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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.

  2. 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)

  3. Nuclear Medicine

    MedlinePlus

    ... here Home » Science Education » Science Topics » Nuclear Medicine SCIENCE EDUCATION SCIENCE EDUCATION Science Topics Resource Links for ... administered by inhalation, by oral ingestion, or by direct injection into an organ. The mode of tracer ...

  4. Children's (Pediatric) Nuclear Medicine

    MedlinePlus Videos and Cool Tools

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  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. 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.

  7. Technologists for Nuclear Medicine

    ERIC Educational Resources Information Center

    Barnett, Huey D.

    1974-01-01

    Physicians need support personnel for work with radioisotopes in diagnosing dangerous diseases. The Nuclear Medicine Technology (NMT) Program at Hillsborough Community College in Tampa, Florida, is described. (MW)

  8. 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)

  9. Your Radiologist Explains Nuclear Medicine

    MedlinePlus

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

  10. 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 ...

  11. Nuclear medicine training and practice in Portugal.

    PubMed

    Vieira, Rosário; Costa, Gracinda

    2013-07-01

    Nuclear medicine in Portugal has been an autonomous speciality since 1984. In order to obtain the title of Nuclear Medicine Specialist, 5 years of training are necessary. The curriculum is very similar to the one approved under the auspices of the European Union of Medical Specialists, namely concerning the minimum recommended number of diagnostic and therapeutic procedures. There is a final assessment, and during the training the resident is in an approved continuing education programme. Departments are accredited by the Medical College in order to verify their capacity to host nuclear medicine residencies.

  12. 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.

  13. Children's (Pediatric) Nuclear Medicine

    MedlinePlus

    ... nuclear medicine facility. Through the natural process of radioactive decay, the small amount of radiotracer in your child’s body will lose its radioactivity over time. In many cases, the radioactivity will ...

  14. 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.

  15. Nuclear medicine annual, 1987

    SciTech Connect

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

    1987-01-01

    Radionuclide evaluation of brain death, bone imaging with SPECT, and lymphoscintigraphy are among the topics covered in Nuclear Medicine Annual, 1987. In addition, the book includes reviews of the role of nuclear medicine in the diagnosis of the Acquired Immunodeficiency Syndrome (AIDS) and in the management of patients with acute myocardial infarction. Reports describe advances in radionuclide and magnetic resonance imaging of the adrenal gland and assess the current status of diuretic renography. Also included are articles on changes in functional imaging with aging, on radionuclide evaluation of the lower genitourinary tract in children, and on cholescintigraphy in children.

  16. Occupational and environmental medicine in a family medicine residency.

    PubMed

    Eckstein, T E; Teitelbaum, H S

    2001-05-01

    Well-rounded instruction in occupational medicine as part of family medicine residency training is feasible through a program that balances a longitudinal curriculum of monthly occupational and environmental medicine (OEM) lectures, community-based OEM patient care, and worksite assessment. Such training would help equip family medicine residents to integrate occupational medicine into their practices, which, in light of a shortage of board-certified practitioners in OEM, would help fill community needs. The Intern-Resident Training Committee of Carson City Hospital in rural Michigan established both learner and institutional goals and objectives for such a program of instruction. A learner-needs assessment found appreciable interest among the residents for occupational medicine training. In addition, results of a survey of the occupational health community suggested there is inadequate coverage of OEM in medical schools and residencies. Furthermore, a focus group of occupational health managers revealed that clarity of communication and standardization of reporting were paramount concerns. Instruments for standardized OEM history and for OEM case management were developed for use within the residency continuity clinic. The curriculum was implemented with a variety of teaching strategies, including worksite assessment. Practice-based, case-oriented instruction was subsequently phased into the program as residents assumed responsibility for managing cases under the supervision of family medicine preceptors knowledgeable in OEM. An occupational medicine rotation was developed that included focused clinical exposure to OEM patients and studies that would lead to eligibility for a certificate of additional qualification in occupational medicine. Learner evaluations included chart reviews and patient satisfaction surveys. Program evaluations included interviews with occupational health managers. The residents were judged by their preceptors to have performed well. The

  17. Traceability in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Zimmerman, Brian E.; Judge, Steven

    2007-08-01

    Accurate, reproducible measurement of radioactivity in nuclear medicine applications is vital to ensure the safety and effectiveness of disease diagnosis and treatment using unsealed radioactive sources. The need to maintain a high degree of confidence in those measurements requires that they be carried out so as to be traceable to national and international standards. In addition, measurement traceability for radioactivity in medicine helps ensure international consistency in measurement at all levels of practice (national measurement laboratories, research institutions, isotope producers, radiopharmaceutical manufacturers and clinics). This paper explores the importance of radioactivity measurement in nuclear medicine and demonstrates how traceability can be extended from international standards to the quantity of the drug administered to the patient.

  18. 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.

  19. 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.

  20. Satisfaction with civilian family medicine residency training

    PubMed Central

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-01-01

    Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of

  1. 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.

  2. [Nuclear medicine and radiopharmaceuticals].

    PubMed

    Sopena Novales, P; Plancha Mansanet, M C; Martinez Carsi, C; Sopena Monforte, R

    2014-06-01

    Nuclear Medicine is a medical specialty that allows modern diagnostics and treatments using radiopharmaceuticals original radiotracers (drugs linked to a radioactive isotope). In Europe, radiopharmaceuticals are considered a special group of drugs and thus their preparation and use are regulated by a set of policies that have been adopted by individual member countries. The radiopharmaceuticals used in diagnostic examinations are administered in very small doses. So, in general, they have no pharmacological action, side effects or serious adverse reactions. The biggest problem associated with their use are the alterations in their biodistribution that may cause diagnostic errors. Nuclear Medicine is growing considerably influenced by the appearance and development of new radiopharmaceuticals in both the diagnostic and therapeutic fields and primarily to the impact of new multimodality imaging techniques (SPECT-CT, PET-CT, PET-MRI, etc.). It's mandatory to know the limitations of these techniques, distribution and eventual physiological alterations of radiopharmaceuticals, contraindications and adverse reactions of radiological contrasts, and the possible interference of both.

  3. Synopsis of nuclear medicine.

    PubMed

    Waweru, F N; Othieno, J O

    1989-10-01

    The application of radionuclides to medical diagnosis and treatment has a relatively short history. The phenomenon of radioactivity was originally discovered by Henri Bacquerel in 1896, whereas Pierre and Marie Curie isolated the naturally occurring element radium in 1899. The use of radium in the treatment of malignant disease was first introduced at the turn of this century, and was established by 1920. It was not until 1938, however, that the discovery of nuclear fission made possible the subsequent development of the nuclear reactor, and the large-scale production of artificial radioactive nuclides. It was immediately realised that the latter opened up great possibilities in the medical field. The radioactive isotope was chemically indistinguishable from the stable isotopes of the element, and minute quantities of it in the body could be detected externally by virtue of the radiation they emitted; it could be used as a "tracer" to follow the metabolism of a substance throughout the body. The following synopsis is a brief attempt to introduce the Kenyan medical personnel into the scope of nuclear energy in medicine.

  4. Curricula and Organization of Primary Care Residencies in Internal Medicine.

    ERIC Educational Resources Information Center

    Eisenberg, John M.

    1980-01-01

    The organization and curricula of internal medicine residencies programs that emphasize primary care are described and compared with traditional residencies in internal medicine. It is noted that primary care residents spend more time in ambulatory care and are allowed more electives in specialties outside of internal medicine. Out-of-hospital…

  5. Nuclear medicine at a crossroads.

    PubMed

    Schelbert, Heinrich R

    2011-12-01

    The growth of molecular imaging heightens the promise of clinical nuclear medicine as a tool for individualization of patient care and for improvement of health-care outcomes. Together with greater use of integrated structure-function imaging, clinical nuclear medicine reaches beyond traditional specialty borders into diagnostic radiology and oncology. Yet, there are concerns about the future of nuclear medicine, including progressively declining reimbursement, the competitive advantages of diagnostic radiology, limited translation of research accomplishments to clinical diagnostic imaging and patient care, and an insufficient pool of incoming highly qualified nuclear medicine clinicians. Thus, nuclear medicine views itself as being at a critical crossroads. What will be important is for nuclear medicine to be positioned as the quintessential molecular imaging modality more centrally within medical imaging and for the integration of nuclear medicine with primary care specialties to be driven more by patient needs than by specialty needs. In this way, the full potential of nuclear medicine as an effective and efficient tool for improving patient outcomes can be realized.

  6. 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.

  7. Mentorship in physical medicine and rehabilitation residencies.

    PubMed

    Galicia, A R; Klima, R R; Date, E S

    1997-01-01

    Mentorship is considered by many authorities as being possibly the most important developmental tool for the progression of a professional in training. In recent years, progressively increasing support of mentoring programs has been documented, especially in business, academia, and overall career development. Despite its recognized importance, there is a paucity of literature examining the needs of physicians in residency training programs in regard to mentorship. A 21-item questionnaire was sent to all physical medicine and rehabilitation (PM&R) residents in training in United States residency programs in May of 1993. The objectives of this survey were 3-fold: to assess interest in mentorship among PM&R residents, to determine the effect of preresidency mentorship on candidates choosing PM&R as a specialty, and to identify the factors that establish a successful mentorship in PM&R residency. A response rate of 36.2% (406/1123) was obtained. Analysis of the results indicated that 97.3% (390/401) of the respondents were interested in mentorship programs during PM&R residency; however, only 28.1% (114/406) had a mentor at the time of the survey. Before residency, 35.4% (143/404) of the respondents had a mentor, and of those, 75.9% (107/141) indicated that mentorship had a positive effect on their decision to choose PM&R as a specialty. Regarding the current mentorship, respondents benefited the most in the categories of increased knowledge of PM&R, 72.8% (83/114), and improved clinical skills, 65.8% (75/114). The least satisfaction was with the mentor's assistance with a research project, 46% (52/113), and with the effect of mentorship on the resident's visibility and reputation, 38.6% (44/114). Overall resident satisfaction with mentorship was significantly higher (P < 0.0001) in mentorships formed by free choice compared with those that were formally assigned by the residency program. Success of mentorship significantly correlated (P < 0.0001) with frequency of

  8. Identifying inaccuracies on emergency medicine residency applications

    PubMed Central

    Katz, Eric D; Shockley, Lee; Kass, Lawrence; Howes, David; Tupesis, Janis P; Weaver, Christopher; Sayan, Osman R; Hogan, Victoria; Begue, Jason; Vrocher, Diamond; Frazer, Jackie; Evans, Timothy; Hern, Gene; Riviello, Ralph; Rivera, Antonio; Kinoshita, Keith; Ferguson, Edward

    2005-01-01

    Background Previous trials have showed a 10–30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. Methods This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans and the NRMP. Results Nine residencies reviewed 493 applications (28.6% of all applicants who applied to any EM program). 56 applications (11.4%, 95%CI 8.6–14.2%) contained at least one error. Excluding "benign" errors, 9.8% (95% CI 7.2–12.4%), contained at least one error. 41% (95% CI 35.0–47.0%) of all publications contained an error. All AOA membership claims were verified, but 13.7% (95%CI 4.4–23.1%) of claimed advanced degrees were inaccurate. Inter-rater reliability of evaluations was good. Investigators were reluctant to notify applicants' dean's offices and the NRMP. Conclusion This is the largest study to date of accuracy on application for residency and the first such multi-centered trial. High rates of incorrect data were found on applications. This data will serve as a baseline for future years of the project, with emphasis on reporting inaccuracies and warning applicants of the project's goals. PMID:16105178

  9. 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

  10. 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.

  11. 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.

  12. Nuclear Medicine Imaging

    MedlinePlus

    ... necesita saber acerca de... Estudios de Imagen de Medicina Nuclear Un procedimiento de medicina nuclear se describe algunas veces como unos rayos- ... través del cuerpo del paciente. Los procedimientos de medicina nuclear utilizan pequeñas cantidades de mate- riales radiactivos, ...

  13. Pediatric training in emergency medicine residency programs.

    PubMed

    Ludwig, S; Fleisher, G; Henretig, F; Ruddy, R

    1982-04-01

    Endorsed emergency medicine (EM) residency programs were surveyed as to the nature and extent of training they provided in pediatric emergency care (PEC). In the surveys returned (82%) there were several important findings. The amount of time in PEC training was generally two months per year of training. This accounted for 16% of training time. However, the volume of pediatric patients was 25% of the overall patient population. There was wide variation in the sites of PEC training. Didactic sessions often did not cover even core topics. The training program directors were equally divided in their satisfaction with this aspect of their programs. Changes were recommended by 80% of the directors. Changes most often suggested were increasing pediatric patient exposure and obtaining PEC specialists as trainers.

  14. 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.

  15. The Residency Training Experience in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David; Chuang, Taijung; Argade, Nina

    2015-01-01

    The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience.

  16. Quo vadis pediatric nuclear medicine.

    PubMed

    Conway, James J

    2007-07-01

    What has happened to the nuclear medicine subspecialty since those earlier issues of the Seminars in Nuclear Medicine? The earliest issues in 1972 presented topics in vogue at the time that included brain "scanning," cisternography, whole body counting, and abdominal imaging with (99m)Tc pertechnetate. The second pediatric subspecialty issues in 1993 reflected a 21-year evolution of the subspecialty and included the topics of renal scintigraphy, labeled cells for abdominal imaging, metaiodobenzylguanidine imaging, single photon emission computed tomography, and bone scintigraphy for benign disorders. The current issues will address diverse topics that cover the spectrum of the current practice of pediatric nuclear medicine. They include radiation exposure and absorbed dose reduction, positron emission tomography/computed tomography in children, neuroblastoma and other neuroendocrine tumors, thyroid cancer and therapy, bone density studies and, of course, the most prevalent studies in children, renal and bone. Brain, heart, and lung studies complete the spectrum.

  17. Computer vision in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Sommer, Gerald

    1990-11-01

    Computervision is used to overcome the mismatch between user models and implementation models of software systems for image analysis in nuclear medicine. Computer vision in nuclear medicine results in an active support of the user by the system. This is reached by modeling of imaging equipment and schedules scenes of interest and the process of visual image interpretation. Computer vision is demonstrated especially in the low level and medium level range. Special highlights are given for the estimation of image quality an uniform approach to enhancement and restoration of images and analysis of shape and dynamics of patterns. 1.

  18. 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.

  19. Radiation Safety in Nuclear Medicine Procedures.

    PubMed

    Cho, Sang-Geon; Kim, Jahae; Song, Ho-Chun

    2017-03-01

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

  20. 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

  1. 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.

  2. 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

  3. Training family medicine residents to care for children

    PubMed Central

    Duke, Pauline; Curran, Vernon; Hollett, Ann

    2011-01-01

    Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160

  4. 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)

  5. 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…

  6. Effect of location on family medicine residents' training.

    PubMed Central

    Lebel, D.; Hogg, W.

    1993-01-01

    A survey of family medicine residents trained at community-based or hospital-based centres suggested differences in experience and in career plans. Community-based residents saw more patients in the same family, believed they knew the community better, made more housecalls, expected to use allied health professionals more frequently, and were more likely to choose a small community practice. PMID:8499787

  7. Enhancing laboratory activities in nuclear medicine education.

    PubMed

    Grantham, Vesper; Martin, Chris; Schmitz, Casey

    2009-12-01

    Hands-on or active learning is important in nuclear medicine education. As more curricula start to require greater standards and as distance education expands, the effective use of laboratories in nuclear medicine education remains important in physics, instrumentation, and imaging but is often overlooked or underutilized. Laboratory exercises are a unique opportunity for nuclear medicine educators to facilitate students' critical thinking and problem-solving skills in a manner that often cannot occur in lectures or during online education. Given the lack of current laboratory tools and publications, there exists a requirement for nuclear medicine educators to develop, enhance, and monitor educational tools for laboratory exercises. Expanding technologies, variations in imaging and measurement systems, and the need to ensure that the taught technology is relevant to nuclear medicine students are issues faced by nuclear medicine educators. This article, based on principles of instructional design, focuses on the components and development of effective and enhanced nuclear medicine laboratories in our current educational environment.

  8. Nuclear Medicine in Pediatric Cardiology.

    PubMed

    Milanesi, Ornella; Stellin, Giovanni; Zucchetta, Pietro

    2017-03-01

    Accurate cardiovascular imaging is essential for the successful management of patients with congenital heart disease (CHD). Echocardiography and angiography have been for long time the most important imaging modalities in pediatric cardiology, but nuclear medicine has contributed in many situations to the comprehension of physiological consequences of CHD, quantifying pulmonary blood flow symmetry or right-to-left shunting. In recent times, remarkable improvements in imaging equipments, particularly in multidetector computed tomography and magnetic resonance imaging, have led to the progressive integration of high resolution modalities in the clinical workup of children affected by CHD, reducing the role of diagnostic angiography. Technology has seen a parallel evolution in the field of nuclear medicine, with the advent of hybrid machines, as SPECT/CT and PET/CT scanners. Improved detectors, hugely increased computing power, and new reconstruction algorithms allow for a significant reduction of the injected dose, with a parallel relevant decrease in radiation exposure. Nuclear medicine retains its distinctive capability of exploring at the tissue level many functional aspects of CHD in a safe and reproducible way. The lack of invasiveness, the limited need for sedation, the low radiation burden, and the insensitivity to body habitus variations make nuclear medicine an ideal complement of echocardiography. This is particularly true during the follow-up of patients with CHD, whose increasing survival represent a great medical success and a challenge for the health system in the next decades. Metabolic imaging using (18)FDG PET/CT has expanded its role in the management of infection and inflammation in adult patients, particularly in cardiology. The same expansion is observed in pediatric cardiology, with an increasing rate of studies on the use of FDG PET for the evaluation of children with vasculitis, suspected valvular infection or infected prosthetic devices. The

  9. 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)

  10. 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…

  11. American Board of Emergency Medicine report on residency training information (2013-2014), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Baren, Jill M; Beeson, Michael S; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C

    2014-05-01

    The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs.

  12. American Board of Emergency Medicine report on residency training information (2012-2013), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Baren, Jill M; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Wahl, Robert P; Korte, Robert C

    2013-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2013 annual report on the status of US emergency medicine training programs.

  13. Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps

    PubMed Central

    Morris, Stephen C.; Schroeder, Erika D.

    2016-01-01

    Introduction International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them. Methods A survey was sent to all U.S. emergency medicine (EM) residencies with publicly available e-mail addresses. The survey documents and examines the training and support that emergency medicine residents are offered for international rotations and the frequency of adverse safety events. Results 72.5% of program director responded that their residents are participating in rotations abroad. However, only 15.4% of programs reported offering training specific to working abroad. The results point to an increased need for specific training and insurance coverage. Conclusion Oversight of international rotations should be improved to guarantee safety and education benefit. PMID:26823933

  14. 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

  15. 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…

  16. 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

  17. 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

  18. Leadership training in a family medicine residency program

    PubMed Central

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-01-01

    Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816

  19. 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

  20. 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.

  1. 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.

  2. Report on residency training information (2011-2012), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Carius, Michael L; Collier, Robert E; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Korte, Robert C

    2012-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency training programs and the residents in those programs. We present the 2012 annual report on the status of US emergency medicine training programs.

  3. American Board of Emergency Medicine report on residency training information (2014-2015).

    PubMed

    Smith-Coggins, Rebecca; Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Heller, Barry N; Kowalenko, Terry; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C; Joldersma, Kevin B

    2015-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2015 annual report on the status of US emergency medicine training programs.

  4. American Board of Emergency Medicine Report on Residency Training Information (2015-2016).

    PubMed

    Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Gausche-Hill, Marianne; Goyal, Deepi G; Kowalenko, Terry; Muelleman, Robert L; Wahl, Robert P; Joldersma, Kevin B

    2016-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2016 annual report on the status of US emergency medicine training programs.

  5. Nuclear medicine training and practice in Poland.

    PubMed

    Teresińska, Anna; Birkenfeld, Bożena; Królicki, Leszek; Dziuk, Mirosław

    2014-10-01

    In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular

  6. Palliative Care Exposure in Internal Medicine Residency Education.

    PubMed

    Edwards, Asher; Nam, Samuel

    2017-01-01

    As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training. In this study, we surveyed 338 Accreditation Council for Graduate Medical Education-accredited internal medicine program directors. We queried how palliative care was integrated into their training programs. The vast majority of respondents felt that palliative care training was "very important" (87.5%) and 75.9% of respondents offered some kind of palliative care rotation, often with a multidisciplinary approach. Moving forward, we are hopeful that the data provided from our survey will act as a launching point for more formal investigations into palliative care education for internal medicine residents. Concurrently, policy makers should aid in palliative care instruction by formalizing required palliative care training for internal medicine residents.

  7. Exploring the experience of residents during the first six months of family medicine residency training

    PubMed Central

    Martin, Dawn; Nasmith, Louise; Takahashi, Susan Glover; Harvey, Bart J.

    2017-01-01

    Background The shift from undergraduate to postgraduate education signals a new phase in a doctor’s training. This study explored the resident’s perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs. PMID:28344713

  8. Assessment of emergency medicine residents: a systematic review

    PubMed Central

    Colmers-Gray, Isabelle N.; Walsh, Kieran; Chan, Teresa M.

    2017-01-01

    Background Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. Methods We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 – June 2014. MeSH terms included “assessment,” “residency,” and “emergency medicine.” We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident. Two reviewers screened abstracts, reviewed full text studies, and abstracted data. Reporting of assessment-related costs was a secondary outcome. Results The search returned 879 articles; 137 articles were full-text reviewed; 73 met inclusion criteria. Half of the studies (54.8%) were pilot projects and one-quarter (26.0%) described fully implemented assessment tools/programs. Assessment tools (n=111) comprised 12 categories, most commonly: simulation-based assessments (28.8%), written exams (28.8%), and direct observation (26.0%). Median assessment frequency (n=39 studies) was twice per month/rotation (range: daily to once in residency). No studies thoroughly reported costs. Conclusion EM resident assessment commonly uses simulation or direct observation, done once-per-rotation. Implemented assessment systems and assessment-associated costs are poorly reported. Moving forward, routine publication will facilitate transitioning to competency-based medical education. PMID:28344722

  9. 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.

  10. Education in long-term care for family medicine residents

    PubMed Central

    Oliver, Doug; Emili, Anna; Chan, David; Taniguchi, Alan

    2011-01-01

    Abstract Problem addressed Family medicine residents require more exposure to all aspects of care of the elderly in the community, including care in long-term care (LTC) homes. Objective of program To provide a framework for the development of integrated LTC rotations in family medicine programs. Program description Clear objectives for residents and clinical preceptors provided the foundation for the program. Rotations of 4 half days per year in LTC homes were integrated into core family medicine blocks. Residents worked with family physician preceptors providing LTC in the community. Teaching was case based and aligned with the core competencies set out in the CanMEDS (Canadian Medical Directives for Specialists) framework for medical education. The program was strongly supported by the university’s administration, clinical preceptors in the community, and LTC homes. Conclusion All the residents rated their LTC rotations as useful or extremely useful in preparing them to provide LTC in their future practices. Long-term care homes realized that investing in training medical residents in LTC could help improve care of the elderly in the community. PMID:21841091

  11. Nuclear Medicine Technology: A Suggested Postsecondary Curriculum.

    ERIC Educational Resources Information Center

    Technical Education Research Center, Cambridge, MA.

    The purpose of this curriculum guide is to assist administrators and instructors in establishing nuclear medicine technician programs that will meet the accreditation standards of the American Medical Association (AMA) Council on Medical Education. The guide has been developed to prepare nuclear medicine technicians (NMT's) in two-year…

  12. Internal Medicine Residents' Preferences regarding Medical Ethics Education.

    ERIC Educational Resources Information Center

    Jacobson, Jay A.; And Others

    1989-01-01

    A survey of residents (N=323) in 6 internal medicine programs investigated the topics students wanted included in the medical ethics curriculum and by which of 17 methods they would prefer to be taught. About three-fourths had previous medical ethics instruction, and most wanted more on specific topics, especially legal and end-of-life issues.…

  13. 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…

  14. Can Emergency Medicine Residents Predict Cost of Diagnostic Testing?

    PubMed Central

    Tainter, Christopher R.; Gentges, Joshua A.; Thomas, Stephen H.; Burns, Boyd D.

    2017-01-01

    Introduction Diagnostic testing represents a significant portion of healthcare spending, and cost should be considered when ordering such tests. Needless and excessive spending may occur without an appreciation of the impact on the larger healthcare system. Knowledge regarding the cost of diagnostic testing among emergency medicine (EM) residents has not previously been studied. Methods A survey was administered to 20 EM residents from a single ACGME-accredited three-year EM residency program, asking for an estimation of patient charges for 20 commonly ordered laboratory tests and seven radiological exams. We compared responses between residency classes to evaluate whether there was a difference based on level of training. Results The survey completion rate was 100% (20/20 residents). We noted significant discrepancies between the median resident estimates and actual charge to patient for both laboratory and radiological exams. Nearly all responses were an underestimate of the actual cost. The group median underestimation for laboratory testing was $114, for radiographs $57, and for computed tomography exams was $1,058. There was improvement in accuracy with increasing level of training. Conclusion This pilot study demonstrates that EM residents have a poor understanding of the charges burdening patients and health insurance providers. In order to make balanced decisions with regard to diagnostic testing, providers must appreciate these factors. Education regarding the cost of providing emergency care is a potential area for improvement of EM residency curricula, and warrants further attention and investigation. PMID:28116030

  15. Portfolios: possibilities for addressing emergency medicine resident competencies.

    PubMed

    O'Sullivan, Patricia; Greene, Constance

    2002-11-01

    Portfolios are an innovative approach to evaluate the competency of emergency medicine residents. Three key characteristics add to their attractiveness. First, portfolios draw from the resident's actual work. Second, they require self-reflection on the part of the resident. Third, they are inherently practice-based learning since residents must review and consider their practice in order to begin the portfolio. This paper illustrates five different applications of portfolios. First, portfolios are applied to evaluating specific competencies as part of the training of emergency physicians. While evaluating specific competencies, the portfolio captures aspects of the general competencies. Second, the article illustrates using portfolios as a way to address a specific residency review committee (RRC) requirement such as follow-ups. Third is a description of how portfolios can be used to evaluate resident conferences capturing the competency of practice-based learning and possibly other competencies such as medical knowledge and patient care. Fourth, the authors of the article designed a portfolio as a way to demonstrate clinical competence. Fifth, they elaborate as to how a continuous quality improvement project could be cast within the portfolio framework. They provide some guidance concerning issues to address when designing the portfolios. Portfolios are carefully structured and not haphazard collections of materials. Following criteria is important in maintaining the validity of the portfolio as well as contributing to reliability. The portfolios can enhance the relationship between faculty and residents since faculty will suggest cases, discuss anomalies, and interact with the residents around the portfolio. The authors believe that in general portfolios can cover many of the general competencies specified by the ACGME while still focusing on issues important to emergency medicine. The authors believe that portfolios provide an approach to evaluation commensurate

  16. 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

  17. Redesigning the nuclear medicine reading room.

    PubMed

    Zemariame, Nigist; Knight, Nancy; Siegel, Eliot L

    2011-11-01

    The process of image review and interpretation has become increasingly complex and challenging for today's nuclear medicine physician from many perspectives, especially with regard to workstation integration and reading room ergonomics. With the recent proliferation of hybrid imaging systems, this complexity has increased rapidly, along with the number of studies performed. At the same time, clinicians throughout the health care enterprise are expecting remote access to nuclear medicine images whereas nuclear medicine physicians require reliable access at the point of care to the electronic medical record and to medical images from radiology and cardiology. The authors discuss the background and challenges related to integration of nuclear medicine into the health care enterprise and provide a series of recommendations for advancing successful integration efforts. Also addressed are unique characteristics of the nuclear medicine environment as well as ergonomic, lighting, and environmental considerations in the design and redesign of the modern reading room.

  18. 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

  19. Moral distress and burnout in internal medicine residents

    PubMed Central

    Sajjadi, Sharareh; Norena, Monica; Wong, Hubert; Dodek, Peter

    2017-01-01

    Background Residents frequently encounter situations in their workplace that may induce moral distress or burnout. The objective of this study was to measure overall and rotation-specific moral distress and burnout in medical residents, and the relationship between demographics and moral distress and burnout. Methods The revised Moral Distress Scale and the Maslach Burnout Inventory (Human Service version) were administered to Internal Medicine residents in the 2013–2014 academic year at the University of British Columbia. Results Of the 88 residents, 45 completed the surveys. Participants (mean age 30+/−3; 46% male) reported a median moral distress score (interquartile range) of 77 (50–96). Twenty-six percent of residents had considered quitting because of moral distress, 21% had a high level of burnout, and only 5% had a low level of burnout. Moral distress scores were highest during Intensive Care Unit (ICU) and Clinical Teaching Unit (CTU) rotations, and lowest during elective rotations (p<0.0001). Women reported higher emotional exhaustion. Moral distress was associated with depersonalization (p=0.01), and both moral distress and burnout were associated with intention to leave the job. Conclusion Internal Medicine residents report moral distress that is greatest during ICU and CTU rotations, and is associated with burnout and intention to leave the job. PMID:28344714

  20. Experience with Nuclear Medicine Information System

    PubMed Central

    Volkan-Salanci, Bilge; Şahin, Figen; Babekoğlu, Vahide; Uğur, Ömer

    2012-01-01

    Objective: Radiology information system (RIS) is basically evolved for the need of radiologists and ignores the vital steps needed for a proper work flow of Nuclear Medicine Department. Moreover, CT/MRI oriented classical PACS systems are far from satisfying Nuclear Physicians like storing dynamic data for reprocessing and quantitative analysis of colored images. Our purpose was to develop a workflow based Nuclear Medicine Information System (NMIS) that fulfills the needs of Nuclear Medicine Department and its integration to hospital PACS system. Material and Methods: Workflow in NMIS uses HL7 (health level seven) and steps include, patient scheduling and retrieving information from HIS (hospital information system), radiopharmacy, acquisition, digital reporting and approval of the reports using Nuclear Medicine specific diagnostic codes. Images and dynamic data from cameras of are sent to and retrieved from PACS system (Corttex©) for reprocessing and quantitative analysis. Results: NMIS has additional functions to the RIS such as radiopharmaceutical management program which includes stock recording of both radioactive and non-radioactive substances, calculation of the radiopharmaceutical dose for individual patient according to body weight and maximum permissible activity, and calculation of radioactivity left per unit volume for each radionuclide according their half lives. Patient scheduling and gamma camera patient work list settings were arranged according to specific Nuclear Medicine procedures. Nuclear Medicine images and reports can be retrieved and viewed from HIS. Conclusion: NMIS provides functionality to standard RIS and PACS system according to the needs of Nuclear Medicine. Conflict of interest:None declared. PMID:23487446

  1. 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

  2. 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

  3. Patient dosimetry in nuclear medicine.

    PubMed

    Mattsson, Sören

    2015-07-01

    In diagnostic nuclear medicine, the biokinetics of the radiopharmaceutical (actually of the radionuclide) is determined for a number of representative patients. At therapy, it is essential to determine the patient's individual biokinetics of the radiopharmaceutical in order to calculate the absorbed doses to critical normal organs/tissues and to the target volume(s) with high accuracy. For the diagnostic situations, there is still a lack of quantitative determinations of the organ/tissue contents of radiopharmaceuticals and their variation with time. Planar gamma camera imaging using the conjugate view technique combined with a limited number of SPECT/CT images is the main method for such studies. In a similar way, PET/CT is used for 3D image-based internal dosimetry for PET substances. The transition from stylised reference phantoms to voxel phantoms will lead to improved dose estimates for diagnostic procedures. Examples of dose coefficients and effective doses for diagnostic substances are given. For the therapeutic situation, a pre-therapeutic low activity administration is used for quantitative measurements of organ/tissue distribution data by a gamma camera or a SPECT- or PET-unit. Together with CT and/or MR images this will be the base for individual dose calculations using Monte Carlo technique. Treatments based on administered activity should only be used if biological variations between patients are small or if a pre-therapeutic activity administration is impossible.

