How to find the right balance
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Abstract—A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients
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Introduction: The Netherlands does not have a national guideline for performing radiographic examinations on pregnant patients. Radiographic examination is a generic term for all examinations performed using ionizing radiation, including but not limited to radiographs, fluoroscopy and computed tomography. A pilot study amongst radiographers (Medical Radiation Technologists (MRTs)) showed that standardized practice of radiographic examinations on pregnant women is not evident between Radiology departments and that there is a need for a national guideline as the varying practice methods may lead to confusion and uncertainty amongst both patients and MRTs. Methods: Focus groups consisting of MRTs from several Radiology departments within the Netherlands were used to map ideas and requirements as to what should be included in the national guideline. Nine focus group sessions were organized with a total of 52 participants. Using a previous review (Wit, Fleur; Vroonland, Colinda; Bijwaard H. Pre-natal X-ray exposure and the risk of developing paediatric cancer; a systematic review of risk factors and a comparison of international guidelines. Health Physics 2021; 121 (3):225e233), the following key points were chosen as discussion topics for the focus group sessions: dose reduction, confirming pregnancy and risk communication. Results: Results showed that the participating MRTs did not agree on the use of lead aprons. That the national guideline should include standardized methods to adjust parameters to decrease radiation dose. Focus group participants find it difficult to ask a patient's pregnancy status, especially when dealing with relatively young and old (er) patients. When communicating the level of risk associated with a radiographic examination the participating MRTs would like to be able to use examples and comparisons, preferably by means of a multilingual website. Conclusion: A national guideline must include information on justification, available alternatives, dose reductions methods and confirmation of pregnancy requirements when fetal dose is a significant risk. Implications for practice: A national guideline ensures standardized practice can be implemented in Radiology departments, increasing clarity of the issues for both patients and MRTs.
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Introduction: Zygomatic fractures can be diagnosed with either computed tomography (CT) or direct digital radiography (DR). The aim of the present study was to assess the effect of CT dose reduction on the preference for facial CT versus DR for accurate diagnosis of isolated zygomatic fractures. Materials and methods: Eight zygomatic fractures were inflicted on four human cadavers with a free fall impactor technique. The cadavers were scanned using eight CT protocols, which were identical except for a systematic decrease in radiation dose per protocol, and one DR protocol. Single axial CT images were displayed alongside a DR image of the same fracture creating a total of 64 dual images for comparison. A total of 54 observers, including radiologists, radiographers and oral and maxillofacial surgeons, made a forced choice for either CT or DR. Results: Forty out of 54 observers (74%) preferred CT over DR (all with P < 0.05). Preference for CT was maintained even when radiation dose reduced from 147.4 mSv to 46.4 mSv (DR dose was 6.9 mSv). Only a single out of all raters preferred DR (P ¼ 0.0003). The remaining 13 observers had no significant preference. Conclusion: This study demonstrates that preference for axial CT over DR is not affected by substantial (~70%) CT dose reduction for the assessment of zygomatico-orbital fractures.
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The value which research brings to health and wellbeing is unquestioned. Without it, progress in diagnosis, treatment and care would probably cease and the service offered to patients and clients would deteriorate. Engaging student radiographers, and radiographers who are early in their careers, with the research agenda is important as it is this group of people particularly who could go on to make meaningful career-long contributions to the radiographic knowledge base and clinical practice advancements. The radiography profession continues to suffer from a lack of engagement in research and because of this, in 2012, a multi-national collaboration was established to create a residential summer school in order to provide a real research experience to inspire participants to value research and/or carry out research as part of their career. The summer school is called OPTIMAX and it is primarily aimed at BSc student radiographers. MSc students and newly qualified radiographers are welcome to participate; also, university tutors are also welcome too as they can gain greatly from it. For doctoral (e.g. PhD) qualified radiographers, attending OPTIMAX could be a good steppingstone in a post-doctoral career as it offers a good experience in team working in research. It is worth remembering that a doctoral qualification is solely intended to develop research abilities and the research career should start on the day the doctoral qualification is acquired. Sadly, for many individuals within radiography, the day the doctoral qualification is attained is the day research stops. OPTIMAX therefore offers an opportunity to a wide range of people, to inspire and help them gain skills, confidence and insight into how research can be conducted in teams and disseminated for the benefit of others.
