The quantum universe: philosophical foundations and oriental medicine.

PubMed

Kafatos, Menas C; Yang, Keun-Hang

2016-12-01

The existence of universal principles in both science and medicine implies that one can explore their common applicability. Here we explore what we have learned from quantum mechanics, phenomena such as entanglement and nonlocality, the role of participation of the observer, and how these may apply to oriental medicine. The universal principles of integrated polarity, recursion, and creative interactivity apply to all levels of existence and all human activities, including healing and medicine. This review examines the possibility that what we have learned from quantum mechanics may provide clues to better understand the operational principles of oriental medicine in an integrated way. Common to both is the assertion that Consciousness is at the foundation of the universe and the inner core of all human beings. This view goes beyond both science and medicine and has strong philosophical foundations in Western philosophy as well as monistic systems of the East.

Pediatric nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 ismore » 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.« less

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. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Could there be a Synthesis between Western and Oriental Medicine, and with Sasang Constitutional Medicine in Particular?

PubMed Central

2009-01-01

Attitudes towards oriental medicine are changing for two major reasons. The first is that many patients, even in the West, are choosing to use its practitioners and methods. The second is that the rise of Systems Biology may offer a better basis for dialogue, and even for synthesis, between the oriental and Western traditions. However, a lot of work is needed to clear the way for such dialogue and synthesis. Much of this work should be devoted to clarifying the meanings of the terms used, and the framework of theory and practice within which oriental methods operate. But it is also necessary for Systems Biology itself to mature as a discipline, particularly at the higher levels of biological organization since it is at these levels that oriental medicine derives its ideas and practice. Higher level Systems Biology could be a basis for interpretation of the Korean version of oriental medicine: Sasang constitutional medicine since it seeks patient specific analysis and treatment, and the mathematical methods of systems biology could be used to analyze the central concept of balance in Sasang. PMID:19745006

[Costing nuclear medicine diagnostic procedures].

PubMed

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

Discrepancies on quality perceived by the patients versus professionals on the quality of a nuclear medicine department.

PubMed

Rodrigo-Rincon, I; Goñi-Girones, E; Serra-Arbeloa, P; Martinez-Lozano, M E; Reyes-Pérez, M

2015-01-01

To evaluate the discrepancies between the professionals and outpatients on quality perceived of a Nuclear Medicine Department (NMD). This cross-sectional study has been carried out using two questionnaires: a validated patient experience questionnaire and a quality perception questionnaire for professionals. Both questionnaires use the same 25 categorical items to measure service quality, 2 Likert scale items to measure satisfaction and willingness to recommend the NMD and 1 open-ended question. The patient questionnaire included 6 socio-demographic items and one job-related question (professionals). The categorical items were classified as "conformity" or "non-conformity." The response rate was 36.7% for outpatients and 100% for professionals. Mean value for satisfaction with the NMD was 9 points for patients and 6.9 points for professionals. Mean number of non-conformity items per person was 2.8 for the patient group and 8.7 for the professional group. Cohen's Kappa value was 0.112, indicating poor agreement in the classification of items as strong points and areas for improvement. Of the 25 items, the professionals and patients coincided on 12 (48%). Agreement was low between the quality perception of patients and professionals. The patients scored quality of service higher than the NMD professionals did. These instruments are useful aid to help health organizations detect areas for improvement, and to improve the quality of the service provided to patients. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Development of Scintillators in Nuclear Medicine.

PubMed

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

2015-01-01

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

History and Perspectives of Nuclear Medicine in Myanmar

PubMed Central

Mar, Win

2018-01-01

Nuclear Medicine was established in Myanmar in 1963 by Dr Soe Myint and International Atomic Energy expert Dr R. Hochel at Yangon General Hospital. Nuclear medicine diagnostic and therapeutic services started with Probe Scintillation Detector Systems and rectilinear scanner. In the early stage, many Nuclear Medicine specialists from the International Atomic Energy Agency (IAEA) spent some time in Myanmar and made significant contributions to the development of Nuclear Medicine in our country. The department participated in various IAEA technical cooperation projects and regional cooperation projects. By the late 1990s, new centers were established in Mandalay, Naypyidaw, and North Okkalapa Teaching Hospital of University of Medicine 11, Yangon. The training program related to Nuclear Medicine includes a postgraduate master’s degree (three years) at the University of Medicine. Currently, all centers are equipped with SPECT, SPECT-CT, PET-CT, and cyclotron in Yangon General Hospital. Up until now, the International Atomic Energy Agency has been playing a crucial role in the growth and development of Nuclear Medicine in Myanmar. Our vision is to provide a wide spectrum of nuclear medicine services at a level compatible with the international standards to become a Center of Excellence. PMID:29333470

Epidemiology for the nuclear medicine technologist.

PubMed

Bolus, N E

2001-09-01

The purpose of this article is to introduce the nuclear medicine technologist to the field of epidemiology. There are many applications of epidemiology in nuclear medicine, including research studies that deal with the causes of disease or ways to prevent disease from occurring and investigating the possible effects of ionizing radiation on occupational workers and the general public. One use of an epidemiologic study is to suggest ways to reduce the occurrence of a disease. After reading this article, the nuclear medicine technologist will be familiar with: a) the history and underlying assumptions of epidemiology, b) types of epidemiologic studies, c) what is a valid statistical association for an epidemiologic study, d) proper judgment of cause and effect relationships, e) definitions of epidemiologic terms, and f) an example of a nuclear medicine research study.

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

[Customer orientation in ambulant medicine].

PubMed

Heinrich, M

2014-07-01

Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications. Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis. The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer. The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict. Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of

Estimation of internal exposure to 99Mo in nuclear medicine patients.

PubMed

Silva, I C O A; Lucena, E A; Souza, W O; Dantas, A L A; Dantas, B M

2010-05-10

(99m)Tc is the most widely used radionuclide in nuclear medicine. It is obtained by elution of (99)Mo-(99m)Tc generators. Depending on the quality of the generator and its integrity, (99)Mo may be extracted from the column during the elution process, becoming a radionuclidic impurity in the (99m)Tc eluate. This fact would impart an unnecessary dose to the patients submitted to diagnostic procedures. The aim of this work is to evaluate (99)Mo incorporation and internal effective doses in nuclear medicine patients through bioassay techniques, providing information on the metabolism of molybdenum in humans. A methodology based on in vivo and in vitro measurements was developed. In vivo measurements were performed with a NaI detector installed in the IRD WBC. Urine samples were analysed with a HPGe at the IRD bioassay laboratory. Patients showed detectable activities of (99)Mo in whole body and urine. Results were interpreted with AIDE software. Estimated incorporation was compared to predicted values based on ICRP model. Effective doses were in the order of micro sieverts. Results suggest the need to implement a routine quality control program of radionuclidic impurity of (99)Mo in (99m)Tc eluates to be conducted by radiopharmacy laboratories of nuclear medicine centers.

Process quality indicators in family medicine: results of an international comparison.

PubMed

Pavlič, Danica Rotar; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor

2015-12-02

The aim of our study was to describe variability in process quality in family medicine among 31 European countries plus Australia, New Zealand, and Canada. The quality of family medicine was measured in terms of continuity, coordination, community orientation, and comprehensiveness of care. The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and three non-European countries (Australia, Canada, and New Zealand). We used random sampling when national registers of practitioners were available. Regional registers or lists of facilities were used for some countries. A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care. Multilevel linear regression analysis was performed to evaluate the variation of quality attributable to the family physician level and the country level. None of the 34 countries in this study consistently scored the best or worst in all categories. Continuity of care was perceived by family physicians as the most important dimension of quality. Some components of comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied substantially between countries. Coordination of care was identified as the weakest part of quality. We found that physician-level characteristics contributed to the majority of variation. A comparison of process quality indicators in family medicine revealed similarities and differences within and between countries. The researchers found that the major proportion of variation can be explained by physicians' characteristics.

Nuclear medicine training and practice in Turkey.

PubMed

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

2017-05-01

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.

National Certification Commission for Acupuncture and Oriental Medicine

MedlinePlus

... Certified Holding To Try Acupuncture or Oriental Medicine Treatment, Find a Practitioner ... to the Website Dr. Kory Ward-Cook, Ph.D., MT(ASCP), CAE serves as the Chief Executive Officer for the ...

Understanding the cause of an unreadable nuclear medicine image: a case of unexpected results with 123I whole-body scintigraphy.

PubMed

Skweres, Justin; Yang, Zhiyun; Gonzalez-Toledo, Eduardo

2014-12-01

When unexpected results are obtained with standard image collection, the nuclear medicine physician must consider many technical factors that may have contributed. When image quality is poor, prior radiotracer administration, among other things, should always be considered. Our case demonstrates how knowledge of patient history and basic principles of nuclear medicine physics allows recognition of the septal penetration artifact. This allows the nuclear medicine physician to tailor the exam to an individual patient and obtain the most useful diagnostic information for the clinician. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Theranostics in nuclear medicine practice.