  4. Nuclear medicine in district general hospitals.

    PubMed

    Croft, D

    1979-11-24

    Nuclear medicine is a recognised clinical specialty both nationally and internationally. Compared with other countries, it is inadequately developed in Britain, particularly in district general hospitals. To create clinical radioisotope services at district level physicians or radiologists with experience in nuclear medicine need to be trained and appointed. Such appointments would allow facilities to evolve that would provide either a comprehensive nuclear medicine service formed around a physician or an imaging service based on a radiologist. Such units would improve the care of patients at a reasonable recurring cost of 15 pounds--30 pounds per investigation.

  5. 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.

  6. Routine quality control of clinical nuclear medicine instrumentation: a brief review.

    PubMed

    Zanzonico, Pat

    2008-07-01

    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, gamma-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.

  7. 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

  8. 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

  9. Nuclear medicine training and practice in Turkey.

    PubMed

    Ozcan, Zehra; Bozkurt, M Fani; Erbas, Belkıs; Durak, Hatice

    2017-01-31

    Nuclear medicine applications in Turkey started in the early 1950s, grew as an independent medical discipline and finally were recognized by the Ministry of Health in 1973. Later on, the professional organization of nuclear medicine physicians and other related professionals including radiopharmacists and technologists under the Turkish Society of Nuclear Medicine were established in 1975. Recently after completing more than a half century in Turkey, nuclear medicine has proved to be a strong and evolving medical field with more than 600 physicians serving for the changing needs of clinical practice throughout these years. This article describes past and present facts in this field and attempts to provide insights into the future which hopefully will be brighter than before.

  10. An overview of nuclear medicine imaging procedures.

    PubMed

    Hogg, Peter; Lawson, Richard

    2015-11-25

    Nuclear medicine imaging is not generally well understood by nurses who work outside this area. Consequently, nurses can find themselves unable to answer patients' questions about nuclear medicine imaging procedures or give them proper information before they attend for a test. This article aims to explain what is involved in some common diagnostic nuclear medicine imaging procedures so that nurses are able to discuss this with patients. It also addresses some common issues about radiation protection that nurses might encounter in their usual working routine. The article includes links to videos showing some typical nuclear medicine imaging procedures from a patient's point of view and links to an e-Learning for Healthcare online resource that provides detailed information for nurses.

  11. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role

    PubMed Central

    HOSEIN NEJAD, HOOMAN; BAGHERABADI, MEHDI; SISTANI, ALIREZA; DARGAHI, HELEN

    2017-01-01

    Introduction: Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents’ teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students’ perception of the residents’ teaching quality. Methods: This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick’s model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents’ teaching skills based on their self-evaluation and Mann-Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop. Results: The results indicated that residents’ attitude towards their teaching ability was improved significantly after participating in the workshop (p<0.001). The result of residents’ evaluation by interns showed no significant difference before and after the workshop (p=0.07). Conclusion: On the whole, the educational workshop for Residents as Teacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick’s model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of

  12. Trends in nuclear medicine in developing countries.

    PubMed

    Dondi, Maurizio; Kashyap, Ravi; Paez, Diana; Pascual, Thomas; Zaknun, John; Bastos, Fernando Mut; Pynda, Yaroslav

    2011-12-01

    This article describes trends in nuclear medicine in the developing world as noted by nuclear medicine professionals at the International Atomic Energy Agency (IAEA). The trends identified are based on data gathered from several sources, including information gathered through a database maintained by the IAEA; evaluation of country program frameworks of various IAEA Member States; personal interactions with representatives in the nuclear medicine field from different regions of the world; official proceedings and meeting reports of the IAEA; participation in numerous national, regional, and international conferences; discussions with the leadership of major professional societies; and relevant literature. The information presented in this article relied on both objective and subjective observations. The aims of this article were to reflect on recent developments in the specialty of nuclear medicine and to envision the directions in which it is progressing. These issues are examined in terms of dimensions of practice, growth, and educational and training needs in the field of nuclear medicine. This article will enable readers to gain perspective on the status of nuclear medicine practice, with a specific focus on the developing world, and to examine needs and trends arising from the observations.

  13. Importance of residency program web sites to emergency medicine applicants.

    PubMed

    Mahler, Simon A; Wagner, Mary-Jo; Church, Amy; Sokolosky, Mitchell; Cline, David M

    2009-01-01

    Emergency Medicine (EM) residency program web sites are an important tool that programs use to attract applicants. However, there are only a few studies examining the aspects of a program's web site that are most important to EM applicants. We conducted a cross-sectional study of 142 prospective residency applicants interviewing for an EM position at one of three EM residency programs for the 2003 match. The survey demonstrated that almost all applicants researched EM programs online. The majority (71%) identified geographic location as the most important factor in applying to a specific program. Approximately 40% considered an easily navigated web site as very/moderately important to their application decision-making process. Rotation schedule was also important in applicant decision-making. The Internet is a significant source of information to the majority of applicants in EM. Online information from programs' web sites, although not as significant as geography, influences an applicant's choice of where to apply for a residency position. An easily navigated, complete web site may improve the recruitment of candidates to EM residency programs.

  14. Electrodiagnostic medicine skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

    PubMed

    Brown, David; Cuccurullo, Sara; Lee, Joseph; Petagna, Ann; Strax, Thomas

    2008-08-01

    This project sought to create an educational module including evaluation methodology to instruct physical medicine and rehabilitation (PM&R) residents in electrodiagnostic evaluation of patients with neuromuscular problems, and to verify acquired competencies in those electrodiagnostic skills through objective evaluation methodology. Sixteen residents were trained by board-certified neuromuscular and electrodiagnostic medicine physicians through technical training, lectures, and review of self-assessment examination (SAE) concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill attainment were measured in (1) clinical skill in diagnostic procedures via a procedure checklist, (2) diagnosis and ability to design a patient-care management plan via chart simulated recall (CSR) exams, (3) physician/patient interaction via patient surveys, (4) physician/staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient-care report and to document a patient-care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). To test the success of the standardized educational module, data were collected on an ongoing basis. Objective measures compared resident SAE scores in electrodiagnostics (EDX) before and after institution of the comprehensive EDX competency module in a PM&R residency program. Fifteen of 16 residents (94%) successfully demonstrated proficiency in every segment of the evaluation element of the educational module by the end of their PGY-4 electrodiagnostic rotation. The resident who did not initially pass underwent remedial coursework and passed on the second attempt. Furthermore, the

  15. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    PubMed

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  16. Real time curriculum map for internal medicine residency

    PubMed Central

    Wong, Roger Y; Roberts, J Mark

    2007-01-01

    Background To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD) in a core internal medicine residency program. Methods We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching), comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. Results There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years). Only 42 hours (15%) involved non-didactic teaching, which increased after implementation of the map (18–19 hours/year versus baseline 5 hours/year). Most AHD hours (78%) focused on medical expert competencies. Resident satisfaction (90% response) was high throughout (range 3.64 ± 0.21, 3.84 ± 0.14 out of 4), which improved after 1 year but returned to baseline after 2 years. Conclusion We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics. PMID:17988402

  17. [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.

  18. 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)

  19. 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.

  20. Internal medicine program directors' perceptions of resident work rounds.

    PubMed

    Boutros, A; Della Ratta, R K

    1994-08-01

    Work rounds have received little attention in the medical education literature. At the outset of the second post graduate year, medical residents are expected to function, without much guidance, as both team leaders and teacher. New York State health code regulation 405 restrict house staff work hours and may influence the manner and content of work rounds. The goals of work rounds were identified through a literature review and our own experiences. A 36-item questionnaire utilizing the identified goals was used in this cross-sectional descriptive study. The participants were the Program Directors of New York State Internal Medicine residency programs. Each of the fourteen goals identified reflects one of three resident behaviors: patient care, teaching, and evaluation. The goals that received the highest importance scores were patient management and updating team leader of events. Ninety percent (90%) or more of the participants indicated that patient management, teaching clinical reasoning and problem solving, verifying important chart data, and verifying physical examination should be performed "often" or "almost always." Most programs employed verbal instructions but only few held conference or provided literature on the expectations and conduct of work rounds. New York State Internal Medicine program directors perceive work rounds as primarily a patient care task, and many rely on verbal instructions to convey the objectives to the house staff. While previous research has demonstrated that work rounds are an important setting for house staff education, this study reveals that in most New York State programs this opportunity may be missed.

  1. Initial experience with a nuclear medicine viewing workstation

    NASA Astrophysics Data System (ADS)

    Witt, Robert M.; Burt, Robert W.

    1992-07-01

    Graphical User Interfaced (GUI) workstations are now available from commercial vendors. We recently installed a GUI workstation in our nuclear medicine reading room for exclusive use of staff and resident physicians. The system is built upon a Macintosh platform and has been available as a DELTAmanager from MedImage and more recently as an ICON V from Siemens Medical Systems. The workstation provides only display functions and connects to our existing nuclear medicine imaging system via ethernet. The system has some processing capabilities to create oblique, sagittal and coronal views from transverse tomographic views. Hard copy output is via a screen save device and a thermal color printer. The DELTAmanager replaced a MicroDELTA workstation which had both process and view functions. The mouse activated GUI has made remarkable changes to physicians'' use of the nuclear medicine viewing system. Training time to view and review studies has been reduced from hours to about 30-minutes. Generation of oblique views and display of brain and heart tomographic studies has been reduced from about 30-minutes of technician''s time to about 5-minutes of physician''s time. Overall operator functionality has been increased so that resident physicians with little prior computer experience can access all images on the image server and display pertinent patient images when consulting with other staff.

  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. 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

  4. Psychiatry Training in Canadian Family Medicine Residency Programs

    PubMed Central

    Kates, Nick; Toews, John; Leichner, Pierre

    1985-01-01

    Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice, in integrating the teaching to a greater degree with clinical work, thereby increasing its relevance, and in utilizing more suitable clinical settings. PMID:21279156

  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.

  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. Impact of obesity on nuclear medicine imaging.

    PubMed

    Ghanem, Mohammad A; Kazim, Nafeesa A; Elgazzar, Abdelhamid H

    2011-03-01

    Obesity, with its alarming increase among adults and children, represents a significant health problem with serious medical, social, psychologic, and economic reverberations. The burden of this problem significantly affects the medical care system, including medical imaging. The effect of obesity on nuclear medicine imaging spans many aspects, from preimaging patient preparation to radiotracer administration, image acquisition, and image interpretation. The acquired images may be suboptimal because of artifacts due to soft-tissue attenuation and incomplete whole-body coverage, and quantification may be suboptimal, especially for PET. Other difficulties include mechanical problems such as the weight limit of the imaging table and the bore size of the PET or SPECT/CT scanner and the need to alter the timing, duration, or protocol of many imaging procedures. These issues are discussed in this review, which clarifies the impact of this epidemic health problem on nuclear medicine services and proposes possible solutions to overcome obesity-related difficulties encountered in nuclear medicine practice.

  8. Informed consent in the nuclear medicine setting.

    PubMed

    Rosenthal, M Sara

    2011-03-01

    In the nuclear medicine setting, the task of obtaining informed consent for procedures that require it is frequently left to the nuclear medicine technologist. Unfortunately, a patient's signature on a consent form does not mean the patient has given informed consent, or what legal scholars call valid consent. On completion of this scholarly bioethics article, the reader will understand the troubled history that led to informed consent as social and regulatory policy. Additionally, the reader will discover the meaning of "informed consent," which includes 3 critical components: disclosure, decision-making capacity, and voluntariness. Finally, this article will discuss which nuclear medicine procedures require informed consent, how to assess whether patients have given informed consent, what to do when the patient refuses a procedure, and what to do when informed consent is unachievable.

  9. Introduction of nuclear medicine research in Japan.

    PubMed

    Inubushi, Masayuki; Higashi, Tatsuya; Kuji, Ichiei; Sakamoto, Setsu; Tashiro, Manabu; Momose, Mitsuru

    2016-12-01

    There were many interesting presentations of unique studies at the Annual Meeting of the Japanese Society of Nuclear Medicine, although there were fewer attendees from Europe than expected. These presentations included research on diseases that are more frequent in Japan and Asia than in Europe, synthesis of original radiopharmaceuticals, and development of imaging devices and methods with novel ideas especially by Japanese manufacturers. In this review, we introduce recent nuclear medicine research conducted in Japan in the five categories of Oncology, Neurology, Cardiology, Radiopharmaceuticals and Technology. It is our hope that this article will encourage the participation of researchers from all over the world, in particular from Europe, in scientific meetings on nuclear medicine held in Japan.

  10. Dose Estimation in Pediatric Nuclear Medicine.

    PubMed

    Fahey, Frederic H; Goodkind, Alison B; Plyku, Donika; Khamwan, Kitiwat; O'Reilly, Shannon E; Cao, Xinhua; Frey, Eric C; Li, Ye; Bolch, Wesley E; Sgouros, George; Treves, S Ted

    2017-03-01

    The practice of nuclear medicine in children is well established for imaging practically all physiologic systems but particularly in the fields of oncology, neurology, urology, and orthopedics. Pediatric nuclear medicine yields images of physiologic and molecular processes that can provide essential diagnostic information to the clinician. However, nuclear medicine involves the administration of radiopharmaceuticals that expose the patient to ionizing radiation and children are thought to be at a higher risk for adverse effects from radiation exposure than adults. Therefore it may be considered prudent to take extra care to optimize the radiation dose associated with pediatric nuclear medicine. This requires a solid understanding of the dosimetry associated with the administration of radiopharmaceuticals in children. Models for estimating the internal radiation dose from radiopharmaceuticals have been developed by the Medical Internal Radiation Dosimetry Committee of the Society of Nuclear Medicine and Molecular Imaging and other groups. But to use these models accurately in children, better pharmacokinetic data for the radiopharmaceuticals and anatomical models specifically for children need to be developed. The use of CT in the context of hybrid imaging has also increased significantly in the past 15 years, and thus CT dosimetry as it applies to children needs to be better understood. The concept of effective dose has been used to compare different practices involving radiation on a dosimetric level, but this approach may not be appropriate when applied to a population of children of different ages as the radiosensitivity weights utilized in the calculation of effective dose are not specific to children and may vary as a function of age on an organ-by-organ bias. As these gaps in knowledge of dosimetry and radiation risk as they apply to children are filled, more accurate models can be developed that allow for better approaches to dose optimization. In turn, this

  11. Outpatient Management of Hypertension By General Medicine and Traditional Track Residents.

    ERIC Educational Resources Information Center

    Robie, Peter W.; Andrus, Peter L.

    1982-01-01

    A study to determine whether general internal medicine and traditional track medicine residents differed in their outpatient management of essential hypertension is discussed. General internal medicine residents seem to do better in the areas of assessment of drug side effects and patient education. (MLW)

  12. Emergency Medicine Resident Orientation: How Training Programs Get Their Residents Started

    PubMed Central

    McGrath, Jillian; Barrie, Michael; Way, David P.

    2017-01-01

    Introduction The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States. Methods In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167). We adapted our survey instrument from one used by Brillman (1995). The survey was designed to assess the orientation program’s purpose, structure, content, and teaching methods. Results The survey return rate was 63% (105 of 167). Most respondents (77%) directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3) and 13 non-clinical days (Std. Dev.=9.3). The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98%) and with other members of the department (91%). Many programs (87%) included special certification courses (ACLS, ATLS, PALS, NRP). Course content included the following: use of electronic medical records (90%), physician wellness (75%), and chief complaint-based lectures (72%). Procedural skill sessions covered ultrasound (94%), airway management (91%), vascular access (90%), wound management (77%), splinting (67%), and trauma skills (62%). Conclusion Compared to Brillman (1995), we found that more programs (99%) are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty

  13. 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

  14. 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.

  15. Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

    PubMed Central

    Neri, P.M.; Redden, L.; Poole, S.; Pozner, C.N.; Horsky, J.; Raja, A.S.; Poon, E.; Schiff, G.

    2015-01-01

    Summary Objective To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. Methods We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Results Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. Conclusion We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Supplemental Milestones for Emergency Medicine Residency Programs: A Validation Study

    PubMed Central

    Ketterer, Andrew R.; Salzman, David H.; Branzetti, Jeremy B.; Gisondi, Michael A.

    2017-01-01

    Introduction Emergency medicine (EM) residency programs may be 36 or 48 months in length. The Residency Review Committee for EM requires that 48-month programs provide educational justification for the additional 12 months. We developed additional milestones that EM training programs might use to assess outcomes in domains that meet this accreditation requirement. This study aims to assess for content validity of these supplemental milestones using a similar methodology to that of the original EM Milestones validation study. Methods A panel of EM program directors (PD) and content experts at two institutions identified domains of additional training not covered by the existing EM Milestones. This led to the development of six novel subcompetencies: “Operations and Administration,” “Critical Care,” “Leadership and Management,” “Research,” “Teaching and Learning,” and “Career Development.” Subject-matter experts at other 48-month EM residency programs refined the milestones for these subcompetencies. PDs of all 48-month EM programs were then asked to order the proposed milestones using the Dreyfus model of skill acquisition for each subcompetency. Data analysis mirrored that used in the original EM Milestones validation study, leading to the final version of our supplemental milestones. Results Twenty of 33 subjects (58.8%) completed the study. No subcompetency or individual milestone met deletion criteria. Of the 97 proposed milestones, 67 (69.1%) required no further editing and remained at the same level as proposed by the study authors. Thirty milestones underwent level changes: 15 (15.5%) were moved one level up and 13 (13.4%) were moved one level down. One milestone (1.0%) in “Leadership and Management” was moved two levels up, and one milestone in “Operations and Administration” was moved two levels down. One milestone in “Research” was ranked by the survey respondents at one level higher than that proposed by the authors

  1. Nuclear medicine technologist training in European countries.

    PubMed

    Lass, Piotr

    2002-08-01

    This article overviews the training of nuclear medicine technologists in chosen European countries, the United States and Canada. There are basically two types of training: at medical schools following secondary school, without any university degree, usually on a 2- or 3-year basis, or else as a university course, leading to a BSc degree after 3 years, and in some countries to an MSc degree after an additional 2 years. In the United States both systems coexist, while in Europe the picture varies from country to country. The number of hours devoted to nuclear medicine also varies between curricula. Some efforts are being made to unify this system by transition to the university model of education in many European countries.

  2. 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…

  3. 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)

  4. Is nuclear medicine cost-effective?

    PubMed

    Ripley, S

    1991-03-01

    Clearly, there is currently no consensus on the cost-effectiveness of nuclear medicine--or in fact any other aspect of medicine. It is hoped that common sense prevails in clinical medicine today. An appropriate case history and physical examination may negate the need for any additional investigation. From the perspective of the capital cost of equipment and supply costs, ultrasound is clearly the most cost-effective diagnostic imaging modality. But while it is useful, it does not always provide definitive answers, and other modalities must be used to arrive at a diagnosis. In comparison, the capital cost of general radiology equipment and nuclear medicine equipment is relatively equal. Radiology has more operating costs per case than nuclear medicine and requires a lower staffing component per given volume of examinations. In any given diagnostic imaging procedure, the practitioner and imagist must maintain a dialogue to ascertain the appropriateness of the study and to use the available resources in the most effective manner. This is even more imperative when CT scanning and MRI are included in the equation. The development of an investigative protocol that makes the most efficient use of the various imaging modalities without compromising the quality of care makes sense for the patient, the physician and the insurance provider. It is unreasonable to expect the physician to be aware of the optimal protocol for the diagnostic workup of every patient. The guidance of the imaging department is required to maximize the efficient use of the available facilities. A critical and exhaustive appraisal of the medical literature may be required to determine the optimal diagnostic protocol.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Nuclear Medicine Procedures in Children: Special Considerations.

    PubMed

    Gelfand, Michael J; Clements, Crysta; MacLean, Joseph R

    2017-03-01

    Nuclear medicine imaging in children is best accomplished when a child-friendly environment is provided for patients and parents. An approach that minimizes patient anxiety and fear is described. International guidelines for administered activity should be used to minimize absorbed radiation doses from radiopharmaceuticals. CT exposure parameters may be reduced to pediatric best practice for diagnostic CT and further reduced when CT images are needed only for localization purposes.

  6. A Tool to Assess Family Medicine Residents' Patient Encounters Using Secure Messaging

    PubMed Central

    Kim, Jung G.; Morris, Carl G.; Heidrich, Fred E.

    2015-01-01

    Background Secure messages exchanged between patients and family medicine residents via an electronic health record (EHR) could be used to assess residents' clinical and communication skills, but the mechanism is not well understood. Objective To design and test a secure messaging competency assessment for family medicine residents in a patient-centered medical home (PCMH). Methods Using the existing literature and evidence-based guidelines, we designed an assessment tool to evaluate secure messaging competency for family medicine residents training in a PCMH. Core faculty performed 2-stage validity and reliability testing (n = 2 and n = 9, respectively). A series of randomly selected EHR secure messages (n = 45) were assessed from a sample of 10 residents across all years of training. Results The secure message assessment tool provided data on a set of competencies and a framework for resident feedback. Assessment showed 10% (n = 2) of residents at the novice level, 50% (n = 10) as progressing, and 40% (n = 8) as proficient. The most common deficiencies for residents' secure messages related to communication rather than clinical competencies (n = 37 [90%] versus n = 4 [10%]). Interrater reliability testing ranged from 60% to 78% agreement and 20% to 44% disagreement. Disagreement centered on interpersonal communication factors. After 2 stages of testing, the assessment using residents' secure messages was incorporated into our existing evaluation process. Conclusions Assessing family medicine residents' secure messaging for patient encounters closed an evaluation gap in our family medicine program, and offered residents feedback on their clinical and communication skills in a PCMH. PMID:26692980

  7. 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

  8. 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.

  9. A Perspective of the future of nuclear medicine training and certification

    PubMed Central

    Arevalo-Perez, Julio; Paris, Manuel; Graham, Michael M.; Osborne, Joseph R.

    2016-01-01

    Nuclear Medicine 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 ABNM, the practice of Nuclear Medicine and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and Nuclear Medicine. The potential for further cooperation or fusion of the American Board of Radiology (ABR) and the American Board of Nuclear Medicine (ABNM) is likely to bring about a new path for Nuclear Medicine 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 Nuclear Medicine – Radiology specialty that combines Physiology and Molecular Biology with detailed anatomic imaging that will sustain the innovation that has been central to nuclear medicine residency and practice. Herein, we also introduce a few basic trends in imaging utilization in the United States. These trends do not predict future utilization, but highlight the need for an appropriately credentialed practitioner to interpret these examinations and provide value to the healthcare system. PMID:26687859

  10. 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.

  11. 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.

  12. Adequacy of Training in Preventive Medicine and Public Health: A National Survey of Residency Graduates.

    ERIC Educational Resources Information Center

    Stein, David H.; Salive, Marcel E.

    1996-01-01

    A survey of 797 preventive medicine residency graduates found that improvements are needed in the curricula for health administration, environmental health, health education, and occupational medicine. Women found their training less adequate than men did in all areas except clinical preventive medicine. Graduates tended to practice ultimately in…

  13. 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.

  14. Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching

    PubMed Central

    Balwan, Sandy; Fornari, Alice; DiMarzio, Paola; Verbsky, Jennifer; Pekmezaris, Renee; Stein, Joanna; Chaudhry, Saima

    2015-01-01

    Background Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. Methods Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. Results Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions. Conclusions We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum. PMID:26692979

  15. Nanotechnology and nuclear medicine; research and preclinical applications.

    PubMed

    Assadi, Majid; Afrasiabi, Kolsoom; Nabipour, Iraj; Seyedabadi, Mohammad

    2011-01-01

    The birth of nanotechnology in human society was around 2000 years ago and soon found applications in various fields. In this article, we highlight the current status of research and preclinical applications and also future prospects of nanotechnology in medicine and in nuclear medicine. The most important field is cancer. A regular nanotechnology training program for nuclear medicine physicians may be welcome.

  16. Weaving public health education into the fabric of a family medicine residency.

    PubMed

    Potts, Stacy E; Deligiannidis, Konstantinos E; Cashman, Suzanne B; Caggiano, Marie E; Carter, Lisa H; Haley, Heather-Lyn; Ferguson, Warren J

    2011-10-01

    Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice. This public health curriculum was designed to integrate new topics within the current residency structure through longitudinal and concentrated experiences. This strategy has substantially improved public health and prevention education without substantial impact on the already strained residency curricular structure. This paper describes the integration of public health and prevention education into a family medicine residency to help residents acquire the fundamental skills necessary to improve a population's health.

  17. 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.

  18. 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

  19. First-year family medicine residents' use of computers: knowledge, skills and attitudes.

    PubMed Central

    Rowe, B H; Ryan, D T; Therrien, S; Mulloy, J V

    1995-01-01

    OBJECTIVE: To identify the computer knowledge, skills and attitudes of first-year family medicine residents. DESIGN: Cross-sectional survey of family medicine residents during the academic year 1993-94; sampling began in July 1993 and ended in October 1993. SETTING: Canada. PARTICIPANTS: All 727 first-year family medicine residents, of whom 433 (60%) responded. OUTCOME MEASURES: Previous computer experience or training, current use, barriers to use, and comfort with and attitudes regarding computers. RESULTS: There was no difference in age or sex between the respondents and all first-year family medicine residents in Canada. French-speaking respondents from Quebec were underrepresented (p < 0.001). Only 56 respondents (13%) felt extremely or very comfortable with computer use. The most commonly cited barriers to obtaining computer training were lack of time (243 respondents [56%]) and the high cost of computers (214 [49%]) but not lack of interest (69 [16%]). Most residents wanted more computer training (367 [85%]) and felt that computer training should be a mandatory component of family medicine training programs (308 [71%]). CONCLUSIONS: Computer knowledge and skills and comfort with computer use appear low among first-year family medicine residents in Canada, and barriers to acquisition of computer knowledge are impressive. Computer training should become an integral part of family medicine training in Canada, and user-friendly applicable computer systems are needed. PMID:7614442

  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. [Three Dimensional Display in Nuclear Medicine].

    PubMed

    Teraoka, Satomi; Souma, Tsutomu

    2015-01-01

    Imaging techniques to obtain a tomographic image in nuclear medicine such as PET and SPECT are widely used. It is necessary to interpreting all of the tomographic images obtained in order to accurately evaluate the individual lesion, whereas three dimensional display is often useful in order to overview and evaluate the feature of the entire lesion or disease such as the position, size and abnormal pattern. In Japan, the use of three dimensional image analysis workstation with an application of the co-registration and image fusion between the functional images such as PET or SPECT and anatomical images such as CT or MRI has been generalized. In addition, multimodality imaging system such as a PET/CT and SPECT/CT has been widespread. Therefore, it is expected to improve the diagnostic accuracy using three dimensionally image fusion to functional images with poor anatomical information. In this commentary, as an example of a three dimensional display that are commonly used in nuclear medicine examination in Japan, brain regions, cardiac region and bone and tumor region will be introduced separately.

  2. 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…

  3. The role of general nuclear medicine in breast cancer.

    PubMed

    Greene, Lacey R; Wilkinson, Deborah

    2015-03-01

    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. 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.

  5. The situation of nuclear medicine in Central and Eastern Europe.

    PubMed

    Lass, Piotr

    2005-12-01

    This paper reviews the situation of nuclear medicine in Central and Eastern Europe (CEE), i.e. a group of 15 countries lying east of the Oder river-Trieste line and west of the present/planned EU eastern border. Together these countries have 106.6 million inhabitants, i.e. about a quarter of the population of the "European economic space". Its nuclear medicine, however, represents less than 10% of European nuclear medicine manpower and equipment. In these countries there are at least 245 nuclear medicine departments with 661 nuclear medicine specialists and at least 376 gamma cameras. There are six dedicated PET units and three PET/SPECT centres, as well as one manufacturer of gamma cameras, six radiopharmaceutical manufacturers and two nuclear medicine scientific journals. The biggest nuclear medicine communities are in the Czech Republic, Hungary and Poland. The scientific input of the CEE countries to European science is moderate-about 10% when measured by EANM congress abstracts, and 5% when measured by the number of papers in MEDLINE-indexed journals. Mean European bibliometric parameters are approached only by Hungary and-to some extent-the Czech Republic. This survey indicates the need for international cooperation to improve the level of nuclear medicine in the CEE countries so that it reaches European standards. The potential of these countries could also be better used to the benefit of European nuclear medicine.

