • 101 questionnaires were completed (an estimated 30% response rate). • 95% of participants supported radiographer involvement

MINAC, portable high energy radiographic inspection system

International Nuclear Information System (INIS)

Lapides, M.E.; Schonberg, R.

1985-01-01

MINAC, a portable, high energy radiographic source (1) was recognized as a desired inspection device for nuclear generation plants during EPRI-sponsored studies of the late 1970s and rapidly transitioned from proof-of-principle (1978-1980) to field-proven hardware (1981-present date). The equipment has completed its second generation of configuration development (SHRINKAC), that has recently been used in the field for detection of pipe cracks. Important auxiliaries for image data processing and real-time, thick section radiography have been demonstrated in both laboratory and field situations. Finally, a 6 MeV accelerator alternate is in bench test. These significant developments have, and are expected to continue to upgrade the utility of radiographic inspection in power plant practice. This paper describes the development and experience with this modular system during the last three years

Digital image analysis of NDT radiographs

International Nuclear Information System (INIS)

Graeme, W.A. Jr.; Eizember, A.C.; Douglass, J.

1989-01-01

Prior to the introduction of Charge Coupled Device (CCD) detectors the majority of image analysis performed on NDT radiographic images was done visually in the analog domain. While some film digitization was being performed, the process was often unable to capture all the usable information on the radiograph or was too time consuming. CCD technology now provides a method to digitize radiographic film images without losing the useful information captured in the original radiograph in a timely process. Incorporating that technology into a complete digital radiographic workstation allows analog radiographic information to be processed, providing additional information to the radiographer. Once in the digital domain, that data can be stored, and fused with radioscopic and other forms of digital data. The result is more productive analysis and management of radiographic inspection data. The principal function of the NDT Scan IV digital radiography system is the digitization, enhancement and storage of radiographic images

A critical analysis of a locally agreed protocol for clinical practice

International Nuclear Information System (INIS)

Owen, A.; Hogg, P.; Nightingale, J.

2004-01-01

Within the traditional scope of radiographic practice (including advanced practice) there is a need to demonstrate effective patient care and management. Such practice should be set within a context of appropriate evidence and should also reflect peer practice. In order to achieve such practice the use of protocols is encouraged. Effective protocols can maximise care and management by minimising inter- and intra-professional variation; they can also allow for detailed procedural records to be kept in case of legal claims. However, whilst literature exists to encourage the use of protocols there is little published material available to indicate how to create, manage and archive them. This article uses an analytical approach to propose a suitable method for protocol creation and archival, it also offers suggestions on the scope and content of a protocol. To achieve this an existing clinical protocol for radiographer reporting barium enemas is analysed to draw out the general issues. Proposals for protocol creation, management, and archival were identified. The clinical practice described or inferred in the protocol should be drawn from evidence, such evidence could include peer-reviewed material, national standards and peer practice. The protocol should include an explanation of how to proceed when the radiographers reach the limit of their ability. It should refer to the initial training required to undertake the clinical duties as well as the on-going continual professional updating required to maintain competence. Audit of practice should be indicated, including the preferred audit methodology, and associated with this should be a clear statement about standards and what to do if standards are not adequately met. Protocols should be archived, in a paper-based form, for lengthy periods in case of legal claims. On the archived protocol the date it was in clinical use should be included

Advanced practice nurses core competencies: a framework for developing and testing an advanced practice nurse discharge intervention.

Science.gov (United States)

Cooke, Liz; Gemmill, Robin; Grant, Marcia

2008-01-01

The purpose of this paper was to describe evidenced-based interventions as implemented by advanced practice nurses (APNs) conducting intervention research with a vulnerable population of blood and marrow transplant patients. In addition, each of the 6 core competencies of the APN role identified by Hamric are outlined and applied using a patient case study. These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision making. This article chronicles a typical patient's journey through a post-hospital discharge nursing research study involving APNs as "intervention nurses" and discusses the various aspects of the APN core competencies throughout the process.

Supporting primary care nurses to work at an advanced level through changing practices.

Science.gov (United States)

Forsdike, Kirsty; Murphy, Tracy Ann; Hegarty, Kelsey

2018-04-06

General practice nurses wishing to develop their careers in general practice are often unsupported, relying on the culture of individual practices. Given the structural diversity of Australian general practice, we qualitatively explored staff experiences of organisational governance, what supports are in place and can be used to assist nurses to advance. Semi-structured interviews with 28 staff (including nurses, GPs, receptions and practice managers) were undertaken across three practices, as part of a case-study approach. It was found that general practice staff know little of organisational governance and how it may be harnessed. Practical and flexible organisational governance were the most important factors in supporting general practice nurses to develop and utilise nursing skills, but advocacy from medical colleagues was necessary to support advancement. Barriers include funding structures, non-supportive cultures and inflexible organisational governance structures. Organisation governance has the potential to assist nurses to work at an advanced level, but significant financial, structural and cultural barriers may be too difficult for organisational governance resources alone to overcome. In addition to utilising resources, it may be useful for general practices to undertake a review of how they function as a team and reflect upon their practice culture.

Pocket atlas of radiographic anatomy

International Nuclear Information System (INIS)

Moeller, T.B.; Reif, E.; Stark, P.

1993-01-01

The 'Pocket Atlas of Radiographic Anatomy' presents 170 radiographs of the various body regions of adults, showing only the normal radiographic anatomy. Each radiograph is supplemented on the opposite page by a drawing of the particular body region. There is no commenting text, but the drawings are provided with captions in English. The atlas is a useful guide for interpreting radiographs. The pictures are arranged in chapters entitled as follows: Skeletal Imaging (skull, spine, upper extremity), lower extremity; Miscellaneous Plain Films (chest, mammogram, trachea, lung tomograms); Contrast Examinations (gastrointestinal tract, intravenous contrast examinations, arthrography, angiography); Special Examinations (myelograms, lymphangiograms, bronchograms, sialograms). (UWA). 348 figs [de

Development of tools for radiographic defects scanning in ceramic materials

International Nuclear Information System (INIS)

Lipnik, Boris.

1994-03-01

This work is concentrated on implementation of the most used non-destructive technique - radiography to quality control of structural ceramics. The present thesis deals with microfocus radiographic evaluation of ceramics produced by slip casting method. Radiographic processes are examined relying on image processing by algorithms expanded from others developed for tomographic images of non ceramics objects. At the first stage experiments aimed for characterization of a real-time microfocus radiographic system were carried out. The question of signal-to-noise ratio referring to a defect's detection limit was explored. Arithmetic image operations were used to correct for the background variations. At the second stage microfocus radiographs of: ceramics were systematically processed and analyzed by means of regularization and 'weak membrane' algorithms. The images were considerably improved and it resulted in identification and dimension extraction of defects as small as 40 pico meter . The usefulness of pseudocoloring methods was explored to obtain a fast assessment of gray level variations and to detect more details in the initial digital image. The potential for practical application was found to be very reasonable. The problems experienced were discussed along with suggestions for further studies and improvement

Radiographic examination of the equine head

International Nuclear Information System (INIS)

Park, R.D.

1993-01-01

Radiographic examinations of the equine head can be performed with portable x-ray machines. The views comprising the examination depend on the area of the head being examined. With a knowledge of radiographic anatomy and radiographic signs of disease, valuable diagnostic information can be obtained from the radiographic examination. In addition, the radiographic information can also be used to develop a prognosis and determine the most appropriate therapy

Radiation Protection in the Medical Practice: Myth and Reality the French Radiographers point of view

International Nuclear Information System (INIS)

Gerson, P.; Fraboulet, P.; Menechal, P.

2002-01-01

The use of the ionising radiation in the medical practice has evolved since its beginnings. Their benefit for the patient is considerable in term of comfort, diagnostic and therapeutic effectiveness. The users can be brought to think that the radiological risk is completely controlled and that the problems of radiation protection for the workers is now of the past. Indeed, the evolutions and the technical, material and scientific revolutions tend to decrease the doses delivered to the patients, and also to the professionals. In addition, the regulation associated with the use of the ionising radiation is strict and constraining, and one can estimate that radiation protection is a model of management of occupational hazards through its mode of declaration, authorization, controls, management and traceability. However, the daily practice and the experience on the hospital ground shows that the radiological exposures remain alarming and that any risk cannot be isolated, generally dependent on unsuited human behaviours. The participation of the radiographers to this reflection is essential. In fact, he is or should be the permanent link between the emission of radiation and the patient. For this reason, he is the last barrier regarding protection for the patient or the staff. He is thus the essential link beside the experts for a quality control in radiation protection. After a detailed and concrete description of the encountered problems, we will submit some non exhaustive but essential proposals for an improvement so that a real policy ALARA is applied and developed in the medical practice. (Author)

Rapidly processable radiographic material

International Nuclear Information System (INIS)

Brabandere, L.A. de; Borginon, H.A.; Pattyn, H.A.; Pollet, R.J.

1981-01-01

A new rapidly processable radiographic silver halide material is described for use in mammography and non-destructive testing of industrial materials. The radiographic material is used for direct exposure to penetrating radiation without the use of fluorescent-intensifying screens. It consists of a transparent support with a layer of hydrophilic colloid silver halide emulsion on one or both sides. Examples of the preparation of three different silver halide emulsions are given including the use of different chemical sensitizers. These new radiographic materials have good resistance to the formation of pressure marks in rapid processing apparatus and they have improved sensitivity for direct exposure to penetrating radiation compared to conventional radiographic emulsions. (U.K.)

Comparative radiographic analysis on the anatomical axis in knee osteoarthritis cases: inter and intraobserver evaluation.

Science.gov (United States)

Matos, Luiz Felipe; Giordano, Marcos; Cardoso, Gustavo Novaes; Farias, Rafael Baptista; E Albuquerque, Rodrigo Pires

2015-01-01

To make a comparative inter and intraobserver analysis on measurements of the anatomical axis between panoramic radiographs of the lower limbs in anteroposterior (AP) view with bipedal weight-bearing, on short film. An accuracy study comparing radiographic measurements on 47 knees of patients attending the knee surgery outpatient clinic due to osteoarthritis. The radiographic evaluation used was as standardized for the total knee arthroplasty program, including panoramic AP views of the lower limbs and short radiographs of the knees in AP and lateral views, all with bipedal weight-bearing. Following this, the anatomical axis of the lower limbs or the femorotibial angle was measured by five independent examiners on the panoramic and short AP radiographs; three of the examiners were considered to be more experienced and two, less experienced. All the measurements were made again by the same examiners after an interval of not less than 15 days. The statistical analysis was performed using the intraclass correlation coefficient, in order to evaluate the inter and intraobserver concordance of the anatomical axis measurements. From the statistical analysis, it was observed that there was strongly significant concordance between the anatomical axis measurements on the panoramic and short radiographs, for all the five examiners and for both measurements. Under the conditions studied, short radiographs were equivalent to panoramic radiographs for evaluating the anatomical axis of the lower limbs in patients with advanced osteoarthritis. The measurements used also showed high rates of inter and intraobserver concordance and reproducibility.

Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

Science.gov (United States)

De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

2008-11-01

An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

Relationship between Investigative Biomarkers and Radiographic Grading in Patients with Knee Osteoarthritis

Science.gov (United States)

Anitua, Eduardo; Sánchez, Mikel; de la Fuente, Maria; Azofra, Juan; Zalduendo, Mar; Aguirre, Jose J.; Andía, Isabel

2009-01-01

Objective. To examine new investigative biomarkers and their relevance for radiographic severity in knee osteoarthritis. Methods. The group comprised 63 patients with 73 knees examined. Patients were divided according to radiographic severity to allow for comparison of biomarker levels. Hyaluronic acid (HA), matrix metalloproteases (MMP-1, MMP-3 and MMP-13), tissue inhibitors of metalloproteases (TIMP-1 and TIMP-2), platelet-derived growth factor (PDGF-AB), transformed growth factor (TGF-β), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and insulin-like growth factor (IGF-I) were measured on synovial fluid and in plasma releasate at a single time point. Principal component analysis (PCA) followed by analysis of covariance were applied to evaluate data. Results. Four different groups of biomarker were identified in plasma releasates. The first (platelet number, PDGF-AB and TGF-β) and second groups (HA and IGF-I) were related to radiographic severity, P = .005 and P = .022, respectively. The third (MMP-1 and TIMP-2) and fourth groups (MMP-3 and TIMP-1) represented the catabolic balance, but were not associated to radiographic grading. Three different clusters of biomarkers were found in synovial fluid but did not show any significant association to radiographic grading. Conclusions. New imaging approaches to assess structural deterioration and correlation with biomarker levels are warranted to advance in OA research. PMID:20130801

Relationship between Investigative Biomarkers and Radiographic Grading in Patients with Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Eduardo Anitua

2009-01-01

Full Text Available Objective. To examine new investigative biomarkers and their relevance for radiographic severity in knee osteoarthritis. Methods. The group comprised 63 patients with 73 knees examined. Patients were divided according to radiographic severity to allow for comparison of biomarker levels. Hyaluronic acid (HA, matrix metalloproteases (MMP-1, MMP-3 and MMP-13, tissue inhibitors of metalloproteases (TIMP-1 and TIMP-2, platelet-derived growth factor (PDGF-AB, transformed growth factor (TGF-β, vascular endothelial growth factor (VEGF, hepatocyte growth factor (HGF and insulin-like growth factor (IGF-I were measured on synovial fluid and in plasma releasate at a single time point. Principal component analysis (PCA followed by analysis of covariance were applied to evaluate data. Results. Four different groups of biomarker were identified in plasma releasates. The first (platelet number, PDGF-AB and TGF-β and second groups (HA and IGF-I were related to radiographic severity, P=.005 and P=.022, respectively. The third (MMP-1 and TIMP-2 and fourth groups (MMP-3 and TIMP-1 represented the catabolic balance, but were not associated to radiographic grading. Three different clusters of biomarkers were found in synovial fluid but did not show any significant association to radiographic grading. Conclusions. New imaging approaches to assess structural deterioration and correlation with biomarker levels are warranted to advance in OA research.

AXIS: An instrument for imaging Compton radiographs using the Advanced Radiography Capability on the NIF

Energy Technology Data Exchange (ETDEWEB)

Hall, G. N., E-mail: hall98@llnl.gov; Izumi, N.; Tommasini, R.; Carpenter, A. C.; Palmer, N. E.; Zacharias, R.; Felker, B.; Holder, J. P.; Allen, F. V.; Bell, P. M.; Bradley, D.; Montesanti, R.; Landen, O. L. [Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550 (United States)

2014-11-15

Compton radiography is an important diagnostic for Inertial Confinement Fusion (ICF), as it provides a means to measure the density and asymmetries of the DT fuel in an ICF capsule near the time of peak compression. The AXIS instrument (ARC (Advanced Radiography Capability) X-ray Imaging System) is a gated detector in development for the National Ignition Facility (NIF), and will initially be capable of recording two Compton radiographs during a single NIF shot. The principal reason for the development of AXIS is the requirement for significantly improved detection quantum efficiency (DQE) at high x-ray energies. AXIS will be the detector for Compton radiography driven by the ARC laser, which will be used to produce Bremsstrahlung X-ray backlighter sources over the range of 50 keV–200 keV for this purpose. It is expected that AXIS will be capable of recording these high-energy x-rays with a DQE several times greater than other X-ray cameras at NIF, as well as providing a much larger field of view of the imploded capsule. AXIS will therefore provide an image with larger signal-to-noise that will allow the density and distribution of the compressed DT fuel to be measured with significantly greater accuracy as ICF experiments are tuned for ignition.

AXIS: an instrument for imaging Compton radiographs using the Advanced Radiography Capability on the NIF.

Science.gov (United States)

Hall, G N; Izumi, N; Tommasini, R; Carpenter, A C; Palmer, N E; Zacharias, R; Felker, B; Holder, J P; Allen, F V; Bell, P M; Bradley, D; Montesanti, R; Landen, O L

2014-11-01

Compton radiography is an important diagnostic for Inertial Confinement Fusion (ICF), as it provides a means to measure the density and asymmetries of the DT fuel in an ICF capsule near the time of peak compression. The AXIS instrument (ARC (Advanced Radiography Capability) X-ray Imaging System) is a gated detector in development for the National Ignition Facility (NIF), and will initially be capable of recording two Compton radiographs during a single NIF shot. The principal reason for the development of AXIS is the requirement for significantly improved detection quantum efficiency (DQE) at high x-ray energies. AXIS will be the detector for Compton radiography driven by the ARC laser, which will be used to produce Bremsstrahlung X-ray backlighter sources over the range of 50 keV-200 keV for this purpose. It is expected that AXIS will be capable of recording these high-energy x-rays with a DQE several times greater than other X-ray cameras at NIF, as well as providing a much larger field of view of the imploded capsule. AXIS will therefore provide an image with larger signal-to-noise that will allow the density and distribution of the compressed DT fuel to be measured with significantly greater accuracy as ICF experiments are tuned for ignition.

Three-dimensional hindfoot alignment measurements based on biplanar radiographs: comparison with standard radiographic measurements

International Nuclear Information System (INIS)

Sutter, Reto; Pfirrmann, Christian W.A.; Buck, Florian M.; Espinosa, Norman

2013-01-01

To establish a hindfoot alignment measurement technique based on low-dose biplanar radiographs and compare with hindfoot alignment measurements on long axial view radiographs, which is the current reference standard. Long axial view radiographs and low-dose biplanar radiographs of a phantom consisting of a human foot skeleton embedded in acrylic glass (phantom A) and a plastic model of a human foot in three different hindfoot positions (phantoms B1-B3) were imaged in different foot positions (20 internal to 20 external rotation). Two independent readers measured hindfoot alignment on long axial view radiographs and performed 3D hindfoot alignment measurements based on biplanar radiographs on two different occasions. Time for three-dimensional (3D) measurements was determined. Intraclass correlation coefficients (ICC) were calculated. Hindfoot alignment measurements on long axial view radiographs were characterized by a large positional variation, with a range of 14 /13 valgus to 22 /27 varus (reader 1/2 for phantom A), whereas the range of 3D hindfoot alignment measurements was 7.3 /6.0 to 9.0 /10.5 varus (reader 1/2 for phantom A), with a mean and standard deviation of 8.1 ± 0.6/8.7 ± 1.4 respectively. Interobserver agreement was high (ICC = 0.926 for phantom A, and ICC = 0.886 for phantoms B1-B3), and agreement between different readouts was high (ICC = 0.895-0.995 for reader 1, and ICC = 0.987-0.994 for reader 2) for 3D measurements. Mean duration of 3D measurements was 84 ± 15/113 ± 15 s for reader 1/2. Three-dimensional hindfoot alignment measurements based on biplanar radiographs were independent of foot positioning during image acquisition and reader independent. In this phantom study, the 3D measurements were substantially more precise than the standard radiographic measurements. (orig.)

Outcomes of Patellofemoral Arthroplasty Based on Radiographic Severity.

Science.gov (United States)

deDeugd, Casey M; Pareek, Ayoosh; Krych, Aaron J; Cummings, Nancy M; Dahm, Diane L

2017-04-01

Patellofemoral arthroplasty (PFA) is increasingly performed for symptomatic patellofemoral arthritis. The purpose of this study was to evaluate the outcomes of PFA based on preoperative radiographic severity of patellofemoral arthritis. All patients who underwent PFA for isolated patellofemoral arthritis between 2002 and 2013 and had undergone preoperative magnetic resonance imaging were identified. Radiographic severity of patellofemoral arthritis was classified according to the Iwano classification system. Groups were divided between mild (grade 0-I) and moderate to severe (grade II-IV) patellofemoral arthritis. Clinical outcomes were evaluated using the Knee Society scores (KSS), University of California at Los Angeles (UCLA) and Tegner scores. Seventy-five knees in 55 patients met inclusion criteria. Mean age was 51 years (range, 36 to 81), and mean follow-up was 3 years (range, 2 to 10). All patients had grade IV patellofemoral chondromalacia and/or significant subchondral cyst formation and edema on magnetic resonance imaging. On plain radiographs, there were no patients with Iwano grade 0, 21 grade I, 15 grade II, 21 grade III, and 18 grade IV patellofemoral arthritis. There was significantly more improvement in KSS pain (P = .046), KSS function (P = .02), University of California at Los Angeles (UCLA) (P = .046) and Tegner (P = .008) scores in the Iwano grade II-IV group vs the Iwano grade I group. Patient-reported pain quality improved significantly more following PFA in the grade II-IV group (P = .04). Patients with evidence of mild patellofemoral arthritis on plain radiographs demonstrated less improvement in pain and function after PFA than those with more advanced patellofemoral arthritis. Caution should be used when considering PFA for patients with minimal radiographic evidence of patellofemoral arthritis. Copyright © 2016 Elsevier Inc. All rights reserved.

Artificial intelligence for analyzing orthopedic trauma radiographs.

Science.gov (United States)

Olczak, Jakub; Fahlberg, Niklas; Maki, Atsuto; Razavian, Ali Sharif; Jilert, Anthony; Stark, André; Sköldenberg, Olof; Gordon, Max

2017-12-01

Background and purpose - Recent advances in artificial intelligence (deep learning) have shown remarkable performance in classifying non-medical images, and the technology is believed to be the next technological revolution. So far it has never been applied in an orthopedic setting, and in this study we sought to determine the feasibility of using deep learning for skeletal radiographs. Methods - We extracted 256,000 wrist, hand, and ankle radiographs from Danderyd's Hospital and identified 4 classes: fracture, laterality, body part, and exam view. We then selected 5 openly available deep learning networks that were adapted for these images. The most accurate network was benchmarked against a gold standard for fractures. We furthermore compared the network's performance with 2 senior orthopedic surgeons who reviewed images at the same resolution as the network. Results - All networks exhibited an accuracy of at least 90% when identifying laterality, body part, and exam view. The final accuracy for fractures was estimated at 83% for the best performing network. The network performed similarly to senior orthopedic surgeons when presented with images at the same resolution as the network. The 2 reviewer Cohen's kappa under these conditions was 0.76. Interpretation - This study supports the use for orthopedic radiographs of artificial intelligence, which can perform at a human level. While current implementation lacks important features that surgeons require, e.g. risk of dislocation, classifications, measurements, and combining multiple exam views, these problems have technical solutions that are waiting to be implemented for orthopedics.

An investigation into the opportunities and barriers to participation in a radiographer comment scheme, in a multi-centre NHS trust

International Nuclear Information System (INIS)

Lancaster, Anne; Hardy, Maryann

2012-01-01

Introduction and purpose: Despite the United Kingdom College of Radiographers aspiration that first line reporting or commenting by radiographers be normal practice, radiographers have not as yet embraced these opportunities in clinical practice and the number of radiographer commenting (initial reporting) schemes in operation is currently limited. This study explores radiographer opinion with regard to commenting with the aim of establishing the perceived opportunities and barriers to operating a commenting scheme with respect to trauma radiography. Method: A survey of 79 radiographers working within a single multi-centre Trust in the north of England was undertaken using a questionnaire. Attitudinal statements were used to elicit information on perceived opportunities and barriers to the implementation of radiographer commenting. Results: Fifty three questionnaires were returned within the specified time frame (n-53/79; 67.1%). A number of barriers to implementing a commenting scheme were identified including time, technology, anatomical confidence and training. Opportunities included improving professional profile and increased professional contribution to decision making within the patient pathway. No correlation was demonstrated between respondent demographic and responses suggesting that opinions expressed were not influenced by hospital site, radiographer grade or years experience. Conclusion: Radiographers generally had a positive attitude towards the implementation of radiographer commenting and felt that their operation was both beneficial to patient care and the professional profile of radiographers. However, a number of barriers were identified and while concerns regarding training may be increasingly addressed by the Department of Health’s e-learning image interpretation package, the impact of changes in technology and subsequent service operation have not yet been fully evaluated.