PubMed

Yordanova, Anna; Eppard, Elisabeth; Kürpig, Stefan; Bundschuh, Ralph A; Schönberger, Stefan; Gonzalez-Carmona, Maria; Feldmann, Georg; Ahmadzadehfar, Hojjat; Essler, Markus

2017-01-01

The importance of personalized medicine has been growing, mainly due to a more urgent need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for specific molecular targeting, both for diagnostics and therapy. The visualization of potential targets can help predict if a patient will benefit from a particular treatment. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents has been continually increasing. In this article, important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with a well-known radioiodine therapy in patients with thyroid cancer and then progresses through various approaches for the treatment of advanced cancer with targeted therapies. The aim of this review was to provide a summary of background knowledge and current applications, and to identify the advantages of targeted therapies and imaging in nuclear medicine practices.

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficacy-oriented compatibility for component-based Chinese medicine

PubMed Central

Zhang, Jun-hua; Zhu, Yan; Fan, Xiao-hui; Zhang, Bo-li

2015-01-01

Single-target drugs have not achieved satisfactory therapeutic effects for complex diseases involving multiple factors. Instead, innovations in recent drug research and development have revealed the emergence of compound drugs, such as cocktail therapies and “polypills”, as the frontier in new drug development. A traditional Chinese medicine (TCM) prescription that is usually composed of several medicinal herbs can serve a typical representative of compound medicines. Although the traditional compatibility theory of TCM cannot be well expressed using modern scientific language nowadays, the fundamental purpose of TCM compatibility can be understood as promoting efficacy and reducing toxicity. This paper introduces the theory and methods of efficacy-oriented compatibility for developing component-based Chinese medicines. PMID:25864650

(Cardiology and nuclear medicine)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Knapp, F.F. Jr.

1988-10-27

The traveler was invited to serve as an external examiner for a doctoral thesis entitled Analysis of Myocardial Time-Activity Curves Related to Radiolabeled Free Fatty Acid Metabolism'' in the Cardiology Department at the Free University of Amsterdam, The Netherlands. The traveler also visited the Institute for Clinical and Experimental Nuclear Medicine in Bonn, West Germany, the Department of Nuclear Medicine in Aachen, West Germany, and the Cyclotron Research Center in Liege, Belgium. He led discussions, reviewed data, and coordinated further collaboration on the preclinical studies and clinical testing of radiopharmaceuticals being developed by the traveler's research group at the Oakmore » Ridge National Laboratory (ORNL).« less

Theranostics in nuclear medicine practice

PubMed Central

Yordanova, Anna; Eppard, Elisabeth; Kürpig, Stefan; Bundschuh, Ralph A; Schönberger, Stefan; Gonzalez-Carmona, Maria; Feldmann, Georg; Ahmadzadehfar, Hojjat; Essler, Markus

2017-01-01

The importance of personalized medicine has been growing, mainly due to a more urgent need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for specific molecular targeting, both for diagnostics and therapy. The visualization of potential targets can help predict if a patient will benefit from a particular treatment. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents has been continually increasing. In this article, important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with a well-known radioiodine therapy in patients with thyroid cancer and then progresses through various approaches for the treatment of advanced cancer with targeted therapies. The aim of this review was to provide a summary of background knowledge and current applications, and to identify the advantages of targeted therapies and imaging in nuclear medicine practices. PMID:29042793

General Nuclear Medicine

MedlinePlus

... The special camera and imaging techniques used in nuclear medicine include the gamma camera and single-photon emission-computed tomography (SPECT). The gamma camera, also called a scintillation camera, detects radioactive energy that is emitted from the patient's body and ...

Mentoring and the Nuclear Medicine Technologist.

PubMed

Burrell, Lance

2018-06-08

The goal of this article is to give an overview of mentoring for nuclear medicine technologists (NMT). Mentoring is an integral part of the training and practice in the field of nuclear medicine technology. There is a great need for NMTs to continue involvement in mentorship so that we can develop and maintain the talent and leadership that the field needs. In this article, definitions of mentorship will be provided. Then, how mentoring can work; including different methods and techniques will be covered. Next, the benefits of mentoring will be discussed. Finally, advice for improved application will be presented. Throughout, this article will discuss how mentoring applies to the NMT. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Complementary and alternative drug therapy versus science-oriented medicine.

PubMed

Anlauf, Manfred; Hein, Lutz; Hense, Hans-Werner; Köbberling, Johannes; Lasek, Rainer; Leidl, Reiner; Schöne-Seifert, Bettina

2015-01-01

This opinion deals critically with the so-called complementary and alternative medical (CAM) therapy on the basis of current data. From the authors' perspective, CAM prescriptions and most notably the extensive current endeavours to the "integration" of CAM into conventional patient care is problematic in several respects. Thus, several CAM measures are used, although no specific effects of medicines can be proved in clinical studies. It is extensively explained that the methods used in this regard are those of evidence-based medicine, which is one of the indispensable pillars of science-oriented medicine. This standard of proof of efficacy is fundamentally independent of the requirement of being able to explain efficacy of a therapy in a manner compatible with the insights of the natural sciences, which is also essential for medical progress. Numerous CAM treatments can however never conceivably satisfy this requirement; rather they are justified with pre-scientific or unscientific paradigms. The high attractiveness of CAM measures evidenced in patients and many doctors is based on a combination of positive expectations and experiences, among other things, which are at times unjustified, at times thoroughly justified, from a science-oriented view, but which are non-specific (context effects). With a view to the latter phenomenon, the authors consider the conscious use of CAM as unrevealed therapeutic placebos to be problematic. In addition, they advocate that academic medicine should again systematically endeavour to pay more attention to medical empathy and use context effects in the service of patients to the utmost. The subsequent opinion discusses the following after an introduction to medical history: the definition of CAM; the efficacy of most common CAM procedures; CAM utilisation and costs in Germany; characteristics of science-oriented medicine; awareness of placebo research; pro and contra arguments about the use of CAM, not least of all in terms of

[Development of whole process quality control and management system of traditional Chinese medicine decoction pieces based on traditional Chinese medicine quality tree].

PubMed

Yu, Wen-Kang; Dong, Ling; Pei, Wen-Xuan; Sun, Zhi-Rong; Dai, Jun-Dong; Wang, Yun

2017-12-01

The whole process quality control and management of traditional Chinese medicine (TCM) decoction pieces is a system engineering, involving the base environment, seeds and seedlings, harvesting, processing and other multiple steps, so the accurate identification of factors in TCM production process that may induce the quality risk, as well as reasonable quality control measures are very important. At present, the concept of quality risk is mainly concentrated in the aspects of management and regulations, etc. There is no comprehensive analysis on possible risks in the quality control process of TCM decoction pieces, or analysis summary of effective quality control schemes. A whole process quality control and management system for TCM decoction pieces based on TCM quality tree was proposed in this study. This system effectively combined the process analysis method of TCM quality tree with the quality risk management, and can help managers to make real-time decisions while realizing the whole process quality control of TCM. By providing personalized web interface, this system can realize user-oriented information feedback, and was convenient for users to predict, evaluate and control the quality of TCM. In the application process, the whole process quality control and management system of the TCM decoction pieces can identify the related quality factors such as base environment, cultivation and pieces processing, extend and modify the existing scientific workflow according to their own production conditions, and provide different enterprises with their own quality systems, to achieve the personalized service. As a new quality management model, this paper can provide reference for improving the quality of Chinese medicine production and quality standardization. Copyright© by the Chinese Pharmaceutical Association.

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…

Exploring in integrated quality evaluation of Chinese herbal medicines: the integrated quality index (IQI) for aconite.

PubMed

Zhang, Ding-kun; Wang, Jia-bo; Yang, Ming; Peng, Cheng; Xiao, Xiao-he

2015-07-01

Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the

New Trends and Possibilities in Nuclear Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmidt, H.A.E.; Csernay, L

New Trends and Possibilities in Nuclear Medicine provides an examination of the latest developments in the field of nuclear medicine. This volume reviews advances made in imaging techniques and presents a detailed overview of many new imaging procedures and their clinical applications, e.g.,the oncological applications of immunoscintigraphy. This book also elucidates the various diagnostic capabilities of nuclear imaging in a wide range of disciplines, including cardiology, neurology, pulmonology, gastroenterology, nephrology, oncology, and hematology.