  6. The role of general nuclear medicine in breast cancer

    PubMed Central

    Greene, Lacey R; Wilkinson, Deborah

    2015-01-01

    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. PMID:26229668

  7. Communicating With Residents About Risks Following the Fukushima Nuclear Accident.

    PubMed

    Murakami, Michio; Sato, Akiko; Matsui, Shiro; Goto, Aya; Kumagai, Atsushi; Tsubokura, Masaharu; Orita, Makiko; Takamura, Noboru; Kuroda, Yujiro; Ochi, Sae

    2017-03-01

    The Fukushima nuclear accident in March 2011 posed major threats to public health. In response, medical professionals have tried to communicate the risks to residents. To investigate forms of risk communication and to share lessons learned, we reviewed medical professionals' activities in Fukushima Prefecture from the prefectural level to the individual level: public communication through Fukushima Health Management Surveys, a Yorozu ("general") health consultation project, communications of radiological conditions and health promotion in Iitate and Kawauchi villages, dialogues based on whole-body counter, and science communications through online media. The activities generally started with radiation risks, mainly through group-based discussions, but gradually shifted to face-to-face communications to address comprehensive health risks to individuals and well-being. The activities were intended to support residents' decisions and to promote public health in a participatory manner. This article highlights the need for a systematic evaluation of ongoing risk communication practices, and a wider application of successful approaches for Fukushima recovery and for better preparedness for future disasters.

  8. A laboratory medicine residency training program that includes clinical consultation and research.

    PubMed

    Spitzer, E D; Pierce, G F; McDonald, J M

    1990-04-01

    We describe a laboratory medicine residency training program that includes ongoing interaction with both clinical laboratories and clinical services as well as significant research experience. Laboratory medicine residents serve as on-call consultants in the interpretation of test results, design of testing strategies, and assurance of test quality. The consultative on-call beeper system was evaluated and is presented as an effective method of clinical pathology training that is well accepted by the clinical staff. The research component of the residency program is also described. Together, these components provide training in real-time clinical problem solving and prepare residents for the changing technological environment of the clinical laboratory. At the completion of the residency, the majority of the residents are qualified laboratory subspecialists and are also capable of running an independent research program.

  9. 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…

  10. 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…

  11. 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.

  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. 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…

  14. A Comparison between Emergency Medicine Residency Training Programs in the United States and Saudi Arabia from the Residents' Perception

    PubMed Central

    2014-01-01

    Objectives. This study was designed to compare the trainees' perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents' levels of confidence and points of satisfaction in education, procedural skills, and work environment. Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA. Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards' examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers. Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA. PMID:24563784

  15. 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.

  16. 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…

  17. 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

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

    PubMed

    Heng, Kenneth Wj

    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.

  19. Maintaining a Twitter Feed to Advance an Internal Medicine Residency Program’s Educational Mission

    PubMed Central

    Narang, Akhil; Arora, Vineet M

    2015-01-01

    Background Residency programs face many challenges in educating learners. The millennial generation’s learning preferences also force us to reconsider how to reach physicians in training. Social media is emerging as a viable tool for advancing curricula in graduate medical education. Objective The authors sought to understand how social media enhances a residency program’s educational mission. Methods While chief residents in the 2013-2014 academic year, two of the authors (PB, AN) maintained a Twitter feed for their academic internal medicine residency program. Participants included the chief residents and categorical internal medicine house staff. Results At the year’s end, the authors surveyed residents about uses and attitudes toward this initiative. Residents generally found the chief residents’ tweets informative, and most residents (42/61, 69%) agreed that Twitter enhanced their overall education in residency. Conclusions Data from this single-site intervention corroborate that Twitter can strengthen a residency program’s educational mission. The program’s robust following on Twitter outside of the home program also suggests a need for wider adoption of social media in graduate medical education. Improved use of data analytics and dissemination of these practices to other programs would lend additional insight into social media’s role in improving residents’ educational experiences. PMID:27731845

  20. Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

    PubMed Central

    Daniels, Michael N.; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

    2017-01-01

    Background Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. Methods This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. Results 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). Conclusions The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology

  1. Minimizing and communicating radiation risk in pediatric nuclear medicine.

    PubMed

    Fahey, Frederic H; Treves, S Ted; Adelstein, S James

    2011-08-01

    The value of pediatric nuclear medicine is well established. Pediatric patients are referred to nuclear medicine from nearly all pediatric specialties including urology, oncology, cardiology, gastroenterology, and orthopedics. Radiation exposure is associated with a potential, small, risk of inducing cancer in the patient later in life and is higher in younger patients. Recently, there has been enhanced interest in exposure to radiation from medical imaging. Thus, it is incumbent on practitioners of pediatric nuclear medicine to have an understanding of dosimetry and radiation risk to communicate effectively with their patients and their families. This article reviews radiation dosimetry for radiopharmaceuticals and also CT given the recent proliferation of PET/CT and SPECT/CT. It also describes the scientific basis for radiation risk estimation in the context of pediatric nuclear medicine. Approaches for effective communication of risk to patients' families are discussed. Lastly, radiation dose reduction in pediatric nuclear medicine is explicated.

  2. Minimizing and communicating radiation risk in pediatric nuclear medicine.

    PubMed

    Fahey, Frederic H; Treves, S Ted; Adelstein, S James

    2012-03-01

    The value of pediatric nuclear medicine is well established. Pediatric patients are referred to nuclear medicine from nearly all pediatric specialties including urology, oncology, cardiology, gastroenterology, and orthopedics. Radiation exposure is associated with a potential, small, risk of inducing cancer in the patient later in life and is higher in younger patients. Recently, there has been enhanced interest in exposure to radiation from medical imaging. Thus, it is incumbent on practitioners of pediatric nuclear medicine to have an understanding of dosimetry and radiation risk to communicate effectively with their patients and their families. This article reviews radiation dosimetry for radiopharmaceuticals and also CT given the recent proliferation of PET/CT and SPECT/CT. It also describes the scientific basis for radiation risk estimation in the context of pediatric nuclear medicine. Approaches for effective communication of risk to patients' families are discussed. Lastly, radiation dose reduction in pediatric nuclear medicine is explicated.

  3. Estimated dose from diagnostic nuclear medicine patients to people outside the Nuclear Medicine department.

    PubMed

    Bartlett, Marissa L

    2013-11-01

    Patients undergoing nuclear medicine scans can be a source of radiation exposure for staff, family and the public. In this paper, 12 common nuclear medicine scans are considered. Doses are estimated for a range of scenarios, to hospital staff, to the public and to the patients' co-workers and family. Estimates are based on dose rates measured as patients left the Nuclear Medicine department. Radiopharmaceutical clearance is calculated from biokinetic models described in International Commission on Radiological Protection publications 53, 80 and 106. For all scan types, and all scenarios, doses are estimated to be substantially less than the trigger level of 300 µSv. Within the hospital, Intensive Care Unit staff receive the highest dose (up to 80 µSv) from patients who have had a myocardial scan or a positron emission tomography scan. For out-patients, the highest doses (up to 100 µSv) are associated with travel on public transport (for 4 h) on the same day as the scan.

  4. Graphic user interface-based nuclear medicine reporting system.

    PubMed

    Sanger, J J

    1993-03-01

    A graphically based, computerized report generation program has been developed and deployed at a dozen nuclear medicine facilities. The system is based on the Macintosh graphical user interface (GUI) and has been designed to be easy to learn and use. The system allows the nuclear medicine practitioner to generate reports for any nuclear medicine or nuclear cardiology procedure without transcriptionist support, dramatically decreasing report turnaround time. The system includes a relational database engine that allows cost-effective storage and rapid retrieval of final reports and also supports facsimile transmission of reports directly to referring clinicians' offices.

  5. Evidence-based medicine training during residency: a randomized controlled trial of efficacy

    PubMed Central

    2010-01-01

    Background Evidence-based medicine (EBM) has been widely integrated into residency curricula, although results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking. We sought to determine if an EBM workshop improved internal medicine residents' EBM knowledge and skills and use of secondary evidence resources. Methods This randomized controlled trial included 48 internal medicine residents at an academic medical center. Twenty-three residents were randomized to attend a 4-hour interactive workshop in their PGY-2 year. All residents completed a 25-item EBM knowledge and skills test and a self-reported survey of literature searching and resource usage in their PGY-1, PGY-2, and PGY-3 years. Results There was no difference in mean EBM test scores between the workshop and control groups at PGY-2 or PGY-3. However, mean EBM test scores significantly increased over time for both groups in PGY-2 and PGY-3. Literature searches, and resource usage also increased significantly in both groups after the PGY-1 year. Conclusions We were unable to detect a difference in EBM knowledge between residents who did and did not participate in our workshop. Significant improvement over time in EBM scores, however, suggests EBM skills were learned during residency. Future rigorous studies should determine the best methods for improving residents' EBM skills as well as their ability to apply evidence during clinical practice. PMID:20807453

  6. Understanding Resident Learning Preferences Within an Internal Medicine Noon Conference Lecture Series: A Qualitative Study

    PubMed Central

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

    2014-01-01

    Background The lecture remains the most common approach for didactic offerings in residency programs despite conflicting evidence about the effectiveness of this format. Objective The purpose of this study was to explore the perspectives of internal medicine residents toward conferences held in the lecture format. Methods The investigators invited internal medicine residents (N  =  144) to participate in focus groups discussing their perspectives about noon conference lectures. The investigators used a semistructured guide to ask about motivations for attendance and effectiveness of noon conferences, transcribed the recordings, coded the discussions, and analyzed the results. Results Seven focus groups with a total of 41 residents were held. This identified 4 major domains: (1) motivations for attendance; (2) appropriate content; (3) effective teaching methods; and (4) perspectives on active participation. Residents' motivations were categorized into external factors, including desire for a break and balance to their workload, and intrinsic attributes, including the learning opportunity, topic, and speaker. Appropriate content was described as clinically relevant, practical, and presenting a balance of evidence. Identified effective teaching methods included shorter teaching sessions focused on high-yield learning points structured around cases and questions. While active participation increases residents' perceived level of stress, the benefits of this format include increased attention and learning. Conclusions This study furthers our knowledge of the learning preferences of internal medicine residents within the changing environment of residency education and can be used in conjunction with principles of adult learning to reform how we deliver core medical knowledge. PMID:24701307

  7. 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. PMID:27796117

  8. 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.

  9. 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.

  10. Developing Educators, Investigators, and Leaders During Internal Medicine Residency: The Area of Distinction Program

    PubMed Central

    Kohlwes, R. Jeffrey; Cornett, Patricia; Dandu, Madhavi; Julian, Katherine; Vidyarthi, Arpana; Minichiello, Tracy; Shunk, Rebecca; Jain, Sharad; Harleman, Elizabeth; Ranji, Sumant; Sharpe, Brad; O'Sullivan, Patricia; Hollander, Harry

    2011-01-01

    Background Professional organizations have called for individualized training approaches, as well as for opportunities for resident scholarship, to ensure that internal medicine residents have sufficient knowledge and experience to make informed career choices. Context and Purpose To address these training issues within the University of California, San Francisco, internal medicine program, we created the Areas of Distinction (AoD) program to supplement regular clinical duties with specialized curricula designed to engage residents in clinical research, global health, health equities, medical education, molecular medicine, or physician leadership. We describe our AoD program and present this initiative's evaluation data. Methods and Program Evaluation We evaluated features of our AoD program, including program enrollment, resident satisfaction, recruitment surveys, quantity of scholarly products, and the results of our resident's certifying examination scores. Finally, we described the costs of implementing and maintaining the AoDs. Results AoD enrollment increased from 81% to 98% during the past 5 years. Both quantitative and qualitative data demonstrated a positive effect on recruitment and improved resident satisfaction with the program, and the number and breadth of scholarly presentations have increased without an adverse effect on our board certification pass rate. Conclusions The AoD system led to favorable outcomes in the domains of resident recruitment, satisfaction, scholarship, and board performance. Our intervention showed that residents can successfully obtain clinical training while engaging in specialized education beyond the bounds of core medicine training. Nurturing these interests 5 empower residents to better shape their careers by providing earlier insight into internist roles that transcend classic internal medicine training. PMID:23205204

  11. 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)

  12. 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.

  13. 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.

  14. What You Should Know About Pediatric Nuclear Medicine and Radiation Safety

    MedlinePlus

    What You Should Know About Pediatric Nuclear Medicine and Radiation Safety www.imagegently.org What is nuclear medicine? Nuclear medicine uses radioactive isotopes to create pictures of the human body. These pictures ...

  15. Use of computers and the Internet by residents in US family medicine programmes.

    PubMed

    King, Richard V; Murphy-Cullen, Cassie L; Mayo, Helen G; Marcee, Alice K; Schneider, Gregory W

    2007-06-01

    Computers, personal digital assistants (PDA), and the Internet are widely used as resources in medical education and clinical care. Educators who intend to incorporate these resources effectively into residency education programmes can benefit from understanding how residents currently use these tools, their skills, and their preferences. The researchers sent questionnaires to 306 US family medicine residency programmes for all of their residents to complete. Respondents were 1177 residents from 125 (41%) programmes. Access to a computer was reported by 95% of respondents. Of these, 97% of desktop and 89% of laptop computers could access the Internet. Residents accessed various educational and clinical resources. Half felt they had 'intermediate' skills at Web searches, 23% had 'some skills,' and 27% were 'quite skilled.' Those under 30 years of age reported higher skill levels. Those who experienced a Web-based curriculum in medical school reported higher search skills and greater success in finding clinical information. Respondents preferred to use technology to supplement the didactic sessions offered in resident teaching conferences. Favourable conditions exist in family medicine residency programmes to implement a blend of traditional and technology-based learning experiences. These conditions include residents' experience, skills, and preferences.

  16. BRIEF REPORT: Multiprogram Evaluation of Reading Habits of Primary Care Internal Medicine Residents on Ambulatory Rotations

    PubMed Central

    Lai, Cindy J; Aagaard, Eva; Brandenburg, Suzanne; Nadkarni, Mohan; Wei, Henry G; Baron, Robert

    2006-01-01

    OBJECTIVE To assess the reading habits and educational resources of primary care internal medicine residents for their ambulatory medicine education. DESIGN Cross-sectional, multiprogram survey of primary care internal medicine residents. PARTICIPANTS/SETTING Second- and third-year residents on ambulatory care rotations at 9 primary care medicine programs (124 eligible residents; 71% response rate). MEASUREMENTS AND MAIN RESULTS Participants were asked open-ended and 5-point Likert-scaled questions about reading habits: time spent reading, preferred resources, and motivating and inhibiting factors. Participants reported reading medical topics for a mean of 4.3 ± 3.0 SD hours weekly. Online-only sources were the most frequently utilized medical resource (mean Likert response 4.16 ± 0.87). Respondents most commonly cited specific patients' cases (4.38 ± 0.65) and preparation for talks (4.08 ± 0.89) as motivating factors, and family responsibilities (3.99 ± 0.65) and lack of motivation (3.93 ± 0.81) as inhibiting factors. CONCLUSIONS To stimulate residents' reading, residency programs should encourage patient- and case-based learning; require teaching assignments; and provide easy access to online curricula. PMID:16704393

  17. A comparison of surgery and family medicine residents' perceptions of cross-cultural care training.

    PubMed

    Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R

    2010-12-01

    The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area.

  18. 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.

  19. Determination of efficacy of nuclear medicine procedures

    SciTech Connect

    Saenger, E.L.; Buncher, C.R.; Specker, B.; McDevitt, R.A.

    1984-01-01

    Nuclear medicine, a high technology field, is evaluated as to its usefulness. This paper describes the SNM study of 2023 patients comparing two methods evaluating efficacy for lung scanning (LS). Only the referring physicians determined the probabilities of the most important (MI) and most likely (ML) diagnoses and management before and after lung scanning. A logistic regression model was developed for probability of a signout diagnosis of PE. Equal patient groups tested the validity of the regression equations for the probability of PE as MI or ML. The models developed on Group I (G-I) and used on Group II (G-II) gave similar results. This shows that LS classifies PE and NOT PE categories where PE was considered both MI and ML. Entropy minimax pattern detection (EMPD) attempts prediction of signout diagnosis and management from prior patient attributes. In 2023 cases, attributes alone could not eliminate the use of LS for all patients. Comparing the two methods, the predictive values, sensitivity and specificity of each method are similar. EMPD predicts on a relatively small percent (40% before LS, 71% post LS) while the logistic equation predicts on 100% of the cases. An advantage of EMPD is that it does not require estimates of prior probability. However, LR, uses this estimate, thus incorporating intuitive knowledge not evaluated by EMPD. These methods are unique in showing that LS can direct the referring physician toward or away from anticoagulant therapy based on findings of the lung scan.

  20. Congenital Hypothyroidism: Role of Nuclear Medicine.

    PubMed

    Keller-Petrot, Isabelle; Leger, Juliane; Sergent-Alaoui, Aline; de Labriolle-Vaylet, Claire

    2017-03-01

    Thyroid scintigraphy holds a key place in the etiologic workup of neonatal hypothyroidism. Routine screening for this disorder in maternity hospitals in industrialized countries, for nearly 40 years, has permitted early treatment and thereby helped to prevent its physical and mental complications. Neonatal hypothyroidism affects approximately 1 in 3000 births. The most common causes are abnormal thyroid gland development and defective hormone synthesis by an eutopic thyroid gland. The incidence of the latter has risen in recent years, for reasons that remain unclear. A thorough etiologic workup helps to determine the disease type. Current guidelines recommend thyroid imaging by means of ultrasound and scintigraphy. Ultrasound should be done by a practitioner trained to examine the cervical region of newborns, as the thyroid is very small and must be distinguished from the particular aspect of the "thyroid empty lodge." Ultrasound lacks sensitivity for detecting small ectopic glands but is the gold standard for measuring thyroid dimensions. Scintigraphy provides an etiologic diagnosis in most cases. The two isotopes used in this setting are technetium-99m and iodine-123. The latter isotope gives more contrast and allows the perchlorate discharge test to be performed to detect abnormal iodide organification in the neonate with an eutopic thyroid. If scintigraphy cannot be performed during the neonatal period, a postponed procedure can be achieved after 3 years of age. Close cooperation between the nuclear medicine physician and the pediatric endocrinologist is crucial for timely and optimized scintigraphy.

  1. 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.

  2. Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia

    PubMed Central

    Alsaad, Saad M.; Alshammari, Sulaiman A.; Almogbel, Turki A.

    2016-01-01

    Objectives: To assess patients’ perceptions of the communication skills of family medicine residents. Methods: This is a cross-sectional study. Data were collected from patients, seeing 23 residents from 4 family medicine residency programs in Riyadh, Kingdom of Saudi Arabia namely, King Khalid University Hospital, Riyadh Military Hospital, Security Forces Hospital, and King Abdul-Aziz Medical City. The translated version of the Communication Assessment Tool (CAT) was used. Data were collected during January and February 2013. Results: A total of 350 patients completed the CAT, with an 87.5% response rate. Patients rated each resident differently, but the mean percentage of items, which residents rated as excellent was 71%. In general, male residents were rated higher 72.8 ± 27.2 than female residents 67.8 ± 32.2 with a significant difference; (p<0.005). Also, significant differences were found based on the gender of the residents, when each item of the CAT was compared. Comparing training centers, there were no significant differences found in the overall percentage of items rated as excellent or among items of the CAT. Conclusion: The study identified areas of strength and weaknesses that need to be addressed to improve communication skills of physicians. PMID:27381544

  3. Benchmarks for Support and Outcomes for Internal Medicine-Pediatrics Residency Programs: A 5-Year Review

    PubMed Central

    Aronica, Michael; Williams, Ronald; Dennar, Princess E.; Hopkins, Robert H.

    2015-01-01

    Background Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. Objective We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. Methods From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Results Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P < .05), and an increase in the average full-time equivalent support (0.32 before accreditation versus 0.42 in 2013, P < .05). There was also an increase in programs with associate program directors (35% versus 78%), programs with chief residents (71% versus 91%), and an increase in program budgets controlled by program directors (52% versus 69%). The 2013 NRMP match rates increased compared to those of 2005 (99% versus 49%). Performance on the American Board of Pediatrics examination was comparable to that for pediatrics residents. Since accreditation, a larger number of residents are choosing careers in hospital medicine. Conclusions Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation. PMID:26692969

  4. Keeping family physicians in rural practice. Solutions favoured by rural physicians and family medicine residents.

    PubMed Central

    Rourke, James T. B.; Incitti, Filomena; Rourke, Leslie L.; Kennard, MaryAnn

    2003-01-01

    OBJECTIVE: To determine how family medicine residents and practising rural physicians rate possible solutions for recruiting and sustaining physicians in rural practice. DESIGN: Cross-sectional mailed survey. SETTING: Rural family practices and family medicine residency programs in Ontario. PARTICIPANTS: Two hundred seventy-six physicians and 210 residents. MAIN OUTCOME MEASURES Ratings of proposed solutions on a 4-point scale from "very unimportant" to "very important". RESULTS: Rural family physicians rated funding for learner-driven continuing medical education (CME) and limiting on-call duty to 1 night in 5 as the most important education and practice solutions, respectively. Residents rated an alternate payment plan to include time off for attending and teaching CME and comprehensive payment plans with a guaranteed income for locums as the most important education and practice solutions, respectively. CONCLUSION: Residents and physicians rated solutions very similarly. A comprehensive package of the highest-rated solutions could help recruit and sustain physicians in rural practice because the solutions were developed by experts on rural practice and rated by family medicine residents and practising rural physicians. PMID:14526866

  5. A Low-Cost Nuclear Medicine Acquisition Station

    NASA Astrophysics Data System (ADS)

    Goble, John C.

    1986-06-01

    A significant obstacle to the use of local area networks in Nuclear Medicine has been the high cost of computer systems capable of digitizing the analog outputs of conventional gamma cameras. A PC-based Nuclear Image Acquisition Station has been designed using readily available components that permits acquisition, display and transfer of nuclear images. Processing functions, including camera uniformity corrections, image rotation and edge enhancement and other operators Elre available locally. With appropriate file format manipulation, images may alternatively be transferred to a conventional Nuclear Medicine computer for processing and archival storage. Hardware and software costs required to implement these functions on an existing micro are less than $4000.

  6. 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.

  7. 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.

  8. Implementation of a Chronic Illness Model for Diabetes Care in a Family Medicine Residency Program

    PubMed Central

    Beresford, Robin

    2010-01-01

    ABSTRACT INTRODUCTION While the Chronic Care Model (CCM) has been shown to improve the care of patients with chronic illnesses, primary care physicians have been unprepared in its use, and residencies have encountered challenges in introducing it into the academic environment. AIM Our residency program has implemented a diabetes management program modeled on the CCM to evaluate its impact on health outcomes of diabetic patients and educational outcomes of residents. SETTING University-affiliated, community-based family medicine residency program. PROGRAM DESCRIPTION Six residents, two faculty clinicians, and clinic staff formed a diabetes management team. We redesigned the outpatient experience for diabetic patients by incorporating elements of the CCM: multidisciplinary team care through planned and group visits; creation of a diabetes registry; use of guidelines-based flow sheets; and incorporation of self-management goal-setting. Residents received extensive instruction in diabetes management, quality improvement, and patient self-management. PROGRAM EVALUATION We achieved overall improvement in all metabolic and process measures for patients, with the percentage achieving HbA1c, LDL, and BP goals simultaneously increasing from 5.7% to 17.1%. Educational outcomes for residents, as measured by compliance with review of provider performance reports and self-management goal-setting with patients, also significantly improved. DISCUSSION Through a learning collaborative experience, residency programs can successfully incorporate chronic care training for residents while addressing gaps in care for patients with diabetes. PMID:20737237

  9. A model of standardized training in basic life support skills of emergency medicine residents.

    PubMed

    Cimrin, Arif H; Topacoglu, Hakan; Karcioglu, Ozgur; Ozsarac, Murat; Ayrik, Cuneyt

    2005-01-01

    This intervention study was designed to determine the current level of basic life support knowledge and skills of residents in a university-based emergency medicine residency program, and to investigate the potential benefit derived by these residents from a standardized theoretical and practical training session. All residents underwent tests before and after the training session. The residents were asked to perform basic life support on a recording cardiopulmonary resuscitation mannequin. Assessments were made using a 10-item checklist, with the highest score being 17. Each step performed by the resident was scored by an emergency physician for accuracy and effectiveness. Twenty-eight residents participated in the study. According to the modified Berden scale, the pretest and posttest scores were 11.2 +/- 2.9 and 15.6 +/- 1.0, respectively, and the mean difference was 4.36 +/- 2.9 (t test, P<.001). Only 11 residents (39.3%) were rated as "good" or "very good" in the pretest, whereas the corresponding figure in the posttest was 27 (96.4%) (P<.001). Skills, such as checking the airway patency (P<.001), checking breathing (P<.001), appropriate compression rate (P<.003), and delivering 2 effective breaths (P<.001), improved significantly. Depth of chest compression (P<.023) was improved significantly only in residents with fewer than 2 years of experience. The training process should comprise standardized courses to facilitate acquisition of the desired skills.

  10. 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.

  11. 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.

  12. 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

  13. Nuclear medicine in the first year of life.

    PubMed

    Treves, S Ted; Baker, Amanda; Fahey, Frederic H; Cao, Xinhua; Davis, Royal T; Drubach, Laura A; Grant, Frederick D; Zukotynski, Katherine

    2011-06-01

    Nuclear medicine has an important role in the care of newborns and children less than 1 y old. Patients in this age group present with a spectrum of diseases different from those of older children or adults. These patients can benefit from the full range of nuclear medicine studies. In these young children, nuclear medicine studies are more likely to be used to evaluate a wide range of congenital conditions but also can be helpful for evaluating acquired conditions such as infection, cancer, and trauma. This review first will cover the general aspects of nuclear medicine practice with these patients, including the special considerations that can help achieve successful diagnostic imaging. These topics will include clinical indications, imaging technology, instrumentation, software, positioning and immobilization, sedation, local and general anesthesia, radiopharmaceutical doses, radiation risk, and dose reduction. The review then will discuss the specific nuclear medicine studies that typically are obtained in patients in this age group. With extra care and attention to the special needs of this population, nuclear medicine departments can successfully study patients less than 1 y old.

  14. History and Perspectives of Nuclear Medicine in Bangladesh.

    PubMed

    Hussain, Raihan

    2016-01-01

    Bangladesh is one of the smaller states in Asia. But it has a long and rich history of nuclear medicine for over sixty years. The progress in science and technology is always challenging in a developing country. In 1958, work for the first Nuclear Medicine facility was commenced in Dhaka in a tin-shed known as 'Radioisotope Centre' and was officially inaugurated in 1962. Since the late 50s of the last century nuclear medicine in Bangladesh has significantly progressed through the years in its course of development, but still the facilities are inadequate. At present there are 20 nuclear medicine establishments with 3 PET-CTs, 42 gamma camera/SPECTs with 95 physicians, 20 physicists, 10 radiochemists and 150 technologists. The Society of Nuclear Medicine, Bangladesh (SNMB) was formed in 1993 and publishing its official journal since 1997. Bangladesh also has close relationships with many international organizations like IAEA, ARCCNM, AOFNMB, ASNM, WFNMB and WARMTH. The history and the present scenario of the status of nuclear medicine in Bangladesh are being described here.

  15. Evaluation of an online program to teach microbiology to internal medicine residents.

    PubMed

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

    2015-01-01

    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.

  16. The Development of a Medical Ethics Curriculum in a General Internal Medicine Residency Program.

    ERIC Educational Resources Information Center

    Wartman, Steven A.; Brock, Dan W.

    1989-01-01

    A three-year curriculum in medical ethics operates at Rhode Island Hospital and Brown University as part of the general internal medicine residency program. The six major topics covered are co-taught as seminars by one or more members of the multidisciplinary ethics faculty (philosopher, internist, and communications specialist) and experienced…

  17. 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…

  18. Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

    ERIC Educational Resources Information Center

    Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

    2001-01-01

    Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

  19. 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…

  20. The contribution of medical physics to nuclear medicine: a physician's perspective.

    PubMed

    Ell, Peter J

    2014-12-01

    This paper is the second in a series of invited perspectives by four pioneers of nuclear medicine imaging and physics. A medical physicist and a nuclear medicine clinical specialist each take a backward look and a forward look at the contributions of physics to nuclear medicine. Here is a backward look from a nuclear medicine physician's perspective.

  1. Examination outcomes for international medical graduates pursuing or completing family medicine residency training in Quebec

    PubMed Central

    MacLellan, Anne-Marie; Brailovsky, Carlos; Rainsberry, Paul; Bowmer, Ian; Desrochers, Micheline

    2010-01-01

    ABSTRACT OBJECTIVE To review the success of international medical graduates (IMGs) who are pursuing or have completed a Quebec residency training program and examinations. DESIGN We retrospectively reviewed IMGs’ success rates on the pre-residency Collège des médecins du Québec medical clinical sciences written examination and objective structured clinical examination, as well as on the post-residency Certification Examination in Family Medicine. SETTING Quebec. PARTICIPANTS All IMGs taking their examinations between 2001 and 2008, inclusive, and Canadian and American graduates taking their examinations during this same period. MAIN OUTCOME MEASURES Success rates for IMGs on the pre-residency and post-residency examinations, compared with success rates for Canadian and American graduates. RESULTS Success rates on the pre-residency clinical examinations remained below 50% from 2001 to 2008 for IMGs. Similarly, during the same period, the average success rate on the Certification examination was 56.0% for IMGs, compared with 93.5% for Canadian and American medical graduates. CONCLUSION Despite pre-residency competency screening and in-program orientation and supports, a substantial number of IMGs in Quebec are not passing their Certification examinations. Another study is under way to analyze reasons for some IMGs’ lack of success and to find ways to help IMGs complete residency training successfully and pass the Certification examination. PMID:20841596

  2. 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)

  3. Using lean methodology to teach quality improvement to internal medicine residents at a safety net hospital.

    PubMed

    Weigel, Charlene; Suen, Winnie; Gupte, Gouri

    2013-01-01

    The overall objective of this initiative was to develop a quality improvement (QI) curriculum using Lean methodology for internal medicine residents at Boston Medical Center, a safety net academic hospital. A total of 90 residents and 8 School of Public Health students participated in a series of four, 60- to 90-minute interactive and hands-on QI sessions. Seventeen QI project plans were created and conducted over a 4-month period. The curriculum facilitated internal medicine residents' learning about QI and development of positive attitudes toward QI (assessed using pre- and post-attitude surveys) and exposed them to an interprofessional team structure that duplicates future working relationships. This QI curriculum can be an educational model of how health care trainees can work collaboratively to improve health care quality.

