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Sample records for nuclear medicine residency

  1. Career prospects for graduating nuclear medicine residents: survey of nuclear medicine program directors.

    PubMed

    Harolds, Jay A; Guiberteau, Milton J; Metter, Darlene F; Oates, M Elizabeth

    2013-08-01

    There has been much consternation in the nuclear medicine (NM) community in recent years regarding the difficulty many NM graduates experience in securing initial employment. A survey designed to determine the extent and root causes behind the paucity of career opportunities was sent to all 2010-2011 NM residency program directors. The results of that survey and its implications for NM trainees and the profession are presented and discussed in this article. PMID:23763875

  2. Nuclear Medicine

    MedlinePlus

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  3. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  4. Handbooks in radiology: Nuclear medicine

    SciTech Connect

    Datz, F.L.

    1988-01-01

    This series of handbooks covers the basic facts, major concepts and highlights in seven radiological subspecialties. ''Nuclear Medicine'' is a review of the principles, procedures and clinical applications that every radiology resident and practicing general radiologist should know about nuclear medicine. Presented in an outline format it covers all of the organ systems that are imaged by nuclear medicine.

  5. Nuclear medicine

    SciTech Connect

    Wagner, H.N. Jr.

    1986-10-17

    In 1985 and 1986 nuclear medicine became more and more oriented toward in vov chemistry, chiefly as a result of advances in positron emission tomography (PET). The most important trend was the extension of PET technology into the care of patients with brain tumors, epilepsy, and heart disease. A second trend was the increasing use of single-photon emission computed tomography (SPECT).

  6. Implementation of an Integrative Medicine Curriculum for Preventive Medicine Residents.

    PubMed

    Chiaramonte, Delia R; D'Adamo, Christopher; Amr, Sania

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents. PMID:26477900

  7. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  8. Interprofessional Integrative Medicine Training for Preventive Medicine Residents.

    PubMed

    Cowen, Virginia S; Thomas, Pauline A; Gould-Fogerite, Susan E; Passannante, Marian R; Mahon, Gwendolyn M

    2015-11-01

    Integrative medicine training was incorporated into the Rutgers New Jersey Medical School Preventive Medicine residency at the Rutgers Biomedical and Health Sciences Newark Campus as a collaboration between the Rutgers New Jersey Medical School and the School of Health Related Professions. Beginning in 2012, an interdisciplinary faculty team organized an Integrative Medicine program in a Preventive Medicine residency that leveraged existing resources across Rutgers Biomedical and Health Sciences. The overarching aim of the programs was to introduce residents and faculty to the scope and practice of integrative medicine in the surrounding Newark community and explore evidence-based research on integrative medicine. The faculty team tapped into an interprofessional network of healthcare providers to organize rotations for the preventive medicine residents that reflected the unique nature of integrative medicine in the greater Newark area. Residents provided direct care as part of interdisciplinary teams at clinical affiliates and shadowed health professionals from diverse disciplines as they filled different roles in providing patient care. The residents also participated in research projects. A combination of formal and informal programs on integrative medicine topics was offered to residents and faculty. The Integrative Medicine program, which ran from 2013 through 2014, was successful in exposing residents and faculty to the unique nature of integrative medicine across professions in the community served by Rutgers Biomedical and Health Sciences. PMID:26477901

  9. Selecting Residents in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David

    2015-01-01

    Limited information exists to guide students of podiatric medicine and residency directors through the resident selection process. The present study aimed to evaluate the podiatric medicine and surgery resident selection process using an online survey. Residency directors of podiatric medicine and surgery programs across the United States and fourth-year students across all 9 colleges of podiatric medicine were contacted for participation. Two separate surveys were created, one for the directors and one for the students. The directors and students were asked the relative importance of 21 items considered in resident selection on a 7-point importance scale. Subsequent questions covered an array of related topics. The directors, compared with the students, identified the following items as more important (p < .05): previous disciplinary actions against the student, number of classes failed during school, undergraduate experiences and activities, number of Part I board attempts, class rank, involvement in research, and grade point average during podiatric medical school. The manual dexterity portion of the residency interview was considered significantly more important by the students than the directors. The directors more satisfied with their residents placed greater importance on the following items (p < .05): opinions of current residents, opinions of other attending physicians, and letters of recommendation. Additional trends and differences were also discovered. The results of the present study provide baseline data on the selection of podiatric medicine and surgery residents. PMID:25459090

  10. Nuclear medicine annual, 1984

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1984-01-01

    The following topics are reviewed in this work: nuclear physicians role in planning for and handling radiation accidents; the role of nuclear medicine in evaluating the hypertensive patient; studies of the heart with radionuclides; role of radionuclide imaging in the patient undergoing chemotherapy; hematologic nuclear medicine; the role of nuclear medicine in sports related injuries; radionuclide evaluation of hepatic function with emphasis on cholestatis.

  11. Public Health Education for Emergency Medicine Residents

    PubMed Central

    Betz, Marian E.; Bernstein, Steven L.; Gutman, Deborah; Tibbles, Carrie D.; Joyce, Nina; Lipton, Robert; Schweigler, Lisa; Fisher, Jonathan

    2015-01-01

    Emergency medicine (EM) has an important role in public health, but the ideal approach for teaching public health to EM residents is unclear. As part of the national regional public health–medicine education centers-graduate medical education (RPHMEC-GM) initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create public health curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine public health and EM clinical topics during usual residency didactics, one partnered with local public health organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health–oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward public health, and a majority of EM residents at that program believed public health training is important. Reliance on pre-existing community partnerships facilitated development of public health rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for public health education for EM residents has not been defined. PMID:21961671

  12. Public health education for emergency medicine residents.

    PubMed

    Betz, Marian E; Bernstein, Steven L; Gutman, Deborah C; Tibbles, Carrie D; Joyce, Nina R; Lipton, Robert I; Schweigler, Lisa M; Fisher, Jonathan

    2011-10-01

    Emergency medicine (EM) has an important role in public health, but the ideal approach for teaching public health to EM residents is unclear. As part of the national Regional Public Health-Medicine Education Centers-Graduate Medical Education initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create public health curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine public health and EM clinical topics during usual residency didactics, one partnered with local public health organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health-oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward public health, and a majority of EM residents at that program believed public health training is important. Reliance on pre-existing community partnerships facilitated development of public health rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for public health education for EM residents has not been defined. PMID:21961671

  13. Clinical nuclear medicine. [Handbook

    SciTech Connect

    Matin, P.

    1981-01-01

    ''Clinical Nuclear Medicine'' is an update to the author's ''Handbook of Clinical Nuclear Medicine.'' Sections on placental imaging, bone marrow imaging, biliary tract imaging and scintigraphy are included in the volume. (JMT)

  14. Educational contracts in family medicine residency training.

    PubMed Central

    Mahood, S.; Rojas, R.; Andres, D.; Zagozeski, C.; White, G.; Bradel, T.

    1994-01-01

    An educational contract for family medicine residency training and evaluation addresses many of the difficulties and challenges of current postgraduate medical education. This article identifies important principles for developing a contractual approach; describes the contract used in one program and its implementation; and discusses its theory, advantages, and limitations. Images p550-a PMID:8199512

  15. Access to palliative medicine training for Canadian family medicine residents.

    PubMed

    Oneschuk, D; Bruera, E

    1998-01-01

    The authors conducted a nine-item mail questionnaire of the 16 Canadian family medicine teaching programme directors to determine the accessibility and operation of palliative care education for their respective family medicine residents. All 16 faculties of medicine responded (100%). The survey revealed that while all universities offer elective time in palliative care only five out of 16 (31%) have a mandatory rotation. The median durations of the mandatory and elective rotations are limited to two and three-and-a-half weeks, respectively. The majority of the universities offer formal lectures in palliative care (12/16, 75%) and educational reading material (13/16, 81%), with the main format in 14/16 (87%) of the sites being case-based learning. The two most common sites for teaching to occur for the residents are the community/outpatient environment and an acute palliative care unit. Fifty-six per cent (9/16) of the universities have designated faculty positions for palliative medicine with a median number of two positions per site. Only one centre offers a specific palliative medicine examination during the rotation. Feedback from the residents regarding their respective palliative medicine programmes were positive overall. Findings from our survey indicate an ongoing need for improved education in palliative medicine at the postgraduate level. PMID:9616456

  16. Do Family Medicine Residents and Their Teachers Have Common Goals?

    ERIC Educational Resources Information Center

    London, Richard L.; Green, Larry A.

    1977-01-01

    Opinions were obtained from residents, family medicine faculty, and attending physicians familiar with an established family medicine residency program regarding the tasks that family doctors should and should not perform. (LBH)

  17. Personal health care of internal medicine residents

    PubMed Central

    Palabindala, Venkataraman; Foster, Paul; Kanduri, Swetha; Doppalapudi, Avanthi; Pamarthy, Amaleswari; Kovvuru, Karthik

    2012-01-01

    Introduction Medical residents, as part of their job to balance the demands of their work with caring for themselves so as to be mentally, emotionally, and physically sound to stay clinically competent. While regulatory and legislative attempts at limiting medical resident work hours have materialized but have yet to attain passage, there are fairly little data looking into how residents cope up with their demands and yet attend to their own personal health. Design Anonymous mailed survey. Subjects Three hundred and thirty-seven residents from all internal medicine residency programs within United States. Methods We conducted a survey in the form of a questionnaire that was sent by e-mail to the program directors of various internal medicine residency programs within the United States, and responses were collected between May 19 and June 21, 2009. Response was well appreciated with total number of participants of 337 with even demographical distribution in gender, residency year, AMG/IMG, age group. Seventy-one percent of the residents felt that they would prefer getting admitted to their own hospital for any acute medical or surgical condition. Of the 216 residents who have had received health care in the past, almost half of them chose their own hospital because of the proximity, while 45% did not choose their own hospital despite proximity. Two out of three residents missed their doctors appointments or cancelled them due to demands of medical training. Only half of the residents have a primary care physician and almost 80% of them did not have their yearly health checkup. Close to 30% held back information regarding their social and sexual history from their provider because of privacy and confidentiality concerns. Eighty percent of residents never received information about barriers that physicians may face in obtaining care for their socially embarrassing conditions. Seventy percent felt that their performance then was suboptimal because of that health

  18. Your Radiologist Explains Nuclear Medicine

    MedlinePlus Videos and Cool Tools

    ... by: Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

  19. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  20. Nuclear Medicine Annual, 1989

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1989-01-01

    Among the highlights of Nuclear Medicine Annual, 1989 are a status report on the thyroid scan in clinical practice, a review of functional and structural brain imaging in dementia, an update on radionuclide renal imaging in children, and an article outlining a quality assurance program for SPECT instrumentation. Also included are discussions on current concepts in osseous sports and stress injury scintigraphy and on correlative magnetic resonance and radionuclide imaging of bone. Other contributors assess the role of nuclear medicine in clinical decision making and examine medicolegal and regulatory aspects of nuclear medicine.

  1. Atlas of nuclear medicine

    SciTech Connect

    Van Nostrand, D. ); Baum, S. )

    1988-01-01

    This book contains the proceeding on the atlas of nuclear medicine. Topics covered include: Radionuclide esophageal transit studies, Iodine-131 neck and chest scintigraphy, Indium-111 white blood cell imaging, and Pediatric radionuclide lymphography.

  2. What Is Nuclear Medicine?

    MedlinePlus

    ... known as cosmic radiation, is in the upper atmosphere due to solar and galactic emissions. A typical ... used in medical procedures. 4 Cosmic Radiation Sun - - + - Atmosphere - + +- + + Earth How many nuclear medicine procedures are performed ...

  3. Emergency Medicine Resident Perceptions of Medical Professionalism

    PubMed Central

    Jauregui, Joshua; Gatewood, Medley O.; Ilgen, Jonathan S.; Schaninger, Caitlin; Strote, Jared

    2016-01-01

    Introduction Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05). Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05). Conclusion Residents perceive differences in the relative

  4. Feedback from Chief Residents about Proposed Revisions of the Special Requirements for Internal Medicine Residencies.

    ERIC Educational Resources Information Center

    Reynolds, P. Preston; And Others

    1995-01-01

    A survey of 272 medical school chief residents concerning proposed revisions of internal medicine residency requirements found the most strongly supported changes were: enhanced training in interviewing, interpersonal, and physical examination skills; increased emphasis on residency as an educational experience and on general internal medicine in…

  5. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  6. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    PubMed

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs. PMID:26477906

  7. Morning Report in Family Medicine Residency Programs: A Descriptive Study.

    ERIC Educational Resources Information Center

    Kuncharapu, Indumathi; Cass, Alvah R.; Carlson, Carol A.; Scott, Jack R.

    Morning Report (MR) is a frequently held case conference in most Family Medicine (FM) residency programs among medical learners who discuss recent inpatient admissions before the day's care of patients. This study conducted a national survey of FM residency program directors to describe the roles of faculty and residents in facilitating MR.…

  8. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training.

    PubMed

    Nawaz, Haq; Via, Christina M; Ali, Ather; Rosenberger, Lisa D

    2015-11-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents' attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  9. Satisfaction and Difficulties of Korean Family Medicine Resident Training Faculty

    PubMed Central

    Kim, Jung-Ha; Kim, Ju Young; Kwon, Kil Young; Lee, Chul-Min; Hyun, Seung Soo

    2013-01-01

    Background Practitioners of family medicine are essential to primary care practices in Korea. Resident training staffs in Korean family medicine departments have a crucial role in producing well-trained family physicians. This study assesses the aspects of satisfaction and difficulties of Korean family medicine resident training staffs. Methods We surveyed the resident training staffs of various Korean family medicine departments using an online survey tool. The survey used in this study was modified from previously used questionnaires. Respondents rated items using a five-point Likert scale and a 0-10 visual analogue scale. Results The response rate was 43.9% (122/278). The mean satisfaction score with regard to current family medicine residency programs was 7.59 out of 10. Resident training staffs found the administrative aspects of their role to be the most difficult. There were considerable differences in the reported difficulties of resident training according to the differing characteristics of each staff member, including age, sex, type of hospital, number of staff members, role as chief, and duration of staff. Most respondents (91.9%) cited a need for faculty development programs. Conclusion Korean family medicine resident training staffs need faculty development programs for the improvement of resident training. For the strengthening of core competencies among resident training staffs, faculty development programs or courses should be designed and implemented in Korea. PMID:24106588

  10. Pediatric nuclear medicine

    SciTech Connect

    Treves, S.T.

    1985-01-01

    This book discusses the diagnostic techniques of nuclear medicine as applied in pediatric patients. Particular emphasis is placed on the subject of scintigraphy of organ systems for diagnostic purposes. The topics covered are: scintigraphy of skeleton, bone marrow spleen, liver, thyroid, lungs, urinary tract, brain, heart and cerebrospinal fluid. The pathology and scintigraphy of lacrimal glands is also covered. Other diagnostic techniques of radiology in pediatrics are also briefly discussed for comparative evaluation.

  11. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    PubMed Central

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2016-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  12. Nuclear medicine in Vietnam.

    PubMed

    Freeman, L M

    1996-12-01

    Despite the presence of many bright Vietnamese nuclear medicine physicians and scientists, the level of clinical practice languishes seriously behind that of Europe, the United States, Japan and most other parts of the world. This is directly attributable to the country's severe poverty, which places serious constraints on the number of available pieces of functioning imaging equipment, the ability to service equipment and establish appropriate quality assurance and preventative maintenance programs and the ability to purchase adequate radiopharmaceuticals to serve their patients' needs. At this time, the Vietnamese nuclear medicine community is anxious to enhance its contact with colleagues throughout the world. They need and welcome help in obtaining instrumentation, in vivo and in vitro diagnostic kits and educational aids from outside agencies, commercial countries and medical centers that are able to assist them. They would be most appreciative to receive and encourage visits from professional colleagues who would be able to provide lectures, seminars, books, journals and other teaching tools that would contribute to the upgrading of their clinical practice of nuclear medicine. PMID:8929319

  13. Nuclear medicine in oncology

    SciTech Connect

    Murphy, J.

    1996-12-31

    Radioactivity was discovered in the late 1890s, and as early as 1903, Alexander Graham Bell advocated that radioactivity be used to treat tumors. In 1913, the first paper describing therapeutic uses of radium was published; in 1936, {sup 24}Na was administered as a therapy to a leukemia patient. Three years later, uptake of {sup 89}Sr was noted in bone metastases. During the 1940s, there was increasing use of iodine therapy for thyroid diseases, including thyroid cancer. Diagnostic {open_quotes}imaging{close_quotes} with radioisotopes was increasingly employed in the 1930s and 40s using probes and grew in importance and utility with the development of scintillation detectors with photorecording systems. Although coincidence counting to detect positron emissions was developed in 1953, the first medical center cyclotron was not installed until 1961. The 1960s saw the development of {sup 99m}Tc-labeled radiopharmaceuticals, emission reconstruction tomography [giving rise to single photon emission computed tomography (SPECT) and positron emission tomography (PET)], and {sup 64}Ga tumor imaging. Nuclear medicine was recognized as a medical specialty in 1971. Radiolabeled antibodies targeting human tumors in animals was reported in 1973; antibody tumor imaging in humans was reported in 1978. Technology has continued to advance, including the development of SPECT cameras with coincidence detection able to perform FDG/PET imaging. With this overview as as backdrop, this paper focuses on the role of nuclear medicine in oncology from three perspectives: nonspecific tumor imaging agents, specific tumor imaging agents, and radioisotopes for tumor therapy. In summary, while tumor diagnosis and treatment were among the first uses explored for radioactivity, these areas have yet to reach their full potential. Development of new radioisotopes and new radiopharmaceuticals, coupled with improvements in technology, make nuclear oncology an area of growth for nuclear medicine.

  14. Frontiers in nuclear medicine symposium: Nuclear medicine & molecular biology

    SciTech Connect

    1995-04-01

    This document contains the abstracts from the American College of Nuclear Physicians 1993 Fall Meeting entitled, `Frontiers in Nuclear Medicine Symposium: Nuclear Medicine and Molecular Biology`. This meeting was sponsored by the US DOE, Office of Health and Environmental Research, Office of Energy Research. The program chairman was Richard C. Reba, M.D.

  15. Resident Research and Scholarly Activity in Internal Medicine Residency Training Programs

    PubMed Central

    Levine, Rachel B; Hebert, Randy S; Wright, Scott M

    2005-01-01

    OBJECTIVES 1) To describe how internal medicine residency programs fulfill the Accreditation Council for Graduate Medical Education (ACGME) scholarly activity training requirement including the current context of resident scholarly work, and 2) to compare findings between university and nonuniversity programs. DESIGN Cross-sectional mailed survey. SETTING ACGME-accredited internal medicine residency programs. PARTICIPANTS Internal medicine residency program directors. MEASUREMENTS Data were collected on 1) interpretation of the scholarly activity requirement, 2) support for resident scholarship, 3) scholarly activities of residents, 4) attitudes toward resident research, and 5) program characteristics. University and nonuniversity programs were compared. MAIN RESULTS The response rate was 78%. Most residents completed a topic review with presentation (median, 100%) to fulfill the requirement. Residents at nonuniversity programs were more likely to complete case reports (median, 40% vs 25%; P =.04) and present at local or regional meetings (median, 25% vs 20%; P =.01), and were just as likely to conduct hypothesis-driven research (median, 20% vs 20%; P =.75) and present nationally (median, 10% vs 5%; P =.10) as residents at university programs. Nonuniversity programs were more likely to report lack of faculty mentors (61% vs 31%; P <.001) and resident interest (55% vs 40%; P =.01) as major barriers to resident scholarship. Programs support resident scholarship through research curricula (47%), funding (46%), and protected time (32%). CONCLUSIONS Internal medicine residents complete a variety of projects to fulfill the scholarly activity requirement. Nonuniversity programs are doing as much as university programs in meeting the requirement and supporting resident scholarship despite reporting significant barriers. PMID:15836549

  16. Nuclear medicine annual

    SciTech Connect

    Freeman, L.M.

    1988-01-01

    This book features a state-of-the-art report on single photon emission computed tomography (SPECT) in abdominal imaging, which highlights the emergency of /sup 99m/Tc-red cell imaging as the procedure of choice for diagnosing heptatic hemangioma. In addition, the use of captropril scinitigraphy in the study of suspected renovascular hypertension is reviewed. Articles survey research on radiolabeled monoclonal antibodies and assess the clinical experience with bone scanning for osseous metastases from breast carcinoma. An article on the role of nuclear medicine in the management of osteoporosis examines the problems that must be overcome before the bone mineral analysis with dual photon absorptiometry gains widespread clinical acceptance.

  17. Family medicine residency training and burnout: a qualitative study

    PubMed Central

    Rutherford, Kimberly; Oda, Joanna

    2014-01-01

    Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

  18. Screening for Cancer by Residents in an Internal Medicine Program.

    ERIC Educational Resources Information Center

    Lynch, Garrett R.; Prout, Marianne N.

    1986-01-01

    A study of cancer screening by internal medicine residents in an inner-city clinic revealed that screening was more frequent for male patients, and breast examinations and Pap smears were performed on less than a third of female patients, suggesting a need for more intensive early-detection education of residents. (MSE)

  19. Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

    ERIC Educational Resources Information Center

    Jones, Roger; Panda, Mukta; Desbiens, Norman

    2008-01-01

    Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

  20. Nuclear medicine annual 1990

    SciTech Connect

    Freeman, L.M. )

    1990-01-01

    Two of the major areas of cutting-edge nuclear medicine research, single-photon emission computed tomography (SPECT) functional brain imaging and monoclonal antibody studies receive attention in this volume. Advances in these areas are critical to the continued growth of our specialty. Fortunately, the current outlook in both areas remains quite optimistic. As has been the policy in the first decade of publication, thorough state-of-the-art reviews on existing procedures are interspersed with chapters dealing with research developments. The editor wishes to express a particular note of appreciation to a very supportive British colleague, Dr. Ignac Fogelman, who is becoming a regular contributor. His exhaustive review of the role of nuclear medicine in the evaluation of osteoporotic patients is packed with extremely useful information that will prove to be fruitful to all readers. The author would like to thank the readers and colleagues who have taken the time to offer useful and constructive comments over the past ten years. The author continue to welcome suggestions that will help to further improve this Annual.

  1. [Skeletal nuclear medicine].

    PubMed

    Yamamoto, I

    1995-05-01

    Bone scintigraphy with 99mTc-phosphate compounds is the most popular examination in clinical nuclear medicine. This was developed more than 20 years ago and its roles in various skeletal disorders are well established. Furthermore, improvement of imaging apparatus and application of SPECT strengthened its value extensively. From scintigram alone, in many cases, differentiation between bone metastasis and other "benign" disorders is easily capable. Further improvement in resolution of scinticamera should strengthen its value more. Other recent developments in skeletal nuclear medicine are those in bone densitometry and in measurement of metabolic bone markers. Bone densitometry using DXA is applied on diagnosis and monitoring of therapeutic effects in various metabolic bone diseases, especially, in osteoporosis. Bone mass measurement combined with assessments of specific bone markers such as bone specific alkaline phosphatase and collagen cross-link metabolites might replace the bone biopsy in evaluating bone metabolism. Treatment of bone metastasis in patients with prostate cancer by administering radiolabeled bone seeking substances is another topics in this field and awaits for more extensive clinical evaluation. PMID:7596073

  2. The Teaching of Liberal Arts in Internal Medicine Residency Training.

    ERIC Educational Resources Information Center

    Povar, Gail J.; Keith, Karla J.

    1984-01-01

    A survey on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine is discussed. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. (Author/MLW)

  3. Hands-On Sports Medicine Training for Residents.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1989-01-01

    Describes the development of a hands-on sports medicine training program for residents at the University of California, Davis, Medical Center. Education strategies include clinical teaching, on-the-field education, experiential learning, and didactic instruction. Programs focusing exclusively on sports medicine are needed because the number of…

  4. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  5. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    ERIC Educational Resources Information Center

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  6. Implementing a global integrative rehabilitation medicine rotation: a physical medicine and rehabilitation residency program's experience.

    PubMed

    Kosasih, Judith B; Jurisic, Daniela H; Gandini, Cristiano; Sauter, Carley N; Braza, Diane W

    2013-06-01

    An innovative international rotation in integrative rehabilitation medicine was implemented as part of the physical medicine and rehabilitation residency program at the Medical College of Wisconsin. Rotation objectives were to introduce medical knowledge of integrative medicine treatments into physical medicine and rehabilitation practice and to initiate collaboration with international academic partners. Residents were approved based on their academic record, completion of prerequisites, and personal statement. During a 4-wk rotation located in Italy, residents developed an integrative treatment strategy for each patient using conventional medical care and other therapeutic options, including acupuncture, biofeedback, aquatic therapy, yoga, and others. Postrotation assessment included evaluations by Italian team and patients, residents' evidence-based presentations, and postrotation self-reflection. Participating residents reported high achievement in clinical performance, improved application of integrative medicine, broader appreciation of cultural diversity in patient care, and increased personal and professional development. This reciprocal program model serves as an example for other programs interested in implementing similar international rotations. PMID:23291603

  7. Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

    PubMed Central

    Nawaz, Haq; Petraro, Paul V.; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M.

    2016-01-01

    Background The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. Results A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Conclusion Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits. PMID:27507540

  8. Teaching skills improvement programmes in US internal medicine residencies.

    PubMed

    Bing-You, R G; Tooker, J

    1993-05-01

    The prevalence and nature of resident teaching skills improvement programmes (TSIP) are unknown. Although residents perceive themselves as important teachers of students, there is little information on how programme directors (PDs) view residents as teachers. A comprehensive questionnaire was sent to all 428 US internal medicine PDs in December 1990, of which 60% (n = 259) responded. Of the 259 responding programmes, only 20% (n = 51) had TSIPs. Characteristics of TSIPs were not uniform. Mean instructional time was 9 hours (range, 1-24 hours). The teacher most frequently utilized to develop and facilitate the TSIP was the PD. PDs from residencies with a TSIP indicated more strongly than PDs without a TSIP that residents contributed to students' learning. Fifty-one per cent of TSIPs required residents to attend. Evaluation/feedback as a teaching method was the most common topic covered in TSIPs. Long-term assessment of teaching skills after programme participation was done in 15% of TSIPs. Although PDs value the resident's role as teacher, current TSIPs in internal medicine residencies are few in number and lack standardization. PDs' attitudes probably influence whether residents are taught teaching skills and whether teaching skills are evaluated. Further investigation of appropriate curriculum for TSIPs and assessment of long-term effectiveness of TSIPs are needed. PMID:8336577

  9. Development of a novel sports medicine rotation for emergency medicine residents.

    PubMed

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

  10. Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians

    PubMed Central

    Olson, Shawn M.; Odo, Nnaemeka U.; Duran, Alisa M.; Pereira, Anne G.; Mandel, Jeffrey H.

    2014-01-01

    Background Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified. Objective To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians. Methods A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire. Results Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99). Conclusions Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted. PMID:26140116

  11. Obstetrics anyone? How family medicine residents' interests changed.

    PubMed Central

    Ruderman, J.; Holzapfel, S. G.; Carroll, J. C.; Cummings, S.

    1999-01-01

    OBJECTIVE: To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs. DESIGN: Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis. SETTING: Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS: Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES: Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires. RESULTS: Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS: Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice. PMID:10099803

  12. Development of a novel sports medicine rotation for emergency medicine residents

    PubMed Central

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students’ and residents’ musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their

  13. Impact of pharmaceutical company representatives on internal medicine residency programs. A survey of residency program directors.

    PubMed

    Lichstein, P R; Turner, R C; O'Brien, K

    1992-05-01

    To survey internal medicine residency program directors regarding interactions between their residents and pharmaceutical company (PC) representatives (PCRs) a questionnaire was sent to the directors of all Accreditation Council for Graduate Medical Education-approved internal medicine residency programs. The survey included 444 program directors, of whom 272 (61.16%) responded. The majority of program directors, 228 (83.8%), allowed PCRs to meet with residents during working hours and 241 (88.6%) permitted PC sponsorship of conferences. About half of the program directors were "moderately" or "very" concerned about the potential adverse effects of PC marketing on resident attitudes and prescribing practices. Seventy percent "agreed" or "strongly agreed" that the benefits of PC sponsorship outweigh the adverse effects and 41.5% believed that refusal to allow PCRs to meet with residents would jeopardize PC funding of other departmental activities. Most program directors reported that alternate funds for conferences were available if PC support was withdrawn. "Unethical" marketing activities were observed by 14.3% of program directors and 37.5% reported that residents had participated in PC-sponsored trips during the 3 years prior to the survey. At the time of this survey, only 35.3% of programs had developed formal policies regulating PCR activities and 25.7% provided residents with formal instruction on marketing issues. Knowledge of the current extent of PCR interactions with residents may be helpful to program directors in developing policies regulating PC-marketing activities. PMID:1580704

  14. Global health education in general preventive medicine residencies.

    PubMed

    Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H

    2015-05-01

    Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health. PMID:25891059

  15. Teaching prenatal ultrasound to family medicine residents.

    PubMed

    Dresang, Lee T; Rodney, William MacMillan; Dees, Jason

    2004-02-01

    Prenatal ultrasound is a powerful diagnostic tool, but there has been little research on how to teach ultrasound to family physicians. The available evidence supports teaching through didactics followed by supervised scanning. Didactic topics include physics and machine usage, indications, fetal biometry, anatomic survey, practice management, ethical issues, and resources. Supervised scanning reinforces the didactic components of training. A "hand-on-hand" supervised scanning technique is recommended for the transmission of psychomotor skills in these sessions. Curricula for teaching ultrasound should include information on which residents will be taught prenatal ultrasound, who will teach them, how to create time for learning ultrasound skills, and how to test for competency. The literature suggests that competency can be achieved within 25-50 supervised scans. Measures of competency include examination and qualitative analysis of scanning. Competency-based testing needs further development because no uniform standards have been established. PMID:14872356

  16. Nuclear medicine imaging system

    DOEpatents

    Bennett, Gerald W.; Brill, A. Bertrand; Bizais, Yves J. C.; Rowe, R. Wanda; Zubal, I. George

    1986-01-01

    A nuclear medicine imaging system having two large field of view scintillation cameras mounted on a rotatable gantry and being movable diametrically toward or away from each other is disclosed. In addition, each camera may be rotated about an axis perpendicular to the diameter of the gantry. The movement of the cameras allows the system to be used for a variety of studies, including positron annihilation, and conventional single photon emission, as well as static orthogonal dual multi-pinhole tomography. In orthogonal dual multi-pinhole tomography, each camera is fitted with a seven pinhole collimator to provide seven views from slightly different perspectives. By using two cameras at an angle to each other, improved sensitivity and depth resolution is achieved. The computer system and interface acquires and stores a broad range of information in list mode, including patient physiological data, energy data over the full range detected by the cameras, and the camera position. The list mode acquisition permits the study of attenuation as a result of Compton scatter, as well as studies involving the isolation and correlation of energy with a range of physiological conditions.

  17. Nuclear medicine imaging system

    DOEpatents

    Bennett, Gerald W.; Brill, A. Bertrand; Bizais, Yves J.; Rowe, R. Wanda; Zubal, I. George

    1986-01-07

    A nuclear medicine imaging system having two large field of view scintillation cameras mounted on a rotatable gantry and being movable diametrically toward or away from each other is disclosed. In addition, each camera may be rotated about an axis perpendicular to the diameter of the gantry. The movement of the cameras allows the system to be used for a variety of studies, including positron annihilation, and conventional single photon emission, as well as static orthogonal dual multi-pinhole tomography. In orthogonal dual multi-pinhole tomography, each camera is fitted with a seven pinhole collimator to provide seven views from slightly different perspectives. By using two cameras at an angle to each other, improved sensitivity and depth resolution is achieved. The computer system and interface acquires and stores a broad range of information in list mode, including patient physiological data, energy data over the full range detected by the cameras, and the camera position. The list mode acquisition permits the study of attenuation as a result of Compton scatter, as well as studies involving the isolation and correlation of energy with a range of physiological conditions.

  18. Building a resident research program in emergency medicine.

    PubMed

    Nocera, Romy; Ramoska, Edward Anthony; Hamilton, Richard Joseph

    2016-03-01

    Residency training programs requirements state, "Residents should participate in scholarly activity." However, there is little consensus regarding how best to achieve these requirements. The objective of this study is to implement a resident research program that emphasizes resident participation in quantitative or qualitative empirical work. A three-step program "Think, Do, Write" roughly follows the 3 years of the residency. During the first phase, the resident chooses a topic, formulates a hypothesis, and completes standard research certifications. Phase 2 involves obtaining Institutional Review Board approval, and conducting the study. The final phase entails analyzing and interpreting the data, and writing an abstract to present during an annual research day. Residents are encouraged to submit their projects for presentation at scientific conferences and for publication. Multiple departmental resources are available, including a Resident Research Fund, and full support of the faculty. Prior to the new program, most scholarly activity consisted of case reports, book chapters, review articles, or other miscellaneous projects; only 27 % represented empirical studies. Starting in 2012, the new program was fully implemented, resulting in notable growth in original empirical works among residents. Currently there is almost 100 % participation in studies, and numerous residents have presented at national conferences, and have peer-reviewed publications. With a comprehensive and supported program in place, emergency medicine residents proved capable of conducting high-quality empirical research within their relatively limited time. Overall, residents developed valuable skills in research design and statistical analysis, and greatly increased their productivity as academic and clinical researchers. PMID:26597875

  19. Diagnostic interventions in nuclear medicine

    SciTech Connect

    Thrall, J.H.; Swanson, D.P.

    1985-01-01

    This book contains 14 chapters. Some of the chapter titles are: Radionuclide Techniques in Peripherral Vascular Disease; Central Nervous System Studies; Hepatic Artery Perfusion Imaging; Drug-Radiopharmaceutical Interactions; and Formulary; Pharmacologic Interventions in Nuclear Medicine.

  20. Firearm injury prevention training in Preventive Medicine Residency programs.

    PubMed

    Khubchandani, Jagdish; Price, James H; Dake, Joseph A

    2009-08-01

    Preventive medicine plays a central role in the reducing the number of deaths due to preventable causes of premature deaths. General Preventive Medicine Residency programs have not been studied in relation to training in this area. A three-wave mail survey was conducted with email and telephone follow-ups. The outcome measures were the portion of program directors involved in training residents on firearm injury prevention issues and their perceived benefits and barriers of training residents on firearm injury prevention issues. Only 25% of the programs provided formal training on firearm injury prevention. Program directors who provided formal training perceived significantly higher number of benefits to offering such training than did directors who did not provide such training but no significant difference was found between the two for number of perceived barriers. If preventive medicine residency graduates are to play a role in reducing premature morbidity and mortality from firearms it will require more residencies to offer formal training in this area. The Association for Prevention Teaching and Research needs to develop guidelines on specific curriculum topics regarding firearm injury prevention. PMID:19326195

  1. The State of Evaluation in Internal Medicine Residency

    PubMed Central

    Holmboe, Eric; Beasley, Brent W.

    2008-01-01

    Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

  2. A Novel Approach to Medicine Training for Psychiatry Residents

    ERIC Educational Resources Information Center

    Onate, John; Hales, Robert; McCarron, Robert; Han, Jaesu; Pitman, Dorothy

    2008-01-01

    Objective: A unique rotation was developed to address limited outpatient internal medicine training in psychiatric residency by the University of California, Davis, Department of Psychiatry and Behavioral Sciences, which provides medical care to patients with mental illness. Methods: The number of patients seen by the service and the number of…

  3. Interpersonal Skills Training: Evaluation in an Internal Medicine Residency.

    ERIC Educational Resources Information Center

    Robbins, Alan S.; And Others

    1979-01-01

    To determine the effectiveness of teaching interpersonal skills in a general internal medicine residency, a program was developed utilizing videotape feedback of hospital house-staff/patient interactions. Fifty-one randomly selected house officers were included in a controlled pre- and post-test study design. The results suggest that such a…

  4. Residency Programs in Veterinary Internal Medicine. Where Are We Going?

    ERIC Educational Resources Information Center

    Oliver, J. E., Jr.

    1979-01-01

    Data from the 6th Symposium on Veterinary Medical Education, the Arthur D. Little, Inc. report, and the survey of the American College of Veterinary Internal Medicine are reported as they pertain to the need for more residency programs, program quality and accreditation. Program funding is also discussed. (JMD)

  5. Herbal medicine use among urban residents in Lagos, Nigeria

    PubMed Central

    2011-01-01

    Background Over three-quarter of the world's population is using herbal medicines with an increasing trend globally. Herbal medicines may be beneficial but are not completely harmless. This study aimed to assess the extent of use and the general knowledge of the benefits and safety of herbal medicines among urban residents in Lagos, Nigeria. Methods The study involved 388 participants recruited by cluster and random sampling techniques. Participants were interviewed with a structured open- and close-ended questionnaire. The information obtained comprises the demography and types of herbal medicines used by the respondents; indications for their use; the sources, benefits and adverse effects of the herbal medicines they used. Results A total of 12 herbal medicines (crude or refined) were used by the respondents, either alone or in combination with other herbal medicines. Herbal medicines were reportedly used by 259 (66.8%) respondents. 'Agbo jedi-jedi' (35%) was the most frequently used herbal medicine preparation, followed by 'agbo-iba' (27.5%) and Oroki herbal mixture® (9%). Family and friends had a marked influence on 78.4% of the respondents who used herbal medicine preparations. Herbal medicines were considered safe by half of the respondents despite 20.8% of those who experienced mild to moderate adverse effects. Conclusions Herbal medicine is popular among the respondents but they appear to be ignorant of its potential toxicities. It may be necessary to evaluate the safety, efficacy and quality of herbal medicines and their products through randomised clinical trial studies. Public enlightenment programme about safe use of herbal medicines may be necessary as a means of minimizing the potential adverse effects. PMID:22117933

  6. [Residency training of European respiratory medicine specialists: The HERMES project].

    PubMed

    Tirado-Conde, Gema; Miravitlles, Marc; Alvarez-Sala, José Luis; de Castro, Felipe Rodríguez; Ancochea, Julio

    2009-02-01

    Given the movement of medical specialists across borders in recent years, and the changes in legislation affecting the structure and operation of boards responsible for the various medical specialties, the task of harmonizing the training of respiratory medicine residents across the European Union has become crucial. The project for Harmonized Education in Respiratory Medicine for European Specialists (HERMES) is a collective response to this need. After 3 years of work toward building consensus, HERMES is entering its second phase. The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has the aim of informing our resident trainees, their instructors, and others concerned with postgraduate education in respiratory medicine in Spain about this undeniably difficult task of harmonization. PMID:19232271

  7. Structure and Activities of Nuclear Medicine in Kuwait.

    PubMed

    Elgazzar, Abdelhamid H; Owunwanne, Azuwuike; Alenezi, Saud

    2016-07-01

    The practice of nuclear medicine in Kuwait began in 1965 as a clinic for treating thyroid diseases. The practice developed gradually and until 1981 when the Faculty of Medicine established the Division of Nuclear Medicine in the Department of Radiology, which later became a separate department responsible for establishing and managing the practice in all hospitals of Kuwait. In 1987, a nuclear medicine residency program was begun and it is administered by Kuwait Institute for Medical Specializations originally as a 4-year but currently as a 5-year program. Currently there are 11 departments in the ministry of health hospitals staffed by 49 qualified attending physicians, mostly the diplomats of the Kuwait Institute for Medical Specializations nuclear medicine residency program, 4 academic physicians, 2 radiopharmacists, 2 physicists, and 130 technologists. These departments are equipped with 33 dual-head gamma cameras, 10 SPET/CT, 5 PET/CT, 2 cyclotrons, 1 breast-specific gamma imaging, 1 positron-emitting mammography, 10 thyroid uptake units, 8 technegas machines, 7 PET infusion systems, and 8 treadmills. Activities of nuclear medicine in Kuwait include education and training, clinical service, and research. Education includes nuclear medicine technology program in the Faculty of Allied Health Sciences, the 5-year residency program, medical school teaching distributed among different modules of the integrated curriculum with 14 didactic lecture, and other teaching sessions in nuclear medicine MSc program, which run concurrently with the first part of the residency program. The team of Nuclear Medicine in Kuwait has been active in research and has published more than 300 paper, 11 review articles, 12 book chapters, and 17 books in addition to 36 grants and 2 patents. A PhD program approved by Kuwait University Council would begin in 2016. PMID:27237444

  8. Internal Medicine Residents' Perceptions of Cross-Cultural Training

    PubMed Central

    Park, Elyse R; Betancourt, Joseph R; Miller, Elizabeth; Nathan, Michael; MacDonald, Ellie; Ananeh-Firempong, Owusu; Stone, Valerie E

    2006-01-01

    BACKGROUND Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations. OBJECTIVES To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations. DESIGN, SETTING, AND PATIENTS Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate = 87%). Interviews were recorded, transcribed, and analyzed. RESULTS Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms. CONCLUSIONS If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base. PMID:16704391

  9. Children's (Pediatric) Nuclear Medicine

    MedlinePlus Videos and Cool Tools

    ... medicine imaging to evaluate organ systems, including the: kidneys and bladder. bones. liver and gallbladder. gastrointestinal tract. ... help diagnose and evaluate: urinary blockage in the kidney. backflow of urine from the bladder into the ...

  10. Five Key Leadership Actions Needed to Redesign Family Medicine Residencies

    PubMed Central

    Kozakowski, Stanley M.; Eiff, M. Patrice; Green, Larry A.; Pugno, Perry A.; Waller, Elaine; Jones, Samuel M.; Fetter, Gerald; Carney, Patricia A.

    2015-01-01

    Background New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. Objective We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. Methods The Preparing the Personal Physician for Practice (P4) project (2007–2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Results Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Conclusions Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation. PMID:26221432

  11. Integrating family medicine residents into a rural practice.

    PubMed Central

    Kelly, L.

    1997-01-01

    PROBLEM: Integrating residents into community family practices can be challenging for busy doctors, especially when new preceptors have no formal preparation or teaching experience. OBJECTIVE OF PROGRAM: To develop an organized and practical approach to teaching residents in our busy rural group practice. Our seven northern Ontario family doctors have been training elective residents and clerks for 15 years. Recently, we have gone from hosting elective residents and students to teaching core family medicine residents. Our precepting plan allows us to dedicate a reasonable time to teaching while fulfilling our primary care duties. MAIN COMPONENTS: The program involves contracting, teaching, monitoring, feedback, and evaluation. CONCLUSION: We think we have developed a sustainable, workable set of teaching parameters that is applicable by various preceptors in different settings. It has simplified our teaching role and lessened our anxieties. Residents have benefited from the consistent protocol, which can be flexible enough to adapt to individual residents and preceptors, and have valued this teaching approach. Images p278-a p280-a PMID:9040915

  12. Documentation of quality improvement exposure by internal medicine residency applicants

    PubMed Central

    Kolade, Victor O.; Sethi, Anuradha

    2016-01-01

    Background Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. Purpose To document the reporting of QI training or experience in residency applications. Methods Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Results Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Conclusion Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns. PMID:26908376

  13. Effect of family medicine residents on use of diagnostic investigations

    PubMed Central

    Seong, Augene; Osmun, W.E.

    2014-01-01

    Abstract Objective To determine the effect of the presence of family medicine residents on the use of laboratory and imaging investigations in a rural emergency department (ED). Design A retrospective cross-sectional electronic chart audit was completed. Background characteristics, as well as type and number of ordered investigations, were compared between study groups. Setting Strathroy Middlesex General Hospital in Strathroy, Ont, a rural community hospital that sees approximately 20 000 ED visits per year. Participants A total of 2000 sequential ED visits, including adult and pediatric patients. The test group consisted of patients seen while a resident was present in the ED. The control group consisted of patients seen while no residents were present in the ED. Main outcome measures Twenty-two distinct categories of common ED investigations were studied. Results There was no statistically significant difference between study groups for 19 of the 22 categories of investigations. There were significant differences in 3 categories: an increased number of D-dimer assays for patients seen while there were no residents in the ED (1.7% of patients vs 0.5% of patients, P = .03) and increased computed tomography and ultrasound imaging for patients seen while a resident was in the ED (4.8% vs 1.8%, P = .0012, and 5.3% and 1.7%, P < .001, respectively). These differences are likely not owing to resident involvement but are explained by a difference in test availability between groups. Conclusion The study was underpowered for most categories of studied investigations. However, the trends demonstrated in this study suggest that the presence of family medicine residents in a rural community ED does not substantially affect the overall use of diagnostic investigations. PMID:25217692

  14. Workplace Violence and Harassment Against Emergency Medicine Residents

    PubMed Central

    Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

    2016-01-01

    Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

  15. Outcomes assessment of a residency program in laboratory medicine.

    PubMed

    Morse, E E; Pisciotto, P T; Hopfer, S M; Makowski, G; Ryan, R W; Aslanzadeh, J

    1997-01-01

    During a down-sizing of residency programs at a State University Medical School, hospital based residents' positions were eliminated. It was determined to find out the characteristics of the residents who graduated from the Laboratory Medicine Program, to compare women graduates with men graduates, and to compare IMGs with United States Graduates. An assessment of a 25 year program in laboratory medicine which had graduated 100 residents showed that there was no statistically significant difference by chi 2 analysis in positions (laboratory directors or staff), in certification (American Board of Pathology [and subspecialties], American Board of Medical Microbiology, American Board of Clinical Chemistry) nor in academic appointments (assistant professor to full professor) when the male graduates were compared with the female graduates or when graduates of American medical schools were compared with graduates of foreign medical schools. There were statistically significant associations by chi 2 analysis between directorship positions and board certification and between academic appointments and board certification. Of 100 graduates, there were 57 directors, 52 certified, and 41 with academic appointments. Twenty-two graduates (11 women and 11 men) attained all three. PMID:9433541

  16. Test ordering for preventive health care among family medicine residents

    PubMed Central

    Fung, Daisy; Schabort, Inge; MacLean, Catherine A.; Asrar, Farhan M.; Khory, Ayesha; Vandermeer, Ben; Allan, G. Michael

    2015-01-01

    Abstract Objective To determine which screening tests family medicine residents order as part of preventive health care. Design A cross-sectional survey. Setting Alberta and Ontario. Participants First- and second-year family medicine residents at the University of Alberta in Edmonton, the University of Calgary in Alberta, and McMaster University in Hamilton, Ont, during the 2011 to 2012 academic year. Main outcome measures Demographic information, Likert scale ratings assessing ordering attitudes, and selections from a list of 38 possible tests that could be ordered for preventive health care for sample 38-year-old and 55-year-old female and male patients. Descriptive and comparative statistics were calculated. Results A total of 318 of 482 residents (66%) completed the survey. Recommended or appropriate tests were ordered by 82% (for cervical cytology) to 95% (for fasting glucose measurement) of residents. Across the different sample patients, residents ordered an average of 3.3 to 5.7 inappropriate tests per patient, with 58% to 92% ordering at least 1 inappropriate test per patient. The estimated average excess costs varied from $38.39 for the 38-year-old man to $106.46 for the 55-year-old woman. More regular use of a periodic health examination screening template did not improve ordering (P = .88). Conclusion In general, residents ordered appropriate preventive health tests reasonably well but also ordered an average of 3.3 to 5.7 inappropriate tests for each patient. Training programs need to provide better education for trainees around inappropriate screening and work hard to establish good ordering behaviour in preparation for entering practice. PMID:25767171

  17. Variation in patient management based on ECG interpretation by emergency medicine and internal medicine residents.

    PubMed

    Trzeciak, Stephen; Erickson, Timothy; Bunney, E Bradshaw; Sloan, Edward P

    2002-05-01

    This study was performed to determine the impact of electrocardiogram (ECG) interpretation on urgent patient care decisions by internal medicine (IM) and emergency medicine (EM) resident physicians. Six clinical scenarios and ECGs were given to 31 IM residents and 31 EM residents at a university medical center. Based on the ECG interpretation, the residents were asked to select the best patient management from a list of choices. IM and EM residents were equally likely to choose the correct management for complete heart block (90% IM v 97% EM, P = NS), and pulseless ventricular tachycardia (VT) (94% IM v 97% EM, P = NS). IM residents were less likely to choose the correct management for acute posterior wall myocardial infarction (MI) (26% IM v 74% EM, P <.0001) and unstable supraventricular tachycardia (SVT) (87% IM v 100% EM, P <.05). Residents in both programs were equally likely to misinterpret left ventricular hypertrophy (LVH) (23% IM and 16% EM, P = NS) and benign early repolarization (BER) (48% IM and 52% EM, P = NS) as acute myocardial ischemia when presented with a clinical history not suggestive of cardiac ischemia. IM and EM residents were equally likely to choose the correct management for complete heart block and pulseless VT. Compared with EM residents, IM residents were less likely to choose the correct management of posterior wall MI and unstable SVT. Both IM and EM residents were prone to misinterpreting LVH and BER as acute myocardial ischemia. Resident education in both specialties should focus on ECG interpretation skills to improve patient management decisions. PMID:11992338

  18. Nuclear medicine training and practice in the Czech Republic.

    PubMed

    Kamínek, Milan; Koranda, Pavel

    2014-08-01

    Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. PMID:24867257

  19. Nuclear medicine imaging system

    DOEpatents

    Bennett, G.W.; Brill, A.B.; Bizais, Y.J.C.; Rowe, R.W.; Zubal, I.G.

    1983-03-11

    It is an object of this invention to provide a nuclear imaging system having the versatility to do positron annihilation studies, rotating single or opposed camera gamma emission studies, and orthogonal gamma emission studies. It is a further object of this invention to provide an imaging system having the capability for orthogonal dual multipinhole tomography. It is another object of this invention to provide a nuclear imaging system in which all available energy data, as well as patient physiological data, are acquired simultaneously in list mode.

  20. Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

    PubMed

    Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

    2015-05-01

    In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. PMID:25725591

  1. Data resources for nuclear medicine

    SciTech Connect

    Bhat, M.R.; Lemmel, H.D.

    1995-07-01

    The objective of this article is to list data resources needed for nuclear medicine and provide information on how to access them. This list will include publications of data compilations or evaluations, databases, and data processing codes for both nuclear structure and decay, as well as reaction data. Sources of bibliographic and related information on nuclear data are also be listed. The authors of this article have used their judgement in choosing a representative list of data sources; a more complete listing may be found in the references.

  2. Effective Research Strategies for Trainees in Internal Medicine Residency Programs

    PubMed Central

    Wiederman, Michael W.; Sawyer, Robert J.

    2015-01-01

    For most training programs, the development of research endeavors among trainees is an ongoing challenge. In this article, we review various considerations when attempting to undertake research activities within an internal medicine residency training program, including availability of institutional resources (eg, dedicated research time for trainees and faculty, available faculty mentors, accessible adjunctive personnel), engagement of residents into research, classic project quagmires in training programs, the institutional review board, publication options (eg, letters to the editor, case reports, literature reviews, original research reports), and journal submission strategies. Given that research entails multiple components and distinct skills, the overall program goal should be to make research an educationally understandable process for trainees. Research can be a rewarding activity when nurtured in a facilitating educational environment. PMID:26137359

  3. Evolution of nuclear medicine training: past, present, and future.

    PubMed

    Graham, Michael M; Metter, Darlene F

    2007-02-01

    Since the official inception of nuclear medicine in 1971, the practice of nuclear medicine and its training programs have undergone major revisions. Numerous procedures that were common in the 1970s are no longer available, and many new radiotracers and procedures have since been developed. Training programs have evolved from an unstructured experience before 1971 to 2 y of nuclear medicine training after 2 clinical years, to 2 y of nuclear medicine training after 1 clinical year and, most recently, to 3 y of nuclear medicine training after 1 clinical year. The most substantial content changes in the new 2007 training program requirements are an increased emphasis on 6 clinical competencies, an increased emphasis on Nuclear Regulatory Commission requirements, and a new CT training requirement that was spawned by the advent of PET/CT. In addition to the new training program requirements, residents will need to become familiar with the concept of maintenance of certification, which will continue to be an important component of their professional careers. Nuclear medicine is gradually evolving into molecular imaging. Hence, it is inevitable that in the near future, training programs will be required to place greater emphasis on molecular imaging in both clinical and research applications. The incorporation of molecular imaging will represent a significant paradigm shift for the specialty but will ensure that nuclear medicine will be a major part of medical practice for the foreseeable future. PMID:17268024

  4. Virtual Alternative to the Oral Examination for Emergency Medicine Residents

    PubMed Central

    McGrath, Jillian; Kman, Nicholas; Danforth, Douglas; Bahner, David P.; Khandelwal, Sorabh; Martin, Daniel R.; Nagel, Rollin; Verbeck, Nicole; Way, David P.; Nelson, Richard

    2015-01-01

    Introduction The oral examination is a traditional method for assessing the developing physician’s medical knowledge, clinical reasoning and interpersonal skills. The typical oral examination is a face-to-face encounter in which examiners quiz examinees on how they would confront a patient case. The advantage of the oral exam is that the examiner can adapt questions to the examinee’s response. The disadvantage is the potential for examiner bias and intimidation. Computer-based virtual simulation technology has been widely used in the gaming industry. We wondered whether virtual simulation could serve as a practical format for delivery of an oral examination. For this project, we compared the attitudes and performance of emergency medicine (EM) residents who took our traditional oral exam to those who took the exam using virtual simulation. Methods EM residents (n=35) were randomized to a traditional oral examination format (n=17) or a simulated virtual examination format (n=18) conducted within an immersive learning environment, Second Life (SL). Proctors scored residents using the American Board of Emergency Medicine oral examination assessment instruments, which included execution of critical actions and ratings on eight competency categories (1–8 scale). Study participants were also surveyed about their oral examination experience. Results We observed no differences between virtual and traditional groups on critical action scores or scores on eight competency categories. However, we noted moderate effect sizes favoring the Second Life group on the clinical competence score. Examinees from both groups thought that their assessment was realistic, fair, objective, and efficient. Examinees from the virtual group reported a preference for the virtual format and felt that the format was less intimidating. Conclusion The virtual simulated oral examination was shown to be a feasible alternative to the traditional oral examination format for assessing EM residents

  5. A Model Longitudinal Observation Medicine Curriculum for an Emergency Medicine Residency.

    PubMed

    Wheatley, Matthew; Baugh, Christopher; Osborne, Anwar; Clark, Carol; Shayne, Philip; Ross, Michael

    2016-04-01

    The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians. Presented here is a model observation medicine longitudinal training curriculum, which can be integrated into an emergency medicine (EM) residency. It was developed by a consensus of content experts representing the observation medicine interest group and observation medicine section, respectively, from EM's two major specialty societies: the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP). The curriculum consists of didactic, clinical, and self-directed elements. It is longitudinal, with learning objectives for each year of training, focusing initially on the basic principles of observation medicine and appropriate observation patient selection; moving to the management of various observation appropriate conditions; and then incorporating further concepts of OU management, billing, and administration. This curriculum is flexible and designed to be used in both academic and community EM training programs within the United States. Additionally, scholarly opportunities, such as elective rotations and fellowship training, are explored. PMID:26806664

  6. Integrative Medicine in Preventive Medicine Education: Competency and Curriculum Development for Preventive Medicine and Other Specialty Residency Programs.

    PubMed

    Jani, Asim A; Trask, Jennifer; Ali, Ather

    2015-11-01

    During 2012, the USDHHS's Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine's dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site's competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees' work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine training

  7. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

    PubMed Central

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release

  8. 1986 yearbook of nuclear medicine

    SciTech Connect

    Hoffer, P.B.; Gore, J.C.; Zaret, B.L.; Gottschalk, A.; Sostman, D.

    1986-01-01

    This year's edition summarizes recent published articles about nuclear medicine in major medical journals. The book starts with a review on quantitative analysis of thallium-201 scintigraphy. Chapters then follow on magnetic resonance imaging, the cardiovascular system, peripheral vasculature, the pulmonary system, physics and instrumentation, radiochemistry, and radiopharmacology, health physics and radiation biology, oncology, infection, bone, joints and muscles, the endocrine system, the genitourinary system, the gastrointestinal tract, hemotology, and the central nervous system.