Advanced practice nursing in child maltreatment: practice characteristics.

Science.gov (United States)

Hornor, Gail; Herendeen, Pamela

2014-01-01

Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Radiographic positioning

International Nuclear Information System (INIS)

Eisenberg, R.L.; Dennis, C.A.; May, C.

1989-01-01

This book concentrates on the routine radiographic examinations commonly performed. It details the wide variety of examinations possible and their place in initial learning and in the radiology department as references for those occasions when an unusual examination is requested. This book provides information ranging from basic terminology to skeletal positioning to special procedures. Positions are discussed and supplemented with a picture of a patient, the resulting radiograph, and a labeled diagram. Immobilization and proper shielding of the patient are also shown

A radiographic study of the position and shape of mental foramen in panoramic radiographs

International Nuclear Information System (INIS)

Choi, Karp Shik; Kim, Dong Youn; Sohn, Jeong Ick; Bae, Yong Chul

1997-01-01

The purpose of this study was to evaluate the position and shape of mental foramen in panoramic radiographs. For this study, panoramic radiographs were obtained from the 200 adults and evaluated the position and shape of mental foramen. According to various positional changes in panoramic radiographs of the patients, the author also obtained panoramic radiographs from the 100 adults and then evaluated the positional and shape changes of mental foramen. The following results were obtained : 1. Shapes of mental foramen were observed elliptical (43.3%), round or oval (42.5%), unidentified (7.5%) and diffuse (6.7%) type in descending order of frequency. 2. Horizontal position of mental foramen were most frequently observed at the 2nd premolar area (54.2%), and area between the 1st premolar and 2nd premolar (43.1%), area between the 2nd premolar and 1st molar (2.7%), and at apex (9.7%), overlap with apex (1.9%), superior of apex (0.2%) in descending order of frequency. 4. According to various positional changes in panoramic radiographs of the patients, shape changes of mental foramen were more obviously observed at the forward 10 mm and chin down 10 degree positioned panoramic radiographs, And changes of horizontal and vertical position were observed in similar to compared with normal positioned panoramic radiographs.

The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

Science.gov (United States)

Morgan, Brianna; Tarbi, Elise

2016-02-01

To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

Student and Preceptor Advancement in a Dedicated Education Site: Innovation in Clinical Education for Advanced Practice Nurses.

Science.gov (United States)

Hall, Katherine C; Diffenderfer, Sandy K; Stidham, April; Mullins, Christine M

2018-04-19

In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Training radiographers to deliver an intervention to promote early presentation of breast cancer

International Nuclear Information System (INIS)

Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

2012-01-01

Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

Radiographic inspection on offshore platforms

International Nuclear Information System (INIS)

Soares, Sergio Damasceno; Sperandio, Augusto Gasparoni

1994-01-01

One of the great challenges for non-destructive inspection is on offshore platforms, where safety is a critical issue. Inspection by gammagraphy is practically forbidden on the platform deck due to problems to personnel safety and radiological protection. Ir-192 sources are used and the risk of an accident with loss of radioisotope must be considered. It is unfeasible to use gammagraphy, because in case of an accident the rapid evacuation from the platform would be impossible. This problem does not occur when X-ray equipment is used as the radiation source. The limited practicality and portability of the X-ray equipment have prevented its use as a replacement for the gammagraphy. This paper presents the preliminary tests to see the viable use of radiographic tests with constant potential on offshore platforms. (author). 2 refs., 1 fig., 2 tabs, 3 photos

Comparative radiographic analysis on the anatomical axis in knee osteoarthritis cases: inter and intraobserver evaluation

Directory of Open Access Journals (Sweden)

Luiz Felipe Matos

2015-06-01

Full Text Available OBJECTIVE: To make a comparative inter and intraobserver analysis on measurements of the anatomical axis between panoramic radiographs of the lower limbs in anteroposterior (AP view with bipedal weight-bearing, on short film.METHODS: An accuracy study comparing radiographic measurements on 47 knees of patients attending the knee surgery outpatient clinic due to osteoarthritis. The radiographic evaluation used was as standardized for the total knee arthroplasty program, including panoramic AP views of the lower limbs and short radiographs of the knees in AP and lateral views, all with bipedal weight-bearing. Following this, the anatomical axis of the lower limbs or the femorotibial angle was measured by five independent examiners on the panoramic and short AP radiographs; three of the examiners were considered to be more experienced and two, less experienced. All the measurements were made again by the same examiners after an interval of not less than 15 days. The statistical analysis was performed using the intraclass correlation coefficient, in order to evaluate the inter and intraobserver concordance of the anatomical axis measurements.RESULTS: From the statistical analysis, it was observed that there was strongly significant concordance between the anatomical axis measurements on the panoramic and short radiographs, for all the five examiners and for both measurements.CONCLUSIONS: Under the conditions studied, short radiographs were equivalent to panoramic radiographs for evaluating the anatomical axis of the lower limbs in patients with advanced osteoarthritis. The measurements used also showed high rates of inter and intraobserver concordance and reproducibility.

Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices.

Science.gov (United States)

Hilbert, Timothy J; Franzblau, Alfred; Dunning, Kari K; Borton, Eric K; Rohs, Amy M; Lockey, James E

2013-11-01

To explore the potential impact of worker hygiene by determining the prevalence of radiographic changes consistent with asbestos exposure among household contacts of workers exposed to Libby vermiculite that contained amphibole fibers. Workers and household contacts had chest radiographs and completed questionnaires regarding hygiene and potential exposure pathways. Participants included 191 household contacts of 118 workers. One household contact (0.5%) had localized pleural thickening, and three (1.6%) had irregular opacities at profusion category 1/0 or greater. Worker radiographs demonstrated pleural changes in 45% and irregular opacities at profusion category 1/0 or greater in 8%. Libby vermiculite-exposed workers demonstrated an elevated prevalence of pleural and interstitial chest radiographic changes. There was, however, no increased prevalence of similar changes among household contacts, likely because of personal hygiene measures taken by the majority of workers.

Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice.

Science.gov (United States)

Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

2016-08-08

to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da pr

Radiographic localization of unerupted mandibular anterior teeth.

Science.gov (United States)

Jacobs, S G

2000-10-01

The parallax method and the use of 2 radiographs taken at right angles to each other are the 2 methods generally used to accurately localize teeth. For the parallax method, the combination of a rotational panoramic radiograph with an occlusal radiograph is recommended. This combination involves a vertical x-ray tube shift. Three case reports are presented that illustrate: (1) how this combination can accurately localize unerupted mandibular anterior teeth, (2) how a deceptive appearance of the labiolingual position of the unerupted tooth can be produced in an occlusal radiograph, (3) how increasing the vertical angle of the tube for the occlusal radiograph makes the tube shift easier to discern, (4) why occlusal radiographs are preferable to periapical radiographs for tube shifts, and (5) how localization can also be carried out with 2 radiographs at right angles to each other, one of which is an occlusal radiograph taken with the x-ray tube directed along the long axis of the reference tooth.

Producing quality radiographic images

International Nuclear Information System (INIS)

Cullinan, A.M.

1987-01-01

This book gives an overview of physics, equipment, imaging, and quality assurance in the radiology department. The chapters are laid out with generous use of subheads to allow for quick reference, Points are illustrated with clear, uncluttered line diagrams and well-produced images. The accompanying explanations are miniature lessons by themselves. Inserted at various points throughout the text are important notes that highlight key concepts. The chapter ''Image Evaluation and Application of Radiographic Principles'' present a systematic approach to evaluating radiographs and contains several sample radiographs to illustrate the points made

Mammography manual for the daily routine. A technical, practical and quality guide for radiologists, gynaecologists and radiographers

International Nuclear Information System (INIS)

Roth-Ganter, G.; Fischer, U.

2002-01-01

Gudrun Roth-Ganther presents in this book a wealth of professional experience that she has been accumulating over many years as a radiographer tutor at home and abroad. Step by step the reader will learn how to make high-quality mammographs. Important aspects: the normal radiographic anatomy of the mamma, factors influencing the image quality, technical parameters, exposure techniques, approaches for quality assessment and quality assurance, detecting and avoiding mistakes. (orig./CB) [de

Radiographic progession of rheumatoid arthritis

International Nuclear Information System (INIS)

Siozos, C.D.

1981-01-01

The radiographic progression of rheumatoid arthritis can be graded on a 0-IV scala. For this purpose five objective criteria are used: a) destruction, b) osteoporosis, c) narrowing of joint space, d) luxation and e) ankylosis. The grading of the radiographic progression is defined by the extent and the number of the measured alterations. The radiographic progression can be registered yearly. (orig.) [de

Radiographic film orientation in radiotherapy dosimetry

International Nuclear Information System (INIS)

Suchowerska, N.; Davison, A.; Drew, J.; Metcalfe, P.

1996-01-01

Since the discovery of x-rays, film has been used as a detection medium for radiation. More recently radiographic film has become established as a practical tool for the measurement of dose distribution in radiotherapy. The accuracy and reproducibility of film dosimetry depends on photon energy, processing conditions and film plane orientation. The relationship between photon energy, processing conditions and film dosimetry accuracy has been studied. The role of film plane orientation is still controversial. The current work aims to clarify the effects film plane orientation has on film dosimetry. Poster 205. (author)

The radiographer's role in child protection: Comparison of radiographers perceptions by use of focus groups

International Nuclear Information System (INIS)

Davis, Michaela; Reeves, Pauline

2006-01-01

The research presented in this paper is taken from a larger study whose aims were to devise a holistic picture of how diagnostic radiographers approach child protection issues and to explore how radiographers and other professionals see the role of radiographers in the chain of evidence in relation to child protection as this applies to children who present at the Imaging Department with suspected non-accidental injuries (NAI). A focus group methodology was used with focus groups being conducted in the United Kingdom and Republic of Ireland. The results indicated that both United Kingdom and Republic of Ireland radiographers agreed that they had a role in child protection; however, they identified a wide interpretation as to the extent of that role. Although radiographers in the United Kingdom and Republic of Ireland work within different legal systems there were themes identified which were common to both countries. Although radiographers referred to a duty to the child as to all patients, no radiographer specifically mentioned the system and child care law under which it is assumed they operate. This research revealed an area which would benefit from more detailed research using a wider audience. However, the study revealed a need for training in relation to possible NAI indicators and the correct procedure for documenting their suspicions and initiating an NAI referral

Chesneys' radiographic imaging. 5. ed.

International Nuclear Information System (INIS)

Ball, J.; Price, T.

1989-01-01

This new edition of Chesney and Chesney: Radiographic Imaging has been completely written by two new authors. The book reflects the change in emphasis in radiology from photographic processes towards electronic imaging methods. There is new material on image intensifiers and television imaging, digital imaging and digital subtractions. Analyses of the various characteristics of, and defects in, images on radiographs, xeroradiographs and the television screen are included. The methods, equipment and materials used to record the cathode ray tube image are described and there is new material on the principles of alternative diagnostic imaging techniques such as ultrasound, computed tomography and radionuclide imaging which provide cathode ray tube images. The book is primarily for student radiographers studying for the Diploma of the College of Radiographers, but radiographers studying for postdiplomate qualifications such as the Higher Diploma (HDCR) will also find the book helpful. (author)

Measuring acetabular cup orientation on antero-posterior radiographs of the hip after total hip arthroplasty with a vector arithmetic radiological method. Is it valid and verified for daily clinical practice?

Energy Technology Data Exchange (ETDEWEB)

Craiovan, B.; Weber, M.; Worlicek, M.; Schneider, M.; Springorum, H.R.; Grifka, J.; Renkawitz, T. [University Medical Center Regensburg, Bad Abbach/Regensburg (Germany). Orthopedic Surgery; Zeman, F. [University Medical Center Regensburg, Bad Abbach/Regensburg (Germany). Center for Clinical Studies

2016-06-15

The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was -1.4 ±3.9 for inclination and 0.8 ±7.9 for anteversion with excellent correlation for inclination (r=0.81, p < 0.001) and moderate correlation for anteversion (r=0.65, p < 0.001). The intraclass correlation coefficient for measurements on radiographs ranged from 0.98 (95%-CI: 0.98; 0.99) for the first observer to 0.94 (95%-CI: 0.92; 0.96) for the second observer. The interrater reliability was 0.96 (95%-CI: 0.93; 0.98) for inclination and 0.93 (95%-CI: 0.85; 0.96) for anteversion. The largest errors in measurements were associated with an extraordinary pelvic tilt. In order to get a valuable measurement for measuring cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future.

Interpreting radiographs. 4. The carpus

International Nuclear Information System (INIS)

Burguez, P.N.

1984-01-01

The complexity of the carpus which has three major joints, seven or eight carpal bones and five adjacent bones, each of which articulates with one or more of the carpal elements, necessitates good quality radiographs for definitive radiographic interpretation may be extremely difficult because of the disparity between radiographic changes and obvious clinical signs and, therefore, must be discussed in the light of a thorough clinical assessment

Justification of radiographic examinations: What are the key issues?

OpenAIRE

Vom, Jason; Williams, Imelda

2017-01-01

Abstract Justification of radiographic examinations is the practice of evaluating requested radiological examinations to assess for clinical merit and appropriateness based on clinical notes and patient information. This implies that justification in radiography requires the evaluation of requested examinations, the justification of exposures being applied and determining whether patients fit the recommended criteria for the procedure. Medico?legal requirements by the professional registratio...

Constructing an Ethical Training for Advanced Nursing Practice: An Interactionist and Competency-Based Approach.

Science.gov (United States)

Pariseau-Legault, Pierre; Lallier, Melisa

2016-07-01

Advanced practice nurses are working in a highly interdisciplinary and political context. Such situations can influence the deliberative and ethical decision-making processes in which they are also involved. This can subsequently compromise their abilities to protect their moral integrity, to find innovative and nondualistic solutions to complex ethical problems, and to collaborate with other health professionals. The authors constructed a training program inspired by discourse and narrative ethics. The objective pursued was to develop advanced practice nurses' moral integrity, highlight the ethical component of their clinical judgement, and foster the development of their deliberative competencies. The pedagogical process proposed exposes how an ethical curriculum adapted to the context in which advanced practice nurses evolve can address power relationships inherent in ethical decision making. The authors suggest that this pedagogical approach has the potential to optimize the consolidation of ethical, reflective, and deliberative competencies among advanced practice nurses. [J Nurs Educ. 2016;55(7):399-402.]. Copyright 2016, SLACK Incorporated.

COMPUTER-AIDED DETECTION OF ACINAR SHADOWS IN CHEST RADIOGRAPHS

Directory of Open Access Journals (Sweden)

Tao Xu

2013-05-01

Full Text Available Despite the technological advances in medical diagnosis, accurate detection of infectious tuberculosis (TB still poses challenges due to complex image features and thus infectious TB continues to be a public health problem of global proportions. Currently, the detection of TB is mainly conducted visually by radiologists examining chest radiographs (CXRs. To reduce the backlog of CXR examination and provide more precise quantitative assessment, computer-aided detection (CAD systems for potential lung lesions have been increasingly adopted and commercialized for clinical practice. CADs work as supporting tools to alert radiologists on suspected features that could have easily been neglected. In this paper, an effective CAD system aimed for acinar shadow regions detection in CXRs is proposed. This system exploits textural and photometric features analysis techniques which include local binary pattern (LBP, grey level co-occurrence matrix (GLCM and histogram of oriented gradients (HOG to analyze target regions in CXRs. Classification of acinar shadows using Adaboost is then deployed to verify the performance of a combination of these techniques. Comparative study in different image databases shows that the proposed CAD system delivers consistent high accuracy in detecting acinar shadows.

An investigation of radiographers' mobile phone use and the success of an awareness campaign at reducing the nosocomial infection risks.

Science.gov (United States)

Crofton, C C; Foley, S J

2018-02-01

Mobile phone use by healthcare workers (HCWs) is widespread. Studies have shown that HCW's mobile phones can harbour pathogens associated with nosocomial infections. This study investigated whether an awareness campaign will result in an improvement in radiographers' phone and hand hygiene practices. Radiographers working in the general department of two university hospitals were invited to participate. One hospital was assigned as the experiment hospital and the other as a control. In the experiment hospital, adenosine triphosphate (ATP) testing of each participant's mobile phone determined the cleanliness of its surface. A corresponding survey was completed to determine their current practices and level of awareness. Subsequently, an infection control poster campaign took place for a one-month period, followed by re-testing. In the control hospital, the ATP testing and survey were also completed before and after a one-month period, but without a poster campaign. Radiographers were generally unaware of the infection risks associated with mobile phone use with 44% of all participants never cleaning their phone. The campaign successfully improved phone hygiene frequency and method in the experiment hospital. However, it did not improve hand hygiene practices and actual phone cleanliness (mean ATP count reductions of 10% (experiment hospital) and 20% (control)). The ATP testing as a less direct form of intervention showed similar levels of success in comparison to the poster campaign. A multifaceted educational approach is likely to be most effective in raising awareness and changing radiographers' phone and hand hygiene practices. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Drivers Advancing Oral Health in a Large Group Dental Practice Organization.

Science.gov (United States)

Simmons, Kristen; Gibson, Stephanie; White, Joel M

2016-06-01

Three change drivers are being implemented to high standards of patient centric and evidence-based oral health care within the context of a large multispecialty dental group practice organization based on the commitment of the dental hygienist chief operating officer and her team. A recent environmental scan elucidated 6 change drivers that can impact the provision of oral health care. Practitioners who can embrace and maximize aspects of these change drivers will move dentistry forward and create future opportunities. This article explains how 3 of these change drivers are being applied in a privately held, accountable risk-bearing entity that provides individualized treatment programs for more than 417,000 members. To facilitate integration of the conceptual changes related to the drivers, a multi-institutional, multidisciplinary, highly functioning collaborative work group was formed. The document Dental Hygiene at a Crossroads for Change(1) inspired the first author, a dental hygienist in a unique position as chief operating officer of a large group practice, to pursue evidence-based organizational change and to impact the quality of patient care. This was accomplished by implementing technological advances including dental diagnosis terminology in the electronic health record, clinical decision support, standardized treatment guidelines, quality metrics, and patient engagement to improve oral health outcomes at the patient and population levels. The systems and processes used to implement 3 change drivers into a large multi-practice dental setting is presented to inform and inspire others to implement change drivers with the potential for advancing oral health. Technology implementing best practices and improving patient engagement are excellent drivers to advance oral health and are an effective use of oral health care dollars. Improved oral health can be leveraged through technological advances to improve clinical practice. Copyright © 2016 Elsevier Inc

On being dyslexic: Student radiographers' perspectives

International Nuclear Information System (INIS)

Murphy, Fred

2011-01-01

The purpose of this paper was to provide an insight into life as a dyslexic student radiographer, identify barriers and risks in clinical training, and develop recommendations for the support of students with dyslexia. The paucity of research into dyslexia within the radiography profession is worrying, with attention focused only on the support provided by Higher Education Institutions (HEI) or inferences drawn from the experiences of other healthcare students. The impact and significance of dyslexia for student radiographers in clinical practice has never been investigated. Results: On a self-reporting scale of clinical tasks there was little or no difference between dyslexic students and non-dyslexics. Some minor traits commonly associated with dyslexics were also reported by students with no learning disabilities and an inclusion support plan for all students was advocated. In-depth interviews of 10 student radiographers revealed six distinct themes of visualising the disability, self-protection, strengths and talents, time, the badge of disability and adjustments and support. Like other healthcare students, some radiography students reported significant difficulties and prejudices and very little structured support in the clinical environment. Despite the Special Educational Needs and Disability Act being in place for several years, the support in clinical departments fell significantly short of that provided in the universities. The dyslexic students took extra responsibility for their own learning and some had developed complex coping strategies to overcome any difficulties. Conclusion: Several inclusive recommendations were developed as a result of this study that could be used to support all students on clinical placement.

Radiographer commenting of trauma radiographs: a survey of the benefits, barriers and enablers to participation in an Australian healthcare setting

International Nuclear Information System (INIS)

Neep, Michael J.; Steffens, Tom; Owen, Rebecca; McPhail, Steven M.

2014-01-01

Radiographer abnormality detection systems that highlight abnormalities on trauma radiographs ('red dot' system) have been operating for more than 30 years. Recently, a number of pitfalls have been identified. These limitations initiated the evolution of a radiographer commenting system, whereby a radiographer provides a brief description of abnormalities identified in emergency healthcare settings. This study investigated radiographers' participation in abnormality detection systems, their perceptions of benefits, barriers and enablers to radiographer commenting, and perceptions of potential radiographer image interpretation services for emergency settings. A cross-sectional survey was implemented. Participants included radiographers from four metropolitan hospitals in Queensland, Australia. Conventional descriptive statistics, histograms and thematic analysis were undertaken. Seventy-three surveys were completed and included in the analysis (68% response rate); 30 (41%) of respondents reported participating in abnormality detection in 20% or less of examinations, and 26(36%) reported participating in 80% or more of examinations. Five overarching perceived benefits of radiographer commenting were identified: assisting multidisciplinary teams, patient care, radiographer ability, professional benefits and quality of imaging. Frequently reported perceived barriers included 'difficulty accessing image interpretation education', 'lack of time' and 'low confidence in interpreting radiographs'. Perceived enablers included 'access to image interpretation education' and 'support from radiologist colleagues'. A range of factors are likely to contribute to the successful implementation of radiographer commenting in addition to abnormality detection in emergency settings. Effective image interpretation education amenable to completion by radiographers would likely prove valuable in preparing radiographers for participation in abnormality detection and commenting systems in

Radiographic testing at Lawrence Livermore National Laboratory

International Nuclear Information System (INIS)

Bossi, R.H.

1982-01-01

Radiographic testing is a nondestructive inspection technique which uses penetrating radiation. The Nondestructive Evaluation (NDE) Section at Lawrence Livermore National Laboratory has a broad spectrum of equipment and techniques for radiographic testing. These resources include low-energy vacuum systems, low- and mid-energy cabinet and cell radiographic systems, high-energy linear accelerators, portable x-ray machines and radioisotopes for radiographic inspections. For diagnostic testing the NDE Section also has real-time and flash radiographic equipment

Interpretation and digestion of radiograph

International Nuclear Information System (INIS)

Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail

2008-01-01

Radiography digestion is final test for the radiography to make sure that radiograph produced will inspect their quality of the image before its interpreted. This level is critical level where if there is a mistake, all of the radiography work done before will be unaccepted. So as mention earlier, it can waste time, cost and more worst it can make the production must shut down. So, this step, level two radiographers or interpreter must evaluate the radiograph carefully. For this purpose, digestion room and densitometer must used. Of course all the procedure must follow the specification that mentioned in document. There are several needs must fill before we can say the radiograph is corrected or not like the location of penetrameter, number of penetrameter that showed, the degree of density of film, and usually there is no problem in this step and the radiograph can go to interpretation and evaluation step as will mentioned in next chapter.

Incidence of Radiographic Cystic Lesions Associated With Unerupted Teeth in Dogs.