Implementation of test for quality assurance in nuclear medicine gamma camera

NASA Astrophysics Data System (ADS)

Moreno, A. Montoya; Laguna, A. Rodríguez; Zamudio, Flavio E. Trujillo

2012-10-01

In nuclear medicine (NM) over 90% of procedures are performed for diagnostic purposes. To ensure adequate diagnostic quality of images and the optimization of the doses received by patients originated from the radioactive material is essential for regular monitoring and equipment performance through a quality assurance program (QAP). The QAP consists of 15 proposed performance tomographic and not tomographic gamma camera (GC) tests, and is based on recommendations of international organizations. We describe some results of the performance parameters of QAP applied to a GC model e.cam Siemens, of the Department of NM of the National Cancer Institute of Mexico (INCan). The results were: (1) The average intrinsic spatial resolution (Rin) was 4.67 ± 0.25 mm at the limit of acceptance criterion of 4.4 mm. (2) The sensitivity extrinsic (Sext), with maximum variations of 1.8% (less than 2% which is the criterion of acceptance). (3) Rotational Uniformity (Urot), with values of integral uniformity (IU) in the useful field of view detector (UFOV), with maximum percentage change of 0.97% and monthly variations equal angles, ranging from 0.13 to 0.99% less than 1%. (4) The displacement of the center of rotation (DCOR), indicated a maximum deviation of 0.155 ± 0.039 mm less than 4.795 mm, an absolute deviation of less than 0.5 where pixel 0.085 pixel is suggested, the criteria are assigned to low-energy collimator high resolution. (5) In tomographic uniformity (Utomo), UI values (%) and percentage noise level (rms%) were 7.54 ± 1.53 and 4.18 ± 1.69 which are consistent with the limits of acceptance of 7.0-12.0% and 3.0-6.0% respectively. The smallest cold sphere has a diameter of 11.4 mm. The implementation of a QAP allows for high quality diagnostic images, optimization of the doses given to patients, a reduction of exposure to occupationally exposed workers (POE, by its Spanish acronym), and generally improves the productivity of the service. This proposal can be used to

Implementation of test for quality assurance in nuclear medicine gamma camera

DOE Office of Scientific and Technical Information (OSTI.GOV)

Montoya Moreno, A.; Rodriguez Laguna, A.; Trujillo Zamudio, Flavio E

2012-10-23

In nuclear medicine (NM) over 90% of procedures are performed for diagnostic purposes. To ensure adequate diagnostic quality of images and the optimization of the doses received by patients originated from the radioactive material is essential for regular monitoring and equipment performance through a quality assurance program (QAP). The QAP consists of 15 proposed performance tomographic and not tomographic gamma camera (GC) tests, and is based on recommendations of international organizations. We describe some results of the performance parameters of QAP applied to a GC model e.cam Siemens, of the Department of NM of the National Cancer Institute of Mexicomore » (INCan). The results were: (1) The average intrinsic spatial resolution (R{sub in}) was 4.67 {+-} 0.25 mm at the limit of acceptance criterion of 4.4 mm. (2) The sensitivity extrinsic (S{sub ext}), with maximum variations of 1.8% (less than 2% which is the criterion of acceptance). (3) Rotational Uniformity (U{sub rot}), with values of integral uniformity (IU) in the useful field of view detector (UFOV), with maximum percentage change of 0.97% and monthly variations equal angles, ranging from 0.13 to 0.99% less than 1%. (4) The displacement of the center of rotation (DCOR), indicated a maximum deviation of 0.155 {+-} 0.039 mm less than 4.795 mm, an absolute deviation of less than 0.5 where pixel 0.085 pixel is suggested, the criteria are assigned to low-energy collimator high resolution. (5) In tomographic uniformity (U{sub tomo}), UI values (%) and percentage noise level (rms%) were 7.54 {+-} 1.53 and 4.18 {+-} 1.69 which are consistent with the limits of acceptance of 7.0-12.0% and 3.0-6.0% respectively. The smallest cold sphere has a diameter of 11.4 mm. The implementation of a QAP allows for high quality diagnostic images, optimization of the doses given to patients, a reduction of exposure to occupationally exposed workers (POE, by its Spanish acronym), and generally improves the productivity of

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.

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.

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 in...

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 in...

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 in...

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 in...

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 in...

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

Complementary and alternative drug therapy versus science-oriented medicine

PubMed Central

Anlauf, Manfred; Hein, Lutz; Hense, Hans-Werner; Köbberling, Johannes; Lasek, Rainer; Leidl, Reiner; Schöne-Seifert, Bettina

2015-01-01

This opinion deals critically with the so-called complementary and alternative medical (CAM) therapy on the basis of current data. From the authors’ perspective, CAM prescriptions and most notably the extensive current endeavours to the “integration” of CAM into conventional patient care is problematic in several respects. Thus, several CAM measures are used, although no specific effects of medicines can be proved in clinical studies. It is extensively explained that the methods used in this regard are those of evidence-based medicine, which is one of the indispensable pillars of science-oriented medicine. This standard of proof of efficacy is fundamentally independent of the requirement of being able to explain efficacy of a therapy in a manner compatible with the insights of the natural sciences, which is also essential for medical progress. Numerous CAM treatments can however never conceivably satisfy this requirement; rather they are justified with pre-scientific or unscientific paradigms. The high attractiveness of CAM measures evidenced in patients and many doctors is based on a combination of positive expectations and experiences, among other things, which are at times unjustified, at times thoroughly justified, from a science-oriented view, but which are non-specific (context effects). With a view to the latter phenomenon, the authors consider the conscious use of CAM as unrevealed therapeutic placebos to be problematic. In addition, they advocate that academic medicine should again systematically endeavour to pay more attention to medical empathy and use context effects in the service of patients to the utmost. The subsequent opinion discusses the following after an introduction to medical history: the definition of CAM; the efficacy of most common CAM procedures; CAM utilisation and costs in Germany; characteristics of science-oriented medicine; awareness of placebo research; pro and contra arguments about the use of CAM, not least of all in terms

The role of general nuclear medicine in breast cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greene, Lacey R, E-mail: lgreene@csu.edu.au; Wilkinson, Deborah; Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales

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 amore » powerful modality for patients with breast cancer.« less

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 ...

Current research in nuclear medicine and molecular imaging in Italy: highlights of the 10th National Congress of the Italian Association of Nuclear Medicine and Molecular Imaging.

PubMed

Cuocolo, A

2011-06-01

The 10th National Congress of the Italian Association of Nuclear Medicine and Molecular Imaging (AIMN) took place in Rimini on March 18-21, 2011 under the chairmanship of Professor Stefano Fanti. The program was of excellent quality and put a further step for the settlement of the standardized AIMN congress structure. A large industrial exhibition demonstrated the latest technological innovations and developments within the field. The congress was a great success with more than 1100 total participants and more than 360 abstracts received. Of these, 40 abstracts were accepted for oral and 285 for poster presentations. The original investigations presented were related to different areas of nuclear medicine and molecular imaging, with particular focus on advances in instrumentation and data processing, progress in radiochemistry and pharmacy, novel diagnostics and therapeutics, and new insights in well established areas of clinical application, such as oncology, cardiology, neurology, psychiatry, endocrinology, paediatrics, and infection and inflammation. Noteworthy, several presentations at this congress, focusing on quantitative interpretation of the imaging data and on pragmatic endpoints, such as adverse outcomes, identified when nuclear medicine procedures achieved clinical effectiveness for patient care and patient management and further demonstrated that nuclear medicine plays a crucial role in the contemporary medical scenario. This highlights lecture is only a brief summary of the large amount of data presented and discussed, which can be found in much greater detail in the congress abstract book, published as volume 55, supplement 1 of the Q J Nucl Med Mol Imaging in April 2011.

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…

[Medicine and orientalism in the late nineteenth century Korea].

PubMed

Lee, Jong-Chan

2002-06-01

The paper investigates medical missionaries that exerted a significant role in establishing Western medicine in the late nineteenth century Chosun, in relation to orientalism, an academically popularized concept introduced by Edward Said. Historical analysis is focused on several important medical missionaries such as Horace N. Allen, William B. Scranton, John W. Heron, C. C. Vinton, and Oliver R. Avison to explain how their activism as medical missionary contributed to the formation of medical orientalism in which Western medicine was 'taught, studied, administered, and judged' in that period. In addition, I explore into how medical orientalism was in service of Japanese imperialism by showing that medical missionaries had to be under imperial surveillance by Japanese colonizers. The article explores the medical system of the Koryo Dynasty period and its social characteristics. First, the structure of medical system and roles of medical institutions during the Koryo Dynasty period will be summarized. Then the characteristics of the medical system will be identified through exploring the principles of its formation in a view of social recognition of medical care and a view of social recognition of medical care and a view of public policy.

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

Radiation safety audit of a high volume Nuclear Medicine Department.

PubMed

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

2014-10-01

Professional radiation exposure cannot be avoided in nuclear medicine practices. It can only be minimized up to some extent by implementing good work practices. 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. 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. 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. 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.

The contribution of physics to Nuclear Medicine: physicians' perspective on future directions.

PubMed

Mankoff, David A; Pryma, Daniel A

2014-12-01

Advances in Nuclear Medicine physics enabled the specialty of Nuclear Medicine and directed research in other aspects of radiotracer imaging, ultimately leading to Nuclear Medicine's emergence as an important component of current medical practice. Nuclear Medicine's unique ability to characterize in vivo biology without perturbing it will assure its ongoing role in a practice of medicine increasingly driven by molecular biology. However, in the future, it is likely that advances in molecular biology and radiopharmaceutical chemistry will increasingly direct future developments in Nuclear Medicine physics, rather than relying on physics as the primary driver of advances in Nuclear Medicine. Working hand-in-hand with clinicians, chemists, and biologists, Nuclear Medicine physicists can greatly enhance the specialty by creating more sensitive and robust imaging devices, by enabling more facile and sophisticated image analysis to yield quantitative measures of regional in vivo biology, and by combining the strengths of radiotracer imaging with other imaging modalities in hybrid devices, with the overall goal to enhance Nuclear Medicine's ability to characterize regional in vivo biology.