  9. Evaluation of a Dementia Education Program for Family Medicine Residents

    PubMed Central

    Prorok, Jeanette C.; Stolee, Paul; Cooke, Martin; McAiney, Carrie A.; Lee, Linda

    2015-01-01

    Background Dementia diagnosis and management is increasing in importance in the training of future family physicians. This study evaluated the impact of a dementia education program for family medicine residents (FMR) on residents’ knowledge, attitudes, and confidence with respect to dementia assessment and management. A three-part questionnaire was developed and validated for these purposes. Methods A mixed methods study design was employed. The questionnaire’s internal consistency and test–retest reliability was determined and content validity was assessed. Twelve FMR participated in questionnaire validation. Program participants completed the validated questionnaire at baseline, at interim, and following program completion. Twenty-seven FMR completed the questionnaire as part of the program evaluation. Willing residents also participated in program feedback interviews. Differences in questionnaire scores between program participants and the comparison group were examined. Results Each questionnaire component demonstrated high internal consistency (Cronbach’s α: 0.83–0.91) and test–retest reliability (intraclass correlation coefficients: 0.74–0.91). Program participants (n = 15) scored significantly higher than the comparison group (n = 12) on the knowledge component and also reported greater confidence in several areas. Qualitative data indicated that residents felt the program focused on important topic areas and appreciated the opportunity to work in an interprofessional team. Conclusion Evaluation results indicate that the program improved FMRs’ knowledge on dementia assessment and management, as well as increased the residents’ confidence levels. PMID:26180561

  10. Assimilating Traditional Healing Into Preventive Medicine Residency Curriculum.

    PubMed

    Kesler, Denece O; Hopkins, L Olivia; Torres, Eliseo; Prasad, Arti

    2015-11-01

    Comprehensive cultural competency includes knowledge and awareness of culturally based healing and wellness practices. Healthcare providers should be aware of the individual patient's beliefs, culture, and use of culturally based health practices because patients may adopt such practices for general wellness or as adjunct therapies without the benefit of discussion with their healthcare provider. This article describes the culturally based traditional healing curriculum that has been implemented in the University of New Mexico Public Health and General Preventive Medicine Residency Program in order to fulfill this knowledge necessity. Curricular elements were added in a stepwise manner starting in 2011, with the full content as described implemented starting in 2013. Data were collected annually with evaluation of the full curriculum occurring in 2015. New Mexico has a diverse population base that includes predominantly Hispanic and Native American cultures, making the inclusion of curriculum regarding traditional healing practices very pertinent. Residents at the University of New Mexico were educated through several curricular components about topics such as Curanderismo, the art of Mexican Folk Healing. An innovative approach was used, with a compendium of training methods that included learning directly from traditional healers and participation in healing practices. The incorporation of this residency curriculum resulted in a means to produce physicians well trained in approaching patient care and population health with knowledge of culturally based health practices in order to facilitate healthy patients and communities. PMID:26477902

  11. The economic impacts of Oklahoma's Family Medicine residency programs.

    PubMed

    Lapolla, Michael; Brandt, Edward N; Barker, Andréa; Ryan, Lori

    2004-06-01

    The enactment of Medicare and Medicaid created a new demand for medical services in Oklahoma, particularly in rural areas. The state of Oklahoma responded by creating The Oklahoma Physician Manpower Training Commission in 1975. The overall purpose of the Commission was to increase the number of primary care physicians and influence distribution into non-metro areas. This analysis concerns the public policy value of this ongoing program. The PMTC has provided resident stipend funding to each of Oklahoma's publicly funded Family Medicine residency programs. Since 1975, the PMTC has provided over 139 million dollars in resident stipend funding and support; and there have been 749 program graduates with 431 practicing in Oklahoma. This model calculates that the Oklahoma-based physicians have created a cumulative 3.7 billion dollars of economic impact on the state; and conservatively estimates that only 10% of the practice decisions/locations were influenced by the PMTC. This creates an estimated return of 370 million dollars on an "investment" of 139 million dollars. Additionally the model demonstrates that the current cohort of physicians is annually responsible for 15,530 jobs and an associated payroll of 428 million dollars. PMID:15346805

  12. Emergency medicine as a primary specialty-French emergency medicine residents' attitudes.

    PubMed

    Yordanov, Youri; Sobotka, Jennifer; Dahan, Benjamin; Jacquin, Laurent; Kalpokdjian, Aurélie; Pateron, Dominique

    2015-11-01

    Emergency medicine (EM) has been a fellowship program (supra-specialty) in France since 2004. Even though the program can be accessed after completion of one of several primary specialties, the vast majority (97%) of its residents enter the program after having completed training in family medicine. A change to develop a primary EM specialty is being discussed. Our objective was to assess French residents and young EM physicians' attitudes toward EM as a primary specialty. We conducted a brief cross-sectional online survey among young EM physicians and trainees in November and December 2012. There were 288 respondents to the survey. Forty-nine percent (n=142) of respondents would have chosen EM if it was a primary specialty, but 73% (n=209) prefer maintaining the status quo, offering EM training as a supra-specialty fellowship program. Work-related quality of life was the main reason for those not choosing EM as a primary specialty. PMID:26012721

  13. Development of residency program guidelines for interaction with the pharmaceutical industry. Education Council, Residency Training Programme in Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ont.

    PubMed Central

    1993-01-01

    Medical residency programs are likely to face increasing pressure to address their relations with the pharmaceutical industry. Our internal medicine residency program has developed guidelines that were adopted after extensive debate by residents and faculty members. The guidelines are based on the principles that residents and faculty should set the educational agenda and that the residency program should not allow gifts of any sort from industry to residents. Specific policies include obtaining and screening educational materials from the industry before residents are exposed to them, proscribing "drug lunches" and accepting industry sponsorship only when the residency program maintains complete control of the educational event being sponsored. The industry response to the guidelines was split; about half reacted negatively, and half found the guidelines acceptable. Our experience suggests that productive debate about guidelines for the interaction of residency programs with the pharmaceutical industry is possible and desirable and that explicit policies can clarify areas of ambiguity. PMID:8348422

  14. Acute pain management curriculum for emergency medicine residency programs.

    PubMed

    Motov, Sergey M; Marshall, John P

    2011-10-01

    Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs possess inadequate knowledge and lack formal training in acute pain management. The purpose of this article is to create a formal educational curriculum that would assist emergency medicine (EM) residents in proper assessment and treatment of acute pain, as well as in providing a solid theoretical and practical knowledge base for managing acute pain in the ED. The authors propose a series of lectures, case-oriented study groups, practical small group sessions, and class-specific didactics with the goal of enhancing the theoretical and practical knowledge of acute pain management in the ED. PMID:21692900

  15. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    PubMed

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

  16. Are family medicine residents adequately trained to deliver palliative care?

    PubMed Central

    Mahtani, Ramona; Kurahashi, Allison M.; Buchman, Sandy; Webster, Fiona; Husain, Amna; Goldman, Russell

    2015-01-01

    Objective To explore educational factors that influence family medicine residents’ (FMRs’) intentions to offer palliative care and palliative care home visits to patients. Design Qualitative descriptive study. Setting A Canadian, urban, specialized palliative care centre. Participants First-year (n = 9) and second-year (n = 6) FMRs. Methods Semistructured interviews were conducted with FMRs following a 4-week palliative care rotation. Questions focused on participant experiences during the rotation and perceptions about their roles as family physicians in the delivery of palliative care and home visits. Participant responses were analyzed to summarize and interpret patterns related to their educational experience during their rotation. Main findings Four interrelated themes were identified that described this experience: foundational skill development owing to training in a specialized setting; additional need for education and support; unaddressed gaps in pragmatic skills; and uncertainty about family physicians’ role in palliative care. Conclusion Residents described experiences that both supported and inadvertently discouraged them from considering future engagement in palliative care. Reassuringly, residents were also able to underscore opportunities for improvement in palliative care education. PMID:27035008

  17. Nuclear analytical techniques in medicine

    SciTech Connect

    Cesareo, R.

    1988-01-01

    This book acquaints one with the fundamental principles and the instrumentation relevant to analytical technique based on atomic and nuclear physics, as well as present and future biomedical applications. Besides providing a theoretical description of the physical phenomena, a large part of the book is devoted to applications in the medical and biological field, particularly in hematology, forensic medicine and environmental science. This volume reviews methods such as the possibility of carrying out rapid multi-element analysis of trace elements on biomedical samples, in vitro and in vivo, by XRF-analysis; the ability of the PIXE-microprobe to analyze in detail and to map trace elements in fragments of biomedical samples or inside the cells; the potentiality of in vivo nuclear activation analysis for diagnostic purposes. Finally, techniques are described such as radiation scattering (elastic and inelastic scattering) and attenuation measurements which will undoubtedly see great development in the immediate future.

  18. Nuclear medicine applications for the diabetic foot

    SciTech Connect

    Hartshorne, M.F.; Peters, V.

    1987-04-01

    Although not frequently described in the podiatric literature, nuclear medicine imaging may be of great assistance to the clinical podiatrist. This report reviews in detail the use of modern nuclear medicine approaches to the diagnosis and management of the diabetic foot. Nuclear medicine techniques are helpful in evaluating possible osteomyelitis, in determining appropriate amputation levels, and in predicting response to conservative ulcer management. Specific indications for bone, gallium, and perfusion imaging are described.

  19. Diagnostic interventions in nuclear medicine

    SciTech Connect

    Thrall, J.H.; Swanson, D.P.

    1989-01-01

    Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references.

  20. Nurses as Evaluators of the Humanistic Behavior of Internal Medicine Residents.

    ERIC Educational Resources Information Center

    Butterfield, Paula S.; And Others

    1987-01-01

    The reliability of a 13-item questionnaire designed to assess the humanistic behaviors of internal medicine residents and the reliability of nurses as raters of those behaviors were examined. Residents were evaluated by nurses on two general medicine services and on cardiology and hematology-oncology services. (Author/MLW)

  1. Evaluation of a Substance Use Disorder Curriculum for Internal Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Melissa R.; Arnsten, Julia H.; Parish, Sharon J.; Kunins, Hillary V.

    2011-01-01

    Teaching about diagnosis, treatment, and sequelae of substance use disorders (SUDs) is insufficient in most Internal Medicine residency programs. To address this, the authors developed, implemented, and evaluated a novel and comprehensive SUD curriculum for first year residents (interns) in Internal Medicine, which anchors the ensuing 3-year…

  2. Social Media in Professional Medicine: New Resident Perceptions and Practices

    PubMed Central

    2016-01-01

    Background For younger generations, unconstrained online social activity is the norm. Little data are available about perceptions among young medical practitioners who enter the professional clinical arena, while the impact of existing social media policy on these perceptions is unclear. Objective The objective of this study was to investigate the existing perceptions about social media and professionalism among new physicians entering in professional clinical practice; and to determine the effects of formal social media instruction and policy on young professionals’ ability to navigate case-based scenarios about online behavior in the context of professional medicine. Methods This was a prospective observational study involving the new resident physicians at a large academic medical center. Medical residents from 9 specialties were invited to participate and answer an anonymous questionnaire about social media in clinical medicine. Data were analyzed using SAS 9.4 (Cary, NC), chi-square or Fisher’s exact test was used as appropriate, and the correct responses were compared between different groups using the Kruskal–Wallis analysis of variance. Results Familiarity with current institutional policy was associated with an average of 2.2 more correct responses (P=.01). Instruction on social media use during medical school was related to correct responses for 2 additional questions (P=.03). On dividing the groups into no policy exposure, single policy exposure, or both exposures, the mean differences were found to be statistically significant (3.5, 7.5, and 9.4, respectively) (P=.03). Conclusions In this study, a number of young physicians demonstrated a casual approach to social media activity in the context of professional medical practice. Several areas of potential educational opportunity and focus were identified: (1) online privacy, (2) maintaining digital professionalism, (3) safeguarding the protected health information of patients, and (4) the impact of

  3. The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs.

    PubMed

    Falvo, Thomas; McKniff, Sueanne; Smolin, Gregory; Vega, David; Amsterdam, James T

    2009-09-01

    Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty. PMID:19689483

  4. Teaching adaptive leadership to family medicine residents: what? why? how?

    PubMed

    Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

    2012-09-01

    Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts. PMID:22906156

  5. Atlas of nuclear medicine artifacts and variants

    SciTech Connect

    Ryo, U.Y.; Alavi, A.; Collier, D.

    1989-01-01

    This book is designed to aid in the interpretation of nuclear medicine scans. The authors purpose is to help practitioners recognize artifacts and variants on nuclear medicine scans and thereby avoid misdiagnoses. It contains 70 pages of cases, including sections on SPECT and PET.

  6. Nuclear Medicine Imaging in Pediatric Neurology

    PubMed Central

    Akdemir, Ümit Özgür; Atay Kapucu, Lütfiye Özlem

    2016-01-01

    Nuclear medicine imaging can provide important complementary information in the management of pediatric patients with neurological diseases. Pre-surgical localization of the epileptogenic focus in medically refractory epilepsy patients is the most common indication for nuclear medicine imaging in pediatric neurology. In patients with temporal lobe epilepsy, nuclear medicine imaging is particularly useful when magnetic resonance imaging findings are normal or its findings are discordant with electroencephalogram findings. In pediatric patients with brain tumors, nuclear medicine imaging can be clinically helpful in the diagnosis, directing biopsy, planning therapy, differentiating tumor recurrence from post-treatment sequelae, and assessment of response to therapy. Among other neurological diseases in which nuclear medicine has proved to be useful are patients with head trauma, inflammatory-infectious diseases and hypoxic-ischemic encephalopathy. PMID:27299282

  7. Health Literacy Teaching in U.S. Family Medicine Residency Programs: A National Survey.

    PubMed

    Coleman, Clifford A; Nguyen, Nancy T; Garvin, Roger; Sou, Channbunmorl; Carney, Patricia A

    2016-01-01

    Health care providers, including medical residents, often lack adequate knowledge and skills to work effectively with patients who have limited health literacy. Little is known about the degree to which medical residents are trained to communicate effectively with people who have limited health literacy. This study aimed to assess the status of health literacy training for physicians in U.S. family medicine residency programs. We conducted an online survey of residency directors at 444 U.S. family medicine residencies. Among 138 respondents (31% response rate), 58 programs (42%) reported teaching residents about health literacy as part of the required curriculum. Most instruction occurred during the 1st year of training. Hours of instruction ranged from 2 to 5 during Years 1 through 3. Skills-based training (e.g., plain language techniques) was taught by most programs. Not having access to a faculty authority on health literacy was strongly associated with lack of a required health literacy curriculum. Respondents overwhelmingly agreed that increasing health literacy training for medical students and residents would help improve residents' clinical skills. This study provides a baseline snapshot of health literacy curricula in U.S. family medicine residencies and likely overestimates the prevalence of such curricula. Additional studies are needed to determine the quality of health literacy instruction in U.S. family medicine residencies and the most effective methods for teaching residents about health literacy. PMID:27043758

  8. How we implemented a resident-led medical simulation curriculum in a large internal medicine residency program.

    PubMed

    Mathai, Susan K; Miloslavsky, Eli M; Contreras-Valdes, Fernando M; Milosh-Zinkus, Tanya; Hayden, Emily M; Gordon, James A; Currier, Paul F

    2014-04-01

    Mannequin-based simulation in graduate medical education has gained widespread acceptance. Its use in non-procedural training within internal medicine (IM) remains scant, possibly due to the logistical barriers to implementation of simulation curricula in large residency programs. We report the Massachusetts General Hospital Department of Medicine's scale-up of a voluntary pilot program to a mandatory longitudinal simulation curriculum in a large IM residency program (n = 54). We utilized an eight-case curriculum implemented over the first four months of the academic year. An intensive care unit curriculum was piloted in the spring. In order to administer a comprehensive curriculum in a large residency program where faculty resources are limited, thirty second-year and third-year residents served as session facilitators and two senior residents served as chairpersons of the program. Post-session anonymous survey revealed high learner satisfaction scores for the mandatory program, similar to those of the voluntary pilot program. Most interns believed the sessions should continue to be mandatory. Utilizing residents as volunteer facilitators and program leaders allowed the implementation of a well-received mandatory simulation program in a large IM residency program and facilitated program sustainability. PMID:24495251

  9. Routine Quality Control of Clinical Nuclear Medicine Instrumentation: A Brief Review*

    PubMed Central

    Zanzonico, Pat

    2009-01-01

    This article reviews routine quality-control (QC) procedures for current nuclear medicine instrumentation, including the survey meter, dose calibrator, well counter, intraoperative probe, organ (“thyroid”) uptake probe, γ-camera, SPECT and SPECT/CT scanner, and PET and PET/CT scanner. It should be particularly useful for residents, fellows, and other trainees in nuclear medicine, nuclear cardiology, and radiology. The procedures described and their respective frequencies are presented only as general guidelines. PMID:18587088

  10. Connecting resident education to patient outcomes: the evolution of a quality improvement curriculum in an internal medicine residency.

    PubMed

    Zafar, Muhammad A; Diers, Tiffiny; Schauer, Daniel P; Warm, Eric J

    2014-10-01

    As part of the Accreditation Council for Graduate Medical Education's Next Accreditation System, residency programs must connect resident-physician education to improved patient care outcomes. Residency training programs, however, face multiple obstacles in doing so. Results from residency quality improvement (QI) curricula tend to show improvement in simple process-based measures but not in more complex outcomes of care such as diabetes or blood pressure control. In this article, the authors describe the evolution of their QI educational program for internal medicine residents at the University of Cincinnati Medical Center within the structure of a novel training model called the Ambulatory Long Block. They discuss a resident-run project that led to reduced rates of patients with uncontrolled diabetes as an example of improvement in outcome measures. Despite favorable results from that particular resident group, the successful intervention did not spread practice-wide. Using this example, they detail the phases of evolution and lessons learned from their curriculum from 2006 to 2014 within a framework of previously published general principles for successful QI education, including those of exemplary care and learning sites. Successful programs require leadership, faculty expertise and mentorship, data management, learner buy-in, and patient engagement. Their experience will hopefully be of help to others as they attempt to simultaneously improve care and education. Further research and innovation are needed in this area, including optimizing strategies for strengthening resident-driven projects through partnership with nursing, allied health, and longitudinally engaged faculty members. PMID:25054419

  11. Nuclear medicine applications: Summary of Panel 4

    SciTech Connect

    Wolf, A.P.

    1988-01-01

    Nuclear medicine is currently facing a desperate shortage of organic and inorganic chemists and nuclear pharmacists who also have advanced training in nuclear and radiochemistry. Ironically, this shortfall is occurring in the face of rapid growth and technological advances which have made the practice of nuclear medicine an integral part of the modern health care system. This shortage threatens to limit the availability of radiopharmaceuticals required in routine hospital procedures and to impede the development of new diagnostic and therapeutic agents. To redress this need and prevent a similar shortfall in the future, this panel recommends immediate action and a long-term commitment to the following: educating the public on the benefits of nuclear medicine; informing undergraduate and graduate chemistry students about career opportunities in nuclear medicine; offering upper level courses in nuclear and radiochemistry (including laboratory) in universities; establishing training centers and fellowships at the postgraduate level for specialized education in the aspects of nuclear and radiochemistry required by the nuclear medicine profession. 1 tab.

  12. Residency: Can It Transform Teaching the Way It Did Medicine?

    ERIC Educational Resources Information Center

    Thorpe, Ronald

    2014-01-01

    Universal teacher residency would benefit the teaching profession and ultimately the education of our children. We have yet to work out the fine details, but there is nothing more important than developing robust residency schools where young educators go between their undergraduate preparation and their arrival in the classroom as autonomous…

  13. Personalized peer-comparison feedback and its effect on emergency medicine resident ultrasound scan numbers

    PubMed Central

    2014-01-01

    Background Clinician-performed ultrasound has become a widely utilized tool in emergency medicine and is a mandatory component of the residency curricula. We aimed to assess the effect of personalized peer-comparison feedback on the number of ultrasound scans performed by emergency medicine residents. Findings A personalized peer-comparison feedback was performed by sending 44 emergency medicine residents a document including personally identified scan numbers and class averages. The number of ultrasound scans per clinical shift for a 3-month period before and after the feedback intervention was calculated. The average number of ultrasound exams per shift improved from 0.39 scans/shift before to 0.61 scans/shift after feedback (p = 0.04). Among the second year residents, the scans/shift ratio improved from 0.35 to 0.87 (p = 0.07); for third year residents, from 0.51 to 0.58 (p = 0.46); and from 0.33 to 0.41 (p = 0.21) for the fourth year residents before and after the intervention, respectively. Conclusions A personalized peer-comparison feedback provided to emergency medicine residents resulted in increased ultrasound scan numbers per clinical shift. Incorporating this method of feedback may help encourage residents to scan more frequently. PMID:24422791

  14. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    ERIC Educational Resources Information Center

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  15. Multi-Source Evaluation of Interpersonal and Communication Skills of Family Medicine Residents

    ERIC Educational Resources Information Center

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-01-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and…

  16. In vivo diagnostic nuclear medicine. Pediatric experience

    SciTech Connect

    Goetz, W.A.; Hendee, W.R.; Gilday, D.L.

    1983-09-01

    The use of radiopharmaceuticals for diagnostic tests in children is increasing and interest in these is evidenced by the addition of scientific sessions devoted to pediatric medicine at annual meetings of The Society of Nuclear Medicine and by the increase in the literature on pediatric dosimetry. Data presented in this paper describe the actual pediatric nuclear medicine experience from 26 nationally representative U.S. hospitals and provide an overview of the pediatric procedures being performed the types of radiopharmaceuticals being used, and the activity levels being administered.

  17. The Teaching of Interviewing and Counseling Skills to Internal Medicine Residents.

    ERIC Educational Resources Information Center

    Levin, Ellen M.; And Others

    1979-01-01

    The primary objective of a training program based within an internal medicine department at the University of Texas Medical Branch was to increase the interviewing skills of medicine residents, especially regarding the psychosocial aspects of patients. The program, evaluation methods, and results are described. (JMD)

  18. Attitudes about Cancer Medicine among Primary Care Residents and Their Teachers.

    ERIC Educational Resources Information Center

    Love, Richard R.; And Others

    1980-01-01

    A cancer attitude survey is analyzed that was administered to residents and faculty physicians in the departments of Family Medicine, Internal Medicine, and Human Oncology at the University of Wisconsin. Categories surveyed include opinions about the benefits of prevention, risk management, early detection and screening, treatment and care, and…

  19. A Training Manual for Nuclear Medicine Technologists.

    ERIC Educational Resources Information Center

    Simmons, Guy H.; Alexander, George W.

    This manual was prepared for a training program in Nuclear Medicine Technology at the University of Cincinnati. Instructional materials for students enrolled in these courses in the training program include: Nuclear Physics and Instrumentation, Radionuclide Measurements, Radiation Protection, and Tracer Methodology and Radiopharmaceuticals. (CS)

  20. [Potential radiation hazard in nuclear medicine].

    PubMed

    Guilabert, Nadine; Ricard, Marcel; Chamoulaud, Karen; Mazelier, Carole; Schlumberger, Martin

    2015-01-01

    Nuclear medicine uses unsealed radioisotopes. The potential radiation hazards depend on the amount of radioactivity administered and the type of radionucleide. Thus, radiation safety instructions will minimize radiation exposure and contamination as low as reasonably achievable. National nuclear safety authority requires rules, regulations and exposure limits for both patients and workers. Good practices and training staff contribute to optimize the radioprotection. PMID:25842441

  1. Out of the wilderness: flipping the classroom to advance scholarship in an internal medicine residency program.

    PubMed

    Vincent, Dale S

    2014-11-01

    Residents in an internal medicine residency program "flipped the classroom" in a series of learner-centered activities which included the creation of a medical student interest group, a continuing medical education symposium, and a journal supplement focused on wilderness medicine topics in Hawai'i and Asia Pacific. The project encompassed both scholarly activities (discovery, integration, application, and teaching) as well as scholarship (writing for publication). The project advanced the professional formation of residents by developing competencies and producing outcomes that are key features of the ACGME Next Accreditation System. PMID:25478292

  2. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    PubMed Central

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated. PMID:25635201

  3. Geriatric Medicine Training for Family Practice Residents in the 21st Century: A Report from the Residency Assistance Program/Hartford Geriatrics Initiative.

    ERIC Educational Resources Information Center

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Summarizes the initial results of the regional geriatric medicine curriculum retreats for family practice residency directors provided as part of the American Academy of Family Physicians multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. (EV)

  4. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    PubMed Central

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation.

  5. Residents' Awareness of Folk Medicine Beliefs of Their Mexican Patients.

    ERIC Educational Resources Information Center

    Mull, J. Dennis; Mull, Dorothy S.

    1981-01-01

    A study is presented that documents widespread unfamiliarity with traditional health beliefs among 30 residents who had been caring for Mexican patients in a Southern California clinic for periods ranging from one to three years. It is suggested that formal curricular material on health beliefs and practices should be provided. (MLW)

  6. Nuclear Medicine Scans for Cancer

    MedlinePlus

    ... are the possible complications? For the most part, nuclear scans are safe tests. The doses of radiation are very small, and the radionuclides have a ... else should I know about these tests? The radiation exposure from a nuclear scan comes from the radionuclides used – the scanner ...

  7. Optimizing global health experiences in emergency medicine residency programs: a consensus statement from the Council of Emergency Medicine Residency Directors 2011 Academic Assembly global health specialty track

    PubMed Central

    2012-01-01

    Background An increasing number of emergency medicine (EM) residency training programs have residents interested in participating in clinical rotations in other countries. However, the policies that each individual training program applies to this process are different. To our knowledge, little has been done in the standardization of these experiences to help EM residency programs with the evaluation, administration and implementation of a successful global health clinical elective experience. The objective of this project was to assess the current status of EM global health electives at residency training programs and to establish recommendations from educators in EM on the best methodology to implement successful global health electives. Methods During the 2011 Council of Emergency Medicine Residency Directors (CORD) Academic Assembly, participants met to address this issue in a mediated discussion session and working group. Session participants examined data previously obtained via the CORD online listserve, discussed best practices in global health applications, evaluations and partnerships, and explored possible solutions to some of the challenges. In addition a survey was sent to CORD members prior to the 2011 Academic Assembly to evaluate the resources and processes for EM residents’ global experiences. Results Recommendations included creating a global health working group within the organization, optimizing a clearinghouse of elective opportunities for residents and standardizing elective application materials, site evaluations and resident assessment/feedback methods. The survey showed that 71.4% of respondents have global health partnerships and electives. However, only 36.7% of programs require pre-departure training, and only 20% have formal competency requirements for these global health electives. Conclusions A large number of EM training programs have global health experiences available, but these electives and the trainees may benefit from

  8. Applications of nuclear medicine in genitourinary imaging

    SciTech Connect

    Blaufox, M.D.; Kalika, V.; Scharf, S.; Milstein, D.

    1982-01-01

    Major advances in nuclear medicine instrumentation and radiopharmaceuticals for renal studies have occurred during the last decade. Current nuclear medicine methodology can be applied for accurate evaluation of renal function and for renal imaging in a wide variety of clinical situations. Total renal function can be estimated from the plasma clearance of agents excreted by glomerular filtration or tubular secretion, and individual function can be estimated by imaging combined with renography. A major area of radionuclide application is in the evaluation of obstructive uropathy. The introduction of diuretic renography and the use of computer-generated regions of interest offer the clinician added useful data which may aid in diagnosis and management. Imaging is of proven value also in trauma, renovascular hypertension, and acute and chronic renal failure. Methods for the evaluation of residual urine, vesicoureteral reflux, and testicular torsion have achieved increasing clinical use. These many procedures assure a meaningful and useful role for the application of nuclear medicine in genitourinary imaging.

  9. Pediatric Integrative Medicine in Residency (PIMR): Description of a New Online Educational Curriculum

    PubMed Central

    McClafferty, Hilary; Dodds, Sally; Brooks, Audrey J.; Brenner, Michelle G.; Brown, Melanie L.; Frazer, Paige; Mark, John D.; Weydert, Joy A.; Wilcox, Graciela M. G.; Lebensohn, Patricia; Maizes, Victoria

    2015-01-01

    Use of integrative medicine (IM) is prevalent in children, yet availability of training opportunities is limited. The Pediatric Integrative Medicine in Residency (PIMR) program was designed to address this training gap. The PIMR program is a 100-hour online educational curriculum, modeled on the successful Integrative Medicine in Residency program in family medicine. Preliminary data on site characteristics, resident experience with and interest in IM, and residents’ self-assessments of perceived knowledge and skills in IM are presented. The embedded multimodal evaluation is described. Less than one-third of residents had IM coursework in medical school or personal experience with IM. Yet most (66%) were interested in learning IM, and 71% were interested in applying IM after graduation. Less than half of the residents endorsed pre-existing IM knowledge/skills. Average score on IM medical knowledge exam was 51%. Sites endorsed 1–8 of 11 site characteristics, with most (80%) indicating they had an IM practitioner onsite and IM trained faculty. Preliminary results indicate that the PIMR online curriculum targets identified knowledge gaps. Residents had minimal prior IM exposure, yet expressed strong interest in IM education. PIMR training site surveys identified both strengths and areas needing further development to support successful PIMR program implementation.

  10. Knowledge of medical-legal issues. Survey of Ontario family medicine residents.

    PubMed Central

    Saltstone, S. P.; Saltstone, R.; Rowe, B. H.

    1997-01-01

    OBJECTIVE: To ascertain how much family medicine residents know about medical-legal issues and what their attitudes toward medical-legal training are. DESIGN: Survey using multiple-choice questions to assess knowledge of typical legal scenarios and attitudes to training. Responses to questions were assessed using a Likert scale. SETTING: University of Ottawa's Family Medicine Program, including the Northeastern Ontario Family Medicine Program and the Melrose and Elizabeth Bruyere Family Medicine Centres. PARTICIPANTS: Forty-five family medicine residents in the University of Ottawa's Family Medicine Program. MAIN OUTCOME MEASURES: Demographic information and answers to questions assessing respondents' knowledge of and attitudes toward medical-legal issues. RESULTS: Mean score for correct responses was 8.6 out of 16 possible correct responses. Resident's knowledge about certain issues was excellent, such as knowing that comments can be constructed as sexual abuse and that they should report patients whose medical conditions make it dangerous for them to operate motor vehicles. On other issues, such as how to treat incompetent individuals and how to treat minors when parents refuse consent for treatment, residents' knowledge seemed poor. Although residents thought knowledge of medical-legal issues was important for providing good-quality care to patients and avoiding litigation, they felt inadequately trained in and uncomfortable about dealing with these issues. CONCLUSIONS: Residents are somewhat confused about medical-legal issues. They seem very interested in learning medical-legal principles. These findings should encourage educators to provide opportunity for residents to gain knowledge in these areas. PMID:9111983

  11. Graduating internal medicine residents' self-assessment and performance of advanced cardiac life support skills.

    PubMed

    Wayne, Diane B; Butter, John; Siddall, Viva J; Fudala, Monica J; Wade, Leonard D; Feinglass, Joe; McGaghie, William C

    2006-06-01

    Internal medicine residents in the US must be competent to perform procedures including Advanced Cardiac Life Support (ACLS) to become board-eligible. Our aim was to determine if residents near graduation could assess their skills in ACLS procedures accurately. Participants were 40 residents in a university-based training program. Self-assessments of confidence in managing six ACLS scenarios were measured on a 0 (very low) to 100 (very high) scale. These were compared to reliable observational ratings of residents' performance on a high-fidelity simulator using published treatment protocols. Residents expressed strong self-confidence about managing the scenarios. Residents' simulator performance varied widely (range from 45% to 94%). Self-confidence assessments correlated poorly with performance (median r = 0.075). Self-assessment of performance by graduating internal medicine residents was not accurate in this study. The use of self-assessment to document resident competence in procedures such as ACLS is not a proxy for objective evaluation. PMID:16807178

  12. HOSPITAL PHYSICS: Nuclear medicine: diagnosis and therapy

    NASA Astrophysics Data System (ADS)

    Dixon-Brown, Ann; Soper, Nigel D. W.

    1996-03-01

    Nuclear Medicine is a small but unique speciality, and any physics student who already enjoys computing, image processing, human biology and physiology as well as physics and chemistry, will be fascinated by this medical speciality. Those who enter, whether they be clinical or scientific, rarely leave and remain under its spell for life.

  13. Dosimetry in Nuclear Medicine Diagnosis and Therapy

    NASA Astrophysics Data System (ADS)

    Noßke, D.; Mattsson, S.; Johansson, L.

    This document is part of Subvolume A 'Fundamentals and Data in Radiobiology, Radiation Biophysics, Dosimetry and Medical Radiological Protection' of Volume 7 'Medical Radiological Physics' of Landolt-Börnstein - Group VIII 'Advanced Materials and Technologies'. It contains the Section '4.7 Necessity of Patient-Specific Dose Planning in Radionuclide Therapy' of the Chapter '4 Dosimetry in Nuclear Medicine Diagnosis and Therapy'.

  14. Effecting Change in an Evidence-Based Medicine Curriculum: Librarians' Role in a Pediatric Residency Program.

    PubMed

    Zeblisky, Kathy; Birr, Rebecca A; Sjursen Guerrero, Anne Marie

    2015-01-01

    Librarians for the joint Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program were asked to assist on the Evidence-Based Medicine (EBM) Subcommittee for the program. Faculty was open to recommendations for revising and improving the curriculum and desired librarian assistance in completing the task. The annual program review and conference evaluations revealed a gap between the objectives of the EBM curriculum and the residents' perceived abilities to integrate knowledge into meaningful literature searches. This column demonstrates how librarians can collaborate with their residency programs to revise and improve processes to effect change in their program's EBM curriculum. PMID:26211797

  15. Radiopharmaceuticals in nuclear medicine practice

    SciTech Connect

    Kowalsky, R.J.; Perry, J.R.

    1987-01-01

    This book discusses the basic principles and clinical applications of radiopharmaceuticals. Topics include atomic physics as applied to radiopharmaceuticals, radionuclide generator function, nuclear pharmacy and safety, and radiopharmaceutical use in evaluating the major organ systems of the body. For each body system the author explains rationale for use, typical procedures, current agents of choice, and interpretation of results. Images, tables, and graphs illustrate normal and abnormal studies.

  16. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

    PubMed Central

    Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

    2006-01-01

    Background In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program. PMID:17044924

  17. Knowledge about cancer screening among medical students and internal medicine residents in Mexico City.

    PubMed

    Villarreal-Garza, Cynthia; García-Aceituno, Luis; Villa, Antonio R; Perfecto-Arroyo, Miguel; Rojas-Flores, Miriam; León-Rodríguez, Eucario

    2010-12-01

    It is extremely important that physicians are aware of cancer screening precise indications. We sought to explore its knowledge among Mexican medical students and internal medicine residents. Students and residents completed a questionnaire-based survey about breast, cervical, colon, and prostate cancer screening. Four hundred fifty-one individuals answered the survey: 64.52% students and 35.48% residents. Mean knowledge score was 63.97 ± 14.97. Residents scored higher than students (p = 0.0001). No difference in the education concerning cervical and colon cancer screening was found. Knowledge of screening guidelines is suboptimal among medical students and residents. Further efforts should be targeted to educational and training programs in this country. PMID:20221811

  18. Acting as standardized patients enhances family medicine residents' self-reported skills in palliative care.

    PubMed

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A J

    2015-08-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory palliative care workshop in communication for incoming, first-year trainees. Four months later, FMR-SPs reflected upon their own experiences. Two independent researchers performed thematic analysis of these interviews. Most of the residents were satisfied with their roles. Twelve reported improved understanding of self, their patients, the doctor-patient relationship, and the underlying philosophy of palliative care. They also described improved verbal and non-verbal communication skills. Eleven of 14 residents reflected upon behavioral changes in problem coping styles. All residents indicated an intention to apply the learning in their future work. Encouraging Thai Family Medicine residents, in years one through three, to portray SPs in palliative care appears to be a valuable learning experience for the resident. Future studies to validate whether this learning has been applied in subsequent practice are planned. PMID:25256636

  19. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital

    PubMed Central

    Blumenthal, Daniel M.; Bernard, Kenneth; Iyasere, Christiana

    2015-01-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  20. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital.

    PubMed

    Fraser, Traci N; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana

    2015-07-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included "leading a team" (98% of residents), "confronting problem employees" (93%), "coaching and developing others" (93%), and "resolving interpersonal conflict" (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  1. Fifteen Years of a Videotape Review Program for Internal Medicine and Medicine-Pediatrics Residents.

    ERIC Educational Resources Information Center

    Edwards, Ann; And Others

    1996-01-01

    The Wayne State University (Michigan) medical school program of videotaping resident interviews with patients and reviewing them with faculty is described and evaluated. Topics discussed include the program's structure and process, recurrent themes in the review sessions, residents' perspectives on the process, potential barriers to a successful…

  2. Evaluation of an Online Program To Teach Microbiology to Internal Medicine Residents

    PubMed Central

    Burd, Eileen M.; Kraft, Colleen S.; Armstrong, Wendy S.; Lenorr, Kenya; Spicer, Jennifer O.; Martin, Donna; del Rio, Carlos

    2014-01-01

    Microbiology rounds are an integral part of infectious disease consultation service. During microbiology rounds, we highlight microbiology principles using vignettes. We created case-based, interactive, microbiology online modules similar to the vignettes presented during microbiology rounds. Since internal medicine residents rotating on our infectious disease elective have limited time to participate in rounds and learn microbiology, our objective was to evaluate the use of the microbiology online modules by internal medicine residents. We asked residents to complete 10 of 25 online modules during their infectious disease elective. We evaluated which modules they chose and the change in their knowledge level. Forty-six internal medicine residents completed assessments given before and after accessing the modules with an average of 11/20 (range, 6 to 19) and 16/20 (range, 9 to 20) correct questions, respectively (average improvement, 5 questions; P = 0.0001). The modules accessed by more than 30 residents included those related to Clostridium difficile, anaerobes, Candida spp., Streptococcus pneumoniae, influenza, Mycobacterium tuberculosis, and Neisseria meningitidis. We demonstrated improved microbiology knowledge after completion of the online modules. This improvement may not be solely attributed to completing the online modules, as fellows and faculty may have provided additional microbiology education during the rotation. PMID:25392364

  3. Perceptions and Practices of Graduates of Combined Family Medicine-Psychiatry Residency Programs: A Nationwide Survey

    ERIC Educational Resources Information Center

    Warner, Christopher H.; Morganstein, Joshua; Rachal, James; Lacy, Timothy

    2007-01-01

    Objective: The authors evaluate the current practices and perceptions of graduates of combined family medicine-psychiatry residency programs in the following areas: preparation for practice, boundary formation, and integration of skills sets. Method: The authors conducted an electronic cross-sectional survey of all nationwide combined family…

  4. Development and Implementation of a Web-based Evaluation System for an Internal Medicine Residency Program.

    ERIC Educational Resources Information Center

    Rosenberg, Mark E.; Watson, Kathleen; Paul, Jeevan; Miller, Wesley; Harris, Ilene; Valdivia, Tomas D.

    2001-01-01

    Describes the development and implementation of a World Wide Web-based electronic evaluation system for the internal medicine residency program at the University of Minnesota. Features include automatic entry of evaluations by faculty or students into a database, compliance tracking, reminders, extensive reporting capabilities, automatic…

  5. Clinical Poems and Clinical Conversations: Some Thoughts on Working with Family Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Howard F.

    2006-01-01

    This paper describes an experiment in which Family Medicine residents composed, read, and discussed their poems as a way of bringing to life their often complex relationships with patients. It argues that this approach mobilizes the physicians' own creativity in the service of reflective practice and improved doctor-patient relationships. This…

  6. A Conceptual Framework for Teaching Geriatrics in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Moore, James T.; Bobula, James A.

    1980-01-01

    A competency-based curriculum model for teaching geriatrics in a family medicine residency is described that divides competencies under four major goals: understanding principles, obtaining and interpreting data, managing geriatric patients, and working in a health care team. Sample objectives, instructional methods, and student evaluation are…

  7. Converting energy to medical progress [nuclear medicine

    SciTech Connect

    2001-04-01

    For over 50 years the Office of Biological and Environmental Research (BER) of the United States Department of Energy (DOE) has been investing to advance environmental and biomedical knowledge connected to energy. The BER Medical Sciences program fosters research to develop beneficial applications of nuclear technologies for medical diagnosis and treatment of many diseases. Today, nuclear medicine helps millions of patients annually in the United States. Nearly every nuclear medicine scan or test used today was made possible by past BER-funded research on radiotracers, radiation detection devices, gamma cameras, PET and SPECT scanners, and computer science. The heart of biological research within BER has always been the pursuit of improved human health. The nuclear medicine of tomorrow will depend greatly on today's BER-supported research, particularly in the discovery of radiopharmaceuticals that seek specific molecular and genetic targets, the design of advanced scanners needed to create meaningful images with these future radiotracers, and the promise of new radiopharmaceutical treatments for cancers and genetic diseases.

  8. Coded-aperture imaging in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Smith, Warren E.; Barrett, Harrison H.; Aarsvold, John N.

    1989-11-01

    Coded-aperture imaging is a technique for imaging sources that emit high-energy radiation. This type of imaging involves shadow casting and not reflection or refraction. High-energy sources exist in x ray and gamma-ray astronomy, nuclear reactor fuel-rod imaging, and nuclear medicine. Of these three areas nuclear medicine is perhaps the most challenging because of the limited amount of radiation available and because a three-dimensional source distribution is to be determined. In nuclear medicine a radioactive pharmaceutical is administered to a patient. The pharmaceutical is designed to be taken up by a particular organ of interest, and its distribution provides clinical information about the function of the organ, or the presence of lesions within the organ. This distribution is determined from spatial measurements of the radiation emitted by the radiopharmaceutical. The principles of imaging radiopharmaceutical distributions with coded apertures are reviewed. Included is a discussion of linear shift-variant projection operators and the associated inverse problem. A system developed at the University of Arizona in Tucson consisting of small modular gamma-ray cameras fitted with coded apertures is described.

  9. Converting Energy to Medical Progress [Nuclear Medicine

    DOE R&D Accomplishments Database

    2001-04-01

    For over 50 years the Office of Biological and Environmental Research (BER) of the United States Department of Energy (DOE) has been investing to advance environmental and biomedical knowledge connected to energy. The BER Medical Sciences program fosters research to develop beneficial applications of nuclear technologies for medical diagnosis and treatment of many diseases. Today, nuclear medicine helps millions of patients annually in the United States. Nearly every nuclear medicine scan or test used today was made possible by past BER-funded research on radiotracers, radiation detection devices, gamma cameras, PET and SPECT scanners, and computer science. The heart of biological research within BER has always been the pursuit of improved human health. The nuclear medicine of tomorrow will depend greatly on today's BER-supported research, particularly in the discovery of radiopharmaceuticals that seek specific molecular and genetic targets, the design of advanced scanners needed to create meaningful images with these future radiotracers, and the promise of new radiopharmaceutical treatments for cancers and genetic diseases.

  10. Coded-aperture imaging in nuclear medicine

    NASA Technical Reports Server (NTRS)

    Smith, Warren E.; Barrett, Harrison H.; Aarsvold, John N.

    1989-01-01

    Coded-aperture imaging is a technique for imaging sources that emit high-energy radiation. This type of imaging involves shadow casting and not reflection or refraction. High-energy sources exist in x ray and gamma-ray astronomy, nuclear reactor fuel-rod imaging, and nuclear medicine. Of these three areas nuclear medicine is perhaps the most challenging because of the limited amount of radiation available and because a three-dimensional source distribution is to be determined. In nuclear medicine a radioactive pharmaceutical is administered to a patient. The pharmaceutical is designed to be taken up by a particular organ of interest, and its distribution provides clinical information about the function of the organ, or the presence of lesions within the organ. This distribution is determined from spatial measurements of the radiation emitted by the radiopharmaceutical. The principles of imaging radiopharmaceutical distributions with coded apertures are reviewed. Included is a discussion of linear shift-variant projection operators and the associated inverse problem. A system developed at the University of Arizona in Tucson consisting of small modular gamma-ray cameras fitted with coded apertures is described.

  11. Filling the Void: Defining Invasive Bedside Procedural Competency for Internal Medicine Residents

    PubMed Central

    Lenchus, Joshua D.; Carvalho, Cristiane Mocelin; Ferreri, Kaitlyn; Sanko, Jill Steiner; Arheart, Kristopher L.; Fitzpatrick, Maureen; Issenberg, S. Barry

    2013-01-01

    Background Residents perform invasive bedside procedures in most training programs. To date, there is no universal approach for determining competency and ensuring quality and safety of care. Objective We developed and implemented an assessment of central venous catheter insertion competency for internal medicine and internal medicine–pediatrics residents, using measurements for knowledge, skill, and attitude and linking them to procedural outcomes. Methods We conducted a cohort study of a 4-week, resident-run procedure service from July 2007 through June 2011 at a large academic medical center. Knowledge was assessed by using a written test, technical skill by using a checklist, and attitude by self- and supervisor assessments of residents' confidence and capability. Competence was defined as (1) a minimum written test score (70%); (2) a perfect checklist score; (3) a resident's self-assessed confidence and capability scores of 4 or 5 of 5; and (4) faculty rating of the resident's confidence and capability as 5 of 5. A composite success rate was based on procedural outcomes (eg, completed procedures, less than 3 forward needle passes, and complication rate) and was compared to the checklist scores. Results A total of 148 internal medicine and medicine–pediatrics residents inserted 639 catheters, and 53 (36%) achieved competence by the end of 4 weeks. Residents judged to be competent by checklist scores had a higher composite success rate than those deemed not competent. Conclusions Our multi-factorial criteria used to define central venous catheter insertion competency effectively discriminated between residents judged to be competent and those judged not competent, using data from procedural outcomes. PMID:24455009

  12. Competency Assessment in Senior Emergency Medicine Residents for Core Ultrasound Skills

    PubMed Central

    Schmidt, Jessica N.; Kendall, John; Smalley, Courtney

    2015-01-01

    Introduction Quality resident education in point-of-care ultrasound (POC US) is becoming increasingly important in emergency medicine (EM); however, the best methods to evaluate competency in graduating residents has not been established. We sought to design and implement a rigorous assessment of image acquisition and interpretation in POC US in a cohort of graduating residents at our institution. Methods We evaluated nine senior residents in both image acquisition and image interpretation for five core US skills (focused assessment with sonography for trauma (FAST), aorta, echocardiogram (ECHO), pelvic, central line placement). Image acquisition, using an observed clinical skills exam (OSCE) directed assessment with a standardized patient model. Image interpretation was measured with a multiple-choice exam including normal and pathologic images. Results Residents performed well on image acquisition for core skills with an average score of 85.7% for core skills and 74% including advanced skills (ovaries, advanced ECHO, advanced aorta). Residents scored well but slightly lower on image interpretation with an average score of 76%. Conclusion Senior residents performed well on core POC US skills as evaluated with a rigorous assessment tool. This tool may be developed further for other EM programs to use for graduating resident evaluation. PMID:26594291

  13. Evaluating and Enhancing a Women's Health Curriculum in an Internal Medicine Residency Program

    PubMed Central

    Wayne, Diane B; DaRosa, Debra A

    2004-01-01

    OBJECTIVE Resident education in women's health is required but is often underemphasized. Our aim was to identify women's health topics with the most relevance to our graduates’ practices and to determine how well they were prepared to address women's health issues. DESIGN Postgraduate survey. SETTING University-affiliated internal medicine residency program. PARTICIPANTS Program graduates in general internal medicine practice. METHODS A survey was drafted listing the 65 topics described in a published residency curriculum in women's health. Respondents indicated the extent to which each item was relevant to their practice and the adequacy of instruction received on a Likert-type scale of 1 (not relevant/inadequate) to 5 (highly relevant/adequate). RESULTS The response rate was 86%. Many of the items were highly relevant to our graduates’ practices. Learning needs were found in all areas as none of the topics were rated as “adequately” taught during residency. Many areas in the curriculum had low relevance scores. Few differences were seen in the perceived relevance of women's health problems or the adequacy of instruction received based on gender, practice type and setting, or amount of ambulatory training during residency. CONCLUSIONS Use of this survey has allowed us to tailor and prioritize learning issues in women's health to meet the needs of our graduates. Increased time in ambulatory rotations alone may not be sufficient to prepare residents to provide comprehensive care in this field. Further study of the effectiveness of a dedicated curriculum in women's heath is needed. PMID:15209589

  14. Impact of a family medicine resident wellness curriculum: a feasibility study

    PubMed Central

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  15. Perceptions of Internal Medicine Residency Program Candidates on the Use of Simulation in the Selection Process

    PubMed Central

    Cannon, Keith; Hartsell, Zachary; Ivanov, Ilko; Charles, Joseph; Joshi, Harshad; Blair, Janis; Geyer, Holly

    2014-01-01

    Background The recruitment of skilled candidates into internal medicine residency programs has relied on traditional interviewing techniques with varying degrees of success. The development of simulated medical technology has provided a new arena in which to assess candidates' clinical skills, knowledge base, situational awareness, and problem-solving dexterities within a standardized environment for educational and assessment purposes. Objective The purpose of this study was to investigate the interest of program candidates in incorporating simulation medicine into the internal medicine residency interview process. Methods As a prospective, survey-based analysis, potential candidates who completed an interview between October 2012 and January 2013 with an accredited internal medicine residency program were sent a postmatch survey that incorporated 3 additional questions relating to their prior experience with medical simulation and their views on incorporating the technology into the interview format. Results Of the 88 candidates who completed an interview, 92% (n  =  81) were scheduled to graduate medical school in 2013 and were graduates of a US medical school. All survey responders described previous experience with medical simulation. Fifty-eight percent (n  =  51) of responders described being “less likely” to interview with or join a residency program if they were required to participate in a 10-minute medical simulation during the interview process. Conclusions The results of this study suggest that despite the increasing role of technology in medical education, its role in high-stakes evaluations (such as residency interviews) requires further maturation before general acceptance by residency candidates can be expected. PMID:24949144

  16. Internal Medicine Residents' Perceived Ability to Direct Patient Care: Impact of Gender and Experience

    PubMed Central

    Bartels, Christie; Goetz, Sarah; Ward, Earlise

    2008-01-01

    Abstract Background Physicians are expected to effect patient care by giving orders to members of a healthcare team. Because women are socialized to be less directive than men, the assertive behavior required of new physicians may be experienced differently by male and female residents. We sought to explore the effects of gender and year of training on residents' experiences and perceived ability to direct patient care. Methods This was a mixed-methods, cross-sectional, descriptive study employing a quantitative written survey and qualitative interviews among internal medicine residents at an academic health center. Measurements included questionnaires and interviews about stress, assertiveness, and personal factors that influence their effectiveness in directing patient care. Analyses examined differences by gender and year of training. Results One hundred residents were invited to participate; 65 returned questionnaires, and 16 of these residents were interviewed. Compared with male residents, female residents selected less assertive behaviors for clinical scenarios (p = 0.047) and were more likely to perceive gender as inhibiting their ability to influence patient care (p < 0.01). Stress associated with being assertive varied more with experience than gender. Interviews corroborated these findings and supported the complexity of gender norms for behavior for female residents in a directive leadership position. Conclusions When compared with male peers, female residents reported more gender issues in residency and chose less assertive behaviors in clinical scenarios. Experience mitigated some gender differences. Our findings suggest that discussion of the existing research on prescriptive gender norms for behavior and leadership may be warranted in resident orientation. PMID:19049356

  17. The Impact of Supervision on Internal Medicine Residents' Attitudes and Management of Depression in Primary Care: A Pilot Study

    ERIC Educational Resources Information Center

    Milone, Jennifer M.; Gottumukkala, Aruna; Ward, Christopher P.; York, Kaki M.

    2013-01-01

    Objective: The authors examined the effect of supervision on internal medicine residents' attitudes toward and management of depression. Method: Internal medicine residents completed a survey during preclinical conferences. The survey included a published, validated questionnaire, the Depression Attitude Questionnaire, and items developed by the…

  18. A Multidisciplinary Approach for Teaching Systems-Based Practice to Internal Medicine Residents

    PubMed Central

    Nabors, Christopher; Peterson, Stephen J; Weems, Roger; Forman, Leanne; Mumtaz, Arif; Goldberg, Randy; Kar, Kausik; Borges, Joseph A; Doctor, Ida; Lubben, Orpha; Pherwani, Nisha; Frishman, William H

    2011-01-01

    Background Rapid growth in the complexity of the health care environment (including monitoring systems for health care quality and patient safety) may result in graduating internists not being adequately prepared for the demands the system places on them. In response, the Residency Review Committee for Internal Medicine created the Educational Innovations Project (EIP) to encourage select residency training programs to develop new strategies and methods to meet changing demands in graduate medical education. Methods As part of the EIP, our program created an innovative administrative internship. This multiyear curriculum provides systems-based practice training and consists of a series of rotations that take place during the 3 years of internal medicine residency. Each session involves close interaction with the nonphysician personnel who are instrumental in making our institution a functional and cohesive unit. To assess the potential impact of the rotations, we survey senior residents, recent graduates, and faculty educators. In conjunction with the Performance and Patient Experience departments of the hospital, we track several systems-based practice metrics for residents, including compliance with core health care measures, length of stay, and patient satisfaction. Results Residents recognize the need to develop systems-based practice skills, to readily participate in structured curricula designed to enhance such skills, and to provide leadership in organizing and publishing quality improvement initiatives, and upon graduation, they may lament that they did not receive even more vigorous training in these areas. Conclusion Although internal medicine residencies continue to improve their training in systems-based practice, our experience suggests that an even greater emphasis on these skills may be warranted. PMID:22379526

  19. Evaluation of Social Media Use by Emergency Medicine Residents and Faculty

    PubMed Central

    Pearson, David; Bond, Michael C.; Kegg, Jason; Pillow, Tyson; Hopson, Laura; Cooney, Robert; Garg, Manish; Khadpe, Jay; Runyon, Michael; Patterson, Leigh

    2015-01-01

    Introduction Clinicians and residency programs are increasing their use of social media (SM) websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM) residents and faculty. Methods In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD) listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher’s exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK) was used for all analyses. Results We received 1,314 responses: 63% of respondents were male, 40% were <30 years of age, 39% were between the ages 31 and 40, and 21% were older than 40. The study group consisted of 772 residents and 542 faculty members (15% were program directors, 21% were assistant or associate PDs, 45% were core faculty, and 19% held other faculty positions. Forty-four percent of respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [p<0.0001]), entertainment (61% vs 47% [p<0.0001]), and videos (42% vs 23% [p=0.0006]). Residents used Facebook™ and YouTube™ more often than faculty (86% vs 67% [p<0.001]; 53% vs 46% [p=0.01]), whereas residents used Twitter™ (19% vs 26% [p=0.005]) and LinkedIn™ (15% vs 32% [p<0.0001]) less than faculty. Overall, residents used SM sites more than faculty, notably in daily use (30% vs 24% [p<0.001]). For professional use, residents were most interested in its use for open positions/hiring (30% vs 18% [p<0.0001]) and videos (33% vs 26% [p=0.005]) and less interested than faculty with award postings (22% vs 33% [p<0.0001]) or publications (30% vs 38% [p

  20. (Coordinated research programs in nuclear medicine)

    SciTech Connect

    Knapp, F.F. Jr.

    1990-10-03

    The traveler visited the Clinic for Nuclear Medicine at the University of Bonn, West Germany, to review, organize, and plan collaborative studies. He also met with the editorial board of the journal NucCompact -- European/American Communications in Nuclear Medicine, on which he serves as US editor. He also visited colleagues at the Cyclotron Research Center (CRC) at the University of Liege, Belgium, to coordinate clinical applications of the ultrashort-lived iridium-191m radionuclide obtained from the osmium-190/iridium-191m generator system. The traveler planned and coordinated continuing collaboration with colleagues at the CRC for further applications of this generator system. He also visited the University of Metz, Metz, France, to organize a three-center project for the synthesis and evaluation of various receptor-specific cerebral imaging agents, involving the Oak Ridge National Laboratory (ORNL), CRC, and the University of Metz.