Science.gov (United States)

Babbitt, Sam G; Krakowski Volker, Mary; Luskin, Ira R

2016-12-01

Medical records and radiographs were retrospectively reviewed over a 3-year period (2012-2015) from dogs presented to a private dental referral practice. Medical records were evaluated for the diagnosis of impacted or embedded teeth. The identified dogs' radiographs were reviewed for the presence of radiographically significant cystic lesions that were associated with the impacted or embedded teeth. Radiographic criteria were established by the authors for the purposes of identifying cystic lesions in dogs of different breeds and sizes, using established indices from human dental pathology as a basis. When histopathology results were available, they were reviewed and reported. In this study, 136 dogs ranging in age from 3 months to 17 years were diagnosed with 213 unerupted teeth during the study period. There were 62 (29.1%) of the 213 radiographically apparent cystic lesions identified based on the criteria proposed in this study. In this study, 146 (68.5%) of the 213 unerupted teeth were identified as mandibular first premolar teeth. Histopathology was obtained on 28 (45.1%) of the 62 diagnosed cystic lesions. Dentigerous cysts accounted for 20 (71.4%) of the 28 cystic lesions. Brachycephalic breeds were overrepresented in this study. Boxer, pug, Shih Tzu, and Boston terrier dogs were most likely to present with cystic lesions associated with unerupted teeth. Seventeen (85%) of the 20 cases with a histopathologic diagnosis of dentigerous cyst were found within these 4 brachycephalic breeds.

The influence of a continuing education program on the image interpretation accuracy of rural radiographers.

Science.gov (United States)

Smith, Tony N; Traise, Peter; Cook, Aiden

2009-01-01

In regional, rural and remote clinical practice, radiographers work closely with medical members of the acute care team in the interpretation of radiographic images, particularly when no radiologist is available. However, the misreading of radiographs by non-radiologist physicians has been shown to be the most common type of clinical error in the emergency department. Further, in Australia few rural radiographers are specifically trained to interpret and report on images. This study aimed to evaluate the accuracy of a group of rural radiographers in interpreting musculoskeletal plain radiographs, and to assess the effectiveness of continuing education (CE) in improving their accuracy within a short time frame. Following ethics approval, 16 rural radiographers were recruited to the study. At inception a purpose-designed 'test-object' of 25 cases compiled by a radiologist was used to assess image interpretation accuracy. The cases were categorised into three grades of complexity. The radiographers entered their answers on a structured radiographer opinion form (ROF) that had three levels of response - 'general opinion', 'observations' and 'open comment'. Subsequent to base-line testing, the radiographers participated in a CE program aimed at improving their image interpretation skills. After a 4 month period they were re-tested using the same methodology. The ROFs were scored by the radiologist and the pooled results analysed for statistically significant changes at all ROF levels and grades of complexity. While for the small number of less complex grade 1 cases there was no change in image interpretation accuracy, for the more numerous and more complex grade 2 and grade 3 cases there was a statistically significant improvement at the 'general opinion' and 'observation' levels (paired t-test, p radiologist. However, radiographers' ability to use radiological vocabulary needs improvement. The complementary role that exists between radiographers and other members of

The role of plain radiographs in the diagnosis of chronic maxillary ...

African Journals Online (AJOL)

Background: Computed tomography is currently the gold standard for the diagnosis of chronic rhinosinusitis. However, this facility is not readily available in many developing countries. Thus, plain sinus radiography is still widely in use in our practice. Objectives: To assess the diagnostic value of plain radiographs in adult ...

Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Directory of Open Access Journals (Sweden)

Tilde Rodrigues Froes

2014-09-01

Full Text Available Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4% and the general practitioners (26.7% group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses.

Radiographic markers for measuring tibial rotation based on CT-reconstructed radiographs. An accuracy and feasibility study

International Nuclear Information System (INIS)

Hakimian, David; Khoury, Amal; Mosheiff, Rami; Liebergall, Meir; Weil, Yoram A.

2018-01-01

Malreduction in the axial plane (malrotation) following tibial fracture surgery is often undiagnosed. A few clinical and radiographic methods have been proposed for measuring tibial rotation intraoperatively, yet have failed to match the accuracy of computed tomography (CT). The aim of this study was to develop radiographic tools for future intraoperative assessment of the tibial shaft rotation profile. The setting was a laboratory computerized analysis. Twenty lower limb CT scans were used to construct a three-dimensional (3D) model using AMIRA copyright software. A virtual 3D cylinder was implanted in the posterior condylar line and in the transmalleolar axis. The 3D models were used to simulate four standard knee and ankle plain radiographs. On each radiograph, four landmarks were depicted by two observers and their relation with the cylinder was measured and analyzed for accuracy and reproducibility. A cadaveric lower leg was implanted with two Kirschner wires. A CT scan was performed in addition to 2D fluoroscopy. The simulated radiographs and the fluoroscopy were compared for accuracy. Measurement of the landmarks showed reliability in most of the knee anteroposterior and ankle mortise radiographs (coefficients of variation < 0.01 and = 0.01) respectively. Cadaveric measurement of the landmarks using real fluoroscopy and simulated radiographs were similar. To date, no reliable and common methods have been reported for the evaluation of tibial axial rotation. We propose a model in which simple radiographic landmarks can be used to calculate a 3D coordinate system that accurately assesses the axial rotation angle of the tibial shaft. (orig.)

Radiographic markers for measuring tibial rotation based on CT-reconstructed radiographs. An accuracy and feasibility study

Energy Technology Data Exchange (ETDEWEB)

Hakimian, David; Khoury, Amal; Mosheiff, Rami; Liebergall, Meir; Weil, Yoram A. [Hadassah Hebrew University Hospital, Department of Orthopaedics, Jerusalem (Israel)

2018-04-15

Malreduction in the axial plane (malrotation) following tibial fracture surgery is often undiagnosed. A few clinical and radiographic methods have been proposed for measuring tibial rotation intraoperatively, yet have failed to match the accuracy of computed tomography (CT). The aim of this study was to develop radiographic tools for future intraoperative assessment of the tibial shaft rotation profile. The setting was a laboratory computerized analysis. Twenty lower limb CT scans were used to construct a three-dimensional (3D) model using AMIRA copyright software. A virtual 3D cylinder was implanted in the posterior condylar line and in the transmalleolar axis. The 3D models were used to simulate four standard knee and ankle plain radiographs. On each radiograph, four landmarks were depicted by two observers and their relation with the cylinder was measured and analyzed for accuracy and reproducibility. A cadaveric lower leg was implanted with two Kirschner wires. A CT scan was performed in addition to 2D fluoroscopy. The simulated radiographs and the fluoroscopy were compared for accuracy. Measurement of the landmarks showed reliability in most of the knee anteroposterior and ankle mortise radiographs (coefficients of variation < 0.01 and = 0.01) respectively. Cadaveric measurement of the landmarks using real fluoroscopy and simulated radiographs were similar. To date, no reliable and common methods have been reported for the evaluation of tibial axial rotation. We propose a model in which simple radiographic landmarks can be used to calculate a 3D coordinate system that accurately assesses the axial rotation angle of the tibial shaft. (orig.)

Practice parameters facilitating adoption of advanced technologies for enhancing neuropsychological assessment paradigms.

Science.gov (United States)

Parsons, Thomas D; McMahan, Timothy; Kane, Robert

2018-01-01

Clinical neuropsychologists have long underutilized computer technologies for neuropsychological assessment. Given the rapid advances in technology (e.g. virtual reality; tablets; iPhones) and the increased accessibility in the past decade, there is an on-going need to identify optimal specifications for advanced technologies while minimizing potential sources of error. Herein, we discuss concerns raised by a joint American Academy of Clinical Neuropsychology/National Academy of Neuropsychology position paper. Moreover, we proffer parameters for the development and use of advanced technologies in neuropsychological assessments. We aim to first describe software and hardware configurations that can impact a computerized neuropsychological assessment. This is followed by a description of best practices for developers and practicing neuropsychologists to minimize error in neuropsychological assessments using advanced technologies. We also discuss the relevance of weighing potential computer error in light of possible errors associated with traditional testing. Throughout there is an emphasis on the need for developers to provide bench test results for their software's performance on various devices and minimum specifications (documented in manuals) for the hardware (e.g. computer, monitor, input devices) in the neuropsychologist's practice. Advances in computerized assessment platforms offer both opportunities and challenges. The challenges can appear daunting but are a manageable and require informed consumers who can appreciate the issues and ask pertinent questions in evaluating their options.

Radiographic testing methods for welds of thin titanium plates and thin wall tubes

International Nuclear Information System (INIS)

1984-01-01

This standard stipulates the testing method by X-ray radiography for the welded parts of titanium plates and titanium tubes with thickness not exceeding 8 mm. The other items than those stipulated here shall be in accordance with JIS Z 3107-1973 ''Testing method by radiography for the welded part of titanium and method of grade classification of radiographs''. As the photographing method of radiographs, the performance of the equipment and materials for testing, the direction of X-ray irradiation, the thickness of parent materials and welds, the use of penetrameters, the arrangement for photographing, the requirement for radiographs and the observation of radiographs are specified. The X-ray apparatuses, photo-sensitive materials and the tools for photographing and observation must be such that the radiographs clearly showing the defects in the welds being tested can be taken or observed. The JIS Z 3107 is insufficient for the test of thin materials like titanium, therefore, this standard was set down. As the thickness of welds, the thickness of parent materials was taken. In this standard, the titanium penetrameters were adopted because they can be made and they conform to practical state. If magnified photographing is carried out with microfocus X-ray apparatuses, precise photographing can be made. (Kako, I.)

Radiographic cup anteversion measurement corrected from pelvic tilt.

Science.gov (United States)

Wang, Liao; Thoreson, Andrew R; Trousdale, Robert T; Morrey, Bernard F; Dai, Kerong; An, Kai-Nan

2017-11-01

The purpose of this study was to develop a novel technique to improve the accuracy of radiographic cup anteversion measurement by correcting the influence of pelvic tilt. Ninety virtual total hip arthroplasties were simulated from computed tomography data of 6 patients with 15 predetermined cup orientations. For each simulated implantation, anteroposterior (AP) virtual pelvic radiographs were generated for 11 predetermined pelvic tilts. A linear regression model was created to capture the relationship between radiographic cup anteversion angle error measured on AP pelvic radiographs and pelvic tilt. Overall, nine hundred and ninety virtual AP pelvic radiographs were measured, and 90 linear regression models were created. Pearson's correlation analyses confirmed a strong correlation between the errors of conventional radiographic cup anteversion angle measured on AP pelvic radiographs and the magnitude of pelvic tilt (P cup anteversion angle from the influence of pelvic tilt. The current method proposes to measure the pelvic tilt on a lateral radiograph, and to use it as a correction for the radiographic cup anteversion measurement on an AP pelvic radiograph. Thus, both AP and lateral pelvic radiographs are required for the measurement of pelvic posture-integrated cup anteversion. Compared with conventional radiographic cup anteversion, the errors of pelvic posture-integrated radiographic cup anteversion were reduced from 10.03 (SD = 5.13) degrees to 2.53 (SD = 1.33) degrees. Pelvic posture-integrated cup anteversion measurement improves the accuracy of radiographic cup anteversion measurement, which shows the potential of further clarifying the etiology of postoperative instability based on planar radiographs. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Use of a radiographic scoring technique for the assessment of dogs with elbow osteochondrosis

International Nuclear Information System (INIS)

Guthrie, S.

1989-01-01

A retrospective study was made of 335 dogs with elbow osteochondrosis that had been seen at the Royal Veterinary College in 1977 to 1987. The most commonly affected breeds were the labrador, retriever and rottweiler. Males were affected more often than females. The condition was bilateral in 50 per cent of cases and the peak age for the onset of lameness was four to six months. In rottweilers, the lesions found at exploratory arthrotomy were predominantly abnormalities of the coronoid process, while in retrievers and labradors lesions most commonly affected the medial humeral condyle or the coronoid process. A scoring system for grading the standard projection (lateral and postero-anterior) radiographs was devised and the score was correlated with the lesion found at surgery. Some cases were reviewed radiographically and any alteration in the degree of periarticular arthrosis, seen as an increase in radiographic score, was noted. The exact extent of the lesion found at surgery was recorded diagrammatically in 65 cases. It did not prove possible to predict from the radiographic score the nature and extent of the lesion and no correlation could be found between the radiographic score [and clinical degree of lameness. The scoring system did have some merit for reviewing cases because an increase in score indicated the extent to which joint changes had advanced

Radiographic examination for successful dental implant

International Nuclear Information System (INIS)

Lee, Sam Sun; Choi, Soon Chul

2005-01-01

Recently implant has become an important field in dental clinic. Radiographic examination of pre- and post-operation is essential for successful treatment. Clinicians should have knowledge about the purpose of the radiographic examination, suitable imaging modality for the cases, anatomic landmarks of tooth and jaw bone, advantage and limitation of panoramic radiographic examination for implant, principle and interpretation of cross-sectional imaging, bone mineral density, post-operative radiographic examination. This paper will be helpful to get above information for dentists who want to do dental implant successfully.

Validity of radiographic assessment of ankylosis

International Nuclear Information System (INIS)

Stenvik, A.; Beyer-Olsen, E.; Aabyholm, F.; Haanaes, H.R.; Gerner, N.W.

1990-01-01

The accuracy and sensitivity of radiographic assessments of reactive processes in dental tissues were evaluated by comparison of radiographs and histologic sections. Experimental lesions inflicted on the roots of 10 monkey incisors had been observed by means of serially obtained radiographs over a period of 315 to 370 days. The material was used for evaluation of radiographic assessment of ankylosis. For comparative purposes, assessment of the experimental lesion penetrating to the pulp and periapical radiolucency was added. True and falsely positive or negative recordings formed the basis for calculation of the accuracy and sensitivity of the radiographic assessment. The sensitivity, or the obsevers ability to detect the actual changes, was high for pulp penetration, intermediate for inflammation, and low for ankylosis. 6 refs., 3 figs., 2 tabs

Radiographic testing - optimum radiographs of plastics and composite materials with dosimeter control

International Nuclear Information System (INIS)

Kuster, J.

1978-01-01

In view of great differencies in X-ray transmission it is more difficult to get optimum radiographs of plastics and especially of reinforced plastics than for example of metals. A procedure will be reported how to get with little effort optimum radiographs especially also in the range of long wavelength radiation corresponding 10 to 25 kV.P. (orig.) [de

21 CFR 892.1840 - Radiographic film.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film. 892.1840 Section 892.1840 Food... DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a) Identification. Radiographic film is a device that consists of a thin sheet of radiotransparent material coated on one or both...

A System Approach to Advanced Practice Clinician Standardization and High Reliability.

Science.gov (United States)

Okuno-Jones, Susan; Siehoff, Alice; Law, Jennifer; Juarez, Patricia

Advanced practice clinicians (APCs) are an integral part of the health care team. Opportunities exist within Advocate Health Care to standardize and optimize APC practice across the system. To enhance the role and talents of APCs, an approach to role definition and optimization of practice and a structured approach to orientation and evaluation are shared. Although in the early stages of development, definition and standardization of accountabilities in a framework to support system changes are transforming the practice of APCs.

Radiographic bone loss in a Scottish non-smoking Type 1 Diabetes mellitus population; a Bitewing Radiographic Study.

Science.gov (United States)

Plessas, Anastasios; Robertson, Douglas P; Hodge, Penny J

2018-05-15

The dental complications of uncontrolled diabetes include reduced salivary flow rate, candidiasis and periodontal manifestations. A recent meta-analysis concluded that diabetes patients have a significantly higher severity, but not extent, of destructive periodontal disease than non-diabetes people. The authors reported that most type-1 diabetes studies using dental radiographic data have not controlled for confounding factors such as smoking. The aim of this cross-sectional study was to compare radiographic alveolar bone loss between type 1 diabetes (T1DM) and non-diabetes (NDM) participants in a Scottish non-smoking population. Digital bitewing radiographs for 174 Scottish adult never or ex-smoker (> 5 years) participants (108 T1DM, 66 NDS), recruited from outpatient clinics throughout Greater Glasgow and Clyde, were included in the analysis. A single blinded, trained and calibrated examiner recorded the radiographic bone loss seen on bitewing radiographs using the digital screen caliper. The bone loss was measured as the distance between the cemento-enamel junction (CEJ) and the deepest radiographic alveolar bone margin interproximally of each tooth. T1DM participants had more radiographic alveolar bone loss throughout the all teeth measured (median:1.27 mm vs 1.06 mm, P diabetes subjects. Patients suffering from type 1 diabetes are at higher risk of periodontitis even when controlling for multiple possible confounding factors and this difference can be detected on routine dental radiographs at an early stage. These data confirm radiographically the previously reported association between T1DM and periodontal bone loss. This article is protected by copyright. All rights reserved. © 2018 American Academy of Periodontology.

The universal, collaborative and dynamic model of specialist and advanced nursing and midwifery practice: A way forward?

Science.gov (United States)

O'Connor, Laserina; Casey, Mary; Smith, Rita; Fealy, Gerard M; Brien, Denise O'; O'Leary, Denise; Stokes, Diarmuid; McNamara, Martin S; Glasgow, Mary Ellen; Cashin, Andrew

2018-03-01

To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. A qualitative study was conducted to initiate this important area of inquiry. Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised "silos," precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient's care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners. The model design has Universal application in a range of contexts "U." It is Collaborative in its inclusivity of all key stakeholders "C." The model is Dynamic pertinent to accommodating movement of nurses and midwives across health continua rather than plateauing in very specialised "silos" "D." © 2017 John Wiley & Sons Ltd.

Reproductive health of male radiographers

International Nuclear Information System (INIS)

Shakhatreh, Farouk M.

2001-01-01

To compare certain reproductive health problems reported in 2 groups of males, one of which was exposed to x-ray radiation (radiographers) and the other group that was not exposed to x-ray radiation. The reproductive health problems were miscarriage, congenital anomalies, still births and infertility. Two groups of men were selected (90 in each group). The first group consisted of radiographers and the other groups consisted of men not exposed to x-ray radiation. The 2 groups were matched for age and source. Relative risk, attributable risk percentage and level of significance were calculated. Incidence rate of reproductive health problems was increasing with the increase in duration of exposure to x-ray radiation ranging between 17% (for those exposed for 1-5 years) to 91% (for those exposed for more than 15 years). There were significant associations between exposure to radiation and miscarriage (relative risk = 1.67, attributable risk percentage = 40%), congenital anomalies (relative risk = 10, attributable risk percentage 90%), still birth (relative risk = 7, attributable risk percentage = 86%), and infertility (relative risk = 4.5, attributable risk = 78%). The incidence rates of reproductive health problems reported by male radiographers were significantly higher than that reported by the non exposed group and higher than the incidence rates reported in community-based studies in Jordan. The incidence rates of fetal death (miscarriage and stillbirth together) and infertility reported by our radiographers were higher than had been reported by the British radiographers. An immediate plan of action is needed to protect our radiographers. Further studies are needed in this field taking into account all extraneous variables that may affect the reproductive health of radiographers. (author)

Radiographic Control of 137-Cs Brachytherapy Sources

International Nuclear Information System (INIS)

Bistrovic, M.; Viculin, T.; Jurkovic, S.

2003-01-01

1 37C s brachytherapy sources are practical for the intracavitary application due to their relatively long lifetime (T 1/2 = 30 y). On the other hand, due to the relatively low energy (0.66 MeV) of the emitted photons, they are suitable for an efficient radiation protection. The dose distribution around the sources is usually calculated by a specific program. However this program requires the knowledge of the position of sources within the applicator as well as the distribution of activity along them. The only way to learn these data is to make an X-ray picture of applicators and sources superimposed to the autoradiography of every source. It is difficult to achieve satisfactory radiographs with high dose rate sources with standard X-ray film material because autoradiography covers the structure of the radiographic shadow. The problem can be overcome either by applying a high intensity X-ray or gamma beam (originating from a radiotherapeutic machine), or by using photographic material of very low sensitivity, for example photographic paper. Combining both possibilities one can obtain satisfactory images. (author)

Occupational stress and its predictors in radiographers

Energy Technology Data Exchange (ETDEWEB)

Rutter, D.R. [Centre for Research in Health Behaviour, Department of Psychology, University of Kent, Keynes College, Canterbury CT2 7NP (United Kingdom)], E-mail: d.r.rutter@kent.ac.uk; Lovegrove, M.J. [Department of Allied Health Professions, London South Bank University, London SE1 0AA (United Kingdom)

2008-05-15

Purpose: The purpose of this study was to establish the level of occupational stress in UK NHS radiographers, and to examine its causes. A total of more than 1600 radiographers sampled nationally completed a postal questionnaire. Four groups were represented - mammography, diagnostics, radiotherapy, and ultrasound - and both junior staff and superintendents were examined. Method: The questionnaire measured role ambiguity, role conflict, work problems, social support from colleagues, and perceived stress. Results: Levels of perceived stress were high in all four groups. The mean was significantly lower in the mammography group than the others, however, and junior staff reported lower levels than superintendents. Role ambiguity, role conflict and work problems all contributed significantly to stress, but the effects were sometimes buffered by social support from colleagues. Conclusion: The implications of the findings are discussed for theory and for policy and practice: occupational stress was predicted by intrinsic features of the job; the levels were similar to those reported by other NHS professionals; and the pattern of findings suggests possible ways to intervene to reduce it.

Occupational stress and its predictors in radiographers

International Nuclear Information System (INIS)

Rutter, D.R.; Lovegrove, M.J.

2008-01-01

Purpose: The purpose of this study was to establish the level of occupational stress in UK NHS radiographers, and to examine its causes. A total of more than 1600 radiographers sampled nationally completed a postal questionnaire. Four groups were represented - mammography, diagnostics, radiotherapy, and ultrasound - and both junior staff and superintendents were examined. Method: The questionnaire measured role ambiguity, role conflict, work problems, social support from colleagues, and perceived stress. Results: Levels of perceived stress were high in all four groups. The mean was significantly lower in the mammography group than the others, however, and junior staff reported lower levels than superintendents. Role ambiguity, role conflict and work problems all contributed significantly to stress, but the effects were sometimes buffered by social support from colleagues. Conclusion: The implications of the findings are discussed for theory and for policy and practice: occupational stress was predicted by intrinsic features of the job; the levels were similar to those reported by other NHS professionals; and the pattern of findings suggests possible ways to intervene to reduce it

A self-directed learning intervention for radiographers rating mammographic breast density

International Nuclear Information System (INIS)

Ekpo, E.U.; Hogg, P.; Wasike, E.; McEntee, M.F.

2017-01-01

Purpose: Subjective methods of mammographic breast density (MBD) assessment are prone to inter-reader variability. This work aims to assess the impact of a short self-directed, experiential learning intervention on radiographers' reproducibility of MBD assessment. Method: The study used two sets of images (test and learning intervention) containing left craniocaudal and left mediolateral oblique views. The test set had MBD ratings from Volpara™ and radiologists using the fourth edition Breast Imaging and Data Systems (BI-RADS ® ). Seven radiographers rated the MBD of the test set before and after a self-directed learning intervention using the percentage descriptors in the fourth edition BI-RADS ® Atlas. The inter-reader agreement, the agreement between radiographers and Volpara™ as well as radiologists, was assessed using a Weighted Kappa (κ w ). Results: Overall, radiographers' inter-reader agreement (κ w ) was substantial (0.79; 95% CI: 0.70–0.87) before the intervention and almost perfect (0.84; 95% CI: 0.77–0.90) after the intervention. Before the intervention, radiographers demonstrated fair agreement with radiologists (0.24; 95% CI: −0.46–0.61) and Volpara™ (0.24; 95% CI: −0.41–0.59). A fair but slightly improved agreement was also observed between radiographers and radiologists (0.31; 95% CI: −0.33–0.64) as well as Volpara™ (0.28; 95% CI: −0.34–0.61) after the intervention. Conclusion: Findings demonstrate that a short duration self-directed, experiential learning intervention reduces inter-reader differences in MBD classification, but has a negligible impact on improving the agreement between inexperienced and expert readers. - Highlights: • Radiographers' MBD rating show fair agreement with radiologists and Volpara™. • Experiential learning intervention improved reproducibility of MBD classification. • Enhanced MBD rating training may be required to develop a standard fit for practice.