  4. 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

  5. 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

  6. 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…

  7. Learning behaviour and preferences of family medicine residents under a flexible academic curriculum

    PubMed Central

    Sy, Alice; Wong, Eric; Boisvert, Leslie

    2014-01-01

    Abstract Objective To determine family medicine residents’ learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Design Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. Setting London, Ont. Participants All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Main outcome measures Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. Results A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians’ teaching sessions (20%), and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents’ homes (32%), and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Conclusion Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents’ various learning preferences and

  8. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

    PubMed Central

    Bellolio, M. Fernanda; Cabrera, Daniel; Sadosty, Annie T.; Hess, Erik P.; Campbell, Ronna L.; Lohse, Christine M.; Sunga, Karmen L.

    2014-01-01

    Introduction Compassion fatigue (CF) is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM) resident physicians, including an assessment of contributing factors. Methods We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress), with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013), or did not work overnight (mean score 23.5 vs 21.3; p=0.022). EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048), and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012). Conclusion CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily night shifts and

  9. 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

  10. 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

  11. 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.

  12. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed Central

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

    1983-01-01

    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

  13. Do emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool?

    PubMed

    Fredette, Jenna; O'Brien, Corinne; Poole, Christy; Nomura, Jason

    2015-04-01

    Experiential learning theory and the Kolb Learning Style Inventory (Kolb LSI) have influenced educators worldwide for decades. Knowledge of learning styles can create efficient learning environments, increase information retention, and improve learner satisfaction. Learning styles have been examined in medicine previously, but not specifically with Emergency Medicine (EM) residents and attendings. Using the Kolb LSI, the learning styles of Emergency Medicine residents and attendings were assessed. The findings showed that the majority of EM residents and attendings shared the accommodating learning style. This result was different than prior studies that found the majority of medical professionals had a converging learning style and other studies that found attendings often have different learning styles than residents. The issue of learning styles among emergency medical residents and attendings is important because learning style knowledge may have an impact on how a residency program structures curriculum and how EM residents are successfully, efficiently, and creatively educated.

  14. The Cost and Burden of the Residency Match in Emergency Medicine

    PubMed Central

    Blackshaw, Aaron M.; Watson, Simon C.; Bush, Jeffrey S.

    2017-01-01

    Introduction To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Methods Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. Results In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The “average applicant” who interviewed at our residency program for the 2015–16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Conclusion Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs. PMID:28116032

  15. 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.

  16. Transforming a family medicine center and residency program into a federally qualified health center.

    PubMed

    Cousineau, Michael R; Flores, Hector; Cheng, Scott; Gates, Jerry D; Douglas, James H; Clute, Gerald B; Coan, Carl E

    2013-05-01

    The authors describe a family medicine center before and after a merger between the Keck School of Medicine of the University of Southern California, the California Hospital Medical Center, and the Eisner Pediatric and Family Medical Center in 2012. The merger provided new opportunities to stabilize the financial base of a clinical practice struggling financially and to enhance the training of residents and other health professionals in primary care, which motivated the partners to consider this new model. After 18 months of negotiations, they were able to convert the family medicine center and residency program into a new federally qualified health center. The benefits to this new model include an increase in both patient volume and the quality of education, supporting residency accreditation; a greater number of residents from U.S. medical schools; enhanced education and preparation of primary care physicians for practice in medically underserved communities; enhanced reimbursements and new opportunities for state, local, and federal grants; and quality improvement and new information technology. The partners overcame academic, administrative, legal, and regulatory obstacles, communication barriers, and differences in culture and expectations to achieve this merger. Keys to their success include the commitment of the leaders at the three institutions to the goals of the merger, a dedicated project manager and consultants, opportunities for new revenue sources and reimbursements, and support from a pioneering charitable foundation. The authors conclude by discussing the implications of using community health centers as the focal point for training primary care clinicians and addressing workforce shortages.

  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. How do Ontario family medicine residents perform on global health competencies? A multi-institutional survey

    PubMed Central

    Veras, Mirella; Pottie, Kevin; Ramsay, Tim; Welch, Vivian; Tugwell, Peter

    2013-01-01

    Background There is an increased interest in global health among medical students, family medicine residents, and medical educators. This paper is based on research to assess confidence in knowledge and skills in global health in family medicine residents in five universities across Ontario. Methods A web-based survey was sent to 166 first-year family medicine residents from five universities within Ontario. Descriptive statistics were used to analyze residents’ confidence in their knowledge and skills in global health. The strength of association between each of the self-perceived knowledge and skills variables was assessed by the Spearman correlation coefficient Results The response rate ranged from 29% to 66% across the five universities. Self-perceived knowledge scores revealed that 34.3% of the respondents were very confident, 51.9% were somewhat confident, and 13.8% were not at all confident about their global health knowledge. Participants’ confidence scores were lower in relation to knowledge of access to health care for low income nations (44.3%), and were better on their global health skills related to working in a team (70.9%) and listening actively to patients’ concerns (64.6%). Conclusions The global health competency scale has identified key areas of strengths and weaknesses of family medicine programs in global health education. This can be used to evaluate and analyze progress over time. PMID:26451209

  19. 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

  20. [Legal implications of information to the patient in nuclear medicine].

    PubMed

    Fernández Sánchez, J

    2004-01-01

    Every patient has the right to be informed about a medical procedure. The nuclear medicine physician has the duty to inform the patients and, if necessary, to obtain a reasonable written consent before some radioisotopic examinations. The following must be considered in every informed consent of a nuclear medicine procedure: the need for the patient information ("why"), the type of information given ("how"), the person who performs it ("who"), the moment in the time ("when") and the place ("where") where the consent is performed. It must always be kept in mind that, although the informed consent has a protection function from the medicolegal point of view, this function may be lost if the consent is not performed correctly. In this paper the importance and the medicolegal implications of the patient information in Nuclear Medicine are evaluated and discussed.

  1. 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.

  2. The power of collaboration: integrating a preventive medicine-public health curriculum into a pediatric residency.

    PubMed

    Varkey, Prathibha; Billings, Marcie L; Matthews, Gretchen A; Voigt, Robert G

    2011-10-01

    This is one of six short papers that describe additional innovations to help integrate public health into medical education; these were featured in the "Patients and Populations: Public Health in Medical Education" conference. They represent relatively new endeavors or curricular components that had not been explored in prior publications. Although evaluation data are lacking, it was considered to be of value to medical educators to share a brief description of the collaboration between the Division of Preventive, Occupational, and Aerospace Medicine and the Department of Pediatrics at Mayo Clinic to integrate a preventive medicine-public health curriculum into the pediatric residency.

  3. Pioneers of nuclear medicine, Madame Curie.

    PubMed

    Grammaticos, Philip C

    2004-01-01

    Among those who have made important discoveries in the field of radioactivity and thus helped in the development of nuclear medicine as an identical entity are: Heinrich Hertz who in 1886 demonstrated the existence of radiowaves. In 1895 Wilhelm Röntgen discovered the X-rays. In 1896 H. Becquerel described the phenomenon of radioactivity. He showed that a radioactive uranium salt was emitting radioactivity which passing through a metal foil darkened a photographic plate. An analogous experiment performed by S.Thomson in London was announced to the president of the Royal Society of London before the time H.Becquerel announced his discovery but Thomson never claimed priority for his discovery. Muarie Sklodowska Curie (1867-1934) was undoubtedly the most important person to attribute to the discovery of radioactivity. In 1898 she discovered radium as a natural radioactive element. This is how she describes the hard time she had, working with her husband Pierre Curie (1859-1906) for the discovery of radium and polonium: "During the first year we did not go to the theater or to a concert or visited friends. I miss my relatives, my father and my daughter that I see every morning and only for a little while. But I do not complain...". In presenting her discovery of radium, Madame Curie said: " ...in the hands of a criminal, radium is very dangerous. So we must often ask ourselves: will humanity earn or lose from this discovery? I, myself belong to those who believe the former...". The notebooks that Madame Curie had when she was working with radium and other radioactive elements like polonium, thorium and uranium are now kept in Paris. They are contaminated with radioactive materials having very long half-lives and for this reason anyone who wishes to have access to these notes should sign that he takes full responsibility. There are some more interesting points in Madame Curie's life which may not be widely known like: Although her full name is Maria Sklodowska

  4. [2015 highlights in hospital-based internal medicine by chief residents].

    PubMed

    Baratali, Laïla; Gachoud, David; Aebischer, Oriane; Bastardot, François; Benmachiche, Malik; Fournier, Judith; Garnier, Antoine; Jaccard, Evrim; Pascual, Marie Mean; Metrailler, Pierre; Pagin, Monica; Voruz, Sophie; Sartori, Claudio

    2016-01-20

    The year 2015 gave us many scientific publications, among whom some will have an impact on our daily practice and some will influence our way of considering some well known diseases. Chief residents in the Service of internal medicine of the Lausanne University hospital, gathered like every year, to share their readings together in order to presentyou a small part of the many publications of 2015, which have been considered to have an impact on our future daily practice.

  5. Characterizing the limited use of point-of-care ultrasound in Colombian emergency medicine residencies

    PubMed Central

    2014-01-01

    Background Emergency medicine (EM) is a growing specialty in Colombia with five residency programs in the country. EM leadership is interested in incorporating point-of-care (POC) ultrasound into a standardized national EM residency curriculum. This study is a nationwide survey of Colombian EM residents designed to explore the current state of POC ultrasound use within EM residencies and examine specific barriers preventing its expansion. Methods We conducted a mix-methodology study of all available current EM residents in the five EM residencies in Colombia. The quantitative survey assessed previous ultrasound experience, current use of various applications, desire for further training, and perceived barriers to expanded use. Focus group discussions (FGDs) were conducted with current EM residents to gather additional qualitative insight into their practice patterns and perceived barriers to clinician-performed ultrasound. Results Sixty-nine EM residents completed the quantitative survey, a response rate of 85% of all current EM residents in Colombia; 52% of resident respondents had previously used ultrasound during their training. Of these, 58% indicated that they had performed <10 scans and 17% reported >40 scans. The most frequently used applications indicated by respondents were trauma, obstetrics, and procedures including vascular access. A quarter indicated they had previously received some ultrasound training, but almost all expressed an interest in learning more. Significant barriers included lack of trained teachers (indicated by 78% of respondents), absence of machines (57%), and limited time (41%). In FGDs, the barriers identified were inter-specialty conflicts over the control of ultrasonography, both institutionally and nationally, and program-specific curriculum decisions to include POC ultrasound. Conclusion While currently limited in their access, EM residents in Colombia have a strong interest in integrating POC ultrasound into their training

  6. 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

  7. 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

  8. Functional Neuroimaging Correlates of Burnout among Internal Medicine Residents and Faculty Members

    PubMed Central

    Durning, Steven J.; Costanzo, Michelle; Artino, Anthony R.; Dyrbye, Liselotte N.; Beckman, Thomas J.; Schuwirth, Lambert; Holmboe, Eric; Roy, Michael J.; Wittich, Christopher M.; Lipner, Rebecca S.; van der Vleuten, Cees

    2013-01-01

    Burnout is prevalent in residency training and practice and is linked to medical error and suboptimal patient care. However, little is known about how burnout affects clinical reasoning, which is essential to safe and effective care. The aim of this study was to examine how burnout modulates brain activity during clinical reasoning in physicians. Using functional Magnetic Resonance Imaging (fMRI), brain activity was assessed in internal medicine residents (n = 10) and board-certified internists (faculty, n = 17) from the Uniformed Services University (USUHS) while they answered and reflected upon United States Medical Licensing Examination and American Board of Internal Medicine multiple-choice questions. Participants also completed a validated two-item burnout scale, which includes an item assessing emotional exhaustion and an item assessing depersonalization. Whole brain covariate analysis was used to examine blood-oxygen-level-dependent (BOLD) signal during answering and reflecting upon clinical problems with respect to burnout scores. Higher depersonalization scores were associated with less BOLD signal in the right dorsolateral prefrontal cortex and middle frontal gyrus during reflecting on clinical problems and less BOLD signal in the bilateral precuneus while answering clinical problems in residents. Higher emotional exhaustion scores were associated with more right posterior cingulate cortex and middle frontal gyrus BOLD signal in residents. Examination of faculty revealed no significant influence of burnout on brain activity. Residents appear to be more susceptible to burnout effects on clinical reasoning, which may indicate that residents may need both cognitive and emotional support to improve quality of life and to optimize performance and learning. These results inform our understanding of mental stress, cognitive control as well as cognitive load theory. PMID:24133462

  9. Can Emergency Medicine Residents Reliably Use the Internet to Answer Clinical Questions?

    PubMed Central

    Krause, Richard; Moscati, Ronald; Halpern, Shravanti; Schwartz, Diane G; Abbas, June

    2011-01-01

    Introduction The study objective was to determine the accuracy of answers to clinical questions by emergency medicine (EM) residents conducting Internet searches by using Google. Emergency physicians commonly turn to outside resources to answer clinical questions that arise in the emergency department (ED). Internet access in the ED has supplanted textbooks for references because it is perceived as being more up to date. Although Google is the most widely used general Internet search engine, it is not medically oriented and merely provides links to other sources. Users must judge the reliability of the information obtained on the links. We frequently observed EM faculty and residents using Google rather than medicine-specific databases to seek answers to clinical questions. Methods Two EM faculties developed a clinically oriented test for residents to take without the use of any outside aid. They were instructed to answer each question only if they were confident enough of their answer to implement it in a patient-care situation. Questions marked as unsure or answered incorrectly were used to construct a second test for each subject. On the second test, they were instructed to use Google as a resource to find links that contained answers. Results Thirty-three residents participated. The means for the initial test were 32% correct, 28% incorrect, and 40% unsure. On the Google test, the mean for correct answers was 59%; 33% of answers were incorrect and 8% were unsure. Conclusion EM residents' ability to answer clinical questions correctly by using Web sites from Google searches was poor. More concerning was that unsure answers decreased, whereas incorrect answers increased. The Internet appears to have given the residents a false sense of security in their answers. Innovations, such as Internet access in the ED, should be studied carefully before being accepted as reliable tools for teaching clinical decision making. PMID:22224135

  10. Small-animal preclinical nuclear medicine instrumentation and methodology.

    PubMed

    Rowland, Douglas J; Cherry, Simon R

    2008-05-01

    Molecular medicine enhances the clinician's ability to accurately diagnose and treat disease, and many technological advances in diverse fields have made the translation of molecular medicine to the clinic possible. Nuclear medicine encompasses 2 technologies--single-photon emission computed tomography (SPECT) and positron emission tomography (PET)--that have driven the field of molecular medicine forward. SPECT and PET, inherently molecular imaging techniques, have been at the forefront of molecular medicine for several decades. These modalities exploit the radioactive decay of nuclides with specific decay properties that make them useful for in vivo imaging. As recently as the mid-1990s, SPECT and PET were mostly restricted to use in the clinical setting because their relatively coarse spatial resolution limited their usefulness in studying animal (especially rodent) models of human disease. About a decade ago, several groups began making significant strides in improving resolution to the point that small-animal SPECT and PET as a molecular imaging technique was useful in the study of rodent disease models. The advances in these 2 techniques progressed as the result of improvements in instrumentation and data reconstruction software. Here, we review the impact of small-animal imaging and, specifically, nuclear medicine imaging techniques on the understanding of the biological basis of disease and the expectation that these advances will be translated to clinical medicine.

  11. Application of nuclear physics in medical physics and nuclear medicine

    NASA Astrophysics Data System (ADS)

    Hoehr, Cornelia

    2016-09-01

    Nuclear physics has a long history of influencing and advancing medical fields. At TRIUMF we use the applications of nuclear physics to diagnose several diseases via medical isotopes and treat cancer by using proton beams. The Life Science division has a long history of producing Positron Emission Tomography (PET) isotopes but we are also investigating the production of SPECT and PET isotopes with a potential shortage for clinical operation or otherwise limited access to chemists, biologists and medical researchers. New targets are being developed, aided by a simulation platform investigating the processes inside a target under proton irradiation - nuclear, thermodynamic, and chemical. Simulations also aid in the development of new beam-shaping devices for TRIUMF's Proton Therapy facility, Canada's only proton therapy facility, as well as new treatment testing systems. Both promise improved treatment delivery for cancer patients.

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

    PubMed

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

    2013-12-03

    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.

  13. 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

  14. Historic images in nuclear medicine: 1976: the first issue of clinical nuclear medicine and the first human FDG study.

    PubMed

    Hess, Søren; Høilund-Carlsen, Poul Flemming; Alavi, Abass

    2014-08-01

    In 1976, 2 major molecular imaging events coincidentally took place: Clinical Nuclear Medicine was first published in June, and in August researchers at the Hospital of the University of Pennsylvania created the first images in humans with F-FDG. FDG was initially developed as part of an evolution set in motion by fundamental research studies with positron-emitting tracers in the 1950s by Michel Ter-Pegossian and coworkers at the Washington University. Today, Clinical Nuclear Medicine is a valued scientific contributor to the molecular imaging community, and FDG PET is considered the backbone of this evolving and exciting discipline.

  15. Trends and different educational pathways for training physicians in nuclear medicine.

    PubMed

    Harolds, Jay A; Smith, Gary T; Baker, Stephen R

    2008-12-01

    The introduction of positron emission tomography/computed tomography (CT), single photon-emission CT/CT, and software packages for multimodality imaging has accelerated the need for nuclear medicine physicians to obtain more training in cross-sectional imaging, especially in CT. In recent years, the Nuclear Regulatory Commission, the Accreditation Council for Graduate Medical Education, the American Board of Radiology, and the American Board of Nuclear Medicine have promulgated new rules and regulations. In addition, the Society of Nuclear Medicine, the American College of Radiology, and the American College of Cardiology Foundation have crafted new guidelines and training requirements. All these changes have consequences for the education of physicians in nuclear medicine. Self-referral and concerns about radiation exposure from nuclear medicine examinations and CT are also affecting the education of physicians practicing nuclear medicine. The authors examine the impact of these developments on training and certification in nuclear medicine and suggest another pathway to train some nuclear medicine physicians.

  16. Australian per caput dose from diagnostic imaging and nuclear medicine.

    PubMed

    Hayton, A; Wallace, A; Marks, P; Edmonds, K; Tingey, D; Johnston, P

    2013-10-01

    The largest man-made contributor to the ionising radiation dose to the Australian population is from diagnostic imaging and nuclear medicine. The last estimation of this dose was made in 2004 (1.3 mSv), this paper describes a recent re-evaluation of this dose to reflect the changes in imaging trends and technology. The estimation was calculated by summing the dose from five modalities, computed tomography (CT), general radiography/fluoroscopy, interventional procedures, mammography and nuclear medicine. Estimates were made using Australian frequency data and dose data from a range of Australian and international sources of average effective dose values. The ionising radiation dose to the Australian population in 2010 from diagnostic imaging and nuclear medicine is estimated to be 1.7 mSv (1.11 mSv CT, 0.30 mSv general radiography/fluoroscopy, 0.17 mSv interventional procedures, 0.03 mSv mammography and 0.10 mSv nuclear medicine). This exceeds the estimate of 1.5 mSv per person from natural background and cosmic radiation.

  17. Is there a place for music in nuclear medicine?

    PubMed

    Giannouli, Vaitsa; Lytras, Nikolaos; Syrmos, Nikolaos

    2012-01-01

    Music, since the time of ancient Greek Asclepieia is well-known for its influence on men's behavior. Nuclear Medicine can study the effect of music in humans' brain. Positron emission tomography (PET) studies have shown brain areas to be activated after colored hearing vs after hearing to words. Furthermore, PET studies gave evidence that visual imagery of a musical stave is used by some musically untrained subjects in a pitch discrimination task. Listening to music combines intellect and emotion by intimate anatomical and functional connexions between temporal lobe, hippocampus and limbic system. Mozart's music is considered the best for bringing favorable music effects to men. This is called "the Mozart's effect" and by some is attributed to the fact that this kind of music's sequences tend to repeat regularly every 20-30sec, which is about the same length of time as brain-wave patterns. It may be useful to suggest that a certain kind of music played in the waiting room and/or in the examining room of a Nuclear Medicine Department may support patients ' cooperation with their physicians, especially in cardiac nuclear medicine. Furthermore, patients should be calm and not afraid of radioactivity. A long DVD program to be played during working hours can be decided between a music therapist and the Nuclear Medicine physician.

  18. Nuclear Medicine | RadTown USA | US EPA

    EPA Pesticide Factsheets

    2016-10-12

    >Nuclear medicine procedures can help detect and treat disease by using a small amount of radioactive material, called a radiopharmaceutical. Some radiopharmaceuticals are used with imaging equipment to detect diseases. Others are placed in or near a cancerous tumor to shrink or kill it.

  19. Nuclear Medicine Technology: A Suggested Two-Year Curriculum Manual.

    ERIC Educational Resources Information Center

    Hunter, David

    This curriculum guide prescribes an educational program for training nuclear medicine technologists. Following a brief section on program development, the curriculum is both outlined and presented in detail. For each of the 44 courses, the following information is given: (1) sequential placement of the course in the curriculum; (2) course…

  20. Basic principles in the radiation dosimetry of nuclear medicine.

    PubMed

    Stabin, Michael; Xu, Xie George

    2014-05-01

    The basic principles of the use of radiation dosimetry in nuclear medicine are reviewed. The basic structure of the main mathematical equations are given and formal dosimetry systems are discussed. An extensive overview of the history and current status of anthropomorphic models (phantoms) is given. The sources and magnitudes of uncertainties in calculated internal dose estimates are reviewed.

  1. A Questionnaire-Based Survey of Physical Medicine and Rehabilitation Residency Training in Pakistan

    PubMed Central

    Butt, Aamir W; Soomro, Nabila; Akhtar, Noreen

    2017-01-01

    Pakistan is one of the three countries in South East Asia that has an active postgraduate physical medicine and rehabilitation (PM&R) training program. College of Physicians and Surgeons Pakistan (CPSP) offers a four-year structured training program in PM&R. It consists of clinical teaching, lectures, rotations in other specialties, and writing a research dissertation. The aim of this survey was to provide an objective analysis of the current PM&R training program, including the facilities available for training, the participation of residents in academic activities, and their participation in different PM&R procedures. Hospital ethics committee approval was obtained. The questionnaire had sections on informed consent; basic demographics; the different components of residency training; and self-assessement of competence in different procedural skills. It was approved by the dean of PM&R at CPSP. There are six accredited training centers in Pakistan. Twelve residents are undergoing residency training at four different centers (Dec 2015). Key persons were nominated at each center to facilitate data collection. All residents (100% response rate) completed the survey. Almost all had read the CPSP training manual. Most had submitted the research dissertation. Training facilities varied across different centers, with the military center being the best equipped. The self-assessed competence of residents in different PM&R procedures varied among different centers, but overall it conformed to the competency levels specified in the training manual. Overall PM&R residency training in Pakistan is satisfactory, but there is a need to strengthen the weak areas and standardize the training across all centers in the country. PMID:28286724

  2. A Questionnaire-Based Survey of Physical Medicine and Rehabilitation Residency Training in Pakistan.

    PubMed

    Rathore, Farooq A; Butt, Aamir W; Soomro, Nabila; Akhtar, Noreen

    2017-01-31

    Pakistan is one of the three countries in South East Asia that has an active postgraduate physical medicine and rehabilitation (PM&R) training program. College of Physicians and Surgeons Pakistan (CPSP) offers a four-year structured training program in PM&R. It consists of clinical teaching, lectures, rotations in other specialties, and writing a research dissertation. The aim of this survey was to provide an objective analysis of the current PM&R training program, including the facilities available for training, the participation of residents in academic activities, and their participation in different PM&R procedures. Hospital ethics committee approval was obtained. The questionnaire had sections on informed consent; basic demographics; the different components of residency training; and self-assessement of competence in different procedural skills. It was approved by the dean of PM&R at CPSP. There are six accredited training centers in Pakistan. Twelve residents are undergoing residency training at four different centers (Dec 2015). Key persons were nominated at each center to facilitate data collection. All residents (100% response rate) completed the survey. Almost all had read the CPSP training manual. Most had submitted the research dissertation. Training facilities varied across different centers, with the military center being the best equipped. The self-assessed competence of residents in different PM&R procedures varied among different centers, but overall it conformed to the competency levels specified in the training manual. Overall PM&R residency training in Pakistan is satisfactory, but there is a need to strengthen the weak areas and standardize the training across all centers in the country.

  3. 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.

  4. 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.

  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.

  6. 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

  7. 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.

  8. Meeting the Challenge of Practice Quality Improvement: A Study of Seven Family Medicine Residency Training Practices

    PubMed Central

    Chase, Sabrina M.; Miller, William L.; Shaw, Eric; Looney, Anna; Crabtree, Benjamin F.

    2011-01-01

    Purpose Incorporating quality improvement (QI) into resident education and clinical care is challenging. This report explores key characteristics shaping the relative success or failure of QI efforts in seven primary care practices serving as family medicine residency training sites. Method The authors used data from the 2002–2008 Using Learning Teams for Reflective Adaptation (ULTRA) study to conduct a comparative case analysis. This secondary data analysis focused on seven residency training practices' experiences with RAP (reflective adaptive process), a 12-week intensive QI process. Field notes, meeting notes, and audiotapes of RAP meetings were used to construct case summaries. A matrix comparing key themes across practices was used to rate practices' QI progress during RAP on a scale of 0 to 3. Results Three practices emerged as unsuccessful (scores of 0–1) and four as successful (scores of 2–3). Larger practices with previous QI experience, faculty with extensive exposure to QI literature, and an office manager, residency director, or medical director who advocated for the process made substantial progress during RAP, succeeding at QI. Smaller practices without these characteristics were unable to do so. Successful practices also engaged residents in the QI process and identified serious problems as potential crises; unsuccessful practices did not. Conclusions Larger residency training practices are more likely to have the resources and characteristics that permit them to create a QI-supportive culture leading to QI success. The authors suggest, however, that smaller practices may increase their chances of success by adopting a developmental approach to QI. PMID:22030767

  9. 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

  10. Discharges of nuclear medicine radioisotopes in Spanish hospitals.

    PubMed

    Krawczyk, E; Piñero-García, F; Ferro-García, M A

    2013-02-01

    Given the increasing use of radiopharmaceuticals in medicine, the aim of this paper is to determine radioactivity levels in the effluents of hospitals with Nuclear Medicine Departments. The radiological study of hospital discharges was carried out by gamma spectrometry, and liquid scintillation spectrometry to determine (14)C and (3)H contents. On March 9th and April 19th, 2010, daily radioactivity levels were monitored from 8:30 a.m. to 7:30 p.m. Each sample was collected at a specific control point of two major public hospitals in Granada (Spain). The analytical results show the presence of radionuclides such as (99m)Tc, (131)I, (67)Ga, and (111)In.They are frequently used in nuclear medicine for diagnostic and/or therapeutic purposes. This study shows the differences between direct and after-storage discharges and also justifies the need of storage tanks in hospitals with nuclear medicine departments. Moreover, monitoring of (99m)Tc released at hospital control points can be a useful tool for optimizing the safety conditions of storage tanks and discharge of radionuclides.

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

    PubMed

    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.

  12. Do Internal Medicine Residents Know Enough About Skilled Nursing Facilities To Orchestrate a Good Care Transition?

    PubMed Central

    Ward, Katherine T.; Eslami, Michelle S.; Garcia, Maristela B.; McCreath, Heather E.

    2015-01-01

    BACKGROUND Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether Internal Medicine (IM) residents have sufficient knowledge of the care that can be provided at this site. METHODS We developed a 10-item multiple choice pre-test that assessed knowledge of the definition of a SNF, SNF staffing requirements, and SNF services provided on-site. The test was administered to trainees on the first day of a mandatory SNF rotation that occurred during their first, second or third year of training. RESULTS 67 IM residents (41 PGY-1, 11 PGY-2, and 15 PGY-3) were assessed with the test. The mean number of questions answered correctly was 4.9, with a standard deviation of 1.6. Regardless of their level of training, residents had a poor baseline knowledge of SNF care (mean scores 4.2 for PGY-1, 5.3 for PGY-2, and 6.3 for PGY-3 (p<0.0001). Performance on some questions improved with increased level of training but others did not. CONCLUSIONS Medical residents have insufficient knowledge about the type of care that can be provided at a SNF and efforts to improve this knowledge are needed to assure proper triage of patients and safe transitions to the SNF. PMID:25282630

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. Understanding appropriate use criteria in nuclear medicine.

    PubMed

    Farrell, Mary Beth; Cerqueira, Manuel D

    2012-06-01

    There has been a significant increase in cardiac radionuclide imaging over the past decade, leading to a corresponding increase in scrutiny from Federal and private health plans questioning the necessity of these tests. In response to efforts by third-party payers to limit all types of cardiovascular imaging studies, the American College of Cardiology Foundation, in conjunction with other professional societies, developed appropriate use criteria. The goal of this article is to explain how the criteria were created and define the 3 categories of indications: appropriate, inappropriate, and uncertain. Tips for using appropriate use criteria and tables, including a definition of several key terms technologists should be familiar with, will be provided. In addition, reimbursement, benchmark data, and practical considerations for implementation will be discussed. Finally, several tools to aid in calculating appropriateness are suggested. With a basic understanding, the appropriate use criteria are relatively easy to apply. It is important for facilities to begin to voluntarily incorporate them into their practice and document levels of appropriateness now as payers are developing 2 trends that are not favorable for nuclear cardiology: preauthorization and denial of payment for inappropriate studies.

  19. Nuclear medicine in clinical neurology: an update

    SciTech Connect

    Oldendorf, W.H.

    1981-01-01

    Isotope scanning using technetium 99m pertechnetate has fallen into disuse since the advent of x-ray computerized tomography. Regional brain blood flow studies have been pursued on a research basis. Increased regional blood flow during focal seizure activity has been demonstrated and is of use in localizing such foci. Cisternography as a predictive tool in normal pressure hydrocephalus is falling into disuse. Positron tomographic scanning is a potent research tool that can demonstrate both regional glycolysis and blood flow. Unfortunately, it is extremely expensive and complex to apply in a clinical setting. With support from the National Institutes of Health, seven extramural centers have been funded to develop positron tomographic capabilities, and they will greatly advance our knowledge of stroke pathophysiology, seizure disorders, brain tumors, and various degenerative diseases. Nuclear magnetic resonance imaging is a potentially valuable tool since it creates tomographic images representing the distribution of brain water. No tissue ionization is produced, and images comparable to second-generation computerized tomographic scans are already being produced in humans.