  1. A nuclear chocolate box: the periodic table of nuclear medicine.

    PubMed

    Blower, Philip J

    2015-03-21

    Radioisotopes of elements from all parts of the periodic table find both clinical and research applications in radionuclide molecular imaging and therapy (nuclear medicine). This article provides an overview of these applications in relation to both the radiological properties of the radionuclides and the chemical properties of the elements, indicating past successes, current applications and future opportunities and challenges for inorganic chemistry. PMID:25406520

  2. Recent advances in pediatric nuclear medicine.

    PubMed

    Piepsz, A

    1995-04-01

    This review is devoted to some controversial topics in the field of pediatric nuclear medicine. In most cases, drug sedation can be avoided and the nuclear medicine procedure can be successfully achieved simply by taking the emotional life of the child into account. Factors such as past negative experiences (painful procedures, hospitalizations), unfamiliar environment (frightening examination room), physical aggressions related to the nuclear medicine procedure (intravenous injections, cystography), and the feeling of loss of parents' protection all contribute to the child's anxiety. People in charge of pediatric procedures should be adequately trained to be aware of these factors and to create the best environmental conditions to avoid unnecessarily frightening the child. Methods for measuring renal clearance in children are numerous. It is my aim to review the different methods proposed in the literature, including the nonradioisotopic methods, the reference radioisotopic methods, the various simplified algorithms using blood samples, and the gamma-camera methods. Gastroesophageal reflux scintigraphy is a well-established procedure for the detection of gastro-esophageal reflux in children. However, despite the numerous advantages of this technique, it has not gained wide acceptance in the field of pediatric gastroenterology. This review focuses mainly on the comparison between scintigraphy and pH metry. Finally, the applications of 99m technetium-hexamethylpropylenamine brain single photon emission computer tomography in the field of pediatric neurology are still under development; this part of the review is an attempt to summarize the real contribution of this technique. PMID:7597419

  3. Computers and quality control in nuclear medicine.

    PubMed

    Brookeman, V A

    1978-04-01

    The general topic of computers and nuclear medicine quality control may be approached from two main areas; controlling the quality of computerized studies, and computer applications in general nuclear medicine quality control. Overlap occurs when quality control of computer studies is performed by the computer itself. The uses of computers in record-keeping and in quality control of imaging instrumentation and in vitro studies, including radioimmunoassay, are discussed in this review. Aspects of quality control for computerized clinical cardiovascular, cerebral, and renal studies and emission computed tomography are reviewed, including consideration of difficulties and inaccuracies involved in the studies. Any automatic computer analysis program should incorporate adequate checks and error detection protocols and should illustrate results for verification. Current routine quality control procedures using the computer unfortunately are few. Quality control criteria are needed for camera/computer systems in high count rate clinical applications, and increasing emphasis should be aimed at quality control of those computerized dynamic and function studies in current clinical use. The computer has a valuable potential for nuclear medicine quality control. In vitro and computerized in vivo studies can be analyzed by readily available statistical programs, and variances can be monitored continuously. Computers can calibrate and monitor instrument performance regularly, and can handle managerial and clerical duties such as bookkeeping. PMID:684439

  4. Hand exposure in nuclear medicine workers.

    PubMed

    Chruscielewski, W; Olszewski, J; Jankowski, J; Cygan, M

    2002-01-01

    As a result of the gamma radiation emitted by radioactive elements (e.g. 99mTc and 131I) used in nuclear medicine laboratories for diagnostic and therapeutic purposes, nuclear medicine workers are exposed to whole-body doses. These doses arc usually measured by using individual film dosemeters. Lead or lead glass shields used during the handling of radioisotopes minimise the whole-body doses received. Nevertheless, part of the job has to be performed manually, hence the hands are more exposed to radiation. This paper presents the results of measuring the equivalent dose to the hands of workers employed in five selected nuclear medicine laboratories where technetium and iodine radioisotopes are in common use. Sixty workers, including physicians, nurses, radiopharmacists and technicians, were included in the study. Doses were measured at 1 month intervals. The study indicated that, in some instances, the danger of radiation dose to the hand may be significant. Monthly doses exceeded 50 mSv, which may suggest that an annual dose may be higher than 500 mSv. PMID:12382741

  5. Rheumatologic skills development: what are the needs of internal medicine residents?

    PubMed

    Kroop, Susan F; Chung, Cecilia P; Davidson, Mario A; Horn, Leora; Damp, Julie B; Dewey, Charlene

    2016-08-01

    Given the burden of rheumatic disease in our society and the anticipated future shortage of rheumatologists, all internal medicine (IM) residencies need to train internists who are capable of caring for patients with rheumatic diseases. The objective of this study was to perform a targeted needs assessment of the self-confidence of IM residents in the evaluation and care of patients with rheumatologic diseases. A 16-item, web-based, self-assessed confidence survey tool was administered to participating post graduate year (PGY)1 (N = 83) and PGY3 (N = 37) residents. The categories of questions included self-confidence in performing a rheumatologic history and exam, performing common rheumatologic procedures, ordering and interpreting rheumatologic laboratory tests, and caring for patients with common rheumatologic diseases. Resident demographics, prior rheumatology exposure, and career plans were also queried. PGY3 residents had higher self-assessed confidence than PGY1 residents in all categories. Self-assessed confidence in joint procedures was consistently low in both groups and when compared to other categories. Prior exposure to a rheumatology course or elective was not consistently associated with higher self-assessed confidence ratings across all categories. PGY3 residents showed less interest in rheumatology as a career than PGY1 residents, although the interest in the topic of rheumatology was not statistically different. Our needs assessment shows a low level of self-assessed confidence in rheumatology knowledge and skills among IM residents. Despite improvement with PGY year of training, self-assessed confidence remains low. To improve resident's skills and self-confidence in rheumatology, more curricular innovations are needed. Such innovations should be assessed for overall effectiveness. PMID:26694057

  6. Ambulatory care training during core internal medicine residency training: the Canadian experience.

    PubMed Central

    McLeod, P J; Meagher, T W

    1993-01-01

    OBJECTIVE: To determine the status of ambulatory care training of core internal medicine residents in Canada. DESIGN: Mail survey. PARTICIPANTS: All 16 program directors of internal medicine residency training programs in Canada. OUTCOME MEASURES: The nature and amount of ambulatory care training experienced by residents, information about the faculty tutors, and the sources and types of patients seen by the residents. As well, the program directors were asked for their opinions on the ideal ambulatory care program and the kinds of teaching skills required of tutors. RESULTS: All of the directors responded. Fifteen stated that the ambulatory care program is mandatory, and the other stated that it is an elective. Block rotations are more common than continuity-of-care assignments. In 12 of the programs 10% or less of the overall training time is spent in ambulatory care. In 11 the faculty tutors comprise a mixture of generalists and subspecialists. The tutors simultaneously care for patients and teach residents in the ambulatory care setting in 14 of the schools. Most are paid through fee-for-service billing. The respondents felt that the ideal program should contain a mix of general and subspecialty ambulatory care training. There was no consensus on whether it should be a block or continuity-of-care experience, but the directors felt that consultation and communication skills should be emphasized regardless of which type of experience prevails. CONCLUSIONS: Although there is a widespread commitment to provide core internal medicine residents with experience in ambulatory care, there is little uniformity in how this is achieved in Canadian training programs. PMID:8324688

  7. Transitioning Toward Competency: A Resident-Faculty Collaborative Approach to Developing a Transitions of Care EPA in an Internal Medicine Residency Program

    PubMed Central

    Chan, Brian; Englander, Honora; Kent, Kyle; Desai, Sima; Obley, Adam; Harmon, David; Kansagara, Devan

    2014-01-01

    Background Residency training and evaluation are moving toward competency-based models. Managing transitions of care is 1 of 16 entrustable professional activities (EPAs) that signal readiness for independent internal medicine practice. Methods for developing EPAs are evolving within the medical education community. Objective We describe a process for developing a transitions-of-care EPA for internal medicine inpatient and ambulatory settings using an iterative, consensus-building, resident-faculty collaborative approach. Methods We used an independent rank-ordering process and successive consensus group meetings to cull an initial list of 142 developmental Milestones to the 15 most relevant to transitions of care for internal medicine patients in an academic medical center and affiliated Veterans Administration hospital. Four senior internal medicine residents and 4 internal medicine faculty members representing inpatient and ambulatory practice settings identified examples of specific tasks and evaluative techniques for each Milestone. Results We demonstrate a feasible resident-faculty collaboration to develop transitions of care as an EPA for an internal medicine training program. Inclusion of residents along with faculty provided broader insights as well as an important learning opportunity for trainees. Conclusions Our process demonstrated the feasibility of designing an EPA, but questions remain about how entrustment-based evaluation can be implemented in clinical settings. Our framework may serve as a foundation for EPA development in other areas of clinical practice. PMID:26140133

  8. The Family Medicine Residency Training Initiative in Miscarriage Management: Impact on Practice in Washington State

    PubMed Central

    Darney, Blair G.; Weaver, Marcia R.; Stevens, Nancy; Kimball, Jeana; Prager, Sarah W.

    2013-01-01

    BACKGROUND AND OBJECTIVES Non-complicated spontaneous abortion cases should be counseled about the full range of management approaches, including uterine evacuation using manual vacuum aspiration (MVA). The Residency Training Initiative in Miscarriage Management (RTI-MM) is an intensive, multidimensional intervention designed to facilitate implementation of office-based management of spontaneous abortion using MVA in family medicine residency settings. The purpose of this study was to test the impact of the RTI-MM on self-reported use of MVA for management of spontaneous abortion. METHODS We used a pretest/posttest one group study design and a web-based, anonymous survey to collect data on knowledge, attitudes, perceived barriers, and practice of office-based management of spontaneous abortion. We used multivariable models to estimate incident relative risks and accounted for data clustering at the residency site level. RESULTS Our sample included 441 residents and faculty from 10 family medicine residency sites. Our findings show a positive association between the RTI-MM and self-reported use of MVA for management of spontaneous abortion (adjusted RR=9.11 [CI=4.20-19.78]) and were robust to model specification. Male gender, doing any type of management of spontaneous abortion (eg, expectant, medication), other on-site reproductive health training interventions, and support staff knowledge scores were also significant correlates of physician practice of MVA. CONCLUSIONS Our findings suggest that the RTI-MM was successful in influencing the practice of management of spontaneous abortion using MVA in this population and that support staff knowledge may impact physician practice. Integrating MVA into family medicine settings would potentially improve access to evidence-based, comprehensive care for women. PMID:23378077

  9. Development of a neurology rotation for internal medicine residents in Haiti.

    PubMed

    Berkowitz, Aaron L; Martineau, Louine; Morse, Michelle E; Israel, Kerling

    2016-01-15

    In many low-income countries where there are few or no neurologists, patients with neurologic diseases are cared for by primary care physicians who receive no formal training in neurology. Here, we report our experience creating a neurology rotation for internal medicine residents in rural Haiti through a collaboration between a public academic medical center in Haiti and a visiting neurologist. We describe the structure of the rotation and the factors that led to its development. PMID:26723993

  10. Informed consent for blood transfusion: what do medicine residents tell? What do patients understand?

    PubMed

    Friedman, Mark; Arja, Wajih; Batra, Rashmi; Daniel, Sugganth; Hoehn, Daniela; Paniz, Alberto Mondolfi; Selegean, Sorin; Slova, Denisa; Srivastava, Swati; Vergara, Norge

    2012-10-01

    Blood transfusion is a common intervention in the hospital setting, and its benefits may not be clear but it has associated risks. Despite this, transfusion consent may not be obtained satisfactorily. We assessed transfusion consent effectiveness by comparing information given by residents with information understood by patients who receive transfusions. Medicine department residents who obtained consent were surveyed via telephone in conjunction with bedside surveys of adult inpatients who received transfusions. A total of 43 patient and 34 resident surveys were completed. Deficiencies in the transfusion consent process were noted. Discussed transfusion benefits (such as wound healing) were not always true benefits whereas some important risks (such as transfusion-related acute lung injury) were infrequently conferred. Risks were more often reported as "not discussed" than benefits. Only a few participants were aware of the hospital's Transfusion Health Guide, which provides information on transfusion benefits, risks, and alternatives. PMID:23010711

  11. Results of a Formal Mentorship Program for Internal Medicine Residents: Can We Facilitate Genuine Mentorship?

    PubMed Central

    Cohee, Brian M.; Koplin, Stephen A.; Shimeall, William T.; Quast, Timothy M.; Hartzell, Joshua D.

    2015-01-01

    Background Mentorship programs are perceived as valuable, yet little is known about the effect of program design on mentoring effectiveness. Intervention We developed a program focused on mentoring relationship quality and evaluated how subsequent relationships compared to preexisting informal pairings. Methods Faculty members were invited by e-mail to participate in a new mentoring program. Participants were asked to complete a biography, subsequently provided to second- and third-year internal medicine residents. Residents were instructed to contact available mentors, and ultimately designate a formal mentor. All faculty and residents were provided a half-day workshop training, written guidelines, and e-mails. Reminders were e-mailed and announced in conferences approximately monthly. Residents were surveyed at the end of the academic year. Results Thirty-seven faculty members completed the biography, and 70% (26 of 37) of residents responded to the survey. Of the resident respondents, 77% (20 of 26) chose a formal mentor. Of the remainder, most had a previous informal mentor. Overall, 96% (25 of 26) of the residents had identified a mentor of some kind compared to 50% (13 of 26) before the intervention (P < .001), and 70% (14 of 20) who chose formal mentors identified them as actual mentors. Similar numbers of residents described their mentors as invested in the mentorship, and there was no statistical difference in the number of times mentors and mentees met. Conclusions Facilitated selection of formal mentors produced relationships similar to preexisting informal ones. This model may increase the prevalence of mentorship without decreasing quality. PMID:26217434

  12. Publishing history does not correlate with clinical performance among internal medicine residents.

    PubMed

    Cavalcanti, Rodrigo B; Detsky, Allan S

    2010-05-01

    OBJECTIVES Selection criteria for applicants to the internal medicine programme at the University of Toronto have included the number and quality of scholarly items published. We sought to determine whether previous publishing record correlated with resident performance as measured by in-training evaluation reports (ITERs) and global impressions of clinical competency by site programme directors and senior educators (global impression). METHODS Data on the total number, quality and type of items published, as well as the timing of publishing with regard to pre-MD training, were abstracted from the curricula vitae of individuals who applied for residency during 2001-2005. These were correlated with overall, Expert and Scholar role ITER scores, and with global impression, using Spearman rank correlation scores. RESULTS We gathered publishing history data on 181 residents, for 162 of whom ITER data were available. Overall, 68.5% of residents had published, but only 14.9% had published during medical school. There was a weak correlation of borderline significance (rho = 0.15, P = 0.055) between overall ITER score and number of items published. No such correlation was found with CanMEDS Medical Expert and Scholar role scores. Global impression classified 33.9% of residents as top-rated. More top-rated residents had published (76.7% versus 65.1%; P = 0.07), but the number of items published during medical school were similar between top-rated and non-top-rated residents (16.1% versus 12.3%; P = 0.46). CONCLUSIONS Our results do not support publishing record as a predictor of residents' clinical performance. Surprisingly, the correlation between publishing record and Scholar role scores was also weak, possibly indicating an inability of the ITER to capture this competency. Further research is needed to identify predictors and measures of performance in scholarly activities. PMID:20345694

  13. Establishment of a General Medicine Residency Training Program in Rural West Africa

    PubMed Central

    Drislane, Frank W.; Akpalu, Albert; Wegdam, Harry H.J.

    2014-01-01

    Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana’s rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the “brain drain” of young physicians out of West Africa. PMID:25191148

  14. Establishment of a general medicine residency training program in rural West Africa.

    PubMed

    Drislane, Frank W; Akpalu, Albert; Wegdam, Harry H J

    2014-09-01

    Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana's rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the "brain drain" of young physicians out of West Africa. PMID:25191148

  15. Aging Q3: an initiative to improve internal medicine residents' geriatrics knowledge, skills, and clinical performance.

    PubMed

    Moran, William P; Zapka, Jane; Iverson, Patty J; Zhao, Yumin; Wiley, M Kathleen; Pride, Pamela; Davis, Kimberly S

    2012-05-01

    A growing number of older adults coupled with a limited number of physicians trained in geriatrics presents a major challenge to ensuring quality medical care for this population. Innovations to incorporate geriatrics education into internal medicine residency programs are needed. To meet this need, in 2009, faculty at the Medical University of South Carolina developed Aging Q(3)-Quality Education, Quality Care, and Quality of Life. This multicomponent initiative recognizes the need for improved geriatrics educational tools and faculty development as well as systems changes to improve the knowledge and clinical performance of residents. To achieve these goals, faculty employ multiple intervention strategies, including lectures, rounds, academic detailing, visual cues, and electronic medical record prompts and decision support. The authors present examples from specific projects, based on care areas including vision screening, fall prevention, and caring for patients with dementia, all of which are based on the Assessing Care of Vulnerable Elders quality indicators. The authors describe the principles driving the design, implementation, and evaluation of the Aging Q(3) program. They present data from multiple sources that illustrate the effectiveness of the interventions to meet the knowledge, skill level, and behavior goals. The authors also address major challenges, including the maintenance of the teaching and modeling interventions over time within the context of demanding primary care and inpatient settings. This organized, evidence-based approach to quality improvement in resident education, as well as faculty leadership development, holds promise for successfully incorporating geriatrics education into internal medicine residencies. PMID:22450181

  16. Development of Scintillators in Nuclear Medicine.

    PubMed

    Khoshakhlagh, Mohammad; Islamian, Jalil Pirayesh; Abedi, Seyed Mohammad; Mahmoudian, Babak

    2015-01-01

    High-quality image is necessary for accurate diagnosis in nuclear medicine. There are many factors in creating a good image and detector is the most important one. In recent years, several detectors are studied to get a better picture. The aim of this paper is comparison of some type of these detectors such as thallium activated sodium iodide bismuth germinate cesium activated yttrium aluminum garnet (YAG: Ce) YAP: Ce "lutetium aluminum garnet activated by cerium" CRY018 "CRY019" lanthanum bromide and cadmium zinc telluride. We studied different properties of these crystals including density, energy resolution and decay times that are more important factors affecting the image quality. PMID:26420984

  17. [Solid liver mass. Studies with nuclear medicine].

    PubMed

    Domínguez Gadea, L; Fernández Salazar, L; García Grávalos, R; Rodríguez Eyré, J L

    2000-04-01

    We present the case of a 23 year old female with two incidentally detected hepatic mass that have not clinically o radiologically specific findings. Nuclear medicine tracers, including colloids and hepatobiliary agents showing the characteristic findings of focal nodular hyperplasia: Hypervascularization, normal uptake of colloids, accumulation of hepatobiliary tracer and hot spots due to the retention of this tracer during the clearance fhase. The patient was underwent hepatectomy. The examination of surgical specimen revealed focal nodular hyperplasia. The scintigraphic studies could be an useful tool in the noninvasive diagnosis of liver masses. PMID:10893773

  18. Horizons in nuclear medicine and molecular imaging: highlights of the Third Gulf Nuclear Medicine Conference.

    PubMed

    Elgazzar, A H

    2009-07-01

    The Third Gulf Nuclear Medicine Conference took place in the state of Kuwait at Salwa Al Sabah hall, Safir marina hotel in Salmiya. The event extended from March 29th to April 1st 2009. The assembly was a great chance for all nuclear medicine, i.e. physicians, technologists and researchers in the field to meet and exchange experience and knowledge. The number of participators registered for this conference was beyond expectations; total registrants of 611 attended the event and actively end it. The conference was attended by international, regional and local participants. There were 23 speakers, including 13 invited guest speakers who came from USA, Canada, Europe and the Gulf region. In addition to the lectures and oral presentations, there were 30 poster presentations. The latest updates in the field together with most recent findings in the participants' own research were presented. The lectures and posters covered different basic and clinical categories of nuclear medicine. This article summarizes the highlights of the major topics discussed with some recommendations when applicable. Proceedings of the conference can be found in the World Journal of Nuclear Medicine of April, 2009. PMID:20194093

  19. Impact of Doximity Residency Rankings on Emergency Medicine Applicant Rank Lists

    PubMed Central

    Peterson, William J.; Hopson, Laura R.; Khandelwal, Sorabh; White, Melissa; Gallahue, Fiona E.; Burkhardt, John; Rolston, Aimee M.; Santen, Sally A.

    2016-01-01

    Introduction This study investigates the impact of the Doximity rankings on the rank list choices made by residency applicants in emergency medicine (EM). Methods We sent an 11-item survey by email to all students who applied to EM residency programs at four different institutions representing diverse geographical regions. Students were asked questions about their perception of Doximity rankings and how it may have impacted their rank list decisions. Results Response rate was 58% of 1,372 opened electronic surveys. This study found that a majority of medical students applying to residency in EM were aware of the Doximity rankings prior to submitting rank lists (67%). One-quarter of these applicants changed the number of programs and ranks of those programs when completing their rank list based on the Doximity rankings (26%). Though the absolute number of programs changed on the rank lists was small, the results demonstrate that the EM Doximity rankings impact applicant decision-making in ranking residency programs. Conclusion While applicants do not find the Doximity rankings to be important compared to other factors in the application process, the Doximity rankings result in a small change in residency applicant ranking behavior. This unvalidated ranking, based principally on reputational data rather than objective outcome criteria, thus has the potential to be detrimental to students, programs, and the public. We feel it important for specialties to develop consensus around measurable training outcomes and provide freely accessible metrics for candidate education. PMID:27330670

  20. Employment in nuclear medicine during pregnancy

    SciTech Connect

    Benedetto, A.R.

    1986-12-01

    A nuclear medicine technologist can work throughout a pregnancy with high confidence that her occupational radiation exposure will not add any significant risk to her changes of having a normal pregnancy and child. All that is required is for the employer to provide an ALARA work place and for the technologist to observe carefully all radiation safety guidelines and to maintain her occupational exposure ALARA. Current guidance is that the total uterine dose during gestation be less than 0.5 rem (5 mSv). The vast majority of nuclear medicine technologists can achieve this dose level easily, with no modifications of duties or work practices. Technologists working with generators and radiopharmaceutical kits may wish to temporarily transfer to other duties within the clinic, not necessarily to reduce routine exposures but to minimize the changes of an accident having high-dose or high-contamination potential. All of the available human data show that there is small additional risk to the fetus or neonate due to occupational radiation exposure compared to naturally occurring risks so long as the dose is within recommended guidelines.

  1. Educating Emergency Medicine Residents in Emergency Department Administration and Operations: Needs and Current Practice

    PubMed Central

    Watase, Taketo; Yarris, Lalena M.; Fu, Rongwei; Handel, Daniel A.

    2014-01-01

    Background Emergency medicine (EM) residents are expected to develop competence in emergency department (ED) administration and operations. Objectives We assessed current needs and educational practices related to preparing EM residents for their role in ED operations, and explored whether there was an association between program characteristics and the presence of ED operations education in US EM residency programs. Methods We conducted a cross-sectional needs assessment, using a web-based survey sent to all US EM residency programs to assess program characteristics, provision of ED operations-related lectures, availability of an ED administrative fellowship, and presence of a formal ED operations curriculum. Logistic regression was used to determine if any program characteristics were associated with the presence of lectures and a formal operations curriculum. Results Of the 158 Accreditation Council for Graduate Medical Education–accredited EM programs, 117 (74%) responded. Of these, 109 (93%) respondents had at least 1 lecture on ED operational topics. Sixty programs (54%) measured resident productivity. Knowledge of Centers for Medicaid & Medicare Services reimbursement guidelines was significantly positively associated with presence of an ED operations curriculum (OR, 3.52, P  =  .009) and with lectures on patient satisfaction (OR, 3.99, P  =  .006). Measuring resident productivity was positively associated with having lectures on productivity (OR, 2.50, P  =  .02) and with ED throughput (OR, 2.32, P  =  .03). No 2 variables were simultaneously significant in the model. Conclusions Most EM programs had at least 1 lecture on ED operations topics. Roughly half of the programs measured resident productivity and half had a formal ED operations curriculum. PMID:26140135

  2. Effect of didactic lectures on obesity documentation and counseling among internal medicine residents

    PubMed Central

    Ren, Vicky; Ellison, Kathleen; Miller, Jonathan; Busireddy, Kiran; Vickery, Erin; Panda, Mukta; Qayyum, Rehan

    2016-01-01

    Background Screening adult patients for obesity and offering appropriate counseling and treatment for weight loss is recommended. However, many healthcare providers feel ill-equipped to address this topic. Objective We examined whether didactic presentations lead to increased obesity documentation and counseling among internal medicine (IM) residents. Methods We reviewed medical records of patients seen at the IM Resident Continuity Clinic during April 2015. Residents were provided feedback at two didactic presentations during May 2015. To examine the effect of this intervention, we repeated medical record review during June 2015. For both reviews, we abstracted patient-specific (i.e., age, body mass index [BMI], race, sex, and number of comorbid diagnoses) and resident-specific (i.e., sex and training level) data as well as evidence of obesity documentation and counseling. We used logistic regression models to examine the effect of intervention on obesity documentation and counseling, adjusting for patient- and resident-specific variables. Results Of the 278 patients with BMI≥30 kg/m2, 139 were seen before and 139 after the intervention. Intervention had no effect on obesity documentation or counseling with or without adjustment for confounding variables (both P>0.05). In adjusted post-hoc analyses, each additional comorbidity increased the odds of obesity documentation by 8% (OR=1.08; 95% CI=1.05–1.11; P<0.001). In addition, as compared to postgraduate year (PGY) 1 residents, PGY-3 residents were 56% (OR=0.44; 95% CI=0.21–0.95; P=0.03) less likely to counsel obese patients. Conclusions Obesity is inadequately addressed in primary care settings, and didactic presentations were unable to increase obesity documentation or weight loss counseling. Future research to identify effective interventions is needed. PMID:27124168

  3. The role of general nuclear medicine in breast cancer

    SciTech Connect

    Greene, Lacey R; Wilkinson, Deborah

    2015-03-15

    The rising incidence of breast cancer worldwide has prompted many improvements to current care. Routine nuclear medicine is a major contributor to a full gamut of clinical studies such as early lesion detection and stratification; guiding, monitoring, and predicting response to therapy; and monitoring progression, recurrence or metastases. Developments in instrumentation such as the high-resolution dedicated breast device coupled with the diagnostic versatility of conventional cameras have reinserted nuclear medicine as a valuable tool in the broader clinical setting. This review outlines the role of general nuclear medicine, concluding that targeted radiopharmaceuticals and versatile instrumentation position nuclear medicine as a powerful modality for patients with breast cancer.

  4. Educating physicians about women's health. Survey of Canadian family medicine residency programs.

    PubMed Central

    McCall, M. A.; Sorbie, J.

    1994-01-01

    OBJECTIVE: To identify which women's health issues are taught in the 2-year core curriculum of Canadian family medicine residency programs and whether educators think their current teaching of women's health is adequate. DESIGN: Mailed survey using a questionnaire. PARTICIPANTS: All program and unit directors of the 16 Canadian family medicine residency training programs were surveyed. Replies were received from 63% (10 of 16) of program directors and 79% (55 of 70) of unit directors. MAIN OUTCOME MEASURES: Percentage of programs teaching specific women's health topics from a list of 21 possible topics; percentage offering educational opportunities with sexual assault teams and women's shelters; participants' assessment of the adequacy of current teaching in each training program; plans to increase women's health education. RESULTS: Topics such as violence against women and medical conditions more common among women were taught in more than 80% of programs, but poverty and the health care concerns of Native and immigrant women were included in fewer than 40% of programs. Half of the program directors indicated that residents were given educational opportunities with sexual assault teams or women's shelters. Unit directors gave a lower estimate. Most (90%) program directors thought their current teaching of women's health issues was inadequate and had plans to increase it, as did 64% of unit directors. CONCLUSION: Violence against women and the traditional medical topics of osteoporosis, weight disorders, and reproductive and breast cancer are frequently taught in family medicine training programs. However, the social and cultural aspects of health are addressed less often. It is encouraging that many family medicine programs plan to increase their teaching of women's health. PMID:8038635

  5. Innovative strategies for transforming internal medicine residency training in resource-limited settings: the Mozambique experience.

    PubMed

    Mocumbi, Ana Olga; Carrilho, Carla; Aronoff-Spencer, Eliah; Funzamo, Carlos; Patel, Sam; Preziosi, Michael; Lederer, Philip; Tilghman, Winston; Benson, Constance A; Badaró, Roberto; Nguenha, A; Schooley, Robert T; Noormahomed, Emília V

    2014-08-01

    With approximately 4 physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient well-trained medical school faculty is one of Mozambique's major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. After an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital's internal medicine residency program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the internal medicine residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities. PMID:25072585

  6. Preparing the personal physician for practice: changing family medicine residency training to enable new model practice.

    PubMed

    Green, Larry A; Jones, Samuel M; Fetter, Gerald; Pugno, Perry A

    2007-12-01

    After two years of intensive study, in 2004 the Future of Family Medicine report concluded that the current U.S. health care system is inadequate and unsustainable, and called for changes within the specialty of family medicine to ensure the future health of the American public. With guidance and encouragement from many disciplines and health experts, a set of 10 recommendations was established to accomplish a transformative change in how family physicians serve their patients and how the essential function of primary care is achieved. From these recommendations came a period of innovation and experimentation in the training of family physicians, entitled Preparing the Personal Physician for Practice (P4). The P4 project is a carefully designed and evaluated initiative led by the American Board of Family Medicine and the Association of Family Medicine Residency Directors and administered by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. Fourteen family medicine programs were chosen to participate and will put their innovations into practice from 2007 to 2012, during which time regular evaluation will be conducted. The purpose of P4 is to learn how to improve the graduate medical education of family physicians such that they are prepared to be outstanding personal physicians and to work in the new models of practice now emerging. The innovations tested by P4 residencies are expected to inspire substantial changes in the content, structure, and locations of training of family physicians and to guide future revisions in accreditation and certification requirements. PMID:18046133

  7. Stereoscopic full aperture imaging in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Strocovsky, Sergio G.; Otero, Dino

    2011-06-01

    Images of planar scintigraphy and single photon emission computerized tomography (SPECT) used in nuclear medicine are often low quality. They usually appear to be blurred and noisy. This problem is due to the low spatial resolution and poor sensitivity of the acquisition technique with the gamma camera (GC). Other techniques, such as coded aperture imaging (CAI) reach higher spatial resolutions than GC. However, CAI is not frequently used for imaging in nuclear medicine, due to the decoding complexity of some images and the difficulty in controlling the noise magnitude. Summing up, the images obtained through GC are low quality and it is still difficult to implement CAI technique. A novel technique, full aperture Imaging (FAI), also uses gamma ray-encoding to obtain images, but the coding system and the method of images reconstruction are simpler than those used in CAI. In addition, FAI also reaches higher spatial resolution than GC. In this work, the principles of FAI technique and the method of images reconstruction are explained in detail. The FAI technique is tested by means of Monte Carlo simulations with filiform and spherical sources. Spatial resolution tests of GC versus FAI were performed using two different source-detector distances. First, simulations were made without interposing any material between the sources and the detector. Then, other more realistic simulations were made. In these, the sources were placed in the centre of a rectangular prismatic region, filled with water. A rigorous comparison was made between GC and FAI images of the linear filiform sources, by means of two methods: mean fluence profile graphs and correlation tests. Finally, three-dimensional capacity of FAI was tested with two spherical sources. The results show that FAI technique has greater sensitivity (>100 times) and greater spatial resolution (>2.6 times) than that of GC with LEHR collimator, in both cases, with and without attenuating material and long and short

  8. Female residents experiencing medical errors in general internal medicine: a qualitative study

    PubMed Central

    2014-01-01

    Background Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today’s approach to errors emphasizes systemic factors. Doctors’ individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital. Methods Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed. Results Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one’s own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience. Conclusions This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our

  9. What is the Prevalence and Success of Remediation of Emergency Medicine Residents?

    PubMed Central

    Silverberg, Mark; Weizberg, Moshe; Murano, Tiffany; Smith, Jessica L.; Burkhardt, John C.; Santen, Sally A.

    2015-01-01

    Introduction The primary objective of this study was to determine the prevalence of remediation, competency domains for remediation, the length, and success rates of remediation in emergency medicine (EM). Methods We developed the survey in Surveymonkey™ with attention to content and response process validity. EM program directors responded how many residents had been placed on remediation in the last three years. Details regarding the remediation were collected including indication, length and success. We reported descriptive data and estimated a multinomial logistic regression model. Results We obtained 126/158 responses (79.7%). Ninety percent of programs had at least one resident on remediation in the last three years. The prevalence of remediation was 4.4%. Indications for remediation ranged from difficulties with one core competency to all six competencies (mean 1.9). The most common were medical knowledge (MK) (63.1% of residents), patient care (46.6%) and professionalism (31.5%). Mean length of remediation was eight months (range 1–36 months). Successful remediation was 59.9% of remediated residents; 31.3% reported ongoing remediation. In 8.7%, remediation was deemed “unsuccessful.” Training year at time of identification for remediation (post-graduate year [PGY] 1), longer time spent in remediation, and concerns with practice-based learning (PBLI) and professionalism were found to have statistically significant association with unsuccessful remediation. Conclusion Remediation in EM residencies is common, with the most common areas being MK and patient care. The majority of residents are successfully remediated. PGY level, length of time spent in remediation, and the remediation of the competencies of PBLI and professionalism were associated with unsuccessful remediation. PMID:26594275

  10. Everyday ethics in internal medicine resident clinic: an opportunity to teach

    PubMed Central

    Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Beach, Mary Catherine; Hughes, Mark T

    2011-01-01

    OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly

  11. Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

    PubMed Central

    Clarke, Samuel; Horeczko, Timothy; Carlisle, Matthew; Barton, Joseph D.; Ng, Vivienne; Al-Somali, Sameerah; Bair, Aaron E.

    2014-01-01

    Background Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM) skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Methods Forty-five emergency medicine residents were tracked with annual simulation assessments between 2006 and 2011. We used mixed-methods repeated-measures regression analyses to evaluate elements of the Ottawa GRS by level of training to predict performance growth throughout a 3-year residency. Results Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. Conclusions In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance. PMID:25499769

  12. Development of Scintillators in Nuclear Medicine

    PubMed Central

    Khoshakhlagh, Mohammad; Islamian, Jalil Pirayesh; Abedi, Seyed Mohammad; Mahmoudian, Babak

    2015-01-01

    High-quality image is necessary for accurate diagnosis in nuclear medicine. There are many factors in creating a good image and detector is the most important one. In recent years, several detectors are studied to get a better picture. The aim of this paper is comparison of some type of these detectors such as thallium activated sodium iodide bismuth germinate cesium activated yttrium aluminum garnet (YAG: Ce) YAP: Ce “lutetium aluminum garnet activated by cerium” CRY018 “CRY019” lanthanum bromide and cadmium zinc telluride. We studied different properties of these crystals including density, energy resolution and decay times that are more important factors affecting the image quality. PMID:26420984

  13. [Nuclear medicine diagnosis of bone metastases].

    PubMed

    Strobel, K

    2009-11-01

    Conventional bone scintigraphy is still the standard investigation for the detection of bone metastases, especially in breast and prostate cancer. In unclear scintigraphic uptakes in the appendicular skeleton conventional x-rays are problem solving in most of the cases. In unclear uptakes in the axial skeleton additional performance of SPECT/CT can increase the specificity. Fluoride-PET/CT is superior to conventional bone scintigraphy but is not yet available in clinical routine. Patients with high-risk breast cancer and patients with lung cancer should be staged with FDG-PET/CT primarily. An additional bone scan is than superfluous. The great advantage of FDG-PET/CT is the fact that bone metastases and organ metastases can be detected in the same investigation. There is a clear trend of shifting patients from conventional nuclear medicine to PET/CT. PMID:20029782

  14. Lossy compression in nuclear medicine images.

    PubMed Central

    Rebelo, M. S.; Furuie, S. S.; Munhoz, A. C.; Moura, L.; Melo, C. P.

    1993-01-01

    The goal of image compression is to reduce the amount of data needed to represent images. In medical applications, it is not desirable to lose any information and thus lossless compression methods are often used. However, medical imaging systems have intrinsic noise associated to it. The application of a lossy technique, which acts as a low pass filter, reduces the amount of data at a higher rate without any noticeable loss in the information contained in the images. We have compressed images of nuclear medicine using the discrete cosine transform algorithm. The decompressed images were considered reliable for visual inspection. Furthermore, a parameter was computed from these images and no discernible change was found from the results obtained using the original uncompressed images. PMID:8130593

  15. Computer Information System For Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Cahill, P. T.; Knowles, R. J.....; Tsen, O.

    1983-12-01

    To meet the complex needs of a nuclear medicine division serving a 1100-bed hospital, a computer information system has been developed in sequential phases. This database management system is based on a time-shared minicomputer linked to a broadband communications network. The database contains information on patient histories, billing, types of procedures, doses of radiopharmaceuticals, times of study, scanning equipment used, and technician performing the procedure. These patient records are cycled through three levels of storage: (a) an active file of 100 studies for those patients currently scheduled, (b) a temporary storage level of 1000 studies, and (c) an archival level of 10,000 studies containing selected information. Merging of this information with reports and various statistical analyses are possible. This first phase has been in operation for well over a year. The second phase is an upgrade of the size of the various storage levels by a factor of ten.

  16. Monte Carlo simulations in Nuclear Medicine

    SciTech Connect

    Loudos, George K.

    2007-11-26

    Molecular imaging technologies provide unique abilities to localise signs of disease before symptoms appear, assist in drug testing, optimize and personalize therapy, and assess the efficacy of treatment regimes for different types of cancer. Monte Carlo simulation packages are used as an important tool for the optimal design of detector systems. In addition they have demonstrated potential to improve image quality and acquisition protocols. Many general purpose (MCNP, Geant4, etc) or dedicated codes (SimSET etc) have been developed aiming to provide accurate and fast results. Special emphasis will be given to GATE toolkit. The GATE code currently under development by the OpenGATE collaboration is the most accurate and promising code for performing realistic simulations. The purpose of this article is to introduce the non expert reader to the current status of MC simulations in nuclear medicine and briefly provide examples of current simulated systems, and present future challenges that include simulation of clinical studies and dosimetry applications.

  17. Monte Carlo simulations in Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Loudos, George K.

    2007-11-01

    Molecular imaging technologies provide unique abilities to localise signs of disease before symptoms appear, assist in drug testing, optimize and personalize therapy, and assess the efficacy of treatment regimes for different types of cancer. Monte Carlo simulation packages are used as an important tool for the optimal design of detector systems. In addition they have demonstrated potential to improve image quality and acquisition protocols. Many general purpose (MCNP, Geant4, etc) or dedicated codes (SimSET etc) have been developed aiming to provide accurate and fast results. Special emphasis will be given to GATE toolkit. The GATE code currently under development by the OpenGATE collaboration is the most accurate and promising code for performing realistic simulations. The purpose of this article is to introduce the non expert reader to the current status of MC simulations in nuclear medicine and briefly provide examples of current simulated systems, and present future challenges that include simulation of clinical studies and dosimetry applications.

  18. Source Book of Educational Materials for Nuclear Medicine.

    ERIC Educational Resources Information Center

    Pijar, Mary Lou, Comp.; Lewis, Jeannine T., Comp.

    The contents of this sourcebook of educational materials are divided into the following sections: Anatomy and Physiology; Medical Terminology; Medical Ethics and Department Management; Patient Care and Medical Decision-Making; Basic Nuclear Medicine; Diagnostic in Vivo; Diagnostic in Vitro; Pediatric Nuclear Medicine; Radiation Detection and…

  19. Common uses of nonradioactive drugs in nuclear medicine

    SciTech Connect

    Ponto, J.A.; Hladik, W.B.

    1984-06-01

    A variety of nonradioactive pharmaceuticals commonly used in patients who receive nuclear medicine diagnostic tests are described. Nonradioactive drugs used in thyroid, brain, hepatobiliary, cardiac, renal, Meckel's diverticulum, gallium, adrenal, and hematological studies are described. Pharmaceutical necessities used as disinfectants, diluents, and anticoagulants are also described. Hospital pharmacists should be familiar with the uses of commonly prescribed nonradioactive drugs in nuclear medicine studies.

  20. Pulmonary nuclear medicine: Techniques in diagnosis of lung disease

    SciTech Connect

    Atkins, H.L.

    1984-01-01

    This book presents papers on the application of nuclear medicine to the diagnosis of lung diseases. Topics considered include lung physiology and anatomy, radiopharmaceuticals in pulmonary medicine, pulmonary embolism, obstructive pulmonary disease, diffuse infiltrative lung disease, pneumoconioses, tumor localization scans in primary lung tumors, the interactions of heart diseases and lung diseases on radionuclide tests of lung anatomy and function, radionuclide imaging in pediatric lung diseases, and future possibilities in pulmonary nuclear medicine.

  1. An interactive web-based project to stimulate internal medicine resident reading using board-type questions.

    PubMed

    Tuncel-Kara, Meryem; Islam, Ebtesam Attaya; Wang, Helen; Pelley, John; Nugent, Kenneth

    2015-04-01

    Since restricted resident work hours have reduced resident participation in traditional educational activities, we wanted to evaluate e-mail-based education in an internal medicine residency. One internal medicine faculty member sent four clinical case-based questions per week to all internal medicine residents over a 10-month period (132 questions total). The mean percentage of participation on a set of questions was 69% (range, 43% to 97%). The mean percentage of correct answers on all questions for all residents was 70% (range, 15% to 100%). Seventy-three percent of the question sets resulted in an electronic interaction between the residents and the faculty sponsor. Based on an anonymous survey, 96% of the residents found the program useful. The faculty sponsor spent 60 to 150 minutes per week on this activity. We think that this program increased overall reading since it did not replace any traditional activity; further, it provided practice with board-type questions. This approach can supplement the educational curriculum for internal medicine training. PMID:25829643

  2. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures.

    PubMed

    Koizumi, Kiyoshi; Masaki, Hidekazu; Matsuda, Hiroshi; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kamiyama, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin-ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

    2014-06-01

    The Japanese Society of Nuclear Medicine has recently published the consensus guidelines for pediatric nuclear medicine. This article is the English version of the guidelines. Part 1 proposes the dose optimization in pediatric nuclear medicine studies. Part 2 comprehensively discusses imaging techniques for the appropriate conduct of pediatric nuclear medicine procedures, considering the characteristics of imaging in children. PMID:24647992

  3. Length of residence, age and patterns of medicinal plant knowledge and use among women in the urban Amazon

    PubMed Central

    2014-01-01

    Background This paper explores patterns of women’s medicinal plant knowledge and use in an urban area of the Brazilian Amazon. Specifically, this paper examines the relationship between a woman’s age and her use and knowledge of medicinal plants. It also examines whether length of residence in three different areas of the Amazon is correlated with a woman’s use and knowledge of medicinal plants. Two of the areas where respondents may have resided, the jungle/seringal and farms/colonias, are classified as rural. The third area (which all of the respondents resided in) was urban. Methods This paper utilizes survey data collected in Rio Branco, Brazil. Researchers administered the survey to 153 households in the community of Bairro da Luz (a pseudonym). The survey collected data on phytotherapeutic knowledge, general phytotherapeutic practice, recent phytotherapeutic practice and demographic information on age and length of residence in the seringal, on a colonia, and in a city. Bivariate correlation coefficients were calculated to assess the inter-relationships among the key variables. Three dependent variables, two measuring general phytotherapeutic practice and one measuring phytotherapeutic knowledge were regressed on the demographic factors. Results The results demonstrate a relationship between a woman’s age and medicinal plant use, but not between age and plant knowledge. Additionally, length of residence in an urban area and on a colonia/farm are not related to medicinal plant knowledge or use. However, length of residence in the seringal/jungle is positively correlated with both medicinal plant knowledge and use. Conclusions The results reveal a vibrant tradition of medicinal plant use in Bairro da Luz. They also indicate that when it comes to place of residence and phytotherapy the meaningful distinction is not rural versus urban, it is seringal versus other locations. Finally, the results suggest that phytotherapeutic knowledge and use should be

  4. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    SciTech Connect

    Not Available

    1990-02-02

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  5. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    SciTech Connect

    Not Available

    1990-02-02

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not? by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  6. A multimethod approach for cross-cultural training in an internal medicine residency program

    PubMed Central

    Staton, Lisa J.; Estrada, Carlos; Panda, Mukta; Ortiz, David; Roddy, Donna

    2013-01-01

    Background Cultural competence training in residency is important to improve learners’ confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers. Methods We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants’ preparedness for cultural encounters. The multimethod approach included (1) a conference series, (2) a webinar with a national expert, (3) small group sessions, (4) a multicultural social gathering, (5) a Grand Rounds presentation on cross-cultural training, and (6) an interactive, online case-based program. Results The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%), and residents comprised 71% of respondents (n=25). Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71%) believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course. Conclusions Multimethod training may improve learners’ confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents’ perceived comfort will translate into improved patient outcomes. PMID:23683845

  7. The Application of Entrustable Professional Activities to Inform Competency Decisions in a Family Medicine Residency Program.

    PubMed

    Schultz, Karen; Griffiths, Jane; Lacasse, Miriam

    2015-07-01

    Assessing entrustable professional activities (EPAs), or carefully chosen units of work that define a profession and are entrusted to a resident to complete unsupervised once she or he has obtained adequate competence, is a novel and innovative approach to competency-based assessment (CBA). What is currently not well described in the literature is the application of EPAs within a CBA system. In this article, the authors describe the development of 35 EPAs for a Canadian family medicine residency program, including the work by an expert panel of family physician and medical education experts from four universities in three Canadian provinces to identify the relevant EPAs for family medicine in nine curriculum domains. The authors outline how they used these EPAs and the corresponding templates that describe competence at different levels of supervision to create electronic EPA field notes, which has allowed educators to use the EPAs as a formative tool to structure day-to-day assessment and feedback and a summative tool to ground competency declarations about residents. They then describe the system to compile, collate, and use the EPA field notes to make competency declarations and how this system aligns with van der Vleuten's utility index for assessment (valid, reliable, of educational value, acceptable, cost-effective). Early outcomes indicate that preceptors are using the EPA field notes more often than they used the generic field notes. EPAs enable educators to evaluate multiple objectives and important but unwieldy competencies by providing practical, manageable, measurable activities that can be used to assess competency development. PMID:25719674

  8. Nuclear medicine imaging and therapy: gender biases in disease.

    PubMed

    Moncayo, Valeria M; Aarsvold, John N; Alazraki, Naomi P

    2014-01-01

    Gender-based medicine is medical research and care conducted with conscious consideration of the sex and gender differences of subjects and patients. This issue of Seminars is focused on diseases for which nuclear medicine is part of routine management and for which the diseases have sex- or gender-based differences that affect incidence or pathophysiology and that thus have differences that can potentially affect the results of the relevant nuclear medicine studies. In this first article, we discuss neurologic diseases, certain gastrointestinal conditions, and thyroid conditions. The discussion is in the context of those sex- or gender-based aspects of these diseases that should be considered in the performance, interpretation, and reporting of the relevant nuclear medicine studies. Cardiovascular diseases, gynecologic diseases, bone conditions such as osteoporosis, pediatric occurrences of some diseases, human immunodeficiency virus-related conditions, and the radiation dose considerations of nuclear medicine studies are discussed in the other articles in this issue. PMID:25362232

  9. Consensus Recommendations of Pediatric Transfusion Medicine Objectives for Clinical Pathology Residency Training Programs

    PubMed Central

    Sanchez, Rosa; Sloan, Steven R.; Josephson, Cassandra D.; Ambruso, Daniel R.; Hillyer, Christopher D.; O’Sullivan, Patricia

    2010-01-01

    BACKGROUND Pediatric transfusion medicine (PTM) is a subspecialty of transfusion medicine (TM) with no formal training program and few specialists. The Pediatric Transfusion Medicine Academic Awardees (PedsTMAA) group surveyed PTM content experts to identify relevant objectives for the first formal PTM curriculum. STUDY DESIGN AND METHODS Eight North American PTM experts were invited to participate in a two-step consensus process. PTM-related objectives compiled from a review of existing training documents were organized into a survey. Experts were asked to rate each objective for relevancy for a clinical pathology trainee. Content validity indices (CVIs) and asymmetric confidence intervals (ACIs) of expert ratings and analysis of respondents’ comments were used to identify relevant objectives. RESULTS Six experts participated and reviewed 117 objectives. Based on content validity criteria (CVI ≥ 0.83 and lower-limit 95% ACI ≥ 3), a total of 65 objectives were considered relevant. Twenty-three objectives were rated “very relevant” by all the experts while some proposed objectives were determined to be not relevant, out-of-date, or inappropriate for a resident trainee level. CONCLUSION The PedsTMAA group identified 65 objectives for a PTM curriculum. Twenty-three represent a clear core set of objectives and should be considered for clinical pathology training. The next step is to consider the teaching strategies and evaluation methods that will be employed to best deliver this content addressing competency in medical knowledge. PMID:20051052

  10. Teaching Emotional Intelligence: A Control Group Study of a Brief Educational Intervention for Emergency Medicine Residents

    PubMed Central

    Gorgas, Diane L.; Greenberger, Sarah; Bahner, David P.; Way, David P.

    2015-01-01

    Introduction Emotional Intelligence (EI) is defined as an ability to perceive another’s emotional state combined with an ability to modify one’s own. Physicians with this ability are at a distinct advantage, both in fostering teams and in making sound decisions. Studies have shown that higher physician EI’s are associated with lower incidence of burn-out, longer careers, more positive patient-physician interactions, increased empathy, and improved communication skills. We explored the potential for EI to be learned as a skill (as opposed to being an innate ability) through a brief educational intervention with emergency medicine (EM) residents. Methods This study was conducted at a large urban EM residency program. Residents were randomized to either EI intervention or control groups. The intervention was a two-hour session focused on improving the skill of social perspective taking (SPT), a skill related to social awareness. Due to time limitations, we used a 10-item sample of the Hay 360 Emotional Competence Inventory to measure EI at three time points for the training group: before (pre) and after (post) training, and at six-months post training (follow up); and at two time points for the control group: pre- and follow up. The preliminary analysis was a four-way analysis of variance with one repeated measure: Group x Gender x Program Year over Time. We also completed post-hoc tests. Results Thirty-three EM residents participated in the study (33 of 36, 92%), 19 in the EI intervention group and 14 in the control group. We found a significant interaction effect between Group and Time (p≤0.05). Post-hoc tests revealed a significant increase in EI scores from Time 1 to 3 for the EI intervention group (62.6% to 74.2%), but no statistical change was observed for the controls (66.8% to 66.1%, p=0.77). We observed no main effects involving gender or level of training. Conclusion Our brief EI training showed a delayed but statistically significant positive impact

  11. [Nuclear medicine for evaluation of liver functions].

    PubMed

    Yamamoto, K

    1994-05-01

    The clinical usefulness of colloid liver scintigraphy to detect space occupying lesions in the liver has been reduced by X-ray CT and ultrasonography. However, scintigraphic examinations have potentials for characteristic diagnosis of liver tumors, such as 99mTc RBC SPECT for hepatic hemangioma, 99mTc PMT for positive imaging of hepatocellular carcinoma and its extrahepatic metastasis, and radioimmunoscintigraphy for metastatic tumors. Moreover, prediction of the prognosis and monitoring therapeutic effect to liver cancer can be made by the use of nuclear medicine techniques. Recently, 99mTc galactosyl serum albumin (GSA), a newly developed radiotracer to evaluate hepatocyte function, has become commercially available. Quantitative parameters of liver functions can be obtained by analysis of time-activity curve in blood and liver after 99mTc-GSA administration. In several cases, 99mTc-GSA study showed intrahepatic unevenness of function, which could not be depicted by other imaging examinations. Positron emission tomography (PET) with 18F-fluoro-2-deoxy glucose (FDG) is useful to detect malignant tumors in the liver. Since PET can provide absolutely quantitative data in better resolution, it is expected that regional true metabolic functions in the liver may be able to be quantitatively evaluated with PET in near future. PMID:8028225

  12. The development of nuclear medicine in Slovenia and Ljubljana; half a century of nuclear medicine in Slovenia

    PubMed Central

    Slavec, Zvonka Zupanic; Gaberscek, Simona; Slavec, Ksenija

    2012-01-01

    Background Nuclear medicine began to be developed in the USA after 1938 when radionuclides were introduced into medicine and in Europe after radionuclides began to be produced at the Harwell reactor (England, 1947). Slovenia began its first investigations in the 1950s. This article describes the development of nuclear medicine in Slovenia and Ljubljana. The first nuclear medicine interventions were performed in Slovenia at the Internal Clinic in Ljubljana in the period 1954–1959. In 1954, Dr Jože Satler started using radioactive iodine for thyroid investigations. In the same year, Dr Bojan Varl, who is considered the pioneer of nuclear medicine in Slovenia, began systematically introducing nuclear medicine. The first radioisotope laboratories were established in January 1960 at the Institute of Oncology and at the Internal Clinic. Under the direction of Dr. Varl, the laboratory at the Internal Clinic developed gradually and in 1973 became the Clinic for Nuclear Medicine with departments for in vivo and in vitro diagnostics and for the treatment of inpatients and outpatients at the thyroid department. The Clinic for Nuclear Medicine became a teaching unit of the Medical Faculty and developed its own post-graduate programme – the first student enrolled in 1972. In the 1960s, radioisotope laboratories opened in the general hospitals of Slovenj Gradec and Celje, and in the 1970s also in Maribor, Izola and Šempeter pri Novi Gorici. Conclusions Nowadays, nuclear medicine units are modernly equipped and the staff is trained in morphological, functional and laboratory diagnostics in clinical medicine. They also work on the treatment of cancer, increased thyroid function and other diseases. PMID:22933984

  13. Can Simulation Measure Differences in Task-Switching Ability Between Junior and Senior Emergency Medicine Residents?

    PubMed Central

    Smith, Dustin; Miller, Daniel G.; Cukor, Jeffrey

    2016-01-01

    Introduction Work interruptions during patient care have been correlated with error. Task-switching is identified by the Accreditation Council for Graduate Medical Education (ACGME) as a core competency for emergency medicine (EM). Simulation has been suggested as a means of assessing EM core competencies. We assumed that senior EM residents had better task-switching abilities than junior EM residents. We hypothesized that this difference could be measured by observing the execution of patient care tasks in the simulation environment when a patient with a ST-elevation myocardial infarction (STEMI) interrupted the ongoing management of a septic shock case. Methods This was a multi-site, prospective, observational, cohort study. The study population consisted of a convenience sample of EM residents in their first three years of training. Each subject performed a standardized simulated encounter by evaluating and treating a patient in septic shock. At a predetermined point in every sepsis case, the subject was given a STEMI electrocardiogram (ECG) for a separate chest pain patient in triage and required to verbalize an interpretation and action. We scored learner performance using a dichotomous checklist of critical actions covering sepsis care, ECG interpretation and triaging of the STEMI patient. Results Ninety-one subjects participated (30 postgraduate year [PGY]1s, 32 PGY2s, and 29 PGY3s). Of those, 87 properly managed the patient with septic shock (90.0% PGY1s, 100% PGY2, 96.6% PGY 3s; p=0.22). Of the 87 who successfully managed the septic shock, 80 correctly identified STEMI on the simulated STEMI patient (86.7% PGY1s, 96.9% PGY2s, 93.1% PGY3s; p=0.35). Of the 80 who successfully managed the septic shock patient and correctly identified the STEMI, 79 provided appropriate interventions for the STEMI patient (73.3% PGY1s, 93.8% PGY2s, 93.8% PGY3s; p=0.07). Conclusion When management of a septic shock patient was interrupted with a STEMI ECG in a simulated

  14. Emergency Medicine in Guyana: Lessons from Developing the Country’s First Degree-conferring Residency Program

    PubMed Central

    Forget, Nicolas P.; Rohde, John Paul; Rambaran, Navindranauth; Rambaran, Madan; Wright, Seth W.

    2013-01-01

    Introduction: Academic departments of emergency medicine are becoming increasingly involved in assisting with the development of long-term emergency medicine training programs in low and middle-income countries. This article presents our 10-year experience working with local partners to improve emergency medical care education in Guyana. Methods: The Vanderbilt Department of Emergency Medicine has collaborated with the Georgetown Public Hospital Corporation on the development of Emergency Medicine skills followed by the implementation of an emergency medicine residency training program. Residency development included a needs assessment, proposed curriculum, internal and external partnerships, University of Guyana and Ministry of Health approval, and funding. Results: In our experience, we have found that our successful program initiation was due in large part to the pre-existing interest of several local partners and followed by long-term involvement within the country. As a newer specialty without significant local expertise, resident educational needs mandated a locally present full time EM trained attending to serve as the program director. Both external and internal funding was required to achieve this goal. Local educational efforts were best supplemented by robust distance learning. The program was developed to conform to local academic standards and to train the residents to the level of consultant physicians. Despite the best preparations, future challenges remain. Conclusion: While every program has unique challenges, it is likely many of the issues we have faced are generalizable to other settings and will be useful to other programs considering or currently conducting this type of collaborative project. PMID:24106546

  15. Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center

    PubMed Central

    McLaughlin, Thomas; Blow, Osbert; Herrick, John; Richman, Peter

    2016-01-01

    Background CHRISTUS Spohn Hospital Corpus Christi - Memorial began an Emergency Medicine Residency Program in March 2007. During each of the three years of their residency, residents are required to complete a trauma surgery rotation. These emergency medicine residents are the only residents participating on this rotation as there is no surgical residency. The Department of Acute Care Surgery, Trauma and Surgical Critical Care analyzed the impact of the residents on trauma patient care outcomes with the hypothesis that there were no differences. Methods Data including length of stay in the hospital, length of stay in the intensive care unit, time spent in the emergency department (ED), morbidities and mortalities were compiled from the trauma registry for patients from the year before the residents began (March 1, 2006 to February 28, 2007) and compared with patients from the first year the residents began their trauma rotations (March 1, 2007 to February 29, 2008). T-tests and Mann-Whitney U tests were used to compare continuous variables and a Chi-square test was used to analyze the categorical variable (mortality). Linear and logistic regression analyses were also performed in order to adjust for potential confounding factors. Results Trauma patient admission rates were 1,316 before and 1,391 after the residents began. No statistically significant differences were found among all of the outcome variables during the two time periods except for time spent in the ED (P = 0.00), which increased during the year the residents began (236.83 ± 4.53 minutes in 2006 compared to 297.40 ± 5.55 minutes in 2007). Linear and logistic regression analyses confirmed these results with the exception of a statistically significant decrease in mortality with the residents on the trauma service (2.8% in 2006 and 2.1% in 2007, P = 0.00) after adjustment for multiple confounding factors. Conclusion The addition of emergency medicine residents to the trauma care service did increase

  16. Knowledge Levels and Training Needs of Disaster Medicine among Health Professionals, Medical Students, and Local Residents in Shanghai, China

    PubMed Central

    Zhang, Hongwei; Yin, Jianhua; Tan, Xiaojie; Chang, Wenjun; Ding, Yibo; Han, Yifang; Cao, Guangwen

    2013-01-01

    Background Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education. Methods A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%. Results Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001). Conclusions Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current

  17. Win/win: creating collaborative training opportunities for behavioral health providers within family medicine residency programs.