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De zorgsector wordt in toenemende mate geconfronteerd met uitdagingen als gevolg van groeiende vraag (o.a. door vergrijzing en complexiteit van zorg) en afnemend aanbod van zorgverleners (o.a. door personeelstekorten). Kunstmatige Intelligentie (AI) wordt als mogelijke oplossing gezien, maar wordt vaak vanuit een technologisch perspectief benaderd. Dit artikel kiest een mensgerichte benadering en bestudeert hoe zorgmedewerkers het werken met AI ervaren. Dit is belangrijk omdat zij uiteindelijk met deze applicaties moeten werken om de uitdagingen in de zorg het hoofd te bieden. Op basis van 21 semigestructureerde interviews met zorgmedewerkers die AI hebben gebruikt, beschrijven we de werkervaringen met AI. Met behulp van het AMO-raamwerk - wat staat voor abilities, motivation en opportunities - laten we zien dat AI een impact heeft op het werk van zorgmedewerkers. Het gebruik van AI vereist nieuwe competenties en de overtuiging dat AI de zorg kan verbeteren. Daarbij is er een noodzaak voor voldoende beschikbaarheid van training en ondersteuning. Tenslotte bediscussiëren we de implicaties voor theorie en geven we aanbevelingen voor HR-professionals.
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Abstract Background: Many countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively. It has, therefore, become increasingly important to take one's insurance into account when choosing a provider. There is little evidence that patients make active choices in the way that policymakers assume they do. This research aims to investigate, firstly, the role of patients in choosing a healthcare provider at the point of referral, then the role of the GP and, finally, the influence of the health insurer/insurance policies within this process. Methods: We videotaped a series of everyday consultations between Dutch GPs and their patients during 2015 and 2016. In 117 of these consultations, with 28 GPs, the patient was referred to another healthcare provider. These consultations were coded by three observers using an observation protocol which assessed the role of the patient, GP, and the influence of the health insurer during the referral. Results: Patients were divided into three groups: patients with little or no input, patients with some input, and those with a lot of input. Just over half of the patients (56%) seemed to have some, or a lot of, input into the choice of a healthcare provider at the point of referral by their GP. In addition, in almost half of the consultations (47%), GPs inquired about their patients' preferences regarding a healthcare provider. Topics regarding the health insurance or insurance policy of a patient were rarely (14%) discussed at the point of referral. Conclusions: Just over half of the patients appear to have some, or a lot of, input into their choice of a healthcare provider at the point of referral by their GP. However, the remainder of the patients had little or no input. If more patient choice continues to be an important aim for policy makers, patients should be encouraged to actively choose the healthcare provider who best fits their needs and preferences.
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Ingezonden artikel in MEMO RAD: dit artikel is een samenvatting van afstudeeronderzoek dat de eerste auteur heeft uitgevoerd ter afronding van de bachelor opleiding Medisch Beeldvorming en Radiotherapeutische Technieken aan de hogeschool Inholland.
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Muziek kan een drager zijn van herinneringen en emoties. In onze jeugd en vroege volwassenheid ontwikkelen we onze persoonlijke muzieksmaak. Voor mensen met dementie, meestal 80-plussers, is dat ruim zestig jaar geleden. Voor hen is er nu een online muziekstation dat muziek uit die periode draait: Radio Remember.
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In de loop van het leven wordt muziek voor de meeste mensen een drager van herinneringen en emoties. In de jeugd en vroege volwassenheid ontwikkelen we onze persoonlijke muzieksmaak. De muziek uit die tijd blijft ons het beste bij. Voor mensen met dementie, meestal 80 plussers, is dat ruim zestig jaar geleden. Daarom maakten de lectoraten Psychogeriatrie en Informatie, Technologie en Samenleving, in samenwerking met muziektherapeut Machgiel Bakker, een online muziekstation dat muziek uit die periode draait: Radio Remember. Een station om naar te luisteren, maar ook om in te zetten als psychosociale interventie om de kwaliteit van leven van mensen met dementie te verbeteren. In dit artikel wordt verslag gedaan van de eerste ervaringen en worden de volgende stappen van het project beschreven.
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