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

    PubMed Central

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

    2015-01-01

    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

  1. Multi-source evaluation of interpersonal and communication skills of family medicine residents.

    PubMed

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

    2012-12-01

    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 teaching staffs and to compare the ratings with the objective structured clinical examination (OSCE). Our results revealed instruments used by staffs, peers, nurses, and self-evaluation have good internal consistency reliability (α > 0.90), except for the behavioral checklist (α = 0.57). Staffs', peers', and nurses' evaluations were highly correlated with one another (r = 0.722 for staff- and peer-rating, r = 0.734 for staff- and nurse-rating, r = 0.634 for peer- and nurse-rating). However, residents' self-rating and patients-rating were not correlated to ratings by any other raters. OSCE evaluation was correlated to peer-rating (r = 0.533) and staff-rating (r = 0.642), but not correlated to self- or patient-rating. The generalizability study revealed the major sources of variance came from the types of rater and the interaction of residents and types of rater. This study found self-rating and patient-rating were not consistent with other sources of rating on residents' interpersonal and communication skills. Whether variations among different types of rater in a multi-source evaluation should be regarded as measurement errors or complementary information is worth further study.

  2. A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents.

    PubMed

    Pugh, Debra; Hamstra, Stanley J; Wood, Timothy J; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

    2015-03-01

    Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.

  3. Compartmental analysis of dynamic nuclear medicine data: models and identifiability

    NASA Astrophysics Data System (ADS)

    Delbary, Fabrice; Garbarino, Sara; Vivaldi, Valentina

    2016-12-01

    Compartmental models based on tracer mass balance are extensively used in clinical and pre-clinical nuclear medicine in order to obtain quantitative information on tracer metabolism in the biological tissue. This paper is the first of a series of two that deal with the problem of tracer coefficient estimation via compartmental modelling in an inverse problem framework. Specifically, here we discuss the identifiability problem for a general n-dimension compartmental system and provide uniqueness results in the case of two-compartment and three-compartment compartmental models. The second paper will utilize this framework in order to show how nonlinear regularization schemes can be applied to obtain numerical estimates of the tracer coefficients in the case of nuclear medicine data corresponding to brain, liver and kidney physiology.

  4. 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

  5. Pediatric Nuclear Medicine and its Development as a Specialty.

    PubMed

    Bielsa, Isabel Roca

    2017-03-01

    Pediatric Nuclear Medicine (PNM) offers to the pediatrician noninvasive procedures, with high clinical impact and low dosimetry. New techniques have been adapted to children, diminishing doses, always looking for less dosimetry, higher sensitivity and higher resolution images. PNM is and will remain a minority subspecialty, but highly complex for general NM physicians due to the different diagnostics in children and due to the higher technical complexity of the examinations. General NM physicians have to be trained and regularly receive CME in this field.

  6. 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.

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

    SciTech Connect

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

    2012-10-23

    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.

  8. The role of nuclear medicine in modern therapy of cancer.

    PubMed

    Kramer-Marek, Gabriela; Capala, Jacek

    2012-06-01

    Nuclear medicine is a multidisciplinary field that develops and uses instrumentation and tracers (radiopharmaceuticals) to study physiological processes and noninvasively diagnose, stage, and treat diseases. Particularly, it offers a unique means to study cancer biology in vivo and to optimize cancer therapy for individual patients. A tracer is either a radionuclide alone, such as iodine-131 or a radiolabel in a carrier molecule such as (18)F in fluorodeoxyglucose ((18)F-FDG), or other feasible radionuclide attached to a drug, a protein, or a peptide, which when introduced into the body, would accumulate in the tissue of interest. Nuclear medicine imaging, including single-photon emission computer tomography and positron emission tomography, can provide important quantitative and functional information about normal tissues or disease conditions, in contrast to conventional, anatomical imaging techniques such as ultrasound, computed tomography, or magnetic resonance imaging. For treatment, tumor-targeting agents, conjugated with therapeutic radionuclides, may be used to deposit lethal radiation at tumor sites. This review outlines the role of nuclear medicine in modern cancer therapy.

  9. 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.

  10. 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

  11. Integration of genomic medicine into pathology residency training: the stanford open curriculum.

    PubMed

    Schrijver, Iris; Natkunam, Yasodha; Galli, Stephen; Boyd, Scott D

    2013-03-01

    Next-generation sequencing methods provide an opportunity for molecular pathology laboratories to perform genomic testing that is far more comprehensive than single-gene analyses. Genome-based test results are expected to develop into an integral component of diagnostic clinical medicine and to provide the basis for individually tailored health care. To achieve these goals, rigorous interpretation of high-quality data must be informed by the medical history and the phenotype of the patient. The discipline of pathology is well positioned to implement genome-based testing and to interpret its results, but new knowledge and skills must be included in the training of pathologists to develop expertise in this area. Pathology residents should be trained in emerging technologies to integrate genomic test results appropriately with more traditional testing, to accelerate clinical studies using genomic data, and to help develop appropriate standards of data quality and evidence-based interpretation of these test results. We have created a genomic pathology curriculum as a first step in helping pathology residents build a foundation for the understanding of genomic medicine and its implications for clinical practice. This curriculum is freely accessible online.

  12. Mastery Learning of Advanced Cardiac Life Support Skills by Internal Medicine Residents Using Simulation Technology and Deliberate Practice

    PubMed Central

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

    2006-01-01

    BACKGROUND Internal medicine residents must be competent in advanced cardiac life support (ACLS) for board certification. OBJECTIVE To use a medical simulator to assess postgraduate year 2 (PGY-2) residents' baseline proficiency in ACLS scenarios and evaluate the impact of an educational intervention grounded in deliberate practice on skill development to mastery standards. DESIGN Pretest-posttest design without control group. After baseline evaluation, residents received 4, 2-hour ACLS education sessions using a medical simulator. Residents were then retested. Residents who did not achieve a research-derived minimum passing score (MPS) on each ACLS problem had more deliberate practice and were retested until the MPS was reached. PARTICIPANTS Forty-one PGY-2 internal medicine residents in a university-affiliated program. MEASUREMENTS Observational checklists based on American Heart Association (AHA) guidelines with interrater and internal consistency reliability estimates; deliberate practice time needed for residents to achieve minimum competency standards; demographics; United States Medical Licensing Examination Step 1 and Step 2 scores; and resident ratings of program quality and utility. RESULTS Performance improved significantly after simulator training. All residents met or exceeded the mastery competency standard. The amount of practice time needed to reach the MPS was a powerful (negative) predictor of posttest performance. The education program was rated highly. CONCLUSIONS A curriculum featuring deliberate practice dramatically increased the skills of residents in ACLS scenarios. Residents needed different amounts of training time to achieve minimum competency standards. Residents enjoy training, evaluation, and feedback in a simulated clinical environment. This mastery learning program and other competency-based efforts illustrate outcome-based medical education that is now prominent in accreditation reform of residency education. PMID:16637824

  13. Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine Residents

    PubMed Central

    MacNamara, Marina; Wilhelm, April; Dy, Geolani; Andiman, Sarah; Landau, Carol; Poshkus, Michael; Feller, Edward

    2014-01-01

    Background Residents report they lack preparation for caring for an increasingly diverse US population. In response, a variety of curricula have been developed to integrate cultural competency into medical training programs. To date, none of these curricula has specifically addressed members of recently resettled populations. Methods A preliminary assessment was conducted among internal medicine (IM) residents at 1 program (N  =  147). Based on 2 conceptual frameworks and the survey results, a pilot curriculum was developed and integrated into the interns' ambulatory block education within the general IM track (n  =  9). It included (1) online information made available to all hospital staff; (2) 4 interactive didactic sessions; and (3) increased exposure to newly arrived patients. The curriculum was qualitatively evaluated through 2 focus groups. Results The preliminary assessment was completed by 101 of 147 residents (69%), with 61% of respondents indicating they felt that they received less than adequate education in this area. Eight of the 9 interns exposed to the new curriculum participated in the focus groups. Overall, respondents reported they thought patient care had improved for recently resettled populations and across their patient panels after exposure to the curriculum. Conclusions This study demonstrated that an intervention that included didactics and enhanced exposure to a diverse population improved IM interns' perceptions of care for all patients, including recently settled individuals. PMID:24949138

  14. Racing Against the Clock: Internal Medicine Residents' Time Spent On Electronic Health Records

    PubMed Central

    Chen, Lu; Guo, Uta; Illipparambil, Lijo C.; Netherton, Matt D.; Sheshadri, Bhairavi; Karu, Eric; Peterson, Stephen J.; Mehta, Parag H.

    2016-01-01

    Background Since the late 1980s, resident physicians have spent increasing amounts of time on electronic health record (EHR) data entry and retrieval. Objective longitudinal data measuring time spent on the EHR are lacking. Objective We sought to quantify the time actually spent using the EHR by all first-year internal medicine residents in a single program (N = 41). Methods Active EHR usage data were collected from the audit logs for May, July, and October 2014 and January 2015. Per recommendations from our EHR vendor (Cerner Corporation), active EHR usage time was defined as more than 15 keystrokes, or 3 mouse clicks, or 1700 “mouse miles” per minute. Active EHR usage time was tallied for each patient chart viewed each day and termed an electronic patient record encounter (EPRE). Results In 4 months, 41 interns accumulated 18 322 hours of active EHR usage in more than 33 733 EPREs. Each intern spent on average 112 hours per month on 206 EPREs. Interns spent more time in July compared to January (41 minutes versus 30 minutes per EPRE, P < .001). Time spent on the EHR in January echoed that of the previous May (30 minutes versus 29 minutes, P = .40). Conclusions First-year residents spent a significant amount of time actively using the EHR, achieving maximal proficiency on or before January of the academic year. Decreased time spent on the EHR may reflect greater familiarity with the EHR, growing EHR efficiencies, or other factors. PMID:26913101

  15. Interprofessional Collaboration on an Internal Medicine Ward: Role Perceptions and Expectations among Nurses and Residents

    PubMed Central

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

    2013-01-01

    Background Effective interprofessional collaboration requires that team members share common perceptions and expectations of each other's roles. Objective Describe and compare residents’ and nurses’ perceptions and expectations of their own and each other’s professional roles in the context of an Internal Medicine ward. Methods A convenience sample of 14 residents and 14 nurses volunteers from the General Internal Medicine Division at the University Hospitals of Geneva, Switzerland, were interviewed to explore their perceptions and expectations of residents’ and nurses’ professional roles, for their own and the other profession. Interviews were analysed using thematic content analysis. The same respondents also filled a questionnaire asking their own intended actions and the expected actions from the other professional in response to 11 clinical scenarios. Results Three main themes emerged from the interviews: patient management, clinical reasoning and decision-making processes, and roles in the team. Nurses and residents shared general perceptions about patient management. However, there was a lack of shared perceptions and expectations regarding nurses’ autonomy in patient management, nurses’ participation in the decision-making process, professional interdependence, and residents’ implication in teamwork. Results from the clinical scenarios showed that nurses’ intended actions differed from residents’ expectations mainly regarding autonomy in patient management. Correlation between residents’ expectations and nurses’ intended actions was 0.56 (p = 0.08), while correlation between nurses’ expectations and residents’ intended actions was 0.80 (p<0.001). Conclusions There are discordant perceptions and unmet expectations among nurses and residents about each other’s roles, including several aspects related to the decision-making process. Interprofessional education should foster a shared vision of each other’s roles and clarify

  16. A multicenter study of internal medicine residents' perceptions of training, competence, and performance in outpatient HIV care.

    PubMed

    Phillips, Karran A; Cofrancesco, Joseph; Sisson, Stephen; Wu, Albert W; Bass, Eric B; Berkenblit, Gail

    2010-03-01

    Routine HIV screening is recommended by the Centers for Disease Control and Prevention (CDC), but it is unknown how well internal medicine residents are trained in HIV risk assessment, testing, counseling, and initial management of HIV patients. We sought to determine internal medicine residents' attitudes about HIV training and the factors that influence their HIV care performance utilizing a cross-sectional survey of 321 second- and third-year internal medicine residents from four programs in Baltimore, Boston, Detroit, and New York City between March and June 2006. Measurements included HIV care experience; attitudes, competency, and adequacy of HIV training; and basic HIV care performance and factors impacting performance. Two hundred twenty-three residents (69%) completed the survey. While 50% of residents reported over 30 HIV inpatient encounters in the past year, the majority of residents had limited outpatient exposure providing care for only 1-5 HIV outpatients. Managing HIV patients was rated an excellent educational opportunity by 89% of residents and 77% planned to care for HIV patients in the future. However, 39% stated that they did not feel competent to provide HIV outpatient care. Higher rates of residents reported deficiency in outpatient HIV training compared to outpatient non-HIV training (p < 0.05) or inpatient HIV training (p < 0.05). Residents reported substandard HIV risk assessment, testing, counseling, and initial management performance. Self-reported proficiency correlated with the number of HIV outpatients cared for and perceived training adequacy. Current residency training in HIV care remains largely inpatient-based and residents frequently rate HIV outpatient training as inadequate.

  17. Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.

    PubMed

    Hoonpongsimanont, Wirachin; Kulkarni, Miriam; Tomas-Domingo, Pedro; Anderson, Craig; McCormack, Denise; Tu, Khoa; Chakravarthy, Bharath; Lotfipour, Shahram

    2016-01-01

    We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required.

  18. Determination of clinically relevant content for a musculoskeletal anatomy curriculum for physical medicine and rehabilitation residents.

    PubMed

    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 method to identify clinically relevant content to incorporate in a musculoskeletal anatomy curriculum for Physical Medicine and Rehabilitation (PM&R) residents. A two round modified Delphi involving PM&R experts was used to establish the curricular content. The anatomical structures and clinical conditions presented to the expert group were compiled using multiple sources: clinical musculoskeletal anatomy cases from the PM&R residency program at the University of Toronto; consultation with PM&R experts; and textbooks. In each round, experts rated the importance of each curricular item to PM&R residency education using a five-point Likert scale. Internal consistency (Cronbach's alpha) was used to determine consensus at the end of each round and agreement scores were used as an outcome measure to determine the content to include in the curriculum. The overall internal consistency in both rounds was 0.99. A total of 37 physiatrists from across Canada participated and the overall response rate over two rounds was 97%. The initial curricular list consisted of 361 items. After the second iteration, the list was reduced by 44%. By using a national consensus method we were able to objectively determine the relevant anatomical structures and clinical musculoskeletal conditions important in daily PM&R practice.

  19. From hagfish to humans: teaching comparative physiology to internal medicine residents.

    PubMed

    Herzig, Shoshana J; Aird, William C; Shah, Brijen J; McKernan, Michael; Zeidel, Mark L

    2012-03-01

    With more clinical information for trainees to master in the face of increasing time pressures, discussions about underlying physiology and the mechanisms of disease seem to have been de-emphasized during residency training. This reduced focus on pathophysiology and basic science may weaken trainees' clinical effectiveness and reduce their interest in pursuing research careers.In response, the authors helped to develop in 2006 a one-week immersive comparative physiology course for second- and third-year internal medicine residents at Beth Israel Deaconess Medical Center. The course, held at the Mount Desert Island Biological Laboratory, includes four modules (hematology, vascular physiology, secretory physiology, and salt and water homeostasis), each composed of basic science experiments using aquatic species and accompanied by clinical correlation discussions and group presentations.From 2007 to 2010, 72 residents rotated through the course. Most reported that it enhanced their understanding of the mechanisms of disease in their patients. After the course, residents reported that physiology played a more prominent role in their teaching and clinical decision making during both ward and intensive care unit rotations. They also reported being more likely than before the course to read about the pathophysiology of disease when faced with a clinical problem.Although cost-intensive and geographically unique, this model for teaching the mechanisms of disease could be applied elsewhere with the help of physician-scientists and clinician-educators. In this article, the authors describe the development of the course, share preliminary data evaluating progress toward its goals, and discuss future directions and lessons learned.

  20. 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

  1. Establishment of Korean Nuclear Ombudsman System Importing Compensation and Insurance Concept for Residents

    SciTech Connect

    Hyun Seok Ko; Yong Min Kim; Young Wook Lee; Dong Hoon Shin; Young Ho Cho; Chang Sun Kang

    2006-07-01

    In Korea, the nuclear power generation is grown technically well. Already, 20 nuclear reactors are operated, and approximate they supply the 40% of whole the consumption of electric power. This is the driving force of Korean industrial development. Besides, Korean Standard Nuclear Power Plant that was developed by Korean self-technique with nuclear plant technique independence, Ul-Chin 6 has started the commercial operation. Advanced Korean Standard Nuclear Power Plant, new Gori 1, 2 constructions are commenced. But, past days Korean situation is that intention of residents is neglected in the decision making process of nuclear power plant construction and operation. In existing decision making process, it is regarded as the role of public opinion is secondary, and the problem of decision making process is that public is persuaded and believed. So, in decision making process, the public opinion is considered restrictively, there is not the actual public participation. Therefore the dissatisfaction of public is increased continuously, and in Korea, bad recognition about nuclear power is getting full. The method of public participation for complement of this problem is public hearing or ombudsman system. The public hearing is ensuring public participation before decision of a case, and ombudsman is the system that elevates the public satisfaction through continuous feedback of public requirement to occur in deciding and performing the matters. In Korean situation, that present 20 nuclear reactors are operated and also the place of radioactive waste repository has been decided, not only the introduction of public hearing to decide the coming matter but also the operation of ombudsman system to continuously correct and collect the public requirements about the matter to already decided and operated is necessary. In Korea, administration type ombudsman is operated now. But, it has operated without basic element at the aspect of organization, function and phase. So it is

  2. Association between periodontal diseases and systemic illnesses: A survey among internal medicine residents in Nigeria

    PubMed Central

    Umeizudike, Kehinde A.; Iwuala, Sandra O.; Ozoh, Obianuju B.; Ayanbadejo, Patricia O.; Fasanmade, Olufemi A.

    2015-01-01

    Objective To assess internal medicine residents’ knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients’ periodontal health. Methods A cross-sectional survey using a self-administered questionnaire was conducted among internal medicine residents attending the Faculty of Internal Medicine 2014 Update Course organized by the National Postgraduate Medical College of Nigeria. Participants came from all over the country. Data on respondents’ demographic characteristics, periodontal disease knowledge, knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients’ periodontal health were collected. Data were analyzed using Epi INFO software. The Pearson chi square test was used to measure significant association between categorical variables such as the knowledge of periodontal disease and gender, age group and designation of the participants (p ⩽ 0.05). Results Of 150 questionnaires distributed, 123 were returned (82% response rate); 109 questionnaires were completed properly and included in the analysis. The most common source of residents’ information on oral health was television (59.4%). Only 11.2% of respondents were aware that gingival bleeding was the earliest sign of periodontal disease. Respondents correctly identified periodontal disease as a risk factor for coronary heart disease (45.9%), stroke (43.5%), hospital-acquired pneumonia (53.2%), diabetes mellitus (13.8%), and preterm birth (11%). Increased age (p = 0.032) and male gender (p = 0.022) were associated significantly with knowledge of periodontal disease as a risk factor for stroke. Higher designation (p = 0.002) and longer duration in residency training (p = 0.004) were associated significantly with knowledge of periodontal disease as risk factor for peripheral arterial disease. The majority (90.9%) of respondents had positive attitudes toward the referral of their patients for

  3. A blueprint for implementation of a structured portfolio in an internal medicine residency.

    PubMed

    Donato, Anthony A; George, David L

    2012-02-01

    The Accreditation Council for Graduate Medical Education recommends the structured portfolio as a preferred assessment tool for assessing all six of its core physician competencies. However, compared with other evaluation measures, it may be one of the most resource-intensive for learners and evaluators. Given the time and effort needed to properly develop mentors, train evaluators, and persuade learners, facilitation of the learning environment supporting a portfolio may be the most important variable determining its success or failure. The authors review the components necessary to successfully build and maintain a robust portfolio learning environment in a graduate medical education setting. These include gaining staff acceptance, staging implementation, enhancing learner participation, training mentors, choosing paper versus electronic formats, and selecting assessment methods. Their blueprint for implementing a portfolio is informed by their five-year experience with a portfolio rollout in one internal medicine residency, from 2006 to 2011.

  4. Interprofessional education: a nurse practitioner impacts family medicine residents' smoking cessation counselling experiences.

    PubMed

    Mitchell, Joan; Brown, Judith Belle; Smith, Carrie

    2009-07-01

    This qualitative research paper describes a successful example of interprofessional education with family medicine residents (FMR) by a nurse practitioner (NP) colleague. The educational impact of the NP role in regard to smoking cessation counselling is revealed by the analysis of 16 semi-structured interviews using a phenomenological approach. The key themes depicted the NP as an educator and mentor, encourager and referral resource. Outcomes of improved knowledge, skills, and motivation towards providing smoking cessation counselling are described. This research provides some understanding of how professional students' learning and practice can be affected by a member of another profession through direct and indirect approaches. The experiences identified how interprofessional education and collaborative clinical practice can affect FMRs' attitudes, knowledge and behaviours. This learning can guide us in enhancing the quality of education provided to all health care professionals.

  5. 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

  6. 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

  7. Faith-based partnerships in graduate medical education: the experience of the Morehouse School of Medicine Public Health/Preventive Medicine Residency Program.

    PubMed

    Taylor, Beverly D; Buckner, Ayanna V; Walker, Carla Durham; Blumenthal, Daniel S

    2011-10-01

    Faith-based organizations can be strategic partners in addressing the needs of low-income and underserved individuals and communities. The Morehouse School of Medicine (MSM) Public Health/Preventive Medicine Residency Program (PH/PMR) collaborates with faith-based organizations for the purpose of resident education, community engagement, and service. These partners provide guidance for the program's community initiatives and health promotion activities designed to address health inequities. Residents complete a longitudinal community practicum experience with a faith-based organization over the 2-year training period. Residents conduct a community health needs assessment at the organization and design a health intervention that addresses the identified needs. The faith-based community practicum also serves as a vehicle for achieving skills in all eight domains of the Public Health Competencies developed by the Council on Linkages and all six Accreditation Council for Graduate Medical Education (ACGME) Core Competencies. The MSM PH/PMR Program has engaged in faith-based partnerships for 7 years. This article discusses the structure of these partnerships, how partners are identified, funding sources for supporting resident projects, and examples of resident health needs assessment and intervention activities. The MSM PH/PMR Program may serve as a model to other residency and fellowship programs that may have an interest in developing partnerships with faith-based organizations.

  8. 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.

  9. 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

  10. 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.

  11. 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

  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.

  13. Evolving Important Role of Lutetium-177 for Therapeutic Nuclear Medicine.

    PubMed

    Pillai, Ambikalmajan M R; Knapp, Furn F Russ

    2015-01-01

    Lutetium-177 ((177)Lu) is a late entrant into the nuclear medicine therapy arena but is expected to become one of the most widely used therapeutic radionuclides. This paper analyses the reason for the increasing preference of (177)Lu as a therapeutic radionuclide. While the radionuclidic properties favor its use for several therapeutic applications, the potential for large scale production of (177)Lu is also an important aspect for its acceptability as a therapeutic radionuclide. This introductory discussion also summarizes some developing clinical uses and suggested future directions for applications of (177)Lu.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

    PubMed

    Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

    2014-01-01

    Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

  20. How confident are internal medicine residents in rheumatology versus other common internal medicine clinical skills: an issue of training time or exposure?

    PubMed

    Katz, Steven J; Oswald, Anna E

    2011-08-01

    The objective of this study was to determine self-confidence of internal medicine (IM) residents regarding rheumatology clinical skills and factors that may affect their confidence. Permission was sought to e-mail a web-based survey to IM residents at all 13 English language Canadian internal medicine programs. Residents were asked to rank self-confidence in rheumatology, cardiology, respirology, and gastroenterology skills. Further questions included site and year of training, career interests, rheumatology experiences, learning opportunities, and assessment frequency. These factors were analyzed by univariate and multivariate analyses. Two hundred sixteen residents (21.8%) from all 13 sites responded to the survey. Resident self-confidence in rheumatology diagnoses was 5.24/10, lower than all three comparator subspecialties. Increasing teaching exposure had a more significant impact on confidence in rheumatology than on comparator subspecialties. Increasing year of training had no association with higher self-confidence for rheumatology, in contrast to the increase in confidence seen with increased year of training for each comparator subspecialty. Further analysis demonstrated that the completion of a rheumatology rotation, increasing learning opportunities, annual assessment, and career interest were associated with greater resident self-confidence. Resident self-confidence for rheumatology skills is cautious at best and is lower than other common subspecialties. Self confidence improves with targeted rheumatology clinical experience and teaching, but does not improve solely with higher year of IM training. Furthermore, the impact of rheumatology teaching is greater than that of other common IM subspecialties. This information is critical to the planning and implementation of effective rheumatology curricula within internal medicine residency programs.

  1. Education in sexual medicine - a nationwide study among German urologists/andrologists and urology residents.

    PubMed

    Schloegl, I; Köhn, F M; Dinkel, A; Schulwitz, H; Gschwend, J E; Bosinski, H A G; Herkommer, K

    2017-03-01

    Although sexual-related problems are very prevalent, inadequate training for physicians has been reported. The aim was to investigate the educational situation in sexual medicine, including sexual dysfunctions, gender dysphoria and paraphilia, among German physicians in urology and andrology. Additional, barriers when addressing sexual health issues and confidence in taking care of patients with sexual-related problems were evaluated. A questionnaire was sent to 5955 urologists, urology residents and andrologists throughout Germany. The results of this study emphasise the need for continuing education and training in sexual medicine including sexual dysfunctions (83.9%), gender dysphoria (58.2%) and paraphilia (56.6%). Physicians, especially when working in urology, need basic skills in order to feel confident (89.0% in taking care of patients with sexual dysfunctions, 25.8% with gender dysphoria and 22.9% with paraphilia) and be able to reduce several barriers when addressing sexual health issues. The main reported barriers were lack of time (61.0%), inadequate financial compensation (42.5%), lack of necessity (29.9%) and the assumption of patients feeling uncomfortable (20.9%). It is within the competence of urologists and andrologists to correctly assess the situation and to refer patients to multidisciplinary support, such as psychologists, psychosomatics or couple therapists.

  2. 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

    2016-04-12

    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.

  3. 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

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

    PubMed

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

    2013-10-01

    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.

  5. Internal medicine interns' and residents' pressure ulcer prevention and assessment attitudes and abilities: results of an exploratory study .

    PubMed

    Suen, Winnie; Parker, Victoria A; Harney, Lauren; Nevin, Siobhan; Jansen, Jane; Alexander, Linda; Berlowitz, Dan

    2012-04-01

     To evaluate and determine differences between attitudes of internal medicine interns and residents toward pressure ulcer (PU) prevention and to evaluate the interns' abilities to accurately identify wounds and stage PUs, an exploratory, quantitative study was conducted in a 639-bed, safety net academic center. Participants (21 internal medicine interns and 21 internal medicine residents) attending an educational session on PU prevention and care were eligible to participate. The 1-hour conference session was prepared and provided by a physician and wound care nurses. Before the lecture, participants were asked to complete an 11-question paper-and-pencil PU attitude survey. Following the lecture, they were asked to identify 11 wounds and stage PUs using the inpatient admission history and physical template used in the hospital's electronic medical record. An audience response system was used to record correct and incorrect responses. Nineteen (19) interns and 20 residents completed the survey. Twenty-one (21) interns successfully completed the wound assessment quiz. Descriptive statistics were used to examine the survey data and residents' and interns' average attitude scores were compared using independent group t-test. The results suggest that interns and residents have a positive attitude toward and are concerned about PU prevention. The significantly higher overall score among interns compared to residents (average 43.8 versus 38.8 respectively, P = 0.002) suggests interns have a more positive attitude than residents. Statistically significant differences between item scores showed that, compared to residents, interns perceived PU prevention to be more time-consuming (P = 0.01), less of a concern in practice (P = 0.02), and a lower priority than other areas of care (P = 0.003). Compared to residents, interns also were more likely to agree to with statement, "In my opinion, patients tend to not get as many pressure

  6. 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.

  7. Up-to-date review of nuclear medicine applications in pediatric thoracic imaging.

    PubMed

    Kwatra, Neha S; Grant, Frederick D; Lim, Ruth; Lee, Edward Y

    2016-04-16

    Nuclear medicine has an important role in the evaluation of various congenital and acquired pediatric chest diseases. Although the radiopharmaceuticals and nuclear medicine examinations used in children are broadly the same as in adults, there are some key differences in clinical indications and underlying disorders. This article provides the reader with an up-to-date review of practice of nuclear medicine as it relates to the pediatric chest, including its current role and future applications.

  8. Problems in detection and measurement in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Aysun Ugur, Fatma

    2015-07-01

    Nuclear Medicine studies are performed with a variety of types of radiation measurement instruments, depending on the kind of radiation source that is being measured and the type of information sought. For example, some instruments are designed for in vitro measurements on blood samples, urine specimens, and so forth. Others are designed for in vivo measurements of radioactivity in patients. All these instruments have special design characteristics to optimize them for their specific tasks, as described in this study; however, some considerations of design characteristics and performance limitations are common to all of them. An important consideration for any radiation measurement instrument is its detection efficiency. Maximum detection efficiency is desirable because one thus obtains maximum information with a minimum amount of radioactivity. Also important are instrument's counting rate limitations. There are finite counting rate limits for all counting and imaging instruments used in nuclear medicine, above which accurate results are obtained because of data losses and other data distortions. Non penetrating radiations, such as ß particles, have special detection and measurement problems. In this study, some of these general considerations have been discussed.

  9. Functional renal imaging: new trends in radiology and nuclear medicine.

    PubMed

    Durand, Emmanuel; Chaumet-Riffaud, Philippe; Grenier, Nicolas

    2011-01-01

    The objective of this work is to compare the characteristics of various techniques for functional renal imaging, with a focus on nuclear medicine and magnetic resonance imaging. Even with low spatial resolution and rather poor signal-to-noise ratio, classical nuclear medicine has the advantage of linearity and good sensitivity. It remains the gold standard technique for renal relative functional assessment. Technetium-99m ((99m)Tc)-labeled diethylenetriamine penta-acetate remains the reference glomerular tracer. Tubular tracers have been improved: (123)I- or (131)I-hippuran, (99m)Tc-MAG3 and, recently, (99m)Tc-nitrilotriacetic acid. However, advancement in molecular imaging has not produced a groundbreaking tracer. Renal magnetic resonance imaging with classical gadolinated tracers probably has potential in this domain but has a lack of linearity and, therefore, its value still needs evaluation. Moreover, the advent of nephrogenic systemic fibrosis has delayed its expansion. Other developments, such as diffusion or blood oxygen level-dependent imaging, may have a role in the future. The other modalities have a limited role in clinical practice for functional renal imaging.