    PubMed

    Ruddy, Nancy Breen; Borresen, Dorothy; Myerholtz, Linda

    2013-01-01

    Integrating behavioral health into primary healthcare offers multiple advantages for patients and health professionals. This model requires a new skill set for all healthcare professionals that is not emphasized in current educational models. The new skills include interprofessional team-based care competencies and expanded patient care competencies. Health professionals must learn new ways to efficiently and effectively address health behavior change, and manage behavioral health issues such as depression and anxiety. Learning environments that co-train mental health and primary care professionals facilitate acquisition of both teamwork and patient care competencies for mental health and primary care professional trainees. Family Medicine Residency programs provide an excellent opportunity for co-training. This article serves as a "how to" guide for residency programs interested in developing a co-training program. Necessary steps to establish and maintain a program are reviewed, as well as goals and objectives for a co-training curriculum and strategies to overcome barriers and challenges in co-training models. PMID:24261270

  18. Evaluation of the educational environment of the Saudi family medicine residency training program

    PubMed Central

    Khoja, Abdullah T.

    2015-01-01

    Objectives: The study was conducted to evaluate the educational environment (EE) in Family Medicine Training Programs. Materials and Methods: A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM), was distributed to all residents at the four training centers in the central region. Cronbach's alpha was used to test the reliability. The mean and standard deviation (SD) for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann–Whitney–Wilcoxon test was used to compare each item based on the selected factors. Results: The overall score was 67.1/160 (SD: 20.1). The PHEEM's domains scores: 24.2/56 (SD: 7.13) for perception of role autonomy; 25.3/60 (SD: 8.88), for perception of teaching; and 17/44 (SD: 5.6), for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program) significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach's alpha of 0.92. Conclusions: There are many problems in the training program. Urgent actions are needed to improve the residents' learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians. PMID:25657612

  19. Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment.

    PubMed

    Min, Alice Ann; Spear-Ellinwood, Karen; Berman, Melissa; Nisson, Peyton; Rhodes, Suzanne Michelle

    2016-09-01

    The skill of delivering bad news is difficult to teach and evaluate. Residents may practice in simulated settings; however, this may not translate to confidence or competence during real experiences. We investigated the acceptability and feasibility of social workers as evaluators of residents' delivery of bad news during patient encounters, and assessed the attitudes of both groups regarding this process. From August 2013 to June 2014, emergency medicine residents completed self-assessments after delivering bad news. Social workers completed evaluations after observing these conversations. The Assessment tools were designed by modifying the global Breaking Bad News Assessment Scale. Residents and social workers completed post-study surveys. 37 evaluations were received, 20 completed by social workers and 17 resident self-evaluations. Social workers reported discussing plans with residents prior to conversations 90 % of the time (18/20, 95 % CI 64.5, 97.8). Social workers who had previously observed the resident delivering bad news reported that the resident was more skilled on subsequent encounters 90 % of the time (95 % CI 42.2, 99). Both social workers and residents felt that prior training or experience was important. First-year residents valued advice from social workers less than advice from attending physicians, whereas more experienced residents perceived advice from social workers to be equivalent with that of attending physicians (40 versus 2.9 %, p = 0.002). Social worker assessment of residents' abilities to deliver bad news is feasible and acceptable to both groups. This formalized self-assessment and evaluation process highlights the importance of social workers' involvement in delivery of bad news, and the teaching of this skill. This method may also be used as direct-observation for resident milestone assessment. PMID:26892405

  20. Life stage differences in resident coping with restart of the Three Mile Island nuclear generating facility.

    PubMed

    Prince-Embury, S; Rooney, J F

    1990-12-01

    A study of residents who remained in the vicinity of Three Mile Island (TMI) immediately following the restart of the nuclear generating plant revealed that older residents employed a more emotion-focused coping style in the face of this event than did younger residents. Coping style was, however, unrelated to the level of psychological symptoms for these older residents, whereas demographic variables were related. Among younger residents, on the other hand, coping style was related to the level of psychological symptoms, whereas demographic variables were not. Among younger residents, emotion-focused coping was associated with more symptoms and problem-focused coping was associated with fewer symptoms, contradicting previous findings among TMI area residents. PMID:2087105

  1. Life stage differences in resident coping with restart of the Three Mile Island nuclear generating facility

    SciTech Connect

    Prince-Embury, S.; Rooney, J.F.

    1990-12-01

    A study of residents who remained in the vicinity of Three Mile Island (TMI) immediately following the restart of the nuclear generating plant revealed that older residents employed a more emotion-focused coping style in the face of this event than did younger residents. Coping style was, however, unrelated to the level of psychological symptoms for these older residents, whereas demographic variables were related. Among younger residents, on the other hand, coping style was related to the level of psychological symptoms, whereas demographic variables were not. Among younger residents, emotion-focused coping was associated with more symptoms and problem-focused coping was associated with fewer symptoms, contradicting previous findings among TMI area residents.

  2. Radiation safety audit of a high volume Nuclear Medicine Department

    PubMed Central

    Jha, Ashish Kumar; Singh, Abhijith Mohan; Shetye, Bhakti; Shah, Sneha; Agrawal, Archi; Purandare, Nilendu Chandrakant; Monteiro, Priya; Rangarajan, Venkatesh

    2014-01-01

    Introduction: Professional radiation exposure cannot be avoided in nuclear medicine practices. It can only be minimized up to some extent by implementing good work practices. Aim and Objectives: The aim of our study was to audit the professional radiation exposure and exposure rate of radiation worker working in and around Department of nuclear medicine and molecular imaging, Tata Memorial Hospital. Materials and Methods: We calculated the total number of nuclear medicine and positron emission tomography/computed tomography (PET/CT) procedures performed in our department and the radiation exposure to the radiation professionals from year 2009 to 2012. Results: We performed an average of 6478 PET/CT scans and 3856 nuclear medicine scans/year from January 2009 to December 2012. The average annual whole body radiation exposure to nuclear medicine physician, technologist and nursing staff are 1.74 mSv, 2.93 mSv and 4.03 mSv respectively. Conclusion: Efficient management and deployment of personnel is of utmost importance to optimize radiation exposure in a high volume nuclear medicine setup in order to work without anxiety of high radiation exposure. PMID:25400361

  3. The forgotten educational needs of the house staff: training internal medicine residents to address end-of-life issues.

    PubMed

    Kerai, Sara Moore; Wheeler, Margot

    2013-01-01

    An intervention was conducted, aimed at providing residents in internal medicine with communication skills to address end-of-life issues with patients. Residents participated in two 1-hour educational sessions designed to teach a communication protocol, enhance listening skills, and to provide practice in effective communication in a safe, small-group format. An anonymous on-line survey assessed the effectiveness of the intervention. Twenty-five residents completed the intervention. There was a trend toward increased comfort level in addressing end-of-life issues among residents who completed the intervention, versus a comparison group. Residents who completed the intervention reported that using the words "death" and "dying" with patients and families was an important teaching point. PMID:23977790

  4. Learning to See Beneath the Surface: A Qualitative Analysis of Family Medicine Residents' Reflections About Communication.

    PubMed

    Duggan, Ashley P; Vicini, Andrea; Allen, Lucas; Shaughnessy, Allen F

    2015-01-01

    Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations. PMID:26147857

  5. Diagnostic Services and Communication Protocols for Remote Nuclear Medicine Laboratories

    PubMed Central

    Herbig, F.K.; Daly, J.L.; Gooch, N.E.; Donati, R.M.; Fletcher, J.W.

    1980-01-01

    A telecommunications system has been designed and implemented which provides diagnostic services to nuclear medicine laboratories established in smaller primary care medical facilities. These remote laboratories are located in areas where nuclear medicine patient services were not previously available because of the lack of trained nuclear physicians. The system provides through the use of computerized data acquisition and telephone data communication capability all routine and specialized imaging procedures with a degree of quality and sophistication normally available only in large urban medical centers. Nuclear image data acquired remotely is transmitted to Saint Louis, Missouri for interpretation by specialists in the Nuclear Medicine Service of the Veterans Administration Medical Center. The functions of hardware and software protocols necessary to assure the correctness and completeness of transmitted data are presented together with essential data descriptors for identification and format.

  6. Nuclear oncology, a fast growing field of nuclear medicine

    NASA Astrophysics Data System (ADS)

    Olivier, Pierre

    2004-07-01

    Nuclear Medicine in oncology has been for a long time synonymous with bone scintigraphy, the first ever whole body imaging modality, and with treatment of thyroid cancer with iodine-131. More recently, somatostatin receptor scintigraphy (SRS) using peptides such as 111In-labelled octreotide became a reference imaging method in the detection and staging of neuroendocrine tumors while 131I- and 123I-MIBG remain the tracers of reference for pheochromocytomas and neuroblastomas. Lymphoscintigraphic imaging based on peritumoral injection of 99mTc-labelled colloids supports, in combination with per operative detection, the procedure of sentinel node identification in breast cancers and melanomas. Positron Emission Tomography (PET) is currently experiencing a considerable growth in oncology based on the use of 18F-FDG (fluorodeoxyglucose), a very sensitive, although non-specific, tumor tracer. Development of instrumentation is crucial in this expansion of PET imaging with new crystals being more sensitive and hybrid imagers that permit to reduce the acquisition time and offer fused PET-CT images. Current developments in therapy can be classified into three categories. Radioimmunotherapy (RIT) based on monoclonal antibodies (or fragments) labelled with beta-emitters. This technique has recently made its entrance in clinical practice with a 90Y-labelled anti-CD20 antibody ( 90Y-ibritumomab tiuxetan (Zevalin ®)) approved in US for the treatment of some subtypes of non-Hodgkin's lymphoma. Radionuclide-bone pain palliation has experienced developments with 153Sm-EDTMP, 186Re-HEDP or 89Sr, efficient in patients with widespread disease. Last, the same peptides, as those used in SRS, are being developed for therapy, labelled with 90Y, 111In or 177Lu in patients who failed to respond to other treatments. Overall, nuclear oncology is currently a fast growing field thanks to the combined developments of radiopharmaceuticals and instrumentation.

  7. Nuclear medicine imaging of bone infections.

    PubMed

    Love, C; Palestro, C J

    2016-07-01

    Osteomyelitis is a broad group of infectious diseases that involve the bone and/or bone marrow. It can arise haematogenously, via extension from a contiguous infection, or by direct inoculation during surgery or trauma. The diagnosis is not always obvious and imaging tests are frequently performed as part of the diagnostic work-up. Commonly performed radionuclide tests include technetium-99m ((99m)Tc)-diphosphonate bone scintigraphy (bone), and gallium-67 ((67)Ga) and in vitro labelled leukocyte (white blood cell; WBC) imaging. Although they are useful, each of these tests has limitations. Bone scintigraphy is sensitive but not specific, especially when underlying osseous abnormalities are present. (67)Ga accumulates in tumour, trauma, and in aseptic inflammation; furthermore, there is typically an interval of 1-3 days between radiopharmaceutical injection of and imaging. Currently, this agent is used primarily for spinal infections. Except for the spine, WBC imaging is the nuclear medicine test of choice for diagnosing complicating osteomyelitis. The in vitro leukocyte labelling process requires skilled personnel, is laborious, and is not always available. Complementary marrow imaging is usually required to maximise accuracy. Not surprisingly, alternative radiopharmaceuticals are continuously being investigated. Radiolabelled anti-granulocyte antibodies and antibody fragments, investigated as in vivo leukocyte labelling agents, have their own limitations and are not widely available. (111)In-biotin is useful for diagnosing spinal infections. Radiolabelled synthetic fragments of ubiquicidin, a naturally occurring human antimicrobial peptide that targets bacteria, have shown promise as infection specific radiopharmaceuticals. 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) with or without computed tomography (CT) is very useful in musculoskeletal infection. Sensitivities of more than 95% and specificities ranging from 75-99% have been

  8. The Feasibility of Consortia for Internal Medicine Graduate Medical Education: Perspectives from a Survey of Residency Directors.

    ERIC Educational Resources Information Center

    Libby, Donald L.; And Others

    1997-01-01

    A survey of 330 internal medicine residency directors found two-thirds of programs had ongoing academic affiliations. Support for the arrangements was stronger in university programs than in community or other hospitals, where such affiliations were considered less equitable and mutually trusting. Experience with consortia mitigated objections to…

  9. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    PubMed Central

    Stoneking, LR; Waterbrook, AL; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, KH; Adamas-Rappaport, W

    2016-01-01

    Background After emergency department (ED) discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit. Objectives To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency. Methods Our ED has two Emergency Medicine Residency Programs, University Campus (UC) and South Campus (SC). SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions. Results Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters – 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters – 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians

  10. Applications of CdTe to nuclear medicine. Final report

    SciTech Connect

    Entine, G.

    1985-05-07

    Uses of cadmium telluride (CdTe) nuclear detectors in medicine are briefly described. They include surgical probes and a system for measuring cerebral blood flow in the intensive care unit. Other uses include nuclear dentistry, x-ray exposure control, cardiology, diabetes, and the testing of new pharmaceuticals. (ACR)

  11. IAEA support to medical physics in nuclear medicine.

    PubMed

    Meghzifene, Ahmed; Sgouros, George

    2013-05-01

    Through its programmatic efforts and its publications, the International Atomic Energy Agency (IAEA) has helped define the role and responsibilities of the nuclear medicine physicist in the practice of nuclear medicine. This paper describes the initiatives that the IAEA has undertaken to support medical physics in nuclear medicine. In 1984, the IAEA provided guidance on how to ensure that the equipment used for detecting, imaging, and quantifying radioactivity is functioning properly (Technical Document [TECDOC]-137, "Quality Control of Nuclear Medicine Instruments"). An updated version of IAEA-TECDOC-137 was issued in 1991 as IAEA-TECDOC-602, and this included new chapters on scanner-computer systems and single-photon emission computed tomography systems. Nuclear medicine physics was introduced as a part of a project on radiation imaging and radioactivity measurements in the 2002-2003 IAEA biennium program in Dosimetry and Medical Radiation Physics. Ten years later, IAEA activities in this field have expanded to cover quality assurance (QA) and quality control (QC) of nuclear medicine equipment, education and clinical training, professional recognition of the role of medical physicists in nuclear medicine physics, and finally, the coordination of research and development activities in internal dosimetry. As a result of these activities, the IAEA has received numerous requests to support the development and implementation of QA or QC programs for radioactivity measurements in nuclear medicine in many Member States. During the last 5 years, support was provided to 20 Member States through the IAEA's technical cooperation programme. The IAEA has also supported education and clinical training of medical physicists. This type of support has been essential for the development and expansion of the Medical Physics profession, especially in low- and middle-income countries. The need for basic as well as specialized clinical training in medical physics was identified as a

  12. Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum

    PubMed Central

    Pagels, Patti; Kindratt, Tiffany; Arnold, Danielle; Brandt, Jeffrey; Woodfin, Grant; Gimpel, Nora

    2015-01-01

    Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents' health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents (N = 25) participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents' ability to measure their patients' health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge (p = 0.001) and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training. PMID:26491565

  13. Shortening the Miles to the Milestones: Connecting EPA-Based Evaluations to ACGME Milestone Reports for Internal Medicine Residency Programs.

    PubMed

    Choe, John H; Knight, Christopher L; Stiling, Rebekah; Corning, Kelli; Lock, Keli; Steinberg, Kenneth P

    2016-07-01

    The Next Accreditation System requires internal medicine training programs to provide the Accreditation Council for Graduate Medical Education (ACGME) with semiannual information about each resident's progress in 22 subcompetency domains. Evaluation of resident "trustworthiness" in performing entrustable professional activities (EPAs) may offer a more tangible assessment construct than evaluations based on expectations of usual progression toward competence. However, translating results from EPA-based evaluations into ACGME milestone progress reports has proven to be challenging because the constructs that underlay these two systems differ.The authors describe a process to bridge the gap between rotation-specific EPA-based evaluations and ACGME milestone reporting. Developed at the University of Washington in 2012 and 2013, this method involves mapping EPA-based evaluation responses to "milestone elements," the narrative descriptions within the columns of each of the 22 internal medicine subcompetencies. As faculty members complete EPA-based evaluations, the mapped milestone elements are automatically marked as "confirmed." Programs can maintain a database that tallies the number of times each milestone element is confirmed for a resident; these data can be used to produce graphical displays of resident progress along the internal medicine milestones.Using this count of milestone elements allows programs to bridge the gap between faculty assessments of residents based on rotation-specific observed activities and semiannual ACGME reports based on the internal medicine milestones. Although potentially useful for all programs, this method is especially beneficial to large programs where clinical competency committee members may not have the opportunity for direct observation of all residents. PMID:27028030

  14. Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey).

    PubMed

    Bağci Bosi, A Tülay; Camur, Derya; Güler, Cağatay

    2007-11-01

    This study has been carried out to "identify highly sensitive behavior on healthy nutrition (orthorexia nervosa-ON)" in residence medical doctors (MD) in the Faculty of Medicine. Diagnoses of ON was based on the presence of a disorder with obsessive-compulsive personality. The study is a cross-sectional research, which reached out to the entire 318 MD. The ORTO-15 test was used to propose a diagnostic proceeding and to try verify the prevalence of ON. Those subjects who were classified below 40 from the ORTO-15 test are accepted to have ON. Chi-square test, ANOVA (univariate) analysis and logistic regression were used for analyses of the data. Mean score of the participants from the ORTO-15 test is 39.8+/-0.22, and there is no statistical difference between women and men. A total of 45.5% of the residence MD involved in the research scored below 40 in the ORTO-15 test. Those who do their food shopping themselves, skip a meal with a salad/fruit, care about the quality of the things they eat, think that eating outside is healthy, look at the content of what they eat and the content of food is important in selection of a product score lower in their average marks in ORTO-15 and the difference among the groups is statistically significant. Food selection of 20.1% of the male participants and 38.9% of the female participants among the residence MD is influenced by the programs on nutrition/health in mass-media. The difference between the groups is statistically significant (p<0.05). Female medical doctors are more careful than men of their physical appearance and weight control and consume less caloric food, which is statistically significant. Since those who exhibit "healthy fanatic" eating habits may have a risk of ON in the future, it would be useful to conduct studies that identify the prevalence of ON in the public. PMID:17586085

  15. What factors promote resilience and protect against burnout in first-year pediatric and medicine-pediatric residents?

    PubMed

    Olson, Kayloni; Kemper, Kathi J; Mahan, John D

    2015-07-01

    Burnout has high costs for pediatricians and their patients. There is increasing interest in educational interventions to promote resilience and minimize burnout among pediatric trainees. This study tested a conceptual model of factors that might promote resilience and protect against burnout, and which could serve as targets for addressing burnout in pediatric residents. Questionnaires were administered in a cross-sectional survey of (n = 45) first-year pediatric and medicine-pediatric residents. A minority (40%) of residents met one or more criteria for burnout. Physician empathy and emotional intelligence were not significantly correlated with burnout or resilience. Self-compassion and mindfulness were positively associated with resilience and inversely associated with burnout. Thus many residents in this sample endorsed burnout; mindfulness and self-compassion were associated with resilience and may promote resilience and protect against burnout in these trainees. Future studies should explore the impact of training in mindfulness and self-compassion in pediatric trainees. PMID:25694128

  16. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed

    Haines, A; de B White, C; Gleisner, J

    1983-12-01

    The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585

  17. Comparative analysis of dosimetry parameters for nuclear medicine

    SciTech Connect

    Toohey, R.E.; Stabin, M.G.

    1999-01-01

    For years many have employed the concept of ``total-body dose`` or ``whole-body dose,`` i.e., the total energy deposited in the body divided by the mass of the body, when evaluating the risks of different nuclear medicine procedures. The effective dose equivalent (H{sub E}), first described in ICRP Publication 26, has been accepted by some as a better quantity to use in evaluating the total risk of a procedure, but its use has been criticized by others primarily because the tissue weighting factors were intended for use in the radiation worker, rather than the nuclear medicine patient population. Nevertheless, in ICRP Publication 52, the ICRP has suggested that the H{sub E} may be used in nuclear medicine. The ICRP also has published a compendium of dose estimates, including H{sub E} values, for various nuclear medicine procedures at various ages in ICRP Publication 53. The effective dose (E) of ICRP Publication 60 is perhaps more suitable for use in nuclear medicine, with tissue weighting factors based on the entire population. Other comparisons of H{sub E} and E have been published. The authors have used the program MIRDOSE 3.1 to compute total-body dose, H{sub E}, and E for 62 radiopharmaceutical procedures, based on the best current biokinetic data available.

  18. Nuclear Medicine in Pediatric and Adolescent Tumors.

    PubMed

    Kiratli, Pınar Özgen; Tuncel, Murat; Bar-Sever, Zvi

    2016-07-01

    Nuclear medicine has an important role in the management of many cancers in pediatric age group with multiple imaging modalities and radiopharmaceuticals targeting various biological uptake mechanisms. 18-Flourodeoxyglucose is the radiotracer of choice especially in patients with sarcoma and lymphoma. (18)FDG-PET, for sarcoma and lymphomas, is proved to be superior to conventional imaging in staging and therapy response. Although studies are limited in pediatric population, (18)FDG-PET/CT has found its way through international guidelines. Limitations and strengths of PET imaging must be noticed before adapting PET imaging in clinical protocols. Established new response criteria using multiple parameters derived from (18)FDG-PET would increase the accuracy and repeatability of response evaluation. Current data suggest that I-123 metaiodobenzylguanidine (MIBG) remains the tracer of choice in the evaluation of neuroblastoma (NB) because of its high sensitivity, specificity, diagnostic accuracy, and prognostic value. It is valuable in determining the response to therapy, surveillance for disease recurrence, and in selecting patients for I-131 therapy. SPECT/CT improves the diagnostic accuracy and the interpretation confidence of MIBG scans. (18)FDG-PET/CT is an important complementary to MIBG imaging despite its lack of specificity to NB. It is valuable in cases of negative or inconclusive MIBG scans and when MIBG findings underestimate the disease status as determined from clinical and radiological findings. F-18 DOPA is promising tracer that reflects catecholamine metabolism and is both sensitive and specific. F-18 DOPA scintigraphy provides the advantages of PET/CT imaging with early and short imaging times, high spatial resolution, inherent morphologic correlation with CT, and quantitation. Regulatory and production issues currently limit the tracer's availability. PET/CT with Ga-68 DOTA appears to be useful in NB imaging and may have a unique role in selecting

  19. Recruiting the occupational and environmental medicine physicians of the future: results of a survey of current residents.

    PubMed

    Schwartz, B S; Pransky, G; Lashley, D

    1995-06-01

    In July 1994, current occupational and environmental medicine (OEM) residents (n = 180) were surveyed about their motivation for decisions to enter OEM residencies, near-term and long-term career goals, and their opinions on various strategies for recruitment to the field. A total of 151 persons responded (84%), representing all 40 accredited OEM residencies in the United States and Canada. A total of 16% first learned about OEM in medical school, and 11% were first exposed during residency training. Most respondents (62%) decided to enter OEM residency training after beginning their professional working careers. Only 11% of respondents decided to enter OEM residency training before (2%) or during (9%) medical school, whereas 24% made their decision during internship or residency. Respondents were attracted to several aspects of OEM, but the prevention focus of the field (64%), lifestyle (56%), and worker and labor issues (53%) were most commonly cited. Although only 25% of respondents stated that a role model had a significant impact on their decision to pursue training in OEM, persons influenced by a role model were more likely to have made the decision to pursue a career in OEM during medical school or clinical residency training (odds ratio = 2.4; 95% CI, 1.0-5.4; Fisher's exact two-tailed P value = 0.04). In the short term, residents were most often interested in working for industry (32%), whereas over the long term, careers in consulting were most often preferred (39%). The data have important implications for strategies to increase recruitment to residency training programs in OEM and to increase staffing in the field. PMID:7670921

  20. Assigning Residents of Emergency Medicine to Screen Patients Before Admission: a Strategy to Overcome Overcrowding

    PubMed Central

    Javadzadeh, Hamid Reza; Davoudi, Amir; Davoudi, Farnoush; Mahmoodi, Sadrollah; Ghane, Mohammad Reza; Goodarzi, Hasan; Faraji, Mehrdad

    2012-01-01

    Background: The overcrowded hospital is an unsafe one. Overcrowding the emergency department (ED) results in increased patient suffering, prolonged waiting time, deteriorating level of service, and on occasion, a worsened medical condition or even death. Objectives: This study proposes a strategy to overcome ED overcrowding. Materials and Methods: The proportion of acute area admitted patients to screened patients (A/S), and the proportion of patients who were finally transferred to inpatient wards (W/A) to those admitted in ED acute area were investigated during 6 consecutive months. Emergency medicine residents were assigned to screen patients before ED admission and afterwards. Results: The average A/S changed from 82.4% to 44.2% (P = 0.028), and the average W/A changed from 28.3% to 51.48% (P = 0.028) before and after screening patients respectively. The initiative resulted in 97 less patients in the acute area per day. Conclusions: Decreased number of acute area admitted patients, and increase W/A proportion showed that the initiative was successful in obviating ED overcrowding while provision of care to those most in need was not altered. PMID:24749100

  1. An Evidence-Based Medicine Curriculum Improves General Surgery Residents' Standardized Test Scores in Research and Statistics

    PubMed Central

    Trickey, Amber W.; Crosby, Moira E.; Singh, Monika; Dort, Jonathan M.

    2014-01-01

    Background The application of evidence-based medicine to patient care requires unique skills of the physician. Advancing residents' abilities to accurately evaluate the quality of evidence is built on understanding of fundamental research concepts. The American Board of Surgery In-Training Examination (ABSITE) provides a relevant measure of surgical residents' knowledge of research design and statistics. Objective We implemented a research education curriculum in an independent academic medical center general residency program, and assessed the effect on ABSITE scores. Methods The curriculum consisted of five 1-hour monthly research and statistics lectures. The lectures were presented before the 2012 and 2013 examinations. Forty residents completing ABSITE examinations from 2007 to 2013 were included in the study. Two investigators independently identified research-related item topics from examination summary reports. Correct and incorrect responses were compared precurriculum and postcurriculum. Regression models were calculated to estimate improvement in postcurriculum scores, adjusted for individuals' scores over time and postgraduate year level. Results Residents demonstrated significant improvement in postcurriculum examination scores for research and statistics items. Correct responses increased 27% (P < .001). Residents were 5 times more likely to achieve a perfect score on research and statistics items postcurriculum (P < .001). Conclusions Residents at all levels demonstrated improved research and statistics scores after receiving the curriculum. Because the ABSITE includes a wide spectrum of research topics, sustained improvements suggest a genuine level of understanding that will promote lifelong evaluation and clinical application of the surgical literature. PMID:26140115

  2. Ready for Discharge? A Survey of Discharge Transition-of-Care Education and Evaluation in Emergency Medicine Residency Programs.

    PubMed

    Gallahue, Fiona E; Betz, Amy E; Druck, Jeffrey; Jones, Jonathan S; Burns, Boyd; Hern, Gene

    2015-11-01

    This study aimed to assess current education and practices of emergency medicine (EM) residents as perceived by EM program directors to determine if there are deficits in resident discharge handoff training. This survey study was guided by the Kern model for medical curriculum development. A six-member Council of EM Residency Directors (CORD) Transitions of Care task force of EM physicians performed these steps and constructed a survey. The survey was distributed to program residency directors via the CORD listserve and/or direct contact. There were 119 responses to the survey, which were collected using an online survey tool. Over 71% of the 167 American College of Graduate Medical Education (ACGME) accredited EM residency programs were represented. Of those responding, 42.9% of programs reported formal training regarding discharges during initial orientation and 5.9% reported structured curriculum outside of orientation. A majority (73.9%) of programs reported that EM residents were not routinely evaluated on their discharge proficiency. Despite the ACGME requirements requiring formal handoff curriculum and evaluation, many programs do not provide formal curriculum on the discharge transition of care or evaluate EM residents on their discharge proficiency. PMID:26594283

  3. Fingertip and whole body exposure to nuclear medicine personnel

    SciTech Connect

    Lis, G.A.; Zu'bi, S.M.; Brahmavar, S.M.

    1981-06-01

    We calculate radiation exposure to the nuclear medicine technologist for all common sources of exposure. Special attention is given to exposure received by fingertips. We include typical exposure rates for patient injections, reagent preparations, generator handling and elution, patient positioning, and other phases of nuclear medicine. The cumulative exposure to fingertips and whole body is estimated. When every precaution is taken to minimize exposure in our laboratory, the unavoidable annual exposure to the fingertips is 11 R; to the whole body it is 1 R from all sources. When precautions are not taken, the annual exposure to the fingertips may exceed 170 R and the whole body dose may then approach 2 R. Our nuclear medicine laboratory averages about 1000 injections per technologist per year.

  4. Training requirements for chemists in radiotracer development for nuclear medicine

    SciTech Connect

    Finn, R.; Fowler, J.

    1988-01-01

    This panel was organized to address the current and anticipated future shortage of chemists with advanced training to fill positions in the nuclear medicine field. Although hard data and statistics are difficult to acquire, we will attempt to highlight the impact of chemistry on nuclear medicine and to describe the growth of the field which has led to an increasing need for chemists resulting in the current manpower shortage. We also will make recommendations for attracting Ph.D. chemists to careers in nuclear medicine research and possible mechanisms for postgraduate training. Solving this problem and establishing a long term committment and mechanism for advanced training is critically important to meet the current needs of the profession and to assure future growth and innovation. 3 tabs.

  5. Resident selection for a physical medicine and rehabilitation program: feasibility and reliability of the multiple mini-interview.

    PubMed

    Finlayson, Heather C; Townson, Andrea F

    2011-04-01

    The development of a process to select the best residents for training programs is challenging. There is a paucity of literature to support the implementation of an evidence-based approach or even best practice for program directors and selection committees. Although assessment of traditional academic markers such as clerkship grades and licensing examination scores can be helpful, these measures typically fail to capture performance in the noncognitive domains of medicine. In the specialty of physical medicine and rehabilitation, physician competencies such as communication, health advocacy, and managerial and collaborative skills are of particular importance, but these are often difficult to evaluate in admission interviews. Recent research on admission processes for medical schools has demonstrated reliability and validity of the "multiple mini-interview." The objective of our project was to develop and evaluate the multiple mini-interview for a physical medicine and rehabilitation residency training program, with a focus on assessment of the noncognitive physician competencies. We found that the process was feasible, time efficient, and cost-efficient and that there was good interrater reliability. The multiple mini-interview may be applied to other physical medicine and rehabilitation residency programs. Further research is needed to confirm reliability and determine validity. PMID:21765249

  6. Interprofessional Collaboration between Residents and Nurses in General Internal Medicine: A Qualitative Study on Behaviours Enhancing Teamwork Quality

    PubMed Central

    Muller-Juge, Virginie; Cullati, Stéphane; Blondon, Katherine S.; Hudelson, Patricia; Maître, Fabienne; Vu, Nu V.; Savoldelli, Georges L.; Nendaz, Mathieu R.

    2014-01-01

    Background Effective teamwork is necessary for optimal patient care. There is insufficient understanding of interactions between physicians and nurses on internal medicine wards. Objective To describe resident physicians’ and nurses’ actual behaviours contributing to teamwork quality in the setting of a simulated internal medicine ward. Methods A volunteer sample of 14 pairs of residents and nurses in internal medicine was asked to manage one non-urgent and one urgent clinical case in a simulated ward, using a high-fidelity manikin. After the simulation, participants attended a stimulated-recall session during which they viewed the videotape of the simulation and explained their actions and perceptions. All simulations were transcribed, coded, and analyzed, using a qualitative method (template analysis). Quality of teamwork was assessed, based on patient management efficiency and presence of shared management goals and of team spirit. Results Most resident-nurse pairs tended to interact in a traditional way, with residents taking the leadership and nurses executing medical prescriptions and assuming their own specific role. They also demonstrated different types of interactions involving shared responsibilities and decision making, constructive suggestions, active communication and listening, and manifestations of positive team building. The presence of a leader in the pair or a truly shared leadership between resident and nurse contributed to teamwork quality only if both members of the pair demonstrated sufficient autonomy. In case of a lack of autonomy of one member, the other member could compensate for it, if his/her own autonomy was sufficiently strong and if there were demonstrations of mutual listening, information sharing, and positive team building. Conclusions Although they often relied on traditional types of interaction, residents and nurses also demonstrated readiness for increased sharing of responsibilities. Interprofessional education should

  7. The Learners' Perceptions Survey—Primary Care: Assessing Resident Perceptions of Internal Medicine Continuity Clinics and Patient-Centered Care

    PubMed Central

    Byrne, John M.; Chang, Barbara K.; Gilman, Stuart C.; Keitz, Sheri A.; Kaminetzky, Catherine P.; Aron, David C.; Baz, Sam; Cannon, Grant W.; Zeiss, Robert A.; Holland, Gloria J.; Kashner, T. Michael

    2013-01-01

    Background In 2010, the Department of Veterans Affairs (VA) implemented a national patient-centered care initiative that organized primary care into interdisciplinary teams of health care professionals to provide patient-centered, continuous, and coordinated care. Objective We assessed the discriminate validity of the Learners' Perceptions Survey—Primary Care (LPS-PC), a tool designed to measure residents' perceptions about their primary and patient-centered care experiences. Methods Between October 2010 and June 2011, the LPS-PC was administered to Loma Linda University Medical Center internal medicine residents assigned to continuity clinics at the VA Loma Linda Healthcare System (VALLHCS), a university setting, or the county hospital. Adjusted differences in satisfaction ratings across settings and over domains (patient- and family-centered care, faculty and preceptors, learning, clinical, work and physical environments, and personal experience) were computed using a generalized linear model. Results Our response rate was 86% (77 of 90). Residents were more satisfied with patient- and family-centered care at the VALLHCS than at either the university or county (P < .001). However, faculty and preceptors (odds ratio [OR]  =  1.53), physical (OR  =  1.29), and learning (OR  =  1.28) environments had more impact on overall resident satisfaction than patient- and family-centered care (OR  =  1.08). Conclusions The LPS-PC demonstrated discriminate validity to assess residents' perceptions of their patient-centered clinical training experience across outpatient primary care settings at an internal medicine residency program. The largest difference in scores was the patient- and family-centered care domain, in which residents rated the VALLHCS much higher than the university or county sites. PMID:24455006

  8. Drug Testing Incoming Residents and Medical Students in Family Medicine Training: A Survey of Program Policies and Practices

    PubMed Central

    Bell, Paul F.; Semelka, Michael W.; Bigdeli, Laleh

    2015-01-01

    Background Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. Objective We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. Methods The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. Results A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Conclusions Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training. PMID:26217424

  9. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    PubMed

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors. PMID:23550215

  10. Ten Tips for Engaging the Millennial Learner and Moving an Emergency Medicine Residency Curriculum into the 21st Century

    PubMed Central

    Toohey, Shannon L.; Wray, Alisa; Wiechmann, Warren; Lin, Michelle; Boysen-Osborn, Megan

    2016-01-01

    Introduction Millennial learners are changing the face of residency education because they place emphasis on technology with new styles and means of learning. While research on the most effective way to teach the millennial learner is lacking, programs should consider incorporating educational theories and multimedia design principles to update the curriculum for these new learners. The purpose of the study is to discuss strategies for updating an emergency medicine (EM) residency program’s curriculum to accommodate the modern learner. Discussion These 10 tips provide detailed examples and approaches to incorporate technology and learning theories into an EM curriculum to potentially enhance learning and engagement by residents. Conclusion While it is unclear whether technologies actually promote or enhance learning, millennials use these technologies. Identifying best practice, grounded by theory and active learning principles, may help learners receive quality, high-yield education. Future studies will need to evaluate the efficacy of these techniques to fully delineate best practices. PMID:27330668

  11. Rheumatoid arthritis: Nuclear Medicine state-of-the-art imaging

    PubMed Central

    Rosado-de-Castro, Paulo Henrique; Lopes de Souza, Sergio Augusto; Alexandre, Dângelo; Barbosa da Fonseca, Lea Mirian; Gutfilen, Bianca

    2014-01-01

    Rheumatoid arthritis (RA) is an autoimmune disease, which is associated with systemic and chronic inflammation of the joints, resulting in synovitis and pannus formation. For several decades, the assessment of RA has been limited to conventional radiography, assisting in the diagnosis and monitoring of disease. Nevertheless, conventional radiography has poor sensitivity in the detection of the inflammatory process that happens in the initial stages of RA. In the past years, new drugs that significantly decrease the progression of RA have allowed a more efficient treatment. Nuclear Medicine provides functional assessment of physiological processes and therefore has significant potential for timely diagnosis and adequate follow-up of RA. Several single photon emission computed tomography (SPECT) and positron emission tomography (PET) radiopharmaceuticals have been developed and applied in this field. The use of hybrid imaging, which permits computed tomography (CT) and nuclear medicine data to be acquired and fused, has increased even more the diagnostic accuracy of Nuclear Medicine by providing anatomical localization in SPECT/CT and PET/CT studies. More recently, fusion of PET with magnetic resonance imaging (PET/MRI) was introduced in some centers and demonstrated great potential. In this article, we will review studies that have been published using Nuclear Medicine for RA and examine key topics in the area. PMID:25035834

  12. Radiation safety and nuclear medicine policies and procedures.

    PubMed

    Berman, C G

    1999-07-01

    There is a growing concern over possible adverse effects from medical applications of ionizing radiation. Hospital personnel must be educated in procedures to minimize exposure to themselves and their patients. Basic radiation safety procedures to protect personnel and patients are discussed. Examples of the nuclear medicine policies and procedures used for lymphatic mapping are provided. PMID:10448699

  13. Learning Curves for Direct Laryngoscopy and GlideScope® Video Laryngoscopy in an Emergency Medicine Residency

    PubMed Central

    Sakles, John C; Mosier, Jarrod; Patanwala, Asad E.; Dicken, John

    2014-01-01

    Introduction Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program. Methods This was an analysis of intubations performed in the emergency department (ED) by EM residents over a seven-year period from July 1, 2007 to June 30, 2014 at an academic ED with 70,000 annual visits. After EM residents perform an intubation in the ED they complete a continuous quality improvement (CQI) form. Data collected includes patient demographics, operator post- graduate year (PGY), difficult airway characteristics (DACs), method of intubation, device used for intubation and outcome of each attempt. We included in this analysis only adult intubations performed by EM residents using a DL or a standard reusable GVL. The primary outcome was first pass success, defined as a successful intubation with a single laryngoscope insertion. First pass success was evaluated for each PGY of training for DL and GVL. Logistic mixed-effects models were constructed for each device to determine the effect of PGY level on first pass success, after adjusting for important confounders. Results Over the seven-year period, the DL was used as the initial device on 1,035 patients and the GVL was used as the initial device on 578 patients by EM residents. When using the DL the first past success of PGY-1 residents was 69.9% (160/229; 95% CI 63.5%–75.7%), of PGY-2 residents was 71.7% (274/382; 95% CI 66.9%–76.2%), and of PGY-3 residents was 72.9% (309/424; 95% CI 68.4%–77.1%). When using the GVL the first pass success of PGY-1 residents was 74.4% (87/117; 95% CI 65.5%–82.0%), of PGY-2 residents was 83.6% (194/232; 95% CI 76.7%–87.7%), and of PGY-3 residents was 90.0% (206/229; 95% CI 85.3%–93.5%). In the mixed-effects model for DL, first pass success for PGY-2 and PGY-3 residents did not improve compared to PGY-1 residents (PGY-2 aOR 1.3, 95% CI 0.9–1

  14. Society of Nuclear Medicine--57th annual meeting.

    PubMed

    Searle, Ben

    2010-08-01

    The 57th Annual Meeting of the Society of Nuclear Medicine, held in Salt Lake City, UT, USA, included topics covering new developments in imaging agents and radiopharmaceutical therapies in the field of nuclear medicine. This conference report highlights selected presentations related to imaging of the brain, the prediction of heart disease, and the detection and treatment of various cancers. Investigational drugs discussed include TF-2 plus [68Ga]IMP-288 and TF-2 plus [111In]IMP-288 (both Immunomedics Inc), [11C]PBR-170 (Royal Prince Alfred Hospital/Australian Nuclear Science & Technology Organization), [11C]LY-2795050 (Eli Lilly & Co), yttrium (90Y) clivatuzumab tetraxetan (Garden State Cancer Center/Immunomedics Inc), [18F]LMI-1195 (Lantheus Medical Imaging Inc), fluciclovine (18F) (GE Healthcare/Nihon Medi-Physics Co Ltd), [99mTc]MIP-1340 and [99mTc]MIP-1407 (both Molecular Insight Pharmaceuticals Inc). PMID:20721816

  15. Application of Technetium and Rhenium in Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Alberto, Roger

    2012-06-01

    Technetium and Rhenium are the two lower elements in the manganese triad. Whereas rhenium is known as an important part of high resistance alloys, technetium is mostly known as a cumbersome product of nuclear fission. It is less known that its metastable isotope 99mTc is of utmost importance in nuclear medicine diagnosis. The technical application of elemental rhenium is currently complemented by investigations of its isotope 188Re, which could play a central role in the future for internal, targeted radiotherapy. This article will briefly describe the basic principles behind diagnostic methods with radionuclides for molecular imaging, review the 99mTc-based radiopharmaceuticals currently in clinical routine and focus on the chemical challenges and current developments towards improved, radiolabeled compounds for diagnosis and therapy in nuclear medicine.

  16. Feasibility of Spanish-language acquisition for acute medical care providers: novel curriculum for emergency medicine residencies

    PubMed Central

    Grall, Kristi H; Panchal, Ashish R; Chuffe, Eliud; Stoneking, Lisa R

    2016-01-01

    Introduction Language and cultural barriers are detriments to quality health care. In acute medical settings, these barriers are more pronounced, which can lead to poor patient outcomes. Materials and methods We implemented a longitudinal Spanish-language immersion curriculum for emergency medicine (EM) resident physicians. This curriculum includes language and cultural instruction, and is integrated into the weekly EM didactic conference, longitudinal over the entire 3-year residency program. Language proficiency was assessed at baseline and annually on the Interagency Language Roundtable (ILR) scale, via an oral exam conducted by the same trained examiner each time. The objective of the curriculum was improvement of resident language skills to ILR level 1+ by year 3. Significance was evaluated through repeated-measures analysis of variance. Results The curriculum was launched in July 2010 and followed through June 2012 (n=16). After 1 year, 38% had improved over one ILR level, with 50% achieving ILR 1+ or above. After year 2, 100% had improved over one level, with 90% achieving the objective level of ILR 1+. Mean ILR improved significantly from baseline, year 1, and year 2 (F=55, df =1; P<0.001). Conclusion Implementation of a longitudinal, integrated Spanish-immersion curriculum is feasible and improves language skills in EM residents. The curriculum improved EM-resident language proficiency above the goal in just 2 years. Further studies will focus on the effect of language acquisition on patient care in acute settings. PMID:26929679

  17. Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

    PubMed Central

    Francis, Maureen D.; Wieland, Mark L.; Drake, Sean; Gwisdalla, Keri Lyn; Julian, Katherine A.; Nabors, Christopher; Pereira, Anne; Rosenblum, Michael; Smith, Amy; Sweet, David; Thomas, Kris; Varney, Andrew; Warm, Eric; Wininger, David; Francis, Mark L.

    2015-01-01

    Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model. PMID:26217420

  18. Nuclear magnetic resonance imaging in medicine

    PubMed Central

    McKinstry, C S

    1986-01-01

    Using the technique of nuclear magnetic resonance (NMR, MR, MRI), the first images displaying pathology in humans were published in 1980.1 Since then, there has been a rapid extension in the use of the technique, with an estimated 225 machines in use in the USA at the end of 1985.2 Considerable enthusiasm has been expressed for this new imaging technique,3 although awareness of its high cost in the present economic climate has led to reservations being expressed in other quarters.2 The aim of this article is to give an outline of the present state of NMR, and indicate some possible future developments. ImagesFig 1Fig 2Fig 3(a)Fig 3 (b)Fig 4Fig 5Fig 6Fig 7 (a)Fig 7 (b)Fig 8Fig 9Fig 10 PMID:3811023

  19. Approved Instructional Resources Series: A National Initiative to Identify Quality Emergency Medicine Blog and Podcast Content for Resident Education.

    PubMed

    Lin, Michelle; Joshi, Nikita; Grock, Andrew; Swaminathan, Anand; Morley, Eric J; Branzetti, Jeremy; Taira, Taku; Ankel, Felix; Yarris, Lalena M

    2016-05-01

    Background Emergency medicine (EM) residency programs can provide up to 20% of their planned didactic experiences asynchronously through the Individualized Interactive Instruction (III) initiative. Although blogs and podcasts provide potential material for III content, programs often struggle with identifying quality online content. Objective To develop and implement a process to curate quality EM content on blogs and podcasts for resident education and III credit. Methods We developed the Approved Instructional Resources (AIR) Series on the Academic Life in Emergency Medicine website. Monthly, an editorial board identifies, peer reviews, and writes assessment questions for high-quality blog/podcast content. Eight educators rate each post using a standardized scoring instrument. Posts scoring ≥ 30 of 35 points are awarded an AIR badge and featured in the series. Enrolled residents can complete an assessment quiz for III credit. After 12 months of implementation, we report on program feasibility, enrollment rate, web analytics, and resident satisfaction scores. Results As of June 2015, 65 EM residency programs are enrolled in the AIR Series, and 2140 AIR quizzes have been completed. A total of 96% (2064 of 2140) of participants agree or strongly agree that the activity would improve their clinical competency, 98% (2098 of 2140) plan to use the AIR Series for III credit, and 97% (2077 of 2140) plan to use it again in the future. Conclusions The AIR Series is a national asynchronous EM curriculum featuring quality blogs and podcasts. It uses a national expert panel and novel scoring instrument to peer review web-based educational resources. PMID:27168891

  20. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  1. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  2. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  3. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  4. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  5. Impact of the prospective payment system on the delivery of nuclear medicine services

    SciTech Connect

    Crucitti, T.W.; Pappas, V.M.

    1986-07-01

    The study evaluates the effect of the Medicare Prospective Payment System (PPS) on nuclear medicine technologists and services. Since 80% of nuclear medicine technologists work in hospitals, a large segment of the professionals would be affected by the new system. The survey was designed to assess the PPSs effect on nuclear medicine departments at the early implementation stage.

  6. Evaluation of metallic osseous implants with nuclear medicine

    SciTech Connect

    Wellman, H.N.; Schauwecker, D.S.; Capello, W.N.

    1988-04-01

    Nuclear medicine has proven to have a valuable role in the evaluation of osseous metallic implants, particularly with joint prostheses, but can assist with evaluation of other appliances as well. The nuclear arthrogram has become an invaluable adjunct to simultaneously performed radiographic contrast arthrography. This application has been best evaluated in what is one of the most common of orthopedic prosthesis problems, namely, loosening of total hip prostheses. Experience indicates that both sensitivity and specificity of loosening of the femoral component can be increased to over 90% through combined use of nuclear with radiographic contrast arthrography. Furthermore the combination of routine skeletal scintimaging with the nuclear arthrogram adds a significant dimension to precise localizing of the nuclear arthrographics agent In-111 chloride. Nuclear medicine also plays an important role in further evaluating the presence of infection associated with metallic implants with In-111 WBC preparations being superior to Ga-67 as the radiopharmaceutical tracer. Infection has been detected with a sensitivity of 73% and a specificity of 93% in our series using combined In-111 WBC and simultaneous skeletal imaging with conventional Tc-99m MDP. Acute infections are more readily identifiable than chronic in association with prostheses. 29 references.

  7. Multiple Mini-Interviews (MMI) and Semistructured Interviews for the Selection of Family Medicine Residents: A Comparative Analysis

    PubMed Central

    Bhanji, Seema

    2014-01-01

    Background. Family Medicine Residency Program at the Aga Khan University has applicants for the residency position in excess of the positions offered resulting in formulation of certain selection criteria. The objective of this study was to compare MMI versus semistructured interviews for assessing noncognitive domains in the selection of residents. The secondary objectives were to determine perceptions of the interviewers and candidates for the acceptability and feasibility of MMI as a selection tool. Methods. The candidates underwent semistructured interviews along with MMI and identical attributes were tested in both. The attributes tested were safe doctor, communication skills, professionalism, problem solving, team approach, ethical issues, reasons for selecting family medicine, and commitment to the program. Descriptive statistics were calculated and comparison between ratings for MMI and interview was performed by Wilcoxon sign rank test. Results. Total number of candidates was 14. On comparison between interview and MMI, the scores were not statistically different for all attributes except ethics (mean interview scores: 3.04, mean MMI scores: 2.5, and P value 0.046). Conclusion. The study showed no difference between MMI and semistructured interviews. However, it needs to be replicated in order to determine the predictive validity and feasibility of MMI over time.

  8. Authentication of Medicines Using Nuclear Quadrupole Resonance Spectroscopy.

    PubMed

    Chen, Cheng; Zhang, Fengchao; Barras, Jamie; Althoefer, Kaspar; Bhunia, Swarup; Mandal, Soumyajit

    2016-01-01

    The production and sale of counterfeit and substandard pharmaceutical products, such as essential medicines, is an important global public health problem. We describe a chemometric passport-based approach to improve the security of the pharmaceutical supply chain. Our method is based on applying nuclear quadrupole resonance (NQR) spectroscopy to authenticate the contents of medicine packets. NQR is a non-invasive, non-destructive, and quantitative radio frequency (RF) spectroscopic technique. It is sensitive to subtle features of the solid-state chemical environment and thus generates unique chemical fingerprints that are intrinsically difficult to replicate. We describe several advanced NQR techniques, including two-dimensional measurements, polarization enhancement, and spin density imaging, that further improve the security of our authentication approach. We also present experimental results that confirm the specificity and sensitivity of NQR and its ability to detect counterfeit medicines. PMID:26841409

  9. A National Study of Internal Medicine--Phase III. Analysis of 1976-1977 Resident Cohort Currently in Practice. Final Report.

    ERIC Educational Resources Information Center

    Schleiter, Mary Kay; Tarlov, Alvin R.

    The different practice styles of young internists and the relationship between training and practice were studied as part of the National Study of Internal Medicine Manpower, Phase III. The practices of four groups of physicians were compared: general internists with traditional residencies, general internists who received their residency training…

  10. Knowledge of and Attitude to Nuclear Power among Residents around Tianwan Nuclear Power Plant in Jiangsu of China

    PubMed Central

    Yu, Ningle; Zhang, Yimei; Wang, Jin; Cao, Xingjiang; Fan, Xiangyong; Xu, Xiaosan; Wang, Furu

    2012-01-01

    Aims: The aims of this paper were to determine the level of knowledge of and attitude to nuclear power among residents around Tianwan Nuclear power plant in Jiangsu of China. Design: A descriptive, cross-sectional design was adopted. Participants: 1,616 eligible participants who lived around the Tianwan nuclear power plant within a radius of 30km and at least 18 years old were recruited into our study and accepted epidemiological survey. Methods: Data were collected through self-administered questionnaires consisting of a socio-demographic sheet. Inferential statistics, t-test, ANOVA test and multivariate regression analysis were used to compare the differences between each subgroup and correlation analysis was conducted to understand the relationship between different factors and dependent variables. Results: Our investigation found that the level of awareness and acceptance of nuclear power was generally not high. Respondents' gender, age, marital status, residence, educational level, family income and the distance away from the nuclear power plant are important effect factors to the knowledge of and attitude to nuclear power. Conclusions: The public concerns about nuclear energy's impact are widespread. The level of awareness and acceptance of nuclear power needs to be improved urgently. PMID:22811610

  11. A Survey of the Current Utilization of Asynchronous Education Among Emergency Medicine Residents in the United States

    PubMed Central

    Schlein, Sarah; Doctor, Shaneen; Stroud, Susan; Dawson, Matthew; Fix, Megan

    2014-01-01

    Problem Medical education is transitioning from traditional learning methods. Resident interest in easily accessible education materials is forcing educators to reevaluate teaching methodology. Approach To determine emergency medicine residents’ current methods of and preferences for obtaining medical knowledge, the authors created a survey and sent it to residents, at all levels of training throughout the United States, whose e-mail addresses were available via their residency’s official Web site (June–December 2012). The eight-question voluntary survey asked respondents about demographics, their use of extracurricular time, and the materials they perceived as most beneficial. The authors used descriptive statistics to analyze results. Outcomes Of the 401 residents who received the e-mailed survey, 226 (56.3%) completed it. Of these, 97.7% reported spending at least one hour per week engaging in extracurricular education, and 34.5% reported spending two to four hours per week (P < .001). Time listening to podcasts was the most popular (reported by 35.0% of residents), followed by reading textbooks (33.6%) and searching Google (21.4%; P < .001). Residents endorsed podcasts as the most beneficial (endorsed by 70.3%) compared with textbooks (endorsed by 54.3%), journals (36.5%), and Google (33.8%; P < .001). Most respondents reported evaluating the quality of evidence or reviewing references “rarely” or less than half the time. A majority (80.0%) selected the topics they accessed based on recent clinical encounters. Next Steps The results suggest that residents are using more open access interactive multimedia tools. Medical educators must engage with current learners to guide appropriate use of these. PMID:24556776

  12. How well will you FIT? Use of a modified MMI to assess applicants’ compatibility with an emergency medicine residency program

    PubMed Central

    Min, Alice A.; Leetch, Aaron; Nuño, Tomas; Fiorello, Albert B.

    2016-01-01

    Purpose Emergency medicine residency programs have evaluated the use of Multiple Mini Interviews (MMIs) for applicants. The authors developed an MMI-style method called the Fast Interview Track (FIT) to predict an applicant's ‘fit’ within an individual residency program. Methods Applicants meet with up to five residents and are asked one question by each. Residents score the applicant using a Likert scale from 1 to 5 on two questions: ‘How well does the applicant think on his/her feet?’ and ‘How well do you think the applicant will fit in here?’. To assess how well these questions predicted a resident's ‘fit’, current residents scored fellow residents on these same questions. These scores were compared with the residents’ interview FIT scores. A postmatch survey of applicants who did not match at this program solicited applicants’ attitudes toward the FIT sessions. Results Among the junior class, the correlation between interview and current scores was significant for question 1 (rho=0.5192 [p=0.03]) and question 2 (rho=0.5753 [p=0.01]). Among seniors, Spearman's rho was statistically significant for question 2, though not statistically significant for question 1. The chi-square measure of high scores (4–5) versus low scores (1–3) found a statistically significant association between interview and current scores for interns and juniors. Of the 29 responses to the postmatch survey, 16 (55%) felt FIT sessions provided a good sense of the program's personality and only 6 (21%) disagreed. Nine (31%) felt FIT sessions positively impacted our program's ranking and 11 (38%) were ‘Neutral’. Only two (7%) reported that FIT sessions negatively impacted their ranking of our program. Conclusions FIT provided program leadership with a sense of an applicant's ‘fit’ within this program. Interview day scores correlated with scores received during residency. Most applicants report a positive experience with FIT sessions. FIT provides a useful tool to

  13. Burnout, empathy and their relationships: a qualitative study with residents in General Medicine.

    PubMed

    Picard, Jeanne; Catu-Pinault, Annie; Boujut, Emilie; Botella, Marion; Jaury, Philippe; Zenasni, Franck

    2016-04-01

    Some studies have shown that burnout may have a negative impact on clinical empathy during internship. However, clinical empathy may also be a protective factor, preventing residents from experiencing burnout. Although several quantitative studies have been conducted to examine these relationships between burnout and empathy, no qualitative studies have been carried out. To examine how residents in general practice evaluate the link between burnout and empathy, 24 of them participated in a semi-structured interview. A thematic analysis was carried out to examine residents' discourses and answers to closed questions. The results indicated that residents thought that empathy and burnout were clearly related in different ways. They identified five types of relationship: regulation strategy, empathy as protection, psychological balance/imbalance, fatigue and moderating factors. PMID:26075525

  14. American College of Nuclear Physics 1991 DOE day symposium: Aids and nuclear medicine

    SciTech Connect

    1991-12-31

    Since first described in 1981, the acquired immunodeficiency syndrome (AIDS) has become the medical dilemma of the century. AIDS retrovirus, and the economic consequences of this exposure are staggering. AIDS has been the topic of conferences and symposia worldwide. This symposium, to be held on January 25, 1991, at the 17th Annual Meeting and Scientific Sessions of the American College of Nuclear Physicians, will expose the Nuclear Medicine Physicians/Radiologists to their role in the diagnosis of AIDS, and will educate them on the socio-economic and ethical issues related to this problem. In addition, the Nuclear Medicine Physicians/Radiologists must be aware of their role in the management of their departments in order to adequately protect the health care professionals working in their laboratories. Strategies are currently being developed to control the spread of bloodborne diseases within the health care setting, and it is incumbent upon the Nuclear Medicine community to be aware of such strategies.