Accuracy of radiographer reporting of paediatric brain CT

International Nuclear Information System (INIS)

Brandt, Andrew; Louw, Brand; Dekker, Gerrit; Andronikou, Savvas; Wieselthaler, Nicki; Kilborn, Tracy; Bertelsman, Jessica; Dreyer, Catherine

2007-01-01

Radiographer reporting has been studied for plain films and for ultrasonography, but not in paediatric brain CT in the emergency setting. To study the accuracy of radiographer reporting in paediatric brain CT. We prospectively collected 100 paediatric brain CT examinations. Films were read from hard copies using a prescribed tick sheet. Radiographers with 12 years' and 3 years' experience, respectively, were blinded to the history and were not trained in diagnostic film interpretation. The radiographers' results were compared with those of a consultant radiologist. Three categories were defined: abnormal scans, significant abnormalities and insignificant abnormalities. Both radiographers had an accuracy of 89.5% in reading a scan correctly as abnormal, and radiographer 1 had a sensitivity of 87.8% and radiographer 2 a sensitivity of 96%. Radiographer 1 had an accuracy in detecting a significant abnormality of 75% and radiographer 2 an accuracy of 48.6%, and the sensitivities for this category were 61.6% and 52.9%, respectively. Results for detecting the insignificant abnormalities were poorer. Selected radiographers could play an effective screening role, but lacking the sensitivity required for detecting significant abnormality, they could not be the final diagnostician. We recommend that the study be repeated after both radiographers have received formal training in interpretation of paediatric brain CT. (orig.)

The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

OpenAIRE

Rahmi Yücel; Kayhan Ahmetoğulları

2015-01-01

This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

Practical measurement of radiation dose in pediatric radiology: use of the dose-area product on digital fluoroscopy and neonatal chest radiographs

International Nuclear Information System (INIS)

Chateil, J.F.; Rouby, C.; Brun, M.; Labessan, C.; Diard, F.

2004-01-01

Purpose. Control of radiation dose in pediatric radiology requires knowledge of the reference levels for all examinations. These data are useful for daily quality assessment, but are not perfectly known for some radiographic examinations. The purpose of our study was to evaluate the dose related to voiding cysto-urethrograms (VCUG), upper GI (UGI) and intravenous urography (IVU). Neonatal chest radiographs in the intensive care unit were also evaluated. Material and methods. For examinations with contrast material (478VCUG, 220UGI, 80IVU), the children were divided in groups based on their weight, from 5 to 30 Kg. Measurements were performed using an ionization chamber and expressed with the-dose-area product (DAP). For chest radiographs, a direct measurement of the entrance-skin dose was performed, with secondary calculation of the DAP. Results. For-VCUGs, the DAP ranged between 42.89 cGy.cm 2 and 125.41 cGy.cm 2 . The range was between 76.43, and 150.62 cGy.cm 2 for UGIs and between 49.06 and 83.33 cGy.cm 2 for IVUs. For neonate chest radiographs, DAP calculations were between 0.29 and 0.99 cGy.cm 2 . Conclusion. These values represent our reference doses. They allow continuous monitoring of our radiographic technical parameters and radiographic equipment and help to correct and improve them if necessary. (author)

The uptake of Continuing Professional Development (CPD) by Ghanaian radiographers

International Nuclear Information System (INIS)

Gawugah, James N.K.; Jadva-Patel, Hansa; Jackson, Marcus T.

2011-01-01

Continuing professional development (CPD) currently gains a priority within healthcare professions all over the globe. It is playing important roles in achieving improved quality care delivery. Healthcare practitioners are expected to continuously undertake CPD to maintain, enhance and improve quality of service delivery to meet the consumers' expectations. CPD offers practitioners the opportunity to retain and enhance the basic knowledge and skills through their working life; thus enhancing competency within one's professional range of practice. In Ghana, awareness of CPD participation has not been created among healthcare practitioners to enable them engage in effective CPD activities in order to improve their knowledge and skills. Purpose: To examine the level of radiographers' participation in CPD activities in Ghana. Method: A 21-item questionnaire was constructed to collect data from 80 participants drawn from among radiographers currently practising in the radiology/X-ray departments of the ten regional hospitals in Ghana. The questionnaire comprised of 3 sections: demographics, CPD and education specific sections. Out of 80 questionnaires administered, 42 were completed and returned representing 52.5%. Out of the percentage, 74% were males and 26% females. The findings highlight that majority (44%) of the participants are currently within the age group of 31-40 years, while 2% is/are 60 or more years. The article also reveals that the radiographers have access to few peer review journals which serve as sources of information on contemporary issues in radiography and CPD learning activities. Again, a generally poor level of CPD awareness among the Ghanaian radiographers has been established. Lack of effective recording of learning and CPD activities have also been revealed. Conclusion: The article concludes by recommending CPD policy guidelines; a regulatory body to register all healthcare professionals under one body to ensure effective CPD participation by

Radiographic tales

DEFF Research Database (Denmark)

Mussmann, Bo Redder

Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities. Meth...... of their narrative alertness. Errors and failure to keep the time schedule can, however, lead the radiographers to a change of perspective that makes them displace man from the scene of radiography by playing on the premises of technology.......Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities...... a practice in which the relationship between man and technology is marked by a struggle of domination of one over the other. The struggle expresses itself through two competing plots: A diagnostic plot with a prevailing, but not merely chronological structure mostly composed of events tied to pathology...

An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

Energy Technology Data Exchange (ETDEWEB)

Gale, A.G.; May, J

1997-10-01

work and the design of the mammography units, breast screening radiographers are often subjected to frequent bending and twisting, static working postures, forceful movements and repetitive work. These are factors which have all been related to muscular problems. It is possible that these factors may have a cumulative effect of wear and tear on the musculoskeletal system of radiographers thus possibly aggravating existing or past injuries and paving the way for new ones. It is important therefore that recommendations are proposed to further the ergonomic design of mammography units, the training, the working practices and conditions of the radiographers. Both causal and contributory factors present in the workplace, regardless of whether the original injury was caused in performing breast screening, general radiography or actually outside work should be addressed. (abstract truncated)

Radiograph identifying means

International Nuclear Information System (INIS)

Sheldon, A.D.

1983-01-01

A flexible character-indentable plastics embossing tape is backed by and bonded to a lead strip, not more than 0.025 inches thick, to form a tape suitable for identifying radiographs. The lead strip is itself backed by a relatively thin and flimsy plastics or fabric strip which, when removed, allows the lead plastic tape to be pressure-bonded to the surface to be radiographed. A conventional tape-embossing gun is used to indent the desired characters in succession into the lead-backed tape, without necessarily severing the lead; and then the backing strip is peeled away to expose the layer of adhesive which pressure-bonds the indented tape to the object to be radiographed. X-rays incident on the embossed tape will cause the raised characters to show up dark on the subsequently-developed film, whilst the raised side areas will show up white. Each character will thus stand out on the developed film. (author)

Computer-assisted instruction and diagnosis of radiographic findings.

Science.gov (United States)

Harper, D; Butler, C; Hodder, R; Allman, R; Woods, J; Riordan, D

1984-04-01

Recent advances in computer technology, including high bit-density storage, digital imaging, and the ability to interface microprocessors with videodisk, create enormous opportunities in the field of medical education. This program, utilizing a personal computer, videodisk, BASIC language, a linked textfile system, and a triangulation approach to the interpretation of radiographs developed by Dr. W. L. Thompson, can enable the user to engage in a user-friendly, dynamic teaching program in radiology, applicable to various levels of expertise. Advantages include a relatively more compact and inexpensive system with rapid access and ease of revision which requires little instruction to the user.

Improving visual observation skills through the arts to aid radiographic interpretation in veterinary practice: A pilot study.

Science.gov (United States)

Beck, Cathy; Gaunt, Heather; Chiavaroli, Neville

2017-09-01

Radiographic interpretation is a perceptual and cognitive skill. Recently core veterinary radiology textbooks have focused on the cognitive (i.e., the clinical aspects of radiographic interpretation) rather than the features of visual observation that improve identification of abnormalities. As a result, the skill of visual observation is underemphasized and thus often underdeveloped by trainees. The study of the arts in medical education has been used to train and improve visual observation and empathy. The use of the arts to improve visual observation skills in Veterinary Science has not been previously described. Objectives of this pilot study were to adapt the existing Visual Arts in Health Education Program for medical and dental students at the University of Melbourne, Australia to third year Doctor of Veterinary Medicine students and evaluate their perceptions regarding the program's effects on visual observation skills and confidence with respect to radiographic interpretation. This adaptation took the form of a single seminar given to third year Doctor of Veterinary Medicine students. Following the seminar, students reported an improved approach to radiographic interpretation and felt they had gained skills which would assist them throughout their career. In the year following the seminar, written reports of the students who attended the seminar were compared with reports from a matched cohort of students who did not attend the seminar. This demonstrated increased identification of abnormalities and greater description of the abnormalities identified. Findings indicated that explicit training in visual observation may be a valuable adjunct to the radiology training of Doctor of Veterinary Medicine students. © 2017 American College of Veterinary Radiology.

Legalities of the radiograph

International Nuclear Information System (INIS)

Bundy, A.L.

1988-01-01

The radiograph itself plays a major role in medical malpractice cases. Also, many questions arise concerning the rights to and storage of x-ray films. These issues are addressed in this chapter. To keep the terminology simple, the word radiograph represents all imaging documentation on hard copy film (x-rays, nuclear medicine, computer-assisted studies, ultrasound, and magnetic resonance imaging)

Motivational interviewing: a valuable tool for the psychiatric advanced practice nurse.

Science.gov (United States)

Karzenowski, Abby; Puskar, Kathy

2011-01-01

Motivational Interviewing (MI) is well known and respected by many health care professionals. Developed by Miller and Rollnick (2002) , it is a way to promote behavior change from within and resolve ambivalence. MI is individualized and is most commonly used in the psychiatric setting; it is a valuable tool for the Psychiatric Advanced Nurse Practice Nurse. There are many resources that talk about what MI is and the principles used to apply it. However, there is little information about how to incorporate MI into a clinical case. This article provides a summary of articles related to MI and discusses two case studies using MI and why advanced practice nurses should use MI with their patients.

Advancing the practice of systems engineering at JPL

Science.gov (United States)

Jansma, Patti A.; Jones, Ross M.

2006-01-01

In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of

Double contrast barium enema sensitivity: A comparison of studies by radiographers and radiologists

International Nuclear Information System (INIS)

Culpan, D.G.; Mitchell, A.J.; Hughes, S.; Nutman, M.; Chapman, A.H.

2002-01-01

PURPOSE: A retrospective study of histologically proven cases of colorectal cancer (CRC) was performed to assess whether the sensitivity of the radiographer-performed double contrast barium enema (DCBE) differed from that of the radiologist-performed study. MATERIALS AND METHODS: Histologically proven cases of CRC were reviewed over a 3-year period to ascertain whether: the diagnosis had been made by DCBE in the 3 years before histological diagnosis; the lesion had been correctly diagnosed; the examination had been performed by a radiologist or radiographer. RESULTS: In the 3-year period there were 478 cases with histologically proven CRC. Of these, 239 (50%) had undergone DCBE as the initial radiological investigation of the colon. Sixty-four examinations had been performed by radiographers. A correct diagnosis was made in 58 cases (90.6%), the report was equivocal in one case (1.6%), there were four false-negatives (6.25%), and one case was abandoned (1.6%). One hundred and seventy-five examinations were performed by radiologists. A correct diagnosis was made in 157 cases (89.7%), the report was equivocal in one case (0.6%), there were 16 false-negatives (9.1%), and one case was abandoned (0.6%). CONCLUSION: A sensitivity of 90.6% for radiographer-performed studies compared favourably with 89.7% for radiologist-performed studies and supports the practice of radiographers undertaking barium enemas. Culpan, D.G. et al. (2002)

Guide to nuclear medicine. A textbook for radiographers' examination and practice

International Nuclear Information System (INIS)

Elser, H.

1999-01-01

The guide to clinical applications of nuclear medicine presents a comprehensive survey of the subject field, encompassing in addition to all medical aspects information on the fundamental physics and radiochemistry involved, examination protocols, case reports, and diagnostic findings. Legal provisions and requirements as well as procedures for quality control are explained and discussed. The material of the textbook has been compiled and arranged in line with the training programme and examination requirements for radiographers, but due to the systematic design and approach and the many pictures and tables it may also be of use as a source of reference for medical students of radiology courses, or specializing doctors. (orig./CB)

Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score: a radiographic method to detect osteoarthritis of the interphalangeal finger joints based on its histopathological alterations.

Science.gov (United States)

Sunk, Ilse-Gerlinde; Amoyo-Minar, Love; Stamm, Tanja; Haider, Stefanie; Niederreiter, Birgit; Supp, Gabriela; Soleiman, Afschin; Kainberger, Franz; Smolen, Josef S; Bobacz, Klaus

2014-11-01

To develop a radiographic score for assessment of hand osteoarthritis (OA) that is based on histopathological alterations of the distal (DIP) and proximal (PIP) interphalangeal joints. DIP and PIP joints were obtained from corpses (n=40). Plain radiographies of these joints were taken. Joint samples were prepared for histological analysis; cartilage damage was graded according to the Mankin scoring system. A 2×2 Fisher's exact test was applied to define those radiographic features most likely to be associated with histological alterations. Receiver operating characteristic curves were analysed to determine radiographic thresholds. Intraclass correlation coefficients (ICC) estimated intra- and inter-reader variability. Spearman's correlation was applied to examine the relationship between our score and histopathological changes. Differences between groups were determined by a Student's t test. The Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score is presented. The score is based on histopathological changes of DIP and PIP joints and follows a simple dichotomy whether OA is present or not. The iOARS score relies on three equally ranked radiographic features (osteophytes, joint space narrowing and subchondral sclerosis). For both DIP and PIP joints, the presence of one x-ray features reflects interphalangeal OA. Sensitivity and specificity for DIP joints were 92.3% and 90.9%, respectively, and 75% and 100% for PIP joints. All readers were able to reproduce their own readings in DIP and PIP joints after 4 weeks. The overall agreement between the three readers was good; ICCs ranged from 0.945 to 0.586. Additionally, outcomes of the iOARS score in a hand OA cohort revealed a higher prevalence of interphalangeal joint OA compared with the Kellgren and Lawrence score. The iOARS score is uniquely based on histopathological alterations of the interphalangeal joints in order to reliably determine OA of the DIP and PIP joints radiographically. Its high

Importance of radiographic monitoring of endoscopic sphincterotomy

International Nuclear Information System (INIS)

Greenberg, H.M.; Goldberg, H.I.; Shapiro, H.A.

1981-01-01

The radiographic features of endoscopic sphincterotomies performed in 44 patients were evaluated. Radiographic landmarks aided in proper sphincterotome placement and also disclosed conditions and anatomic variations that made catheter placement difficult. Fluoroscopic and radiographic monitoring not only assisted the performance of endoscopic sphincterotomy, but also confirmed successful results and revealed reasons for failure. Radiographic changes in the biliary tract after sphincterotomy, as well as potential complications of sphincterotomy, are discussed and illustrated

Advanced practice nursing for enduring health needs management: a global perspective.

Science.gov (United States)

Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

2012-07-01

Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Radiation protection - radiographer's role and responsibilities

International Nuclear Information System (INIS)

Popli, P.K.

2002-01-01

Ever since discovery of x-rays, radiographers has been the prime user of radiation. With the passage of time, the harmful effects of radiation were detected. Some of radiographers, radiologists and public were affected by radiation, but today with enough knowledge of radiation, the prime responsibility of radiation protection lies with the radiographers only. The radiologist and physicist are also associated with radiation protection to some extent

Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

Science.gov (United States)

Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

2014-04-07

Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

Intra-observer reproducibility and interobserver reliability of the radiographic parameters in the Spinal Deformity Study Group's AIS Radiographic Measurement Manual.

Science.gov (United States)

Dang, Natasha Radhika; Moreau, Marc J; Hill, Douglas L; Mahood, James K; Raso, James

2005-05-01

Retrospective cross-sectional assessment of the reproducibility and reliability of radiographic parameters. To measure the intra-examiner and interexaminer reproducibility and reliability of salient radiographic features. The management and treatment of adolescent idiopathic scoliosis (AIS) depends on accurate and reproducible radiographic measurements of the deformity. Ten sets of radiographs were randomly selected from a sample of patients with AIS, with initial curves between 20 degrees and 45 degrees. Fourteen measures of the deformity were measured from posteroanterior and lateral radiographs by 2 examiners, and were repeated 5 times at intervals of 3-5 days. Intra-examiner and interexaminer differences were examined. The parameters include measures of curve size, spinal imbalance, sagittal kyphosis and alignment, maximum apical vertebral rotation, T1 tilt, spondylolysis/spondylolisthesis, and skeletal age. Intra-examiner reproducibility was generally excellent for parameters measured from the posteroanterior radiographs but only fair to good for parameters from the lateral radiographs, in which some landmarks were not clearly visible. Of the 13 parameters observed, 7 had excellent interobserver reliability. The measurements from the lateral radiograph were less reproducible and reliable and, thus, may not add value to the assessment of AIS. Taking additional measures encourages a systematic and comprehensive assessment of spinal radiographs.

On being dyslexic: Student radiographers' perspectives

Energy Technology Data Exchange (ETDEWEB)

Murphy, Fred, E-mail: f.j.murphy@salford.ac.u [Directorate of Radiography, School of Health Sport and Rehabilitation Sciences, University of Salford, Greater Manchester, M6 6PU (United Kingdom)

2011-05-15

The purpose of this paper was to provide an insight into life as a dyslexic student radiographer, identify barriers and risks in clinical training, and develop recommendations for the support of students with dyslexia. The paucity of research into dyslexia within the radiography profession is worrying, with attention focused only on the support provided by Higher Education Institutions (HEI) or inferences drawn from the experiences of other healthcare students. The impact and significance of dyslexia for student radiographers in clinical practice has never been investigated. Results: On a self-reporting scale of clinical tasks there was little or no difference between dyslexic students and non-dyslexics. Some minor traits commonly associated with dyslexics were also reported by students with no learning disabilities and an inclusion support plan for all students was advocated. In-depth interviews of 10 student radiographers revealed six distinct themes of visualising the disability, self-protection, strengths and talents, time, the badge of disability and adjustments and support. Like other healthcare students, some radiography students reported significant difficulties and prejudices and very little structured support in the clinical environment. Despite the Special Educational Needs and Disability Act being in place for several years, the support in clinical departments fell significantly short of that provided in the universities. The dyslexic students took extra responsibility for their own learning and some had developed complex coping strategies to overcome any difficulties. Conclusion: Several inclusive recommendations were developed as a result of this study that could be used to support all students on clinical placement.

Management of advanced pancreatic cancer in daily clinical practice.

Science.gov (United States)

Giuliani, Jacopo; Piacentini, Paolo; Bonetti, Andrea

2016-01-01

The aim of this outcome study was to evaluate the management of advanced pancreatic cancer in a real-world clinical practice; few such experiences have been reported in the literature. A retrospective analysis was performed of all consecutive patients with advanced pancreatic ductal adenocarcinoma followed at our medical oncology unit between January 2003 and December 2013. We evaluated 78 patients, mostly with metastatic disease (64.1%). Median follow-up was 10.77 months, by which time 74 patients (94.9%) had died. Median overall survival was 8.29 months. Median age was 67 years. In univariate analysis, pain at onset (p = 0.020), ECOG performance status (p<0.001), stage (p = 0.047), first-line chemotherapy (p<0.001), second-line chemotherapy (p<0.001) and weight loss at diagnosis (p = 0.029) were factors that had an impact on overall survival. In multivariate analysis, the presence of pain at onset (p = 0.043), stage (p = 0.003) and second-line chemotherapy (p = 0.004) were confirmed as independent prognostic factors. Our data, derived from daily clinical practice, confirmed advanced pancreatic cancer as an aggressive malignant disease with a very short expected survival. Second-line treatment seems to provide an advantage in terms of overall survival in patients who showed a partial response as their best response to first-line treatment.

An evaluation of musculoskeletal discomfort experience by radiographers performing mammography

International Nuclear Information System (INIS)

Gale, A.G.; May, J.

1997-01-01

work and the design of the mammography units, breast screening radiographers are often subjected to frequent bending and twisting, static working postures, forceful movements and repetitive work. These are factors which have all been related to muscular problems. It is possible that these factors may have a cumulative effect of wear and tear on the musculoskeletal system of radiographers thus possibly aggravating existing or past injuries and paving the way for new ones. It is important therefore that recommendations are proposed to further the ergonomic design of mammography units, the training, the working practices and conditions of the radiographers. Both causal and contributory factors present in the workplace, regardless of whether the original injury was caused in performing breast screening, general radiography or actually outside work should be addressed. Recommendations are made in order to reduce the adoption of poor and awkward postures while breast screening in the future and therefore reduce the amount of musculoskeletal discomfort experienced by radiographers. All changes to the workplace should be initially conducted on a trial basis and monitored to determine their success to ensure that they represent no additional problems

Integrating Social Neuroscience and Social Work: Innovations for Advancing Practice-Based Research

Science.gov (United States)

Matto, Holly C.; Strolin-Goltzman, Jessica

2010-01-01

Throughout the social work profession, there is ongoing interest in building a social science agenda that can address the complex practice-based questions faced by social work professionals today. Methodological innovations and unique funding opportunities have already significantly advanced research on social work practice. Still, there is…

Are chest radiographs justified in pre-employment examinations. Presentation of legal position and medical evidence based on 1760 cases

International Nuclear Information System (INIS)

Ladd, S.C.; Krause, U.; Ladd, M.E.

2006-01-01

The legal and medical basis for chest radiographs as part of pre-employment examinations (PEE) at a University Hospital is evaluated. The radiographs are primarily performed to exclude infectious lung disease. A total of 1760 consecutive chest radiographs performed as a routine part of PEEs were reviewed retrospectively. Pathologic findings were categorized as ''nonrelevant'' or ''relevant.'' No positive finding with respect to tuberculosis or any other infectious disease was found; 94.8% of the chest radiographs were completely normal. Only five findings were regarded as ''relevant'' for the individual. No employment-relevant diagnosis occurred. The performance of chest radiography as part of a PEE is most often not justified. The practice is expensive, can violate national and European law, and lacks medical justification. (orig.) [de

[Advanced nursing practice: a must for the quality of care and mental health services].

Science.gov (United States)

Ricard, Nicole; Page, Claire; Laflamme, France

2014-01-01

New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

Radiographic, high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus in weanling young and adult horses

International Nuclear Information System (INIS)

Laverty, S.; Stover, S.M.; Bélanger, D.; O'Brien, T.R.; Pool, R.R.; Pascoe, J.R.; Taylor, K.; Harrington, T.