  10. An Innovative Educational and Mentorship Program for Emergency Medicine Women Residents to Enhance Academic Development and Retention.

    PubMed

    Bhatia, Kriti; Takayesu, James Kimo; Arbelaez, Christian; Peak, David; Nadel, Eric S

    2015-11-01

    Given the discrepancy between men and women's equal rates of medical school matriculation and their rates of academic promotion and leadership role acquisition, the need to provide mentorship and education to women in academic medicine is becoming increasingly recognized. Numerous large-scale programs have been developed to provide support and resources for women's enrichment and retention in academic medicine. Analyses of contributory factors to the aforementioned discrepancy commonly cite insufficient mentoring and role modeling as well as challenges with organizational navigation. Since residency training has been shown to be a critical juncture for making the decision to pursue an academic career, there is a need for innovative and tailored educational and mentorship programs targeting residents. Acknowledging residents' competing demands, we designed a program to provide easily accessible mentorship and contact with role models for our trainees at the departmental and institutional levels. We believe that this is an important step towards encouraging women's pursuit of academic careers. Our model may be useful to other emergency medicine residencies looking to provide such opportunities for their women residents.

  11. 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

  12. Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

    PubMed Central

    Sabath, Bruce F.; Singh, Gurkeerat

    2016-01-01

    Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution – a community hospital – in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available. PMID:27802866

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

    PubMed

    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.

  14. Integrating Systematic Chronic Care for Diabetes into an Academic General Internal Medicine Resident-Faculty Practice

    PubMed Central

    Dorr, David A.; Kelso, Christine; Bowen, Judith L.

    2008-01-01

    Background The quality of care for diabetes continues to fall short of recommended guidelines and results. Models for improving the care of chronic illnesses advocate a multidisciplinary team approach. Yet little is known about the effectiveness of such models in an academic setting with a diverse patient population and resident physicians participating in clinical care. Objective To implement a chronic illness management (CIM) practice within an academic setting with part-time providers, and evaluate its impact on the completion of diabetes-specific care processes and on the achievement of recommended outcomes for patients with diabetes mellitus. Design Retrospective cohort study Subjects Patients with the diagnosis of diabetes mellitus who receive their primary care in an academic general internal medicine resident-faculty practice. Measurements Process and outcomes measures in patients exposed to the CIM practice were compared with non-exposed patients receiving usual care. Main Results Five hundred and sixty-five patients met inclusion criteria. Patients in the CIM practice experienced a significant increase in completion of care processes compared to control patients for measurement of annual low-density lipoprotein (LDL) cholesterol (OR 3.1, 95% CI 1.7–5.7), urine microalbumin (OR 3.3, 95% CI 2.1–5.5), blood pressure (OR 1.8, 95% CI 1.1–2.8), retinal examination (OR 1.9, 95% CI 1.3–2.7), foot monofilament examination (OR 4.2, 95% CI 3.0–6.1) and administration of pneumococcal vaccination (OR 5.2, 95% CI 3.0–9.3). CIM-exposed patients were also more likely to achieve improvements in clinical outcomes of glycemic and blood pressure control reflected by hemoglobin A1c less than 7.0% (OR 1.7, 95% CI 1.02–3) and blood pressure less than 130/80 (OR 2.8, 95% CI 2.1–4.5) compared to controls. Conclusions A systematic chronic care model can be successfully integrated into an academic general internal medicine practice and may result in improved

  15. AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training.

    PubMed

    Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzutiello, Robert J

    2015-09-08

    The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear  medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics  Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.

  16. AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training.

    PubMed

    Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzuitello, Robert J

    2015-09-01

    The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to: Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years, Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and Identify approaches that may be considered to facilitate the training of nuclear medicine physicists. As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission. PACS number: 01.40.G.

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Role of nuclear medicine in clinical urology and nephrology

    SciTech Connect

    Blaufox, M.D.; Fine, E.; Lee, H.B.; Scharf, S.

    1984-05-01

    The application of radionuclide studies to nephrologic and urologic practice has reached a measurable degree of maturity during the past several years. In spite of this, the utilization of these techniques in many institutions in the United States continues to be far less frequent than one would expect from the clinical advantages. The aim of this editorial is to try to place the role of nuclear medicine in urology and nephrology in perspective. At the present time, in spite of the large number of renal agents that have been developed, there is no practical ideal radiopharmaceutical that can serve as a universal agent. Arbitrarily, one may reduce the chief armamentarium to only four radiopharmaceuticals; technetium-99m DTPA, I-131 OIH (orthoiodohippurate), technetium-99m glucoheptonate and technetium-99m DMSA. These agents are discussed with their relative advantages and disadvantages.

  7. 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.

  8. Nuclear medicine techniques in the assessment of alkaptonuria.

    PubMed

    Vinjamuri, Sobhan; Ramesh, Chandakacharla N; Jarvis, Jonathan; Gallagher, Jim A; Ranganath, Lakshminarayana L

    2011-10-01

    Alkaptonuria is a rare autosomal recessive disorder due to a lack of the enzyme homogentisate dioxygenase, leading to ochronosis, a process of accumulation of a melanin-like polymer of homogentisic acid in cartilage and other collagenous structures. Patients develop severe osteoarthropathy that resembles osteoarthritis. Although the diagnosis of alkaptonuria is not particularly challenging in view of the blue-black discolouration of visible connective tissue and the presence of homogentisic acid in urine, the natural history of alkaptonuria remains poorly understood. Patients would benefit immensely from an objective assessment of their disease status and from a clearer understanding of the pathophysiology and associated physical changes. Isotope bone scans, which are commonly used to identify the extent of involvement of bones in cancerous processes, have also been increasingly used for characterizing the extent of arthropathy in conditions such as osteoarthritis and rheumatoid arthritis. Semiquantitative scores based on the extent of involvement of joints have been used to describe the involvement of large joints in the context of symptomatic treatment for osteoarthritis. A similar semiquantitative isotope bone scan score depending on the involvement of the number of large joints in patients with alkaptonuria can be formulated and validated in a suitable cohort of patients. Bone densitometry measurement using dual-energy X-ray absorptiometry scanning is an internationally accepted tool to assess the risk and extent of osteoporosis, and is increasingly used to assess the additional fracture risk in patients with arthropathy. We believe that, currently, nuclear medicine techniques can provide useful information, which can be incorporated into disease severity scores for alkaptonuria. Once the biological basis for alkaptonuria is better understood, it is feasible that nuclear medicine techniques of even greater sensitivity and specificity can be developed, thereby

  9. 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.

  10. 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.

  11. Do we need a universal 'code of ethics' in nuclear medicine?

    PubMed

    Ramesh, Chandakacharla N; Vinjamuri, Sobhan

    2010-06-01

    Recent years have seen huge advances in medicine and the science of medicine. Nuclear medicine has been no exception and there has been rapid acceptance of new concepts, new technologies and newer ways of working. Ethical principles have been traditionally considered as generic skills applicable to wide groups of scientists and doctors, with only token refinement at specialty level. Specialist bodies across the world representing wide groups of practitioners frequently have subgroups dealing exclusively with ethical issues. It could easily be argued that the basic principles of ethical practice adopted by specialist bodies closest to nuclear medicine practice, such as radiology and oncology, will also be applicable to nuclear medicine and that time and effort need not be spent on specifying a separate code for nuclear medicine. It could also be argued that nuclear medicine is an independent specialty and some (if not most) practitioners will not be aware of the guidelines adopted by other specialist societies, and that there is a need for re-iteration of ethical principles at the specialty level and on a worldwide scale.In this article we would like to present a brief history of medical ethics, discuss some of the advances in nuclear medicine and their associated ethical aspects, as well as list a framework of principles for consideration, should a specialist body deem it suitable to establish a 'code of ethics' for nuclear medicine.

  12. Intention of residents in internal medicine to care for patients infected with HIV at a university hospital in Taiwan.

    PubMed

    Hsiung, P C; Tsai, Y F; Hung, C C; Chen, M Y

    2001-09-01

    The purpose of this study was to investigate internal medicine residents' HIV-related knowledge and their attitudes towards caring for HIV-infected patients, and determine the extent to which these variables influence their care-providing intention. A cross-sectional survey was conducted in 56 internal medicine residents at a university hospital in Taiwan. Results showed residents' lack of sufficient knowledge was reflected by their inaccurate assessment of HIV-associated risk and their tendency to overuse protective gear in unnecessary situations. In general, residents expressed slightly positive attitudes with a neutral intention to care for HIV-infected patients. Knowledge and attitudes were significantly correlated with intention. The use of stepwise regression analysis revealed attitudes accounted for 59% of the variance in intention. Future efforts should focus on designing, implementing, and evaluating educational programmes that address residents' needs to ensure a solid HIV-related knowledge base, support their positive attitudes, address their ambivalent feelings toward providing HIV care, and enhance their intention to care for HIV-infected patients.

  13. 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.

  14. Assessing the Influence of a Fitbit Physical Activity Monitor on the Exercise Practices of Emergency Medicine Residents: A Pilot Study

    PubMed Central

    2017-01-01

    Background Targeted interventions have improved physical activity and wellness of medical residents. However, no exercise interventions have focused on emergency medicine residents. Objective This study aimed to measure the effectiveness of a wearable device for tracking physical activity on the exercise habits and wellness of this population, while also measuring barriers to adoption and continued use. Methods This pre-post cohort study enrolled 30 emergency medicine residents. Study duration was 6 months. Statistical comparisons were conducted for the primary end point and secondary exercise end points with nonparametric tests. Descriptive statistics were provided for subjective responses. Results The physical activity tracker did not increase the overall self-reported median number of days of physical activity per week within this population: baseline 2.5 days (interquartile range, IQR, 1.9) versus 2.8 days (IQR 1.5) at 1 month (P=.36). There was a significant increase in physical activity from baseline to 1 month among residents with median weekly physical activity level below that recommended by the Centers for Disease Control and Prevention at study start, that is, 1.5 days (IQR 0.9) versus 2.4 days (IQR 1.2; P=.04), to 2.0 days (IQR 2.0; P=.04) at 6 months. More than half (60%, 18/30) of participants reported a benefit to their overall wellness, and 53% (16/30) reported a benefit to their physical activity. Overall continued use of the device was 67% (20/30) at 1 month and 33% (10/30) at 6 months. Conclusions The wearable physical activity tracker did not change the overall physical activity levels among this population of emergency medicine residents. However, there was an improvement in physical activity among the residents with the lowest preintervention physical activity. Subjective improvements in overall wellness and physical activity were noted among the entire study population. PMID:28143805

  15. (In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine)

    SciTech Connect

    Not Available

    1989-01-01

    The overall goals of our research remains to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation in human lymphocytes. We are studying hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologists who administer radionuclides.

  16. [In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine]. Technical progress report

    SciTech Connect

    Not Available

    1989-12-31

    The overall goals of our research remains to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation in human lymphocytes. We are studying hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologists who administer radionuclides.

  17. 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

  18. Implementation and evaluation of a novel research education rotation for Royal College of Physicians and Surgeons emergency medicine residents.

    PubMed

    Abu-Laban, Riyad B; Jarvis-Selinger, Sandra; Newton, Lana; Chung, Brian

    2013-07-01

    Royal College of Physicians and Surgeons (RCPS) emergency medicine (EM) residents must complete a scholarly project; however, significant variation exists in Canadian EM resident research education and facilitation. We developed and implemented a novel mandatory research education rotation for RCPS EM residents intended to increase knowledge, faculty/resident collaborations, and, ultimately, scholarly output. This 4-week rotation took place in the fall of 2011 and consisted of 37 faculty-led didactic, critical appraisal, and workshop seminars. Exposure to faculty research and resulting opportunities and the development of resident research projects were integrated into the rotation. Twelve participating residents completed daily evaluations and took part in an exit focus group analyzed using a constant comparative method. Knowledge acquisition was assessed with a pre/post comprehensive examination instrument evaluated by a paired t-test. Evaluations indicated generally high satisfaction throughout the rotation. Focus group analysis indicated that residents felt two important but competing goals existed: developing a research project and developing critical appraisal skills. The research knowledge of all participants improved significantly (mean/SD examination change +35.4%/+10.4%, range +20.0% to +53.6%, p < 0.001), and several new resident/faculty research collaborations arose from the rotation. A rotation of this nature is an efficient and effective means to increase research and critical appraisal knowledge and faculty/resident collaborations. As a result of our positive experience, the rotation will continue annually and has been expanded to include pediatric EM fellows. Longitudinal tracking of the participating trainee cohort will remain ongoing to assess the scholarly output impact of the rotation.

  19. 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

  20. 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.

  1. The residency program in social medicine of Montefiore Medical Center: 37 years of mission-driven, interdisciplinary training in primary care, population health, and social medicine.

    PubMed

    Strelnick, A H; Swiderski, Debbie; Fornari, Alice; Gorski, Victoria; Korin, Eliana; Ozuah, Philip; Townsend, Janet M; Selwyn, Peter A

    2008-04-01

    Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received Title VII grants during most of its history. The RPSM has tailored its mission and structured its curriculum to promote a community and population orientation and to provide the requisite knowledge and skills for integrating social medicine into clinical practice. Six unique hallmarks of RPSM training are (1) mission-oriented resident recruitment/selection and self-management, (2) interdisciplinary collaborative training among primary care professionals, (3) community-health-center-based and community-oriented primary care education, (4) biopsychosocial and ecological family systems curriculum, (5) the social medicine core curriculum and projects, and (6) grant support through Title VII. These hallmark curricular, training, and funding elements, in which population health is deeply embedded, have been carefully evaluated, regularly revised, and empirically validated since the program's inception. Practice outcomes for RPSM graduates as leaders in and advocates for population health and the care of underserved communities are described and discussed in this case study.

  2. 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.

  3. 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

  4. A hypothesis on the most prevalent psychological type for chief residents in the field of internal medicine.

    PubMed

    Hearney, Elaine G; Razavi, Hossein

    2003-08-01

    Communication is the key to good doctor-patient relations. Resident learning occurs through the process of observation and role modeling. We hypothesize that the most prevalent personality type for chief residents will be in discordance with the most prevalent type (Sensor) in the general population. We set out to determine the communication styles of a national sampling of recent chief residents in the field of medicine. The survey based on Jung's Psychological types: thinker, feeler, the intuitor and sensor. Overall self report of psychological types revealed the majority, both male and female (45.6%) to be in the 'feeler' category. Feelers are described as persons with a high need for interpersonal harmony. They value compassion and empathy and enjoy meeting other people's needs.

  5. Facilitating the transition to practice: a weekend retreat curriculum for business-of-medicine education of United States anesthesiology residents.

    PubMed

    Holak, Elena J; Kaslow, Olga; Pagel, Paul S

    2010-10-01

    Anesthesiology residents in the United States (US) not only must develop the clinical skills needed to provide independent patient care, but also are required to become familiar with the business aspects of the modern health care system. Unfortunately, practice management education may be inadequate during anesthesiology residency training. The authors describe the design and implementation of a weekend retreat curriculum in business-of-medicine education for anesthesiology residents. Experts were recruited to discuss interviewing skills, contract law and negotiation, billing and reimbursement, insurance, malpractice, and financial planning. A strict lecture didactic format was avoided, and presentations were designed to encourage speaker-audience interaction. The program was relatively simple to design and implement, satisfied several Accreditation Council of Graduate Medical Education core competencies for US anesthesiology education, may be altered as practice management evolves, and may be adapted to accommodate the needs of programs in other countries.

  6. 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

  7. External Practicum-Year Residency Training in Occupational and Environmental Medicine: the University of Pennsylvania Medical Center Program.

    PubMed

    Emmett, E A; Green-McKenzie, J

    2001-05-01

    We describe a competency-based training program that allows physicians employed full-time in occupational and environmental medicine to satisfy the supervised practicum year of training required by the American Board of Preventive Medicine (ABPM). The program is designed for trainees with greater clinical experience than the 1 clinical year required by the ABPM. To date, 25 physicians from clinic-based, academic, corporate, and government employment across most geographic regions of the United States have been admitted into the program. Most completed a master's in public health (MPH) in a distance-learning, on-job, on-campus, or executive program. The practicum-year training has been highly successful, as evidenced by improvements in resident self-assessment of competency, resident satisfaction with the training, faculty evaluation of resident performance, and success rate in the ABPM examination. The program has opened a new pathway for physicians making a mid-career shift to occupational and environmental medicine to obtain high-quality, in-depth education and board certification.

  8. Impact of an Evidence-Based Medicine Curriculum on Resident Use of Electronic Resources: A Randomized Controlled Study

    PubMed Central

    Willett, Laura R.; Murphy, David J.; O’Rourke, Kerry; Sharma, Ranita; Shea, Judy A.

    2008-01-01

    Background Evidence-based medicine (EBM) is widely taught in residency, but evidence for effectiveness of EBM teaching on changing residents’ behavior is limited. Objective To investigate the impact of an EBM curriculum on residents’ use of evidence-based resources in a simulated clinical experience. Design/Participants Fifty medicine residents randomized to an EBM teaching or control group. Measurements A validated test of EBM knowledge (Fresno test) was administered before and after intervention. Post intervention, residents twice completed a Web-based, multiple-choice instrument (15 items) comprised of clinical vignettes, first without then with access to electronic resources. Use of electronic resources was tracked using ProxyPlus software. Within group pre–post differences and between group post-test differences were examined. Results There was more improvement in EBM knowledge (100-point scale) for the intervention group compared to the control group (mean score increase 22 vs. 12,  = 0.012). In the simulated clinical experience, the most commonly accessed resources were Ovid (71% of residents accessed) and InfoPOEMs (62%) for the EBM group and UptoDate (67%) and MDConsult (58%) for the control group. Residents in the EBM group were more likely to use evidence-based resources than the control group. Performance on clinical vignettes was similar between the groups both at baseline ( = 0.19) and with access to information resources ( = 0.89). Conclusions EBM teaching improved EBM knowledge and increased use of evidence-based resources by residents, but did not improve performance on Web-based clinical vignettes. Future studies will need to examine impact of EBM teaching on clinical outcomes. PMID:18769979

  9. Nuclear medicine for photodynamic therapy in cancer: planning, monitoring and nuclear PDT.

    PubMed

    Kharroubi Lakouas, Dris; Huglo, Damien; Mordon, Serge; Vermandel, Maximilien

    2017-03-11

    Photodynamic therapy (PDT) is a modality with promising results for the treatment of various cancers. PDT is increasingly included in the standard of care for different pathologies. This therapy relies on the effects of light delivered to photosensitized cells. At different stages of delivery, PDT requires imaging to plan, evaluate and monitor treatment. The contribution of molecular imaging in this context is important and continues to increase. In this article, we review the contribution of nuclear medicine imaging in oncology to PDT for planning and therapeutic monitoring purposes. Several solutions have been proposed to plan PDT from nuclear medicine imaging. For instance, photosensitizer biodistribution has been evaluated with a radiolabeled photosensitizer or with conventional radiopharmaceuticals on positron emission tomography. The effects of PDT delivery have also been explored with specific SPECT or PET radiopharmaceuticals to evaluate the effects on cells (apoptosis, necrosis, proliferation, metabolism) or vascular damage. Finally, the synergy between photosensitizers and radiopharmaceuticals has been studied considering the Cerenkov effect to activate photosensitized cells.

  10. 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

  11. 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)...

  12. 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)...

  13. 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)...

  14. 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)...

  15. 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)...

  16. Toward competency-based curricula in patient-centered spiritual care: recommended competencies for family medicine resident education.

    PubMed

    Anandarajah, Gowri; Craigie, Frederic; Hatch, Robert; Kliewer, Stephen; Marchand, Lucille; King, Dana; Hobbs, Richard; Daaleman, Timothy P

    2010-12-01

    Spiritual care is increasingly recognized as an important component of medical care. Although many primary care residency programs incorporate spiritual care into their curricula, there are currently no consensus guidelines regarding core competencies necessary for primary care training. In 2006, the Society of Teachers of Family Medicine's Interest Group on Spirituality undertook a three-year initiative to address this need. The project leader assembled a diverse panel of eight educators with dual expertise in (1) spirituality and health and (2) family medicine. The multidisciplinary panel members represented different geographic regions and diverse faith traditions and were nationally recognized senior faculty. They underwent three rounds of a modified Delphi technique to achieve initial consensus regarding spiritual care competencies (SCCs) tailored for family medicine residency training, followed by an iterative process of external validation, feedback, and consensus modifications of the SCCs. Panel members identified six knowledge, nine skills, and four attitude core SCCs for use in training and linked these to competencies of the Accreditation Council for Graduate Medical Education. They identified three global competencies for use in promotion and graduation criteria. Defining core competencies in spiritual care clarifies training goals and provides the basis for robust curricula evaluation. Given the breadth of family medicine, these competencies may be adaptable to other primary care fields, to medical and surgical specialties, and to medical student education. Effective training in this area may enhance physicians' ability to attend to the physical, mental, and spiritual needs of patients and better maintain sustainable healing relationships.

  17. 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.

  18. 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

  19. [Introducing formative portfolio as a tool for Internal Medicine residents mentoring: review of a pilot project, 2005-2006].

    PubMed

    Arnau I Figueras, J; Torán Monserrat, P; Martínez-Carretero, J M; Forteza-Rey, J; Pinilla Llorente, B; Brailovsky, C A

    2008-10-01

    Recent educational projects in our country have been trying to introduce professional portfolios as assessment/learning tools on the undergraduate and specialized post-graduate education levels. The approval of a new formative program for the Internal Medicine specialty in an effort to adapt to the present health care needs offers an opportunity to apply these formative and evaluative methodologies in the learning process of future internists. During the 2005-2006 academic year, the Formative Work Group of the Spanish Internal Medicine Society (SEMI) developed a pilot study on portfolio application as a tool for formative assessment and mentoring. This article describes the project of designing, developing, applying and assessing an electronic portfolio for first year Internal Medicine residents. It presents an analysis of the SEMI Portfolio strengths and weaknesses and finally makes suggestions for future development.

  20. 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.

  1. Proceedings of a workshop on molecular nuclear medicine

    SciTech Connect

    Reba, R.C. )

    1992-01-01

    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. 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.

  3. 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

  4. 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.

  5. Overall system design of a PACS for nuclear medicine images

    NASA Astrophysics Data System (ADS)

    Ottes, Fenno P.; Bakker, Albert R.; VanGennip, Chel; van Poppel, Bas M.; Toussaint, Pieter J.; Weber, Ruud; Weier, Onno

    1996-05-01

    This paper describes the global system design of a PACS for nuclear medicine images. This NM PACS provides facilities for image capture, storage, display, manipulation and analysis. The NM PACS workstation displays besides images also the patient data from the HIS database. The NM PACS is equipped with well-defined HIS interface, which provides interoperability with HIS systems. The system design of the NM PACS is based on: a twin client-server concept, i.e. each workstation can run a HIS client and a PACS client, each interfaced with their own server. The HIS and the PACS servers are in turn inter-connected. The PACS images can be retrieved and displayed by evoking a command to a HIS menu. The X-protocol, together with GUI tools, such as Builder Xcsessory and the Motif tools in the Xmt library, are used to create the software modules that displays, manipulates and analyzes the images. The image file storage architecture consists of a single layer, namely an array of magnetical disks.

  6. Therapeutic radionuclides in nuclear medicine: current and future prospects.

    PubMed

    Yeong, Chai-Hong; Cheng, Mu-hua; Ng, Kwan-Hoong

    2014-10-01

    The potential use of radionuclides in therapy has been recognized for many decades. A number of radionuclides, such as iodine-131 ((131)I), phosphorous-32 ((32)P), strontium-90 ((90)Sr), and yttrium-90 ((90)Y), 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.

  7. Use of Nonphysician Staff to Evaluate Humanistic Behavior of Internal Medicine Residents and Faculty Members.

    ERIC Educational Resources Information Center

    Linn, Lawrence S.; And Others

    1986-01-01

    The use of nurses or other health workers to assess residents' humanistic behavior is discussed. Since nurses and other paramedical staff members observe residents interacting with their patients, these professionals may be a valuable but underused resource in the evaluation of physicians' humanistic qualities. (MLW)

  8. 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.

  9. 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.

  10. Current research in nuclear medicine and molecular imaging: highlights of the 23rd Annual EANM Congress.

    PubMed

    Carrió, Ignasi

    2011-02-01

    The most recent research developments in nuclear medicine and molecular imaging were presented at the 2010 Annual Congress of the EANM. This review summarizes some of the most relevant contributions made in the fields of oncology, cardiovascular science, neurology and psychiatry, technological innovation and novel tracers. Presentations covered basic and clinical research in nuclear medicine and molecular imaging, and diagnostic and therapeutic applications of radioisotopes and radiopharmaceuticals on a global scale. The results reported demonstrate that investigative strategies using nuclear medicine techniques facilitate effective diagnosis and management of patients with most prevalent disease states. At the same time novel tracers and technologies are being explored, which hold promise for future new applications of nuclear medicine and molecular imaging in research and clinical practice.

  11. Nuclear Medicine at Berkeley Lab: From Pioneering Beginnings to Today (LBNL Summer Lecture Series)

    ScienceCinema

    Budinger, Thomas [LBNL, Center for Functional Imaging

    2016-07-12

    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.

  12. NCRP report 160 and what it means for medical imaging and nuclear medicine.

    PubMed

    Bolus, Norman E

    2013-12-01

    The purpose of this paper is to briefly explain report 160 of the National Council on Radiation Protection and Measurement and the significance of the report to medical imaging as a whole and nuclear medicine specifically. The implications of the findings of report 160 have had repercussions and will continue to affect all of ionizing radiation medical imaging. The nuclear medicine community should have an understanding of why and how report 160 is important. After reading this article, the nuclear medicine technologist will be familiar with the main focus of report 160, the significant change that has occurred since the 1980s in the ionizing radiation exposure of people in the United States, the primary background source of ionizing radiation in the United States, the primary medical exposure to ionizing radiation in the United States, trends in nuclear medicine procedures and patient exposure, and a comparison of population doses between 2006 and the early 1980s as outlined in report 160.

  13. 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.

  14. 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

    2016-01-01

    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.

  15. Residents values in a rational decision-making model: an interest in academics in emergency medicine.

    PubMed

    Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

    2016-10-01

    Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career.

  16. Promoting teamwork: an event-based approach to simulation-based teamwork training for emergency medicine residents.

    PubMed

    Rosen, Michael A; Salas, Eduardo; Wu, Teresa S; Silvestri, Salvatore; Lazzara, Elizabeth H; Lyons, Rebecca; Weaver, Sallie J; King, Heidi B

    2008-11-01

    The growing complexity of patient care requires that emergency physicians (EPs) master not only knowledge and procedural skills, but also the ability to effectively communicate with patients and other care providers and to coordinate patient care activities. EPs must become good team players, and consequently an emergency medicine (EM) residency program must systematically train these skills. However, because teamwork-related competencies are relatively new considerations in health care, there is a gap in the methods available to accomplish this goal. This article outlines how teamwork training for residents can be accomplished by employing simulation-based training (SBT) techniques and contributes tools and strategies for designing structured learning experiences and measurement tools that are explicitly linked to targeted teamwork competencies and learning objectives. An event-based method is described and illustrative examples of scenario design and measurement tools are provided.

  17. Quality management in nuclear medicine for better patient care: the IAEA program.

    PubMed

    Dondi, Maurizio; Kashyap, Ravi; Pascual, Thomas; Paez, Diana; Nunez-Miller, Rodolfo

    2013-05-01

    The International Atomic Energy Agency promotes the practice of nuclear medicine among its Member States with a focus on quality and safety. It considers quality culture as a part of the educational process and as a tool to reduce heterogeneity in the practice of nuclear medicine, and in turn, patient care. Sensitization about quality is incorporated in all its delivery mechanisms. The Agency has developed a structured peer-review process called quality management (QM) audits in nuclear medicine practices to help nuclear medicine facilities improve their quality through this voluntary comprehensive audit process. The process is multidisciplinary, covering all aspects of nuclear medicine practice with a focus on the patient. It complements other QM and accreditation approaches developed by professional societies or accreditation agencies. The Agency is committed to propagate its utility and assist in the implementation process. Similar auditing programs for practice in diagnostic radiology and radiotherapy, called QUADRIL and QUATRO, respectively, are also in place. Necessary amendments in the auditing process and content are incorporated based on technological and practice changes with time. The reader will become familiar with the approach of the Agency on QM in nuclear medicine and its implementation process to improve patient care.

  18. 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.

  19. Occupational exposure in nuclear medicine in Portugal in the 1999-2003 period.

    PubMed

    Martins, M B; Alves, J G; Abrantes, J N; Roda, A R

    2007-01-01

    The annual doses received by the staff of nuclear medicine departments from public hospitals and private clinics and evaluated by the Individual Monitoring Service of the Radiological Protection and Nuclear Safety Department (DPRSN) of the Nuclear and Technological Institute (ITN) in Portugal, in the 5 y period from 1999 to 2003, are analysed and presented in this paper. In the 1999-2003 period, ITN-DPRSN monitored on an average 462 workers from nuclear medicine departments, which represents 6% of the 8000 workers of the medical field (approximately). The medical sector represents 80-85% of all the monitored population in Portugal. The professions of the monitored workers at nuclear medicine departments were identified by the respective departments as administrative, auxiliary, medical doctor, nuclear medicine technician, nurse, pharmacist and physicist. This information was collected at the onset of the monitoring and was updated over the last 3 y. The annual whole-body doses evaluated in the period 1999-2003 were used to derive the distribution of workers by dose intervals for every profession. The respective annual average doses and annual collective doses, as well as, the total average and total collective doses for the nuclear medicine sector were also determined and are presented. Internal radiation hasn't been monitored.

  20. 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

  1. Social media responses to the Annals of Emergency Medicine residents' perspective article on multiple mini-interviews.

    PubMed

    Joshi, Nikita K; Yarris, Lalena M; Doty, Christopher I; Lin, Michelle

    2014-09-01

    In May 2014, Annals of Emergency Medicine continued a successful 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 "Does the Multiple Mini-Interview Address Stakeholder Needs? An Applicant's Perspective" by Phillips and Garmel. This dialogue included Twitter conversations, a live videocast with the authors and other experts, and detailed discussions on the ALiEM Web site's comment section. This summary article serves the dual purpose of reporting the qualitative thematic analysis from a global online discussion and the Web analytics for our novel multimodal approach. Social media technologies provide a unique opportunity to engage with a diverse audience to detect existing and new emerging themes. Such technologies allow rapid hypothesis generation for future research and enable more accelerated knowledge translation.