The Belgian commitment to pharmaceutical quality: a model policy to improve quality assurance of medicines available through humanitarian and development programs.

PubMed

Ravinetto, Raffaella; Roosen, Tim; Dujardin, Catherine

2018-01-01

Today, a combination of globalization of pharmaceutical production, lack of regulatory harmonization, and weakness of Medicines Regulatory Authorities, creates the "perfect conditions" for poor-quality medicine to circulate in the global market and to penetrate the less-regulated countries. Medicines regulation is the responsibility of the national regulatory authorities in the recipient country, but in the poorer countries, in practice, the responsibility of supply of quality-assured medicines is often taken by Non-Governmental Organizations and other implementers. But with some notable exceptions, many donors lack a pharmaceutical procurement policy with adequate quality requirements; and many implementers lack the skills and expertise needed to orient themselves in the complex web of global pharmaceutical supply. Thus, patients served by humanitarian or development programs may remain exposed to the risk of poor-quality medicines. When public money is used to purchase medicines for medical programs to be carried out overseas, adequate policies should be in place to assure that the same quality requirements are set that would be required for medicines marketed in the "donor" country. We will describe here a policy recently adopted in Belgium, i.e. the "Commitment to Quality Assurance for Pharmaceutical Products", signed in October 2017 by the Vice Prime Minister and Minister for Development Cooperation and 19 Belgian implementing agencies. By signing the new policy, the counterparts committed to ensure quality of medicines in the programs funded by Belgium's Official Development Assistance, and to build quality-assurance capacity in the recipient countries. Implementers are requested to integrate in their financing applications a section for pharmaceutical quality assurance, with a justified budget. They are also invited to consider how costs could be rationalized and mutualized by aligning the strengths of the various implementers. This model policy has the

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.

Avoidable challenges of a nuclear medicine facility in a developing nation

PubMed Central

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

2013-01-01

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

Pulmonary nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loken, M.K.

1987-01-01

This book contains 19 chapters. Some of the titles are: Pulmonary Nuclear Medicine; Radionuclide Venography as an Adjunct to V-P Imaging in the Assessment of Thromboembolic Disease; Assessment of Mucous Transport in the Respiratory Tract by Radioisotopic Techniques; Radiolabeled Blood Cells and Tracers in the Study of Acute Pulmonary Injury and ARDS; and Magnetic Resonance Imaging of the Lungs.

Comparative analysis of dosimetry parameters for nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

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 ICRPmore » 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.« less

Effects of oriental medicine music therapy in an ovarian cancer patient with So-Eum-type constitution: a case report.

PubMed

Lee, Seung-Hyun; Song, Eunhye; Kim, Seul-Ki

2015-03-01

The cancer incidence in Korea has been increasing, although there is a serious lack of supportive care for the treatment and management of the rapidly increasing number of cancer patients, and there is an immense need for therapeutic interventions to support cancer patients. A 47-year-old So-Eum -type Korean female patient, who was diagnosed with ovarian cancer, had been receiving chemotherapies. She was experiencing pain due to swelling of her hands and feet, and under extreme stress due to hardships of life. During the patient's fourth chemotherapy treatment, she received oriental medicine music therapy twice per week for 2 weeks, for 1 hour each time (4 sessions in total). A self-administered questionnaire and the visual analog scale were used to assess and determine the level of negative and positive feelings. After receiving the oriental medicine music therapy, her negative and positive feelings as well as the visual analog scale score that reflects subjective health conditions have improved and stabilized. This case report suggests the potential of oriental medicine music therapy as a complementary and alternative medical treatment method to promote and enhance quality of life and health conditions of cancer patients in postsurgical care and chemotherapy treatment.

Thirty years from now: future physics contributions in nuclear medicine.

PubMed

Bailey, Dale L

2014-12-01

This paper is the first in a series of invited perspectives by pioneers of nuclear medicine imaging and physics. A medical physicist and a nuclear medicine physician each take a backward and a forward look at the contributions of physics to nuclear medicine. Here, we provide a forward look from the medical physicist's perspective. The author examines a number of developments in nuclear medicine and discusses the ways in which physics has contributed to these. Future developments are postulated in the context of an increasingly personalised approach to medical diagnostics and therapies. A skill set for the next generation of medical physicists in nuclear medicine is proposed in the context of the increasing complexity of 'Molecular Imaging' in the next three decades. The author sees a shift away from 'traditional' roles in instrumentation QA to more innovative approaches in understanding radiobiology and human disease.

Converting energy to medical progress [nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

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 biologicalmore » 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.« less

A profile of Australian nuclear medicine technologist practice.

PubMed

Adams, Edwina J; Cox, Jennifer M; Adamson, Barbara J; Schofield, Deborah J

2008-01-01

Nuclear medicine in Australia has encountered significant change over the past 30 years, with a move to privately owned practices, technological advances and the transfer of education of the nuclear medicine technologist (NMT) from technical college apprenticeships to university degrees. Currently, shortages of nuclear medicine technologists are reported in some states of Australia. It is not known whether changes in NMT practice or the type of centre in which an NMT works have an influence on retention of staff. The primary objective of this survey was to establish a profile of NMT practice in Australia, with the aim of producing baseline data that could be used in further research to establish levels of retention and job satisfaction. Chief technologists in three states of Australia were invited to respond to a written questionnaire. The questionnaire included data about staffing levels, imaging modalities, procedures performed, and movement of staff. Findings presented will relate to the profile of practice data only. Forty-eight (54%) chief technologists responded to the questionnaire with 73% working in privately owned practices. The majority of centres employ up to two full-time equivalent nuclear medicine technologists and have two gamma cameras and one full-time equivalent nuclear medicine physician. Most centres perform a limited range of studies with bone scans predominating. More than half the centres make some use of a centralized radiopharmacy service. Further research is required to determine how these changes may impact on workplace satisfaction and in turn, on retention.

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2014-02-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to external quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2013-09-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

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

Linking quality and performance. Quality orientation can be a competitive strategy for health care providers.

PubMed

Rapert, M I; Babakus, E

1996-01-01

Many organizations are not convinced a quality orientation pays off and are looking for ways to link quality with performance. The authors' exploratory study found that a quality orientation is a differentiating factor between low-performing and high-performing general service hospitals. They also developed a quality scale to assess the performance implications of quality-based strategies in the health care industry. Successful health care organizations (1) develop a strategic quality orientation at the management level, (2) support the pursuit of quality at the contact level, and (3) monitor external customers' perceptions of quality.

Interprofessional student education: exchange program between Albert Einstein College of Medicine and Pacific College of Oriental Medicine.

PubMed

Anderson, Belinda J; Herron, Patrick D; Downie, Sherry A; Myers, Daniel C; Milan, Felise B; Olson, Todd R; Kligler, Ben E; Sierpina, Victor S; Kreitzer, Mary Jo

2012-01-01

The growing popularity of complementary and alternative medicine (CAM), of which estimated 38% of adults in the United States used in 2007, has engendered changes in medical school curricula to increase students' awareness of it. Exchange programs between conventional medical schools and CAM institutions are recognized as an effective method of interprofessional education. The exchange program between Albert Einstein College of Medicine (Einstein, Yeshiva University) and Pacific College of Oriental Medicine, New York campus (PCOM-NY) is in its fifth year and is part of a broader relationship between the schools encompassing research, clinical training, interinstitutional faculty and board appointments, and several educational activities. The Einstein/PCOM-NY student education exchange program is part of the Einstein Introduction to Clinical Medicine Program and involves students from Einstein learning about Chinese medicine through a lecture, the experience of having acupuncture, and a four-hour preceptorship at the PCOM outpatient clinic. The students from PCOM learn about allopathic medicine training through an orientation lecture, a two-and-a-half-hour dissection laboratory session along side Einstein student hosts, and a tour of the clinical skills center at the Einstein campus. In the 2011/2012 offering of the exchange program, the participating Einstein and PCOM students were surveyed to assess the educational outcomes. The data indicate that the exchange program was highly valued by all students and provided a unique learning experience. Survey responses from the Einstein students indicated the need for greater emphasis on referral information, which has been highlighted in the literature as an important medical curriculum integrative medicine competency. Copyright © 2012 Elsevier Inc. All rights reserved.

Guidelines on nuclear medicine imaging in neuroblastoma.

PubMed

Bar-Sever, Zvi; Biassoni, Lorenzo; Shulkin, Barry; Kong, Grace; Hofman, Michael S; Lopci, Egesta; Manea, Irina; Koziorowski, Jacek; Castellani, Rita; Boubaker, Ariane; Lambert, Bieke; Pfluger, Thomas; Nadel, Helen; Sharp, Susan; Giammarile, Francesco

2018-06-25

Nuclear medicine has a central role in the diagnosis, staging, response assessment and long-term follow-up of neuroblastoma, the most common solid extracranial tumour in children. These EANM guidelines include updated information on 123 I-mIBG, the most common study in nuclear medicine for the evaluation of neuroblastoma, and on PET/CT imaging with 18 F-FDG, 18 F-DOPA and 68 Ga-DOTA peptides. These PET/CT studies are increasingly employed in clinical practice. Indications, advantages and limitations are presented along with recommendations on study protocols, interpretation of findings and reporting results.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

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 awaremore » 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.« less

Utilization of nuclear medicine scintigraphy in Taiwan, 1997-2009.