1991-01-01

Clinical radiographic (LM and D35L-P1MO reviews), high detail radiographic, microangiographic and histological findings of distal portion of the tarsus of 16 horses (five weanling, four young and six adult), without known clinical histories, were evaluated to determine the sensitivity of clinical radiographs for the detection of abnormalities in the distal tarsus and the prevalence of abnormalities in this population. Clinical radiographic and high detail radiographic abnormalities were observed in at least 30 per cent of the tarsi examined. Statistical agreement between observations from clinical radiographs and corresponding post mortem high detail radiographs was not good for subchondral bone plate irregularities and joint margin changes. Three patterns of sclerosis of the medullary spongiosa were visualized on high detail radiographs; thickening of the subchondral bone plate was seen commonly in the weaning group,, whereas arching and bridging patterns were more prevalent in the young and adult groups. Bone production on the dorsal cortex of the central and third tarsal bones did not increase with age. Abnormalities in vascular perfusion and articular cartilage histology were observed in association with subchondral bone plate irregularities and focal regions of osteopenia observed on high detail radiographs

The Competencies, Roles and Scope of Practice of Advanced Psychiatric Nursing in Indonesia

Directory of Open Access Journals (Sweden)

Yulia Wardani

2014-01-01

Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.

Simulated radiographic bone and joint modeling from 3D ankle MRI: feasibility and comparison with radiographs and 2D MRI

Energy Technology Data Exchange (ETDEWEB)

Nordeck, Shaun M. [University of Texas Southwestern Medical College, Dallas, TX (United States); University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); Koerper, Conrad E.; Adler, Aaron [University of Texas Southwestern Medical College, Dallas, TX (United States); Malhotra, Vidur; Xi, Yin [University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); Liu, George T. [University of Texas Southwestern Medical Center, Orthopaedic Surgery, Dallas, TX (United States); Chhabra, Avneesh [University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); University of Texas Southwestern Medical Center, Orthopaedic Surgery, Dallas, TX (United States)

2017-05-15

The purpose of this work is to simulate radiographs from isotropic 3D MRI data, compare relationship of angle and joint space measurements on simulated radiographs with corresponding 2D MRIs and real radiographs (XR), and compare measurement times among the three modalities. Twenty-four consecutive ankles were included, eight males and 16 females, with a mean age of 46 years. Segmented joint models simulating radiographs were created from 3D MRI data sets. Three readers independently performed blinded angle and joint space measurements on the models, corresponding 2D MRIs, and XRs at two time points. Linear mixed models and the intraclass correlation coefficient (ICC) was ascertained, with p values less than 0.05 considered significant. Simulated radiograph models were successfully created in all cases. Good agreement (ICC > 0.65) was noted among all readers across all modalities and among most measurements. Absolute measurement values differed between modalities. Measurement time was significantly greater (p < 0.05) on 2D versus simulated radiographs for most measurements and on XR versus simulated radiographs (p < 0.05) for nearly half the measurements. Simulated radiographs can be successfully generated from 3D MRI data; however, measurements differ. Good inter-reader and moderate-to-good intra-reader reliability was observed and measurements obtained on simulated radiograph models took significantly less time compared to measurements with 2D and generally less time than XR. (orig.)

Predicting lower third molar eruption on panoramic radiographs after cephalometric comparison of profile and panoramic radiographs

DEFF Research Database (Denmark)

Begtrup, Anders; Grønastøð, Halldis Á; Christensen, Ib Jarle

2012-01-01

and to find a simple and reliable method for predicting the eruption of the mandibular third molar by measurements on panoramic radiographs. The material consisted of profile and panoramic radiographs, taken before orthodontic treatment, of 30 males and 23 females (median age 22, range 18-48 years......Previous studies have suggested methods for predicting third molar tooth eruption radiographically. Still, this prediction is associated with uncertainty. The aim of the present study was to elucidate the association between cephalometric measurements on profile and panoramic radiographs...... the length from the ramus to the incisors (olr-id) showed a statistically significant correlation. By combining this length with the mesiodistal width of the lower second molar, the prediction of eruption of the lower third molar was strengthened. A new formula for calculating the probability of eruption...

Ergonomic strategies to improve radiographers' posture during mammography activities.

Science.gov (United States)

Cernean, Nicolai; Serranheira, Florentino; Gonçalves, Pedro; Sá Dos Reis, Cláudia

2017-08-01

To identify alternatives for radiographers' postures while performing mammography that can contribute to reduce the risk of work-related musculoskeletal disorders (WRMSDs). Radiographers' postures to positioning craniocaudal (CC) and mediolateral oblique (MLO) views were simulated without any intervention for three scenarios: radiographer/patient with similar statures, radiographer smaller than patient and radiographer taller than patient. Actions were taken to modify the postures: seated radiographer; patient on a step; seated patient; radiographer on a step. All the postures were analysed using kinovea 0.8.15 software and the angles were measured twice and classified according to European standard EN1005-4: 2005. The non-acceptable angles were measured mainly during MLO positioning when radiographer was taller than the patient: 139° and 120° for arm-flexion and abduction, 72° for trunk and -24° for head/neck-flexion. The introduction of alternative postures (radiographer seated), allowed improvements in posture (60° and 99° for arm flexion and abduction, 14° for trunk and 0° for head/neck flexion), being classified as acceptable. The alternative postures simulated have the potential to reduce the risk of developing WRMSDs when radiographers and patients have different statures. • Radiographers' postures in mammography can contribute to work-related musculoskeletal disorders • Non-acceptable posture was identified for MLO breast positioning (radiographer taller than patient) • Adapting posture to patient biotype reduces the WRMSD risk for radiographers.

Chest radiograph interpretation by medical students

International Nuclear Information System (INIS)

Jeffrey, D.R.; Goddard, P.R.; Callaway, M.P.; Greenwood, R.

2003-01-01

AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK

Radiographic markers - A reservoir for bacteria?

International Nuclear Information System (INIS)

Tugwell, Jenna; Maddison, Adele

2011-01-01

Introduction: Amongst the most frequently handled objects in the radiology department are radiographic markers. They are personal accessories used with every patient, and are kept in the radiographers pockets when not utilised. Upon enquiry it was discovered that many radiographers disregarded the potential of these accessories to become a vector for cross-contamination thus never or rarely clean them. The aims of this study were therefore to identify if radiographic markers are a reservoir for bacteria and to establish an effective cleaning method for decontaminating them. Methodology: 25 radiographers/student radiographers were selected for this study. Swabbing of their markers prior and post cleaning took place. The microbiology laboratory subsequently analyzed the results by quantifying and identifying the bacteria present. The participants also completed a closed questionnaire regarding their markers (e.g. frequency of cleaning and type of marker) to help specify the results gained from the swabbing procedure. Results: From the sample swabbed, 92% were contaminated with various organisms including Staphylococcus and Bacillus species, the amount of bacteria present ranged from 0 to >50 CFU. There were no significant differences between disinfectant wipes and alcohol gel in decontaminating the markers. Both successfully reduced their bacterial load, with 80% of the markers post cleaning having 0 CFU. Conclusion: The results indicated that radiographic markers can become highly contaminated with various organisms thus serve as a reservoir for bacteria. In addition, the markers need to be cleaned on a regular basis, with either disinfectant wipes or alcohol gel to reduce their bacterial load.

An observational study based on the interaction between the paediatric patient and radiographer

International Nuclear Information System (INIS)

Harding, J.; Davis, M.

2015-01-01

Background: The practice of paediatric radiography requires a completely different skill set to that of adult radiography. Often, obtaining a paediatric patient's cooperation is the most difficult aspect of the role. Ensuring that a child cooperates for the examination can make positioning easier, thereby potentially providing a more diagnostic image. Aim: The aim of this study was to observe the interaction between the paediatric patient and the radiographer and to uncover techniques used by the radiographer to help alleviate any fear or stress that the child might have had. Method: A direct observational method was conducted, after both the radiographer and the child's guardians provided full written consent. The actions of the radiographer and resultant reactions from the child were recorded on an observational checklist designed for paediatric examinations. Results: Seventy-nine patients aged between three months to fifteen years and thirteen radiographers with no specific paediatric training other than experience were observed. Examinations observed included lower limb, upper limb, pelvis, abdomen and chest projections. The data gathered were the result of radiographer actions when interacting with both happy and sad children. Conclusions: Successful methods of alleviating a child's fear and anxiety whilst in the X-ray room included the use of child friendly equipment such as colourful lead protection and posters on the wall, a simple explanation of what the equipment is before moving it, offering rewards such as stickers and praise and showing the child their image after the examination. When time was short and the workload was high, it was observed that radiographers were less likely to spend time calming the child down and instead were more focused on completing the examination as quickly as possible. - Highlights: • Seventy-nine patients and thirteen radiographers were observed in this study. • The use of child-friendly equipment and

The utility of plain radiographs in the initial evaluation of knee pain amongst sports medicine patients.

Science.gov (United States)

Alaia, Michael J; Khatib, Omar; Shah, Mehul; A Bosco, Joseph; M Jazrawi, Laith; Strauss, Eric J

2015-08-01

To evaluate whether screening radiographs as part of the initial workup of knee pain impacts clinical decision-making in a sports medicine practice. A questionnaire was completed by the attending orthopaedic surgeon following the initial office visit for 499 consecutive patients presenting to the sports medicine centre with a chief complaint of knee pain. The questionnaire documented patient age, duration of symptoms, location of knee pain, associated mechanical symptoms, history of trauma within the past 2 weeks, positive findings on plain radiographs, whether magnetic resonance imaging was ordered, and whether plain radiographs impacted the management decisions for the patient. Patients were excluded if they had prior X-rays, history of malignancy, ongoing pregnancy, constitutional symptoms as well as those patients with prior knee surgery or intra-articular infections. Statistical analyses were then performed to determine which factors were more likely do correspond with diagnostic radiographs. Overall, initial screening radiographs did not change management in 72 % of the patients assessed in the office. The mean age of patients in whom radiographs did change management was 57.9 years compared to 37.1 years in those patients where plain radiograph did not change management (p < 0.0001). Plain radiographs had no impact on clinical management in 97.3 % of patients younger than 40. In patients whom radiographs did change management, radiographs were more likely to influence management if patients were over age forty, had pain for over 6 months, had medial or diffuse pain, or had mechanical symptoms. A basic cost analysis revealed that the cost of a clinically useful radiographic series in a patient under 40 years of age was $7,600, in contrast to $413 for a useful series in patients above the age of 40. Data from the current study support the hypothesis that for the younger patient population, routine radiographic imaging as a screening tool may be of

Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model.

Science.gov (United States)

Gullick, Janice G; West, Sandra H

2016-03-01

The aim of this study was to evaluate Wenger's Community of Practice as a framework for building research capacity and productivity. While research productivity is an expected domain in influential models of advanced nursing practice, internationally it remains largely unmet. Establishment of nursing research capacity precedes productivity and consequently, there is a strong imperative to identify successful capacity-building models for nursing-focussed research in busy clinical environments. Prospective, longitudinal, qualitative descriptive design was used in this study. Bruyn's participant observation framed evaluation of a Community of Practice comprising 25 advanced practice nurses. Data from focus groups, education evaluations, blog/email transcripts and field observations, collected between 2007 and 2014, were analysed using a qualitative descriptive method. The Community of Practice model invited differing levels of participation, allowed for evolution of the research community and created a rhythm of research-related interactions and enduring research relationships. Participants described the value of research for their patients and families and the significance of the developing research culture in providing richness to their practice and visibility of their work to multidisciplinary colleagues. Extensive examples of research dissemination and enrolment in doctoral programmes further confirmed this value. A Community of Practice framework is a powerful model enabling research capacity and productivity evidenced by publication. In developing a solid foundation for a nursing research culture, it should be recognized that research skills, confidence and growth develop over an extended period of time and success depends on skilled coordination and leadership. © 2015 John Wiley & Sons Ltd.

Educational Changes to Support Advanced Practice Nursing Education.

Science.gov (United States)

LeFlore, Judy L; Thomas, Patricia E

2016-01-01

Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system.

Developing an advanced practice nurse-led liver clinic.

Science.gov (United States)

McAfee, Jean L

2012-01-01

End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

Reference Neutron Radiographs of Nuclear Reactor Fuel

DEFF Research Database (Denmark)

Domanus, Joseph Czeslaw

1986-01-01

Reference neutron radiographs of nuclear reactor fuel were produced by the Euraton Neutron Radiography Working Group and published in 1984 by the Reidel Publishing Company. In this collection a classification is given of the various neutron radiographic findings, that can occur in different parts...... of pelletized, annular and vibro-conpacted nuclear fuel pins. Those parts of the pins are shown where changes of appearance differ from those for the parts as fabricated. Also radiographs of those as fabricated parts are included. The collection contains 158 neutron radiographs, reproduced on photographic paper...

Practical radiation protection for radiography

International Nuclear Information System (INIS)

Hubbard, S.K.; Proudfoot, E.A.

1978-01-01

Nondestructive Testing Applications and Radiological Engineering at the Hanford Engineering Development Laboratory have developed radiation protection procedures, radiation work procedures, and safe practice procedures to assure safe operation for all radiographic work. The following topics are discussed: training in radiation safety; radiation exposure due to operations at Hanford; safeguards employed in laboratory radiography; field radiographic operations; and problems

Radiographic enhancement and analysis system

International Nuclear Information System (INIS)

Schlosser, M.S.

1981-01-01

Radiographic image enhancement and analysis techniques are discussed as they apply to nondestructive inspection. A system is described which has been developed to enhance and quantitatively evaluate radiographic images using digital computer techniques. Some examples of typical applications are also presented as an introduction to this new inspection technique. (author)

Agreement between radiographic and photographic trabecular patterns

Energy Technology Data Exchange (ETDEWEB)

Korstjens, C.M.; Geraets, W.G.M.; Stelt, P.F. van der [Dept. of Oral Radiology, Academic Centre for Dentistry, Amsterdam (Netherlands); Spruijt, R.J. [Div. of Psychosocial Research and Epidemiology, Netherlands Cancer Inst., Amsterdam (Netherlands); Mosekilde, L. [Dept. of Cell Biology, Univ. of Aarhus (Denmark)

1998-11-01

Purpose: It has been hypothesized that photographs can facilitate the interpretation of the radiographic characteristics of trabecular bone. The reliability of these photographic and radiographic approaches has been determined, as have various agreements between the two approaches and their correlations with biomechanical characteristics. Material and Methods: Fourteen vertebral bodies were obtained at autopsy from 6 women and 8 men aged 22-76 years. Photographs (n=28) and radiographs (n=28) were taken of midsagittal slices from the third lumbar vertebra. The radiographs and photographs were digitized and the geometric properties of the trabecular architecture were then determined with a digital images analysis technique. Information on the compressive strength and ash density of the vertebral body was also available. Results: The geometric properties of both radiographs and photographs could be measured with a high degree of reliability (Cronbach`s {alpha}>0.85). Agreement between the radiographic and photographic approaches was mediocre as only the radiographic measurements showed insignificant correlations (p<0.05) with the biomechanical characteristics. We suggest that optical phenomena may result in the significant correlations between the photographs and the biomechanical characteristics. Conclusion: For digital image processing, radiography offers a superior description of the architecture of trabecular bone to that offered by photography. (orig.)

Agreement between radiographic and photographic trabecular patterns

International Nuclear Information System (INIS)

Korstjens, C.M.; Geraets, W.G.M.; Stelt, P.F. van der; Spruijt, R.J.; Mosekilde, L.

1998-01-01

Purpose: It has been hypothesized that photographs can facilitate the interpretation of the radiographic characteristics of trabecular bone. The reliability of these photographic and radiographic approaches has been determined, as have various agreements between the two approaches and their correlations with biomechanical characteristics. Material and Methods: Fourteen vertebral bodies were obtained at autopsy from 6 women and 8 men aged 22-76 years. Photographs (n=28) and radiographs (n=28) were taken of midsagittal slices from the third lumbar vertebra. The radiographs and photographs were digitized and the geometric properties of the trabecular architecture were then determined with a digital images analysis technique. Information on the compressive strength and ash density of the vertebral body was also available. Results: The geometric properties of both radiographs and photographs could be measured with a high degree of reliability (Cronbach's α>0.85). Agreement between the radiographic and photographic approaches was mediocre as only the radiographic measurements showed insignificant correlations (p<0.05) with the biomechanical characteristics. We suggest that optical phenomena may result in the significant correlations between the photographs and the biomechanical characteristics. Conclusion: For digital image processing, radiography offers a superior description of the architecture of trabecular bone to that offered by photography. (orig.)

Correlation of macroscopic osteoarthrotic changes and radiographic findings in the acromioclavicular joint

International Nuclear Information System (INIS)

Stenlund, B.; Marions, O.; Engstroem, K.F.; Goldie, I.; Soedersjukhuset, Stockholm; Karolinska Sjukhuset, Stockholm

1988-01-01

In a total of 108 acromioclavicular articulations from cadavers the osteoarthrotic changes were studied. The articulations were macroscopically and radiographically ranked according to their grade of osteoarthrosis. The two ranking lines were correlated statistically and showed a rank correlation of 0.741. In 38 articulations tomography was also carried out. These articulations were classified into five grades of osteoarthrosis and the macroscopic, conventional radiographic and tomographic gradings were compared. The correlation coefficient for tomography versus macroscopy was 0.714. Tomography versus standard radiography showed a correlation of 0.767 and standard radiography versus macroscopy a correlation of 0.841. The standard radiographic investigation reveals moderate and severe osteoarthrotic changes in the acromioclavicular joint but cannot depict smaller changes. Tomography does not seem to improve the specificity. There is a need for a better radiologic technique in the examination of the acromioclavicular joint. Radiography during some kind of loading might be a practical way of improving the specificity and make it possible to show early osteoarthrosis in the acromioclavicular articulation. (orig.)

Correlation of macroscopic osteoarthrotic changes and radiographic findings in the acromioclavicular joint

Energy Technology Data Exchange (ETDEWEB)

Stenlund, B.; Marions, O.; Engstroem, K.F.; Goldie, I.

In a total of 108 acromioclavicular articulations from cadavers the osteoarthrotic changes were studied. The articulations were macroscopically and radiographically ranked according to their grade of osteoarthrosis. The two ranking lines were correlated statistically and showed a rank correlation of 0.741. In 38 articulations tomography was also carried out. These articulations were classified into five grades of osteoarthrosis and the macroscopic, conventional radiographic and tomographic gradings were compared. The correlation coefficient for tomography versus macroscopy was 0.714. Tomography versus standard radiography showed a correlation of 0.767 and standard radiography versus macroscopy a correlation of 0.841. The standard radiographic investigation reveals moderate and severe osteoarthrotic changes in the acromioclavicular joint but cannot depict smaller changes. Tomography does not seem to improve the specificity. There is a need for a better radiologic technique in the examination of the acromioclavicular joint. Radiography during some kind of loading might be a practical way of improving the specificity and make it possible to show early osteoarthrosis in the acromioclavicular articulation.

Correlates of Teacher Practices Influencing Student Outcomes in Reading Instruction for Advanced Readers

Science.gov (United States)

Hunsaker, Scott L.; Nielsen, Aubree; Bartlett, Brianne

2010-01-01

In a professional development project, six teaching practices were posited as necessary for improving affective and cognitive outcomes for identified advanced readers. These practices were identification, organization for instruction, content, instructional strategies, continuous improvement assessment, and ambassadorship. Sixty-one teachers…

The role of advanced practice providers in pediatric otolaryngology academic practices.

Science.gov (United States)

Reilly, Brian K; Brandon, Gretchen; Shah, Rahul; Preciado, Diego; Zalzal, George

2013-01-01

The goal of this study was to examine the roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) in pediatric academic otolaryngology programs to provide a better understanding of their scope of practice, levels of autonomy, clinical duties, teaching opportunities and research participation. An anonymous web-based electronic survey tool was sent to all pediatric otolaryngology fellowship program directors in the United States. Nurse Practitioners and Physician Assistants are utilized in approximately 3 out of every 4 pediatric otolaryngology practices. The top three job activities of both the PA and NP were: (1) seeing patients independently, (2) working alongside doctors in clinic, and (3) answering phone lines/parental calls. A higher percentage of PAs (83%), worked alongside doctors in clinic, as compared to NPs, where only 55% work alongside MDs. Over half of PAs round with the in-patient team and see consults as compared to just over one third of NPs who participate in such activities. Twenty-five percent of practices reported that PAs cover call and assist in the OR. Most PAs/NPs saw between 11 and 15 patients per clinic which provides a clear productivity advantage when looking to screen patients, provide medical care, generate surgical cases, and maximize billings. NPs and PAs have complimentary skill sets ideal for the pediatric otolaryngology workplace, although job activities and "best fit" are hospital and practice dependent. Our study suggests that the use of PAs and NPs will continue to grow to meet increased demand for services in the field of pediatric otolaryngology. Employing advanced practice providers enables academic centers to improve access, provide additional financial remuneration, reduce wait times for new patients, and allow attending physicians to meet increased practice demands. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Prevalence and pattern of radiographic intervertebral disc degeneration in Vietnamese: a population-based study.

Science.gov (United States)

Ho-Pham, Lan T; Lai, Thai Q; Mai, Linh D; Doan, Minh C; Pham, Hoa N; Nguyen, Tuan V

2015-06-01

Intervertebral disc degeneration (IDD) is one of the most common skeletal disorders, yet few data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic IDD in a Vietnamese population. This population-based cross-sectional investigation involved 170 men and 488 women aged ≥40 years, who were randomly sampled from the Ho Chi Minh City (Vietnam). Anthropometric data, clinical history and self-reported back and neck pain were ascertained by a questionnaire. Plain radiographs (from the cervical spine, thoracic spine to the lumbar spine) were examined for the presence of disc space narrowing and/or osteophytosis using the Kellgren-Lawrence (KL) grading system. The presence of radiographic IDD was defined if the KL grade was 2 or greater in at least one disc. The prevalence of radiographic IDD was 62.4% (n = 106) in men and 54.7% (n = 267) in women. The most frequently affected site was the lumbar spine with prevalence being 50.6 and 43.2% in men and women, respectively. The prevalence of IDD increased with advancing age: 18.8% among those aged 40-49 years, and increased to 83.4% in those aged ≥60 years. Self-reported neck pain and lower back pain were found in 30 and 44% of individuals, respectively. There was no statistically significant association between self-reported neck pain and cervical spine OA. These data suggest that radiographic IDD is highly prevalent in the Vietnamese population, and that self-reported back pain is not a sensitive indicator of IDD.

Practice and prospect of advanced fuel management and fuel technology application in PWR in China

International Nuclear Information System (INIS)

Xiao Min; Zhang Hong; Ma Cang; Bai Chengfei; Zhou Zhou; Wang Lei; Xiao Xiaojun

2015-01-01

Since Daya Bay nuclear power plant implemented 18-month refueling strategy in 2001, China has completed a series of innovative fuel management and fuel technology projects, including the Ling Ao Advanced Fuel Management (AFM) project (high-burnup quarter core refueling) and the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. First, this paper gives brief introduction to China's advanced fuel management and fuel technology experience. Second, it introduces practices of the advanced fuel management in China in detail, which mainly focuses on the implementation and progress of the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. Finally, the paper introduces the practices of advanced fuel technology in China and gives the outlook of the future advanced fuel management and fuel technology in this field. (author)

Retention of anatomy knowledge by student radiographers

International Nuclear Information System (INIS)

Hall, A. Susanne; Durward, Brian R.