  2. 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

  3. Semiconductor gamma-ray detectors for nuclear medicine

    NASA Astrophysics Data System (ADS)

    Eskin, Joshua Daniel

    Semiconductor-based gamma-ray-imaging detectors are under development for use in high-resolution nuclear medicine imaging applications. These detectors, based on cadmium zinc telluride, hold great promise for delivering improved spatial resolution and detection efficiency over current methods. This dissertation presents work done on three fronts, all directed toward enhancing the practicality of these imaging devices. Electronic readout systems were built to produce gamma-ray images from the raw signals generated by the imagers. Mathematical models were developed to describe the detection process in detail. Finally, a method was developed for recovering the energy spectrum of the original source by using maximum-likelihood estimation techniques. Two electronics systems were built to read out signals from the imaging detectors. The first system takes signals from a 48 x 48-pixel array at 500 k samples per second. Pulse-height histograms are formed for each pixel in the detector, all in real time. A second system was built to read out four 64 x 64 arrays at 4 million pixels per second. This system is based on digital signal processors and flexible software, making it easily adaptable to new imaging tasks. A mathematical model of the detection process was developed as a tool for evaluating possible detector designs. One part of the model describes how the mobile charge carriers, which are released when a gamma ray is absorbed in a photoelectric interaction, induce signals in a readout circuit. Induced signals follow a 'near- field effect,' wherein only carriers moving close to a pixel electrode produce significant signal. Detector pixels having lateral dimensions that are small compared to the detector thickness will develop a signal primarily due to a single carrier type. This effect is confirmed experimentally in time-resolved measurements and with pulse-height spectra. The second part of the model is a simulation of scattering processes that take place when a gamma

  4. 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....

  5. 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....

  6. 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....

  7. 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....

  8. 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....

  9. 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.

  10. 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…

  11. 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,…

  12. 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…

  13. 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:…

  14. Teaching Evidence-Based Medicine Skills through a Residency-Developed Guideline.

    ERIC Educational Resources Information Center

    Epling, John; Smucny, John; Patil, Anita; Tudiver, Fred

    2002-01-01

    Describes a curriculum intended to culminate in a resident-produced, evidence-based guideline for the care of patients with diabetes. Evaluation of the curriculum showed that learners appreciated the skills and knowledge gained in devising guidelines in an evidence-based manner but were uncertain that their searches were complete. Clinical…

  15. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure.

    PubMed

    Brennan, J Matthew; Blair, John E; Goonewardena, Sascha; Ronan, Adam; Shah, Dipak; Vasaiwala, Samip; Brooks, Erica; Levy, Ari; Kirkpatrick, James N; Spencer, Kirk T

    2007-06-01

    Physicians' ability to accurately estimate right atrial (RA) pressure from bedside evaluation of the jugular venous waveform is poor, particularly when performed by physicians in training. Conventional ultrasound measurement of the inferior vena cava (IVC) accurately predicts RA pressure, but the cost, lack of portability, and specialized training required to acquire and interpret the data render this modality impractical for routine clinical use. The objective of this study was to compare physical examination with hand-carried ultrasound (HCU) in the detection of elevated RA pressure (>10 mm Hg). After limited training (4 hours didactic and 20 studies), 4 internal medicine residents using an HCU device estimated RA pressure from images of the IVC in 40 consecutive patients <1 hour after right-sided cardiac catheterization. RA pressure was also estimated from examination of the jugular venous pulse (JVP) in 40 patients before right-sided cardiac catheterization. RA pressure was successfully estimated from HCU images of the IVC in 90% of patients, compared with 63% from JVP examination. The sensitivity for predicting RA pressure >10 mm Hg was 82% with HCU and 14% from JVP inspection. Specificities were similar between the techniques. Overall accuracies were 71% using HCU and 60% with JVP assessment. In conclusion, internal medicine residents with brief training in echocardiography can more frequently and more accurately predict elevated RA pressure using HCU measurements of the IVC than with physical examination of the JVP.

  16. Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

    PubMed Central

    Dion, Maxime; Diouf, Ndeye Thiab; Robitaille, Hubert; Turcotte, Stéphane; Adekpedjou, Rhéda; Labrecque, Michel; Cauchon, Michel

    2016-01-01

    Background DECISION+2, a Web-based tutorial, was designed to train family physicians in shared decision making (SDM) regarding the use of antibiotics for acute respiratory infections (ARIs). It is currently mandatory for second-year family medicine residents at Université Laval, Quebec, Canada. However, little is known about how such tutorials are used, their effect on knowledge scores, or how best to assess resident participation. Objective The objective of our study was to describe the usage of this Web-based training platform by family medicine residents over time, evaluate its effect on their knowledge scores, and identify what kinds of data are needed for a more comprehensive analysis of usage and knowledge acquisition. Methods We identified, collected, and analyzed all available data about participation in and current usage of the tutorial and its before-and-after 10-item knowledge test. Residents were separated into 3 log-in periods (2012-2013, 2013-2014, and 2014-2015) depending on the day of their first connection. We compared residents’ participation rates between entry periods (Cochran-Armitage test), assessed the mean rank of the difference in total scores and category scores between pre- and posttest (Wilcoxon signed-rank test), and compared frequencies of each. Subsequent to analyses, we identified types of data that would have provided a more complete picture of the usage of the program and its effect on knowledge scores. Results The tutorial addresses 3 knowledge categories: diagnosing ARIs, treating ARIs, and SDM regarding the use of antibiotics for treating ARIs. From July 2012 to July 2015, all 387 second-year family medicine residents were eligible to take the Web-based tutorial. Out of the 387 eligible residents, 247 (63.8%) logged in at least once. Their participation rates varied between entry periods, most significantly between the 2012-2013 and 2013-2014 cohorts (P=.006). For the 109 out of 387 (28.2%) residents who completed the

  17. [Occupational medicine in nuclear industry and power engineering].

    PubMed

    Gus'kova, A K

    2004-01-01

    The author analysed results of medical service in atomic industry and power engineering over 50 years. Those results are beneficial for management in occupational medicine for any new complicated and potentially dangerous technology and activity.

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

    PubMed

    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. Conclusion

  19. 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.

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

    PubMed

    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.

  1. [Survey questionnaire of pediatric nuclear medicine examinations in 14 Japanese institutes].

    PubMed

    Karasawa, Kensuke; Kamiyama, Hiroshi; Hashimoto, Teisuke; Koizumi, Kiyoshi

    2013-05-01

    Under the auspices of the Japanese Society of Pediatric Nuclear Medicine, an annual aggregate from a 5-year period, 2007 to 2011, of a survey questionnaire of pediatric nuclear medicine examinations performed at 14 institutes in the Kanto region was conducted. The subjects were pediatric patients 15 years old or younger. The survey questions included the determination method for administered dose of radiopharmaceuticals, the items examined and number of examinations. Of 14 institutes, 11 determined administered doses using the formula: adult dose X (age +1) / (age+7), while the remaining 3 used the adult dose as the maximum dose and used a conversion formula based on age and physical condition. In 2011, in a total of 3,884 pediatric patients, renoscintigraphy accounted for 41.5%, brain 14.4%, pulmonary scintigraphy 12.9%, oncology 9.0%, hepatobiliary scintigraphy 6.3%, gastrointestinal scintigraphy 4.8%, musculoskeletal scintigraphy 4.3%, cardiology 2.5%, and other 4.9% of all nuclear medicine examinations. Pediatric nuclear medicine examinations in general hospitals accounted for only 3.4% of all examinations. A similar trend was observed in previous years. Since pediatric patients have a longer reproductive term and higher sensitivity to radiation exposure, pediatric nuclear medicine requires a strict selection of appropriate studies and administered dose. These results show the current practice and would warrant further consideration.

  2. 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

  3. Determination of total tritium in urine from residents living in the vicinity of nuclear power plants in Qinshan, China.

    PubMed

    Shen, Bao-Ming; Ji, Yan-Qin; Tian, Qing; Shao, Xiang-Zhang; Yin, Liang-Liang; Su, Xu

    2015-01-16

    To estimate the tritium doses of the residents living in the vicinity of a nuclear power plant, urine samples of 34 adults were collected from residents living near the Qinshan nuclear power plant. The tritium-in-urine (HTO plus OBT) was measured by liquid scintillation counting. The doses of tritium-in-urine from participants living at 2, 10 and 22 km were in a range of 1.26-6.73 Bq/L, 1.31-3.09 Bq/L and 2.21-3.81 Bq/L, respectively, while the average activity concentrations of participants from the three groups were 3.53 ± 1.62, 2.09 ± 0.62 and 2.97 ± 0.78 Bq/L, respectively. The personal committed effective doses for males were 2.5 ± 1.7 nSv and for females they were 2.9 ± 1.3 nSv. These results indicate that tritium concentrations in urine samples from residents living at 2 km from a nuclear power plant are significantly higher than those at 10 km. It may be the downwind direction that caused a higher dose in participants living at 22 km. All the measured doses of tritium-in-urine are in a background level range.

  4. 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 to 184…

  5. (In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine)

    SciTech Connect

    Not Available

    1990-01-01

    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. We are utilizing these endpoints to examine sets of individuals who have been exposed to ionizing radiation as a result of medical procedures. The cohorts we are studying include: nuclear medicine technicians, two set of nuclear medicine patients, sets of controls and a new set of Hodgkins disease patients. Emphasis in the second year has been on measurements of chromosome aberrations in patients imaged with thallium-201, mutant frequencies in patients imaged with technetium-99, mutant frequencies in nuclear medicine technicians and physical therapists, and mutant frequencies in patients treated for Hodgkins disease with radiotherapy. The progress in these areas is described in this report in more detail.

  6. 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.

  7. 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.

  8. Triggering radiation alarm at security checks. Patients should be informed even after diagnostic nuclear medicine procedures.

    PubMed

    Palumbo, Barbara; Neumann, Irmgard; Havlik, Ernst; Palumbo, Renato; Sinzinger, Helmut

    2009-01-01

    During the last few years an increasing number of nuclear medicine patients in various countries evoked a radiation alarm after therapeutic or diagnostic procedures, and even after passive exposure. A prospective calculation of activity retention in the patient's body is difficult due to extremely high variation of uptake and kinetics. Furthermore, different sensitivities and distances of the detectors make a prospective calculation even more difficult. In this article a number of cases are being reported, related problems are discussed and the surprisingly very limited literature reviewed. In order to minimize problems after eventually triggering alarms, we strongly recommend that each patient receives a certificate providing personal data, tracer, dose, half-life of the radionuclide, type and date of procedure applied as well as the nuclear medicine unit to contact for further information. Furthermore, a closer cooperation and exchange of information between the authorities and local nuclear medicine societies, would be welcome.

  9. 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)

  10. [Activities of administered radiopharmaceuticals and population dose from nuclear medicine in Czechoslovakia].

    PubMed

    Gushak, V; Rzhichkova, G

    1991-01-01

    The authors assessed by means of questionnaires the activities of radiopharmaceuticals administered in departments of nuclear medicine in Czechoslovakia. The mean activities of individual radiopharmaceuticals are roughly equal as in Great Britain but lower than in the Canadian province of Manitoba. The differences of activities used in different departments are approximately equal in all compared countries. In the Czech Republic the annual collective effective dose equivalent from nuclear medicine was 433 Sv in 1983 and 609 Sv in 1987. The mean effective dose equivalent per examination was 2.23 mSv in 1983 and 2.44 mSv in 1987. The mean effective dose equivalent per inhabitant of the Czech Republic was 0.042 mSv in 1983 and 0.059 mSv in 1987. The radiation dose of the Czech population from nuclear medicine amounts approximately to one tenth of the load from radiodiagnostics.

  11. Comparison between Impact factor, SCImago journal rank indicator and Eigenfactor score of nuclear medicine journals.

    PubMed

    Ramin, Sadeghi; Sarraf Shirazi, Alireza

    2012-08-27

    Despite its widespread acceptance in the scientific world, impact factor (IF) has been criticized recently on many accounts: including lack of quality assessment of the citations, influence of self citation, English language bias, etc. In the current study, we evaluated three indices of journal scientific impact: (IF), Eigenfactor Score (ES), and SCImago Journal rank indicator (SJR) of nuclear medicine journals. Overall 13 nuclear medicine journals are indexed in ISI and SCOPUS and 7 in SCOPUS only. Self citations, Citations to non-English articles, citations to non-citable items and citations to review articles contribute to IFs of some journals very prominently, which can be better detected by ES and SJR to some extent. Considering all three indices while judging quality of the nuclear medicine journals would be a better strategy due to several shortcomings of IF.

  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. 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

  14. The Production of Radionuclides for Radiotracers in Nuclear Medicine

    NASA Astrophysics Data System (ADS)

    Ruth, Thomas J.

    Medical applications represent the vast majority of the uses for radiotracers. This review addresses how accelerators are employed for the production of high purity radionuclides that are used in basic biomedical research, as well as for clinical medicine both for diagnosing disease and for treatment.

  15. 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.

  16. Patient safety principles in family medicine residency accreditation standards and curriculum objectives

    PubMed Central

    Kassam, Aliya; Sharma, Nishan; Harvie, Margot; O’Beirne, Maeve; Topps, Maureen

    2016-01-01

    Abstract Objective To conduct a thematic analysis of the College of Family Physicians of Canada’s (CFPC’s) Red Book accreditation standards and the Triple C Competency-based Curriculum objectives with respect to patient safety principles. Design Thematic content analysis of the CFPC’s Red Book accreditation standards and the Triple C curriculum. Setting Canada. Main outcome measures Coding frequency of the patient safety principles (ie, patient engagement; respectful, transparent relationships; complex systems; a just and trusting culture; responsibility and accountability for actions; and continuous learning and improvement) found in the analyzed CFPC documents. Results Within the analyzed CFPC documents, the most commonly found patient safety principle was patient engagement (n = 51 coding references); the least commonly found patient safety principles were a just and trusting culture (n = 5 coding references) and complex systems (n = 5 coding references). Other patient safety principles that were uncommon included responsibility and accountability for actions (n = 7 coding references) and continuous learning and improvement (n = 12 coding references). Conclusion Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID:27965349

  17. Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns.

    PubMed

    Hemming, Patrick; Teague, Paula J; Crowe, Thomas; Levine, Rachel

    2016-04-01

    Improved collaboration between physicians and chaplains has the potential to improve patient experiences. To better understand the benefits and challenges of learning together, the authors conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. The authors derived four major qualitative themes from the transcripts: (1) physician learners became aware of effective communication skills for addressing spirituality. (2) Chaplain interns enhanced the delivery of team-based patient-centered care. (3) Chaplains were seen as a source of emotional support to the medical team. (4) The partnership has three keys to success: adequate introductions for team members, clear expectations for participants, and opportunities for feedback. The themes presented indicate several benefits of pairing physicians and chaplains in the setting of direct patient care and suggest that this is an effective approach to incorporating spirituality in medical training.

  18. Nuclear medicine in the acute clinical setting: indications, imaging findings, and potential pitfalls.

    PubMed

    Uliel, Livnat; Mellnick, Vincent M; Menias, Christine O; Holz, Andrew L; McConathy, Jonathan

    2013-01-01

    Nuclear medicine imaging provides valuable functional information that complements information obtained with anatomic imaging techniques in the evaluation of patients with specific acute clinical manifestations. Nuclear medicine studies are most often used in conjunction with other imaging modalities and as a problem-solving tool. Under certain circumstances a nuclear medicine study may be indicated as the first-line imaging modality, as in the case of renal scintigraphy for transplant dysfunction in the early postoperative period. Nuclear imaging may be preferred when a conventional first-line study is contraindicated or when it is important to minimize radiation exposure. The portability of nuclear imaging offers particular advantages for the evaluation of critically ill patients whose clinical condition is unstable and who cannot be safely transported out of the intensive care unit. The ability to visualize physiologic and pathophysiologic processes over relatively long time periods without adding to the patient's radiation exposure contributes to the high diagnostic sensitivity of several types of nuclear medicine studies. Viewing the acquired images in the cine mode adds to the value of these studies for diagnosing and characterizing dynamic abnormalities such as intermittent internal bleeding and bile or urine leakage. In this pictorial review, the spectrum of nuclear medicine studies commonly performed in the acute care setting is reviewed according to body systems and organs, with detailed descriptions of the indications, technical considerations, findings, and potential pitfalls of each type of study. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.332125098/-/DC1.

  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. 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.

  1. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities

    PubMed Central

    Mercuri, Mathew; Rehani, Madan M.; Einstein, Andrew J.

    2013-01-01

    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 U.S., currently lags behind x-ray based procedures with respect to reporting of radiation dosimetric information. This paper 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

  2. EPR DOSIMETRY STUDY FOR POPULATION RESIDING IN THE VICINITY OF FALLOUT TRACE FOR NUCLEAR TEST ON 7 AUGUST 1962.

    PubMed

    Zhumadilov, Kassym Sh; Ivannikov, Alexander I; Stepanenko, Valeriy F; Toyoda, Shin; Skvortsov, Valeriy G; Hoshi, Masaharu

    2016-12-01

    The method of electron paramagnetic resonance (EPR) dosimetry using extracted teeth has been applied to human tooth enamel to obtain individual absorbed doses of residents of settlements in the vicinity of the central axis of radioactive fallout trace from the contaminating surface nuclear test on 7 August 1962. Most of the settlements (Kurchatov, Akzhar, Begen, Buras, Grachi, Mayskoe, Semenovka) are located from 70 to 120 km to the North-East from the epicenter of the explosion at the Semipalatinsk Nuclear Test Site (SNTS). This region is basically an agricultural region. A total of 57 teeth samples were collected from these sites. Eight teeth from residents of the Kokpekty settlement, which was not subjected to any radioactive contamination and located 400 km to the Southeast from SNTS, were chosen as a control. The principal findings, using this method, were that the average excess dose obtained after subtraction of the natural background radiation was 13 mGy and ranged up to about 100 mGy all for residents in this region.

  3. A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

    PubMed Central

    2014-01-01

    Background In 2011, the Accreditation Council of Graduate Medical Education implemented updated guidelines for medical resident duty hours, further limiting continuous work hours for first-year residents. We sought to investigate the impact of these restrictions on graduate medical education among internal medicine residents. Methods We conducted eight focus groups with internal medicine residents at the University of Alabama at Birmingham in 06/2012-07/2012. Discussion questions included, “How do you feel the 2011 ACGME work hour restrictions have impacted your graduate medical education?” Transcripts of the focus groups were reviewed and themes identified using a deductive/inductive approach. Participants completed a survey to collect demographic information and future practice plans. Results Thirty-four residents participated in our focus groups. Five themes emerged: decreased teaching, decreased experiential learning, shift-work mentality, tension between residency classes, and benefits and opportunities. Residents reported that since implementation of the guidelines, teaching was often deferred to complete patient-care tasks. Residents voiced concern that PGY-1 s were not receiving adequate clinical experience and that procedural and clinical reasoning skills are being negatively impacted. PGY-1 s reported being well-rested and having increased time for independent study. Conclusions Residents noted a decline in teaching and are concerned with the decrease in “hands-on” clinical education that is inevitably impacted by fewer hours in the hospital, though some benefits were also reported. Future studies are needed to further elucidate the impact of decreased resident work hours on graduate medical education. PMID:24755276

  4. A comparison of simulation-based education versus lecture-based instruction for toxicology training in emergency medicine residents.

    PubMed

    Maddry, Joseph K; Varney, Shawn M; Sessions, Daniel; Heard, Kennon; Thaxton, Robert E; Ganem, Victoria J; Zarzabal, Lee A; Bebarta, Vikhyat S

    2014-12-01

    Simulation-based teaching (SIM) is a common method for medical education. SIM exposes residents to uncommon scenarios that require critical, timely actions. SIM may be a valuable training method for critically ill poisoned patients whose diagnosis and treatment depend on key clinical findings. Our objective was to compare medical simulation (SIM) to traditional lecture-based instruction (LEC) for training emergency medicine (EM) residents in the acute management of critically ill poisoned patients. EM residents completed two pre-intervention questionnaires: (1) a 24-item multiple-choice test of four toxicological emergencies and (2) a questionnaire using a five-point Likert scale to rate the residents' comfort level in diagnosing and treating patients with specific toxicological emergencies. After completing the pre-intervention questionnaires, residents were randomized to SIM or LEC instruction. Two toxicologists and three EM physicians presented four toxicology topics to both groups in four 20-min sessions. One group was in the simulation center, and the other in a lecture hall. Each group then repeated the multiple-choice test and questionnaire immediately after instruction and again at 3 months after training. Answers were not discussed. The primary outcome was comparison of immediate mean post-intervention test scores and final scores 3 months later between SIM and LEC groups. Test score outcomes between groups were compared at each time point (pre-test, post-instruction, 3-month follow-up) using Wilcoxon rank sum test. Data were summarized by descriptive statistics. Continuous variables were characterized by means (SD) and tested using t tests or Wilcoxon rank sum. Categorical variables were summarized by frequencies (%) and compared between training groups with chi-square or Fisher's exact test. Thirty-two EM residents completed pre- and post-intervention tests and comfort questionnaires on the study day. Both groups had higher post-intervention mean test

  5. 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.

  6. [Interdisciplinary training opportunities for residents in occupational medicine: the experience of the ERC Tour 2012].

    PubMed

    Toninelli, E; Fostinelli, J; Rosen, M A; Lucchini, R; Apostoli, P

    2012-01-01

    This paper describes the experience of the School of Occupational Medicine of the University of Brescia at the current edition of the New York and New Jersey Education and Research Center--Historical Perspectives Tour on Occupational Safety and Health, that involved 5 different industrial and environmental sites, appropriate for understanding the complex occupational health and safety problems. In every site, the participants have interacted with workers and professionals and discussed about the specific work processes, to better understand the risk faced by the workers, occupational pathologies that can occur, personal protective equipment used and preventive measures adopted. This experience has been successful in provide interdisciplinary educations to occupational safety and health professionals in training in order to prepare them for the collaboration and cooperation required to solve the complex occupational health and safety problems they will face in their future careers.

  7. ``THE UNVEILED HEART'' a teaching program in cardiovascular nuclear medicine

    NASA Astrophysics Data System (ADS)

    Itti, Roland; Merabet, Yasmina; Roca, Ramona; Bontemps, Laurence; Itti, Emmanuel

    2004-07-01

    The functional investigation of cardiac diseases using nuclear techniques involves several variables, such as myocardial perfusion, cellular viability or mechanical contraction. The combined, topographical and quantitative assessment of these variables can characterize the functional state of the heart in terms of normal myocardium, ischemia, hibernation or necrosis. The teaching program, "The Unveiled Heart", has been designed in order to help nuclear physicians or cardiologists approaching these concepts and their implications for diagnosis of coronary artery disease, optimization of therapeutic strategies and prognosis evaluation. Anatomical correlations with coronary angiographic results obtained during balloon occlusion at the time of coronary angioplasty demonstrate the complementary role of imaging techniques and highlight the patient to patient variability of risk areas. A sectorial model derived from a polar projection of the myocardium presents for each sector the probability of involvement of a given coronary artery.

  8. Comparison of the activity measurements in nuclear medicine services in the Brazilian northeast region.

    PubMed

    de Farias Fragoso, Maria da Conceição; de Albuquerque, Antônio Morais; de Oliveira, Mércia L; de Lima, Fabiana Farias; Barreto, Flávio Chiappetta Paes; de Andrade Lima, Ricardo

    2013-12-01

    The Northeastern Regional Centre for Nuclear Sciences (CRCN-NE), National Nuclear Energy Commission, has organized for the first time in nuclear medicine services (NMSs) in the Brazilian northeast region a comparison of activity measurements for (99m)Tc, (131)I, (67)Ga, (201)Tl and (57)Co. This tool is widely utilized to evaluate not only the accuracy of radionuclide calibrators, but also the competence of NMSs to measure the activity of the radiopharmaceuticals and the performance of the personnel involved in these measurements. The comparison results showed that 90% of the results received from participants are within the ±10% limit established by the Brazilian Norm.

  9. 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.

  10. Development of RadRob15, A Robot for Detecting Radioactive Contamination in Nuclear Medicine Departments

    PubMed Central

    Shafe, A.; Mortazavi, S.M.J.; Joharnia, A.; Safaeyan, Gh.H.

    2016-01-01

    Accidental or intentional release of radioactive materials into the living or working environment may cause radioactive contamination. In nuclear medicine departments, radioactive contamination is usually due to radionuclides which emit high energy gamma photons and particles. These radionuclides have a broad range of energies and penetration capabilities. Rapid detection of radioactive contamination is very important for efficient removing of the contamination without spreading the radionuclides. A quick scan of the contaminated area helps health physicists locate the contaminated area and assess the level of activity. Studies performed in IR Iran shows that in some nuclear medicine departments, areas with relatively high levels of activity can be found. The highest contamination level was detected in corridors which are usually used by patients. To monitor radioactive contamination in nuclear medicine departments, RadRob15, a contamination detecting robot was developed in the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC). The motor vehicle scanner and the gas radiation detector are the main components of this robot. The detection limit of this robot has enabled it to detect low levels of radioactive contamination. Our preliminary tests show that RadRob15 can be easily used in nuclear medicine departments as a device for quick surveys which identifies the presence or absence of radioactive contamination. PMID:27853728

  11. 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.

  12. Development of RadRob15, A Robot for Detecting Radioactive Contamination in Nuclear Medicine Departments.

    PubMed

    Shafe, A; Mortazavi, S M J; Joharnia, A; Safaeyan, Gh H

    2016-09-01

    Accidental or intentional release of radioactive materials into the living or working environment may cause radioactive contamination. In nuclear medicine departments, radioactive contamination is usually due to radionuclides which emit high energy gamma photons and particles. These radionuclides have a broad range of energies and penetration capabilities. Rapid detection of radioactive contamination is very important for efficient removing of the contamination without spreading the radionuclides. A quick scan of the contaminated area helps health physicists locate the contaminated area and assess the level of activity. Studies performed in IR Iran shows that in some nuclear medicine departments, areas with relatively high levels of activity can be found. The highest contamination level was detected in corridors which are usually used by patients. To monitor radioactive contamination in nuclear medicine departments, RadRob15, a contamination detecting robot was developed in the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC). The motor vehicle scanner and the gas radiation detector are the main components of this robot. The detection limit of this robot has enabled it to detect low levels of radioactive contamination. Our preliminary tests show that RadRob15 can be easily used in nuclear medicine departments as a device for quick surveys which identifies the presence or absence of radioactive contamination.

  13. Development of Career Opportunities for Technicians in the Nuclear Medicine Field. Final Report.

    ERIC Educational Resources Information Center

    Technical Education Research Center, Cambridge, MA.

    This report describes a nationally coordinated program development project whose purpose was to catalyze the implementation of needed postsecondary educational programs in the field of nuclear medicine technology (NMT). The NMT project was carried out during the six year period 1968-74 in cooperation with more than 36 community/junior colleges and…

  14. Applying Image Gently SM and Image Wisely SM in nuclear medicine.

    PubMed

    Jafari, Mary Ellen; Daus, Alan M

    2013-02-01

    Although computed tomography (CT) scan radiation dose has drawn much attention, radiation dose from nuclear medicine procedures should not be overlooked. An estimated 19.7 million nuclear medicine procedures are done annually in the United States, with patient radiation dose comparable to that from CT scans. Nuclear medicine departments should implement Image Gently SM and Image Wisely SM recommendations to reduce nuclear medicine patient radiation dose. Pediatric administered radiopharmaceutical doses should be compared with the North American Consensus Guidelines for Administered Radiopharmaceutical Activities in Children and Adolescents, and adult doses should be compared with national and international standards. In a 2011 patient quality and safety initiative at Gundersen Lutheran Health System, 24 pediatric protocols and 52 adult protocols were compared with standards. Doses not comparable to the recommended values were adjusted accordingly and the resultant image quality evaluated. Additional steps to reduce patient radiation dose include decision support to reduce inappropriate ordering, technique optimization for the CT portion of single-photon emission computed tomography/computed tomography and positron emission tomography/computed tomography scans, use of vendor's dose reduction camera and software technology, use of shorter lived radiopharmaceuticals, and "right sizing" patient doses by weight.

  15. A Rotating Phantom: Evaluation Of Hard And Software For Gated Gamma Camera Systems In Nuclear Medicine.

    NASA Astrophysics Data System (ADS)

    Vanregemorter, J.; Deconinck, F.; Bossuyt, A.

    1986-06-01

    In this paper we describe a rotating dynamic phantom which allows quality control of hardware and software for gated gamma camera systems in nuclear medicine. The phantom not only allows simulation of a gated heart study but also testing of the response of the whole system to time frequencies.

  16. The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine

    PubMed Central

    2010-01-01

    Background The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution. Methods A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country. Results There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed

  17. Knowledge, Current Status, and Barriers toward Healthcare Worker Vaccination among Family Medicine Resident Participants in a Web-Based Survey in Korea

    PubMed Central

    Ko, Kyungjin; Kim, Sungjong; Kim, Sang-Hyun; Son, Ki Young; Lee, Jungun

    2017-01-01

    Background We investigated the knowledge, status, and barriers toward healthcare workers receiving vaccinations among Korean family medicine residents. To date, a systematic study has not been conducted among medical practitioners examining these variables. Methods A web-based, anonymous, self-administered questionnaire was distributed to all 942 family medicine residents working in 123 training hospitals in Korea. A multiple logistic regression analysis was performed to investigate factors affecting vaccination completion. Results Korean family medicine residents (N=242, 25.7%) from 54 training hospitals (43.9%) participated in the survey. Only 24 respondents (9.9%) had correct knowledge on all the recommended vaccinations by the Korean Society of Infectious Diseases. The complete vaccination rates against hepatitis B virus and influenza were relatively high (69.4% and 83.0%, respectively), whereas they were relatively low against other infections (e.g., 16.5%– 53.1%). The most common reason for not receiving a vaccination was the belief that there was little possibility of infection from the vaccine-preventable diseases. Conclusion Knowledge and vaccination coverage were poor among family medicine residents in Korea. Medical schools should provide vaccination information to healthcare workers as part of their mandatory curriculum. Further research should confirm these findings among primary care physicians and other healthcare workers. PMID:28197329

  18. 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…

  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.