PubMed

Hung, Mao-Chin; Hsieh, Wanhua Annie; Chang, Peter Wushou; Hwang, Jeng-Jong

2011-12-01

To analyze the utilization of nuclear medicine scintigraphy in the Taiwanese population within the national health-care system between 1997 and 2009. Based on the Taiwan's National Health Insurance Research Database of 1997-2009, a retrospective population-based analysis was conducted. Descriptive statistics and regression analysis were employed to analyze the frequencies and longitudinal trends in the utilization of diagnostic nuclear medicine procedures during the period. In addition, correlation analysis was applied to determine the correlated factors in the utility of nuclear medicine scintigraphy. The annual total nuclear medicine scintigraphy was estimated to be 256,389 on average in 1997-2009 and 11.7 per 1,000 population over the period. The frequency had increased by 67% over the years, from 8.2 per 1,000 population in 1997 to 13.7 per 1,000 population in 2009. The most frequently performed procedures were whole-body bone scans (33.4% of total) and myocardial perfusion scans (29.4% of total), with 4,615 and 5,620 increments per year, respectively. Most patients were in the age group of 41-65 years old when taking examinations. In addition, male subjects were slightly more than female patients (51.5 vs. 48.5%). Furthermore, the frequencies of whole-body bone scans and PET scans were proportional to the incidences of cancers (correlation coefficients were 0.96 and 0.94, respectively). The utilization of nuclear medicine scintigraphy with the National Health Insurance system in Taiwan has been changed considerably in the past 13 years. Both whole-body bone scan and myocardial perfusion scan were performed most often with significantly increases. The trend of nuclear medicine scintigraphy may have potential impact on making health-care policy in Taiwan.

Quality Measures in Orthopaedic Sports Medicine: A Systematic Review.

PubMed

Abrams, Geoffrey D; Greenberg, Daniel R; Dragoo, Jason L; Safran, Marc R; Kamal, Robin N

2017-10-01

To report the current quality measures that are applicable to orthopaedic sports medicine physicians. Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website. Results were screened by 2 Board-certified orthopaedic surgeons with fellowship training in sports medicine and dichotomized based on sports medicine-specific or general orthopaedic (nonarthroplasty) categories. Hip and knee arthroplasty measures were excluded. Included quality measures were further categorized based on Donabedian's domains and the Center for Medicare and Medicaid (CMS) National Quality Strategy priorities. A total of 1,292 quality measures were screened and 66 unique quality measures were included. A total of 47 were sports medicine-specific and 19 related to the general practice of orthopaedics for a fellowship-trained sports medicine specialist. Nineteen (29%) quality measures were collected within PQRS, with 5 of them relating to sports medicine and 14 relating to general orthopaedics. AAOS Clinical Practice Guidelines (CPGs) comprised 40 (60%) of the included measures and were all within sports medicine. Five (8%) additional measures were collected within AHRQ and 2 (3%) within NQF. Most quality measures consist of process rather than outcome or structural measures. No measures addressing concussions were identified. There are many existing quality measures relating to the practice of orthopaedic sports medicine. Most quality measures are process measures described within PQRS or AAOS CPGs. Knowledge of quality measures are important as they may be used to improve care, are increasingly being used to

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)

Nuclear Medicine Physics: The Basics. 7th ed.

PubMed

Mihailidis, Dimitris

2012-10-01

Nuclear Medicine Physics: The Basics. 7th ed. Ramesh Chandra, Lippincott Williams and Wilkins, a Wolters Kluwer Business. Philadelphia, 2012. Softbound, 224 pp. Price: $69.99. ISBN: 9781451109412. © 2012 American Association of Physicists in Medicine.

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

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

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.

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

ACR-SNM Task Force on Nuclear Medicine Training: report of the task force.

PubMed

Guiberteau, Milton J; Graham, Michael M

2011-06-01

The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in physiology and molecular biology. These changes have unmasked weaknesses in current nuclear medicine and radiology training programs. Adding to the impetus for change are the attendant realities of the job market and uncertain employment prospects for physicians trained in nuclear medicine but not also trained in diagnostic radiology. With this background, the ACR and the Society of Nuclear Medicine convened the Task Force on Nuclear Medicine Training to define the issues and develop recommendations for resident training.

UK nuclear medicine survey, 1992-93.

PubMed

Elliott, A T; Elliott, F M; Shields, R A

1996-01-01

A postal survey of UK nuclear medicine departments was undertaken to collate information on equipment, numbers of procedures and staffing levels for the years 1992 and 1993. It was estimated that there are 235 sites undertaking nuclear medicine, the total number of procedures performed being some 490,000 in 1993 compared with 430,000 in 1989. Informal investigation suggests that the increase is due to greater usage of myocardial perfusion and lung ventilation/perfusion studies. Wide variations were noted in staffing levels, with only 22% of departments having medical cover of half-time equivalent or better: over 30% of departments have less than one consultant session per week. Approximately 20% of departments claimed to have no physics input, with a further 20% having less than one session per week.

The contribution of Medical Physics to Nuclear Medicine: looking back - a physicist's perspective.

PubMed

Hutton, Brian F

2014-12-01

This paper is the first 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 Medical Physics to Nuclear Medicine. Contributions of Medical Physics are presented from the early discovery of radioactivity, development of first imaging devices, computers and emission tomography to recent development of hybrid imaging. There is evidence of significant contribution of Medical Physics throughout the development of Nuclear Medicine.

[Acupuncture with Point Location-a mandatory examination for American NCCAOM certification of acupuncture and oriental medicine].

PubMed

Tian, Kaiyu; Rao, Hong; Lin, Yongqing; He, Yang; Zhao, Junqing; Chen, Qiang

2017-03-12

Acupuncture with Point Location is one of the mandatory examinations for the Diplomate of Oriental Medicine (Dipl.OM.) or Acupuncture (Dipl. Ac.) by American National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). In reference to NCCAOM Certification Handbook, Acupuncture with Point Location Expanded Content Outline , and Study Guide for Diplomates in Acupuncture Certification , the authors introduced the examination pattern and examination-related contents including such aspects as safety and professional responsibilities, treatment plan, and point location and discussed additionally the enlightening effects on acupuncture practice and examination in universities and international associations of Chinese medicine in our country.

TH-E-9A-01: Medical Physics 1.0 to 2.0, Session 4: Computed Tomography, Ultrasound and Nuclear Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samei, E; Nelson, J; Hangiandreou, N

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. CT 2.0: CT has been undergoing a dramatic transition in themore » last few decades. While the changes in the technology merits discussions of their own, an important question is how clinical medical physicists are expected to effectively engage with the new realities of CT technology and practice. Consistent with the upcoming paradigm of Medical Physics 2.0, this CT presentation aims to provide definitions and demonstration of the components of the new clinical medical physics practice pertaining CT. The topics covered include physics metrics and analytics that aim to provide higher order clinicallyrelevant quantification of system performance as pertains to new (and not so new) technologies. That will include the new radiation and dose metrics (SSDE, organ dose, risk indices), image quality metrology (MTF/NPS/d’), task-based phantoms, and the effect of patient size. That will follow with a discussion of the testing implication of new CT hardware (detectors, tubes), acquisition methods (innovative helical geometries, AEC, wide beam CT, dual energy, inverse geometry, application specialties), and image processing and analysis (iterative reconstructions, quantitative CT, advanced renditions). The presentation will conclude with a discussion of clinical and operational aspects of Medical Physics 2.0 including training and

Physicochemical equivalence of generic antihypertensive medicines (EQUIMEDS): protocol for a quality of medicines assessment

PubMed Central

Redfern, Julie; Adedoyin, Rufus Adesoji; Ofori, Sandra; Anchala, Raghupathy; Ajay, Vamadevan S; De Andrade, Luciano; Zelaya, Jose; Kaur, Harparkash; Balabanova, Dina; Sani, Mahmoud U

2016-01-01

Background Prevention and optimal management of hypertension in the general population is paramount to the achievement of the World Heart Federation (WHF) goal of reducing premature cardiovascular disease (CVD) mortality by 25% by the year 2025 and widespread access to good quality antihypertensive medicines is a critical component for achieving the goal. Despite research and evidence relating to other medicines such as antimalarials and antibiotics, there is very little known about the quality of generic antihypertensive medicines in low-income and middle-income countries. The aim of this study was to determine the physicochemical equivalence (percentage of active pharmaceutical ingredient, API) of generic antihypertensive medicines available in the retail market of a developing country. Methods An observational design will be adopted, which includes literature search, landscape assessment, collection and analysis of medicine samples. To determine physicochemical equivalence, a multistage sampling process will be used, including (1) identification of the 2 most commonly prescribed classes of antihypertensive medicines prescribed in Nigeria; (2) identification of a random sample of 10 generics from within each of the 2 most commonly prescribed classes; (3) a geographical representative sampling process to identify a random sample of 24 retail outlets in Nigeria; (4) representative sample purchasing, processing to assess the quality of medicines, storage and transport; and (5) assessment of the physical and chemical equivalence of the collected samples compared to the API in the relevant class. In total, 20 samples from each of 24 pharmacies will be tested (total of 480 samples). Discussion Availability of and access to quality antihypertensive medicines globally is therefore a vital strategy needed to achieve the WHF 25×25 targets. However, there is currently a scarcity of knowledge about the quality of antihypertensive medicines available in developing countries

Radiation exposure to sonographers from nuclear medicine patients: A review.