2009-01-01

Introduction: Anatomy has long been regarded as an integral part of the core curriculum. However, anecdotal evidence suggests that long-term retention of anatomy knowledge may be deficient. This study aims to evidence whether student radiographers demonstrate the same level of knowledge of anatomy after a period of time has elapsed and to correlate to approaches to learning and studying. Methodology: A repeated measures design was utilised to measure retention of anatomy knowledge for both MCQs and short-response answers to a Practical Radiographic Anatomy Examination; alpha value p < 0.05. Fifty-one students from levels 2 and 3 were retested after a time lapse of 10 and 22 months respectively. The students were not aware that their knowledge was being retested. Approaches to learning and studying were measured using the ASSIST inventory. Results: Statistical analysis found no difference in performance on MCQ assessment, in either the combined sample or levels 2 and 3 separately, from baseline to retention occasions; average retention rate being 99%. However, a statistical difference in performance on PRAE assessment was found, with level 2 experiencing a larger reduction in scores; retention rate of 67% compared to level 3 at 77%. The students perceived themselves to be principally strategic in their approach to learning and studying but no strong relationships were found when correlated to test scores. Conclusion: The student radiographers in this study demonstrated varied anatomy retention rates dependent on assessment method employed and time interval that had elapsed. It is recommended that diverse teaching and assessment strategies are adopted to encourage a deeper approach to learning and studying.

Digital interactive learning of oral radiographic anatomy.

Science.gov (United States)

Vuchkova, J; Maybury, T; Farah, C S

2012-02-01

Studies reporting high number of diagnostic errors made from radiographs suggest the need to improve the learning of radiographic interpretation in the dental curriculum. Given studies that show student preference for computer-assisted or digital technologies, the purpose of this study was to develop an interactive digital tool and to determine whether it was more successful than a conventional radiology textbook in assisting dental students with the learning of radiographic anatomy. Eighty-eight dental students underwent a learning phase of radiographic anatomy using an interactive digital tool alongside a conventional radiology textbook. The success of the digital tool, when compared to the textbook, was assessed by quantitative means using a radiographic interpretation test and by qualitative means using a structured Likert scale survey, asking students to evaluate their own learning outcomes from the digital tool. Student evaluations of the digital tool showed that almost all participants (95%) indicated that the tool positively enhanced their learning of radiographic anatomy and interpretation. The success of the digital tool in assisting the learning of radiographic interpretation is discussed in the broader context of learning and teaching curricula, and preference (by students) for the use of this digital form when compared to the conventional literate form of the textbook. Whilst traditional textbooks are still valued in the dental curriculum, it is evident that the preference for computer-assisted learning of oral radiographic anatomy enhances the learning experience by enabling students to interact and better engage with the course material. © 2011 John Wiley & Sons A/S.

Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.

Science.gov (United States)

Mboineki, Joanes Faustine; Zhang, Weihong

The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

Radiographic manifestations of hypochondroplasia

Energy Technology Data Exchange (ETDEWEB)

Heselson, N G; Cremin, B J [Groote Schuur Hospital, Cape Town (South Africa); Beighton, P

1979-01-01

Hypochrondroplasia is an inherited skeletal dysplasia that resembles achondroplasia in mild degree. Radiographic manifestations encountered in 12 affected individuals in South Africa include slight shortening of all segments of the tubular bones, moderate caudal diminution of the lumbar interpedicular distances, increased lumbar lordosis with cacral tilt and distal prolongation of the fibular. Hypochondroplasia can be distinguished from other osteochondrodystrophies such as achondroplasia, pseudo-achondroplasia and metaphyseal chondroplasia by the recognition of it clinical and radiographic manifestations.

Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

Science.gov (United States)

Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

2014-09-01

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.

Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

Science.gov (United States)

Potter, Pamela J.

2013-01-01

Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

Neonatal resuscitation: advances in training and practice

Directory of Open Access Journals (Sweden)

Sawyer T

2016-12-01

Full Text Available Taylor Sawyer, Rachel A Umoren, Megan M Gray Department of Pediatrics, Division of Neonatology, Neonatal Education and Simulation-based Training (NEST Program, University of Washington School of Medicine, Seattle, WA, USA Abstract: Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. Keywords: neonatal resuscitation, Neonatal Resuscitation Program, NRP, simulation, deliberate practice, debriefing, eSIM

Consultant radiographers: Profile of the first generation

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Maehle, Valerie

2010-01-01

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

Consultant radiographers: Profile of the first generation

Energy Technology Data Exchange (ETDEWEB)

Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)

2010-11-15

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

Interpretation and evaluation of radiograph

International Nuclear Information System (INIS)

Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail

2008-01-01

After digestion, the interpreter must interpreted and evaluate the image on film, usually many radiograph stuck in this step, if there is good density, so there are no problem. This is a final stage of radiography work and this work must be done by level two or three radiographer. This is a final stages before the radiographer give a result to their customer for further action. The good interpreter must know what kind of artifact, is this artifact are dangerous or not and others. In this chapter, the entire artifact that usually showed will be discussed briefly with the good illustration and picture to make the reader understand and know the type of artifact that exists.

Where radiographers fear to tread: Resistance and apathy in radiography practice

Energy Technology Data Exchange (ETDEWEB)

Yielder, Jill [Medical Imaging, Unitec New Zealand (New Zealand)], E-mail: jyielder@unitec.ac.nz; Davis, Michaela [School of Medicine and Medical Science, University College Dublin (Ireland)

2009-11-15

This article explores some of the key issues that characterise the culture of the radiography profession as experienced and reported in the United Kingdom, New Zealand and Australia. It raises many questions for professionals concerned about the future of the profession to consider, arguing that if these issues remain unchallenged they may limit both ongoing professional development of individuals and the profession as a whole. The authors conclude that a multi-faceted approach is needed that includes a reconceptualisation of our formal education programmes to include an increased emphasis on critical reflection; an attempt to change the workplace culture through targeted professional development and effective leadership; and the commitment by radiographers to finding a new focus and sense of professionalism.

Where radiographers fear to tread: Resistance and apathy in radiography practice

International Nuclear Information System (INIS)

Yielder, Jill; Davis, Michaela

2009-01-01

This article explores some of the key issues that characterise the culture of the radiography profession as experienced and reported in the United Kingdom, New Zealand and Australia. It raises many questions for professionals concerned about the future of the profession to consider, arguing that if these issues remain unchallenged they may limit both ongoing professional development of individuals and the profession as a whole. The authors conclude that a multi-faceted approach is needed that includes a reconceptualisation of our formal education programmes to include an increased emphasis on critical reflection; an attempt to change the workplace culture through targeted professional development and effective leadership; and the commitment by radiographers to finding a new focus and sense of professionalism.

Reliability of radiographic parameters in adults with hip dysplasia

Energy Technology Data Exchange (ETDEWEB)

Terjesen, Terje [Oslo University Hospital, Rikshospitalet, Department of Orthopaedics, Oslo (Norway); Gunderson, Ragnhild B. [Oslo University Hospital, Rikshospitalet, Department of Radiology, Oslo (Norway)

2012-07-15

To assess the reliability of radiographic measurements in adults previously treated for developmental dysplasia of the hip (DDH) and to clarify whether these parameters differ according to position of the patient (supine versus standing). Fifty-one patients (41 females and 10 males) with 63 affected hips were included in the study. The mean follow-up period was 45 (44-49) years in the patients who had not undergone total hip replacement (THR). Anteroposterior radiographs of the pelvis were taken with the patient in the supine and in the standing position. Measurements used for residual hip dysplasia were center-edge (CE) angle and migration percentage (MP). The joint space width (JSW) was measured at three or four locations of the upper, weight-bearing part of the joint, and the shortest distance was termed the minimum joint space width (minJSW). One radiologist and one orthopaedic surgeon, each with more than 30 years of experience, independently measured the radiographic parameters. The limits of agreement (LOA) of the CE angle (mean interobserver difference {+-} 2SD) were within the range -8 to 7 . The LOA of the MP were in the range -8 to 8% and of the minJSW -0.6 to 1.1 mm. The mean differences in CE angle between supine and standing radiographs (supine - standing) ranged from -1.1 to 0.0 and the mean differences in MP between supine and standing positions were below 1%. The mean positional differences in minJSW were below 0.1 mm and were not statistically significant. The interobserver variations with regard to CE angle, MP, and minJSW were moderate, indicating that these are reliable measurements in clinical practice. Femoral head coverage and JSW did not significantly differ between supine and weight-bearing positions. (orig.)

Can radiographers be trained to deliver an intervention to raise breast cancer awareness, and thereby promote early presentation of breast cancer, in older women?

International Nuclear Information System (INIS)

Omar, L.; Burgess, C.C.; Tucker, L.D.; Whelehan, P.; Ramirez, A.J.

2010-01-01

Aims: To assess the feasibility of training radiographers to deliver a one-to-one intervention to raise breast cancer awareness among older women. The ultimate aim is to increase the likelihood of early presentation of breast cancer by older women and improve survival from the disease. Method: Four radiographers were trained to deliver a 10-min scripted one-to-one intervention. Key elements of training included rehearsal of the intervention using role-play with actors and colleagues and practice interviews with women attending NHS breast screening clinics. All practice interventions were videotaped to facilitate positive, constructive feedback on performance. Competence to deliver the intervention was assessed on delivery of the key messages and the style of delivery. Radiographers' experiences of training and intervention delivery were collated from reflective diaries. Results: Three radiographers were assessed as competent after training and all four increased in confidence to deliver the intervention. Reported benefits to radiographers included increased awareness of communication skills and enhanced interaction with women attending breast screening. Radiographers reported challenges relating to mastering the prescriptive nature of the intervention and to delivering complex health messages within time constraints. Discussion: It was feasible but challenging for radiographers to be trained to deliver a one-to-one intervention designed to raise breast cancer awareness and thereby to promote early presentation of breast cancer. If the intervention is found to be cost-effective it may be implemented across the NHS Breast Screening Programme with diagnostic radiographers playing a key role in promoting early presentation of breast cancer.

Does advanced practice in radiography benefit the healthcare system? A literature review.

Science.gov (United States)

Thom, S E

2018-02-01

With ever-increasing demands on the National Health Service (NHS), members of staff are blurring their professional boundaries in the attempt to benefit the healthcare system. This review aims to establish whether advancing practice within radiography does benefit the healthcare system by examining published literature. Key words were input into databases such as: CINAHL, Science Direct and PubMed. Various filters were applied to narrow down the articles. Key themes were identified within the literature: cost, job satisfaction, patient benefits, restrictions and workload. Having advanced practitioners undertake some of the radiologists' workload was potentially cost effective whilst continuing/increasing the standard of quality. Patients benefitted from the quality of their examinations, the high accuracy of their reports and the speed those reports were attained. Evidence within the literature emphasises that advanced practice does benefit the healthcare system by means of: cost reduction, job satisfaction, patient benefits and workload. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Advancing Evaluation Theory and Practice in South Asia : Building a ...

International Development Research Centre (IDRC) Digital Library (Canada)

Advancing Evaluation Theory and Practice in South Asia : Building a Community of Experts. This grant will allow the Association for ... to other evaluation practitioners in the region. It is expected that the project will help strengthen evaluation in South Asia, leading to more effective and efficient development interventions.

Advancing Empirical Scholarship to Further Develop Evaluation Theory and Practice

Science.gov (United States)

Christie, Christina A.

2011-01-01

Good theory development is grounded in empirical inquiry. In the context of educational evaluation, the development of empirically grounded theory has important benefits for the field and the practitioner. In particular, a shift to empirically derived theory will assist in advancing more systematic and contextually relevant evaluation practice, as…

Assessment of skeletal age using MP3 and hand-wrist radiographs and its correlation with dental and chronological ages in children.

Science.gov (United States)

Bala, M; Pathak, A; Jain, R L

2010-01-01

The purpose of the study was to assess skeletal age using MP3 and hand-wrist radiographs and to find the correlation amongst the skeletal, dental and chronological ages. One hundred and sixty North-Indian healthy children in the age group 8-14 years, comprising equal number of males and females were included in the study. The children were radiographed for middle phalanx of third finger (MP3) and hand-wrist of the right hand and intra oral periapical X-ray for right permanent maxillary canine. Skeletal age was assessed from MP3 and hand-wrist radiographs according to the standards of Greulich and Pyle. The dental age was assessed from IOPA radiographs of right permanent maxillary canine based on Nolla's calcification stages. Skeletal age from MP3 and hand-wrist radiographs shows high correlation in all the age groups for both sexes. Females were advanced in skeletal maturation than males. Skeletal age showed high correlation with dental age in 12-14 years age group. Chronological age showed inconsistent correlation with dental and skeletal ages.

Detection of proximal caries using digital radiographic systems with different resolutions.

Science.gov (United States)

Nikneshan, Sima; Abbas, Fatemeh Mashhadi; Sabbagh, Sedigheh

2015-01-01

Dental radiography is an important tool for detection of caries and digital radiography is the latest advancement in this regard. Spatial resolution is a characteristic of digital receptors used for describing the quality of images. This study was aimed to compare the diagnostic accuracy of two digital radiographic systems with three different resolutions for detection of noncavitated proximal caries. Diagnostic accuracy. Seventy premolar teeth were mounted in 14 gypsum blocks. Digora; Optime and RVG Access were used for obtaining digital radiographs. Six observers evaluated the proximal surfaces in radiographs for each resolution in order to determine the depth of caries based on a 4-point scale. The teeth were then histologically sectioned, and the results of histologic analysis were considered as the gold standard. Data were entered using SPSS version 18 software and the Kruskal-Wallis test was used for data analysis. P detection of proximal caries (P > 0.05). RVG access system had the highest specificity (87.7%) and Digora; Optime at high resolution had the lowest specificity (84.2%). Furthermore, Digora; Optime had higher sensitivity for detection of caries exceeding outer half of enamel. Judgment of oral radiologists for detection of the depth of caries had higher reliability than that of restorative dentistry specialists. The three resolutions of Digora; Optime and RVG access had similar accuracy in detection of noncavitated proximal caries.

Animal radiographs

International Nuclear Information System (INIS)

Anon.

1993-01-01

This chapter presents historical x rays of a wide variety of animals taken within 5 years of the discovery of x radiation. Such photos were used as tests or as illustrations for radiographic publications. Numerous historical photographs are included. 10 refs

An American and Dutch partnership for psychiatric mental health advance nursing practice: nurturing a relationship across the ocean.

Science.gov (United States)

Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke

2012-07-01

The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.

Guidelines on best practice in the X-ray imaging of children. A manual for all X-ray departments

International Nuclear Information System (INIS)

Cook, J.; Pettett, A.; Shah, K.

1998-01-01

When we were first asked to participate in a CEC project looking at best practice in paediatric radiology, we did not appreciate how much our own practice could be improved. The department already had high standards of radiography. However, despite our initial reservations we found that by reassessing all our practices, including choice of screen/film systems, use of filters, grids and exposure factors we were able to standardise our techniques and reduce our doses in many areas by over 50%, while still maintaining diagnostic quality. The published European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Paediatrics (1996) was our initiative. They provide a combination of positioning and visibility criteria. Radiographs which do not meet these criteria are not thought to be diagnostic and alternatively aesthetically high quality radiographs which exceed these criteria are not deemed necessary. The reference dose levels in the European Guidelines are those above which corrective action should be taken. The dose measurements in our guidelines are much lower and represent what is achievable with the available equipment at QMHC, while still meeting the European Quality Criteria. A new age of Digital radiography is replacing conventional radiography. However, as digital techniques can mask high doses, careful observation of quality criteria and recommended technique is even more important to obtain the most benefit from these technical advances. Despite the time consuming nature of the initial study the whole department has benefited and we encourage all those involved in the X-ray imaging of children to consider re-evaluating their own practices using these guidelines as a reference for comparison. We recognise that all the recommendations given are entirely dependent on the range of equipment available and pathology expected but can be modified to meet individual departmental needs. If practices/ techniques; diagnostic quality of radiographs or

Radiographic signs and diagnosis of dental disease

International Nuclear Information System (INIS)

Bellows, J.

1993-01-01

Dental radiographs are critical for the complete assessment and treatment of dental diseases. Dental radiography is commonly used to evaluate congenital dental defects, periodontal disease, orthodontic manipulations, oral tumors, endodontic treatments, oral trauma, and any situation where an abnormality is suspected. Although standard radiographic equipment and film can be used to produce dental radiographs, dental X-ray equipment and film provide superior quality images and greater convenience of animal patient positioning. An understanding of normal dental radiographic anatomy is important when interpreting dental radiographs. Stage III periodontitis is the earliest stage of periodontal disease at which radiographic abnormalities become apparent. Bone loss associated with periodontal disease can be classified as either horizontal or vertical. Periapical radiolucencies can represent granulomas, cysts, or abscesses, whereas periapical radiodensities may represent sclerotic bone or condensing osteitis. Lytic lesions of the bone of the jaw often represent oral neoplasms. Neoplasms also can displace or disrupt teeth in the dental arch. Resorptive lesions can be external or internal and appear as radiolucent areas involving the external surface of the root or the pulp cavity, respectively. Feline dental resorptive lesions, also known as odontoclastic resorptions, are a specific form of dental resorptive lesions unique to cats

Radiographic heart-volume estimation in normal cats

International Nuclear Information System (INIS)

Ahlberg, N.E.; Hansson, K.; Svensson, L.; Iwarsson, K.

1989-01-01

Heart volume mensuration was evaluated on conventional radiographs from eight normal cats in different body positions using computed tomography (CT). Heart volumes were calculated from orthogonal thoracic radiographs in ventral and dorsal recumbency and from radiographs exposed with a vertical X-ray beam in dorsal and lateral recumbency using the formula for an ellipsoid body. Heart volumes were also estimated with CT in ventral, dorsal, right lateral and left lateral recumbency. No differences between heart volumes from CT in ventral recumbency and those from CT in right and left lateral recumbency were seen. In dorsal recumbency, however, significantly lower heart volumes were obtained. Heart volumes from CT in ventral recumbency were similar to those from radiographs in ventral and dorsal recumbency and dorsal/left lateral recumbency. Close correlation was also demonstrated between heart volumes from radiographs in dorsal/ left lateral recumbency and body weights of the eight cats

Breast surgical specimen radiographs: How reliable are they?

International Nuclear Information System (INIS)

Britton, P.D.; Sonoda, L.I.; Yamamoto, A.K.; Koo, B.; Soh, E.; Goud, A.

2011-01-01

Radiography of the excised surgical specimen following wire guided localisation of impalpable breast lesions is standard surgical practice. The aims of the study were to establish the reliability of the breast specimen radiograph (SR) in determining lesion excision and to determine whether the radiographic margin correlated with the histological margin. The clinical, imaging, SR and pathological details of 106 patients with a pre-operative diagnosis of breast cancer were retrospectively reviewed. The reliability of orientation was estimated and the appearance and distance from the mammographic abnormality to each radial margin were measured and correlated with surgical histological findings. The overall accuracy of the specimen radiograph in determining whether the mammographic lesion was present was 99%. The SR could be orientated 'very reliably' or 'reliably' in 80% of patients however in only 48% of patients did the closest margin on the SR correspond with the same nearest margin at final histology. A maximum measurement of 11 mm or more from the lesion to the specimen edge was associated with a 77% likelihood of having a clear final histological margin (taken as 5 mm or more) and if <11 mm a 58% chance of having involved final histological margins. There was however a wide overlap in the results with patients having an apparently wide SR margin but histologically involved margins and vice versa. The SR is reliable at determining whether the target lesion has been removed. The correlation of SR margin orientation and measurement with final histological measurement is however far less reliable.

Measure by image analysis of industrial radiographs

International Nuclear Information System (INIS)

Brillault, B.

1988-01-01

A digital radiographic picture processing system for non destructive testing intends to provide the expert with computer tool, to precisely quantify radiographic images. The author describes the main problems, from the image formation to its characterization. She also insists on the necessity to define a precise process in order to automatize the system. Some examples illustrate the efficiency of digital processing for radiographic images [fr

Ionising radiation risk disclosure: When should radiographers assume a duty to inform?

Science.gov (United States)

Younger, C W E; Douglas, C; Warren-Forward, H

2018-05-01

Autonomy is a fundamental patient right for ethical practice, and informed consent is the mechanism by which health care professionals ensure this right has been respected. The ethical notion of informed consent has evolved alongside legal developments. Under Australian law, a provider who fails to disclose risk may be found to be in breach of a duty of disclosure, potentially facing legal consequences if the patient experiences harm that is attributable to an undisclosed risk. These consequences may include the common law tort of negligence. Ionising radiation, in the form of a medical imaging examination, has the potential to cause harm. However, stochastic effects cannot be attributable to a specific ionising radiation event. What then is the role of the Australian medical imaging service provider in disclosing ionising radiation risk? The ethical and legal principles of informed consent, and the duty of information provision to the patient are investigated. These general principles are then applied to the specific and unusual case of ionising radiation, and what responsibilities apply to the medical imaging provider. Finally, the legal, professional and ethical duties of the radiographer to disclose information to their patients are investigated. Australian law is unclear as to whether a radiographer has a common law responsibility to disclose radiation risk. There is ambiguity as to whether stochastic ionising radiation risk could be considered a legal disclosure responsibility. While it is unlikely that not disclosing risk will have medicolegal consequences, doing so represents sound ethical practice. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

Science.gov (United States)

Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant

2017-05-01

Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally

Radiographic aspects of xeroradiography

International Nuclear Information System (INIS)

Rao, G.U.V.; Fatouros, P.P.

1980-01-01

The quality of a conventional radiographic image can be characterized in terms of five basic parameters; density, contrast, latitude, resolution and noise. Since xeroradiographic images exhibit very limited broad area contrasts, and image formation is predominantly due to edge enhancement, a straightforward description of image quality using the same five parameters is not adequate. A detailed study was made of the radiographic aspects of xeroradiography with special reference to mammography, and a summary of major findings to date with appropriate references to published papers is presented

Radiologist perceptions of radiographer role development in Scotland

Energy Technology Data Exchange (ETDEWEB)

Forsyth, Lesley J. [School of Health Sciences, Robert Gordon University, Faculty of Health and Social Care, Garthdee Road, Garthdee, Aberdeen AB10 7QG (United Kingdom)]. E-mail: l.forsyth@rgu.ac.uk; Robertson, Elizabeth M. [Department of Radiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN (United Kingdom)]. E-mail: e.m.robertson@arh.grampian.scot.nhs.uk

2007-02-15

Aim: To survey the perceptions of the Scottish radiology community in relation to radiographer role development. Methods: A postal questionnaire was sent to all consultant radiologists recorded on the NHS Scotland database of consultants. Results: Response rate was 63%. (i) Respondents considered increased professional standing of radiographers, best use of manpower resources, reduced pressure on the service and improved recruitment and retention, as positive advantages of radiographer development. (ii) The potential impact on radiology specialist registrar training, lack of clear medico-legal responsibilities and radiographers recognising the limitations of their abilities were identified as the main areas of radiologist anxiety. (iii) Fifty-seven percent did not consider current post-registration radiography education and training resources adequate to underpin the requirement of developed roles. (iv) Barriers to radiographer development were identified as lack of radiography and radiology staff, suitable education, financial constraints, traditional views and resistance to change. (v) Eighty-two percent reported support for radiographer role development and willingness to participate actively in developments. Conclusion: Despite reservations Scottish radiologists are supportive of the development of radiography colleagues, however, guidance is required on the medico-legal and accountability aspects of radiographers assuming new roles. Radiologist involvement in education and training for new roles may increase their confidence and trust in radiographers to work within the limitations of their competency and training.

Radiologist perceptions of radiographer role development in Scotland

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Robertson, Elizabeth M.