  15. Radiation doses to staff in a department of nuclear medicine.

    PubMed

    Harbottle, E A; Parker, R P; Davis, R

    1976-07-01

    A survey of data concerning radiation protection of staff working in the Nuclear Medicine Department and associated sections of the Physics Department at the Royal Marsden Hospital (Surrey Branch) is given for the period 1972 to 1975 inclusive. Results of routine film monitoring and whole-body counting are presented. Additional film monitors were used to check working areas, finger doses and any discrepancies between doses to the upper and lower trunk of personnel. In general, exposure to staff in the Nuclear Medicine Department is below 220 mrad per person per year, and below 1,000 mrad per person per year in the Radioisotope Dispensary. The dose received by radiographers is primarily due to spending time close to patients. Since about 5,000 intravenous injections of radionuclides are given each year in our department, the resulting finger doses to the staff involved may give rise to concern unless the task is shared. PMID:824004

  16. Establishment of dose reference levels for nuclear medicine in Greece.

    PubMed

    Vogiatzi, S; Kipouros, P; Chobis, M

    2011-09-01

    Greek Atomic Energy Commission's Department of Licensing and Inspections conducted a national survey for the establishment of nuclear medicine (NM) dose reference levels (DRLs) for adult patients, in Greece. The administered activities (AAs) (MBq) were collected from 120 NM departments (88 % of total), during on-site inspections for licensing purposes. Factors influencing the image quality were also investigated. The established national DRLs represent the AA value corresponding to the 75th percentile of the AA frequency distributions. In their majority, national DRLs and average AAs are comparable with the ones published in the international literature. In the light of new technologies, there might be potential for reducing the higher values of AAs, in co-operation with the nuclear medicine experts. PMID:21765158

  17. Hand exposure to ionising radiation of nuclear medicine workers.

    PubMed

    Wrzesień, M; Olszewski, J; Jankowski, J

    2008-01-01

    The specific nature of work in nuclear medicine departments involves the use of isotopes and handling procedures, which contribute to the considerable value of an equivalent dose received, in particular, by the fingertips. Standard nuclear medicine department uses ring dosemeters placed usually at the base of the middle finger. The main aim of the study was to find out whether a relationship exists between the doses recorded by thermoluminescent detectors placed at various locations on the radiopharmacists' hands and the doses recorded by the ring detectors, and to determine the character of that relationship. The correction factor represents a correction value to be used to calculate the doses which might be received by locations on the hand from the dose recorded by the ring dosemeter. The dose recorded by the ring dosemeter is on the average five times lower than that received by the fingertips of thumb, index and middle fingers. PMID:18310609

  18. Effect of the Fukushima nuclear accident on the risk perception of residents near a nuclear power plant in China

    PubMed Central

    Huang, Lei; Zhou, Ying; Han, Yuting; Hammitt, James K.; Bi, Jun; Liu, Yang

    2013-01-01

    We assessed the influence of the Fukushima nuclear accident (FNA) on the Chinese public’s attitude and acceptance of nuclear power plants in China. Two surveys (before and after the FNA) were administered to separate subsamples of residents near the Tianwan nuclear power plant in Lianyungang, China. A structural equation model was constructed to describe the public acceptance of nuclear power and four risk perception factors: knowledge, perceived risk, benefit, and trust. Regression analysis was conducted to estimate the relationship between acceptance of nuclear power and the risk perception factors while controlling for demographic variables. Meanwhile, we assessed the median public acceptable frequencies for three levels of nuclear events. The FNA had a significant impact on risk perception of the Chinese public, especially on the factor of perceived risk, which increased from limited risk to great risk. Public acceptance of nuclear power decreased significantly after the FNA. The most sensitive groups include females, those not in public service, those with lower income, and those living close to the Tianwan nuclear power plant. Fifty percent of the survey respondents considered it acceptable to have a nuclear anomaly no more than once in 50 y. For nuclear incidents and serious incidents, the frequencies are once in 100 y and 150 y, respectively. The change in risk perception and acceptance may be attributed to the FNA. Decreased acceptance of nuclear power after the FNA among the Chinese public creates additional obstacles to further development of nuclear power in China and require effective communication strategies. PMID:24248341

  19. Forensic Medicine: Age Written in Teeth by Nuclear Bomb Tests

    SciTech Connect

    Lawrence Livermore National Laboratory

    2005-05-04

    Establishing the age of individuals is an important step in identification and a frequent challenge in forensic medicine. This can be done with high precision up to adolescence by analysis of dentition, but establishing the age of adults has remained difficult. Here we show that measuring {sup 14}C from nuclear bomb tests in tooth enamel provides a sensitive way to establish when a person was born.

  20. Radiation safety in nuclear medicine: a practical guide. Final report

    SciTech Connect

    Sodd, V.J.

    1981-11-01

    This publication brings together, in concise form, information regarding the many recommendations and requirements for safe operation of a nuclear medicine laboratory. The need for such a compendium was perceived by the staff of the Nuclear Medicine Laboratory. This need arises from several sources. Many individuals enter the field with little training in the handling of radioactive materials; for example, a physician trained in cardiology, oncology, or neurology. The increasing development of portable instrumentation has allowed movement of radiopharmaceuticals from the confines of the nuclear medicine lab to coronary and intensive care facilities where personnel may lack adequate knowledge of safe handling procedures. A health physicist, trained to account for all radioactive material placed under his control, may have difficulty adapting to the accepted practice of releasing a patient who has been administered millicurie quantities of radioactivity, with little or no control over subsequent disposal of excreta. Further differences exist between handling practices for radioactive materials in the scientific laboratory and in the medical facility. This guide tries where possible to clarify some of these issues.

  1. Radionuclide calibrator comparisons and quality improvement in nuclear medicine.

    PubMed

    Oropesa, P; Woods, M J; Olsovcová, V; dos Santos, J A

    2008-03-01

    The traceability of activity measurements performed during the development phase of the radiopharmaceutical and in its clinical application is essential for establishing the comparability of clinical results reported in the nuclear medicine field. This paper presents and discusses the evaluation over time of the quality of activity measurement results obtained in Cuban nuclear medicine, on the basis of statistical samples taken during the radionuclide calibrator comparison program. An attempt is also made to evaluate the role played by such comparisons in quality measurement improvement in nuclear medicine, on the basis of results obtained in a number of countries and published by several authors over a period of time. Specifically, improvements of the measurement performance over time assessed by such exercises were found dissimilar in magnitudes for different countries. Two phases could be distinguished in the improvement process over time. Firstly, a fast improvement can be obtained resulting from the improvement in measurement accuracy of devices. After that, the achievement of new and sustained improvements goes slowly and requires an application of quality assurance programs where the qualification upgrading of personnel become an essential point. PMID:17855099

  2. Accuracy and Precision of Radioactivity Quantification in Nuclear Medicine Images

    PubMed Central

    Frey, Eric C.; Humm, John L.; Ljungberg, Michael

    2012-01-01

    The ability to reliably quantify activity in nuclear medicine has a number of increasingly important applications. Dosimetry for targeted therapy treatment planning or for approval of new imaging agents requires accurate estimation of the activity in organs, tumors, or voxels at several imaging time points. Another important application is the use of quantitative metrics derived from images, such as the standard uptake value commonly used in positron emission tomography (PET), to diagnose and follow treatment of tumors. These measures require quantification of organ or tumor activities in nuclear medicine images. However, there are a number of physical, patient, and technical factors that limit the quantitative reliability of nuclear medicine images. There have been a large number of improvements in instrumentation, including the development of hybrid single-photon emission computed tomography/computed tomography and PET/computed tomography systems, and reconstruction methods, including the use of statistical iterative reconstruction methods, which have substantially improved the ability to obtain reliable quantitative information from planar, single-photon emission computed tomography, and PET images. PMID:22475429

  3. Assessment of OEP health's risk in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M.

    2012-10-01

    The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 ± 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

  4. [Cost analysis of twenty-nine nuclear medicine procedures].

    PubMed

    Kastanioti, Catherine K; Alphalbouharali, Gihand; Fotopoulos, Andreas

    2004-01-01

    The aim of this study was to compare actual cost estimates for diagnostic procedures as applied in the nuclear medicine department of our University Hospital, with cost estimates obtained through an analytical activity-based costing methodology. Activity data on the use of twenty-nine nuclear medicine procedures were collected. The actual hospital prices for the fiscal years of 2003-2004 were obtained from the Accounting Department of the Hospital. Cost estimates were calculated per patient. Activity-based data were compared with hospital prices and also with unit costs from the activity-based costing methodology. Our results showed a significant statistical difference between unit cost estimates per patient based on hospital prices, as compared with those based on unit costs. This study shows that in our university hospital, reliance on generic hospital prices for nuclear medicine procedures, considerable underestimates their real cost by a mean value of 40% as derived through the activity-based costing methodology and can lead to substantial financial hospital deficits. PMID:15841290

  5. Limitations of Condensed Teaching Strategies to Develop Hand-Held Cardiac Ultrasonography Skills in Internal Medicine Residents.

    PubMed

    Wilkinson, Jeffrey S; Barake, Walid; Smith, Chris; Thakrar, Amar; Johri, Amer M

    2016-08-01

    Advances in ultrasonographic technology have allowed for hand-held cardiac ultrasonography (HHCU) units that fit into a physician's laboratory coat. Recently, studies to educate internal medicine residents have shown promise. The optimal duration and methodology for teaching HHCU skills has not been established. Over a 1-year period, internal medicine residents were recruited during their cardiology ward rotation into a single-centre nonblinded randomized trial. The 2 condensed teaching strategies were (1) a conventional ward-based program and (2) a technology-driven simulation-based strategy. Outcomes were evaluated by (1) an objective structured clinical examination (OSCE) to evaluate interpretation ability (assessing both type I and type II error rates) and (2) demonstration of HHCU skills graded by 2 level III echocardiographers. Twenty-four internal medicine residents were randomized. After teaching, the conventional teaching group had a significant absolute increase in the ability to make a singular correct diagnosis (20%; P < 0.001). In the technology arm, making a singular correct diagnosis increased 24% from baseline (P = 0.001). Interpretation skill was not significantly different between groups. The false-positive rate increased by an absolute 14% and 17% in the conventional and technology groups, respectively (P = 0.079 and P = 0.008). Our findings suggest that HHCU interpretation skills improve after either a conventional ward-based or a technology-driven approach. However, our study emphasizes the important limitations of both teaching programs, because we detected a trend toward an increase in the false-positive rate after both approaches. This suggests that a short duration of training may not be sufficient for HHCU to be performed in a safe manner. PMID:26860772

  6. Determinants of Patient Satisfaction in Internal Medicine Resident Continuity Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

    PubMed Central

    Francis, Maureen D.; Warm, Eric; Julian, Katherine A.; Rosenblum, Michael; Thomas, Kris; Drake, Sean; Gwisdalla, Keri Lyn; Langan, Michael; Nabors, Christopher; Pereira, Anne; Smith, Amy; Sweet, David; Varney, Andrew; Francis, Mark L.

    2014-01-01

    Background Many internal medicine programs have reorganized their resident continuity clinics to improve the ambulatory care experience for residents. The effect of this redesign on patient satisfaction is largely unknown. Methods Our multi-institutional, cross-sectional study included 569 internal medicine residents from 11 programs participating in the Educational Innovations Project Ambulatory Collaborative. An 11-item patient satisfaction survey from the Consumer Assessment of Healthcare Providers and Systems was used to assess patient satisfaction, comparing patient satisfaction in traditional models of weekly continuity clinic with 2 new clinic models. We then examined the relationship between patient satisfaction and other practice variables. Results Patient satisfaction responses related to resident listening and communication skills, knowledge of medical history, perception of adequate visit time, overall rating, and willingness to refer to family and friends were significantly better in the traditional and block continuity models than the combination model. Higher ambulatory workload was associated with reduced patient perception of respect shown by the physician. The percentage of diabetic patients with glycated hemoglobin < 8% was positively correlated with number of visits, knowledge of medical history, perception of respect, and higher scores for recommending the physician to others. The percentage of diabetic patients with low density lipoprotein < 100 mg/dL was positively correlated with the physician showing respect. Conclusions Patient satisfaction was similar in programs using block design and traditional models for continuity clinic, and both outperformed the combination model programs. There was a delicate balance between workload and patient perception of the physician showing respect. Care outcome measures for diabetic patients were associated with aspects of patient satisfaction. PMID:26279771

  7. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center

    PubMed Central

    Ahn, James; Golden, Andrew; Bryant, Alyssa; Babcock, Christine

    2016-01-01

    Introduction In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. Methods TRs were present in the ED from 12pm–10pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief “chalk talks,” instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Results Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. Conclusion The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare. PMID:26973739

  8. Uncertainty and sensitivity analysis of biokinetic models for radiopharmaceuticals used in nuclear medicine.

    PubMed

    Li, W B; Hoeschen, C

    2010-01-01

    Mathematical models for kinetics of radiopharmaceuticals in humans were developed and are used to estimate the radiation absorbed dose for patients in nuclear medicine by the International Commission on Radiological Protection and the Medical Internal Radiation Dose (MIRD) Committee. However, due to the fact that the residence times used were derived from different subjects, partially even with different ethnic backgrounds, a large variation in the model parameters propagates to a high uncertainty of the dose estimation. In this work, a method was developed for analysing the uncertainty and sensitivity of biokinetic models that are used to calculate the residence times. The biokinetic model of (18)F-FDG (FDG) developed by the MIRD Committee was analysed by this developed method. The sources of uncertainty of all model parameters were evaluated based on the experiments. The Latin hypercube sampling technique was used to sample the parameters for model input. Kinetic modelling of FDG in humans was performed. Sensitivity of model parameters was indicated by combining the model input and output, using regression and partial correlation analysis. The transfer rate parameter of plasma to other tissue fast is the parameter with the greatest influence on the residence time of plasma. Optimisation of biokinetic data acquisition in the clinical practice by exploitation of the sensitivity of model parameters obtained in this study is discussed. PMID:20185457

  9. Adoption of a wiki within a large internal medicine residency program: a 3-year experience

    PubMed Central

    Mostaghimi, Arash; Reynolds, Eileen E

    2011-01-01

    Objective To describe the creation and evaluate the use of a wiki by medical residents, and to determine if a wiki would be a useful tool for improving the experience, efficiency, and education of housestaff. Materials and methods In 2008, a team of medical residents built a wiki containing institutional knowledge and reference information using Microsoft SharePoint. We tracked visit data for 3 years, and performed an audit of page views and updates in the second year. We evaluated the attitudes of medical residents toward the wiki using a survey. Results Users accessed the wiki 23 218, 35 094, and 40 545 times in each of three successive academic years from 2008 to 2011. In the year two audit, 85 users made a total of 1082 updates to 176 pages and of these, 91 were new page creations by 17 users. Forty-eight percent of residents edited a page. All housestaff felt the wiki improved their ability to complete tasks, and 90%, 89%, and 57% reported that the wiki improved their experience, efficiency, and education, respectively, when surveyed in academic year 2009–2010. Discussion A wiki is a useful and popular tool for organizing administrative and educational content for residents. Housestaff felt strongly that the wiki improved their workflow, but a smaller educational impact was observed. Nearly half of the housestaff edited the wiki, suggesting broad buy-in among the residents. Conclusion A wiki is a feasible and useful tool for improving information retrieval for house officers. PMID:22140210

  10. Introducing routine HIV screening for patients on an internal medicine residency inpatient service: a quality improvement project.

    PubMed

    Padrnos, Leslie J; Barr, Patrick J; Klassen, Christine L; Fields, Heather E; Azadeh, Natalya; Mendoza, Neil; Saadiq, Rayya A; Pauwels, Emanuel M; King, Christopher S; Chung, Andrew A; Sakata, Kenneth K; Blair, Janis E

    2016-01-01

    The US Centers for Disease Control and Prevention (CDC) recommend human immunodeficiency virus (HIV) screening for all persons aged 13 to 64 years who present to a health care provider. We sought to improve adherence to the CDC guidelines on the Internal Medicine Resident Hospital Service. We surveyed residents about the CDC guidelines, sent email reminders, provided education, and engaged them in friendly competition. Credit for guideline adherence was awarded if an offer of HIV screening was documented at admission, if a screening test was performed, or if a notation in the resident sign out sheet indicated why screening was not performed. We examined HIV screening of a postintervention group of patients admitted between August 8, 2012, and June 30, 2013, and compared them to a preintervention group admitted between August 1, 2011, and June 30, 2012. Postintervention offers of HIV screening increased significantly (7.9% [44/559] vs 55.5% [300/541]; P<.001), as did documentation of residents' contemplation of screening (8.9% [50/559] vs 67.5% [365/541]; P<.001). A significantly higher proportion of HIV screening tests was ordered postintervention (7.7% [43/559] vs 44.4% [240/541]; P<.001). Monthly HIV screening documentation ranged from 0% (0/53) to 17% (9/53) preintervention, whereas it ranged from 30.6% (11/36) to 100% (62/62) postintervention. HIV screening adherence can be improved through resident education, friendly competition, and system reminders. Barriers to achieving sustained adherence to the CDC guidelines include a heterogeneous patient population and provider discomfort with the subject. PMID:27239302

  11. Psychometric properties of a novel knowledge assessment tool of mechanical ventilation for emergency medicine residents in the northeastern United States

    PubMed Central

    2016-01-01

    Purpose: Prior descriptions of the psychometric properties of validated knowledge assessment tools designed to determine Emergency medicine (EM) residents understanding of physiologic and clinical concepts related to mechanical ventilation are lacking. In this setting, we have performed this study to describe the psychometric and performance properties of a novel knowledge assessment tool that measures EM residents’ knowledge of topics in mechanical ventilation. Methods: Results from a multicenter, prospective, survey study involving 219 EM residents from 8 academic hospitals in northeastern United States were analyzed to quantify reliability, item difficulty, and item discrimination of each of the 9 questions included in the knowledge assessment tool for 3 weeks, beginning in January 2013. Results: The response rate for residents completing the knowledge assessment tool was 68.6% (214 out of 312 EM residents). Reliability was assessed by both Cronbach’s alpha coefficient (0.6293) and the Spearman-Brown coefficient (0.6437). Item difficulty ranged from 0.39 to 0.96, with a mean item difficulty of 0.75 for all 9 questions. Uncorrected item discrimination values ranged from 0.111 to 0.556. Corrected item-total correlations were determined by removing the question being assessed from analysis, resulting in a range of item discrimination from 0.139 to 0.498. Conclusion: Reliability, item difficulty and item discrimination were within satisfactory ranges in this study, demonstrating acceptable psychometric properties of this knowledge assessment tool. This assessment indicates that this knowledge assessment tool is sufficiently rigorous for use in future research studies or for assessment of EM residents for evaluative purposes. PMID:26924540

  12. Introducing routine HIV screening for patients on an internal medicine residency inpatient service: a quality improvement project

    PubMed Central

    Padrnos, Leslie J; Barr, Patrick J; Klassen, Christine L; Fields, Heather E; Azadeh, Natalya; Mendoza, Neil; Saadiq, Rayya A; Pauwels, Emanuel M; King, Christopher S; Chung, Andrew A; Sakata, Kenneth K; Blair, Janis E

    2016-01-01

    The US Centers for Disease Control and Prevention (CDC) recommend human immunodeficiency virus (HIV) screening for all persons aged 13 to 64 years who present to a health care provider. We sought to improve adherence to the CDC guidelines on the Internal Medicine Resident Hospital Service. We surveyed residents about the CDC guidelines, sent email reminders, provided education, and engaged them in friendly competition. Credit for guideline adherence was awarded if an offer of HIV screening was documented at admission, if a screening test was performed, or if a notation in the resident sign out sheet indicated why screening was not performed. We examined HIV screening of a postintervention group of patients admitted between August 8, 2012, and June 30, 2013, and compared them to a preintervention group admitted between August 1, 2011, and June 30, 2012. Postintervention offers of HIV screening increased significantly (7.9% [44/559] vs 55.5% [300/541]; P<.001), as did documentation of residents' contemplation of screening (8.9% [50/559] vs 67.5% [365/541]; P<.001). A significantly higher proportion of HIV screening tests was ordered postintervention (7.7% [43/559] vs 44.4% [240/541]; P<.001). Monthly HIV screening documentation ranged from 0% (0/53) to 17% (9/53) preintervention, whereas it ranged from 30.6% (11/36) to 100% (62/62) postintervention. HIV screening adherence can be improved through resident education, friendly competition, and system reminders. Barriers to achieving sustained adherence to the CDC guidelines include a heterogeneous patient population and provider discomfort with the subject. PMID:27239302

  13. The role of commercial nuclear pharmacy in the future practice of nuclear medicine.

    PubMed

    Callahan, R J

    1996-04-01

    It has been estimated that today 70% to 80% of all radiopharmaceutical doses are dispensed through commercial nuclear pharmacy channels. These services are provided by the approximately 250 facilities in the United States, with some multisite corporations dispensing in excess of 20,000 unit-dose prescriptions per day. As pressures mount within health care institutions to reduce manpower, increase cost-effectiveness, increase participation in managed care contracts, and to seek outside vendors for many services that were previously provided in-house, the future role of the commercial nuclear pharmacy in the practice of nuclear medicine will only continue to increase. The essence of nuclear pharmacy practice is the dispensing of a full range of high quality radiopharmaceuticals in patient-specific unit doses. These doses must be delivered in a timely and cost effective manner, without compromising quality or patient safety. Commercial nuclear pharmacies have expanded to provide such varied functions as radiation safety and waste management, as well as consultative and marketing activities directed towards clinicians within a nuclear medicine practitioners own facility. In-service continuing education programs directed towards physicians and technologists are frequently offered by many commercial nuclear pharmacies. Changes in health care economics, merging and down-sizing in the hospital industry, and the overall impact of managed care on the viability of hospitals in general has resulted in slow growth, or even a small decline in the number of institutionally based nuclear pharmacists. As a result, nuclear medicine practitioners will be looking to the commercial nuclear pharmacies to meet a larger portion of their radiopharmaceutical needs, as well as to value added services, such as education and research and development. Specialized practice settings, such as nuclear cardiology and free-standing nuclear medicine clinics, are especially well suited to the services

  14. Nuclear medicine imaging in dementia: a practical overview for hospitalists.

    PubMed

    Toney, Lauren Kay; McCue, Tim J; Minoshima, Satoshi; Lewis, David H

    2011-08-01

    Dementia is a clinical syndrome with diverse presentation, a challenging differential diagnosis, and time-sensitive therapy. The most common cause of dementia in patients aged > 65 years is Alzheimer's disease, which now affects 4 million people in the United States, but is often underrecognized, especially in the inpatient population. The hospitalist may have the opportunity to evaluate a patient's initial presentation of dementia. Addressing the inpatient's dementia symptoms can improve overall care and outcomes, so it is imperative that the hospitalist is abreast of recent developments in the dementia workup. The focus of this article is to overview how nuclear medicine imaging of the brain can aid in this process, with perfusion single-photon emission computed tomography (SPECT) and fludeoxyglucose F 18 ((18)F-FDG) positron emission tomography (PET) as the 2 most common modalities. Our discussion focuses on Alzheimer's disease, as this the most common etiology of dementia in patients aged > 65 years; however, we also touch on the other common neurodegenerative dementias (eg, dementia with Lewy bodies, vascular dementia, and frontotemporal dementia) for completeness. We begin with a summary of the most recent published guidelines for each of these neurodegenerative diseases, and then expand on the role that nuclear imaging plays in each. We provide a basic overview of the principles of these nuclear medicine techniques, and then illustrate findings in perfusion SPECT and (18)F-FDG PET for typical patterns of dementia, with emphasis on evidence regarding diagnostic accuracy of each modality, in comparison with accepted gold standards. Finally, we outline some future research topics within the field of nuclear medicine in dementia, including amyloid plaque imaging and dopamine transporter imaging. PMID:21881402

  15. Determination of Clinically Relevant Content for a Musculoskeletal Anatomy Curriculum for Physical Medicine and Rehabilitation Residents

    ERIC Educational Resources Information Center

    Lisk, Kristina; Flannery, John F.; Loh, Eldon Y.; Richardson, Denyse; Agur, Anne M. R.; Woods, Nicole N.

    2014-01-01

    To address the need for more clinical anatomy training in residency education, many postgraduate programs have implemented structured anatomy courses into their curriculum. Consensus often does not exist on specific content and level of detail of the content that should be included in such curricula. This article describes the use of the Delphi…

  16. Developing a Cancer Survivorship Curriculum for Family Medicine Residents: A Needs Assessment

    ERIC Educational Resources Information Center

    Schubart, Jane R.; Gusani, Niraj J.; Kass, Rena; Lewis, Peter

    2013-01-01

    With the increasing survival of cancer patients, primary care residents must be familiar with the late effects of cancer treatment and be able to offer appropriate survivorship care in partnership with cancer care specialists. To address these paired public health and educational needs, an interdisciplinary group at our institution is developing,…

  17. A Web-Based Compendium of Clinical Questions and Medical Evidence To Educate Internal Medicine Residents.

    ERIC Educational Resources Information Center

    Crowley, Steven H.; Owens, Thomas A.; Schardt, Connie M.; Wardell, Sarah I.; Peterson, Josh; Garrison, Scott; Keitz, Sheri A.

    2003-01-01

    Describes an electronic database of clinical questions (CQs) and medical evidence, the Critical Appraisal Resource (CAR). Evaluation of ten months of use found that medical residents did engage the medical literature on behalf of their patients, which influenced approximately half of their patient-care decisions. (EV)

  18. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    ERIC Educational Resources Information Center

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  19. The Impact of 2011 ACGME Duty Hour Restrictions on Internal Medicine Resident Workload and Education

    ERIC Educational Resources Information Center

    Vucicevic, Darko; Mookadam, Farouk; Webb, Brandon J.; Labonte, Helene R.; Cha, Stephen S.; Blair, Janis E.

    2015-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) implemented work hour restrictions for physicians in training in 2003 that were revised July 1, 2011. Current published data are insufficient to assess whether such work hour restrictions will have long-term impact on residents' education. We searched computer-generated reports…

  20. Internal Structure of Mini-CEX Scores for Internal Medicine Residents: Factor Analysis and Generalizability

    ERIC Educational Resources Information Center

    Cook, David A.; Beckman, Thomas J.; Mandrekar, Jayawant N.; Pankratz, V. Shane

    2010-01-01

    The mini-CEX is widely used to rate directly observed resident-patient encounters. Although several studies have explored the reliability of mini-CEX scores, the dimensionality of mini-CEX scores is incompletely understood. Objective: Explore the dimensionality of mini-CEX scores through factor analysis and generalizability analysis. Design:…

  1. Assessment of a Human Cadaver Model for Training Emergency Medicine Residents in the Ultrasound Diagnosis of Pneumothorax

    PubMed Central

    Adhikari, Srikar; Zeger, Wesley; Wadman, Michael; Walker, Richard; Lomneth, Carol

    2014-01-01

    Objectives. To assess a human cadaver model for training emergency medicine residents in the ultrasound diagnosis of pneumothorax. Methods. Single-blinded observational study using a human cadaveric model at an academic medical center. Three lightly embalmed cadavers were used to create three “normal lungs” and three lungs modeling a “pneumothorax.” The residents were blinded to the side and number of pneumothoraces, as well as to each other's findings. Each resident performed an ultrasound examination on all six lung models during ventilation of cadavers. They were evaluated on their ability to identify the presence or absence of the sliding-lung sign and seashore sign. Results. A total of 84 ultrasound examinations (42-“normal lung,” 42-“pneumothorax”) were performed. A sliding-lung sign was accurately identified in 39 scans, and the seashore sign was accurately identified in 34 scans. The sensitivity and specificity for the sliding-lung sign were 93% (95% CI, 85–100%) and 90% (95% CI, 81–99%), respectively. The sensitivity and specificity for the seashore sign were 80% (95% CI, 68–92%) and 83% (95% CI, 72–94%), respectively. Conclusions. Lightly embalmed human cadavers may provide an excellent model for mimicking the sonographic appearance of pneumothorax. PMID:24790999

  2. Minimal Internal Radiation Exposure in Residents Living South of the Fukushima Daiichi Nuclear Power Plant Disaster

    PubMed Central

    Akiyama, Junichi; Kato, Shigeaki; Tsubokura, Masaharu; Mori, Jinichi; Tanimoto, Tetsuya; Abe, Koichiro; Sakai, Shuji; Hayano, Ryugo; Tokiwa, Michio; Shimmura, Hiroaki

    2015-01-01

    Following the Fukushima nuclear power plant disaster, assessment of internal radiation exposure was indispensable to predict radiation-related health threats to residents of neighboring areas. Although many evaluations of internal radiation in residents living north and west of the crippled Fukushima nuclear power plant are available, there is little information on residents living in areas south of the plant, which were similarly affected by radio-contamination from the disaster. To assess the internal radio-contamination in residents living in affected areas to the south of the plant or who were evacuated into Iwaki city, a whole body counter (WBC) screening program of internal radio-contamination was performed on visitors to the Jyoban hospital in Iwaki city, which experienced less contamination than southern areas adjacent to the nuclear plant. The study included 9,206 volunteer subjects, of whom 6,446 were schoolchildren aged 4–15 years. Measurements began one year after the incident and were carried out over the course of two years. Early in the screening period only two schoolchildren showed Cs-137 levels that were over the detection limit (250 Bq/body), although their Cs-134 levels were below the detection limit (220 Bq/body). Among the 2,760 adults tested, 35 (1.3%) had detectable internal radio-contamination, but only for Cs-137 (range: 250 Bq/body to 859 Bq/body), and not Cs-134. Of these 35 subjects, nearly all (34/35) showed elevated Cs-137 levels only during the first year of the screening. With the exception of potassium 40, no other radionuclides were detected during the screening period. The maximum annual effective dose calculated from the detected Cs-137 levels was 0.029 and 0.028 mSv/year for the schoolchildren and adults, respectively, which is far below the 1 mSv/year limit set by the government of Japan. Although the data for radiation exposure during the most critical first year after the incident are unavailable due to a lack of systemic

  3. Minimal Internal Radiation Exposure in Residents Living South of the Fukushima Daiichi Nuclear Power Plant Disaster.

    PubMed

    Akiyama, Junichi; Kato, Shigeaki; Tsubokura, Masaharu; Mori, Jinichi; Tanimoto, Tetsuya; Abe, Koichiro; Sakai, Shuji; Hayano, Ryugo; Tokiwa, Michio; Shimmura, Hiroaki

    2015-01-01

    Following the Fukushima nuclear power plant disaster, assessment of internal radiation exposure was indispensable to predict radiation-related health threats to residents of neighboring areas. Although many evaluations of internal radiation in residents living north and west of the crippled Fukushima nuclear power plant are available, there is little information on residents living in areas south of the plant, which were similarly affected by radio-contamination from the disaster. To assess the internal radio-contamination in residents living in affected areas to the south of the plant or who were evacuated into Iwaki city, a whole body counter (WBC) screening program of internal radio-contamination was performed on visitors to the Jyoban hospital in Iwaki city, which experienced less contamination than southern areas adjacent to the nuclear plant. The study included 9,206 volunteer subjects, of whom 6,446 were schoolchildren aged 4-15 years. Measurements began one year after the incident and were carried out over the course of two years. Early in the screening period only two schoolchildren showed Cs-137 levels that were over the detection limit (250 Bq/body), although their Cs-134 levels were below the detection limit (220 Bq/body). Among the 2,760 adults tested, 35 (1.3%) had detectable internal radio-contamination, but only for Cs-137 (range: 250 Bq/body to 859 Bq/body), and not Cs-134. Of these 35 subjects, nearly all (34/35) showed elevated Cs-137 levels only during the first year of the screening. With the exception of potassium 40, no other radionuclides were detected during the screening period. The maximum annual effective dose calculated from the detected Cs-137 levels was 0.029 and 0.028 mSv/year for the schoolchildren and adults, respectively, which is far below the 1 mSv/year limit set by the government of Japan. Although the data for radiation exposure during the most critical first year after the incident are unavailable due to a lack of systemic

  4. Role of nuclear medicine in chemotherapy of malignant lesions

    SciTech Connect

    Kim, E.E.; Haynie, T.P.

    1985-01-01

    The major role of nuclear medicine in clinical oncology is in tumor imaging, which includes evaluating specific organs or the entire body for the presence of tumor. Nuclear medicine studies have been used clinically in the initial evaluation of the tumor extent and in the subsequent management of the cancer patient to assess response to treatment, to detect early relapse, and to assist in making decisions concerning follow-up treatment. Technetium-99m macroaggregated albumin perfusion study for intraarterial chemotherapy has been helpful in monitoring the catheter tip, providing a map of regional perfusion at the capillary level (tumor vascularity), evaluating the degree of arteriovenous shunt in tumor bed, and optimizing division of the dose of chemotherapeutic agent when bilateral arterial catheters are used. Quantitative and serial radionuclide angiocardiography has been useful in assessing doxorubicin (Adriamycin, Adria Laboratories, Columbus, Ohio) toxicity, and /sup 67/Ga-citrate imaging has been used to monitor chemotherapy effect on lungs and kidneys. Radionuclide venography can demonstrate suspected thrombus, and the delineation of the vascular anatomy also allows proper placement of another catheter for continuous effective chemotherapy. Serial bone scans have been the primary modality to assess the response of bone metastasis to systemic therapy in breast cancer patients, and nuclear hepatic imaging may show tumor response, hepatocellular dysfunction, and cholecystitis related to chemotherapeutic agents. 41 references.

  5. Understanding the challenges to facilitating active learning in the resident conferences: a qualitative study of internal medicine faculty and resident perspectives

    PubMed Central

    Sawatsky, Adam P.; Zickmund, Susan L.; Berlacher, Kathryn; Lesky, Dan; Granieri, Rosanne

    2015-01-01

    Background In the Next Accreditation System, the Accreditation Council for Graduate Medical Education outlines milestones for medical knowledge and requires regular didactic sessions in residency training. There are many challenges to facilitating active learning in resident conferences, and we need to better understand resident learning preferences and faculty perspectives on facilitating active learning. The goal of this study was to identify challenges to facilitating active learning in resident conferences, both through identifying specific implementation barriers and identifying differences in perspective between faculty and residents on effective teaching and learning strategies. Methods The investigators invited core residency faculty to participate in focus groups. The investigators used a semistructured guide to facilitate discussion about learning preferences and teaching perspectives in the conference setting and used an ‘editing approach’ within a grounded theory framework to qualitative analysis to code the transcripts and analyze the results. Data were compared to previously collected data from seven resident focus groups. Results Three focus groups with 20 core faculty were conducted. We identified three domains pertaining to facilitating active learning in resident conferences: barriers to facilitating active learning formats, similarities and differences in faculty and resident learning preferences, and divergence between faculty and resident opinions about effective teaching strategies. Faculty identified several setting, faculty, and resident barriers to facilitating active learning in resident conferences. When compared to residents, faculty expressed similar learning preferences; the main differences were in motivations for conference attendance and type of content. Resident preferences and faculty perspectives differed on the amount of information appropriate for lecture and the role of active participation in resident conferences

  6. Preceptors' Strategies for Correcting Residents in an Ambulatory Care Medicine Setting: A Qualitative Analysis.

    ERIC Educational Resources Information Center

    Ende, Jack; And Others

    1995-01-01

    A study of precepting conversations between 11 pairs of internal medicine interns and faculty preceptors found strategies used to correct the interns consistent with pedagogic norms favoring discovery learning and with societal norms favoring egalitarianism and respect for individuals. However, this raises questions about effects on interns'…

  7. Recent developments and future trends in nuclear medicine instrumentation.

    PubMed

    Zaidi, Habib

    2006-01-01

    Molecular imaging using high-resolution single-photon emission computed tomography (SPECT) and positron emission tomography (PET) has advanced elegantly and has steadily gained importance in the clinical and research arenas. Continuous efforts to integrate recent research findings for the design of different geometries and various detector technologies of SPECT and PET cameras have become the goal of both the academic comcameras have become the goal of both the academic community and nuclear medicine industry. As PET has recently become of more interest for clinical practice, several different design trends seem to have developed. Systems are being designed for "low cost" clinical applications, very high-resolution research applications (including small-animal imaging), and just about everywhere in-between. The development of dual-modality imaging systems has revolutionized the practice of nuclear medicine. The major advantage being that SPECT/PET data are intrinsically aligned to anatomical information from the X-ray computed tomography (CT), without the use of external markers or internal landmarks. On the other hand, combining PET with Magnetic Resonance Imaging (MRI) technology is scientifically more challenging owing to the strong magnetic fields. Nevertheless, significant progress has been made resulting in the design of a prototype small animal PET scanner coupled to three multichannel photomultipliers via optical fibers, so that the PET detector can be operated within a conventional MR system. Thus, many different design paths are being pursued--which ones are likely to be the main stream of future commercial systems? It will be interesting, indeed, to see which technologies become the most popular in the future. This paper briefly summarizes state-of-the art developments in nuclear medicine instrumentation. Future prospects will also be discussed. PMID:16696367

  8. Developing and successfully implementing a competency-based portfolio assessment system in a postgraduate family medicine residency program.

    PubMed

    McEwen, Laura A; Griffiths, Jane; Schultz, Karen

    2015-11-01

    The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs. PMID:25993277

  9. Relationship of residency program characteristics with pass rate of the American Board of Internal Medicine certifying exam

    PubMed Central

    Atsawarungruangkit, Amporn

    2015-01-01

    Objectives To evaluate the relationship between the pass rate of the American Board of Internal Medicine (ABIM) certifying exam and the characteristics of residency programs. Methods The study used a retrospective, cross-sectional design with publicly available data from the ABIM and the Fellowship and Residency Electronic Interactive Database. All categorical residency programs with reported pass rates were included. Using univariate and multivariate, linear regression analyses, I analyzed how 69 factors (e.g., location, general information, number of faculty and trainees, work schedule, educational environment) are related to the pass rate. Results Of 371 programs, only one region had a significantly different pass rate from the other regions; however, as no other characteristics were reported in this region, I excluded program location from further analysis. In the multivariate analysis, pass rate was significantly associated with four program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of osteopathic doctors, formal mentoring program, and on-site child care (OCC). Numerous factors were not associated at all, including minimum exam scores, salary, vacation days, and average hours per week. Conclusions As shown through the ratio of full-time equivalent paid faculty to positions and whether there was a formal mentoring program, a highly supervised training experience was strongly associated with the pass rate. In contrast, percentage of osteopathic doctors was inversely related to the pass rate. Programs with OCC significantly outperformed programs without OCC. This study suggested that enhancing supervision of training programs and offering parental support may help attract and produce competitive residents. PMID:26426400

  10. Interface requirements in nuclear medicine devices and systems

    SciTech Connect

    Maguire, G.Q. Jr.; Brill, A.B.; Noz, M.E.

    1982-01-01

    Interface designs for three nuclear medicine imaging systems, and computer networking strategies proposed for medical imaging departments are presented. Configurations for two positron-emission-tomography devices (PET III and ECAT) and a general-purpose tomography instrument (the UNICON) are analyzed in terms of specific performance parameters. Interface designs for these machines are contrasted in terms of utilization of standard versus custom modules, cost, and ease of modification, upgrade, and support. The requirements of general purpose systems for medical image analysis, display, and archiving, are considered, and a realizable state-of-the-art system is specfied, including a suggested timetable.

  11. Nuclear Medicine in Thyroid Diseases in Pediatric and Adolescent Patients

    PubMed Central

    Volkan-Salancı, Bilge; Özgen Kıratlı, Pınar

    2015-01-01

    Both benign and malignant diseases of the thyroid are rare in the pediatric and adolescent population, except congenital hypothyroidism. Nuclear medicine plays a major role, both in the diagnosis and therapy of thyroid pathologies. Use of radioactivity in pediatric population is strictly controlled due to possible side effects such as secondary cancers; therefore, management of pediatric patients requires detailed literature knowledge. This article aims to overview current algorithms in the management of thyroid diseases and use of radionuclide therapy in pediatric and adolescent population. PMID:26316469

  12. The birth of nuclear medicine instrumentation: Blumgart and Yens, 1925.

    PubMed

    Patton, Dennis D

    2003-08-01

    In 1925, Hermann Blumgart performed the first diagnostic procedure using radioactive indicators on humans; this first is well recognized. Less well recognized is the fact that Blumgart and his coworker Otto C. Yens, then a medical student, developed the first instrumentation used in a diagnostic procedure involving radioactive indicators. The instrumentation, a modified Wilson cloud chamber, turned out to be the detector most suitable for their purpose. Blumgart also showed remarkable foresight in outlining the requirements both for a satisfactory indicator (tracer) and for a satisfactory detector--requirements that still hold true today. The Blumgart-Yens modified cloud chamber was the birth of nuclear medicine instrumentation. PMID:12902429

  13. Anniversary Paper: Nuclear medicine: Fifty years and still counting

    PubMed Central

    Williams, Lawrence E.

    2008-01-01

    The history, present status, and possible future of nuclear medicine are presented. Beginning with development of the rectilinear scanner and gamma camera, evolution to the present forms of hybrid technology such as single photon emission computed tomography∕computed tomography (CT) and positron emission tomography∕CT is described. Both imaging and therapy are considered and the recent improvements in dose estimation using hybrid technologies are discussed. Future developments listed include novel radiopharmaceuticals created using short chains of nucleic acids and varieties of nanostructures. Patient-specific radiotherapy is an eventual outcome of this work. Possible application to proving the targeting of potential chemotherapeutics is also indicated. PMID:18697524

  14. Nuclear medicine for imaging of epithelial ovarian cancer.

    PubMed

    Abedi, Seyed Mohammad; Mardanshahi, Alireza; Shahhosseini, Roza; Hosseinimehr, Seyed Jalal

    2016-05-01

    Cancer is one of the leading causes of mortality worldwide. Usually, the diagnosis of cancer at an early stage is important to facilitate proper treatment and survival. Nuclear medicine has been successfully used in the diagnosis, staging, therapy and monitoring of cancers. Single-photon emission computed tomography and PET-based companion imaging agents are in development for use as a companion diagnostic tool for patients with ovarian cancer. The present review discusses the basic and clinical studies related to the use of radiopharmaceuticals in the diagnosis and management of ovarian cancer, focusing on their utility and comparing them with other imaging techniques such as computed tomography and MRI. PMID:26984362

  15. Citation guidelines for nuclear data retrieved from databases resident at the Nuclear Data Centers Network

    SciTech Connect

    McLane, V.

    1996-07-01

    The Nuclear Data Centers Network is a world-wide cooperation of nuclear data centers under the auspices of the International Atomic Energy Agency. The Network organizes the task of collecting, compiling, standardizing, storing, assessing, and distributing the nuclear data on an international scale. Information available at the Centers includes bibliographic, experimental, and evaluated databases for nuclear reaction data and for nuclear structure and radioactive decay data. The objective of the Network is to provide the information to users in a convenient, readily-available form. To this end, online data services have been established at three of the centers: the National Nuclear Data Center (NNDC), the Nuclear Data Section of the International Atomic Energy Agency (NDS), and the OECD Nuclear Energy Agency Data Bank (NEADB). Some information is also available at the NNDC and NEADB World Wide Web sites.

  16. Nuclear medicine technologists and unauthorized self-injections.

    PubMed

    Miller, K L; King, S H; Eggli, D F; Thompson, L K

    2006-02-01

    An Office of Investigation (OI) investigation by the U.S. Nuclear Regulatory Commission (NRC) determined that, on three separate occasions over the past 10 years, technologists in one licensed nuclear medicine program were injected with radiopharmaceuticals without Authorized User knowledge or approval. The most recent instance, the one that precipitated the investigation, was discovered by the licensee and self-reported to the NRC; the other two instances were discovered during the OI investigation and came as a complete surprise to the licensee. In a mediated Alternative Dispute Resolution (ADR) involving the licensee, a professional, independent mediator and representatives of the NRC, an agreement was worked out whereby the licensee would admit to the violations and work with the NRC to inform other licensees that this is not an acceptable practice and that there are additional precautions that licensees can and should take to assure that such violations do not happen on their watch. PMID:16404185

  17. Image Reconstruction for Prostate Specific Nuclear Medicine imagers

    SciTech Connect

    Mark Smith

    2007-01-11

    There is increasing interest in the design and construction of nuclear medicine detectors for dedicated prostate imaging. These include detectors designed for imaging the biodistribution of radiopharmaceuticals labeled with single gamma as well as positron-emitting radionuclides. New detectors and acquisition geometries present challenges and opportunities for image reconstruction. In this contribution various strategies for image reconstruction for these special purpose imagers are reviewed. Iterative statistical algorithms provide a framework for reconstructing prostate images from a wide variety of detectors and acquisition geometries for PET and SPECT. The key to their success is modeling the physics of photon transport and data acquisition and the Poisson statistics of nuclear decay. Analytic image reconstruction methods can be fast and are useful for favorable acquisition geometries. Future perspectives on algorithm development and data analysis for prostate imaging are presented.

  18. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

    PubMed

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-01-01

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely. PMID:27077874

  19. Avoidable challenges of a nuclear medicine facility in a developing nation

    PubMed Central

    Adedapo, Kayode Solomon; Onimode, Yetunde Ajoke; Ejeh, John Enyi; Adepoju, Adewale Oluwaseun

    2013-01-01

    The role of nuclear medicine in disease management in a developing nation is as impactful as it is in other regions of the world. However, in the developing world, the practice of nuclear medicine is faced with a myriad of challenges, which can be easily avoided. In this review, we examine the many avoidable challenges to the practice of nuclear medicine in a developing nation. The review is largely based on personal experiences of the authors who are the pioneers and current practitioners of nuclear medicine in a typical developing nation. If the challenges examined in this review are avoided, the practice of nuclear medicine in such a nation will be more effective and practitioners will be more efficient in service delivery. Hence, the huge benefits of nuclear medicine will be made available to patients in such a developing nation. PMID:24379527

  20. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital

    PubMed Central

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-01-01

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely. PMID:27077874

  1. Narrative medicine as a means of training medical students toward residency competencies

    PubMed Central

    Arntfield, Shannon L.; Slesar, Kristen; Dickson, Jennifer; Charon, Rita

    2014-01-01

    Objective This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture. Conclusion/Practice implications Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance. PMID:23462070

  2. On-site storage of high level nuclear waste: attitudes and perceptions of local residents.

    PubMed

    Bassett, G W; Jenkins-Smith, H C; Silva, C

    1996-06-01

    No public policy issue has been as difficult as high-level nuclear waste. Debates continue regarding Yucca Mountain as a disposal site, and-more generally-the appropriateness of geologic disposal and the need to act quickly. Previous research has focused on possible social, political, and economic consequences of a facility in Nevada. Impacts have been predicted to be potentially large and to emanate mainly from stigmatization of the region due to increased perceptions of risk. Analogous impacts from leaving waste at power plants have been either ignored or assumed to be negligible. This paper presents survey results on attitudes of residents in three counties where nuclear waste is currently stored. Topics include perceived risk, knowledge of nuclear waste and radiation, and impacts on jobs, tourism, and housing values from leaving waste on site. Results are similar to what has been reported for Nevada; the public is concerned about possible adverse effects from on-site storage of waste. PMID:8693158

  3. Establishment of a national program for quality control of nuclear medicine instrumentation.

    PubMed

    Coca Perez, Marco A; Torres Aroche, Leonel A; Bejerano, Gladys López; Mayor, Roberto Fraxedas; Corona, Consuelo Varela; López, Adlin

    2008-12-01

    Monitoring the quality of instrumentation used in nuclear medicine is mandatory to guarantee the clinical efficacy of medical practice. A national program for the quality control of nuclear medicine instruments was established in Cuba and was certified and approved by the regulatory authorities. The program, which establishes official regulations and audit services, sets up educational activities, distributes technical documentation, and maintains a national phantom bank, constitutes a valuable and useful tool to guarantee the quality of nuclear medicine instrumentation. PMID:19008290

  4. Java-based PACS and reporting system for nuclear medicine

    NASA Astrophysics Data System (ADS)

    Slomka, Piotr J.; Elliott, Edward; Driedger, Albert A.

    2000-05-01

    In medical imaging practice, images and reports often need be reviewed and edited from many locations. We have designed and implemented a Java-based Remote Viewing and Reporting System (JaRRViS) for a nuclear medicine department, which is deployed as a web service, at the fraction of the cost dedicated PACS systems. The system can be extended to other imaging modalities. JaRRViS interfaces to the clinical patient databases of imaging workstations. Specialized nuclear medicine applets support interactive displays of data such as 3-D gated SPECT with all the necessary options such as cine, filtering, dynamic lookup tables, and reorientation. The reporting module is implemented as a separate applet using Java Foundation Classes (JFC) Swing Editor Kit and allows composition of multimedia reports after selection and annotation of appropriate images. The reports are stored on the server in the HTML format. JaRRViS uses Java Servlets for the preparation and storage of final reports. The http links to the reports or to the patient's raw images with applets can be obtained from JaRRViS by any Hospital Information System (HIS) via standard queries. Such links can be sent via e-mail or included as text fields in any HIS database, providing direct access to the patient reports and images via standard web browsers.

  5. Nuclear Medicine in Diagnosis of Prosthetic Valve Endocarditis: An Update

    PubMed Central

    Musso, Maria; Petrosillo, Nicola

    2015-01-01

    Over the past decades cardiovascular disease management has been substantially improved by the increasing introduction of medical devices as prosthetic valves. The yearly rate of infective endocarditis (IE) in patient with a prosthetic valve is approximately 3 cases per 1,000 patients. The fatality rate of prosthetic valve endocarditis (PVE) remains stable over the years, in part due to the aging of the population. The diagnostic value of echocardiography in diagnosis is operator-dependent and its sensitivity can decrease in presence of intracardiac devices and valvular prosthesis. The modified Duke criteria are considered the gold standard for diagnosing IE; their sensibility is 80%, but in clinical practice their diagnostic accuracy in PVE is lower, resulting inconclusively in nearly 30% of cases. In the last years, these new imaging modalities have gained an increasing attention because they make it possible to diagnose an IE earlier than the structural alterations occurring. Several studies have been conducted in order to assess the diagnostic accuracy of various nuclear medicine techniques in diagnosis of PVE. We performed a review of the literature to assess the available evidence on the role of nuclear medicine techniques in the diagnosis of PVE. PMID:25695043

  6. Development and implementation of a geriatric care/case management program in a military community-based family medicine residency.

    PubMed

    Williams, C M; Petrelli, J; Murphy, M

    2000-11-01

    This article discusses how the development of a longitudinal geriatric assessment form facilitated a case management program in identifying high-risk frail elders within a military family practice clinic. A careful review of geriatric assessment tools was performed. From this review, a model geriatric assessment form was developed. A "SWOT" (strengths, weaknesses, opportunities, and threats) analysis of the family medicine department was completed to determine if the environment was ready for case management. Analysis of the SWOT data revealed that the environment was favorable for a population-based approach to case management. Results of this initial study are encouraging. The new longitudinal geriatric assessment form has assisted family practice residents in organizing problems and data while seeing elderly patients. As a direct result, higher-risk frail elders have been identified for closer evaluation and follow-up. Future goals are to measure outcomes-based data and to refine the geriatric assessment process. PMID:11143424

  7. A simplified training method for soft tissue foreign body detection using ultrasound in emergency medicine residency program

    PubMed Central

    Farahmand, Shervin; Mehran, Sadjad; Arbab, Mona; Khazaeipour, Zahra; Basir-Ghafouri, Hamed; Saeedi, Morteza

    2014-01-01

    Using ultrasound for detecting soft tissue foreign bodies seems to be the preferred choice with minimum invasion and easy availability at the bedside in emergency departments. In this study, a workshop (1 hour of lecture presentation and 3 hours of interactive hands-on) was designed to evaluate the efficacy of a short course of simple interactive training to improve the ability of emergency medicine residents to detect foreign bodies with ultrasound. Eight pieces of fresh full thickness (10 × 10 × 10 cm) lamb leg muscle were used in this study. Five different types of foreign bodies, including: a piece of glass (5 × 5 × 4 mm), wood (5 × 5 × 4 mm), gravel (5 mm diameter), plastic (5 × 5 × 2 mm) and a nail (25 mm in length) were placed deep inside each lamb leg. An ultrasound machine with a 7.5 MHz linear probe was used in this study. 35 emergency medicine residents (12 PGY1, 11 PGY2 and 12 PGY3) were enrolled in this study. Pretest and post-test results were compared and analyzed. Among all 35 participants in the training session, foreign body detection was significantly improved after the workshop (p < 0.001). Overall sensitivity and specificity for differentiating the presence and absence of a foreign body with 95% confidence were 60% (75% for PGY3) and 85.7% (91.7% for PGY3), respectively. The overall accuracy increased from 20.2% to 72.8% due to this session. This study supported the possibility of using ultrasound to detect foreign bodies by emergency physicians with a very short training course. This is highly beneficial for overcrowded emergency departments.

  8. Using the M/G/∞ queueing model to predict inpatient family medicine service census and resident workload.

    PubMed

    Garrison, Gregory M; Pecina, Jennifer L

    2016-09-01

    The number and timing of unplanned admissions to inpatient teaching services vary. Recent changes to resident duty hours make it essential to maximize learning experiences and balance workload on these services. Queueing theory provides a mechanism for understanding and planning for the variations in admissions and daily census. Daily admissions, length of stay, and daily census were modeled for a teaching inpatient family medicine service over 46 months using an M/G/∞ queueing model. Q-Q plots and a Kolmogorov-Smirnov test were used to check the fit of actual data to the model. Admissions and daily census followed a Poisson distribution (λ = 3.28 and λ = 8.28, respectively), while length-of-stay followed a lognormal distribution (µ = 0.49, σ2 = 0.83). The M/G/∞ queueing model proved useful for predicting overflow admission frequency, defining expected resident workload in terms of patient-days, and determining hospital unit size requirements. PMID:25609083

  9. Measurement of doses to the extremities of nuclear medicine staff

    NASA Astrophysics Data System (ADS)

    Shousha, Hany A.; Farag, Hamed; Hassan, Ramadan A.

    Medical uses of ionizing radiation now represent>95% of all man-made radiation exposure, and is the largest single radiation source after natural background radiation. Therefore, it is important to quantify the amount of radiation received by occupational individuals to optimize the working conditions for staff, and further, to compare doses in different departments to ensure compatibility with the recommended standards. For some groups working with unsealed sources in nuclear medicine units, the hands are more heavily exposed to ionizing radiation than the rest of the body. A personal dosimetry service runs extensively in Egypt. But doses to extremities have not been measured to a wide extent. The purpose of this study was to investigate the equivalent radiation doses to the fingers for five different nuclear medicine staff occupational groups for which heavy irradiation of the hands was suspected. Finger doses were measured for (1) nuclear medicine physicians, (2) technologists, (3) nurses and (4) physicists. The fifth group contains three technicians handling 131I, while the others handled 99mTc. Each staff member working with the radioactive material wore two thermoluminescent dosimeters (TLDs) during the whole testing period, which lasted from 1 to 4 weeks. Staff performed their work on a regular basis throughout the month, and mean annual doses were calculated for these groups. Results showed that the mean equivalent doses to the fingers of technologist, nurse and physicist groups were 30.24±14.5, 30.37±17.5 and 16.3±7.7 μSv/GBq, respectively. Equivalent doses for the physicians could not be calculated per unit of activity because they did not handle the radiopharmaceuticals directly. Their doses were reported in millisieverts (mSv) that accumulated in one week. Similarly, the dose to the fingers of individuals in Group 5 was estimated to be 126.13±38.2 μSv/GBq. The maximum average finger dose, in this study, was noted in the technologists who handled

  10. Measurement of doses to the extremities of nuclear medicine staff

    NASA Astrophysics Data System (ADS)

    Shousha, Hany A.; Farag, Hamed; Hassan, Ramadan A.

    2010-01-01

    Medical uses of ionizing radiation now represent>95% of all man-made radiation exposure, and is the largest single radiation source after natural background radiation. Therefore, it is important to quantify the amount of radiation received by occupational individuals to optimize the working conditions for staff, and further, to compare doses in different departments to ensure compatibility with the recommended standards. For some groups working with unsealed sources in nuclear medicine units, the hands are more heavily exposed to ionizing radiation than the rest of the body. A personal dosimetry service runs extensively in Egypt. But doses to extremities have not been measured to a wide extent. The purpose of this study was to investigate the equivalent radiation doses to the fingers for five different nuclear medicine staff occupational groups for which heavy irradiation of the hands was suspected. Finger doses were measured for (1) nuclear medicine physicians, (2) technologists, (3) nurses and (4) physicists. The fifth group contains three technicians handling 131I, while the others handled 99mTc. Each staff member working with the radioactive material wore two thermoluminescent dosimeters (TLDs) during the whole testing period, which lasted from 1 to 4 weeks. Staff performed their work on a regular basis throughout the month, and mean annual doses were calculated for these groups. Results showed that the mean equivalent doses to the fingers of technologist, nurse and physicist groups were 30.24±14.5, 30.37±17.5 and 16.3±7.7 μSv/GBq, respectively. Equivalent doses for the physicians could not be calculated per unit of activity because they did not handle the radiopharmaceuticals directly. Their doses were reported in millisieverts (mSv) that accumulated in one week. Similarly, the dose to the fingers of individuals in Group 5 was estimated to be 126.13±38.2 μSv/GBq. The maximum average finger dose, in this study, was noted in the technologists who handled

  11. Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant.