PubMed

Earl, Victoria Jean; Badawy, Mohamed Khaldoun

2018-06-01

Following nuclear medicine scans a patient can be a source of radiation exposure to the hospital staff, including sonographers. Sonographers are not routinely monitored for occupational radiation exposure as they do not commonly interact with radioactive patients or other sources of ionizing radiation. This review aims to find evidence relating to the risk and amount of radiation the sonographer is exposed to from nuclear medicine patients. It is established in the literature that the radiation exposure to the sonographer following diagnostic nuclear medicine studies is low and consequently the risk is not significant. Nevertheless, it is paramount that basic radiation safety principles are followed to ensure any exposure to ionizing radiation is kept as low as reasonably achievable. Practical recommendations are given to assist the sonographer in radiation protection. Nuclear medicine therapy procedures may place the sonographer at higher risk and as such consultation with a Radiation Safety Officer or Medical Physicist as to the extent of exposure is recommended. © 2018 The Royal Australian and New Zealand College of Radiologists.

[Correction of respiratory movement using ultrasound for cardiac nuclear medicine examinations: fundamental study using an X-ray TV machine].

PubMed

Yoda, Kazushige; Umeda, Tokuo; Hasegawa, Tomoyuki

2003-11-01

Organ movements that occur naturally as a result of vital functions such as respiration and heartbeat cause deterioration of image quality in nuclear medicine imaging. Among these movements, respiration has a large effect, but there has been no practical method of correcting for this. In the present study, we examined a method of correction that uses ultrasound images to correct baseline shifts caused by respiration in cardiac nuclear medicine examinations. To evaluate the validity of this method, simulation studies were conducted with an X-ray TV machine instead of a nuclear medicine scanner. The X-ray TV images and ultrasound images were recorded as digital movies and processed with public domain software (Scion Image). Organ movements were detected in the ultrasound images of the subcostal four-chamber view mode using slit regions of interest and were measured on a two-dimensional image coordinate. Then translational shifts were applied to the X-ray TV images to correct these movements by using macro-functions of the software. As a result, respiratory movements of about 20.1 mm were successfully reduced to less than 2.6 mm. We conclude that this correction technique is potentially useful in nuclear medicine cardiology.

[Quality of medicines in least developed countries].

PubMed

Videau, J Y

2006-12-01

Due to worsening economic conditions and poor enforcement of existing pharmaceutical and customs regulations, third world countries are faced with a growing threat from counterfeit and substandard medicines. With the expansion of illicit markets in urban areas, the sales of medicines of uncertain quality and origin are increasing. Most victims of this illicit trade are among the world's poorest populations that cannot afford to buy quality drugs through private-sector distribution channels. National pharmaceutical programs promoting universal access to essential generic medicines at reasonable cost are the key to curbing this problem. A system based on strict, rational pharmaceutical purchasing and distribution policies with quality assurance at every level of the supply chain is needed to guarantee that patients receive safe effective high quality healthcare products.

Quality-Oriented Management of Educational Innovation at Madrasah Ibtidaiyah

ERIC Educational Resources Information Center

Sofanudin, Aji; Rokhman, Fathur; Wasino; Rusdarti

2016-01-01

This study aims to explore the quality-oriented management of educational innovation at Madrasah Ibtidaiyah. Quality-Oriented Management of Educational Innovation is the process of managing new resources (ideas, practices, objects, methods) in the field of education to achieve educational goals or solve the problem of education. New ideas,…

[Establishment of traceability system of Chinese medicinal materials' quality].

PubMed

Qi, Yao-dong; Gao, Shi-man; Liu, Hai-tao; Li, Xi-wen; Wei, Jian-he; Zhang, Ben-gang; Sun, Xiao-bo; Xiao, Pei-gen

2015-12-01

The quality of Chinese medicinal materials relates greatly to the clinical curative effect and security. In order to ensure the quality and safety of Chinese medicinal materials, a systematic and operable traceability system needs to be established. It can realize the whole process of quality and safety management of Chinese medicinal materials "from production to consumption" through recording and inquiring information and recalling defective products, which is an important direction for the future development of traditional Chinese medicine. But it is still at the exploration and trial stage. In this paper, a framework of Chinese medicinal materials' quality and safety traceability system was established on the basis of the domestic and international experience about the construction of food and agricultural products traceability systems. The relationship between traceability system of Chinese medicinal materials' quality and GAP, GMP, GSP was analyzed, and the possible problems and the corresponding solutions were discussed.

Nuclear medicine. Bibliography from Nuclear Science Abstracts, Volumes 31--33

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1976-12-01

References to 4362 publications related to nuclear medicine announced in Nuclear Science Abstracts (NSA) volumes 31(Jan.--June 1975), 32(July--Dec. 1975), and 33(Jan.--June 1976) are contained in this bibliography. References are arranged in order by the original NSA abstract number which approximately places them in chronological order. Sequence numbers appear beside each reference, and the indexes refer to these sequence numbers. Indexes included are: Corporate, Personal Author, Subject, and Report Number.

NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

Will the Australian nuclear medicine technologist workforce meet anticipated health care demands?

PubMed

Adams, Edwina; Schofield, Deborah; Cox, Jennifer; Adamson, Barbara

2008-05-01

Determination of national nuclear medicine technologist workforce size was made from census data in 2001 and 1996 and from the professional body in 2004. A survey conducted by the authors in 2005 provided retention patterns in north-eastern Australia and suggested causes. Utilisation of nuclear medicine diagnostic services was established through the Medicare Benefits Schedule group statistics. More than half the nuclear medicine technologist workforce is under 35 years of age. Attrition commences from age 30, with very few workers over 55 years. In 2005 there was a 12% attrition of the survey workforce. In the past decade, service provision increased while workforce size decreased and the nuclear medicine technologist workforce is at risk of failing to meet the anticipated rise in health service needs.

Assessment of OEP health's risk in nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.

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. Ourmore » 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.« less

Monte Carlo simulations in Nuclear Medicine

NASA Astrophysics Data System (ADS)

Loudos, George K.

2007-11-01

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

Radiation doses for pediatric nuclear medicine studies: comparing the North American consensus guidelines and the pediatric dosage card of the European Association of Nuclear Medicine.

PubMed

Grant, Frederick D; Gelfand, Michael J; Drubach, Laura A; Treves, S Ted; Fahey, Frederic H

2015-04-01

Estimated radiation dose is important for assessing and communicating the risks and benefits of pediatric nuclear medicine studies. Radiation dose depends on the radiopharmaceutical, the administered activity, and patient factors such as age and size. Most radiation dose estimates for pediatric nuclear medicine have not been based on administered activities of radiopharmaceuticals recommended by established practice guidelines. The dosage card of the European Association of Nuclear Medicine (EANM) and the North American consensus guidelines each provide recommendations of administered activities of radiopharmaceuticals in children, but there are substantial differences between these two guidelines. For 12 commonly performed pediatric nuclear medicine studies, two established pediatric radiopharmaceutical administration guidelines were used to calculate updated radiation dose estimates and to compare the radiation exposure resulting from the recommendations of each of the guidelines. Estimated radiation doses were calculated for 12 common procedures in pediatric nuclear medicine using administered activities recommended by the dosage card of the EANM (version 1.5.2008) and the 2010 North American consensus guidelines for radiopharmaceutical administered activities in pediatrics. Based on standard models and nominal age-based weights, radiation dose was estimated for typical patients at ages 1, 5, 10 and 15 years and adult. The resulting effective doses were compared, with differences greater than 20% considered significant. Following either the EANM dosage card or the 2010 North American guidelines, the highest effective doses occur with radiopharmaceuticals labeled with fluorine-18 and iodine-123. In 24% of cases, following the North American consensus guidelines would result in a substantially higher radiation dose. The guidelines of the EANM dosage card would lead to a substantially higher radiation dose in 39% of all cases, and in 62% of cases in which patients

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.

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

Relationship factors and quality among mixed-orientation couples.

PubMed

Kays, Jill L; Yarhouse, Mark A; Ripley, Jennifer S

2014-01-01

Mixed-orientation couples are defined as a heterosexual couple in which 1 partner experiences same-sex attraction and the other does not. Despite the fact that there is a sizable number of mixed-orientation couples in the U.S. adult population, few researchers have studied this population, and thus, there is limited understanding of these relationships. The authors examined the degree to which relationship commitment, partner-focused forgivingness, and marital values were associated with relationship quality, and how these variables predicted relationship quality. The total sample (N = 265) consisted of 2 independent samples-105 sexual minorities (i.e., the spouse who experiences same-sex attraction) and 160 heterosexual spouses. The data were not dyadic. Together, commitment, partner-focused forgivingness, and marital values accounted for roughly 43% of the variance in relationship quality. Relationship commitment was found to be the largest single predictor of relationship quality, followed by partner-focused forgivingness. Research and clinical implications are discussed. This study significantly adds to the current research base by quantitatively measuring various variables in these relationships, as well as expanding our understanding of relationship quality in mixed-orientation couples and factors that may play a role.