2007-01-01

Aim: To survey the perceptions of the Scottish radiology community in relation to radiographer role development. Methods: A postal questionnaire was sent to all consultant radiologists recorded on the NHS Scotland database of consultants. Results: Response rate was 63%. (i) Respondents considered increased professional standing of radiographers, best use of manpower resources, reduced pressure on the service and improved recruitment and retention, as positive advantages of radiographer development. (ii) The potential impact on radiology specialist registrar training, lack of clear medico-legal responsibilities and radiographers recognising the limitations of their abilities were identified as the main areas of radiologist anxiety. (iii) Fifty-seven percent did not consider current post-registration radiography education and training resources adequate to underpin the requirement of developed roles. (iv) Barriers to radiographer development were identified as lack of radiography and radiology staff, suitable education, financial constraints, traditional views and resistance to change. (v) Eighty-two percent reported support for radiographer role development and willingness to participate actively in developments. Conclusion: Despite reservations Scottish radiologists are supportive of the development of radiography colleagues, however, guidance is required on the medico-legal and accountability aspects of radiographers assuming new roles. Radiologist involvement in education and training for new roles may increase their confidence and trust in radiographers to work within the limitations of their competency and training

Segmentation of lung fields using Chan-Vese active contour model in chest radiographs

Science.gov (United States)

Sohn, Kiwon

2011-03-01

A CAD tool for chest radiographs consists of several procedures and the very first step is segmentation of lung fields. We develop a novel methodology for segmentation of lung fields in chest radiographs that can satisfy the following two requirements. First, we aim to develop a segmentation method that does not need a training stage with manual estimation of anatomical features in a large training dataset of images. Secondly, for the ease of implementation, it is desirable to apply a well established model that is widely used for various image-partitioning practices. The Chan-Vese active contour model, which is based on Mumford-Shah functional in the level set framework, is applied for segmentation of lung fields. With the use of this model, segmentation of lung fields can be carried out without detailed prior knowledge on the radiographic anatomy of the chest, yet in some chest radiographs, the trachea regions are unfavorably segmented out in addition to the lung field contours. To eliminate artifacts from the trachea, we locate the upper end of the trachea, find a vertical center line of the trachea and delineate it, and then brighten the trachea region to make it less distinctive. The segmentation process is finalized by subsequent morphological operations. We randomly select 30 images from the Japanese Society of Radiological Technology image database to test the proposed methodology and the results are shown. We hope our segmentation technique can help to promote of CAD tools, especially for emerging chest radiographic imaging techniques such as dual energy radiography and chest tomosynthesis.

Survey of advanced practice registered nurses disciplinary action.

Science.gov (United States)

Hudspeth, Randall

2007-04-02

The nursing profession continues to struggle to find the most appropriate approach to credentialing Advanced Practice Registered Nurses (APRNs). One early step in addressing this struggle is determining the incidence of APRN disciplinary actions by boards of nursing. This article presents data from 2003 and 2004 describing the incidence of APRN disciplinary actions by United States boards of nursing. Fifty-one boards of nursing, all members of the National Council of State Boards of Nursing, were asked to report the numbers of APRN discipline cases for 2003 and 2004 which had been resolved, using a tool that differentiated disciplinary cases into four data categories: chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients. Thirty-eight (74.5%) of 51 boards of nursing reported discipline data for a total of 125,882 APRNs showing 688 disciplinary actions were taken during 2003 and 2004. This indicates that APRNs experience a low incidence of discipline related to chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients.

Chest radiography practice in critically ill patients: a postal survey in the Netherlands

International Nuclear Information System (INIS)

Graat, Marleen E; Hendrikse, Karin A; Spronk, Peter E; Korevaar, Johanna C; Stoker, Jaap; Schultz, Marcus J

2006-01-01

To ascertain current chest radiography practice in intensive care units (ICUs) in the Netherlands. Postal survey: a questionnaire was sent to all ICUs with > 5 beds suitable for mechanical ventilation; pediatric ICUs were excluded. When an ICU performed daily-routine chest radiographs in any group of patients it was considered to be a 'daily-routine chest radiography' ICU. From the number of ICUs responding, 63% practice a daily-routine strategy, in which chest radiographs are obtained on a daily basis without any specific reason. A daily-routine chest radiography strategy is practiced less frequently in university-affiliated ICUs (50%) as compared to other ICUs (68%), as well as in larger ICUs (> 20 beds, 50%) as compared to smaller ICUs (< 20 beds, 65%) (P > 0.05). Remarkably, physicians that practice a daily-routine strategy consider daily-routine radiographs helpful in guiding daily practice in less than 30% of all performed radiographs. Chest radiographs are considered essential for verification of the position of invasive devices (81%) and for diagnosing pneumothorax, pneumonia or acute respiratory distress syndrome (82%, 74% and 69%, respectively). On demand chest radiographs are obtained after introduction of thoracic drains, central venous lines and endotracheal tubes in 98%, 84% and 75% of responding ICUs, respectively. Chest films are also obtained in case of ventilatory deterioration (49% of responding ICUs), and after cardiopulmonary resuscitation (59%), tracheotomy (58%) and mini-tracheotomy (23%). There is notable lack of consensus on chest radiography practice in the Netherlands. This survey suggests that a large number of intensivists may doubt the value of daily-routine chest radiography, but still practice a daily-routine strategy

Challenges to implementation of advance directives of will in hospital practice.

Science.gov (United States)

Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

2016-01-01

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Chest radiographic findings in acute paraquat poisoning

Energy Technology Data Exchange (ETDEWEB)

Na, Gyeong Gyun; Lee, Mi Sook; Kim, Hee Jun; Sun, In O [Presbyterian Medical Center, Jeonju (Korea, Republic of)

2016-01-15

To describe the chest radiographic findings of acute paraquat poisoning. 691 patients visited the emergency department of our hospital between January 2006 and October 2012 for paraquat poisoning. Of these 691, we identified 56 patients whose initial chest radiographs were normal but who developed radiographic abnormalities within one week. We evaluated their radiographic findings and the differences in imaging features based on mortality. The most common finding was diffuse consolidation (29/56, 52%), followed by consolidation with linear and nodular opacities (18/56, 32%), and combined consolidation and pneumomediastinum (7/56, 13%). Pleural effusion was noted in 17 patients (30%). The two survivors (4%) showed peripheral consolidations, while the 54 patients (96%) who died demonstrated bilateral (42/54, 78%) or unilateral (12/54, 22%) diffuse consolidations. Rapidly progressing diffuse pulmonary consolidation was observed within one week on follow-up radiographs after paraquat ingestion in the deceased, but the survivors demonstrated peripheral consolidation.

Advances in pulsed-power-driven radiography system design

International Nuclear Information System (INIS)

Portillo, Salvador; Hinshelwood, David D.; Rovang, Dean Curtis; Cordova, Steve Ray; Oliver, Bryan Velten; Weber, Bruce V.; Welch, Dale Robert; Shelton, Bradley Allen; Sceiford, Matthew E.; Cooperstein, Gerald; Gignac, Raymond Edward; Puetz, Elizabeth A.; Rose, David Vincent; Barker, Dennis L.; Van De Valde, David M.; Droemer, Darryl W.; Wilkins, Frank Lee; Molina, Isidro; Jaramillo, Deanna M.; Swanekamp, Stephen Brian; Commisso, Robert J.; Bailey, Vernon Leslie; Maenchen, John Eric; Johnson, David Lee; Griffin, Fawn A.; Hahn, Kelly Denise; Smith, Ian

2004-01-01

Flash x-ray radiography has undergone a transformation in recent years with the resurgence of interest in compact, high intensity pulsed-power-driven electron beam sources. The radiographic requirements and the choice of a consistent x-ray source determine the accelerator parameters, which can be met by demonstrated Induction Voltage Adder technologies. This paper reviews the state of the art and the recent advances which have improved performance by over an order of magnitude in beam brightness and radiographic utility.

Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain.

Science.gov (United States)

Nepple, Jeffrey J; Brophy, Robert H; Matava, Matthew J; Wright, Rick W; Clohisy, John C

2012-10-01

The purpose of this study was to investigate the prevalence of radiographic findings of femoroacetabular impingement (FAI) in elite football players with a history of hip pain or groin injury who underwent radiographs. We performed a retrospective review of athletes undergoing hip radiography at the National Football League Combine from 2007 to 2009. Radiographs were obtained in athletes with a history of hip pain or injury. Anteroposterior pelvis and frog-lateral radiographs were obtained in 123 hips (107 players) that met our inclusion criteria. Radiographic indicators of cam-type FAI (alpha angle, head-neck offset ratio) and pincer-type FAI (acetabular retroversion, center-edge angle, acetabular inclination) were recorded. Findings were correlated with clinical factors (previous groin/hip pain, position, race, and body mass index). The most common previous injuries included groin strain (n = 57) and sports hernia/abdominal strain (n = 21). Markers of cam- and/or pincer-type FAI were present in 94.3% of hips (116 of 123). Radiographic evidence of combined cam- and pincer-type FAI was the most common (61.8%, 76 hips), whereas isolated cam-type FAI (9.8%, 12 hips) and pincer-type FAI (22.8%, 28 hips) were less common. The most common deformities included acetabular retroversion (71.5%) and an abnormal alpha angle (61.8%). A body mass index greater than 35 was associated with the presence of global overcoverage (46.2% v 17.3%, P = .025). Radiographic indicators of FAI are very common among athletes evaluated at the National Football League Scouting Combine subjected to radiographic examination for the clinical suspicion of hip disease. Elite football athletes with significant or recurrent pain about the hip should be evaluated clinically and radiographically for FAI, because pain from FAI may be falsely attributed to or may be present in addition to other disorders. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America

A radiographic analysis of implant component misfit.

LENUS (Irish Health Repository)

Sharkey, Seamus

2011-07-01

Radiographs are commonly used to assess the fit of implant components, but there is no clear agreement on the amount of misfit that can be detected by this method. This study investigated the effect of gap size and the relative angle at which a radiograph was taken on the detection of component misfit. Different types of implant connections (internal or external) and radiographic modalities (film or digital) were assessed.

The use and abuse of radiographic grids

International Nuclear Information System (INIS)

Brough, P.D.

1981-01-01

It is generally accepted that scattered radiation degrades the quality of the radiographic image. When this problem occurs, a radiographic grid may be applied which necessitates an increase in exposure. Investigations are reported in the following areas: reasons for the introduction of a radiographic grid; the ratio between kilovoltage and grid ratio; techniques resulting in higher contrast and resolution at low patient dose and the abuse of grids

21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator synchronizer. (a) Identification. A radiographic ECG/respirator synchronizer is a device intended to be used to...

Complications from radiographer-performed double contrast barium enemas

Energy Technology Data Exchange (ETDEWEB)

Vora, P.; Chapman, A. E-mail: anthony.chapman@leedsth.nhs.uk

2004-04-01

AIM: To determine the types and rates of complications encountered by radiographers when performing double contrast barium enemas (DCBE). MATERIALS AND METHODS: Seven hundred and forty-one questionnaires were posted to radiographers who had in the last 5 years attended one of the biannual barium enema training courses. RESULTS: Of 741 questionnaires posted 407 (54.9%) were returned completed. Approximately 348,000 barium enema examinations had been performed. Fifty-nine radiographers reported 89 complications, including 13 intra-peritoneal and 11 extra-peritoneal perforations. There were five deaths (mortality 1 in 70,000). Deaths resulted from two of 24 (10%) perforations, two of 45 (5%) cardiac events and one cerebrovascular accident that occurred during an examination. CONCLUSIONS: Radiographers have been regularly performing DCBEs for almost a decade. The mortality for radiographer-performed DCBE is similar to that previously reported for radiologists, although a slightly higher rate of perforation is noted and so this is an area where radiographer training should be targeted.

Complications from radiographer-performed double contrast barium enemas

International Nuclear Information System (INIS)

Vora, P.; Chapman, A.

2004-01-01

AIM: To determine the types and rates of complications encountered by radiographers when performing double contrast barium enemas (DCBE). MATERIALS AND METHODS: Seven hundred and forty-one questionnaires were posted to radiographers who had in the last 5 years attended one of the biannual barium enema training courses. RESULTS: Of 741 questionnaires posted 407 (54.9%) were returned completed. Approximately 348,000 barium enema examinations had been performed. Fifty-nine radiographers reported 89 complications, including 13 intra-peritoneal and 11 extra-peritoneal perforations. There were five deaths (mortality 1 in 70,000). Deaths resulted from two of 24 (10%) perforations, two of 45 (5%) cardiac events and one cerebrovascular accident that occurred during an examination. CONCLUSIONS: Radiographers have been regularly performing DCBEs for almost a decade. The mortality for radiographer-performed DCBE is similar to that previously reported for radiologists, although a slightly higher rate of perforation is noted and so this is an area where radiographer training should be targeted

Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents

International Nuclear Information System (INIS)

Andronikou, Savvas; Lambert, Elena; Hilder, Lucy; Halton, Jarred; Crumley, Iona; Kosack, Cara; Lyttle, Mark D.

2017-01-01

National guidance from the United Kingdom and the United States on community-acquired pneumonia in children states that chest radiographs are not recommended routinely in uncomplicated cases. The main reason in the ambulatory setting is that there is no evidence of a substantial impact on clinical outcomes. However clinical practice and adherence to guidance is multifactorial and includes the clinical context (developed vs. developing world), the confidence of the attending physician, the changing incidence of complications (according to the success of immunisation programs), the availability of alternative imaging (and its relationship to perceived risks of radiation) and the reliability of the interpretation of imaging. In practice, chest radiographs are performed frequently for suspected pneumonia in children. Time pressures facing clinicians at the front line, difficulties in distinguishing which children require admission, restricted bed numbers for admissions, imaging-resource limitations, perceptions regarding risk from procedures, novel imaging modalities and the probability of other causes for the child's presentation all need to be factored into a guideline. Other drivers that often weigh in, depending on the setting, include cost-effectiveness and the fear of litigation. Not all guidelines designed for the developed world can therefore be applied to the developing world, and practice guidelines require regular review in the context of new information. In addition, radiologists must improve radiographic diagnosis of pneumonia, reach consensus on the interpretive terminology that clarifies their confidence regarding the presence of pneumonia and act to replace one imaging technique with another whenever there is proof of improved accuracy or reliability. (orig.)

Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents

Energy Technology Data Exchange (ETDEWEB)

Andronikou, Savvas; Lambert, Elena; Hilder, Lucy [University of Bristol, Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol (United Kingdom); CRICBristol, Bristol (United Kingdom); Halton, Jarred; Crumley, Iona; Kosack, Cara [Medecins Sans Frontieres, Diagnostic Network, Amsterdam (Netherlands); Lyttle, Mark D. [Bristol Royal Hospital for Children, Emergency Department, Bristol (United Kingdom); University of the West of England, Faculty of Health and Life Sciences, Bristol (United Kingdom)

2017-10-15

National guidance from the United Kingdom and the United States on community-acquired pneumonia in children states that chest radiographs are not recommended routinely in uncomplicated cases. The main reason in the ambulatory setting is that there is no evidence of a substantial impact on clinical outcomes. However clinical practice and adherence to guidance is multifactorial and includes the clinical context (developed vs. developing world), the confidence of the attending physician, the changing incidence of complications (according to the success of immunisation programs), the availability of alternative imaging (and its relationship to perceived risks of radiation) and the reliability of the interpretation of imaging. In practice, chest radiographs are performed frequently for suspected pneumonia in children. Time pressures facing clinicians at the front line, difficulties in distinguishing which children require admission, restricted bed numbers for admissions, imaging-resource limitations, perceptions regarding risk from procedures, novel imaging modalities and the probability of other causes for the child's presentation all need to be factored into a guideline. Other drivers that often weigh in, depending on the setting, include cost-effectiveness and the fear of litigation. Not all guidelines designed for the developed world can therefore be applied to the developing world, and practice guidelines require regular review in the context of new information. In addition, radiologists must improve radiographic diagnosis of pneumonia, reach consensus on the interpretive terminology that clarifies their confidence regarding the presence of pneumonia and act to replace one imaging technique with another whenever there is proof of improved accuracy or reliability. (orig.)

Radiographic determination of urinary bladder volume and residual urine volume

International Nuclear Information System (INIS)

Klumair, J.

1977-01-01

In the course of a long study the author has tested most of the methods for determination of urinary bladder volume. A radiographic method which can state bladder volume exactly in cc's is attainable only with great time and effort. In the author's experience, however, it is possible, by means of a pattern in connection with a IVP, to estimate residual urine volume from a post-void picture of the bladder with sufficient accuracy for practical purposes. An account is given of the production of this pattern and of two relatively simple calculations for residual volume based on AP and lateral views of circular- and ellipsoid-shaped bladders. Also discussed is the radiation exposure which varies with the radiographic methods used. In male patients, the radiation exposure appears to be negligible, especially when the testicles are protected by a radiation shield. In female patients - which make up only a small fraction of all patients -, radiation exposure is higher but must be accepted. (orig./MG) [de

Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

Science.gov (United States)

Fierke, Kerry K.; Lepp, Gardner A.

2015-01-01

The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

Bash bash bash – It almost fits perfectly now. College of Radiographers 39th Welbeck Memorial Lecture

International Nuclear Information System (INIS)

Hogg, Peter

2012-01-01

This paper outlines The College of Radiographers 39th Welbeck Memorial Eponymous Lecture presented at United Kingdom Radiological Congress in 2010. The presentation considered the future of radiography practice and how that future might be influenced. The presentation was structured into 4 sections: approaches to predicting the future; use of imaging techniques and technologies; 2025 - our future; a roadmap to our future. With an emphasis on the business sector the first section considers traditional and creative ways of predicting the future; some examples of predicting the future are taken from radiography. Using specific examples from radiographic practice the second section attempts to determine whether imaging technologies and radiography techniques are optimised and whether clinical decision making is based upon research evidence. In this section consideration is also given to the temporal relationship between the introduction of new equipment, the research that supports its use and the skills required to work with it. The third section is short and it contains general predictions about what 2025 may look like. The final section proposes briefly how the radiographic profession might move forward into the future we would wish to exist.

Radiographic manifestations of arthritis in AIDS patients

International Nuclear Information System (INIS)

Rosenberg, Z.S.; Norman, A.; Solomon, G.

1988-01-01

The purpose of this study is to familiarize the radiologist with a newly discovered association between arthritis and acquired immunodeficiency syndrome (AIDS). The authors retrospectively reviewed the clinical and radiographic findings in 31 patients with human immunodeficiency virus (HIV) infection referred to their rheumatology clinic with musculoskeletal complaints. The patients carried a wide range of clinical diagnosis including Reiter syndrome, psoriatic arthritis, undifferentiated seronegative arthritis, isolated enthesopathies, rheumatoid arthritis and osteonecrosis. Radiographs were available in 24 of the 31 patients, and in 20 they showed radiographic features of arthritis, which included soft-tissue swelling periarticular osteoporosis, synovial effusions, sacroiliitis, periosteal reaction, joint space narrowing, marginal erosions, and osteonecrosis. Although the radiographic abnormalities were frequently mild, they were significant, given the short duration of disease in many of their patients (weeks to months) at the time radiographs were obtained. The range of radiographic findings in their series was varied and paralleled the wide range of clinical diagnoses. No findings were pathognomonic for HIV-associated arthritis. Nevertheless, HIV infection needs to be considered in any patient belonging to a recognized risk group who presents with musculoskeletal disease. This is particularly important since immunosupressive drugs used for the treatment of arthritis can be detrimental to patients with HIV infection

Radiographic evaluation of the diabetic foot

International Nuclear Information System (INIS)

Jacobs, A.M.

1989-01-01

Radiographic evaluation of the foot in the patient with diabetes mellitus is discussed in this paper. According to the author, it can only be of value when the soft tissue and bony and joint pathologic conditions, which occur more frequently in the diabetic patient are also considered and understood. Although not pathognomic for diabetes mellitus, neuroarthopathy, osteomyelitis, soft tissue infection, and some rheumatic disorders are present with greater frequency in diabetic populations than in non-diabetic populations. Frequently, edema, erythema, hyperthermia, and tenderness are present as nonspecific clinical findings, in which case radiographic evaluation is called upon to define the specific etiology of a particular patient's pathology. Unfortunately, many radiographic, computerized tomographic, and radionuclide studies demonstrate less than optimal positive and negative predictive values unless interpreted in view of clinical history and examination and integrated with the results of other laboratory data. Radiographic evaluation of the diabetic foot may be utilized to establish the presence of disease, the extent of pedal involvement, and the response to therapy. The establishment of the nature of disease processes from radiographic findings alone, however, may be problematic. The diagnosis of osteomyelitis, for example, rests on the recovery of the offending microorganisms from bone aspiration or culture

Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

International Nuclear Information System (INIS)

Szwedowski, Dawid; Walecki, Jerzy

2014-01-01

The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved

Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features

Directory of Open Access Journals (Sweden)

Iwona Sudoł-Szopińska

2016-03-01

Full Text Available Psoriatic arthritis is one of the spondyloarthritis. It is a disease of clinical heterogenicity, which may affect peripheral joints, as well as axial spine, with presence of inflammatory lesions in soft tissue, in a form of dactylitis and enthesopathy. Plain radiography remains the basic imaging modality for PsA diagnosis, although early inflammatory changes affecting soft tissue and bone marrow cannot be detected with its use, or the image is indistinctive. Typical radiographic features of PsA occur in an advanced disease, mainly within the synovial joints, but also in fibrocartilaginous joints, such as sacroiliac joints, and additionally in entheses of tendons and ligaments. Moll and Wright classified PsA into 5 subtypes: asymmetric oligoarthritis, symmetric polyarthritis, arthritis mutilans, distal interphalangeal arthritis of the hands and feet and spinal column involvement. In this part of the paper we discuss radiographic features of the disease. The next one will address magnetic resonance imaging and ultrasonography.

Stereotaxic approach to hypothalamic nuclei of the shiba goat with radiographic monitoring

International Nuclear Information System (INIS)

Mori, Y.; Takeuchi, Y.; Shimada, M.; Hayashi, S.; Hoshino, K.

1990-01-01

Practical method was devised for precise approach to hypothalamic nuclei in the Shiba goat. A stereotaxic instrument and a brain atlas with stereotaxic coordinates were developed. For an accurate placement of probes into specific hypothalamic regions a radiographic method was employed in which radio-opaque material was injected into the lateral ventricle and the ventricular outline was depicted. A sagittal diagram showing the arrangement of hypothalamic nuclei in relation to the brain ventricular system was constructed from the transverse stereotaxic atlas. This diagram was revealed extremely useful in pinpointing the target on the radiographs of lateral view. Precision of this method was evaluated in female Shiba goats (n = 4) by comparing radiographically estimated positions of hypothalamic nuclei with those histologically determined. Despite of cranial variability among individual animals these two parameters matched well each other in all the nuclei examined. Furthermore, chronic cannulae were implanted into different hypothalamic structures of one goat and the accuracy of their placement was confirmed histologically. Thus, it was revealed that the stereotaxy by aid of radiography herein described was accurate enough to apply to various neuroendocrinological studies in the Shiba goat

Radiographic features of periapical cysts and granulomas

OpenAIRE

Zain, R. B.; Roswati, N.; Ismail, K.

1989-01-01

Many studies have been reported on radiographic lesion sizes of periapical lesions. However no studies have been reported on prevalences of subjective radiographic features in these lesions except for the early assumption that a periapical cyst usually exhibit a radiopaque cortex. This study is conducted to evaluate the prevalences of several subjective radiographic features of periapical cysts and granulomas in the hope to identify features that maybe suggestive of either diagnosis. The resu...

Comparison of radiographic and anatomic femoral varus angle measurements in normal dogs.