  20. Nuclear medicine in the 1990s: a quantitative physiological approach.

    PubMed

    Ott, R J

    1989-05-01

    This paper describes the potential advantages to medical diagnosis and treatment that might be obtained from the wider application of positron emission tomography as a clinical tool. Developments along the lines suggested here will require a radical change in thinking from both clinicians and the medically related scientific community in the UK and some enlightened and resourceful funding from a mixture of charitable, industrial and government sources. If these ideas are to be pursued successfully, then the work must start now on a much wider scale than is presently perceived in the UK, and close collaboration between physicists, engineers, chemists, biochemists, clinicians and industrialists is needed. Furthermore, it is imperative that the scientific developments now underway in silicon technology, parallel data processors, biochemical and pharmacological processes and even high-temperature superconductors be kept under close and constant review by those associated with the technological advancements of medicine, so that the value of such developments is rapidly transferred to applications to medicine. This must include closer relationships between academic medicine and science than is the general rule in the UK at present. In conclusion, the scenario presented here includes the installation of regional cyclotron facilities to provide a large number of institutions in the UK with positron-emitter labelled radiopharmaceuticals. Additionally, agents labelled with radionuclides from in-house generators and other already existing higher-energy cyclotrons will provide a versatile and valuable range of radiopharmaceuticals for the study of human disease. These developments must be supported by the manufacture of lower-cost positron camera systems, as suggested here, connected to high-data-rate parallel processors to provide images of body function and to determine the effects brought about by disease. These images may then be processed using algorithms based on kinetic

  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.

  2. Building and Querying RDF/OWL Database of Semantically Annotated Nuclear Medicine Images.

    PubMed

    Hwang, Kyung Hoon; Lee, Haejun; Koh, Geon; Willrett, Debra; Rubin, Daniel L

    2017-02-01

    As the use of positron emission tomography-computed tomography (PET-CT) has increased rapidly, there is a need to retrieve relevant medical images that can assist image interpretation. However, the images themselves lack the explicit information needed for query. We constructed a semantically structured database of nuclear medicine images using the Annotation and Image Markup (AIM) format and evaluated the ability the AIM annotations to improve image search. We created AIM annotation templates specific to the nuclear medicine domain and used them to annotate 100 nuclear medicine PET-CT studies in AIM format using controlled vocabulary. We evaluated image retrieval from 20 specific clinical queries. As the gold standard, two nuclear medicine physicians manually retrieved the relevant images from the image database using free text search of radiology reports for the same queries. We compared query results with the manually retrieved results obtained by the physicians. The query performance indicated a 98 % recall for simple queries and a 89 % recall for complex queries. In total, the queries provided 95 % (75 of 79 images) recall, 100 % precision, and an F1 score of 0.97 for the 20 clinical queries. Three of the four images missed by the queries required reasoning for successful retrieval. Nuclear medicine images augmented using semantic annotations in AIM enabled high recall and precision for simple queries, helping physicians to retrieve the relevant images. Further study using a larger data set and the implementation of an inference engine may improve query results for more complex queries.

  3. French diagnostic reference levels in diagnostic radiology, computed tomography and nuclear medicine: 2004-2008 review.

    PubMed

    Roch, P; Aubert, B

    2013-04-01

    After 5 y of collecting data on diagnostic reference levels (DRLs), the Nuclear Safety and Radiation Protection French Institute (IRSN) presents the analyses of this data. The analyses of the collected data for radiology, computed tomography (CT) and nuclear medicine allow IRSN to estimate the level of regulatory application by health professionals and the representativeness of current DRL in terms of relevant examinations, dosimetric quantities, numerical values and patient morphologies. Since 2004, the involvement of professionals has highly increased, especially in nuclear medicine, followed by CT and then by radiology. Analyses show some discordance between regulatory examinations and clinical practice. Some of the dosimetric quantities used for the DRL setting are insufficient or not relevant enough, and some numerical values should also be reviewed. On the basis of these findings, IRSN formulates recommendations to update regulatory DRL with current and relevant examination lists, dosimetric quantities and numerical values.

  4. Cyclotron Production of Radionuclides for Nuclear Medicine at Academic Centers

    NASA Astrophysics Data System (ADS)

    Lapi, Suzanne

    2016-09-01

    The increase in use of radioisotopes for medical imaging has led to the development of new accelerator targetry and separation techniques for isotope production. For example, the development of longer-lived position emitting radionuclides has been explored to allow for nuclear imaging agents based on peptides, antibodies and nanoparticles. These isotopes (64Cu, 89Zr, 86Y) are typically produced via irradiation of solid targets on smaller cyclotrons (10-25 MeV) at academic or hospital based facilities. Recent research has further expanded the toolbox of PET tracers to include additional isotopes such as 52Mn, 55Co, 76Br and others. The smaller scale of these types of facilities can enable the straightforward involvement of students, thus adding to the next generation of nuclear science leaders. Research pertaining to development of robust and larger scale production technologies including solid target systems and remote systems for transport and purification of these isotopes has enabled both preclinical and clinical imaging research for many diseases. In particular, our group has focused on the use of radiolabeled antibodies for imaging of receptor expression in preclinical models and in a clinical trial of metastatic breast cancer patients.

  5. Communication skills curriculum for foreign medical graduates in an internal medicine residency program.

    PubMed

    Ramaswamy, Ravishankar; Williams, Alicia; Clark, Elizabeth M; Kelley, Amy S

    2014-11-01

    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. The workshop consisted of two interactive sessions in a small group with two learners and one or two facilitators, during the 4-week geriatrics block in IM internship training year. Twenty-three IM interns at an urban Veterans Affairs Medical Center were surveyed at the beginning and at the end of the 4-week block and 3 months after completion of the workshop about their knowledge, confidence, and skill in communication and asked about challenges to effective communication with older adults. The primary outcome measure was change in self-reported confidence and behavior in communication at 4 weeks. On a 4-point Likert scale, there was average improvement of 0.70 in self-reported confidence in communication, which was sustained 3 months after completion of the workshop. Participants reported several patient, physician, and system barriers to effective communication. Communication skills education in a small-group setting and the opportunity for repeated practice and self-reflection resulted in a sustained increase in overall confidence in IM interns in communication with older adults and may help overcome certain patient- and physician-specific communication barriers.

  6. 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…

  7. The impact of a hybrid online and classroom-based course on palliative care competencies of family medicine residents.

    PubMed

    Pereira, J; Palacios, M; Collin, T; Wedel, R; Galloway, L; Murray, A; Violato, C; Lockyer, J

    2008-12-01

    The University of Calgary offers a palliative care course that involves both classroom- and web-based learning for rural-based family medicine residents. This study assessed the impact of the course on palliative care-related competencies for two classes: 2004 and 2005. Instruments were developed to evaluate pre- versus post-course changes in knowledge (15-item quiz), attitudes (12-item survey), self-perceived comfort levels (19-item survey) and skills (3 long Objective Structured Clinical Examination stations (OSCEs), with accompanying standardised score sheets). In all, 16 and 20 residents participated in the 2004 and 2005 classes, respectively. Internal reliability values were acceptable to very good (Knowledge Quiz, Kuder-Richardson 20 = 0.5; Attitude Scale, alpha = 0.68-0.78; OSCE score sheets, alpha = 0.63-0.89; Self-Perceived Comfort Survey, alpha = 0.89-0.92). Inter-rater reliability values of the OSCE score sheets were alpha = 0.87 to 0.92. There was a significant improvement in the pre- versus post-course performances in OSCE 2 for 2004 and 2005 (P = 0.01; P = 0.01; d = 1.42 and 1.94, respectively). Despite statistically insignificant changes in the other OSCEs, acceptable to large effect sizes were noted (d = 0.4-1.34) for OSCE 1 in 2004 and OSCEs 3 in 2004 and 2005. Knowledge improved significantly pre-versus post-course in 2004 and 2005 (t = 4.44 and 8.99; d = 2.29 and 2.24, respectively). Significant improvements and large effect sizes were noted in the comfort scales, but a ceiling effect was noted in the communication subscale. This hybrid course resulted in significant improvements across four domains, knowledge, attitudes, self-perceived comfort scale, and skills, in 2 consecutive classes.

  8. 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

  9. Nuclear medicine in urological cancers: what is new?

    PubMed

    Nanni, Cristina; Zanoni, Lucia; Fanti, Stefano

    2014-10-01

    The diffusion of PET/computed tomography has opened up a new role for nuclear imaging in urological oncology. Prostate cancer is evaluated with choline ((11)C or (18)F) PET due to a lack of sensitivity of (18)F-fluorodeoxyglucose (FDG). However, many new tracers, such as (18)F-fluorocyclobutane-1-carboxylic acid and (68)Ga-prostate-specific membrane antigen, are under investigation, offering promising results in the particular setting of radically treated patients with biochemical relapse. The performance of (18)F-FDG depends on the histological type; indeed, renal cell cancer may present variable metabolic uptake. In this field, mainly antibodies labeled with positron emitters are under clinical evaluation. Finally, (18)F-FDG PET/computed tomography has been proven to show good accuracy in detecting metastatic testicular and bladder cancers, despite not having valid results in detecting local disease. The urological cancer diagnostic process is currently under continuous development.

  10. 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.

  11. 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

  12. 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

    2016-02-09

    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

  13. What can be expected from nuclear medicine tomorrow?

    PubMed

    Barbet, Jacques; Kraeber-Bodéré, Françoise; Chatal, Jean-François

    2008-08-01

    Imaging can take advantage of developments in "omics" approaches and go from routine individual biomarkers to multiple-scale biomarker profiles. Imaging structural, functional, metabolic, cellular, and molecular changes will be made possible by multimodality hybrid techniques, such as positron emission tomography-magnetic resonance imaging. Imaging should predict treatment response, look at stratification for specific treatment modalities, and look at the "omic" characterization of an individual patient or a specific tumor. This should lead to the development of "personalized" medicine. In cancer radiotherapy, patient responses should be accurately predicted. In specific cases, proton and hadrontherapy will be further enhanced by the irradiation dose delivered to the tumors. For disseminated or metastatic disease, targeted radionuclide therapy is an effective addition to the arsenal against cancer. The clinical efficacy of radiolabeled antibodies has been clearly demonstrated in lymphoma as well as that of radiolabeled peptides derived from somatostatin in the treatment of neuroendocrine tumors. Preliminary studies now show interesting results in solid tumors, too. Even if the number of objective clinical responses based on tumor shrinkage is small, targeted radionuclide therapy increases progression-free survival or overall survival in some specific cases where tumor burden is small. Avenues for further improvement are multiple and include combination with other therapeutic modalities, development of new approaches (e.g., small molecules, pretargeting, and antibody alternatives). Using alpha-emitting radionuclides is another possibility for specific diseases, such as leukemias, multiple myeloma, or brain tumor remnants.

  14. 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.

  15. Applying the milestones in an internal medicine residency program curriculum: a foundation for outcomes-based learner assessment under the next accreditation system.

    PubMed

    Lowry, Becky N; Vansaghi, Lisa M; Rigler, Sally K; Stites, Steven W

    2013-11-01

    In 2010, University of Kansas Medical Center internal medicine residency program leaders concluded that their competency-based curriculum and evaluation system was not sufficient to promote accurate assessment of learners' performance and needed revision to meet the requirements of the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS). Evaluations of learners seldom referenced existing curricular goals and objectives and reflected an "everyone is exceptional, no one is satisfactory" view.The authors identified the American Board of Internal Medicine and ACGME's Developmental Milestones for Internal Medicine Residency Training as a published standard for resident development. They incorporated the milestones into templates, a format that could be modified for individual rotations. A milestones-based curriculum for each postgraduate year of training and every rotation was then created, with input from educational leaders within each division in the Department of Internal Medicine and with the support of the graduate medical education office.In this article, the authors share their implementation process, which took approximately one year, and discuss their current work to create a documentation system for direct observation of entrustable professional activities, with the aim of providing guidance to other programs challenged with developing an outcomes-based curriculum and assessment system within the time frame of the NAS.

  16. Short- and long-term responses to molybdenum-99 shortages in nuclear medicine.

    PubMed

    Ballinger, J R

    2010-11-01

    Most nuclear medicine studies use (99)Tc(m), which is the decay product of (99)Mo. The world supply of (99)Mo comes from only five nuclear research reactors and availability has been much reduced in recent times owing to problems at the largest reactors. In the short-term there are limited actions that can be taken owing to capacity issues on alternative imaging modalities. In the long-term, stability of (99)Mo supply will rely on a combination of replacing conventional reactors and developing new technologies.

  17. Refurbishing of a Freeze Drying Machine, used in Nuclear Medicine for Radiopharmaceuticals Production

    NASA Astrophysics Data System (ADS)

    Gaytán-Gallardo, E.; Desales-Galeana, G.

    2006-09-01

    The refurbishing of a freeze drying machine used in the radiopharmaceuticals production, applied in nuclear medicine in the Radioactive Materials Department of the Nuclear Research National Institute in México (ININ in Spanish), is presented. The freeze drying machine was acquired in the 80's decade and some components started having problems. Then it was necessary to refurbish this equipment by changing old cam-type temperature controllers and outdated recording devices, developing a sophisticated software system that substitutes those devices. The system is composed by a freeze drying machine by Hull, AC output modules for improved temperature control, a commercial data acquisition card, and the software system.

  18. 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.

  19. Different sets of ER-resident J-proteins regulate distinct polar nuclear-membrane fusion events in Arabidopsis thaliana.

    PubMed

    Maruyama, Daisuke; Yamamoto, Masaya; Endo, Toshiya; Nishikawa, Shuh-ichi

    2014-11-01

    Angiosperm female gametophytes contain a central cell with two polar nuclei. In many species, including Arabidopsis thaliana, the polar nuclei fuse during female gametogenesis. We previously showed that BiP, an Hsp70 in the endoplasmic reticulum (ER), was essential for membrane fusion during female gametogenesis. Hsp70 function requires partner proteins for full activity. J-domain containing proteins (J-proteins) are the major Hsp70 functional partners. A. thaliana ER contains three soluble J-proteins, AtERdj3A, AtERdj3B, and AtP58(IPK). Here, we analyzed mutants of these proteins and determined that double-mutant ovules lacking AtP58(IPK) and AtERdj3A or AtERdj3B were defective in polar nuclear fusion. Electron microscopy analysis identified that polar nuclei were in close contact, but no membrane fusion occurred in mutant ovules lacking AtP58(IPK) and AtERdj3A. The polar nuclear outer membrane appeared to be connected via the ER remaining at the inner unfused membrane in mutant ovules lacking AtP58(IPK) and AtERdj3B. These results indicate that ER-resident J-proteins, AtP58(IPK)/AtERdj3A and AtP58(IPK)/AtERdj3B, function at distinct steps of polar nuclear-membrane fusion. Similar to the bip1 bip2 double mutant female gametophytes, the aterdj3a atp58(ipk) double mutant female gametophytes defective in fusion of the outer polar nuclear membrane displayed aberrant endosperm proliferation after fertilization with wild-type pollen. However, endosperm proliferated normally after fertilization of the aterdj3b atp58(ipk) double mutant female gametophytes defective in fusion of the inner membrane. Our results indicate that the polar nuclear fusion defect itself does not cause an endosperm proliferation defect.

  20. 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.

  1. Delivery and collection of radioactive packages to and from UK hospital nuclear medicine departments.

    PubMed

    Lawson, Richard S; Davies, Glyn; Hesslewood, Stuart R; Hinton, Paul J; Maxwell, Alan

    2004-12-01

    Under radiation protection legislation in the UK, employers have a duty to maintain appropriate records to account for radioactive materials in their possession and to ensure security of these materials. This applies to radioactive packages, containing items such as technetium generators, which are regularly delivered to hospital nuclear medicine departments. It also applies to the collection of packages, such as those containing used generators for return to the supplier. This article has been written by the professional bodies representing nuclear medicine in the UK in order to provide guidance to hospitals on appropriate procedures that will comply with the legislation. General principles, which should be met by any acceptable protocol, are stated, and practical guidance on how these may be implemented is given. Some example scenarios are outlined.

  2. Practical matters for the control of contamination in a nuclear medicine department.

    PubMed

    Nicol, A; Robertson, J; McCurrach, A

    2011-03-01

    A practicable and safe methodology is required for the control of contamination arising due to work in nuclear medicine departments, taking account of the range of radionuclides used for diagnostic and therapeutic procedures. A method for categorising radionuclides is proposed, based on their contamination derived limits. The categories utilised are: low energy gamma, imaging gamma, high energy gamma with beta, low energy beta, high energy beta and (51)Cr. A framework for the preparation of a risk assessment for the control of contamination in a nuclear medicine department is presented. This includes assessment of the procedures performed, occupancies and workflows for the department and a review of control measures. A risk assessment should also include a contamination monitoring programme and a practicable approach is presented.

  3. Communication of radiation risk in nuclear medicine: Are we saying the right thing?

    PubMed

    Pandit, Manish; Vinjamuri, Sobhan

    2014-07-01

    The radiation risk arising from nuclear medicine investigations represents a small but manageable risk to patients and it needs to be effectively communicated to them. Frequently in the culture of "doctor knows best," patients trust their doctors to do whatever is right and appropriate and leave it to them to worry about any attendant risks associated with any tests involving the use of radiation. The benefit to the patient of having a speedier diagnosis and a further guide to management may not be effectively communicated in a comprehensive, timely and professional manner. In this article, we address the issue of communication of radiation risk and benefits to patients and the basis for such information. While there are different ways of communicating radiation risk, we recognize that certain basic parameters are absolutely essential for patients to enable them to make an informed choice about undergoing a nuclear medicine investigation under the direction of a well-trained and qualified individual.

  4. The development and use of radionuclide generators in nuclear medicine -- recent advances and future perspectives

    SciTech Connect

    Knapp, F.F. Jr.

    1998-03-01

    Although the trend in radionuclide generator research has declined, radionuclide generator systems continue to play an important role in nuclear medicine. Technetium-99m obtained from the molybdenum-99/technetium-99m generator system is used in over 80% of all diagnostic clinical studies and there is increasing interest and use of therapeutic radioisotopes obtained from generator systems. This paper focuses on a discussion of the major current areas of radionuclide generator research, and the expected areas of future research and applications.

  5. 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)

  6. Experience In The Integration Of A Nuclear Medicine PACS Into A PACS Radiology System

    NASA Astrophysics Data System (ADS)

    Tobes, Michael C.; Stahl, Theodore J.; Dasika, Rao

    1988-06-01

    A local Picture Archiving and Communication System (PACS) has been operational in the Division of Nuclear Medicine at Robert Wood Johnson University Hospital for the past five years. Recently, it has been interfaced to a total PACS which is based on different hardware and software. Using this hybrid system, we describe our initial efforts to facilitate the short and long term archiving of NM studies and the use of combined image displays for correlative image analysis.

  7. Nuclear medicine in pediatric neurology and neurosurgery: epilepsy and brain tumors.

    PubMed

    Patil, Shekhar; Biassoni, Lorenzo; Borgwardt, Lise

    2007-09-01

    In pediatric drug-resistant epilepsy, nuclear medicine can provide important additional information in the presurgical localization of the epileptogenic focus. The main modalities used are interictal (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and ictal regional cerebral perfusion study with single-photon emission computed tomography (SPECT). Nuclear medicine techniques have a sensitivity of approximately 85% to 90% in the localization of an epileptogenic focus in temporal lobe epilepsy; however, in this clinical setting, they are not always clinically indicated because other techniques (eg, icterictal and ictal electroencephalogram, video telemetry, magnetic resonance imaging [MRI]) may be successful in the identification of the epileptogenic focus. Nuclear medicine is very useful when MRI is negative and/or when electroencephalogram and MRI are discordant. A good technique to identify the epileptogenic focus is especially needed in the setting of extra-temporal lobe epilepsy; however, in this context, identification of the epileptogenic focus is more difficult for all techniques and the sensitivity of the isotope techniques is only 50% to 60%. This review article discusses the clinical value of the different techniques in the clinical context; it also gives practical suggestions on how to acquire good ictal SPECT and interictal FDG-PET scans. Nuclear medicine in pediatric brain tumors can help in differentiating tumor recurrence from post-treatment sequelae, in assessing the response to treatment, in directing biopsy, and in planning therapy. Both PET and SPECT tracers can be used. In this review, we discuss the use of the different tracers available in this still very new, but promising, application of radioisotope techniques.

  8. Residency Directors' Assessments of Which Selection Criteria Best Predict the Performances of Foreign-Born Foreign Medical Graduates during Internal Medicine Residencies.

    ERIC Educational Resources Information Center

    Gayed, Nasser M.

    1991-01-01

    A 1990 survey of 102 directors of internal medical residencies with the largest numbers of foreign-born foreign medical graduates revealed the most important performance predictors were performance on the Foreign Medical Graduate Examination or National Board of Medical Examiners test, interviews, and U.S. postgraduate clinical experience.…

  9. 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

  10. General comparison of functional imaging in nuclear medicine with other modalities

    SciTech Connect

    Adam, W.E.

    1987-01-01

    New (noninvasive) diagnostic procedures in medicine (ultrasound (US), digital subtraction angiography (DSA), computed tomography (CT), nuclear magnetic resonance (NMR)) create a need for a review of the clinical utility of functional imaging in nuclear medicine. A general approach that is valid for all imaging procedures is not possible. For this reason, an individual assessment for each class of functional imaging is necessary, taking into account the complexity and sophistication of the various imaging procedures. This leads to a hierarchical order: first order functional imaging: imaging of organ motion (heart, lungs, blood); second order functional imaging: imaging of excretory function (kidneys, liver); and third and fourth order functional imaging: imaging of metabolism (except excretory function). First order functional imaging is possible fundamentally, although with limitations in detail, by all modalities. Second order functional imaging is not possible with US. Third and fourth order functional imaging is a privilege of nuclear medicine alone. Up to now, NMR has not proven clinically useful to produce metabolic images in its true sense. First and second order functional imaging of nonradioactive procedures face severe disadvantages, including difficulties in performing stress investigations, which are essential for coronary heart disease, limited capability for true quantitative information (eg, kidney clearance in mL/min), side effects of contrast media and paramagnetic substances, and high costs. 58 references.

  11. 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.

  12. Use of radiopharmaceuticals in diagnostic nuclear medicine in the United States: 1960-2010.

    PubMed

    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

    2015-05-01

    To reconstruct reliable nuclear medicine-related occupational radiation doses or doses received as patients from radiopharmaceuticals over the last five decades, the authors 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 technologists' cohort and in reconstructing radiation doses from occupational or patient radiation exposures to other U.S. workers or patient populations.

  13. A Poisson resampling method for simulating reduced counts in nuclear medicine images.

    PubMed

    White, Duncan; Lawson, Richard S

    2015-05-07

    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.

  14. 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.

  15. Integrated package for interactive analysis and interpretation of nuclear medicine images

    NASA Astrophysics Data System (ADS)

    Silva, Augusto F. d.; Sousa Pereira, Antonio; Botelho, M. F.; de Lima, J. J.

    1992-06-01

    This paper describes a software package based on a set of integrated tools intended to be used in nuclear medicine imaging environments. These tools, following a functionally consistent and open architecture, aim to provide an efficient and user-friendly way for handling the analysis and interpretation of nuclear medicine images in a broad range of applications. The Image, Graphics, and Colors tools are the basic building blocks. Besides basic image handling facilities, the Image tool was designed to accomplish both conventional and special purposed processing tasks. Among these, the interactive definition of organ shaped regions of interest, functional imaging (e.g., mean transit time images in ventilatory lung studies) and activity quantitation should be pointed out as the most intensively used facilities. The Graphics tool is used mainly to display and analyze the activity/time curves resulting from parametric related studies. As intensity color coding has gained wide acceptance in nuclear medicine it was thought convenient to implement a Colors tool intended to provide interactive intensity manipulation. The X Window graphics interface system is the basis for the implementation of this set of independent but intercommunicating tools which are intended to run on all UNIX workstations provided with, at least, an 8 bit depth frame buffer.

  16. [Fetus radiation doses from nuclear medicine and radiology diagnostic procedures. Potential risks and radiation protection instructions].

    PubMed

    Markou, Pavlos

    2007-01-01

    Although in pregnancy it is strongly recommended to avoid diagnostic nuclear medicine and radiology procedures, in cases of clinical necessity or when pregnancy is not known to the physician, these diagnostic procedures are to be applied. In such cases, counseling based on accurate information and comprehensive discussion about the risks of radiation exposure to the fetus should follow. In this article, estimations of the absorbed radiation doses due to nuclear medicine and radiology diagnostic procedures during the pregnancy and their possible risk effects to the fetus are examined and then discussed. Stochastic and detrimental effects are evaluated with respect to other risk factors and related to the fetus absorbed radiation dose and to the post-conception age. The possible termination of a pregnancy, due to radiation exposure is discussed. Special radiation protection instructions are given for radiation exposures in cases of possible, confirmed or unknown pregnancies. It is concluded that nuclear medicine and radiology diagnostic procedures, if not repeated during the pregnancy, are rarely an indication for the termination of pregnancy, because the dose received by the fetus is expected to be less than 100 mSv, which indicates the threshold dose for having deterministic effects. Therefore, the risk for the fetus due to these diagnostic procedures is low. However, stochastic effects are still possible but will be minimized if the radiation absorbed dose to the fetus is kept as low as possible.

  17. 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

  18. Cancer risk in adult residents near nuclear power plants in Korea - a cohort study of 1992-2010.

    PubMed

    Ahn, Yoon-Ok; Li, Zhong Min

    2012-09-01

    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.

  19. 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

  20. Ensuring safe and quality medication use in nuclear medicine: a collaborative team achieves compliance with medication management standards.

    PubMed

    Beach, Trent A; Griffith, Karen; Dam, Hung Q; Manzone, Timothy A

    2012-03-01

    As hospital nuclear medicine departments were established in the 1960s and 1970s, each department developed detailed policies and procedures to meet the specialized and specific handling requirements of radiopharmaceuticals. In many health systems, radiopharmaceuticals are still unique as the only drugs not under the control of the health system pharmacy; however, the clear trend--and now an accreditation requirement--is to merge radiopharmaceutical management with the overall health system medication management system. Accomplishing this can be a challenge for both nuclear medicine and pharmacy because each lacks knowledge of the specifics and needs of the other field. In this paper we will first describe medication management standards, what they cover, and how they are enforced. We will describe how we created a nuclear medicine and pharmacy team to achieve compliance, and we will present the results of their work. We will examine several specific issues raised by incorporating radiopharmaceuticals in the medication management process and describe how our team addressed those issues. Finally, we will look at how the medication management process helps ensure ongoing quality and safety to patients through multiple periodic reviews. The reader will gain an understanding of medication management standards and how they apply to nuclear medicine, learn how a nuclear medicine and pharmacy team can effectively merge nuclear medicine and pharmacy processes, and gain the ability to achieve compliance at the reader's own institution.

  1. 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.

  2. Debt management and financial planning support for primary care students and residents at Boston University School of Medicine.

    PubMed

    Terrell, C; Hindle, D

    1999-01-01

    Boston University Medical Center created the Office of Residency Planning and Practice Management as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative. Since 1995, the office has improved the medical center's ability to promote and support the generalist career decisions of its students and residents by removing indebtedness as a disincentive. After a brief review of the relationship between indebtedness and specialty selection, the authors delineate the nature and volume of debt-management assistance provided by the office to students and residents through individual counseling sessions, workshops, and other means between April 1995 and March 1998. A case study shows the progression of these services throughout residency training. The medical center also coordinates its debt-management assistance with counseling from physician-oriented financial planning groups. In conclusion, the authors discuss several characteristics of a successful debt-management program for residents.

  3. 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

  4. A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

    PubMed

    Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R

    2003-01-01

    Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.

  5. Monte Carlo simulation of the dose to nuclear medicine staff wearing protective garments.

    PubMed

    Fog, L S; Collins, P

    2008-12-01

    The literature contains both endorsements of, and advice against, the use of protective apparel in nuclear medicine procedures. The main issues usually centre around: Whether the shielding which can be provided by a protective garment light enough to wear (0 to 0.6 mm lead equivalent at the gamma energies commonly encountered in nuclear medicine) is enough to warrant its use; and (more recently); Whether the dose enhancement behind the protective garment from electron scatter in lead is sufficient to be of concern. In this work, the Monte Carlo code EGSnrc was used to investigate the effectiveness of lead of thicknesses of 0 to 0.6 mm, in shielding staff from photons of energies of 140 and 511 keV. Furthermore, dose escalation behind the lead was investigated. Reasonable dose reductions are obtained at 140 keV with protective garments of 0.5 mm lead equivalence. This perhaps warrants their use, in certain circumstances. At 511 keV, the reduction in dose is less than 10%, and their use is probably not justified (given the weight that has to be carried) from an ALARA point of view. It should be noted here that protective garments designed for X-ray shielding will generally not have the same lead equivalence at the gamma energies used in nuclear medicine. It should also be noted that protective garments which do not contain lead do not always attenuate as much as their stated lead equivalence claims. Dose escalation does occur, but the depth of penetration of the scattered electrons beyond the exit side of the lead shielding is such that it is highly unlikely that a significant dose would be delivered to viable tissue in wearers of protective garments.

  6. 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

  7. Principles of nuclear medicine imaging: planar, SPECT, PET, multi-modality, and autoradiography systems.

    PubMed

    Zanzonico, Pat

    2012-04-01

    The underlying principles of nuclear medicine imaging involve the use of unsealed sources of radioactivity in the form of radiopharmaceuticals. The ionizing radiations that accompany the decay of the administered radioactivity can be quantitatively detected, measured, and imaged in vivo with instruments such as gamma cameras. This paper reviews the design and operating principles, as well as the capabilities and limitations, of instruments used clinically and preclinically for in vivo radionuclide imaging. These include gamma cameras, single-photon emission computed tomography (SPECT) scanners, and positron emission tomography (PET) scanners. The technical basis of autoradiography is reviewed as well.

  8. A strategy for intensive production of molybdenum-99 isotopes for nuclear medicine using CANDU reactors.

    PubMed

    Morreale, A C; Novog, D R; Luxat, J C

    2012-01-01

    Technetium-99m is an important medical isotope utilized worldwide in nuclear medicine and is produced from the decay of its parent isotope, molybdenum-99. The online fueling capability and compact fuel of the CANDU(®)(1) reactor allows for the potential production of large quantities of (99)Mo. This paper proposes (99)Mo production strategies using modified target fuel bundles loaded into CANDU fuel channels. Using a small group of channels a yield of 89-113% of the weekly world demand for (99)Mo can be obtained.

  9. Role of nuclear</