MO-AB-207-03: ACR Update in Nuclear Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harkness, B.

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date asmore » the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.« less

Nuclear Medicine | RadTown USA | US EPA

EPA Pesticide Factsheets

2018-05-01

>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.

Quality Evaluation Scores are no more Reliable than Gestalt in Evaluating the Quality of Emergency Medicine Blogs: A METRIQ Study.

PubMed

Thoma, Brent; Sebok-Syer, Stefanie S; Colmers-Gray, Isabelle; Sherbino, Jonathan; Ankel, Felix; Trueger, N Seth; Grock, Andrew; Siemens, Marshall; Paddock, Michael; Purdy, Eve; Kenneth Milne, William; Chan, Teresa M

2018-01-30

Construct: We investigated the quality of emergency medicine (EM) blogs as educational resources. Online medical education resources such as blogs are increasingly used by EM trainees and clinicians. However, quality evaluations of these resources using gestalt are unreliable. We investigated the reliability of two previously derived quality evaluation instruments for blogs. Sixty English-language EM websites that published clinically oriented blog posts between January 1 and February 24, 2016, were identified. A random number generator selected 10 websites, and the 2 most recent clinically oriented blog posts from each site were evaluated using gestalt, the Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) score, and the Medical Education Translational Resources: Impact and Quality (METRIQ-8) score, by a sample of medical students, EM residents, and EM attendings. Each rater evaluated all 20 blog posts with gestalt and 15 of the 20 blog posts with the ALiEM AIR and METRIQ-8 scores. Pearson's correlations were calculated between the average scores for each metric. Single-measure intraclass correlation coefficients (ICCs) evaluated the reliability of each instrument. Our study included 121 medical students, 88 EM residents, and 100 EM attendings who completed ratings. The average gestalt rating of each blog post correlated strongly with the average scores for ALiEM AIR (r = .94) and METRIQ-8 (r = .91). Single-measure ICCs were fair for gestalt (0.37, IQR 0.25-0.56), ALiEM AIR (0.41, IQR 0.29-0.60) and METRIQ-8 (0.40, IQR 0.28-0.59). The average scores of each blog post correlated strongly with gestalt ratings. However, neither ALiEM AIR nor METRIQ-8 showed higher reliability than gestalt. Improved reliability may be possible through rater training and instrument refinement.

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.

Ethical challenges in designing and conducting medicine quality surveys.

PubMed

Tabernero, Patricia; Parker, Michael; Ravinetto, Raffaella; Phanouvong, Souly; Yeung, Shunmay; Kitutu, Freddy E; Cheah, Phaik Yeong; Mayxay, Mayfong; Guerin, Philippe J; Newton, Paul N

2016-06-01

In this paper we discuss the main ethical challenges related to the conduct of medicine quality surveys and make suggestions on how to address them. Most evidence-based information regarding medicine quality derives from surveys. However, existing research ethical guidelines do not provide specific guidance for medicine quality surveys. Hence, those conducting surveys are often left wondering how to judge what counts as best practice. A list of the main ethical challenges in the design and conduct of surveys is presented. It is vital that the design and conduct of medicine quality surveys uphold moral and ethical obligations and analyse the ethical implications and consequences of such work. These aspects include the impact on the local availability of and access to medicines; the confidentiality and privacy of the surveyors and the surveyed; questions as to whether outlet staff personnel should be told they are part of a survey; the need of ethical and regulatory approvals; and how the findings should be disseminated. Medicine quality surveys should ideally be conducted in partnership with the relevant national Medicine Regulatory Authorities. An international, but contextually sensitive, model of good ethical practice for such surveys is needed. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

The use of nuclear medicine techniques in the emergency department

PubMed Central

McGlone, B; Balan, K

2001-01-01

Nuclear medicine techniques have received little attention in the practice of emergency medicine, yet radionuclide imaging can provide valuable and unique information in the management of acutely ill patients. In this review, emphasis is placed on the role of these techniques in patients with bone injuries, non-traumatic bone pain and in those with pleuritic chest pain. New developments such as single photon emission computed tomography (SPECT) in myocardial infarction are outlined and older techniques such as scrotal scintigraphy are reviewed. Radionuclide techniques are discussed in a clinical context and in relation to alternative imaging modalities or strategies that may be available to the emergency medicine physician. Aspects of a 24 hour nuclear medicine service are considered. PMID:11696487

Nuclear medicine in cancer diagnosis and therapy

NASA Astrophysics Data System (ADS)

Chernov, V.; Zeltchan, R.; Medvedeva, A.; Sinilkin, I.; Bragina, O.

2017-09-01

Early cancer diagnosis remains one of the most actual problems of medicine, since it allows using the most effective methods of cancer treating. Unlike most diagnostic methods used in oncology, the methods of nuclear medicine allow assessing not so much the anatomic changes in the organ as the disturbance of metabolic processes in tumors and surrounding tissues. The authors describe the main radiopharmaceuticals used for diagnose and radiotherapy of malignant tumors.

Quality of natural product clinical trials: a comparison of those published in alternative medicine versus conventional medicine journals.

PubMed

Cochrane, Zara Risoldi; Gregory, Philip; Wilson, Amy

2011-06-01

To compare the quality of natural product clinical trials published in alternative medicine journals versus those published in conventional medicine journals. Systematic search and review of the literature. Randomized controlled trials of natural products were included if they were published in English between 2003 and 2008. Articles were categorized by their journal of publication (alternative medicine versus conventional medicine). Two independent reviewers evaluated study quality using guidelines from the Cochrane Collaboration. The results with respect to the primary outcome (positive or negative) were also assessed. Thirty articles were evaluated, 15 published in alternative medicine journals and 15 in conventional medicine journals. Of articles published in alternative medicine journals, 33.33% (n = 5) were considered low quality, and none were considered high quality. Of articles published in conventional medicine journals, 26.67% (n = 4) were considered low quality and 6.67% (n = 1) were considered high quality. Two thirds of all trials reviewed were of unclear quality, due to inadequate reporting of information relating to the study's methodology. Similar proportions of positive and negative primary outcomes were found in alternative and conventional medicine journals, and low-quality articles were not more likely to report a positive primary outcome (Fisher's exact test, two-tailed p = .287). The quality of natural product randomized controlled trials was similar among alternative and conventional medicine journals. Efforts should be made to improve the reporting of natural product clinical trials for accurate determinations of study quality to be possible.

Trends in radiation exposure from clinical nuclear medicine procedures in Shanghai, China.

PubMed

Yi, Yanling; Zheng, Junzheng; Zhuo, Weihai; Gao, Linfeng

2012-03-01

This study was designed to assess the trends in the frequencies of nuclear medicine procedures in Shanghai, China, and to determine their contributions to the per capita effective dose to the Shanghai population. The mean activities of radionuclides administered by nuclear medicine departments were compared with the Chinese national guidelines on diagnostic reference levels. On the basis of the three surveys carried out by Shanghai Municipal Center for Disease Control and Prevention in 1996, 1998, and 2008, the typically administered radiopharmaceuticals, levels of activity, the number of procedures, and population were systematically analyzed to assess the frequencies of nuclear medicine procedures and the per capita effective dose. The frequencies were approximately 2.77, 3.46, and 6.63 per 1000 people in 1996, 1998, and 2008, respectively. The annual per capita doses from diagnostic nuclear medicine were estimated to be 0.016, 0.022, and 0.032 mSv in 1996, 1998, and 2008, respectively. The annual frequency of therapeutic nuclear medicine procedures increased from 0.131 to 0.430 per 1000 people in the intervening 12 years. In the 12 years before 2008, diagnostic and therapeutic procedures in nuclear medicine in Shanghai increased continuously, and the annual per capita dose doubled. Increases in PET imaging and bone scans were the major contributors to the increasing frequency and magnitude of radiation exposure to the population. The activities administered for most diagnostic procedures were generally consistent with the designated reference levels.

Medieval European medicine and Asian spices.

PubMed

Nam, Jong Kuk

2014-08-01

This article aimed to explain the reasons why Asian spices including pepper, ginger, and cinnamon were considered as special and valuable drugs with curative powers in the Medieval Europe. Among these spices, pepper was most widely and frequently used as medicine according to medieval medical textbooks. We analyzed three main pharmacology books written during the Middle Ages. One of the main reasons that oriental spices were widely used as medicine was due to the particular medieval medical system fundamentally based on the humoral theory invented by Hippocrates and Galen. This theory was modified by Arab physicians and imported to Europe during the Middle Ages. According to this theory, health is determined by the balance of the following four humors which compose the human body: blood, yellow bile, black bile, and phlegm. Each humor has its own qualities such as cold, hot, wet, and dry. Humoral imbalance was one of the main causes of disease, so it was important to have humoral equilibrium. Asian spices with hot and dry qualities were used to balance the cold and wet European diet. The analysis of several major medical textbooks of the Middle Ages proves that most of the oriental spices with hot and dry qualities were employed to cure diverse diseases, particularly those caused by coldness and humidity. However, it should be noted that the oriental spices were considered to be much more valuable and effective as medicines than the local medicinal ingredients, which were not only easily procured but also were relatively cheap. Europeans mystified oriental spices, with the belief that they have marvelous and mysterious healing powers. Such mystification was related to the terrestrial Paradise. They believed that the oriental spices were grown in Paradise which was located in the Far East and were brought to the Earthly world along the four rivers flowing from the Paradise.