Science.gov (United States)

Swiderski, Jennifer K; Radecki, Steven V; Park, Richard D; Palmer, Ross H

2008-01-01

To determine if the clinically practiced method of radiographic femoral varus angle (R-FVA) measurement is repeatable, reproducible, and accurate. Radiographic and anatomic study. ANIMALS/SAMPLE POPULATION: Normal Walker hound cadavers (n=5) and femora (n=10). Cadavers were held in dorsally-recumbent and torso-elevated positions as 3 craniocaudal radiographs were made of each femur, by each of 2 different technicians. Femora were then harvested for direct measurement of anatomic femoral varus angle (A-FVA). R-FVA was measured on each radiograph by each of 3 examiners on 3 separate occasions. Intra-observer (repeatability) and inter-observer (reproducibility) variance in R-FVA measurement and the strength of relationship between R-FVA and A-FVA (accuracy) were determined. Mean (+/-SD) A-FVA was 5.2+/-2.1 degrees (range, 2.4-8.2 degrees). Mean (+/-SD) R-FVA was 5.8+/-1.0 degrees (range, 2.7-9.6 degrees). Intra-observer variance (range: 11-16%) and inter-observer variance (16%) were acceptable. The strength of relationship between measured R-FVA and A-FVA (maximum adjusted R(2)hounds. The detected inaccuracy may be real or the result of a selection bias for normal dogs obscuring the true relationship. R-FVA may not be an accurate method of femoral varus measurement in dogs with A-FVA10 degrees), the procedure would not have been erroneously performed in any of the normal dogs of this study.

Leadership and the everyday practice of Consultant Radiographers in the UK: Transformational ideals and the generation of self-efficacy.

Science.gov (United States)

Booth, L; Henwood, S; Miller, P K

2017-05-01

This paper outlines findings from a broader, two-year project investigating the role of Consultant Radiographers (CRs) in the UK, focussing specifically on the leadership aspect of that role. Using a qualitative-thematic approach, the leadership-related experiences of a purposive sample of six participating CRs are explored, alongside the systems through which they evaluated how successful they had been as leaders. It is evidenced that many of the ways in which participants describe their own leadership practice, particularly in the intra-team domain, is consistent with the precepts of the Transformational Leadership Model. For example, they highlight how they have asserted positive influence and encouraged collective action and decision-making. However, the experiential focus of the analysis reveals that in specific examples of practice, the transformational approach was not always seen as the most useful route to a productive outcome given constrictions on time and other resources within real professional environments. More 'direct' managerial approaches were sometimes deemed necessary, and at others leadership was reduced to simply 'solving other people's problems'. It was also found that the manner in which participants evaluated their own success as leaders was a practical concern, based in part upon having satisfied 'hard' institutional goals, but also on the more personal business of having affirmatively 'surprised' oneself, or a general sense of feeling trusted by colleagues. These findings may help support CRs in the business of real leadership, not least through better understanding how even apparently mundane outcomes can have significant impacts on professional self-efficacy. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Comparison of film/screen and PCR digital lateral cervical spine radiographs

International Nuclear Information System (INIS)

Silver, D.I.; Kreipke, D.L.; Tarver, R.; Braunstein, E.M.

1988-01-01

The authors compared film/screen and Phillips computed radiography (PCR) radiographs of the cervical spine. In 109 patients. fiilm/screen and digital radiographs were compared for adequate visualization (readability) of bone, soft tissue, and trachea. The lowest cervical vertebra seen was noted in each case. The radiographs were interpreted by four radiologists, and both interobserver and intraobserver consistency were measured. Of the PCR radiographs, 97% were readable with a viewbox alone. Of the film/screen radiographs, 9% were readable with a viewbox. With a hotlight, 83% of the film/screen radiographs became readable. Bone, soft tissue, and trachea were better seen on PCR radiographs than on film/screen radiographs (P<.001). There was less interobserver variation on digital radiographs. Readability of cervical spine radiographs was significantly improved with PCR

Radiographic identification of the equine ventral conchal bulla.

Science.gov (United States)

Finnegan, C M; Townsend, N B; Barnett, T P; Barakzai, S Z

Involvement of the ventral conchal sinus (VCS) is an important diagnostic and prognostic feature in cases of the equine sinus disease. The authors aimed to ascertain if the caudo-dorsal extension of the VCS, the ventral conchal bulla (VCB) is identifiable on plain radiographs of cadaver skulls without sinus disease. Bilateral frontonasal sinus flaps were made in 10 equine cadaver skulls. Plain lateral, lateral oblique and dorso-ventral radiographs were then obtained followed by the same views taken with stainless steel wire outlining the caudal border of the VCB. Plain radiographs were randomised and blindly evaluated by two observers who marked where they believed the VCB to be positioned. This was then correlated with the true position of the VCB using radiographs with wires in place. The ease of identification of the VCB was classified as 'easy' or 'difficult'. The VCB was correctly identified in 70 per cent of lateral radiographs, but only 45 per cent of lateral oblique radiographs and 17 per cent of dorso-ventral radiographs. If a clinician was confident that he or she could identify the VCB, they were usually correct. Conversely if the clinician judged VCB identification as 'difficult', they usually identified it incorrectly. In the authors' clinical experience, the VCB of horses with sinusitis involving this compartment is more radiologically evident than in clinically normal horses. Knowledge of the normal radiographic anatomy of this structure should aid clinicians in identifying horses with sinusitis affecting the VCS.

Contribution to identification of factors causing radiographic image unsharpness

International Nuclear Information System (INIS)

Branzan, C.; Popescu, A.; Radu, R.

1995-01-01

Radiographic image quality is crucial for the ability of the radiographic method to give us a maximum information about the macroscopic structure of materials and pieces, investigated by penetrating radiation. Radiographic image quality depends on several factors. A high quality image is able to show small and typical defects. One of the most important factor affecting radiographic image is unsharpness. The total effective unsharpness of the film must be some function of several factors and their contribution is taken into account by summing up different kinds of unsharpness: geometric unsharpness, internal unsharpness, screen unsharpness, and accidental unsharpness. This work analyses the weight of the radiographic image unsharpness and the possibilities for determining its influence on the quality of the radiographic image. (author)

Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?

Science.gov (United States)

Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree

2017-05-15

Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re

The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation.

Science.gov (United States)

Romain-Glassey, Nathalie; Ninane, Françoise; de Puy, Jacqueline; Abt, Maryline; Mangin, Patrice; Morin, Diane

2014-01-01

The objectives of this article were to systematically describe and examine the novel roles and responsibilities assumed by nurses in a forensic consultation for victims of violence at a University Hospital in French-speaking Switzerland. Utilizing a case study methodology, information was collected from two main sources: (a) discussion groups with nurses and forensic pathologists and (b) a review of procedures and protocols. Following a critical content analysis, the roles and responsibilities of the forensic nurses were described and compared with the seven core competencies of advanced nursing practice as outlined by Hamric, Spross, and Hanson (2009). Advanced nursing practice competencies noted in the analysis included "direct clinical practice," "coaching and guidance," and "collaboration." The role of the nurse in terms of "consultation," "leadership," "ethics," and "research" was less evident in the analysis. New forms of nursing are indeed practiced in the forensic clinical setting, and our findings suggest that nursing practice in this domain is following the footprints of an advanced nursing practice model. Further reflections are required to determine whether the role of the forensic nurse in Switzerland should be developed as a clinical nurse specialist or that of a nurse practitioner.

A descriptive study of the radiographic density of implant restorative cements.

Science.gov (United States)

Wadhwani, Chandur; Hess, Timothy; Faber, Thomas; Piñeyro, Alfonso; Chen, Curtis S K

2010-05-01

Cementation of implant prostheses is a common practice. Excess cement in the gingival sulcus may harm the periodontal tissues. Identification of the excess cement may be possible with the use of radiographs if the cement has sufficient radiopacity. The purpose of this study was to compare the radiographic density of different cements used for implant prostheses. Eight different cements were compared: TempBond Original (TBO), TempBond NE (TBN), Fleck's (FL), Dycal (DY), RelyX Unicem (RXU), RelyX Luting (RXL), Improv (IM), and Premier Implant Cement (PIC). Specimen disks, 2 mm in thickness, were radiographed. Images were made using photostimulable phosphor (PSP) plates with standardized exposure values. The average grey level of the central area of each specimen disk was selected and measured in pixels using a software analysis program, ImageTool, providing an average grey level value representative of radiodensity for each of the 8 cements. The radiodensity was determined using the grey level values of the test materials, which were recorded and compared to a standard aluminum step wedge. An equivalent thickness of aluminum in millimeters was calculated using best straight line fit estimates. To assess contrast effects by varying the exposure settings, a second experiment using 1-mm-thick cement specimens radiographed at both 60 kVp and 70 kVp was conducted. The PSP plates with specimens were measured for a grey level value comparison to the standard aluminum step wedge, using the same software program. The highest grey level values were recorded for the zinc cements (TBO, TBN, and FL), with the 1-mm specimen detectable at both 60- and 70-kVp settings. A lower grey level was recorded for DY, indicative of a lower radiodensity compared to the zinc cements, but higher than RXL and RXU. The implant-specific cements had the lowest grey level values. IM could only be detected in 2-mm-thick sections with a lower aluminum equivalence value than the previously mentioned

A national survey of current practices of preparation and management of radical prostate radiotherapy patients during treatment

International Nuclear Information System (INIS)

Nightingale, H.; Conroy, R.; Elliott, T.; Coyle, C.; Wylie, J.P.; Choudhury, A.

2017-01-01

developing in the advent of advance practice radiographers. • Further research should be considered to establish best practice.

Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean.

Science.gov (United States)

Oldenburger, David; De Bortoli Cassiani, Silvia Helena; Bryant-Lukosius, Denise; Valaitis, Ruta Kristina; Baumann, Andrea; Pulcini, Joyce; Martin-Misener, Ruth

2017-06-08

SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

An investigation into current protocols and radiographer opinions on contrast extravasation in Irish CT departments

International Nuclear Information System (INIS)

Cleary, N.; McNulty, J.P.; Foley, S.J.; Kelly, E.

2017-01-01

Background: Iodinated contrast extravasation is a serious complication associated with intravenous administration in radiology. Departmental protocols and the radiographer's approach on both prevention techniques and treatment will affect the prevalence of extravasation, and the eventual outcome for the patient when it does occur. Aims: To examine contrast extravasation protocols in place in Irish CT departments for alignment with European Society of Urogenital Radiology (ESUR) Guidelines (2014); to establish radiographer's opinions on contrast extravasation; and to examine radiographer adherence to protocols. Methods: Contrast extravasation protocols from a purposively selected sample of CT departments across Ireland (n = 6) were compared to ESUR guidelines, followed by an online survey of CT radiographers practicing in the participating centres. Results: All participating CT departments (n = 5) had written protocols in place. High risk patients, such as elderly or unconscious, were identified in most protocols, however, children were mentioned in just one protocol and obese patients were not specified in any. The response rate of CT radiographers was 23% (n = 24). 58% (n = 14) of respondents indicated that contrast extravasation was more likely during CTA examinations. While high levels of confidence in managing extravasation were reported, suggested treatment approaches, and confidence in same, was more variable. Clinical workload in CT departments was also identified as a factor impacting on patient care and management. Conclusion: While contrast extravasation protocols were generally in line with ESUR Guidelines, high risk patients may not be getting sufficient attention. More radiographer awareness of patient monitoring needs, particularly in busy departments with a heavy workload may also reduce extravasation risk, and improve management of same. - Highlights: • Irish protocols on contrast extravasation are generally in line with

Gender Creative or Transgender Youth and Advanced Nursing Practice.

Science.gov (United States)

Kirouac, Nicole; Tan, Mabel

2017-06-01

The World Professional Association for Transgender Health (WPATH) defines gender dysphoria as "Discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)" (WPATH, 2016). Gender creative (GC) and transgender (TG) youth are at high risk for severe mental health disparities if they don't receive competent and timely gender transitioning care. Although awareness and early care of TG youth in specialty clinics is improving and increasing, there is still much effort that is required to eliminate barriers to care at many levels and thus improve outcomes. Nurses, particularly advanced practice nurses, are poised to lead the way in creating safe, inclusive, family centered spaces for TG and GC children, youth and their families as well as acting as vital mentors for other nurses. The purpose of this paper is to discuss the increasing prevalence of GC and TG youth, the significance of inclusive care for GC and TG youth, treatment guidelines, and the impact parents and advanced practice nurses can have on the journey of these youth as they explore and find their place on the gender spectrum. Copyright© of YS Medical Media ltd.

Central polydactyly of the foot: surgical management with plantar and dorsal advancement flaps.

Science.gov (United States)

Osborn, Emily J; Davids, Jon R; Leffler, Lauren C; Gibson, Thomas W; Pugh, Linda I

2014-01-01

Central polydactyly is the least common form of foot polydactyly, and the intercalary location of the duplicated ray makes the surgical exposure, excision, and closure more complex. For these reasons there is little consensus concerning the optimal technique for surgical management. A retrospective case series of 22 patients with 27 feet with central polydactyly, treated surgically by the dorsal and plantar advancement flap technique, was performed. Change in width of the forefoot was measured from radiographs by the metatarsal gap ratio. Functional outcomes were assessed by the Foot and Ankle Ability Measure. Signficant narrowing of the forefoot, as measured radiographically by the metatarsal gap ratio, was achieved after surgery (Psports, and overall function categories. The few reports of less than normal foot function were related to shoe wear issues and incisional scarring that was painful or cosmetically unappealing. The radiographic and functional outcomes after surgical management of central polydactyly with the dorsal and plantar advancement flap technique are excellent. The technique successfully narrows the forefoot on radiographs, and this narrowing is maintained with growth over time. However, families should be advised that persistent perceived widening of the forefoot relative to normal is common, despite successful radiographic narrowing after surgery. IV.

Radiographic alterations of the frontal sinus morphology according to variations of the vertical angle in posteroanterior radiographs of the skull

Directory of Open Access Journals (Sweden)

Rhonan Ferreira Silva

2014-03-01

The frontal sinuses play a highly relevant role in comparative human identification processes. Since forensic radiology is a branch in the forensic sciences, adequate radiological analysis of the frontal sinuses is essential for comparative human identifications. The current study investigates radiographic morphological changes in the frontal sinuses according to vertical angle distortions in posteroanterior (PA radiographs. A standard PA radiograph of the skull of an adult was obtained. Eight addition PA radiographs were taken at different vertical angles. Frontal sinuses were analyzed qualitatively and quantitatively according to Ribeiro´s (2000 technique. Both qualitative and quantitative analyses revealed significant image distortions. Further, overlapping anatomical structures were reported when PA radiographs were analyzed in negative angulation distortions (from -10° to -40°. Positive and negative angular distortions up to 20º slightly affected the qualitative morphological analysis. However, 10° positive and negative distortions provided a significant interference in quantitative analysis and impaired the measuring process. Most forensic techniques for the analysis of frontal sinuses comprise measurements of morphological distances. Distortions of approximately 10° or over in vertical angulation of cranial PA radiographs should be avoided so that more accurate comparative human identifications could be achieved.

Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

Energy Technology Data Exchange (ETDEWEB)

McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: collson@intrinsik.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: fenvdean@sfu.ca [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)

2015-11-15

Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

Unicystic Jaw Lesions: A Radiographic Guideline

Directory of Open Access Journals (Sweden)

Giju George

2010-01-01

Full Text Available The unilocular radiolucencies remain the topic of much interest for the clinicians and histhopathologists for decades. Adequate use of diagnostic aids and careful observation will clinically help the dentist to arrive at a proper diagnosis and renders quality treatment to patients. Despite of the development of various cross-sectional imaging modalities, the radiograph still remains as the first and most important investigation. Jaw bone lesions, especially unilocular ones, are difficult to diagnose radiologically because of their similar radiographic appearance. It is, thus, very important for the clinician to have a sound knowledge of various radiographic features of the tooth and its supporting structures.

Adult Sail Sign: Radiographic and Computed Tomographic Features

Energy Technology Data Exchange (ETDEWEB)

Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Youn, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo (Dept. of Radiology, Cheil General Hospital, Kwandong Univ. College of Medicine, Seoul (KR))

2008-02-15

Background: The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. Purpose: To investigate the sail sign appearing in adult chest radiography. Material and Methods: Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). Results: The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. Conclusion: The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging

Adult Sail Sign: Radiographic and Computed Tomographic Features

International Nuclear Information System (INIS)

Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Y oun, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo

2008-01-01

Background: The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. Purpose: To investigate the sail sign appearing in adult chest radiography. Material and Methods: Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). Results: The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. Conclusion: The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging

Adult sail sign: radiographic and computed tomographic features.

Science.gov (United States)

Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Youn, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo

2008-02-01

The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. To investigate the sail sign appearing in adult chest radiography. Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging.

The AGREE Enterprise: a decade of advancing clinical practice guidelines.

Science.gov (United States)

Makarski, Julie; Brouwers, Melissa C

2014-08-15

The original AGREE (Appraisal of Guidelines for REsearch and Evaluation) Instrument was published in 2003, and its revision, the AGREE II, in 2009. Together, they filled an important gap in the guideline and quality of care fields. Ten years later, the AGREE Enterprise reflects on a trajectory of projects and international collaboration that have contributed to advancing the science and quality of practice guidelines and the uptake of AGREE/AGREE II. The AGREE Enterprise has undertaken activities to improve the tool and to develop resources to support its use. Since 2003, the uptake and adoption of AGREE by the international community has been swift and broad. A total of 33 language translations of the original AGREE Instrument and the current AGREE II are available and were initiated by the international community. A recent scan of the published literature identified over 600 articles that referenced the AGREE tools. The AGREE tools have been widely received and applied, with several organizations having incorporated the AGREE as part of their formal practice guideline programs. Since its redevelopment in 2010, the AGREE Enterprise website (www.agreetrust.org) continues to experience steady increases in visitors per month and currently has over 10,000 registered users. The AGREE Enterprise has contributed to the advancements of guidelines through research activities and international participation by scientific and user communities. As we enter a new decade, we look forward to ongoing collaborations and contributing to further advancements to improve quality of care and health care systems.

Common pitfalls in radiographic interpretation of the Thorax

International Nuclear Information System (INIS)

Godshalk, C.P.

1994-01-01

Errors in radiographic interpretation of the thorax are common. Many mistakes result from interpreting normal anatomic variants as abnormalstructures, such as misdiagnosing dorsal and rightward deviation of the cranial thoracic trachea on lateral radiographs of normal dogs. Some of the more common errors specifically relate to misinterpretation of radiographs made on obese patients. The age of the patient also plays a role in misdiagnosis. Aging cats seem to have a horizontally positioned heart on lateral radiographs, and older dogs, primarily collies,often have pulmonary osteomas that are misdiagnosed as metastatic neoplastic disease or healed pulmonary fungal infections

Method for taking X radiographs

International Nuclear Information System (INIS)

Orth, G.

1983-01-01

The method is aimed at obtaining X radiographs of any human organ with the aid of an X-ray-shadowless radiation detector of a dose measuring device, which is arranged between patient and imaging system, and of a controlling microprocessor system, so that the image-forming parameters are automatically adjusted to the specific properties of the patient. This procedure minimices the efforts in preparing the radiograph and the radiation exposure of the patient

Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

Science.gov (United States)

Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

2015-12-01

Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

Leadership and the everyday practice of Consultant Radiographers in the UK: Transformational ideals and the generation of self-efficacy

International Nuclear Information System (INIS)

Booth, L.; Henwood, S.; Miller, P.K.

2017-01-01

Introduction: This paper outlines findings from a broader, two-year project investigating the role of Consultant Radiographers (CRs) in the UK, focussing specifically on the leadership aspect of that role. Methods: Using a qualitative-thematic approach, the leadership-related experiences of a purposive sample of six participating CRs are explored, alongside the systems through which they evaluated how successful they had been as leaders. Results: It is evidenced that many of the ways in which participants describe their own leadership practice, particularly in the intra-team domain, is consistent with the precepts of the Transformational Leadership Model. For example, they highlight how they have asserted positive influence and encouraged collective action and decision-making. However, the experiential focus of the analysis reveals that in specific examples of practice, the transformational approach was not always seen as the most useful route to a productive outcome given constrictions on time and other resources within real professional environments. More ‘direct’ managerial approaches were sometimes deemed necessary, and at others leadership was reduced to simply ‘solving other people's problems'. It was also found that the manner in which participants evaluated their own success as leaders was a practical concern, based in part upon having satisfied ‘hard’ institutional goals, but also on the more personal business of having affirmatively ‘surprised’ oneself, or a general sense of feeling trusted by colleagues. Conclusion: These findings may help support CRs in the business of real leadership, not least through better understanding how even apparently mundane outcomes can have significant impacts on professional self-efficacy. - Highlights: • CRs report a rich variety of diverse tasks emerging from their leadership roles. • The leadership role is both inward and outward facing. • Transformational leadership strategies are often

Radiographic evaluation of dentigerous cyst with cone beam CT

International Nuclear Information System (INIS)

Park, Yong Chan; Lee, Wan; Lee, Byung Do

2010-01-01

The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.

Radiographic evaluation of dentigerous cyst with cone beam CT

Energy Technology Data Exchange (ETDEWEB)

Park, Yong Chan; Lee, Wan; Lee, Byung Do [School of Dentisity, Wonkwang University, Iksan (Korea, Republic of)

2010-09-15

The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.

Relationships between rotator cuff tear types and radiographic abnormalities

Energy Technology Data Exchange (ETDEWEB)

Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying [Dept. of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

2014-11-15

To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

Relationships between rotator cuff tear types and radiographic abnormalities

International Nuclear Information System (INIS)

Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying

2014-01-01

To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

Science.gov (United States)

Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

2010-05-01

This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

Absorbed doses received by infants subjected to panoramic dental and cephalic radiographs

International Nuclear Information System (INIS)

Carrizales, L.; Carreno, S.

1998-01-01

The IAEA Report No. 115 recommends that each country or region can establish levels of absorbed doses for each radiographic technique employed in diagnostic. assuming the extended and expensive of this purpose, we have been to begin in a first step with the dentistry area, in order to estimate the dose levels received at crystalline and thyroid level in infants that go to an important public institution in our country to realize panoramic and cephalic radiographs. This work will serve to justify and impel a quality assurance program in Venezuela on the dentistry area which includes aspects such as training for the medical lap referring the justification of the radiological practice, optimization of X-ray units to produce an adequate image quality that delivers to patient an absorbed dose as much lower as reasonably it can be reached without diagnostic detriment. (Author)

Blending work-integrated learning with distance education in an Australian radiation therapy advanced practice curriculum

International Nuclear Information System (INIS)

Matthews, Kristie; Wright, Caroline; Osborne, Catherine

2014-01-01

Advanced practice for radiation therapists has been a part of the international landscape for several years; however formal implementation into the Australian health care system is yet to happen. Despite this, three short course radiation therapy advanced practitioner programs have been established by an Australian tertiary institution in response to clinical service needs at several organisations. This paper describes the rationale for curriculum design and development of the program materials, the small-scale implementation of the programs at pilot sites, and the evolution of the curriculum to be available to registered radiation therapists nationally. Each program has been designed around a specific clinical role, where flexibility of delivery to busy practitioners was central to the decision to offer them via distance education. The curriculum comprises theoretical units of study which run in parallel to and underpin clinical practice units, where advanced competence in the specific area of practice is overseen by an experienced radiation oncologist mentor. Given the nature of the disparate clinical services requiring an advanced radiation therapy practitioner, the workplace learning component of the course is individually negotiated at a local level. Outcomes suggest that the flexible clinically based training underpinned by a distance education academic curriculum is able to support the development of advanced radiation therapy practitioners responsive to local service need, and ultimately may improve the patient experience