    PubMed

    Orita, Makiko; Hayashida, Naomi; Nakayama, Yumi; Shinkawa, Tetsuko; Urata, Hideko; Fukushima, Yoshiko; Endo, Yuuko; Yamashita, Shunichi; Takamura, Noboru

    2015-01-01

    The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents' risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP. PMID:26057539

  12. Process improvement of pap smear tracking in a women's medicine center clinic in residency training.

    PubMed

    Calhoun, Byron C; Goode, Jeff; Simmons, Kathy

    2011-11-01

    Application of Six-Sigma methodology and Change Acceleration Process (CAP)/Work Out (WO) tools to track pap smear results in an outpatient clinic in a hospital-based residency-training program. Observational study of impact of changes obtained through application of Six-Sigma principles in clinic process with particular attention to prevention of sentinel events. Using cohort analysis and applying Six-Sigma principles to an interactive electronic medical record Soarian workflow engine, we designed a system of timely accession and reporting of pap smear and pathology results. We compared manual processes from January 1, 2007 to February 28, 2008 to automated processes from March 1, 2008 to December 31, 2009. Using the Six-Sigma principles, CAP/WO tools, including "voice of the customer" and team focused approach, no outlier events went untracked. Applying the Soarian workflow engine to track prescribed 7 day turnaround time for completion, we identified 148 pap results in 3,936, 3 non-gynecological results in 15, and 41 surgical results in 246. We applied Six-Sigma principles to an outpatient clinic facilitating an interdisciplinary team approach to improve the clinic's reporting system. Through focused problem assessment, verification of process, and validation of outcomes, we improved patient care for pap smears and critical pathology. PMID:22103702

  13. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    PubMed Central

    Shimizu, Taro; Tsugawa, Yusuke; Tanoue, Yusuke; Konishi, Ryota; Nishizaki, Yuji; Kishimoto, Mitsumasa; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2013-01-01

    Background It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods To assess the knowledge base of medicine, we conducted the General Medicine InTraining Examination (GM-ITE) for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM) score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women) participated and completed the exam. There were no residents who declined to participate in the exam. The mean GM-ITE score was 58 (standard deviation 8.4). The mixed-effects linear regression analysis showed that a higher PHEEM score was associated with a higher GM-ITE score (P = 0.02). Having a department of general medicine, and hospital location in a provincial community (versus an urban setting), were also shown to have a significant relationship with the higher score (P = 0.03, and P = 0.02, respectively). Conclusion We found that the performance of the medical knowledge base of resident physicians was significantly associated with the educational environment of their hospitals. Improvement of the educational environment in teaching hospitals might be crucial for enhancing the performance of resident physicians in Japan. PMID:23930077

  14. NMINT--introductory courseware for nuclear medicine: database design.

    PubMed

    Mankovich, N J; Verma, R C; Yue, A; Veyne, D; Ratib, O; Bennett, L R

    1991-01-01

    Computer-Aided Instruction (CAI) provides a dynamic and self-paced learning experience to the medical trainee. Microcomputer based hypermedia systems integrate text, graphics, and image information. We present the design of an introductory CAI course for nuclear medicine called NMINT and elaborate on the underlying relational database that contains clinically relevant information and links to local or remote image storage over high speed networks. The IBM PS/2 Windows system uses Toolbook software augmented by C language modules for image and image-overlay database access. The current implementation stores text, graphical lesson material, and image index information on microcomputer magnetic disk; image data are stored on the attached optical disk. The storage architecture is described in detail. We emphasize its multi-access methods and its expandability into department-wide image networks. PMID:1807706

  15. Future developments in nuclear medicine instrumentation: a review.

    PubMed

    Kuikka, J T; Britton, K E; Chengazi, V U; Savolainen, S

    1998-01-01

    This review article forecasts developments in nuclear medicine instrumentation which are on the horizon. Special attention is paid to the physical properties of detectors and multiple-processor parallel processing systems needed for fast and high-quality imaging in emission tomography. Advances in detector technology will improve imaging resolution below 5 mm and will increase sensitivity and quantitative accuracy. In addition, high count rate list-mode acquisition enables 'true' four-dimensional data-sets. A sandwich-like construction of two different crystals allows the simultaneous use of conventional tracers and positron tracers (multiple emission tomography, MET). Transmission-based attenuation and scatter compensation with fast iterative reconstruction methods will further improve image quality. The clinical and scientific importance of improved images and the limits on advances in instrumentation are also reviewed. PMID:9515542

  16. Flexible nuclear medicine camera and method of using

    DOEpatents

    Dilmanian, F.A.; Packer, S.; Slatkin, D.N.

    1996-12-10

    A nuclear medicine camera and method of use photographically record radioactive decay particles emitted from a source, for example a small, previously undetectable breast cancer, inside a patient. The camera includes a flexible frame containing a window, a photographic film, and a scintillation screen, with or without a gamma-ray collimator. The frame flexes for following the contour of the examination site on the patient, with the window being disposed in substantially abutting contact with the skin of the patient for reducing the distance between the film and the radiation source inside the patient. The frame is removably affixed to the patient at the examination site for allowing the patient mobility to wear the frame for a predetermined exposure time period. The exposure time may be several days for obtaining early qualitative detection of small malignant neoplasms. 11 figs.

  17. Flexible nuclear medicine camera and method of using

    DOEpatents

    Dilmanian, F. Avraham; Packer, Samuel; Slatkin, Daniel N.

    1996-12-10

    A nuclear medicine camera 10 and method of use photographically record radioactive decay particles emitted from a source, for example a small, previously undetectable breast cancer, inside a patient. The camera 10 includes a flexible frame 20 containing a window 22, a photographic film 24, and a scintillation screen 26, with or without a gamma-ray collimator 34. The frame 20 flexes for following the contour of the examination site on the patient, with the window 22 being disposed in substantially abutting contact with the skin of the patient for reducing the distance between the film 24 and the radiation source inside the patient. The frame 20 is removably affixed to the patient at the examination site for allowing the patient mobility to wear the frame 20 for a predetermined exposure time period. The exposure time may be several days for obtaining early qualitative detection of small malignant neoplasms.

  18. Selected Interventions in Nuclear Medicine: Gastrointestinal Motor Functions

    PubMed Central

    Odunsi, Suwebatu T.; Camilleri, Michael

    2009-01-01

    Measurement of gastrointestinal functions by scintigraphy is established in clinical practice and research. The most commonly used test is the gastric emptying test. This is acknowledged as the gold standard and is conducted according to a consensus statement from the national nuclear medicine and motility societies. Other techniques are somewhat more esoteric (e.g. measurement of gastric accommodation with SPECT) or the scintigraphic approach is not the acknowledged gold standard (e.g. colonic transit, recto-anal angle and emptying, esophageal transit). The performance characteristics of many of the scintigraphic measurements have been published and the pros and cons established in the literature. Gastrointestinal scintigraphy is an integral and important component of the assessment of gastrointestinal function. PMID:19341838

  19. Nuclear medicine in acute and chronic renal failure

    SciTech Connect

    Sherman, R.A.; Byun, K.J.

    1982-07-01

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. /sup 131/I OIH, /sup 67/gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease.

  20. Development of thyroid anthropomorphic phantoms for use in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Cerqueira, R. A. D.; Maia, A. F.

    2014-02-01

    The objective of this study was to develop thyroid anthropomorphic phantoms to be used in control tests of medical images in scintillation cameras. The main difference among the phantoms was the neck shape: in the first, called OSCT, it was geometrically shaped, while in the second, called OSAP, it was anthropomorphically shaped. In both phantoms, thyroid gland prototypes, which were made of acrylic and anthropomorphically shaped, were constructed to allow the simulation of a healthy thyroid and of thyroids with hyperthyroidism and hypothyroidism. Images of these thyroid anthropomorphic phantoms were obtained using iodine 131 with an activity of 8.695 MBq. The iodine 131 was chosen because it is widely used in studies of thyroid scintigraphy. The images obtained proved the effectiveness of the phantoms to simulate normal or abnormal thyroids function. These phantoms can be used in medical imaging quality control programs and, also in the training of professionals involved in the analysis of images in nuclear medicine centers.

  1. Diffusion processes in tumors: A nuclear medicine approach

    NASA Astrophysics Data System (ADS)

    Amaya, Helman

    2016-07-01

    The number of counts used in nuclear medicine imaging techniques, only provides physical information about the desintegration of the nucleus present in the the radiotracer molecules that were uptaken in a particular anatomical region, but that information is not a real metabolic information. For this reason a mathematical method was used to find a correlation between number of counts and 18F-FDG mass concentration. This correlation allows a better interpretation of the results obtained in the study of diffusive processes in an agar phantom, and based on it, an image from the PETCETIX DICOM sample image set from OsiriX-viewer software was processed. PET-CT gradient magnitude and Laplacian images could show direct information on diffusive processes for radiopharmaceuticals that enter into the cells by simple diffusion. In the case of the radiopharmaceutical 18F-FDG is necessary to include pharmacokinetic models, to make a correct interpretation of the gradient magnitude and Laplacian of counts images.

  2. Cancer in children residing near nuclear power plants: an open question

    PubMed Central

    2010-01-01

    Background Global warming and the established responsibility of the anthropogenic emissions of greenhouse gases represent a strong push towards the construction of new nuclear power plants (NPPs) to cope with the growing energy needs. The toxicity of nuclear waste associated with the extreme difficulty of their disposal and increase in cancer mortality and incidence following occupational radiation exposure are considered the only health problems. Methods A search of scientific articles and government documents published since January 1, 1980 to July 1, 2010 was performed to evaluate cancer rate and mortality in residents, particularly children, in the vicinity of NPPs. Results A recent well conducted state-of-the-art case-control study of childhood cancers in the areas around German NPPs (KiKK study) showed a statistically significant cancers (2.2-fold increase in leukemia and a 1.6-fold increase in solid tumor) among children under five years of age living in the inner 5 km circle around NPPs when compared to residence outside this area. These findings have been confirmed by two meta-analyses. Nevertheless, other UK, France, Spain and Finland studies did not find cancer incidence and/or death increase near NPPs. Conclusions Increased cancer risk near NPPs remains in fact an open question. The stronger evidence from the KiKK study suggests there may well be such increases at least in children regardless of the country in which nuclear reactors are located. In fact, few months ago the U.S. Nuclear Regulatory Commission has asked the National Academy of Sciences (NAS) to perform a state-of-the-art study on cancer risk for populations surrounding NPPs. PMID:20831815

  3. The A-bomb, 50 years later: The evolution of nuclear medicine

    SciTech Connect

    Kotz, D.

    1995-08-01

    In the wake of the Hiroshima and Nagasaki bombings, the U.S. government began to invest heavily in its nuclear program. Nuclear medicine stood to gain from these postwar policies, but it also suffered some setbacks. Fifty years ago this month, two atomic bombs were dropped on Japan, killing thousands of civilians and ushering in a quick and final end to World War II. The beginning of the post-war era signaled the birth of nuclear medicine as it is widely applied today. In fact, the same nuclear reactor that produced elements for the A-bomb project was turned over for the mass production of radionuclides for medicine and industry. The link between the A-bomb and nuclear medicine, however, has always been a sensitive subject among nuclear physicians whose patients may associate radionuclide injections with mushroom clouds. Although this link is not justified, the government`s interest in developing nuclear technology following World War II did have a significant impact on nuclear medicine: on the upside, millions of federal dollars were funneled into the production of radionuclides for research and medicine. On the downside, Congress established the Atomic Energy Commission (AEC)-which later became the Nuclear Regulatory Commission (NRC)-to oversee safety issues, making nuclear medicine the only medical field regulated by a federal agency.

  4. Special Radiation Protection Precautions in Therapeutic Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Stefanoyiannis, A. P.; Gerogiannis, J.

    2010-01-01

    Therapeutic Nuclear Medicine concerns the administration of appropriate amounts of radioactivity of certain isotopes, in order to achieve internal localized irradiation of neoplasmatic cells. Due to the increased level and the specific isotope characteristics of administered radioactivity, special Radiation Protection precautions must be taken. This study addresses such issues, based on national as well as international legislation and guidelines. Application of the principle of optimization is of outmost importance and is based on individual dose planning. The decision about the release of Nuclear Medicine patients after therapy is determined on an individual basis, taking into account patients' pattern of contact with other people, their age and that of persons in the home environment, in addition to other factors. Estimation of the absorbed dose given to the treated organ is based on uptake measurements and other biokinetic data, as well as on the mass of the treated tissue or organ. Concerning pregnant women, the rule of thumb is that they should not be treated, unless the radionuclide therapy is required to save their lives. In that case, the potential absorbed dose and risk to the foetus should be estimated and conveyed to the patient. After radionuclide therapy, a female should be advised to avoid pregnancy for the period of time depending on the specific radionuclide. This is to ensure that the dose to a conceptus/foetus would probably not exceed 1 mGy (the member of the public dose limit). The radiation risk for relatives and caregivers is small and unlikely to exceed the legal dose constraints during the period of the patient's treatment. Solid waste from the patient's stay in hospital is a different matter, and is normally incinerated or held for a period until radioactive decay brings the activity to an acceptable level.

  5. Standardization of Administered Activities in Pediatric Nuclear Medicine: A Report of the First Nuclear Medicine Global Initiative Project, Part 2-Current Standards and the Path Toward Global Standardization.

    PubMed

    Fahey, Frederic H; Bom, Henry Hee-Seung; Chiti, Arturo; Choi, Yun Young; Huang, Gang; Lassmann, Michael; Laurin, Norman; Mut, Fernando; Nuñez-Miller, Rodolfo; O'Keeffe, Darin; Pradhan, Prasanta; Scott, Andrew M; Song, Shaoli; Soni, Nischal; Uchiyama, Mayuki; Vargas, Luis

    2016-07-01

    The Nuclear Medicine Global Initiative (NMGI) was formed in 2012 and consists of 13 international organizations with direct involvement in nuclear medicine. The underlying objectives of the NMGI are to promote human health by advancing the field of nuclear medicine and molecular imaging, encourage global collaboration in education, and harmonize procedure guidelines and other policies that ultimately lead to improvements in quality and safety in the field throughout the world. For its first project, the NMGI decided to consider the issues involved in the standardization of administered activities in pediatric nuclear medicine. It was decided to divide the final report of this project into 2 parts. Part 1 was published in this journal in the spring of 2015. This article presents part 2 of the final report. It discusses current standards for administered activities in children and adolescents that have been developed by various professional organizations. It also presents an evaluation of the current practice of pediatric nuclear medicine specifically with regard to administered activities as determined by an international survey of 313 nuclear medicine clinics and centers from 29 countries. Lastly, it provides recommendations for a path toward global standardization of the administration of radiopharmaceuticals in children. PMID:27033894

  6. IBA-Europhysics Prize in Applied Nuclear Science and Nuclear Methods in Medicine

    NASA Astrophysics Data System (ADS)

    MacGregor, I. J. Douglas

    2014-03-01

    The Nuclear Physics Board of the European Physical Society is pleased to announce that the 2013 IBA-Europhysics Prize in Applied Nuclear Science and Nuclear Methods in Medicine is awarded to Prof. Marco Durante, Director of the Biophysics Department at GSI Helmholtz Center (Darmstadt, Germany); Professor at the Technical University of Darmstadt (Germany) and Adjunct Professor at the Temple University, Philadelphia, USA. The prize was presented in the closing Session of the INPC 2013 conference by Mr. Thomas Servais, R&D Manager for Accelerator Development at the IBA group, who sponsor the IBA Europhysics Prize. The Prize Diploma was presented by Dr. I J Douglas MacGregor, Chair-elect of the EPS Nuclear Physics Division and Chair of the IBA Prize committee.

  7. Stress and impairment during residency training: strategies for reduction, identification, and management. Resident Services Committee, Association of Program Directors in Internal Medicine.

    PubMed

    1988-07-15

    Graduate physicians face formidable developmental tasks during residency training as they prepare for their professional careers. Adapting to becoming a skilled physician involves assuming and mastering many professional responsibilities for the proper care of patients while taking on many personal obligations such as marriage, parenthood, and financial independence. Adaptation requires physicians to cope successfully with a series of stresses that have been divided into three categories: situational, professional, and personal stresses. Each category is reviewed and both general and specific recommendations are offered to reduce the level of stress. Normal and abnormal responses to the stresses of residency training are described, and guidelines are provided for recognizing the impaired resident early. Recommendations are made for managing the residency program and treating the resident, should he or she become impaired. PMID:3382106

  8. EVALUATION OF INTERNAL MEDICINE RESIDENTS AS EXERCISE ROLE MODELS AND ASSOCIATIONS WITH SELF-REPORTED COUNSELING BEHAVIOR, CONFIDENCE, AND PERCEIVED SUCCESS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Patients perceive physicians who practice healthy personal behaviors as more credible and better able to motivate patients to make healthy lifestyle choices. Purposes: To evaluate internal medicine resident physicians as role models for promoting exercise by an assessment of physician ph...

  9. Development and Validation of a Measurement Scale to Analyze the Environment for Evidence-Based Medicine Learning and Practice by Medical Residents

    ERIC Educational Resources Information Center

    Mi, Fangqiong

    2010-01-01

    A growing number of residency programs are instituting curricula to include the component of evidence-based medicine (EBM) principles and process. However, these curricula may not be able to achieve the optimal learning outcomes, perhaps because various contextual factors are often overlooked when EBM training is being designed, developed, and…

  10. Communication Skills Curriculum for Foreign Medical Graduates in an Internal Medicine Residency Program

    PubMed Central

    Ramaswamy, Ravishankar; Williams, Alicia; Clark, Elizabeth M.; Kelley, Amy S.

    2014-01-01

    Background Effective communication is an important aspect of caring for the elderly, who are more likely to have multimorbidity, limited health literacy and psychosocial barriers to care. About half of Internal Medicine (IM) trainees in the United States are foreign medical graduates, and may not have been exposed to prior communication skills education. This novel communication skills curriculum for IM interns aimed to increase trainees' confidence and use of specific communication tools with older adults, particularly in delivering bad news and conducting family meetings. Methods The workshop consisted of 2 interactive sessions, in a small group with 2 learners and 1-2 facilitators, during the Geriatrics block of the internship year. Twenty-three IM interns were surveyed at the beginning and at the end of the 4-week block and at 3 months after completion of the workshop about their knowledge, confidence and skill in communication, and asked about any challenges to effective communication with older patients. The primary outcome measure was change in self-reported confidence and behavior in communication at 4 weeks. Results On a 4-point Likert scale, there was an average improvement of 0.70 in self-reported confidence in communication, which sustained at 3 months after completion of the workshop. Participants reported several patient, physician and system barriers to effective communication. Conclusion Communication skills education in a small-group setting and the opportunity for repeated practice and self-reflection resulted in sustained increase in overall confidence among IM interns in communication with older adults, and may help overcome certain patient and physician-specific communication barriers. PMID:25354834

  11. Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant

    PubMed Central

    Orita, Makiko; Hayashida, Naomi; Nakayama, Yumi; Shinkawa, Tetsuko; Urata, Hideko; Fukushima, Yoshiko; Endo, Yuuko; Yamashita, Shunichi; Takamura, Noboru

    2015-01-01

    The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP. PMID:26057539

  12. [Investigation of radiation safety management of nuclear medicine facilities in Japan; contamination of radioactivity in the draining-water system. A Working Group of Japanese Society of Nuclear Medicine for the Guidelines of Nuclear Medicine Therapy].

    PubMed

    Endo, K; Koizumi, M; Kinoshita, F; Nakazawa, K

    1999-12-01

    Radiation safety management condition in Japanese nuclear medicine facilities were investigated by the questionnaire method. The first questionnaire was asked in all Japanese 1,401 Nuclear Medicine facilities. Answers from 624 institutes (44.5%) were received and analyzed. The radiation-safety management in nuclear medicine institutes was considered to be very well performed everyday. Opinion for the present legal control of nuclear medicine institutes was that the regulation in Japan was too strict for the clinical use of radionuclides. The current regulation is based on the assumption that 1% of all radioactivity used in nuclear medicine institutes contaminates into the draining-water system. The second questionnaire detailing the contamination of radioactivity in the draining-water system was sent to 128 institutes, and 64 answers were received. Of them, 42 institutes were considered to be enough to evaluate the contamination of radioactivity in the draining-water system. There was no difference between 624 institutes answered to the first questionnaire and 42 institutes, where the radioactivity in the draining-water system was measured, in the distribution of the institute size, draining-water system equipment and the radioactivity measuring method, and these 42 institutes seemed to be representative of Japanese nuclear medicine institutes. Contamination rate of radioactivity into the draining system was calculated by the value of radioactivity in the collecting tank divided by the amount of radionuclides used daily in each institute. The institutes were divided into two categories on the basis of nuclear medicine practice pattern; type A: in-vivo use only and type B: both in-vivo and in-vitro use. The contamination rate in 27 type A institutes did not exceed 0.01%, whereas in 15 type B institutes the contamination rate distributed widely from undetectable to above 1%. These results indicated that the present regulation for the draining-water system, which

  13. [Bone-seeking radioactive substances in nuclear medicine].

    PubMed

    Pfeiffer, G

    1976-12-01

    The concept of bone affinity of a radioactive tracer is developed on theoretical grounds and is discussed on the basis of the various substances used in nuclear medical diagnosis of bone disease. On the basis of results on the uptake of very short lived nuclides and extremely large molecules, evidence is provided that the incorporation of the tracer in the apatite crystal is not a primary criterion of bone affinity since incorporation cannot take place on timelimiting grounds in the former case and on spatial grounds in the latter. The fixation on bone is therefore more likely the result of non-specific adsorption processes. The utility of a radioactive substance in practical application in nuclear medicine depends on the radioactive characteristics of the nuclide and on its behavior in the organism. In this context the quality of the scintigram is particularly dependent on the mode and rate of elimination of that fraction of the tracer that is not bound by the skeleton. The various mechanism which cause differences in the uptake of tracer by healthy and pathological bone tissue are discussed with special regard to the role of blood flow. PMID:1012921

  14. The Application of Margin in Life Theory in Regard to Attrition and Remediation among Emergency Medicine Residents

    ERIC Educational Resources Information Center

    Kalynych, Colleen J.

    2010-01-01

    Medical residency is a time of high stress, long hours, high case loads, fatigue, and lack of free time. Burnout rates among residents have been reported to be between 25-76%. Scant literature exists in regard to resident stress and its impact on learning and attrition during residency. The theory of margin posits that a healthy margin is…

  15. A Comparative Analysis of Diagnostic Accuracy of Focused Assessment With Sonography for Trauma Performed by Emergency Medicine and Radiology Residents

    PubMed Central

    Zamani, Majid; Masoumi, Babak; Esmailian, Mehrdad; Habibi, Amin; Khazaei, Mehdi; Mohammadi Esfahani, Mohammad

    2015-01-01

    Background: Focused assessment with sonography in trauma (FAST) is a method for prompt detection of the abdominal free fluid in patients with abdominal trauma. Objectives: This study was conducted to compare the diagnostic accuracy of FAST performed by emergency medicine residents (EMR) and radiology residents (RRs) in detecting peritoneal free fluids. Patients and Methods: Patients triaged in the emergency department with blunt abdominal trauma, high energy trauma, and multiple traumas underwent a FAST examination by EMRs and RRs with the same techniques to obtain the standard views. Ultrasound findings for free fluid in peritoneal cavity for each patient (positive/negative) were compared with the results of computed tomography, operative exploration, or observation as the final outcome. Results: A total of 138 patients were included in the final analysis. Good diagnostic agreement was noted between the results of FAST scans performed by EMRs and RRs (κ = 0.701, P < 0.001), also between the results of EMRs-performed FAST and the final outcome (κ = 0.830, P < 0.0010), and finally between the results of RRs-performed FAST and final outcome (κ = 0.795, P < 0.001). No significant differences were noted between EMRs- and RRs-performed FASTs regarding sensitivity (84.6% vs 84.6%), specificity (98.4% vs 97.6%), positive predictive value (84.6% vs 84.6%), and negative predictive value (98.4% vs 98.4%). Conclusions: Trained EMRs like their fellow RRs have the ability to perform FAST scan with high diagnostic value in patients with blunt abdominal trauma. PMID:26756009

  16. Highlights lecture EANM 2015: the search for nuclear medicine's superheroes.

    PubMed

    Buck, Andreas; Decristoforo, Clemens

    2016-09-01

    The EANM 2015 Annual Congress, held from October 10th to 14th in Hamburg, Germany, was outstanding in many respects. With 5550 participants, this was by far the largest European congress concerning nuclear medicine. More than 1750 scientific presentations were submitted, with more than 250 abstracts from young scientists, indicating that the future success of our discipline is fuelled by a high number of young individuals becoming involved in a multitude of scientific activities. Significant improvements have been made in molecular imaging of cancer, particularly in prostate cancer. PSMA-directed PET/CT appears to become a new gold standard for staging and restaging purposes. Novel tumour specific compounds have shown their potential for target identification also in other solid neoplasms and further our understanding of tumour biology and heterogeneity. In addition, a variety of nuclear imaging techniques guiding surgical interventions have been introduced. A particular focus of the congress was put on targeted, radionuclide based therapies. Novel theranostic concepts addressing also tumour entities with high incidence rates such as prostate cancer, melanoma, and lymphoma, have shown effective anti-tumour activity. Strategies have been presented to improve further already established therapeutic regimens such as somatostatin receptor based radio receptor therapy for treating advanced neuroendocrine tumours. Significant contributions were presented also in the neurosciences track. An increasing number of target structures of high interest in neurology and psychiatry are now available for PET and SPECT imaging, facilitating specific imaging of different subtypes of dementia and movement disorders as well as neuroinflammation. Major contributions in the cardiovascular track focused on further optimization of cardiac perfusion imaging by reducing radiation exposure, reducing scanning time, and improving motion correction. Besides coronary artery disease, many

  17. Measurements of individual radiation doses in residents living around the Fukushima Nuclear Power Plant.

    PubMed

    Nagataki, Shigenobu; Takamura, Noboru; Kamiya, Kenji; Akashi, Makoto

    2013-11-01

    At the outset of the accident at Fukushima Daiichi Nuclear Power Plant in March 2011, the radiation doses experienced by residents were calculated from the readings at monitoring posts, with several assumptions being made from the point of view of protection and safety. However, health effects should also be estimated by obtaining measurements of the individual radiation doses. The individual external radiation doses, determined by a behavior survey in the "evacuation and deliberate evacuation area" in the first 4 months, were <5 mSv in 97.4% of residents (maximum: 15 mSv). Doses in Fukushima Prefecture were <3 mSv in 99.3% of 386,572 residents analyzed. External doses in Fukushima City determined by personal dosimeters were <1 mSv/3 months (September-November, 2011) in 99.7% of residents (maximum: 2.7 mSv). Thyroid radiation doses, determined in March using a NaI (TI) scintillation survey meter in children in the evacuation and deliberate evacuation area, were <10 mSv in 95.7% of children (maximum: 35 mSv). Therefore, all doses were less than the intervention level of 50 mSv proposed by international organizations. Internal radiation doses determined by cesium-134 ((134)C) and cesium-137 ((137)C) whole-body counters (WBCs) were <1 mSv in 99% of the residents, and the maximum thyroid equivalent dose by iodine-131 WBCs was 20 mSv. The exploratory committee of the Fukushima Health Management Survey mentions on its website that radiation from the accident is unlikely to be a cause of adverse health effects in the future. In any event, sincere scientific efforts must continue to obtain individual radiation doses that are as accurate as possible. However, observation of the health effects of the radiation doses described above will require reevaluation of the protocol used for determining adverse health effects. The dose-response relationship is crucial, and the aim of the survey should be to collect sufficient data to confirm the presence or absence of radiation health

  18. A Brief Boot Camp for 4th-Year Medical Students Entering into Pediatric and Family Medicine Residencies

    PubMed Central

    Adler, Mark; Mangold, Karen; Trainor, Jennifer

    2016-01-01

    The transition from medical student to intern is a challenging process characterized by a steep learning curve. Focused courses targeting skills necessary for success as a resident have increased self-perceived preparedness, confidence, and medical knowledge. Our aim was to create a brief educational intervention for 4th-year medical students entering pediatric, family practice, and medicine/pediatric residencies to target skills necessary for an internship. The curriculum used a combination of didactic presentations, small group discussions, role-playing, facilitated debriefing, and simulation-based education. Participants completed an objective structured clinical exam requiring synthesis and application of multiple boot camp elements before and after the elective. Participants completed anonymous surveys assessing self-perceived preparedness for an internship, overall and in regards to specific skills, before the elective and after the course. Participants were asked to provide feedback about the course. Using checklists to assess performance, students showed an improvement in performing infant lumbar punctures (47.2% vs 77.0%; p < 0.01, 95% CI for the difference 0.2, 0.4%) and providing signout (2.5 vs. 3.9 (5-point scale) p < 0.01, 95% CI for the difference 0.6, 2.3). They did not show an improvement in communication with a parent. Participants demonstrated an increase in self-reported preparedness for all targeted skills, except for obtaining consults and interprofessional communication. There was no increase in reported overall preparedness. All participants agreed with the statements, “The facilitators presented the material in an effective manner,” “I took away ideas I plan to implement in internship,” and “I think all students should participate in a similar experience.” When asked to assess the usefulness of individual modules, all except order writing received a mean Likert score > 4. A focused boot camp addressing key knowledge and skills

  19. A Brief Boot Camp for 4th-Year Medical Students Entering into Pediatric and Family Medicine Residencies.

    PubMed

    Burns, Rebekah; Adler, Mark; Mangold, Karen; Trainor, Jennifer

    2016-01-01

    The transition from medical student to intern is a challenging process characterized by a steep learning curve. Focused courses targeting skills necessary for success as a resident have increased self-perceived preparedness, confidence, and medical knowledge. Our aim was to create a brief educational intervention for 4th-year medical students entering pediatric, family practice, and medicine/pediatric residencies to target skills necessary for an internship. The curriculum used a combination of didactic presentations, small group discussions, role-playing, facilitated debriefing, and simulation-based education. Participants completed an objective structured clinical exam requiring synthesis and application of multiple boot camp elements before and after the elective. Participants completed anonymous surveys assessing self-perceived preparedness for an internship, overall and in regards to specific skills, before the elective and after the course. Participants were asked to provide feedback about the course. Using checklists to assess performance, students showed an improvement in performing infant lumbar punctures (47.2% vs 77.0%; p < 0.01, 95% CI for the difference 0.2, 0.4%) and providing signout (2.5 vs. 3.9 (5-point scale) p < 0.01, 95% CI for the difference 0.6, 2.3). They did not show an improvement in communication with a parent. Participants demonstrated an increase in self-reported preparedness for all targeted skills, except for obtaining consults and interprofessional communication. There was no increase in reported overall preparedness. All participants agreed with the statements, "The facilitators presented the material in an effective manner," "I took away ideas I plan to implement in internship," and "I think all students should participate in a similar experience." When asked to assess the usefulness of individual modules, all except order writing received a mean Likert score > 4. A focused boot camp addressing key knowledge and skills required for

  20. An influential factor for external radiation dose estimation for residents after the Fukushima Daiichi Nuclear Power Plant accident-time spent outdoors for residents in Iitate Village.

    PubMed

    Ishikawa, Tetsuo; Yasumura, Seiji; Ohtsuru, Akira; Sakai, Akira; Akahane, Keiichi; Yonai, Shunsuke; Sakata, Ritsu; Ozasa, Kotaro; Hayashi, Masayuki; Ohira, Tetsuya; Kamiya, Kenji; Abe, Masafumi

    2016-06-01

    Many studies have been conducted on radiation doses to residents after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Time spent outdoors is an influential factor for external dose estimation. Since little information was available on actual time spent outdoors for residents, different values of average time spent outdoors per day have been used in dose estimation studies on the FDNPP accident. The most conservative value of 24 h was sometimes used, while 2.4 h was adopted for indoor workers in the UNSCEAR 2013 report. Fukushima Medical University has been estimating individual external doses received by residents as a part of the Fukushima Health Management Survey by collecting information on the records of moves and activities (the Basic Survey) after the accident from each resident. In the present study, these records were analyzed to estimate an average time spent outdoors per day. As an example, in Iitate Village, its arithmetic mean was 2.08 h (95% CI: 1.64-2.51) for a total of 170 persons selected from respondents to the Basic Survey. This is a much smaller value than commonly assumed. When 2.08 h is used for the external dose estimation, the dose is about 25% (23-26% when using the above 95% CI) less compared with the dose estimated for the commonly used value of 8 h. PMID:27034103

  1. On-site storage of high level nuclear waste: Attitudes and perceptions of local residents

    SciTech Connect

    Bassett, G.W. Jr.; Jenkins-Smith, H.C.; Silva, C.

    1996-06-01

    No public policy issue has been as difficult as high-level nuclear waste. Debates continue regarding Yucca Mountain as a disposal site, and - more generally - the appropriateness of geologic disposal and the need to act quickly. Previous research has focused on possible social, political, and economic consequences of a facility in Nevada. Impacts have been predicted to be potentially large and to emanate mainly from stigmatization of the region due to increased perceptions of risk. Analogous impacts from leaving waste at power plants have been either ignored or assumed to be negligible. This paper presents survey results on attitudes of residents in three countries where nuclear waste is currently stored. Topics include perceived risk, knowledge of nuclear waste and radiation, and impacts on jobs, tourism, and housing values from leaving waste on site. Results are similar to what has been reported for Nevada; the public is concerned about possible adverse effects from on-site storage of waste. 24 refs., 7 figs., 5 tabs.

  2. Beyond a curricular design of convenience: replacing the noon conference with an academic half day in three internal medicine residency programs.

    PubMed

    Batalden, Maren K; Warm, Eric J; Logio, Lia S

    2013-05-01

    Several residency programs have created an academic half day (AHD) for the delivery of core curriculum, and some program Web sites provide narrative descriptions of individual AHD curricula; nonetheless, little published literature on the AHD format exists. This article details three distinctive internal medicine residency programs (Cambridge Health Alliance, University of Cincinnati, and New York Presbyterian/Weill Cornell Medical College) whose leaders replaced the traditional noon conference curriculum with an AHD. Although each program's AHD developed independently of the other two, retrospective comparative review reveals instructive similarities and differences that may be useful to other residency directors. In this article, the authors describe the distinct approaches to the AHD at the three institutions through a framework of six core principles: (1) protect time and space to facilitate learning, (2) nurture active learning in residents, (3) choose and sequence curricular content deliberately, (4) develop faculty, (5) encourage resident preparation and accountability for learning, and (6) employ a continuous improvement approach to curriculum development and evaluation. The authors chronicle curricular adaptations at each institution over the first three years of experience. Preliminary outcome data, presented in the article, suggests that the transition from the traditional noon conference to an AHD may increase conference attendance, improve resident and faculty satisfaction with the curriculum, and improve resident performance on the In Training Examination. PMID:23524926

  3. Cancer rates after the Three Mile Island nuclear accident and proximity of residence to the plant.

    PubMed Central

    Hatch, M C; Wallenstein, S; Beyea, J; Nieves, J W; Susser, M

    1991-01-01

    BACKGROUND: In the light of a possible link between stress and cancer promotion or progression, and of previously reported distress in residents near the Three Mile Island (TMI) nuclear power plant, we attempted to evaluate the impact of the March 1979 accident on community cancer rates. METHODS: Proximity of residence to the plant, which related to distress in previous studies, was taken as a possible indicator of accident stress; the postaccident pattern in cancer rates was examined in 69 "study tracts" within a 10-mile radius of TMI, in relation to residential proximity. RESULTS: A modest association was found between postaccident cancer rates and proximity (OR = 1.4; 95% CI = 1.3, 1.6). After adjusting for a gradient in cancer risk prior to the accident, the odds ratio contrasting those closest to the plant with those living farther out was 1.2 (95% CI = 1.0, 1.4). A postaccident increase in cancer rates near the Three Mile Island plant was notable in 1982, persisted for another year, and then declined. Radiation emissions, as modeled mathematically, did not account for the observed increase. CONCLUSION: Interpretation in terms of accident stress is limited by the lack of an individual measure of stress and by uncertainty about whether stress has a biological effect on cancer in humans. An alternative mechanism for the cancer increase near the plant is through changes in care-seeking and diagnostic practice arising from postaccident concern. PMID:2029040

  4. Androgen receptor regulates nuclear trafficking and nuclear domain residency of corepressor HDAC7 in a ligand-dependent fashion

    SciTech Connect

    Karvonen, Ulla; Jaenne, Olli A.; Palvimo, Jorma J. . E-mail: jorma.palvimo@uku.fi

    2006-10-01

    In addition to chromosomal proteins, histone deacetylases (HDACs) target transcription factors in transcriptional repression. Here, we show that the class II HDAC family member HDAC7 is an efficient corepressor of the androgen receptor (AR). HDAC7 resided in the cytoplasm in the absence of AR or a cognate ligand, but hormone-occupancy of AR induced nuclear transfer of HDAC7. Nuclear colocalization pattern of AR and HDAC7 was dependent on the nature of the ligand. In the presence of testosterone, a portion of HDAC7 localized to pearl-like nuclear domains, whereas AR occupied with antagonistic ligands cyproterone acetate- or casodex (bicalutamide) recruited HDAC7 from these domains to colocalize with the receptor in speckles and nucleoplasm in a more complete fashion. Ectopic expression of PML-3 relieved the repressive effect of HDAC7 on AR function by sequestering HDAC7 to PML-3 domains. AR acetylation at Lys630/632/633 was not the target of HDAC7 repression, since repression of AR function was independent of these acetylation sites. Moreover, the deacetylase activity of HDAC7 was in part dispensable in the repression of AR function. In sum, our results identify HDAC7 as a novel AR corepressor whose subcellular and subnuclear compartmentalization can be regulated in an androgen-selective manner.

  5. 42 CFR Appendix D to Part 75 - Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... for Nuclear Medicine Technologists D Appendix D to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... of patient care; (b) Radiation safety and protection; (c) Nuclear medicine physics; (d)...

  6. 42 CFR Appendix D to Part 75 - Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... for Nuclear Medicine Technologists D Appendix D to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... of patient care; (b) Radiation safety and protection; (c) Nuclear medicine physics; (d)...

  7. 42 CFR Appendix D to Part 75 - Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... for Nuclear Medicine Technologists D Appendix D to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... of patient care; (b) Radiation safety and protection; (c) Nuclear medicine physics; (d)...

  8. 42 CFR Appendix D to Part 75 - Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... for Nuclear Medicine Technologists D Appendix D to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... of patient care; (b) Radiation safety and protection; (c) Nuclear medicine physics; (d)...

  9. 42 CFR Appendix D to Part 75 - Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for Nuclear Medicine Technologists D Appendix D to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... of patient care; (b) Radiation safety and protection; (c) Nuclear medicine physics; (d)...

  10. Examining Quality Management Audits in Nuclear Medicine Practice as a lifelong learning process: opportunities and challenges to the nuclear medicine professional and beyond.

    PubMed

    Pascual, Thomas N B

    2016-08-01

    This essay will explore the critical issues and challenges surrounding lifelong learning for professionals, initially exploring within the profession and organizational context of nuclear medicine practice. It will critically examine how the peer-review process called Quality Management Audits in Nuclear Medicine Practice (QUANUM) of the International Atomic Energy Agency (IAEA) can be considered a lifelong learning opportunity to instill a culture of quality to improve patient care and elevate the status of the nuclear medicine profession and practice within the demands of social changes, policy, and globalization. This will be explored initially by providing contextual background to the identity of the IAEA as an organization responsible for nuclear medicine professionals, followed by the benefits that QUANUM can offer. Further key debates surrounding lifelong learning, such as compulsification of lifelong learning and impact on professional change, will then be weaved through the discussion using theoretical grounding through a qualitative review of the literature. Keeping in mind that there is very limited literature focusing on the implications of QUANUM as a lifelong learning process for nuclear medicine professionals, this essay uses select narratives and observations of QUANUM as a lifelong learning process from an auditor's perspective and will further provide a comparative perspective of QUANUM on the basis of other lifelong learning opportunities such as continuing professional development activities and observe parallelisms on its benefits and challenges that it will offer to other professionals in other medical speciality fields and in the teaching profession. PMID:27195385

  11. IAEA programs in empowering the nuclear medicine profession through online educational resources.

    PubMed

    Pascual, Thomas Nb; Dondi, Maurizio; Paez, Diana; Kashyap, Ravi; Nunez-Miller, Rodolfo

    2013-05-01

    The International Atomic Energy Agency's (IAEA) programme in human health aims to enhance the capabilities in Member States to address needs related to the prevention, diagnosis, and treatment of diseases through the application of nuclear techniques. It has the specific mission of fostering the application of nuclear medicine techniques as part of the clinical management of certain types of diseases. Attuned to the continuous evolution of this specialty as well as to the advancement and diversity of methods in delivering capacity building efforts in this digital age, the section of nuclear medicine of the IAEA has enhanced its program by incorporating online educational resources for nuclear medicine professionals into its repertoire of projects to further its commitment in addressing the needs of its Member States in the field of nuclear medicine. Through online educational resources such as the Human Health Campus website, e-learning modules, and scheduled interactive webinars, a validation of the commitment by the IAEA in addressing the needs of its Member States in the field of nuclear medicine is strengthened while utilizing the advanced internet and communications technology which is progressively becoming available worldwide. The Human Health Campus (www.humanhealth.iaea.org) is the online educational resources initiative of the Division of Human Health of the IAEA geared toward enhancing professional knowledge of health professionals in radiation medicine (nuclear medicine and diagnostic imaging, radiation oncology, and medical radiation physics), and nutrition. E-learning modules provide an interactive learning environment to its users while providing immediate feedback for each task accomplished. Webinars, unlike webcasts, offer the opportunity of enhanced interaction with the learners facilitated through slide shows where the presenter guides and engages the audience using video and live streaming. This paper explores the IAEA's available online

  12. Ethical dilemmas in today's nuclear medicine and radiology practice.

    PubMed

    Barron, Bruce J; Kim, E Edmund

    2003-11-01

    Throughout history, societies have developed their own codes of ethics, including those pertaining to the practice of medicine. In the United States, physicians have adopted a set of ethics based on religious values and historical teachings. We, as physicians, have been presented several codes of ethics, including the American Medical Association Code of Ethics and the American College of Radiology Code of Ethics. Over time, we have learned to appropriately apply these codes to our daily practice. With the advent of new technologies in imaging, we may lose sight as to the transfer of these principles to reflect current conditions. Recent history has shown a trend of new technology leading to potential misuse of this technology and further leading to stricter governmental regulations. It is the purpose of this review to give guidelines for dealing with new technologies, such as PET imaging, and we describe a radiologist's ethical responsibility in a doctor-patient relationship. A historical review of medical ethics will lead to discussions about various issues affecting radiologists and nuclear physicians. To be sure, not all ethical situations are black and white, and therefore there are many gray areas. The opinions expressed in this article are those of the authors and are based on extension of already established rules of ethical conduct. PMID:14602866

  13. Motion estimation for nuclear medicine: a probabilistic approach

    NASA Astrophysics Data System (ADS)

    Smith, Rhodri; Abd. Rahni, Ashrani Aizzuddin; Jones, John; Tahavori, Fatemeh; Wells, Kevin

    2014-03-01

    Accurate, Respiratory Motion Modelling of the abdominal-thoracic organs serves as a pre-requisite for motion correction of Nuclear Medicine (NM) Images. Many respiratory motion models to date build a static correspondence between a parametrized external surrogate signal and internal motion. Mean drifts in respiratory motion, changes in respiratory style and noise conditions of the external surrogate signal motivates a more adaptive approach to capture non-stationary behavior. To this effect we utilize the application of our novel Kalman model with an incorporated expectation maximization step to allow adaptive learning of model parameters with changing respiratory observations. A comparison is made with a popular total least squares (PCA) based approach. It is demonstrated that in the presence of noisy observations the Kalman framework outperforms the static PCA model, however, both methods correct for respiratory motion in the computational anthropomorphic phantom to < 2mm. Motion correction performed on 3 dynamic MRI patient datasets using the Kalman model results in correction of respiratory motion to ≍ 3mm.

  14. [The psychodynamics of work with iodine-131 in nuclear medicine].

    PubMed

    da Silveira, Leila Cunha; Guilam, Maria Cristina Rodrigues; de Oliveira, Sergio Ricardo

    2013-11-01

    This paper seeks to demonstrate to what extent alternative forms adopted in the working process of professionals with iodine-131 in nuclear medicine can assist in managing risks of ionizing radiation. The design is based on the main theoretical concepts of the psychodynamics of work in relation to workers' health. In the case study, data were gathered from 15 workers of a public health institution in the city of Rio de Janeiro by means of semi-structured individual interviews and non-systematic direct observation. Bardin's content analysis method was used for the data analysis. When comparing the results obtained with standard prescribed models, it was found that the respondents had changed their approach. They developed individual defense mechanisms, such as denial of risk, and collective defensive strategies, leading them to tackle the greatest danger as a form of defense. The defensive role of ideologies of the profession are manifest. On the contrary, the acquired knowledge derived from prudence proved effective in minimizing the risks of radiation exposure. The authors discuss the limitations of security management that does not consider the workers' subjectivity and inherent knowledge. PMID:24196882

  15. On the safety of persons accompanying nuclear medicine patients.

    PubMed

    Díaz Barreto, Marlenin; López Bejerano, Gladys M; Varela Corona, Consuelo; Fleitas Estévez, Ileana

    2012-12-01

    The presence of caretakers/comforters during nuclear medicine examinations is relatively common. These caretakers receive higher doses than the general public, who receive only environmental/background exposure. The aim of this research was to know about the doses received by two significant groups of caretakers: comforters of cancer patients (Group I) and mothers of small children (Group II). The patients were scheduled to undergo two different diagnostic studies: Inmuno-Scintigraphy using a monoclonal antibody bound to (99m)Tc (for adults) and Renal Scintigraphy using (99m)Tc-dimercaptosuccinic acid (for children). The average effective doses were 0.27 and 0.29 mSv for Groups I and II, respectively. Additionally, environmental monitoring was performed in the waiting room for injected patients (Room I) and inside the procedure room (Room II). Equivalent environmental doses of 0.28 and 0.24 mSv for Rooms 1 and II, respectively, were found, which are similar to values reported by other authors. PMID:22517979

  16. High transparency coded apertures in planar nuclear medicine imaging.

    PubMed

    Starfield, David M; Rubin, David M; Marwala, Tshilidzi

    2007-01-01

    Coded apertures provide an alternative to the collimators of nuclear medicine imaging, and advances in the field have lessened the artifacts that are associated with the near-field geometry. Thickness of the aperture material, however, results in a decoded image with thickness artifacts, and constrains both image resolution and the available manufacturing techniques. Thus in theory, thin apertures are clearly desirable, but high transparency leads to a loss of contrast in the recorded data. Coupled with the quantization effects of detectors, this leads to significant noise in the decoded image. This noise must be dependent on the bit-depth of the gamma camera. If there are a sufficient number of measurable values, high transparency need not adversely affect the signal-to-noise ratio. This novel hypothesis is tested by means of a ray-tracing computer simulator. The simulation results presented in the paper show that replacing a highly opaque coded aperture with a highly transparent aperture, simulated with an 8-bit gamma camera, worsens the root-mean-square error measurement. However, when simulated with a 16-bit gamma camera, a highly transparent coded aperture significantly reduces both thickness artifacts and the root-mean-square error measurement. PMID:18002997

  17. Therapeutic radionuclides in nuclear medicine: current and future prospects

    PubMed Central

    Yeong, Chai-Hong; Cheng, Mu-hua; Ng, Kwan-Hoong

    2014-01-01

    The potential use of radionuclides in therapy has been recognized for many decades. A number of radionuclides, such as iodine-131 (131I), phosphorous-32 (32P), strontium-90 (90Sr), and yttrium-90 (90Y), have been used successfully for the treatment of many benign and malignant disorders. Recently, the rapid growth of this branch of nuclear medicine has been stimulated by the introduction of a number of new radionuclides and radiopharmaceuticals for the treatment of metastatic bone pain and neuroendocrine and other malignant or non-malignant tumours. Today, the field of radionuclide therapy is enjoying an exciting phase and is poised for greater growth and development in the coming years. For example, in Asia, the high prevalence of thyroid and liver diseases has prompted many novel developments and clinical trials using targeted radionuclide therapy. This paper reviews the characteristics and clinical applications of the commonly available therapeutic radionuclides, as well as the problems and issues involved in translating novel radionuclides into clinical therapies. PMID:25294374

  18. Applying activity-based costing to the nuclear medicine unit.

    PubMed

    Suthummanon, Sakesun; Omachonu, Vincent K; Akcin, Mehmet

    2005-08-01

    Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better. PMID:16102243

  19. Preliminary investigations of active pixel sensors in Nuclear Medicine imaging

    NASA Astrophysics Data System (ADS)

    Ott, Robert; Evans, Noel; Evans, Phil; Osmond, J.; Clark, A.; Turchetta, R.

    2009-06-01

    Three CMOS active pixel sensors have been investigated for their application to Nuclear Medicine imaging. Startracker with 525×525 25 μm square pixels has been coupled via a fibre optic stud to a 2 mm thick segmented CsI(Tl) crystal. Imaging tests were performed using 99mTc sources, which emit 140 keV gamma rays. The system was interfaced to a PC via FPGA-based DAQ and optical link enabling imaging rates of 10 f/s. System noise was measured to be >100e and it was shown that the majority of this noise was fixed pattern in nature. The intrinsic spatial resolution was measured to be ˜80 μm and the system spatial resolution measured with a slit was ˜450 μm. The second sensor, On Pixel Intelligent CMOS (OPIC), had 64×72 40 μm pixels and was used to evaluate noise characteristics and to develop a method of differentiation between fixed pattern and statistical noise. The third sensor, Vanilla, had 520×520 25 μm pixels and a measured system noise of ˜25e. This sensor was coupled directly to the segmented phosphor. Imaging results show that even at this lower level of noise the signal from 140 keV gamma rays is small as the light from the phosphor is spread over a large number of pixels. Suggestions for the 'ideal' sensor are made.

  20. Portable gamma camera for clinical use in nuclear medicine

    SciTech Connect

    Pani, R.; Pellegrini, R.; Scopinaro, F.

    1996-12-31

    Up today Hamamatsu R3292 is the Position Sensitive Photo Multiplier Tube (PSPMT) with the largest sensitive area (10 cm of diameter). At the same time it has the minimum size for clinical application in Nuclear Medicine. A portable gamma camera was realized, based on 5 inches PSPMT coupled to a scintillating array. The head has a light weight (15 Kg.) spatial resolution resulted better than that of Anger Camera with good linearity response, good energy resolution and FOV coincident with intrinsic one of PSPMT. To optimize gamma camera response two different scintillating arrays were tested: YAP:Ce and CsI (Tl). Their overall size cover all photochatode active area, and crystal pixel size was 2 mm x 2 mm. The detection efficiency resulted comparable to that of Anger Camera. The best result was obtained by CsI (Tl) scintillating: an intrinsic spatial resolution of 1.6 mm FWHM and a relative energy resolution of 17% FWHM. With a standard general purpose collimator a spatial resolution of about 2 mm resulted. Some preliminary results were also obtained in breast scintigraphy.

  1. Proceedings of a workshop on molecular nuclear medicine

    SciTech Connect

    Reba, R.C.

    1992-12-31

    The Office of Health and Environmental Research (OHER) of the Department of Energy (DOE) has increased the emphasis on research in structural biology and molecular biology. The Department has increased support substantially in the area of basic molecular and structural biology research. To exploit the advances in these fields, OHER has sought to apply those advances in their other areas of responsibility, e.g., health effects research, environmental biology, and, in particular, nuclear medicine. The applications of biotechnology have contributed greatly to the productive research efforts of molecular biology. These techniques include gene manipulation for targeted gene delivery; characterization of molecular probes for hormone, tumor, and neuroreceptors; the receptor-agonist/antagonist binding interactions; studies of mechanisms of cellular communication; and the development of in vitro diagnostics such as molecular probes for studying the aging process and patients with mental disorders, cancer, and atherosclerosis. The importance of this work is the reasonable expectation that mainly, through an appreciation of the molecular basis of disease, will the most effective and rapid progress be made toward understanding, identifying, solving, and preventing specific disease processes. Critical questions arising before and during the Workshop are how the following technologies can be applied in a practical clinical research or patient management setting: the recombinant DNA methodology, the technology of engineered monoclonal antibodies, the new methods for protein production and purification, and the production of transgenic animals.

  2. Status of and trends in nuclear medicine in the United States.

    PubMed

    Delbeke, Dominique; Segall, George M

    2011-12-01

    Nuclear medicine in the United States has grown because of advances in technology, including hybrid imaging, the introduction of new radiopharmaceuticals for diagnosis and therapy, and the development of molecular imaging based on the tracer principle, which is not based on radioisotopes. Continued growth of the field will require cost-effectiveness data and evidence that nuclear medicine procedures affect patients' outcomes. Nuclear medicine physicians and radiologists will need more training in anatomic and molecular imaging. New educational models are being developed to ensure that future physicians will be adequately prepared. PMID:22144551

  3. [What is new in 2014 for the specialist in hospital internal medicine? The point of view of university hospital chief residents].

    PubMed

    Bonjour, T; Voruz, S; Aebischer, O; Benmachiche, M; Carrel, G; Castioni, J; Cosma-Rochat, M; Gachoud, D; Gagliano, M; Giger, A; Greiser, J; Fournier, J; Méan, M; Mieville, A; Rouiller Larpin, N; Tusgul, S; Wenger, N; Lamy, O

    2015-01-21

    The year 2014 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice and on the way we manage one problem or another. From the use of the ultrasound for the diagnosis of pneumonia to the choice of the site of venous access and the type of line, and the increasing complexity of choosing an oral anticoagulant agent, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings. PMID:25831610

  4. Nuclear medicine: proof of principle for targeted drugs in diagnosis and therapy.

    PubMed

    Leitha, Thomas

    2009-01-01

    Delivering a drug to a specific target in the body is comparable to the "magic bullet principle" applied in Nuclear Medicine. If clinical medicine today found treatment options by targeting specific receptors, proteins or enzymes by "small-molecule drugs" it utilizes concepts that have been initially described by Nobel Laureate George von Hevesy as "tracer principle". This article is going to show that molecular imaging probes in Nuclear Medicine can be regarded as proof of principle of many of recent trends in diagnosis and therapy and offers exciting opportunities for further developments. Radioiodine therapy of benign and malignant thyroid disease has been established in Nuclear Medicine over six decades ago and is a fine example for using the same highly specific probe for diagnosis and treatment of a given disease. The use of radio labeled monoclonal antibodies against surface receptors of tumor cells (e.g. CEA) dominated diagnostic Nuclear Medicine in the eighties and sees a recent revival in lymphoma treatment radioimmunotherapy. Finally Nuclear Medicine has shown that it may advance drug development by visualizing its biodistribution and site of action. On the other hand some drugs like somatostatin analogues have been reinvented as diagnostic and therapeutic probes over a decade after their initial introduction as therapeutics. Molecular Imaging and targeted therapy are merging and potentiate their individual strength. Nuclear Medicine has ample experience in applying Molecular Imaging in clinical research and practice and has a bright future in this exciting field. PMID:19149611

  5. Radiation safety in the nuclear medicine department: impact of the UK Ionising Radiations Regulations.

    PubMed

    Harding, L K

    1987-09-01

    The practice of nuclear medicine requires integration of radiation safety with patient care and radiopharmaceutical standards. Nationally there was useful discussion in the UK before the Ionising Radiations Regulations and Approved Code of Practice were published, although such consultation had been lacking when the Medicines Act was implemented. Most of the new considerations relating to nuclear medicine stem from Schedule 6 of the Regulations. Generally, the presence of a single patient does not require a controlled area. However, when several patients are present, or radiopharmaceuticals are being prepared prior to injection, a controlled area is required. Classification of workers is not likely to be required in a typical nuclear medicine department in the UK, although most parts of the nuclear medicine department will need to be controlled areas. These include the radiopharmacy, radionuclide dispensary, injection room, and imaging rooms if patients are injected in them. The importance of finger dose measurements is emphasised. Patient wards, however, need not be controlled areas. A particular concern in nuclear medicine was that patients should not need to be admitted to hospital merely to comply with legislation. This is possibly the case and clarification will probably be available when the Notes for Guidance are published. Most procedures in nuclear medicine departments will remain unchanged. Further information is required, however, on patient waiting rooms, handling flood sources, pregnancy, and breast feeding. Within the hospital, detailed and multidisciplinary discussion will need to take place within the forum of the radiation safety committee. PMID:3664186

  6. The current status and future perspectives of nuclear medicine in Korea.

    PubMed

    Lee, Myung Chul; Oh, So Won; Chung, June-Key; Lee, Dong Soo

    2010-06-01

    Since the introduction of nuclear medicine in 1959, Korea accomplished a brilliant development in terms of both clinical practice and research activities, which was mainly due to the dedication of nuclear medicine specialists, consisting of physicians, technicians, and scientists, and strong support from the Korean Government. Now, Korea has 150 medical institutes, performing approximately 561,000 nuclear imaging procedures and 11.6 million in vitro studies in 2008, and ranked fourth in the number of presentations at the Annual Meeting of the Society of Nuclear Medicine (SNM) in 2008. The successful progress in this field has allowed Korea to focus on the international promotion of nuclear medicine, especially in the developing and underdeveloped countries. In consequence, the Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM) was established in 2001, and Seoul hosted the 9th Congress of the World Federation of Nuclear Medicine and Biology (WFNMB) in 2006. In the future, Korea will strive to sustain its rate of advancement in the field and make every effort to share its progress and promote the exchange of scientific information at the international level. PMID:25013521

  7. A Perspective of the Future of Nuclear Medicine Training and Certification.

    PubMed

    Arevalo-Perez, Julio; Paris, Manuel; Graham, Michael M; Osborne, Joseph R

    2016-01-01

    Nuclear Medicine (NM) has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become "Molecular Imaging." Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle-imaging, radiopharmaceuticals, and instrumentation. Since the foundation of the American Board of NM, the practice of NM and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and NM. The potential for further cooperation or fusion of the American Board of Radiology and the American Board of NM is likely to bring about a new path for NM and Molecular Imaging training. If the merger is done carefully, respecting the strengths of both partners equally, there is an excellent potential to create a hybrid NM-Radiology specialty that combines Physiology and Molecular Biology with detailed anatomical imaging that sustains the innovation that has been central to NM residency and practice. We introduce a few basic trends in imaging use in the United States. These trends do not predict future use, but highlight the need for an appropriately credentialed practitioner to interpret these examination results and provide value to the health care system. PMID:26687859

  8. Nuclear Medicine at Berkeley Lab: From Pioneering Beginnings to Today (LBNL Summer Lecture Series)

    ScienceCinema

    Budinger, Thomas [LBNL, Center for Functional Imaging

    2011-10-04

    Summer Lecture Series 2006: Thomas Budinger, head of Berkeley Lab's Center for Functional Imaging, discusses Berkeley Lab's rich history pioneering the field of nuclear medicine, from radioisotopes to medical imaging.

  9. Nuclear medicine annual external occupational dose distribution: Rio de Janeiro, Brazil, year 2005.

    PubMed

    Mauricio, Claudia L P; Lima, Ana L S; da Silva, Herica L R; Souza-Santos, Denison; Silva, Claudio R

    2011-03-01

    Brazil has about 300 nuclear medicine services (NMS), 44 of them located in the state of Rio de Janeiro (RJ). Most nuclear medicine staff are routinely monitored for external dose. This paper makes a statistical analysis of all the RJ NMS annual external occupational doses in year 2005. Around 100 professionals of RJ NMS received annual doses >4.0 mSv, considering only external doses, but no one receives doses higher than the mean annual dose limit of 20 mSv. Extremities dosemeters are used by about 10 % of the staff. In some cases, these doses are more than 10 times higher than the dose in thorax. The maximum ratio of extremity dose/thorax dose, in 2005, was 72. This study shows the importance to improve radiation protection procedures in nuclear medicine, mainly because the number of occupational individuals in nuclear medicine and their external doses are increasing. PMID:21051433

  10. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

    PubMed

    Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2016-01-01

    Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores. PMID:27301504

  11. Radiation dose study in nuclear medicine using GATE

    NASA Astrophysics Data System (ADS)

    Aguwa, Kasarachi

    Dose as a result of radiation exposure is the notion generally used to disclose the imparted energy in a volume of tissue to a potential biological effect. The basic unit defined by the international system of units (SI system) is the radiation absorbed dose, which is expressed as the mean imparted energy in a mass element of the tissue known as "gray" (Gy) or J/kg. The procedure for ascertaining the absorbed dose is complicated since it involves the radiation transport of numerous types of charged particles and coupled photon interactions. The most precise method is to perform a full 3D Monte Carlo simulation of the radiation transport. There are various Monte Carlo toolkits that have tool compartments for dose calculations and measurements. The dose studies in this thesis were performed using the GEANT4 Application for Emission Tomography (GATE) software (Jan et al., 2011) GATE simulation toolkit has been used extensively in the medical imaging community, due to the fact that it uses the full capabilities of GEANT4. It also utilizes an easy to-learn GATE macro language, which is more accessible than learning the GEANT4/C++ programming language. This work combines GATE with digital phantoms generated using the NCAT (NURBS-based cardiac-torso phantom) toolkit (Segars et al., 2004) to allow efficient and effective estimation of 3D radiation dose maps. The GATE simulation tool has developed into a beneficial tool for Monte Carlo simulations involving both radiotherapy and imaging experiments. This work will present an overview of absorbed dose of common radionuclides used in nuclear medicine and serve as a guide to a user who is setting up a GATE simulation for a PET and SPECT study.

  12. New filter for iodine applied in nuclear medicine services.

    PubMed

    Ramos, V S; Crispim, V R; Brandão, L E B

    2013-12-01

    In Nuclear Medicine, radioiodine, in various chemical forms, is a key tracer used in diagnostic practices and/or therapy. Medical professionals may incorporate radioactive iodine during the preparation of the dose to be administered to the patient. In radioactive iodine therapy doses ranging from 3.7 to 7.4 GBq per patient are employed. Thus, aiming at reducing the risk of occupational contamination, we developed a low cost filter to be installed at the exit of the exhaust system (where doses of radioiodine are handled within fume hoods, and new filters will be installed at their exit), using domestic technology. The effectiveness of radioactive iodine retention by silver impregnated silica [10%] crystals and natural activated carbon was verified using radiotracer techniques. The results showed that natural activated carbon and silver impregnated silica are effective for I2 capture with large or small amounts of substrate but the use of activated carbon is restricted due to its low flash point (423 K). Besides, when poisoned by organic solvents, this flash point may become lower, causing explosions if absorbing large amounts of nitrates. To hold the CH3I gas, it was necessary to use natural activated carbon since it was not absorbed by SiO2+Ag crystals. We concluded that, for an exhaust flow range of (145 ± 2)m(3)/h, a double stage filter using SiO2+Ag in the first stage and natural activated carbon in the second stage is sufficient to meet radiological safety requirements. PMID:23974306

  13. CdZnTe arrays for nuclear medicine imaging

    SciTech Connect

    Barber, H.B.

    1996-12-31

    In nuclear medicine, a gamma-ray-emitting radiotracer is injected into the body, and the resulting biodistribution is imaged using a gamma camera. Current gamma cameras use a design developed by Anger. An Anger camera makes use of a slab of scintillation detector that is viewed by an array of photomultiplier tubes and uses an analog position estimation technique to determine the position of the gamma ray`s interaction. The image-forming optics is usually a multi-bore collimator made of lead. Such cameras are characterized by poor, system spatial resolution ({approximately}1 cm) due to poor detector resolution ({approximately}0.4 cm) and poor collimator performance. Arrays of semiconductor detectors are an attractive alternative to scintillators for use in gamma cameras. Semiconductor detectors have excellent energy resolution. High spatial resolution is also possible because large semiconductor detector arrays with small pixel sizes can be produced using photolithography techniques. A new crystal growth technique (high-pressure vertical Bridgman) allows production of detector grade CdTe and CdZnTe in multikilogram ingots. Although the cost of CdZnTe detectors has come down substantially in the last few years, in part because of economies of scale, costs are still more than an order of magnitude higher than those required for a commercial camera ($20--$50/gram). High detector costs are perhaps the major stumbling block to developing a semiconductor gamma camera. The photolithography techniques required to make large CdZnTe arrays have already been demonstrated. This paper discusses the recent developments made in CdZnTe detectors.

  14. Importance of Bladder Radioactivity for Radiation Safety in Nuclear Medicine

    PubMed Central

    Gültekin, Salih Sinan; Şahmaran, Turan

    2013-01-01

    Objective: Most of the radiopharmaceuticals used in nuclear medicine are excreted via the urinary system. This study evaluated the importance of a reduction in bladder radioactivity for radiation safety. Methods: The study group of 135 patients underwent several organ scintigraphies [40/135; thyroid scintigraphy (TS), 30/135; whole body bone scintigraphy (WBS), 35/135; myocardial perfusion scintigraphy (MPS) and 30/135; renal scintigraphy (RS)] by a technologist within 1 month. In full and empty conditions, static bladder images and external dose rate measurements at 0.25, 0.50, 1, 1.5 and 2 m distances were obtained and decline ratios were calculated from these two data sets. Results: External radiation dose rates were highest in patients undergoing MPS. External dose rates at 0.25 m distance for TS, TKS, MPS and BS were measured to be 56, 106, 191 and 72 μSv h-1 for full bladder and 29, 55, 103 and 37 μSv h-1 for empty bladder, respectively. For TS, WBS, MPS and RS, respectively, average decline ratios were calculated to be 52%, 55%, 53% and 54% in the scintigraphic assessment and 49%, 51%, 49%, 50% and 50% in the assessment with Geiger counter. Conclusion: Decline in bladder radioactivity is important in terms of radiation safety. Patients should be encouraged for micturition after each scintigraphic test. Spending time together with radioactive patients at distances less than 1 m should be kept to a minimum where possible. Conflict of interest:None declared. PMID:24416625

  15. 4.8 Dose to Embryo and Foetuses in Diagnostic Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Noßke, D.; Mattsson, S.; Johansson, L.

    This document is part of Subvolume A 'Fundamentals and Data in Radiobiology, Radiation Biophysics, Dosimetry and Medical Radiological Protection' of Volume 7 'Medical Radiological Physics' of Landolt-Börnstein - Group VIII 'Advanced Materials and Technologies'. It contains the Section '4.8 Dose to Embryo and Foetuses in Diagnostic Nuclear Medicine' of the Chapter '4 Dosimetry in Nuclear Medicine Diagnosis and Therapy' with the contents:

  16. Impact of Community-Based Integrated Traditional Chinese and Western Medicine Metabolic Syndrome Intervention Technology in Rural Residents in Southern Jiangsu, China

    PubMed Central

    Wang, Yuqing; Xie, Bo; Tao, Yanghong; Ma, Yonghua; Zhang, Kaijin

    2015-01-01

    Background To explore the feasibility and efficiency of community-based integrated traditional Chinese medicine (TCM) and Western medicine metabolic syndrome (MS) intervention in rural residents. Material/Methods The MS intervention was administered to 598 rural community residents aged 45 years and older in Zhoushi from 2011 to 2013. Subjects completed a health examination and health behavior questionnaire before and after the intervention. In the intervention, we designed a “healthy life self-help program” using TCM appropriate technologies for the subjects. Results After 2 years of intervention by means of integrated traditional Chinese and Western medicine, 57.0% (341 persons) of the subjects no longer suffered from MS. The recovery rate of BMI, blood pressure, FBG, TG, and HDL-C were 22.1%, 40.5%, 37.9%, 32.8%, and 62.4%, respectively. There were statistically significant differences in exercise, smoking, and alcohol drinking between baseline and 2 years later. Conclusions The integrated traditional Chinese and Western medicine MS intervention was effective in deceasing most of the parameters of MS, especially blood pressure, and helping people to do more exercise. The program would be useful to implement in other similar populations. PMID:26210819

  17. TRACER: an ‘eye-opener’ to the patient experience across the transition of care in an internal medicine resident program

    PubMed Central

    Meade, Lauren B.; Hall, Susana L.; Kleppel, Reva W.; Hinchey, Kevin T.

    2015-01-01

    Background A safe patient transition requires a complex set of physician skills within the interprofessional practice. Objective To evaluate a rotation which applies self-reflection and workplace learning in a TRAnsition of CarE Rotation (TRACER) for internal medicine (IM) residents. TRACER is a 2-week required IM resident rotation where trainees join a ward team as a quality officer and follow patients into postacute care. Methods In 2010, residents participated in semistructured, one-on-one interviews as part of ongoing program evaluation. They were asked what they had learned on TRACER, the year prior, and how they used those skills in their practice. Using transcripts, the authors reviewed and coded each transcript to develop themes. Results Five themes emerged from a qualitative, grounded theory analysis: seeing things from the other side, the ‘ah ha’ moment of fragmented care, team collaboration including understanding nursing scope of practice in different settings, patient understanding, and passing the learning on. TRACER gives residents a moment to breathe and open their eyes to the interprofessional practice setting and the patient's experience of care in transition. Conclusions Residents learn about transitions of care through self-reflection. This learning is sustained over time and is valued enough to teach to their junior colleagues. PMID:25846349

  18. Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

    PubMed Central

    Nomura, Shuhei; Gilmour, Stuart; Tsubokura, Masaharu; Yoneoka, Daisuke; Sugimoto, Amina; Oikawa, Tomoyoshi; Kami, Masahiro; Shibuya, Kenji

    2013-01-01

    Background Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees. Methods A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression. Results Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04–3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34–1.76) to 2.88 (95% CI: 1.74–4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07–3.49). Conclusion High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality. PMID:23555921

  19. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Medicine Technologists, and Radiation Therapy Technologists F Appendix F to Part 75 Public Health PUBLIC..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  20. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Medicine Technologists, and Radiation Therapy Technologists F Appendix F to Part 75 Public Health PUBLIC..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  1. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Medicine Technologists, and Radiation Therapy Technologists F Appendix F to Part 75 Public Health PUBLIC..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  2. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Medicine Technologists, and Radiation Therapy Technologists F Appendix F to Part 75 Public Health PUBLIC..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  3. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medicine Technologists, and Radiation Therapy Technologists F Appendix F to Part 75 Public Health PUBLIC..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  4. Current research in nuclear medicine and molecular imaging in Italy: highlights of the 10th National Congress of the Italian Association of Nuclear Medicine and Molecular Imaging.

    PubMed

    Cuocolo, A

    2011-06-01

    The 10th National Congress of the Italian Association of Nuclear Medicine and Molecular Imaging (AIMN) took place in Rimini on March 18-21, 2011 under the chairmanship of Professor Stefano Fanti. The program was of excellent quality and put a further step for the settlement of the standardized AIMN congress structure. A large industrial exhibition demonstrated the latest technological innovations and developments within the field. The congress was a great success with more than 1100 total participants and more than 360 abstracts received. Of these, 40 abstracts were accepted for oral and 285 for poster presentations. The original investigations presented were related to different areas of nuclear medicine and molecular imaging, with particular focus on advances in instrumentation and data processing, progress in radiochemistry and pharmacy, novel diagnostics and therapeutics, and new insights in well established areas of clinical application, such as oncology, cardiology, neurology, psychiatry, endocrinology, paediatrics, and infection and inflammation. Noteworthy, several presentations at this congress, focusing on quantitative interpretation of the imaging data and on pragmatic endpoints, such as adverse outcomes, identified when nuclear medicine procedures achieved clinical effectiveness for patient care and patient management and further demonstrated that nuclear medicine plays a crucial role in the contemporary medical scenario. This highlights lecture is only a brief summary of the large amount of data presented and discussed, which can be found in much greater detail in the congress abstract book, published as volume 55, supplement 1 of the Q J Nucl Med Mol Imaging in April 2011. PMID:21532541

  5. A Randomized Controlled Trial to Decrease Job Burnout in First-Year Internal Medicine Residents Using a Facilitated Discussion Group Intervention.

    PubMed

    Ripp, Jonathan A; Fallar, Robert; Korenstein, Deborah

    2016-05-01

    Background Burnout is common in internal medicine (IM) trainees and is associated with depression and suboptimal patient care. Facilitated group discussion reduces burnout among practicing clinicians. Objective We hypothesized that this type of intervention would reduce incident burnout among first-year IM residents. Methods Between June 2013 and May 2014, participants from a convenience sample of 51 incoming IM residents were randomly assigned (in groups of 3) to the intervention or a control. Twice-monthly theme-based discussion sessions (18 total) led by expert facilitators were held for intervention groups. Surveys were administered at study onset and completion. Demographic and personal characteristics were collected. Burnout and burnout domains were the primary outcomes. Following convention, we defined burnout as a high emotional exhaustion or depersonalization score on the Maslach Burnout Inventory. Results All 51 eligible residents participated; 39 (76%) completed both surveys. Initial burnout prevalence (10 of 21 [48%] versus 7 of 17 [41%], P = .69), incidence of burnout at year end (9 of 11 [82%] versus 5 of 10 [50%], P = .18), and secondary outcomes were similar in intervention and control arms. More residents in the intervention group had high year-end depersonalization scores (18 of 21 [86%] versus 9 of 17 [53%], P = .04). Many intervention residents revealed that sessions did not truly free them from clinical or educational responsibilities. Conclusions A facilitated group discussion intervention did not decrease burnout in resident physicians. Future discussion-based interventions for reducing resident burnout should be voluntary and effectively free participants from clinical duties. PMID:27168899

  6. Radiological Justification for and Optimization of Nuclear Medicine Practices in Korea.

    PubMed

    Kim, Byung Il

    2016-02-01

    Nuclear medicine is a rapidly growing discipline that employs advanced novel hybrid techniques that provide unique anatomical and functional information, as well as targets for molecular therapy. Concomitantly, there has been an increase in the attention paid to medical radiation exposure. A radiological justification for the practice of nuclear medicine has been implemented mainly through referral guidelines based on research results such as prospective randomized clinical trials. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical mechanism to optimize medical radiation exposure in order to be commensurate with the medical purpose. The Korean Society of Nuclear Medicine has been implementing radiological optimization through a survey of the protocols on how each hospital determines the dose of administration of each radiopharmaceutical. In the case of nuclear medicine, radiation exposure of caregivers and comforters of patients discharged after administration of therapeutic radiopharmaceuticals can occur; therefore, optimization has been implemented through written instructions for patients, based on international recommendations. The development of patient-radiation-dose monitoring software, and a national registry and management system of patient-radiation-dose is needed to implement radiological optimization through diagnostic reference levels. This management system must work in agreement with the "Institute for Quality Management of Nuclear Medicine", and must take into account the medical reality of Korea, such as low medicine fee, in order to implement reasonable radiological justification and optimization. PMID:26908990

  7. Current Status of Nuclear Medicine Practice in the Middle East.

    PubMed

    Paez, Diana; Becic, Tarik; Bhonsle, Uday; Jalilian, Amir R; Nuñez-Miller, Rodolfo; Osso, Joao Alberto

    2016-07-01

    The practice of nuclear medicine (NM) in the Middle East region has experienced an important growth in the last 2 decades and has become crucial in providing healthcare to the region's population of about 395 million people. Even though there are some countries in which the services provided are limited to basic coverage of studies with (99m)Tc and (131)I, most have well-established practices covering most of the available studies in this medical specialty; this is the case in for example, Iran, Israel, Kuwait, Saudi Arabia, and Turkey. According to data provided by the NM professionals in the 17 countries included in the present publication, which was collected by the International Atomic Energy Agency in 2015, the total number of gamma cameras in the region is 910 with an average of 2.3 gamma cameras per million inhabitants. Out of these, 107 cameras, or 12%, are SPECT/CT cameras. There are 194 operating PET/CT scanners, translating to one PET/CT scanner for 2.04 million people on average. The availability of PET/CT scanners in relation to population is the highest in Lebanon and Kuwait, with 2.2 and 1.7 scanners per million people, respectively. There is a total of 628 NM centers in the 17 countries, whereas most NM centers belong to the public healthcare system and in most of the countries are widely spread and not confined exclusively to capital cities. As for the radionuclide therapies, (131)I is used regularly in diagnostic workup as well as in therapeutic applications in all the countries included in this analysis. Only five countries have the capability of assembling (99)Mo-(99m)Tc generators (Egypt, Iran, Saudi Arabia, Israel, and Turkey), and cold kits are produced in several countries. Although there are no capabilities in the region to produce (99)Mo from nuclear reactors, a total of 46 cyclotrons are operated for production of PET radionuclides. The most widely used PET tracer in the region is (18)F-FDG followed by (18)F-NaF; concomitantly, the

  8. Highlights of the Annual Congress of the European Association of Nuclear Medicine, Istanbul, 2005: The incremental value of nuclear medicine for patient management and care.

    PubMed

    Cuocolo, Alberto; Acampa, Wanda; Varrone, Andrea; Salvatore, Marco

    2006-03-01

    The 2005 Annual Congress of the European Association of Nuclear Medicine (EANM) took place in Istanbul on October 15-19, under the chairmanship of Professor Hatice Durak. The programme was of excellent quality and represented a further step towards the achievement of a standardized EANM congress structure. A large industrial exhibition demonstrated the latest technological innovations and developments within the field. The congress was a great success: there were more than 4,000 participants, and 1,670 abstracts were received. Of these, 1,399 were accepted for oral or poster presentations, with a rejection rate of 16.2%. The original investigations presented were related to different areas of nuclear medicine, and addressed particularly advances in instrumentation and data processing, progress in radiochemistry and pharmacy, novel diagnostics and therapeutics, and new insights in well-established areas of clinical application, such as oncology, cardiology, neurology, psychiatry, endocrinology, paediatrics, nephrology, and infection and inflammation. It is noteworthy that a number of studies presented at this congress focussed on the quantitative interpretation of the imaging data and on pragmatic endpoints, such as adverse outcomes, and identified when nuclear medicine procedures achieved clinical effectiveness for patient care and management. These and many other studies presented at the congress demonstrate once more the crucial role that nuclear medicine has to play in contemporary medicine. This highlights lecture is only a brief summary of the large amount of data presented and discussed, which can be found in much greater detail in the congress proceedings book, published as volume 32, supplement 1 of the Eur J Nucl Med Mol Imaging in September 2005. PMID:16538466

  9. Blood transport method for chromosome analysis of residents living near Semipalatinsk nuclear test site.

    PubMed

    Rodzi, Mohd; Ihda, Shozo; Yokozeki, Masako; Takeichi, Nobuo; Tanaka, Kimio; Hoshi, Masaharu

    2009-12-01

    A study was conducted to compare the storage conditions and transportation period for blood samples collected from residents living in areas near the Semipalatinsk nuclear test site (SNTS). Experiments were performed to simulate storage and shipping environments. Phytohaemagglutinin (PHA)-stimulated blood was stored in 15-ml tubes (condition A: current transport method) in the absence or in 50-ml flasks (condition B: previous transport method) in the presence of RPMI-1640 and 20% fetal bovine serum (FBS). Samples were kept refrigerated at 4 degrees C and cell viability was assessed after 3, 8, 12 and 14 days of storage. RPMI-1640, 20% FBS and further PHA were added to blood samples under condition A in 50-ml flasks for culture. Whole-blood samples under condition B were directly incubated without further sub-culturing process, neither media nor PHA were added, to adopt a similar protocol to that employed in the previous transport method. Samples in condition A and condition B were incubated for 48 hr at 37 degrees C and their mitotic index was determined. The results showed that viable lymphocytes were consistent in both storage conditions but the mitotic index was higher in condition A than in condition B. Although further confirmation studies have to be carried out, previous chromosomal studies and the present experiment have shown that PHA-stimulated blood could be stored without culture medium for up to 8 days under condition A. The present results will be useful for cytogenetic analysis of blood samples that have been transported long distances wherever a radiation accident has occurred. PMID:20349749

  10. Radiological Justification for and Optimization of Nuclear Medicine Practices in Korea

    PubMed Central

    2016-01-01

    Nuclear medicine is a rapidly growing discipline that employs advanced novel hybrid techniques that provide unique anatomical and functional information, as well as targets for molecular therapy. Concomitantly, there has been an increase in the attention paid to medical radiation exposure. A radiological justification for the practice of nuclear medicine has been implemented mainly through referral guidelines based on research results such as prospective randomized clinical trials. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical mechanism to optimize medical radiation exposure in order to be commensurate with the medical purpose. The Korean Society of Nuclear Medicine has been implementing radiological optimization through a survey of the protocols on how each hospital determines the dose of administration of each radiopharmaceutical. In the case of nuclear medicine, radiation exposure of caregivers and comforters of patients discharged after administration of therapeutic radiopharmaceuticals can occur; therefore, optimization has been implemented through written instructions for patients, based on international recommendations. The development of patient-radiation-dose monitoring software, and a national registry and management system of patient-radiation-dose is needed to implement radiological optimization through diagnostic reference levels. This management system must work in agreement with the “Institute for Quality Management of Nuclear Medicine”, and must take into account the medical reality of Korea, such as low medicine fee, in order to implement reasonable radiological justification and optimization. PMID:26908990

  11. Quality Assessment of Research Articles in Nuclear Medicine Using STARD and QUADAS-2 Tools

    PubMed Central

    Roysri, Krisana; Chotipanich, Chanisa; Laopaiboon, Vallop; Khiewyoo, Jiraporn

    2014-01-01

    Objective(s): Diagnostic nuclear medicine is being increasingly employed in clinical practice with the advent of new technologies and radiopharmaceuticals. The report of the prevalence of a certain disease is important for assessing the quality of that article. Therefore, this study was performed to evaluate the quality of published nuclear medicine articles and determine the frequency of reporting the prevalence of studied diseases. Methods: We used Standards for Reporting of Diagnostic Accuracy (STARD) and Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklists for evaluating the quality of articles published in five nuclear medicine journals with the highest impact factors in 2012. The articles were retrieved from Scopus database and were selected and assessed independently by two nuclear medicine physicians. Decision concerning equivocal data was made by consensus between the reviewers. Results: The average STARD score was approximately 17 points, and the highest score was 17.19±2.38 obtained by the European Journal of Nuclear Medicine. QUADAS-2 tool showed that all journals had low bias regarding study population. The Journal of Nuclear Medicine had the highest score in terms of index test, reference standard, and time interval. Lack of clarity regarding the index test, reference standard, and time interval was frequently observed in all journals including Clinical Nuclear Medicine, in which 64% of the studies were unclear regarding the index test. Journal of Nuclear Cardiology had the highest number of articles with appropriate reference standard (83.3%), though it had the lowest frequency of reporting disease prevalence (zero reports). All five journals had the same STARD score, while index test, reference standard, and time interval were very unclear according to QUADAS-2 tool. Unfortunately, data were too limited to determine which journal had the lowest risk of bias. In fact, it is the author's responsibility to provide details of

  12. Monitoring of radiation dose rates around a clinical nuclear medicine site

    NASA Astrophysics Data System (ADS)

    Shao, Chia-Ho; Lu, Cheng-Chang; Chen, Tou-Rong; Weng, Jui-Hung; Kao, Pan-Fu; Dong, Shang-Lung; Chou, Ming-Jen

    2014-11-01

    The monitoring of radiation dose around the nuclear medicine site is an important study issue. In this study, TLD-100H radiation dosimeters were used to measure the ambient radiation dose rates around a clinical nuclear medicine site in order to investigate the latent hot zones of radiation exposure. Results of this study showed that the radiation doses measured from all piping and storage systems were comparable to the background dose. A relatively high dose was observed at the single bend point of waste water piping of the PET/CT. Another important finding was the unexpected high dose rates observed at the non-restricted waiting area (NRWA) of SPECT. To conclude, this study provides useful information for further determination of an appropriate dose reduction strategy to achieve the ALARA principle in a clinical nuclear medicine site.

  13. Management of the pediatric nuclear medicine patient (or children are not small adults)

    SciTech Connect

    Kieffer, C.T.; Suto, P.A.

    1983-03-01

    The first of a four-part continuing education series on pediatric nuclear medicine is presented. Included are: (1) clinical indications for performing nuclear medicine studies in children; (2) comparison of nuclear medicine procedures for adult and pedicatric patients; (3) appropriate radiopharmaceuticals for performing pediatric studies; (4) radiation protection techniques (5) the principles of pediatric radiopharmaceutical dose calculation and common calculation methods; (6) possible injection sites and administration methods (7) radiopharmaceutical clearance times and imaging times in adults and children; (8) the collimators of choice for most procedures performed in children; (9) certain behaviors exhibited by children according to their stage of emotional development and children's response to the hospital setting; and (10) patient immobilization techniques and advantages of physical restraint over sedation. (JMT)

  14. In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine

    SciTech Connect

    Kelsey, K.T.

    1991-01-01

    The overall goal of our research remains to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation to human lymphocytes. Principally, we are studying hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologies who administer radionuclides. Emphasis in the first year, as described in the first progress report, was on optimization of the hprt mutation assay, measurement of mutant frequencies in patients imaged with thallium-201, and measurement of mutant frequencies in controls. Emphasis in the second year has been on measurements of (1) chromosome aberrations in patients imaged with thallium-201, (2) mutant frequencies in patients imaged with technetium-99, (3) mutant frequencies in nuclear medicine technicians and physical therapists, (4) mutant frequencies in patients treated for Hodgkins disease with radiotherapy. The progress in these areas is described.

  15. In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine. Annual technical progress report, [1991

    SciTech Connect

    Kelsey, K.T.

    1991-12-31

    The overall goal of our research remains to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation to human lymphocytes. Principally, we are studying hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologies who administer radionuclides. Emphasis in the first year, as described in the first progress report, was on optimization of the hprt mutation assay, measurement of mutant frequencies in patients imaged with thallium-201, and measurement of mutant frequencies in controls. Emphasis in the second year has been on measurements of (1) chromosome aberrations in patients imaged with thallium-201, (2) mutant frequencies in patients imaged with technetium-99, (3) mutant frequencies in nuclear medicine technicians and physical therapists, (4) mutant frequencies in patients treated for Hodgkins disease with radiotherapy. The progress in these areas is described.

  16. Neutron interaction tool, PyNIC, for advanced applications in nuclear power, nuclear medicine, and nuclear security

    NASA Astrophysics Data System (ADS)

    Moffitt, Gregory Bruce

    A neutron interaction simulation tool, PyNIC, was developed for the calculation of neutron activation products and prompt gamma ray emission from neutron capture, neutron inelastic scattering, and fission interactions. This tool was developed in Python with a graphical user interface to facilitate its easy applications. The tool was validated for neutron activation analysis of a number of samples irradiated in the University of Utah TRIGA Reactor. These samples included nickel wire and the NIST standard for coal fly ash. The experimentally determined isotopes for coal fly ash were 56Mn, 40K, and 139Ba. The samples were irradiated at reactor power levels from 1 kW to 90 kW, and the average percent difference between PyNIC estimated and laboratory measured values was 4%, 24%, 38%, and 22% for 64Ni, 56Mn, 40K, and 139Ba, respectively. These differences are mainly attributed to calibration of the high-purity germanium detector and too short of count times. The PyNIC tool is applicable to neutron activation analysis but also can find its applications in nuclear power, nuclear medicine, and in homeland security such as predicting the contents of explosives and special nuclear materials in samples of complex and unknown origins.

  17. Assessment of radiation safety awareness among nuclear medicine nurses: a pilot study

    NASA Astrophysics Data System (ADS)

    Yunus, N. A.; Abdullah, M. H. R. O.; Said, M. A.; Ch'ng, P. E.

    2014-11-01

    All nuclear medicine nurses need to have some knowledge and awareness on radiation safety. At present, there is no study to address this issue in Malaysia. The aims of this study were (1) to determine the level of knowledge and awareness on radiation safety among nuclear medicine nurses at Putrajaya Hospital in Malaysia and (2) to assess the effectiveness of a training program provided by the hospital to increase the knowledge and awareness of the nuclear medicine nurses. A total of 27 respondents attending a training program on radiation safety were asked to complete a questionnaire. The questionnaire consists 16 items and were categorized into two main areas, namely general radiation knowledge and radiation safety. Survey data were collected before and after the training and were analyzed using descriptive statistics and paired sample t-test. Respondents were scored out of a total of 16 marks with 8 marks for each area. The findings showed that the range of total scores obtained by the nuclear medicine nurses before and after the training were 6-14 (with a mean score of 11.19) and 13-16 marks (with a mean score of 14.85), respectively. Findings also revealed that the mean score for the area of general radiation knowledge (7.59) was higher than that of the radiation safety (7.26). Currently, the knowledge and awareness on radiation safety among the nuclear medicine nurses are at the moderate level. It is recommended that a national study be conducted to assess and increase the level of knowledge and awareness among all nuclear medicine nurses in Malaysia.

  18. Nuclear medicine dose equivalent a method for determination of radiation risk

    SciTech Connect

    Huda, W.

    1986-12-01

    Conventional nuclear medicine dosimetry involves specifying individual organ doses. The difficulties that can arise with this approach to radiation dosimetry are discussed. An alternative scheme is described that is based on the ICRP effective dose equivalent, H/sub E/, and which is a direct estimate of the average radiation risk to the patient. The mean value of H/sub E/ for seven common /sup 99m/Tc nuclear medicine procedures is 0.46 rem and the average radiation risk from this level of exposure is estimated to be comparable to the risk from smoking approx. 28 packs of cigarettes or driving approx. 1300 miles.

  19. Sources and magnitude of occupational and public exposures from nuclear medicine procedures

    SciTech Connect

    1996-03-11

    This Report addresses the sources of exposures incurred in the practice of nuclear medicine and provides the necessary data to evaluate the magnitude of exposures to those directly associated with that practice and to those who provide nursing care to the patients containing radiopharmaceuticals. Exposure to members of the public are also addressed. The primary emphasis of this Report is on these individuals and not on the patient, since the patient receives the direct benefit from the nuclear medicine procedure. It is recognized that the patient also receives the bulk of any potential radiation decrement.

  20. EC Project 'GUIDELINES ON MPE': proposed qualification and curriculum frameworks and the MPE in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Caruana, C. J.

    2011-09-01

    The objectives of EC project 'Guidelines on Medical Physics Expert' are to provide for improved implementation of the provisions relating to the Medical Physics Expert within Council Directive 97/43/EURATOM and the proposed recast Basic Safety Standards directive. This includes harmonisation of the mission statement for Medical Physics Services as well as the education and training of the MPE. It also includes detailed knowledge-skills-competence inventories for the Medical Physics Expert in each of Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy. This paper presents the proposed Qualification and Curriculum Frameworks and their application to the Medical Physics Expert in Nuclear Medicine.

  1. Internal radiation therapy: a neglected aspect of nuclear medicine in the molecular era

    PubMed Central

    Lin, Yansong

    2015-01-01

    Abstract With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era. In this paper, recent developments regarding internal radiation therapy, including developments in radioiodine-131 (131I) and thyroid, radioimmunotherapy (RIT) for non-Hodgkin lymphoma (NHL), and radiopharmaceuticals for bone metastases. Relevant differences and status of their applications in China were mentioned as well. These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine. PMID:26445567

  2. [Report from Minamisoma City: diversity and complexity of psychological distress in local residents after a nuclear power plant accident].

    PubMed

    Hori, Arinobu; Tsumuraya, Kunihiro; Kanamori, Ryo; Maeda, Masaharu; Yabe, Hirooki; Niwa, Shinichi

    2014-01-01

    Natural disasters can severely impact local communities. When a disaster is limited in type or scope, the loss and distress felt by individual residents can be sympathetically visualized and shared, and this can help bring the community together. In 2011, however, Japan experienced the Great East Japan Earthquake and accompanying tsunami, and the scale of this disaster was compounded by the Fukushima nuclear power plant accident. As a result of this complex disaster, residents experienced very different problems, particularly in Fukushima Prefecture. In this paper, we describe the situation in Minamisoma City, which is located to the north of the Fukushima Daiichi nuclear power plant. After the accident, the city was divided into three zones. The southern part of the city, which is within 20 km of the plant, was designated as a restricted area; the middle section, located between 20 and 30 km of the plant, was initially designated as an evacuation readiness area; and the northern part of the city received no evacuation-related designation. In April 2012, ordinary residents were finally allowed to visit the restricted area, but utilities and municipal services in the area had not yet been restored, and residents were still prohibited from staying overnight even in August 2013. The overall situation was further complicated by the existence of conflicting opinions regarding exposure to low dose ionizing radiation and compensation for subsequent distress. Things became so complex that residents of the same city sometimes struggled to imagine their neighbors' feelings and state of mind. After the disaster, aging of the city accelerated dramatically. The proportion of elders (those aged 65 or older) in the population stood at 25.9% in March 2011, but this had increased to 32.9% by March 2013. Elders tend to have strong emotional ties to their hometowns, while younger generations are more likely to move away and start over. As some young people have left the area or

  3. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities.

    PubMed

    Mercuri, Mathew; Rehani, Madan M; Einstein, Andrew J

    2012-10-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency's Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray-based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the US, currently lags behind x-ray-based procedures with respect to reporting of radiation dosimetric information. This article discusses qualitative differences between nuclear medicine and x-ray-based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying, monitoring, and reporting strategies used in x-ray-based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists, and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  4. Permanent resident

    PubMed Central

    Fisher, John F.

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff. PMID:27193992

  5. Optimal Methods to Screen Men and Women for Intimate Partner Violence: Results from an Internal Medicine Residency Continuity Clinic

    ERIC Educational Resources Information Center

    Kapur, Nitin A.; Windish, Donna M.

    2011-01-01

    Contradictory data exist regarding optimal methods and instruments for intimate partner violence (IPV) screening in primary care settings. The purpose of this study was to determine the optimal method and screening instrument for IPV among men and women in a primary-care resident clinic. We conducted a cross-sectional study at an urban, academic,…

  6. A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine

    PubMed Central

    2014-01-01

    Background Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n = 234) and specialists (n = 813) working at a university hospital were examined using cross-sectional data. Results Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR = 0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR = 0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR = 2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists. PMID:24655908

  7. Residents’ and preceptors’ perceptions of the use of the iPad for clinical teaching in a family medicine residency program

    PubMed Central

    2014-01-01

    Background As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Methods Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Results Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants’ responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad’s contribution to teaching/learning compared to preceptors. Conclusions iPad’s interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing

  8. The IAEA technical cooperation programme and nuclear medicine in the developing world: objectives, trends, and contributions.

    PubMed

    Casas-Zamora, Juan Antonio; Kashyap, Ridhi

    2013-05-01

    The International Atomic Energy Agency's technical cooperation (TC) programme helps Member States in the developing world with limited infrastructure and human resource capacity to harness the potential of nuclear technologies in meeting socioeconomic development challenges. As a part of its human health TC initiatives, the Agency, through the TC mechanism, has the unique role of promoting nuclear medicine applications of fellowships, scientific visits, and training courses, via technology procurement, and in the past decade has contributed nearly $54 million through 180 projects in supporting technology procurement and human resource capacity development among Member States from the developing world (low- and middle-income countries). There has been a growing demand in nuclear medicine TC, particularly in Africa and ex-Soviet Union States where limited infrastructure presently exists, based on cancer and cardiovascular disease management projects. African Member States received the greatest allocation of TC funds in the past 10 years dedicated to building new or rehabilitating obsolete nuclear medicine infrastructure through procurement support of single-photon emission computed tomography machines. Agency support in Asia and Latin America has emphasized human resource capacity building, as Member States in these regions have already acquired positron emission tomography and hybrid modalities (positron emission tomography/computed tomography and single-photon emission computed tomography/computed tomography) in their health systems. The strengthening of national nuclear medicine capacities among Member States across different regions has enabled stronger regional cooperation among developing countries who through the Agency's support and within the framework of regional cooperative agreements are sharing expertise and fostering the sustainability and productive integration of nuclear medicine within their health systems. PMID:23561454

  9. Is hybridic positron emission tomography/computerized tomography the only option? The future of nuclear medicine and molecular imaging.

    PubMed

    Grammaticos, Philip; Zerva, Cherry; Asteriadis, Ioannis; Trontzos, Christos; Hatziioannou, Kostas

    2007-01-01

    As we all know, Nuclear Medicine is the medical science using nuclear radiation for diagnosis, treatment and research. Nuclear Medicine, in contrast to Radiology, makes use of unsealed sources of radiation. Nuclear Medicine a few years ago has partly offered Nuclear Cardiology, the most lucrative of all Nuclear Medicine "children" at that time, to Cardiology. Radiology, has succeeded in being recognized by the European Union Authorities as Clinical Radiology. The word "clinical" offers greater independence to Clinical Radiology and makes it difficult for such a specialty to relinquish any of its equipment i.e. the diagnostic CT scan or the newly developed fast angiography CT, to other specialties. Contrary to Clinical Radiology, Nuclear Medicine being a laboratory specialty in most countries seems to have no right to deny offering, after some period of "proper certified education", its PET camera to Clinical Radiologists. Nuclear Medicine by virtue of its unique diagnostic techniques and treatments, is and should be recognized as a "Clinical Specialty" The interference of other specialties in the fields of Nuclear Medicine is also indicated by the fact that in vitro techniques of Nuclear Medicine are often used by Endocrinologists and Oncologists in their own laboratories. Also in some hospitals the Director of the Radiology Department acts as the Director of Nuclear Medicine Laboratory. Finally at present, Radiologists wish after "proper certified education", to be on equal terms in charge of the new hybridic equipment, the PET/CT scanner. If that is followed to happen, Nuclear Medicine will be in a difficult position losing at least part of PET and consequently should ask for help from its "Overlords and Protectors" i.e. the National and the European Societies of Nuclear Medicine and the Society of Nuclear Medicine of the United States of America. Radiology as a specialty participating om equal terms with the PET camera will then include the study of: a) "open

  10. Solid Tumor-Targeting Theranostic Polymer Nanoparticle in Nuclear Medicinal Fields

    PubMed Central

    Makino, Akira; Kimura, Shunsaku

    2014-01-01

    Polymer nanoparticles can be prepared by self-assembling of amphiphilic polymers, and various types of molecular assemblies have been reported. In particular, in medicinal fields, utilization of these polymer nanoparticles as carriers for drug delivery system (DDS) has been actively tried, and some nanoparticulate drugs are currently under preclinical evaluations. A radionuclide is an unstable nucleus and decays with emission of radioactive rays, which can be utilized as a tracer in the diagnostic imaging systems of PET and SPECT and also in therapeutic purposes. Since polymer nanoparticles can encapsulate most of diagnostic and therapeutic agents with a proper design of amphiphilic polymers, they should be effective DDS carriers of radionuclides in the nuclear medicinal field. Indeed, nanoparticles have been recently attracting much attention as common platform carriers for diagnostic and therapeutic drugs and contribute to the development of nanotheranostics. In this paper, recent developments of solid tumor-targeting polymer nanoparticles in nuclear medicinal fields are reviewed. PMID:25379530

  11. Solid tumor-targeting theranostic polymer nanoparticle in nuclear medicinal fields.

    PubMed

    Makino, Akira; Kimura, Shunsaku

    2014-01-01

    Polymer nanoparticles can be prepared by self-assembling of amphiphilic polymers, and various types of molecular assemblies have been reported. In particular, in medicinal fields, utilization of these polymer nanoparticles as carriers for drug delivery system (DDS) has been actively tried, and some nanoparticulate drugs are currently under preclinical evaluations. A radionuclide is an unstable nucleus and decays with emission of radioactive rays, which can be utilized as a tracer in the diagnostic imaging systems of PET and SPECT and also in therapeutic purposes. Since polymer nanoparticles can encapsulate most of diagnostic and therapeutic agents with a proper design of amphiphilic polymers, they should be effective DDS carriers of radionuclides in the nuclear medicinal field. Indeed, nanoparticles have been recently attracting much attention as common platform carriers for diagnostic and therapeutic drugs and contribute to the development of nanotheranostics. In this paper, recent developments of solid tumor-targeting polymer nanoparticles in nuclear medicinal fields are reviewed. PMID:25379530

  12. Recommendations for quality assurance programs in nuclear medicine facilities. Radiation recommendations series

    SciTech Connect

    Segal, P.; Hamilton, D.R.

    1984-10-01

    The publication provides the elements that should be considered by nuclear medicine facilities to improve their existing programs or develop new quality assurance programs. The important administrative aspects of quality assurance programs are stressed. Each facility is encouraged to adopt those elements of the recommended program that are appropriate to its individual needs and resources.

  13. Nuclear medicine and imaging research (instrumentation and quantitative methods of evaluation)

    SciTech Connect

    Beck, R.N.; Cooper, M.; Chen, C.T.

    1992-07-01

    This document is the annual progress report for project entitled 'Instrumentation and Quantitative Methods of Evaluation.' Progress is reported in separate sections individually abstracted and indexed for the database. Subject areas reported include theoretical studies of imaging systems and methods, hardware developments, quantitative methods of evaluation, and knowledge transfer: education in quantitative nuclear medicine imaging.

  14. What You Should Know About Pediatric Nuclear Medicine and Radiation Safety

    MedlinePlus

    ... the Pediatric Imaging Council of the Society of Nuclear Medicine, as well as over 50 other societies, are members of this group. We are a group of over 700,000 health care professionals in radiology, pediatrics, medical physics and radiation protection. More information can be found ...

  15. Nuclear Medicine to Evaluate Complications of Cerebral Shunts: Two Cases and Review of Literature

    PubMed Central

    Vettiyil, Beth; Bessette, Sabrina; McQuiston, Samuel; Greiner, Francis

    2015-01-01

    We present two cases of cerebral shunts - a ventriculopleural shunt and a ventriculoperitoneal shunt, with their associated complications. We also hope to provide a comprehensive literature review on various imaging modalities, including nuclear medicine studies in evaluating cerebral shunt complications. PMID:26420995

  16. Mitochondrial and nuclear genomics and the emergence of personalized medicine

    PubMed Central

    2012-01-01

    Developing early detection biosensors for disease has been the long‒held goal of the Human Genome Project, but with little success. Conversely, the biological properties of the mitochondrion coupled with the relative simplicity of the mitochondrial genome give this organelle extraordinary functionality as a biosensor and places the field of mitochondrial genomics in a position of strategic advantage to launch significant advances in personalized medicine. Numerous factors make the mitochondrion organelle uniquely suited to be an early detection biosensor with applications in oncology as well as many other aspects of human health and disease. Early detection of disease translates into more effective, less expensive treatments for disease and overall better prognoses for those at greater risk for developing diseases. PMID:23244780

  17. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  18. Medicines

    MedlinePlus

    ... you get better. In the United States, the Food and Drug Administration is in charge of assuring ... can cause unwanted side effects or interactions with food or other medicines you may be taking. They ...

  19. Current global and Korean issues in radiation safety of nuclear medicine procedures.

    PubMed

    Song, H C

    2016-06-01

    In recent years, the management of patient doses in medical imaging has evolved as concern about radiation exposure has increased. Efforts and techniques to reduce radiation doses are focussed not only on the basis of patient safety, but also on the fundamentals of justification and optimisation in cooperation with international organisations such as the International Commission on Radiological Protection, the International Atomic Energy Agency, and the World Health Organization. The Image Gently campaign in children and Image Wisely campaign in adults to lower radiation doses have been initiated in the USA. The European Association of Nuclear Medicine paediatric dosage card, North American consensus guidelines, and Nuclear Medicine Global Initiative have recommended the activities of radiopharmaceuticals that should be administered in children. Diagnostic reference levels (DRLs), developed predominantly in Europe, may be an important tool to manage patient doses. In Korea, overexposure to radiation, even from the use of medical imaging, has become a public issue, particularly since the accident at the Fukushima nuclear power plant. As a result, the Korean Nuclear Safety and Security Commission revised the technical standards for radiation safety management in medical fields. In parallel, DRLs for nuclear medicine procedures have been collected on a nationwide scale. Notice of total effective dose from positron emission tomography-computed tomography for cancer screening has been mandatory since mid-November 2014. PMID:26960820

  20. Self-assessment of current knowledge in nuclear medicine (second edition)

    SciTech Connect

    Selby, J.B.; Frey, G.D.; Cooper, J.F.; Klobukoski, C.J.

    1981-01-01

    In this updated second edition, the order of contents of the textbook has been reorganized. It has been divided into main parts: Basic Science and Clinical Nuclear Medicine. Basic Science, Part I, encompasses basic physics, radiation protection, interaction of radiation with matter and radiation detection, imaging, nuclear pharmacy, and radiation biology. Part II, Clinical Nuclear Medicine, covers the central nervous system, bone, gastroenterology (liver/spleen), cardiovascular system, pulmonary system, genitourinary system, thyroid and endocrine systems, gallium studies, radioassay, hematology, and therapy. The total number of pages of the current edition is increased to 250 from the 213 of the first edition but there are fewer questions because those in the basic science area have been carefully selected to 60 of the original 98 questions. Compared with the previous edition, there are two advantages in the current one: (1) the addition of explanatory answers; and (2) the inclusion of up-to-date scintiphotos replacing rectilinear scan illustrations.

  1. Nuclear medicine survey recommendations for a changing regulatory environment.

    PubMed

    Vernig, P G; Schumacher, T A

    2001-11-01

    The revision of 10 CFR 35 approved on 23 September 2000 and due for implementation in 2001, reduces the number of required radiation and contamination surveys to one ambient radiation survey each day when an administration requiring a written directive is used. This paper compares the current requirements in 10 CFR 35; the single, remaining, specific requirement in the revised part 35; the Nuclear Regulatory Commission's guidance in the proposed NUREG SR1556 and the general requirement for surveys to demonstrate compliance with 10 CFR 20. We also make recommendations on what periodic surveys are prudent. PMID:11669196

  2. Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 1-statement of the issue and a review of available resources.

    PubMed

    Fahey, Frederic H; Bom, Henry Hee-Seong; Chiti, Arturo; Choi, Yun Young; Huang, Gang; Lassmann, Michael; Laurin, Norman; Mut, Fernando; Nuñez-Miller, Rodolfo; O'Keeffe, Darin; Pradhan, Prasanta; Scott, Andrew M; Song, Shaoli; Soni, Nischal; Uchiyama, Mayuki; Vargas, Luis

    2015-04-01

    The Nuclear Medicine Global Initiative (NMGI) was formed in 2012 and consists of 13 international organizations with direct involvement in nuclear medicine. The underlying objectives of the NMGI were to promote human health by advancing the field of nuclear medicine and molecular imaging, encourage global collaboration in education, and harmonize procedure guidelines and other policies that ultimately lead to improvements in quality and safety in the field throughout the world. For its first project, the NMGI decided to consider the issues involved in the standardization of administered activities in pediatric nuclear medicine. This article presents part 1 of the final report of this initial project of the NMGI. It provides a review of the value of pediatric nuclear medicine, the current understanding of the carcinogenic risk of radiation as it pertains to the administration of radiopharmaceuticals in children, and the application of dosimetric models in children. A listing of pertinent educational and reference resources available in print and online is also provided. The forthcoming part 2 report will discuss current standards for administered activities in children and adolescents that have been developed by various organizations and an evaluation of the current practice of pediatric nuclear medicine specifically with regard to administered activities as determined by an international survey of nuclear medicine clinics and centers. Lastly, the part 2 report will recommend a path forward toward global standardization of the administration of radiopharmaceuticals in children. PMID:25766899

  3. Radiation risk and nuclear medicine: An interview with a Nobel Prize winner

    SciTech Connect

    Yalow, R.S.

    1995-12-01

    In a speech given years ago at the Veterans Administration Medical Center, Bronx, NY, Rosalyn S. Yalow, 1977 Nobel Prize recipient for her invention of radioimmunoassay, made several salient points on the perception of fear or hazards from exposure to low-level radiation and low-level radioactive wastes. For the past three years, Yalow has been concerned with the general fear of radiation. In this interview, Newsline solicited Yalow`s views on public perceptions on radiation risk and what the nuclear medicine community can do to emphasize the fact that, if properly managed, the use of isotopes in medicine and other cases is not dangerous.

  4. Quantitative 35Cl nuclear quadrupole resonance in tablets of the antidiabetic medicine Diabinese.

    PubMed

    Tate, Elizabeth; Althoefer, Kaspar; Barras, Jamie; Rowe, Michael D; Smith, John A S; Pearce, Gareth E S; Wren, Stephen A C

    2009-07-01

    Pulsed (35)Cl nuclear quadrupole resonance (NQR) experiments have been performed on 250-mg tablets of the antidiabetic medicine Diabinese to establish the conditions needed for noninvasive quantitative analysis of the medicine in standard bottles. One important condition is the generation of a uniform radio-frequency (RF) field over the sample, which has been achieved by two designs of sample coil: one of variable pitch, and the other a resonator that has been fabricated from a single turn of copper sheet with a longitudinal gap bridged by tuning capacitors. The results from blind tests show that the number of tablets in a bottle could be predicted to within +/-3%. PMID:19492808

  5. Observation Leads to Improved Operations in Nuclear Medicine.

    PubMed

    Religioso, Deo G

    2016-01-01

    The concept of observation--going out and seeing what is happening in daily operations---would seem like a normal management activity, but the reality in practice of the philosophy and technique is often underutilized. Once an observation has been determined, the next steps are to test and validate any discoveries on paper. For process change to be implemented, numerical data is needed to back-up observations in order to be heard and taken seriously by the executive team. Boca Raton Regional Hospital saw an opportunity to improve the process for radiopharmaceutical standing orders within its nuclear imaging department. As a result of this observation, the facility realized improved savings and an increase in employee motivation. PMID:27172652

  6. Intra-operative nuclear medicine in surgical practice.

    PubMed

    Perkins, A C; Hardy, J G

    1996-12-01

    The use of radionuclides for the intra-operative localization of tumours has increased steadily over the past 15 years. We reviewed more than 15 years experience of a peripatetic service using a sterilizable probe system in operating theatres throughout the UK for localizing bone and soft tissue lesions. The technique requires the positive concentration of an appropriate radiopharmaceutical, together with a suitably designed detector system which can be sterilized for use during surgery. All surgical procedures were undertaken following initial positive imaging studies. A well-collimated nuclear probe with a 5 mm diameter CdTe detector was sterilized with ethylene oxide gas and coupled to a digital counter and ratemeter for use in the operating theatre. A total of 68 surgical procedures have been undertaken at 35 hospitals. Fifty-eight patients underwent excision of osteoid osteoma subsequently proven by histology. The other lesions successfully resected included osteoblastoma, hamartoma, Brodie's abscess, chronic bone infection, ectopic parathyroid adenoma and metastatic neuroblastoma. The technique can now be regarded as the method of choice for the surgical localization of osteoid osteoma. The successful detection of lesions at surgery can be assured providing that clear localization of the radiopharmaceutical occurs on the pre-operative images. The intra-operative use of conventional and new tumour-specific radiopharmaceuticals is reviewed and we confirm an increasing role for the surgical-probe-guided localization of primary and metastatic tumours. PMID:9004295

  7. Application of TlBr to nuclear medicine imaging

    NASA Astrophysics Data System (ADS)

    Cirignano, Leonard; Kim, Hadong; Kargar, Alireza; Churilov, Alexei V.; Ciampi, Guido; Higgins, William; Kim, Suyoung; Barber, Bradford; Haston, Kyle; Shah, Kanai

    2012-10-01

    Thallium bromide (TlBr) has been under development for room temperature gamma ray spectroscopy due to high density, high Z and wide bandgap of the material. Furthermore, its low melting point (460 °C), cubic crystal structure and congruent melting with no solid-solid phase transitions between the melting point and room temperature, TlBr can be grown by relatively simple melt based methods. As a result of improvements in material processing and detector fabrication over the last several years, TlBr with electron mobility-lifetime products (μeτe) in the mid 10-3 cm2/V range has been obtained. In this paper we are going to report on our unipolar charging TlBr results for the application as a small animal imaging. For SPECT application, about 5 mm thick pixellated detectors were fabricated and tested. About 1 % FWHM at 662 keV energy resolution was estimated at room temperature. By applying the depth correction technique, less than 1 % energy resolution was estimated. We are going to report the results from orthogonal strip TlBr detector for PET application. In this paper we also present our latest detector highlights and recent progress made in long term stability of TlBr detectors at or near room temperature. This work is being supported by the Domestic Nuclear Detection Office (DNDO) and the Department of Energy (DOE).

  8. Botanical compounds and their regulation of nuclear receptor action: the case of traditional Chinese medicine.

    PubMed

    Li, Ling; Bonneton, François; Chen, Xiao Yong; Laudet, Vincent

    2015-02-01

    Nuclear receptors (NRs) are major pharmacological targets that allow an access to the mechanisms controlling gene regulation. As such, some NRs were identified as biological targets of active compounds contained in herbal remedies found in traditional medicines. We aim here to review this expanding literature by focusing on the informative articles regarding the mechanisms of action of traditional Chinese medicines (TCMs). We exemplified well-characterized TCM action mediated by NR such as steroid receptors (ER, GR, AR), metabolic receptors (PPAR, LXR, FXR, PXR, CAR) and RXR. We also provided, when possible, examples from other traditional medicines. From these, we draw a parallel between TCMs and phytoestrogens or endocrine disrupting chemicals also acting via NR. We define common principle of action and highlight the potential and limits of those compounds. TCMs, by finely tuning physiological reactions in positive and negative manners, could act, in a subtle but efficient way, on NR sensors and their transcriptional network. PMID:25449417

  9. Nuclear physics for medicine: how nuclear research is improving human health

    NASA Astrophysics Data System (ADS)

    Bracco, Angela

    2015-05-01

    The Nuclear Physics European Collaboration Committee (NuPECC) is an associated Committee of the European Science Foundation (ESF). Its mission is to strengthen European Collaboration in nuclear science through the promotion of nuclear physics, and its trans-disciplinary use and application in collaborative ventures between research groups.

  10. Redundant array of independent disks: practical on-line archiving of nuclear medicine image data.

    PubMed

    Lear, J L; Pratt, J P; Trujillo, N

    1996-02-01

    While various methods for long-term archiving of nuclear medicine image data exist, none support rapid on-line search and retrieval of information. We assembled a 90-Gbyte redundant array of independent disks (RAID) system using 10-, 9-Gbyte disk drives. The system was connected to a personal computer and software was used to partition the array into 4-Gbyte sections. All studies (50,000) acquired over a 7-year period were archived in the system. Based on patient name/number and study date, information could be located within 20 seconds and retrieved for display and analysis in less than 5 seconds. RAID offers a practical, redundant method for long-term archiving of nuclear medicine studies that supports rapid on-line retrieval. PMID:8814767

  11. MAGIC-f Gel in Nuclear Medicine Dosimetry: study in an external beam of Iodine-131

    NASA Astrophysics Data System (ADS)

    Schwarcke, M.; Marques, T.; Garrido, C.; Nicolucci, P.; Baffa, O.

    2010-11-01

    MAGIC-f gel applicability in Nuclear Medicine dosimetry was investigated by exposure to a 131I source. Calibration was made to provide known absorbed doses in different positions around the source. The absorbed dose in gel was compared with a Monte Carlo Simulation using PENELOPE code and a thermoluminescent dosimetry (TLD). Using MRI analysis for the gel a R2-dose sensitivity of 0.23 s-1Gy-1was obtained. The agreement between dose-distance curves obtained with Monte Carlo simulation and TLD was better than 97% and for MAGIC-f and TLD was better than 98%. The results show the potential of polymer gel for application in nuclear medicine where three dimensional dose distribution is demanded.

  12. Some results of a simulated test for administration of activity in nuclear medicine.

    PubMed

    Oropesa, P; Hernández, A T; Serra, R A; Varela, C; Woods, M J

    2006-04-01

    This paper describes the results obtained using a simulated test for administration of activity in nuclear medicine between 2002 and 2004. Measurements in the radionuclide calibrator are made during the different stages of the procedure. The test attempts to obtain supplementary information on the quality of the measurement, with the aim of evaluating in a more complete way the accuracy of the administered activity value compared with the prescribed one. The participants' performance has been assessed by means of a statistical analysis of the reported data. Dependences between several attributes of the simulated administration tests results are discussed. Specifically, the proportion of satisfactory results in the 2003-2004 period was found to be higher than in 2002. It reveals an improvement of the activity administration in the Cuban nuclear medicine departments since 2003. PMID:16303312

  13. NEED FOR INDIVIDUAL CANCER RISK ESTIMATES IN X-RAY AND NUCLEAR MEDICINE IMAGING.

    PubMed

    Mattsson, Sören

    2016-06-01

    To facilitate the justification of an X-ray or nuclear medicine investigation and for informing patients, it is desirable that the individual patient's radiation dose and potential cancer risk can be prospectively assessed and documented. The current dose-reporting is based on effective dose, which ignores body size and does not reflect the strong dependence of risk on the age at exposure. Risk estimations should better be done through individual organ dose assessments, which need careful exposure characterisation as well as anatomical description of the individual patient. In nuclear medicine, reference biokinetic models should also be replaced with models describing individual physiological states and biokinetics. There is a need to adjust population-based cancer risk estimates to the possible risk of leukaemia and solid tumours for the individual depending on age and gender. The article summarises reasons for individual cancer risk estimates and gives examples of methods and results of such estimates. PMID:26994092

  14. [Nationwide survey of nuclear medicine practice and estimation of collective effective dose in Japan.].

    PubMed

    Matsumoto, Masaki; Nishizawa, Kanae; Iwai, Kazuo; Akahane, Keiichi; Maruyama, Takashi

    2006-01-01

    For the estimation of collective effective dose from radiopharmaceuticals used in nuclear medicine diagnosis, a national survey was carried out in Japan. The survey contents covered radiopharmaceutical use, sex, age, activity, and so on of each patient in October 1997 and the monthly number of examinations in 1997. The annual number of diagnostic examinations using radiopharmaceuticals was 0.82 million for males and 0.74 million for females. The frequency of examination was about 3% for patients less than 17 years old and about 60% for those more than 60 years old. Effective dose was calculated on the basis of such literature as ICRP publications. The dose used most frequently was 5-6mSv per examination. The collective effective doses from diagnostic nuclear medicine examinations were estimated to be 13100 man .Sv for males and 20200 man .Sv for females. PMID:17164536

  15. Survey of physician requirements in six specialties: manpower needs in anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, radiology. Final report

    SciTech Connect

    Wills, J.

    1980-07-01

    This report was prepared to assist the Graduate Medical Education National Advisory Committee (GMENAC) in its efforts to model physician manpower requirements in six specialties: anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology. The purpose of this report is to (1) survey and present the existing literature on manpower requirements in each of these six specialties, and (2) discuss the special problems present in each specialty in modeling manpower requirements, and where possible, suggest possible avenues of resolution.

  16. Reactor production and processing of radioisotopes for therapeutic applications in nuclear medicine

    SciTech Connect

    Knapp, F.F. Jr.; Mirzadeh, S.; Beets, A.L.

    1995-02-01

    Nuclear reactors continue to play an important role in providing radioisotopes for nuclear medicine. Many reactor-produced radioisotopes are ``neutron rich`` and decay by beta-emission and are thus of interest for therapeutic applications. This talk discusses the production and processing of a variety of reactor-produced radioisotopes of current interest, including those produced by the single neutron capture process, double neutron capture and those available from beta-decay of reactorproduced radioisotopes. Generators prepared from reactorproduced radioisotopes are of particular interest since repeated elution inexpensively provides many patient doses. The development of the alumina-based W-188/Re-188 generator system is discussed in detail.

  17. [German Society of Nuclear Medicine procedure guideline on beta-amyloid brain PET imaging].

    PubMed

    Barthel, Henryk; Meyer, Philipp T; Drzezga, Alexander; Bartenstein, Peter; Boecker, Henning; Brust, Peter; Buchert, Ralph; Coenen, Heinz H; la Fougère, Christian; Gründer, Gerhard; Grünwald, Frank; Krause, Bernd J; Kuwert, Torsten; Schreckenberger, Matthias; Tatsch, Klaus; Langen, Karl-Josef; Sabri, Osama

    2016-08-01

    Recently, a number of positron emission tomography (PET) radiotracers have been approved for clinical use. These tracers target cerebral beta-amyloid (Aβ) plaques, a hallmark of Alzheimer's disease. Increasing use of this method implies the need for respective standards. This German Society of Nuclear Medicine guideline describes adequate procedures for Aβ plaque PET imaging. It not only discusses the tracers used for that purpose, but also lists measures for correct patient preparation, image data generation, processing, analysis and interpretation. With that, this "S1" category (according to the German Association of the Scientific Medical Societies standard) guideline aims at contributing to quality assurance of nuclear imaging in Germany. PMID:27080914

  18. The content of family practice: a family medicine resident's 2 1/2-year experience with the E-book.

    PubMed

    Shank, J C

    1977-09-01

    The purpose of this paper is to present the content of office family practice problems seen over a 2 1/2-year residency period and to afford comparison with the well-known Virginia Study. It illustrates the usefulness of the diagnostic E-Book, with which all the data were collected and preserved. Over a 2 1/2-year period, the author cared for 592 patients in the family practice office. The ratio of one physician to 592 patients compares to the Virginia Study's one physician to approximately 745 patients. A total of 1,640 problems were coded in the E-Book. In this study 55 problems/physician/month were seen, whereas in the Virginia Study approximately 177 problems/physician/month were noted. Respiratory illnesses were the most common diagnostic category in both studies. Among specific problems, obesity ranked first at Hershey, with afebrile colds second, hypertension and Beta streptococcal pharyngitis third, and smoking fourth. Obesity and smoking were ranked considerably lower in the Virginia Study, whereas "health maintenance examinations" were ranked number one. Finally, for age-sex practice profiles, the present data revealed two peak age groups for both sexes, whereas the Virginia work noted only one peak age range. PMID:903750

  19. Evaluation of 133Xe radiation exposure dosimetry for workers in nuclear medicine laboratories.

    PubMed

    Piltingsrud, H V; Gels, G L

    1982-06-01

    Evaluation of past studies of 133Xe dosimetry and nuclear medicine laboratory air concentrations of 133Xe indicates that significant levels of 133Xe may exist in routine operational environments of a nuclear medicine laboratory. This leads to the question of whether present health physics radiation control methods are adequate to keep occupational personnel exposures within acceptable levels. It would appear that if personnel dosimeters (film and TLD badges) respond properly to the radiation of 133Xe, normal health physics control procedures are probably adequate. If they do not respond adequately, personnel exposures may exceed recommended levels and special instrumentation or administrative procedures are called for. Therefore, the first step in studying potential problems in the subject area is to evaluate the response of a variety of personnel radiation dosimeters to 133Xe. This paper describes the methods and materials used to expose personnel dosimeters to known amounts of 133Xe radiations in an exposure chamber constructed at the BRH Nuclear Medicine Laboratory. Also presented are calculated values for Dose Equivalents (D.E.) in a phantom from external radiation resulting from immersion in clouds having a constant concentration of 133Xe but varying cloud radii. This implies the relative importance of the beta and the X + gamma radiation responses of the personnel dosimeters under various exposure conditions. Results of this study indicate that none of the dosimeter systems evaluated provide adequate performance for use as a primary indicator of the D.E. resulting from 133Xe radiations for a worker in a nuclear medicine laboratory, and that personnel dosimetry considerations in 133Xe-containing atmospheres are very dependent on the radii of the 133Xe clouds. PMID:7107291

  20. Applications of CdTe to nuclear medicine. Annual report, February 1, 1979-January 31, 1980

    SciTech Connect

    Entine, G

    1980-01-01

    The application of CdTe gamma detectors in nuclear medicine is reported on. An internal probe was developed which can be inserted into the heart to measure the efficiency of various radiopharmaceuticals in the treatment of heart attacks. A second application is an array of detectors which is light enough to be worn by ambulatory patients and can measure the change in cardiac output over an eight hour period during heart attack treatment. The instrument includes an on board tape recorder. (ACR)

  1. A Poisson resampling method for simulating reduced counts in nuclear medicine images

    NASA Astrophysics Data System (ADS)

    White, Duncan; Lawson, Richard S.

    2015-05-01

    Nuclear medicine computers now commonly offer resolution recovery and other software techniques which have been developed to improve image quality for images with low counts. These techniques potentially mean that these images can give equivalent clinical information to a full-count image. Reducing the number of counts in nuclear medicine images has the benefits of either allowing reduced activity to be administered or reducing acquisition times. However, because acquisition and processing parameters vary, each user should ideally evaluate the use of images with reduced counts within their own department, and this is best done by simulating reduced-count images from the original data. Reducing the counts in an image by division and rounding off to the nearest integer value, even if additional Poisson noise is added, is inadequate because it gives incorrect counting statistics. This technical note describes how, by applying Poisson resampling to the original raw data, simulated reduced-count images can be obtained while maintaining appropriate counting statistics. The authors have developed manufacturer independent software that can retrospectively generate simulated data with reduced counts from any acquired nuclear medicine image.

  2. Radiation exposure from diagnostic nuclear medicine in Alagoas (Brazil) in 2002-2005.

    PubMed

    Yano, V F; Lima, F F

    2010-01-01

    Use of radionuclides in medical practice has grown steadily in recent years due to the introduction of new radiopharmaceuticals and new equipments. This paper presents a survey of nuclear medicine procedures performed in Alagoas, State of Brazil, in order to help establish reference levels for nuclear medicine patients. Data were gathered on the type of radiopharmaceuticals used and administered activity of each kind of examination, and the age and sex of the patients involved over the period 2002-2005. Based on ICRP-60, the effective dose (E) and collective effective dose (Ecol) have been calculated. The results showed an annual increase in the nuclear medicine examinations during the period of study and cardiac scintigraphy are the most common procedure. The results also indicated that the activities administered to patients are higher than the guidance levels of the Basic Safety Standards (BSS) in most of the kind of examinations. The differences found in the administered activities may reflect the differences in the quality assurance programs implemented. It was observed that the Ecol and E/inhabitant are higher than other countries. Therefore, it is suggested that the protocols have been revised in order to reduce the patient dose without reduce the image quality. PMID:20525455

  3. USE OF RADIOPHARMACEUTICALS IN DIAGNOSTIC NUCLEAR MEDICINE IN THE UNITED STATES: 1960–2010

    PubMed Central

    Drozdovitch, Vladimir; Brill, Aaron B.; Callahan, Ronald J.; Clanton, Jeffrey A.; DePietro, Allegra; Goldsmith, Stanley J.; Greenspan, Bennett S.; Gross, Milton D.; Hays, Marguerite T.; Moore, Stephen C.; Ponto, James A.; Shreeve, Walton W.; Melo, Dunstana R.; Linet, Martha S.; Simon, Steven L.

    2014-01-01

    To reconstruct reliable nuclear medicine-related occupational radiation doses or doses received as patients from radiopharmaceuticals over the last five decades, we assessed which radiopharmaceuticals were used in different time periods, their relative frequency of use, and typical values of the administered activity. This paper presents data on the changing patterns of clinical use of radiopharmaceuticals and documents the range of activity administered to adult patients undergoing diagnostic nuclear medicine procedures in the U.S. between 1960 and 2010. Data are presented for 15 diagnostic imaging procedures that include thyroid scan and thyroid uptake, brain scan, brain blood flow, lung perfusion and ventilation, bone, liver, hepatobiliary, bone marrow, pancreas, and kidney scans, cardiac imaging procedures, tumor localization studies, localization of gastrointestinal bleeding, and non-imaging studies of blood volume and iron metabolism. Data on the relative use of radiopharmaceuticals were collected using key informant interviews and comprehensive literature reviews of typical administered activities of these diagnostic nuclear medicine studies. Responses of key informants on relative use of radiopharmaceuticals are in agreement with published literature. Results of this study will be used for retrospective reconstruction of occupational and personal medical radiation doses from diagnostic radiopharmaceuticals to members of the U.S. radiologic technologist’s cohort and in reconstructing radiation doses from occupational or patient radiation exposures to other U.S. workers or patient populations. PMID:25811150

  4. Nuclear medicine program progress report for quarter ending December 31, 1996

    SciTech Connect

    Knapp, F.F. Jr.; Beets, A.L.; Boll, R.; Luo, H.; McPherson, D.W.; Mirzadeh, S.

    1997-03-20

    In this report the authors describe the use of an effective method for concentration of the rhenium-188 bolus and the results of the first Phase 1 clinical studies for bone pain palliation with rhenium-188 obtained from the tungsten-188/rhenium-188 generator. Initial studies with therapeutic levels of Re-188-HEDP at the Clinic for Nuclear Medicine at the University of Bonn, Germany, have demonstrated the expected good metastatic uptake of Re-188-HEDP in four patients who presented with skeletal metastases from disseminated prostatic cancer with good pain palliation and minimal marrow suppression. In addition, skeletal metastatic targeting of tracer doses of Re-188(V)-DMSA has been evaluated in several patients with metastases from prostatic cancer at the Department of Nuclear Medicine at the Canterbury and Kent Hospital in Canterbury, England. In this report the authors also describe further studies with the E-(R,R)-IQNP ligand developed in the ORNL Nuclear Medicine Program as a potential imaging agent for detection of changes which may occur in the cerebral muscarinic-cholinergic receptors (mAChR) in Alzheimer`s and other diseases.

  5. Radionuclide radiologist directed nuclear medicine services in district general hospitals in the South Thames Region.

    PubMed

    Conry, B G; Burwood, R J

    2001-08-01

    The equipment, staffing levels and imaging workload of all 14 radiologist directed nuclear medicine services in district general hospitals in the South Thames Region are presented. These are generally single camera departments providing a broad range of imaging procedures, including cardiac studies and white cell labelling, as well as the more usual renal, lung, thyroid and bone examinations. All departments have a high throughput, averaging 2358 examinations per year. Departmental staffing levels are variable, with some institutions having inadequate consultant radiology sessions free of other commitments as well as inadequate physics support. Potentially, these are important quality and legal issues that departments may need to address with hospital Trusts and Commissioning Agencies. Four small departments provided a service without any formally contracted radiologist sessions for nuclear medicine in the radiologists' job plans. The three medium sized departments have a closer match between sessions contracted and those actually worked, but in only one of these did the contracted sessional commitment equal the recommendation of the Nuclear Medicine Committee of the Royal College of Physicians. There is a disparity between the number of contracted consultant sessions and those actually worked in most institutions (86%), being at least two sessions in eight hospitals. Recommendations are made regarding the adequacy of some of the elements of provision in South Thames and the legal and safety implications for hospital Trust management and Commissioning Agencies. PMID:11511496

  6. Review of common occupational hazards and safety concerns for nuclear medicine technologists.

    PubMed

    Bolus, Norman E

    2008-03-01

    The purpose of this article is to address common occupational hazards and safety concerns of nuclear medicine technologists. There are many possible occupational hazards, but this review is intended to concentrate on common hazards and safety concerns. These include radiation safety issues and concerns about the possibility of developing latent diseases, such as eye cataracts or cancer; pregnant workers and radiation safety issues; biohazard concerns associated with patient body fluids; possible low-back pain from moving heavy equipment and performing patient transfers; and possible repetitive trauma disorders, such as carpal tunnel syndrome, from computer work. Suggestions are made regarding how to identify potential hazards and avoid them. After reading this article, nuclear medicine technologists should be able to explain the importance of the as-low-as-reasonably-achievable concept, discuss the possible effects of ionizing radiation on the adult and the developing fetus, list several basic principles to avoid injury to the back, list and describe the more common repetitive trauma disorders or injuries and how to avoid them, and list and describe the biohazard safety issues that nuclear medicine technologists face and how to develop policy to minimize exposure risk. PMID:18287195

  7. Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010

    PubMed Central

    Li, Zhong Min

    2012-01-01

    This study evaluated cancer risk for adult residents near Nuclear Power Plants (NPPs) in Korea through a valid prospective cohort study during 1992-2010. The study cohort was composed of 11,367 adults living within a five km radius from the NPPs for the exposed and 24,809 adults for the non-exposed or reference cohort set at two different levels of proximity; 5-30 km radius and more than 30 km radius away from NPPs. In 303,542.5 person-years of follow-up, a total of 2,298 cancer cases of all sites, or 1,377 radio-inducible cancers diagnosed during 1992-2008 were ascertained. Multiple adjusted hazard ratios and 95% confidence intervals were estimated using multivariate Cox proportional hazard model. There were no epidemiological evidence for increased risk of cancer due to radiation from NPPs. Radiological study results or surveillance data of radiation doses around NPPs could be well documented for risk estimation of radio-inducible cancers, instead of epidemiological study results of the long-time required. Continuous surveillance of quantitative measures of dose levels around NPPs and radiation exposures to the residents is warranted. PMID:22969244

  8. Internal Medicine Residents' Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents' Self-Perceived Preparedness to Diagnose and Treat Addiction

    ERIC Educational Resources Information Center

    Wakeman, Sarah E.; Baggett, Meridale V.; Pham-Kanter, Genevieve; Campbell, Eric G.

    2013-01-01

    Background: Resident physicians are the direct care providers for many patients with addiction. This study assesses residents' self-perceived preparedness to diagnose and treat addiction, measures residents' perceptions of the quality of addictions instruction, and evaluates basic knowledge of addictions. Methods: A survey was e-mailed…

  9. SUS in nuclear medicine in Brazil: analysis and comparison of data provided by Datasus and CNEN*

    PubMed Central

    Pozzo, Lorena; Coura Filho, George; Osso Júnior, João Alberto; Squair, Peterson Lima

    2014-01-01

    Objective To investigate the outpatient access to nuclear medicine procedures by means of the Brazilian Unified Health System (SUS), analyzing the correspondence between data provided by this system and those from Comissão Nacional de Energia Nuclear (CNEN) (National Commission of Nuclear Energy). Materials and Methods Data provided by Datasus regarding number of scintillation chambers, outpatient procedures performed from 2008 to 2012, administrative responsibility for such procedures, type of service providers and outsourced services were retrieved and evaluated. Also, such data were compared with those from institutions certified by CNEN. Results The present study demonstrated that the system still lacks maturity in terms of correct data input, particularly regarding equipment available. It was possible to list the most common procedures and check the growth of the specialty along the study period. Private centers are responsible for most of the procedures covered and reimbursed by SUS. However, many healthcare facilities are not certified by CNEN. Conclusion Datasus provides relevant data for analysis as done in the present study, although some issues still require attention. The present study has quantitatively depicted the Brazilian reality regarding access to nuclear medicine procedures offered by/for SUS. PMID:25741070

  10. Pictorial review of SPECT/CT imaging applications in clinical nuclear medicine

    PubMed Central

    Bhargava, Peeyush; He, Guocheng; Samarghandi, Amin; Delpassand, Ebrahim S

    2012-01-01

    Integrated SPECT/CT scanners are gaining popularity as hybrid molecular imaging devices which can acquire SPECT and CT in a single exam. CT can be a low dose non-contrast enhanced scan for attenuation correction and anatomical localization, or a contrast enhanced diagnostic quality scan for additional anatomical characterization. We present a pictorial review highlighting the usefulness of this emerging technology. We present SPECT/CT images of 13 patients where additional information was provided by the co-registered low dose non-contrast enhanced CT scan. They belong to 12 male and 1 female patients with age ranging from 28 to 76 yrs, who were referred to the Nuclear Medicine Department for various indications. We describe these cases under in the following categories: bone scintigraphy (2), leukocyte scintigraphy (2), nuclear oncology (5), nuclear cardiology (1), and general nuclear medicine (3). Additional information provided by the co-registered low dose CT improves the diagnostic confidence in image interpretation of SPECT imaging. PMID:23133813

  11. A background to nuclear transfer and its applications in agriculture and human therapeutic medicine*

    PubMed Central

    Campbell, Keith HS

    2002-01-01

    The development of a single celled fertilized zygote to an animal capable of reproduction involves not only cell division but the differentiation or specialization to numerous cell types forming each tissue and organ of the adult animal. The technique of nuclear transfer allows the reconstruction of an embryo by the transfer of genetic material from a single donor cell, to an unfertilized egg from which the genetic material has been removed. Successful development of live offspring from such embryos demonstrates that the differentiated state of the donor nucleus is not fixed and can be reprogrammed by the egg cytoplasm to control embryo and fetal development. Nuclear transfer has many applications in agriculture and human medicine. This article will review some of the factors associated with the success of embryo development following nuclear transfer and outline the potential uses of the technology. PMID:12033731

  12. Development of a new photon diffraction imaging system for diagnostic nuclear medicine

    NASA Astrophysics Data System (ADS)

    Roa, D. E.; Smither, R. K.; Zhang, X.; Nie, K.; Shieh, Y. Y.; Ramsinghani, N. S.; Milne, N.; Kuo, J. V.; Redpath, J. L.; Al-Ghazi, M. S. A. L.; Caligiuri, P.

    2005-12-01

    The objective of this project is to develop and construct an innovative imaging system for nuclear medicine and molecular imaging that uses photon diffraction and is capable of generating 1 2 mm spatial resolution images in two or three dimensions. The proposed imaging system would be capable of detecting radiopharmaceuticals that emit 100 200 keV gamma rays which are typically used in diagnostic nuclear medicine and in molecular imaging. The system is expected to be optimized for the 140.6 keV gamma ray from a Tc-99m source, which is frequently used in nuclear medicine. This new system will focus the incoming gamma rays in a manner analogous to a magnifying glass focusing sunlight into a small focal point on a detector's sensitive area. Focusing gamma rays through photon diffraction has already been demonstrated with the construction of a diffraction lens telescope for astrophysics and a scaled-down lens for medical imaging, both developed at Argonne National Laboratory (ANL). In addition, spatial resolutions of 3 mm have been achieved with a prototype medical lens. The proposed imaging system would be comprised of an array of photon diffraction lenses tuned to diffract a specific gamma ray energy (within 100 200 keV) emitted by a common source. The properties of photon diffraction make it possible to diffract only one specific gamma ray energy at a time, which significantly reduces scattering background. The system should be sufficiently sensitive to the detection of small concentrations of radioactivity that can reveal potential tumor sites at their initial stages of development. Moreover, the system's sensitivity would eliminate the need for re-injecting a patient with more radiopharmaceutical if this patient underwent a prior nuclear imaging scan. Detection of a tumor site at its inception could allow for an earlier initiation of treatment and wider treatment options, which can potentially improve the chances for cure.

  13. Energetic electron processes fluorescence effects for structured nanoparticles X-ray analysis and nuclear medicine applications

    NASA Astrophysics Data System (ADS)

    Taborda, A.; Desbrée, A.; Carvalho, A.; Chaves, P. C.; Reis, M. A.

    2016-08-01

    Superparamagnetic iron oxide (SPIO) nanoparticles are widely used as contrast agents for nuclear magnetic resonance imaging (MRI), and can be modified for improved imaging or to become tissue-specific or even protein-specific. The knowledge of their detailed elemental composition characterisation and potential use in nuclear medicine applications, is, therefore, an important issue. X-ray fluorescence techniques such as particle induced X-ray emission (PIXE) or X-ray fluorescence spectrometry (XRF), can be used for elemental characterisation even in problematic situations where very little sample volume is available. Still, the fluorescence coefficient of Fe is such that, during the decay of the inner-shell ionised atomic structure, keV Auger electrons are produced in excess to X-rays. Since cross-sections for ionisation induced by keV electrons, for low atomic number atoms, are of the order of 103 barn, care should be taken to account for possible fluorescence effects caused by Auger electrons, which may lead to the wrong quantification of elements having atomic number lower than the atomic number of Fe. Furthermore, the same electron processes will occur in iron oxide nanoparticles containing 57Co, which may be used for nuclear medicine therapy purposes. In the present work, simple approximation algorithms are proposed for the quantitative description of radiative and non-radiative processes associated with Auger electrons cascades. The effects on analytical processes and nuclear medicine applications are quantified for the case of iron oxide nanoparticles, by calculating both electron fluorescence emissions and energy deposition on cell tissues where the nanoparticles may be embedded.

  14. Impact on house staff evaluation scores when changing from a Dreyfus- to a Milestone-based evaluation model: one internal medicine residency program's findings

    PubMed Central

    Friedman, Karen A.; Balwan, Sandy; Cacace, Frank; Katona, Kyle; Sunday, Suzanne; Chaudhry, Saima

    2014-01-01

    Purpose As graduate medical education (GME) moves into the Next Accreditation System (NAS), programs must take a critical look at their current models of evaluation and assess how well they align with reporting outcomes. Our objective was to assess the impact on house staff evaluation scores when transitioning from a Dreyfus-based model of evaluation to a Milestone-based model of evaluation. Milestones are a key component of the NAS. Method We analyzed all end of rotation evaluations of house staff completed by faculty for academic years 2010–2011 (pre-Dreyfus model) and 2011–2012 (post-Milestone model) in one large university-based internal medicine residency training program. Main measures included change in PGY-level average score; slope, range, and separation of average scores across all six Accreditation Council for Graduate Medical Education (ACGME) competencies. Results Transitioning from a Dreyfus-based model to a Milestone-based model resulted in a larger separation in the scores between our three post-graduate year classes, a steeper progression of scores in the PGY-1 class, a wider use of the 5-point scale on our global end of rotation evaluation form, and a downward shift in the PGY-1 scores and an upward shift in the PGY-3 scores. Conclusions For faculty trained in both models of assessment, the Milestone-based model had greater discriminatory ability as evidenced by the larger separation in the scores for all the classes, in particular the PGY-1 class. PMID:25425408

  15. PREFACE: International Conference on Image Optimisation in Nuclear Medicine (OptiNM)

    NASA Astrophysics Data System (ADS)

    Christofides, Stelios; Parpottas, Yiannis

    2011-09-01

    Conference logo The International Conference on Image Optimisation in Nuclear Medicine was held at the Atlantica Aeneas Resort in Ayia Napa, Cyprus between 23-26 March 2011. It was organised in the framework of the research project "Optimising Diagnostic Value in SPECT Myocardial Perfusion Imaging" (YΓΕΙΑ/ΔYΓΕΙΑ/0308/11), funded by the Cyprus Research Promotion Foundation and the European Regional Development Fund, to present the highlights of the project, discuss the progress and results, and define future related goals. The aim of this International Conference was to concentrate on image optimization approaches in Nuclear Medicine. Experts in the field of nuclear medicine presented their latest research results, exchanged experiences and set future goals for image optimisation while balancing patient dose and diagnostic value. The conference was jointly organized by the Frederick Research Centre in Cyprus, the Department of Medical and Public Health Services of the Cyprus Ministry of Health, the Biomedical Research Foundation in Cyprus and the AGH University of Science and Technology in Poland. It was supported by the Cyprus Association of Medical Physics and Biomedical Engineering, and the Cyprus Society of Nuclear Medicine. The conference was held under the auspices of the European Federation of Organisations for Medical Physics and the European Association of Nuclear Medicine. The conference scientific programme covered several important topics such as functional imaging; image optimization; quantification for diagnosis; justification; simulations; patient dosimetry, staff exposures and radiation risks; quality assurance and clinical audit; education, training and radiation protection culture; hybrid systems and image registration; and new and competing technologies. The programme consisted of 13 invited and keynote presentations as well as workshops, round table discussions and a number of scientific sessions. A total of 51 speakers presented their

  16. Health concerns related to radiation exposure of the female nuclear medicine patient.

    PubMed Central

    Stabin, M G

    1997-01-01

    The female nuclear medicine patient is of special concern in evaluating radiation dose and risk in nuclear medicine. The female's overall body size and organ sizes generally are smaller than those of her male counterpart (thus her radiation doses will be higher, given the same amounts of administered activity and similar biokinetics); female gonads are inside the body instead of outside and are near several organs often important as source organs in internal dosimetry (urinary bladder, liver, kidneys, intestines); risk of breast cancer is significantly higher among females than males; and in the case of pregnancy, exposure to radiation of the embryo/fetus and the nursing infant are of special concern in such an analysis. All these concerns are addressed in this study through a comparative study of radiation doses for males and females over a large number (approximately 60) of nuclear medicine studies and through a study of what is known about radiation dosimetry in pregnancy and breast feeding. It was found that women's critical organ doses and effective doses (as defined by the International Commission on Radiological Protection 60 [ICRP 60] are about 25% higher than those for men across all these studies. Women's gonad doses, however, may be as much as 10 to 30 times higher than those in men, although 2- to 3-fold differences are common. Many radiopharmaceuticals are administered to women of childbearing age; however, little is known about how much activity crosses the placenta and about the biokinetics in the fetus should it occur. Nonetheless, dose estimates are provided at four stages of pregnancy (early, 3-month, 6-month, and 9-month gestation) for a large number of radiopharmaceuticals, whether or not quantitative estimates of placental crossover can be made. Many radiopharmaceuticals are also excreted in breast milk of nursing mothers. Breast feeding interruption schedules are suggested through analysis of the observed kinetics of these pharmaceuticals and

  17. Role of nuclear medicine bone scans in evaluating pain in athletic injuries

    SciTech Connect

    Martire, J.R.

    1987-10-01

    The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.

  18. The traceability chain of 131I measurements for nuclear medicine in Cuba.

    PubMed

    Oropesa, P; Moreno, Y; Serra, R A; Hernández, A T

    2012-09-01

    The national traceability chain for (131)I activity measurements performed in nuclear medicine in Cuba is described. At the highest (primary) level, liquid scintillation counting employing the CIEMAT/NIST method is used; at the secondary level, a secondary standard radionuclide calibrator is utilized that allows for a quick and simple transference of the measurement unit to the tertiary level of end-users' instruments. The equivalence of Cuban standards and the assessment of measurement uncertainties at the end-user level are determined through the results of measurement comparisons. PMID:22534014

  19. Detection of thoracic infections by nuclear medicine techniques in the acquired immunodeficiency syndrome

    SciTech Connect

    Kramer, E.L.; Sanger, J.J. )

    1989-11-01

    The challenge of the acquired immunodeficiency syndrome (AIDS) for nuclear medicine has been the early detection of related intrathoracic opportunistic infections, inflammatory conditions, and neoplasms. Gallium-67 citrate scanning has proved a sensitive test not only for Pneumocystis carinii pneumonia but for many of the other opportunistic infections and malignancies, including mycobacterial infections and lymphoma. Patterns and intensity of gallium uptake may suggest more specific diagnoses. Indium-111-labeled white blood cells may also be a valuable diagnostic tool in the AIDS patient.41 references.

  20. Radiation safety review for 511-keV emitters in nuclear medicine.

    PubMed

    Dell, M A

    1997-03-01

    With the advent of high-energy collimators and dual-head coincidence cameras, standard nuclear medicine facilities will soon begin imaging with PET isotopes. The use of 511-keV emitters raises new radiation safety concerns for technologists traditionally limited to handling 99mTc and other low-energy isotopes. This article is a basic review of positron emitters, measurement concerns, exposure rates, shielding requirements and external radiation exposure mitigation. Newly developed PET shielding products are presented and regulatory status is discussed briefly. PMID:9239598

  1. Relationship between leukemia incidence and residing and/or working near the Pilgrim 1 nuclear power plant in Plymouth, Massachusetts

    SciTech Connect

    Morris, M.S.

    1992-01-01

    To determine whether a strong association between leukemia incidence between 1978 and 1986 and potential for exposure to radiation emitted from the Pilgrim 1 nuclear power plant in Plymouth, Massachusetts was a spurious finding resulting from either (1) failure to account for temporal variation in the level of radioactivity released from the plant or (2) inattention to certain potentially confounding factors, additional age/sex-matched case-control analyses controlled for the effects of socioeconomic status (SES), work history, and cigarette smoking were performed with data collected in the Southeastern Massachusetts Health Investigation -- a study of leukemia among residents aged 13 and older of 22 southeastern Massachusetts towns. None of the additional analyses, including incorporation of emissions data into the exposure-assessment scheme and crude attempts to control for (1) medical-radiation exposure, (2) potential for exposure to pesticides sprayed on cranberry bogs, or (3) workplace exposure to radiation, chemical solvents, dust, or fumes, altered the finding of a statistically significant dose-response relationship between leukemia incidence and potential for exposure to radioactive emissions. The trend in the association over time was not entirely consistent, however, with the hypothesis that unusually large amounts of radioactivity reportedly released from the plant during the mid-1970s were responsible for the observed effects. Recommendations were made for further study of the Plymouth-area population for studies of this problem elsewhere.

  2. SiPM MEPhI Megagrant Developments in Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Popova, E. V.; Belyaev, V. N.; Berdnikov, V. V.; Buzhan, P. Zh.; Ilyin, A. L.; Lazarenko, E. O.; Philippov, D. E.; Skryabin, A. A.; Stifutkin, A. A.

    Three projects has been started in our laboratory as part of megagrant "High energy physics and nuclear medicine with silicon photomultiplier detectors" in NRNU MEPHI. The goal of these projects is development of devices for nuclear medicine in which replacement of photomultiplier tubes (PMT) with solid-state silicon photomultipliers promises various advantages. The first project is full-body SPECT, where replacement of PMT's could reduce size of the detector module and improve spatial resolution while keeping other parameters. The second project is development of a TOF-PET module. Replacement of PMTs with silicon photomultipliers makes it possible to use that detector not only in high magnetic fields but also for Time-of-Flight measurements (higher signal-to-noise ratio on final image) due to very high timing resolution of a SiPM. And the last project is the SiPM-based position-sensitive Gamma-spectrometer for dose monitoring in neutron-capture therapy based on SiPM's.

  3. [Development of the software package of the nuclear medicine data processor for education and research].

    PubMed

    Maeda, Hisato; Yamaki, Noriyasu; Azuma, Makoto

    2012-01-01

    The objective of this study was to develop a personal computer-based nuclear medicine data processor for education and research in the field of nuclear medicine. We call this software package "Prominence Processor" (PP). Windows of Microsoft Corporation was used as the operating system of this PP, which have 1024 × 768 image resolution and various 63 applications classified into 6 groups. The accuracy was examined for a lot of applications of the PP. For example, in the FBP reconstruction application, there was visually no difference in the image quality as a result of comparing two SPECT images obtained from the PP and GMS-5500A (Toshiba). Moreover, Normalized MSE between both images showed 0.0003. Therefore the high processing accuracy of the FBP reconstruction application was proven as well as other applications. The PP can be used in an arbitrary place if the software package is installed in note PC. Therefore the PP is used to lecture and to practice on an educational site and used for the purpose of the research of the radiological technologist on a clinical site etc. widely now. PMID:22449907

  4. Collective effective dose in Europe from X-ray and nuclear medicine procedures.

    PubMed

    Bly, R; Jahnen, A; Järvinen, H; Olerud, H; Vassileva, J; Vogiatzi, S

    2015-07-01

    Population doses from radiodiagnostic (X-ray and nuclear medicine) procedures in Europe were estimated based on data collected from 36 European countries. For X-ray procedures in EU and EFTA countries (except Liechtenstein) the collective effective dose is 547,500 man Sv, resulting in a mean effective dose of 1.06 mSv per caput. For all European countries included in the survey the collective effective dose is 605,000 man Sv, resulting in a mean effective dose of 1.05 mSv per caput. For nuclear medicine procedures in EU countries and EFTA (except Liechtenstein) countries the collective effective dose is 30,700 man Sv, resulting in a mean effective dose of 0.06 mSv per caput. For all European countries included in the survey the collective effective dose is 31,100 man Sv, resulting in a mean effective dose of 0.05 mSv per caput. PMID:25848115

  5. Minimizing nuclear medicine technologist radiation exposure during 131I-MIBG therapy.

    PubMed

    Turpin, Brian K; Morris, Victoria R; Lemen, Lisa; Weiss, Brian D; Gelfand, Michael J

    2013-02-01

    131I-metaiodobenzylguanidine is a norepinephrine analog that concentrates in adrenergic tissue and has been shown to be an effective radiotherapeutic agent used to treat tumors of neural crest origin, particularly neuroblastoma, a sympathetic nervous system malignancy of children. The purpose of this study was to determine the radiation dose received by nuclear medicine technologists while preparing and administering 131I-metaiodobenzylguanidine therapy dosages, and if any changes could be implemented that would reduce a technologist's dose. The study involves the collection of total whole body doses received by technologists during the treatment of six patients. Patient dosages ranged from 9.25 to 31.1 GBq, with radiation exposures to the nuclear medicine technologists averaging 0.024 μSv per MBq administered to the patient. Subsequently, the doses received by the technologists were analyzed with respect to specific process steps performed during 131I-metaiodobenzylguanidine therapy including package receipt, dosage preparation, and dosage administration. Results show that the largest contribution to the technologist's whole body radiation dose (>83%) is received during the dosage administration process step. After additional shielding was installed for use during the dosage administration process step, technologists' doses decreased 80%. PMID:23287519

  6. The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism

    PubMed Central

    Cacko, Marek; Królicki, Leszek

    2015-01-01

    Primary hyperparathyroidism (PH) represents one of the most common endocrine diseases. In most cases, the disorder is caused by parathyroid adenomas. Bilateral neck exploration has been a widely used treatment method for adenomas since the 20's of the twentieth century. In the last decade, however, it has been increasingly replaced by a minimally invasive surgical treatment. Smaller extent, shorter duration and lower complication rate of such a procedure are emphasized. Its efficacy depends on a precise location of parathyroid tissue during the preoperative imaging. Scintigraphy and ultrasound play a major role in the diagnostic algorithms. The efficacy of both methods has been repeatedly verified and compared. The still-current guidelines of the European Association of Nuclear Medicine (2009) emphasize the complementary role of scintigraphy and ultrasonography in the preoperative diagnostics in patients with primary hyperparathyroidism. At the same time, attempts are made to improve both these techniques by implementing new study protocols or innovative technologies. Publications have emerged in the recent years in the field of ultrasonography, whose authors pointed out the usefulness of elastography and contrast media. Nuclear medicine studies, on the other hand, focus mainly on the assessment of new radiotracers used in the positron emission tomography (PET). The aim of this article is to present, based on literature data, the possibilities of ultrasound and scintigraphy in the preoperative diagnostics in patients with primary hyperparathyroidism. Furthermore, the main directions in the development of imaging techniques in PH patients were evaluated. PMID:26807297

  7. The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism.

    PubMed

    Nieciecki, Michał; Cacko, Marek; Królicki, Leszek

    2015-12-01

    Primary hyperparathyroidism (PH) represents one of the most common endocrine diseases. In most cases, the disorder is caused by parathyroid adenomas. Bilateral neck exploration has been a widely used treatment method for adenomas since the 20's of the twentieth century. In the last decade, however, it has been increasingly replaced by a minimally invasive surgical treatment. Smaller extent, shorter duration and lower complication rate of such a procedure are emphasized. Its efficacy depends on a precise location of parathyroid tissue during the preoperative imaging. Scintigraphy and ultrasound play a major role in the diagnostic algorithms. The efficacy of both methods has been repeatedly verified and compared. The still-current guidelines of the European Association of Nuclear Medicine (2009) emphasize the complementary role of scintigraphy and ultrasonography in the preoperative diagnostics in patients with primary hyperparathyroidism. At the same time, attempts are made to improve both these techniques by implementing new study protocols or innovative technologies. Publications have emerged in the recent years in the field of ultrasonography, whose authors pointed out the usefulness of elastography and contrast media. Nuclear medicine studies, on the other hand, focus mainly on the assessment of new radiotracers used in the positron emission tomography (PET). The aim of this article is to present, based on literature data, the possibilities of ultrasound and scintigraphy in the preoperative diagnostics in patients with primary hyperparathyroidism. Furthermore, the main directions in the development of imaging techniques in PH patients were evaluated. PMID:26807297

  8. Russian practical guidance on radiological support for justification of X-ray and nuclear medicine examinations.

    PubMed

    Balonov, M; Golikov, V; Kalnitsky, S; Zvonova, I; Chipiga, L; Sarycheva, S; Shatskiy, I; Vodovatov, A

    2015-07-01

    An important part of the justification process is assessment of the radiation risks caused by exposure of a patient during examination. The authors developed official national methodology both for medical doctors and sanitary inspectors called 'assessment of radiation risks of patients undergoing diagnostic examinations with the use of ionizing radiation'. The document addresses patients of various age groups and a wide spectrum of modern X-ray and nuclear medicine examinations. International scale of risk categorisation was implemented by the use of effective dose with account for age dependence of radiation risk. The survey of effective doses in radiology, including CT, mammography, and intervention radiology, and nuclear medicine, including single-photon emission tomography and positron emission tomography, for patients of various age groups from several regions of Russia was used for the risk assessment. The output of the methodology is a series of tables for each diagnostic technology with lists of examinations for three age groups (children/adolescents, adults and seniors) corresponding to various radiation risk categories. PMID:25862538

  9. Radiation accidents and their management: emphasis on the role of nuclear medicine professionals

    PubMed Central

    Novruzov, Fuad; Vinjamuri, Sobhan

    2014-01-01

    Large-scale radiation accidents are few in number, but those that have occurred have subsequently led to strict regulation in most countries. Here, different accident scenarios involving exposure to radiation have been reviewed. A triage of injured persons has been summarized and guidance on management has been provided in accordance with the early symptoms. Types of casualty to be expected in atomic blasts have been discussed. Management at the scene of an accident has been described, with explanation of the role of the radiation protection officer, the nature of contaminants, and monitoring for surface contamination. Methods for early diagnosis of radiation injuries have been then described. The need for individualization of treatment according to the nature and grade of the combined injuries has been emphasized, and different approaches to the treatment of internal contamination have been presented. The role of nuclear medicine professionals, including physicians and physicists, has been reviewed. It has been concluded that the management of radiation accidents is a very challenging process and that nuclear medicine physicians have to be well organized in order to deliver suitable management in any type of radiation accident. PMID:25004166

  10. Automated motion correction based on target tracking for dynamic nuclear medicine studies

    NASA Astrophysics Data System (ADS)

    Cao, Xinhua; Tetrault, Tracy; Fahey, Fred; Treves, Ted

    2008-03-01

    Nuclear medicine dynamic studies of kidneys, bladder and stomach are important diagnostic tools. Accurate generation of time-activity curves from regions of interest (ROIs) requires that the patient remains motionless for the duration of the study. This is not always possible since some dynamic studies may last from several minutes to one hour. Several motion correction solutions have been explored. Motion correction using external point sources is inconvenient and not accurate especially when motion results from breathing, organ motion or feeding rather than from body motion alone. Centroid-based motion correction assumes that activity distribution is only inside the single organ (without background) and uniform, but this approach is impractical in most clinical studies. In this paper, we present a novel technique of motion correction that first tracks the organ of interest in a dynamic series then aligns the organ. The implementation algorithm for target tracking-based motion correction consists of image preprocessing, target detection, target positioning, motion estimation and prediction, tracking (new search region generation) and target alignment. The targeted organ is tracked from the first frame to the last one in the dynamic series to generate a moving trajectory of the organ. Motion correction is implemented by aligning the organ ROIs in the image series to the location of the organ in the first image. The proposed method of motion correction has been applied to several dynamic nuclear medicine studies including radionuclide cystography, dynamic renal scintigraphy, diuretic renography and gastric emptying scintigraphy.

  11. BOOK REVIEW: Therapeutic Applications of Monte Carlo Calculations in Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Coulot, J.

    2003-08-01

    H Zaidi and G Sgouros (eds) Bristol: Institute of Physics Publishing (2002) £70.00, ISBN: 0750308168 Monte Carlo techniques are involved in many applications in medical physics, and the field of nuclear medicine has seen a great development in the past ten years due to their wider use. Thus, it is of great interest to look at the state of the art in this domain, when improving computer performances allow one to obtain improved results in a dramatically reduced time. The goal of this book is to make, in 15 chapters, an exhaustive review of the use of Monte Carlo techniques in nuclear medicine, also giving key features which are not necessary directly related to the Monte Carlo method, but mandatory for its practical application. As the book deals with `therapeutic' nuclear medicine, it focuses on internal dosimetry. After a general introduction on Monte Carlo techniques and their applications in nuclear medicine (dosimetry, imaging and radiation protection), the authors give an overview of internal dosimetry methods (formalism, mathematical phantoms, quantities of interest). Then, some of the more widely used Monte Carlo codes are described, as well as some treatment planning softwares. Some original techniques are also mentioned, such as dosimetry for boron neutron capture synovectomy. It is generally well written, clearly presented, and very well documented. Each chapter gives an overview of each subject, and it is up to the reader to investigate it further using the extensive bibliography provided. Each topic is discussed from a practical point of view, which is of great help for non-experienced readers. For instance, the chapter about mathematical aspects of Monte Carlo particle transport is very clear and helps one to apprehend the philosophy of the method, which is often a difficulty with a more theoretical approach. Each chapter is put in the general (clinical) context, and this allows the reader to keep in mind the intrinsic limitation of each technique

  12. Joint CDRH (Center for Devices and Radiological Health) and state quality-assurance surveys in nuclear medicine: Phase 2 - radiopharmaceuticals

    SciTech Connect

    Hamilton, D.R.; Evans, C.D.

    1986-08-01

    The report discusses survey results on aspects of the quality assurance of radio-pharmaceuticals from 180 nuclear-medicine facilities in the United States. Data were collected from facilities in 8 states. Demographic information about nuclear-medicine operations and quality-assurance programs was gathered by state radiation-control-program personnel. The data collected from the survey show an incomplete acceptance of quality-assurance practices for radiopharmaceuticals. Most of the facilities in the survey indicated that, because an inferior radiopharmaceutical was prepared so infrequently, they did not believe it was cost-effective to perform extensive quality-assurance testing. The Center for Devices and Radiological Health hopes that the information from the survey will stimulate nuclear-medicine professionals and their organizations to encourage appropriate testing of all radiopharmaceuticals.

  13. In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine. Final performance report, January 1, 1989--December 31, 1991

    SciTech Connect

    Kelsey, K.T.

    1991-12-31

    The overall goal of our research was to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation to human lymphocytes. Principally, we studied hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologists who administer radionuclides. Emphasis in the first year, as described in the first progress report, was on optimization of the hprt mutation assay, measurement of mutant frequencies in patients imaged with thallium-201, and measurement of mutant frequencies in controls. Emphasis in the second and third years was on measurements of: (1) chromosome aberrations in patients imaged with thallium-201; (2) mutant frequencies in patients imaged with technetium-99; (3) mutant frequencies in nuclear medicine technicians and physical therapists; and (4) mutant frequencies in patients treated for Hodgkins disease with radiotherapy. The completed work has been published and is described below in more detail.

  14. Design and operation of a nuclear medicine picture archiving and communication system.

    PubMed

    Brown, P H; Krishnamurthy, G T

    1990-07-01

    Construction of a new Veterans Administration Medical Center provided a unique opportunity to design and implement a state-of-the-art nuclear medicine department in a large teaching and research hospital. The new medical center allowed the acquisition of all new gamma cameras and computer systems without any historical need to patch together a system of old and new equipment. The picture archiving and communication system (PACS) was designed to link five gamma cameras to four image viewing areas, followed by digital archive on an optical disc. The gamma cameras' computers and viewing areas' computers are linked to a central networking computer in a manner that provides nine independent but digitally communicating image computers. Each nuclear medicine computer is capable of acquiring gamma camera data while possibly also performing up to three other simultaneous tasks: analysis of image data, transfer of image data from node to node, and patient database manipulation. The nine image computers each appear to the user as a digital file cabinet, containing various folders, which in turn contain patient studies. To transfer a patient study from one location to another, the user simply queues a transfer request by selecting a file drawer-folder combination for the source and destination locations. It takes only a few seconds to queue a transfer request, and the transfer is complete about a minute later without any further user intervention. A computer genie awakens during the early morning off-hours and performs housekeeping tasks, including movement of patient studies (based on date of acquisition) from active viewing folders to inactive archive folders. All scheduling, workload data, patient image reports, etc, are handled by a patient textual information database system. Patient reports and scheduling information are transmitted to the medical center's central computer where they are made readily available throughout the medical center. The PACS, in clinical use

  15. Nuclear medicine and the failed joint replacement: Past, present, and future

    PubMed Central

    Palestro, Christopher J

    2014-01-01

    Soon after the introduction of the modern prosthetic joint, it was recognized that radionuclide imaging provides useful information about these devices. The bone scan was used extensively to identify causes of prosthetic joint failure. It became apparent, however, that although sensitive, regardless of how the images were analyzed or how it was performed, the test was not specific and could not distinguish among the causes of prosthetic failure. Advances in anatomic imaging, notably cross sectional modalities, have facilitated the diagnosis of many, if not most, causes of prosthetic failure, with the important exception of infection. This has led to a shift in the diagnostic paradigm, in which nuclear medicine investigations increasingly have focused on diagnosing infection. The recognition that bone scintigraphy could not reliably diagnose infection led to the development of combined studies, first bone/gallium and subsequently leukocyte/bone and leukocyte/marrow imaging. Labeled leukocyte imaging, combined with bone marrow imaging is the most accurate (about 90%) imaging test for diagnosing joint arthroplasty infection. Its value not withstanding, there are significant disadvantages to this test. In-vivo techniques for labeling leukocytes, using antigranulocyte antibodies have been explored, but have their own limitations and the results have been inconsistent. Fluorodeoxyglucose (FDG)-positron emission tomography (FDG-PET) has been extensively investigated for more than a decade but its role in diagnosing the infected prosthesis has yet to be established. Antimicrobial peptides bind to bacterial cell membranes and are infection specific. Data suggest that these agents may be useful for diagnosing prosthetic joint infection, but large scale studies have yet to be undertaken. Although for many years nuclear medicine has focused on diagnosing prosthetic joint infection, the advent of hybrid imaging with single-photon emission computed tomography

  16. Internal dosimetry of nuclear medicine workers through the analysis of (131)I in aerosols.

    PubMed

    Carneiro, Luana Gomes; de Lucena, Eder Augusto; Sampaio, Camilla da Silva; Dantas, Ana Letícia Almeida; Sousa, Wanderson Oliveira; Santos, Maristela Souza; Dantas, Bernardo Maranhão

    2015-06-01

    (131)I is widely used in nuclear medicine for diagnostic and therapy of thyroid diseases. Depending of workplace safety conditions, routine handling of this radionuclide may result in a significant risk of exposure of the workers subject to chronic intake by inhalation of aerosols. A previous study including in vivo and in vitro measurements performed recently among nuclear medicine personnel in Brazil showed the occurrence of (131)I incorporation by workers involved in the handling of solutions used for radioiodine therapy. The present work describes the development, optimization and application of a methodology to collect and analyze aerosol samples aiming to assess internal doses based on the activity of (131)I present in a radiopharmacy laboratory. Portable samplers were positioned at one meter distant from the place where non-sealed liquid sources of (131)I are handled. Samples were collected over 1h using high-efficiency filters containing activated carbon and analyzed by gamma spectrometry with a high-purity germanium detection system. Results have shown that, although a fume hood is available in the laboratory, (131)I in the form of vapor was detected in the workplace. The average activity concentration was found to be of 7.4Bq/m(3). This value is about three orders of magnitude below the Derived Air Concentration (DAC) of 8.4kBq/m(3). Assuming that the worker is exposed by inhalation of iodine vapor during 1h, (131)I concentration detected corresponds to an intake of 3.6Bq which results in a committed effective dose of 7.13×10(-5)mSv. These results show that the radiopharmacy laboratory evaluated is safe in terms of internal exposure of the workers. However it is recommended that the presence of (131)I should be periodically re-assessed since it may increase individual effective doses. It should also be pointed out that the results obtained so far reflect a survey carried out in a specific workplace. Thus, it is suggested to apply the methodology

  17. A no-gold-standard technique for objective assessment of quantitative nuclear-medicine imaging methods.

    PubMed

    Jha, Abhinav K; Caffo, Brian; Frey, Eric C

    2016-04-01

    The objective optimization and evaluation of nuclear-medicine quantitative imaging methods using patient data is highly desirable but often hindered by the lack of a gold standard. Previously, a regression-without-truth (RWT) approach has been proposed for evaluating quantitative imaging methods in the absence of a gold standard, but this approach implicitly assumes that bounds on the distribution of true values are known. Several quantitative imaging methods in nuclear-medicine imaging measure parameters where these bounds are not known, such as the activity concentration in an organ or the volume of a tumor. We extended upon the RWT approach to develop a no-gold-standard (NGS) technique for objectively evaluating such quantitative nuclear-medicine imaging methods with patient data in the absence of any ground truth. Using the parameters estimated with the NGS technique, a figure of merit, the noise-to-slope ratio (NSR), can be computed, which can rank the methods on the basis of precision. An issue with NGS evaluation techniques is the requirement of a large number of patient studies. To reduce this requirement, the proposed method explored the use of multiple quantitative measurements from the same patient, such as the activity concentration values from different organs in the same patient. The proposed technique was evaluated using rigorous numerical experiments and using data from realistic simulation studies. The numerical experiments demonstrated that the NSR was estimated accurately using the proposed NGS technique when the bounds on the distribution of true values were not precisely known, thus serving as a very reliable metric for ranking the methods on the basis of precision. In the realistic simulation study, the NGS technique was used to rank reconstruction methods for quantitative single-photon emission computed tomography (SPECT) based on their performance on the task of estimating the mean activity concentration within a known volume of interest

  18. A no-gold-standard technique for objective assessment of quantitative nuclear-medicine imaging methods

    NASA Astrophysics Data System (ADS)

    Jha, Abhinav K.; Caffo, Brian; Frey, Eric C.

    2016-04-01

    The objective optimization and evaluation of nuclear-medicine quantitative imaging methods using patient data is highly desirable but often hindered by the lack of a gold standard. Previously, a regression-without-truth (RWT) approach has been proposed for evaluating quantitative imaging methods in the absence of a gold standard, but this approach implicitly assumes that bounds on the distribution of true values are known. Several quantitative imaging methods in nuclear-medicine imaging measure parameters where these bounds are not known, such as the activity concentration in an organ or the volume of a tumor. We extended upon the RWT approach to develop a no-gold-standard (NGS) technique for objectively evaluating such quantitative nuclear-medicine imaging methods with patient data in the absence of any ground truth. Using the parameters estimated with the NGS technique, a figure of merit, the noise-to-slope ratio (NSR), can be computed, which can rank the methods on the basis of precision. An issue with NGS evaluation techniques is the requirement of a large number of patient studies. To reduce this requirement, the proposed method explored the use of multiple quantitative measurements from the same patient, such as the activity concentration values from different organs in the same patient. The proposed technique was evaluated using rigorous numerical experiments and using data from realistic simulation studies. The numerical experiments demonstrated that the NSR was estimated accurately using the proposed NGS technique when the bounds on the distribution of true values were not precisely known, thus serving as a very reliable metric for ranking the methods on the basis of precision. In the realistic simulation study, the NGS technique was used to rank reconstruction methods for quantitative single-photon emission computed tomography (SPECT) based on their performance on the task of estimating the mean activity concentration within a known volume of interest

  19. One-year clinical experience with a fully digitized nuclear medicine department: organizational and economical aspects

    NASA Astrophysics Data System (ADS)

    Anema, P. C.; de Graaf, C. N.; Wilmink, J. B.; Hall, David R.; Hoekstra, A. G.; van Rijk, P. P.; Van Isselt, J. W.; Viergever, Max A.

    1991-07-01

    At the department of nuclear medicine of the University Hospital Utrecht a single-modality PACS has been operational since mid-1990. After one year of operation the functionality, the organizational and economical consequences, and the acceptability of the PACS were evaluated. The functional aspects reviewed were: viewing facilities, patient data management, connectivity, reporting facilities, archiving, privacy, and security. It was concluded that the improved quality of diagnostic viewing and the potential integration with diagnosis, reporting, and archiving are highly appreciated. The many problems that have occurred during the transition period, however, greatly influence the appreciation and acceptability of the PACS. Overall, it is felt that in the long term there will be a positive effect on the quality and efficiency of the work.

  20. New imaging systems in nuclear medicine. Technical progress report, January 1, 1985-November 1, 1985

    SciTech Connect

    Brownell, G.L.

    1985-01-01

    Developments of improved imaging systems in nuclear medicine are reported with emphasis on development of positron emission tomographs that combine high resolution, with high sensitivity and high count rate capability. A second generation cylindrical analog positron camera design has provided excellent light collection with limited light spread, characteristics needed for high spatial and temporal resolution. Other aspects of the camera development include the design of associated electronics, and provision for data storage and processing. Utilizing the above camera basic studies have been performed to evaluate blood flow in the cat brain stem during auditory stimulation, ventilation in the dog using /sup 13/N and blood flow in the canine heart. 2 refs., 2 figs.