Survey of Chinese Medicine Students to Determine Research and Evidence-Based Medicine Perspectives at Pacific College of Oriental Medicine.

PubMed

Anderson, Belinda J; Kligler, Benjamin; Cohen, Hillel W; Marantz, Paul R

2016-01-01

Research literacy and the practice of evidence-based medicine (EBM) are important initiatives in complementary and alternative medicine (CAM), which requires cultural change within educational institutions for successful implementation. To determine the self-assessed research and EBM perspectives of Chinese medicine Masters degree students at Pacific College of Oriental Medicine, New York campus (PCOM-NY). A survey with 17 close-ended questions and one open-ended question was administered through Survey Monkey to students at PCOM-NY. The survey was sent to 420 Masters students and 176 (41.9%) responded. Students in all four years of the Masters degree indicated a generally high degree of interest in, and support for the value of research. However, increasing years (one to four years) in the program was associated with lower interest in post-graduation research participation and entering the doctoral program, and the fourth year students reported low levels of interest in having greater research content and training in their Masters degree programs. Students who responded to the open-ended question (23% of respondents) expressed enthusiasm for research and concerns about the relevance of research in Chinese medicine. Consistent with findings in similar studies at CAM colleges, interest in research, and EBM of the PCOM-NY Masters students appeared to decline with increasing years in the program. Concerns around paradigm and epistemological issues associated with research and EBM among Chinese medicine students and practitioners warrants further investigation, and may be an important challenge for integrative medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

Peculiarities of organizing the construction of nuclear medicine facilities and the transportation of radionuclide

NASA Astrophysics Data System (ADS)

Telichenko, Valeriy; Malykha, Galina; Dorogan, Igor

2017-10-01

The article is devoted to the organization of construction of nuclear medicine facilities in Russia. The article describes the main methods of nuclear medical diagnostics, as well as the peculiarities of nuclear medicine facilities that determine the need for application of specific methods for organizing and managing the construction, methods of requirements management in the organization of construction of nuclear medicine facilities. Sustainable development of the transport of radioactive isotopes from the place of production to places of consumption is very important for the safety of the population. The requirements management system is an important and necessary component in organizing the construction of complex facilities, such as nuclear medicine facilities. The author developed and proposed a requirements management system for the design, construction and operation of a nuclear medicine facility, which provides for a cyclic sequence of actions. This system allows reducing the consumption of resources including material and energy during construction and operation of complex objects.

[Introduction of a quality management system compliant with DIN EN 9001:2000 in a university department of nuclear medicine].

PubMed

Jansen-Schmidt, V; Paschen, U; Kröger, S; Bohuslavizki, K H; Clausen, M

2001-12-01

In 1995, the management of the University Clinic Hamburg-Eppendorf proposed to establish a total quality assurance (QA) system. A revised QA-system has been introduced stepwise in the department of nuclear medicine since 1997, and certification was achieved in accordance with DIN EN ISO 9001:2000 on February 14, 2001. The QA-handbook is divided into two parts. The first part contains operational (diagnostic and therapeutic) procedures in so-called standard operating procedures (SOP). They describe the indication of procedures as well as the competences and time necessary in a standardized manner. Up to now, more than 70 SOPs have been written as a collaborative approach between technicians and physicians during daily clinical routine after analysing and discussing the procedures. Thus, the results were more clearly defined processes and more satisfied employees. The second part consists of general rules and directions concerning the security of work and equipment as well as radiation protection tasks, hygiene etc. as it is required by the law. This part was written predominantly by the management of the department of nuclear-medicine and the QA-coordinator. Detailed information for the patients, documentation of the work-flows as well as the medical report was adopted to the QM-system. Although in the introduction phase of a QA-system a vast amount of time is necessary, some months later a surplus for the clinical workday will become available. The well defined relations of competences and procedures will result in a gain of time, a reduction of costs and a help to ensure the legal demands. Last but not least, the QA-system simply helps to build up confidence and acceptance both by the patients and the referring physicians.

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.

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

PubMed Central

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.

2015-01-01

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, andIdentify 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‐ PMID:26699325

Material science as basis for nuclear medicine: Holmium irradiation for radioisotopes production

NASA Astrophysics Data System (ADS)

Usman, Ahmed Rufai; Khandaker, Mayeen Uddin; Haba, Hiromitsu; Otuka, Naohiko

2018-05-01

Material Science, being an interdisciplinary field, plays important roles in nuclear science. These applications are seen in weaponry, armoured vehicles, accelerator structure and development, semiconductor detectors, nuclear medicine and many more. Present study presents the applications of some metals in nuclear medicine (radioisotope production). The charged-particle-induced nuclear reactions by using cyclotrons or accelerators have become a very vital feature of the modern nuclear medicine. Realising the importance of excitation functions for the efficient production of medical radionuclides, some very high purity holmium metals are generally prepared or purchased for bombardment in nuclear accelerators. In the present work, various methods to obtain pure holmium for radioisotope production have been discussed while also presenting details of our present studies. From the experimental work of the present studies, some very high purity holmium foils have been used in the work for a comprehensive study of residual radionuclides production cross-sections. The study was performed using a stacked-foil activation technique combined with γ-ray spectrometry. The stack was bombarded with 50.4 MeV alpha particle beam from AVF cyclotron of RI Beam Factory, Nishina Centre for Accelerator-Based Science, RIKEN, Japan. The work produced thulium radionuclides useful in nuclear medicine.

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.

Quality in laboratory medicine: 50years on.

PubMed

Plebani, Mario

2017-02-01

The last 50years have seen substantial changes in the landscape of laboratory medicine: its role in modern medicine is in evolution and the quality of laboratory services is changing. The need to control and improve quality in clinical laboratories has grown hand in hand with the growth in technological developments leading to an impressive reduction of analytical errors over time. An essential cause of this impressive improvement has been the introduction and monitoring of quality indicators (QIs) such as the analytical performance specifications (in particular bias and imprecision) based on well-established goals. The evolving landscape of quality and errors in clinical laboratories moved first from analytical errors to all errors performed within the laboratory walls, subsequently to errors in laboratory medicine (including errors in test requesting and result interpretation), and finally, to a focus on errors more frequently associated with adverse events (laboratory-associated errors). After decades in which clinical laboratories have focused on monitoring and improving internal indicators of analytical quality, efficiency and productivity, it is time to shift toward indicators of total quality, clinical effectiveness and patient outcomes. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Behaviors of providers of traditional korean medicine therapy and complementary and alternative medicine therapy for the treatment of cancer patients.

PubMed

Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young

2015-03-01

In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Adequate management and quality control of CAM providers is thought to involve both education and legislation.

Current Status and Clinical Studies of Oriental Herbs in Sexual Medicine in Korea

PubMed Central

Shin, Yu Seob; Zhao, Chen; Zhang, Li Tao

2015-01-01

Erectile dysfunction (ED) is one of the most common diseases among aging men. Although previous studies have shown that type 5 phosphodiesterase inhibitors (PDE5-Is) are very effective for the treatment of ED, many researchers are currently attempting to identify therapeutic agents from natural sources with comparable or better effects than PDE5-Is. Herbal medicine is thought to be advantageous because it is natural; moreover, it not only treats isolated symptoms, but also maintains general well-being. Furthermore, since newly created chemical compound libraries have limited structural diversity with regard to pharmaceutical agents, more attention has recently been paid to the ability of oriental herbs to enhance physical health, including sexual function. Herein, we review the current status of Korean preclinical or clinical studies of the application of oriental herbs to sexual medicine. PMID:26331122

Is eye lens dosimetry needed in nuclear medicine?

PubMed

Wrzesień, M; Królicki, L; Albiniak, Ł; Olszewski, J

2018-06-01

The exact level of exposure experienced by nuclear medicine personnel, whose work often requires performing manual procedures involving radioactive isotopes, is associated with the form of radiation source used. The variety of radionuclides and medical procedures, and the yearly increase in the number of patients, as well as the change of the individual dose limit for the lens of the eye from a value of 150 mSv yr -1 to 20 mSv yr -1 , mean that issues of eye lens routine dosimetry become interesting from the radiation protection point of view. This paper presents an analysis of the exposure of the eye lenses of nuclear medicine department personnel, as well as those of personnel in the facilities that produce radiopharmaceuticals for the purpose of diagnosis by positron emission tomography, from the viewpoint of the advisability of routine eye lens exposure monitoring, taking into account changes in the dose limit for the lens of the eye. The paper considers the two most commonly used radionuclides for diagnostic purposes 99m Tc, 18 F, and-for therapeutic purposes- 131 I. Dose measurements were made using thermoluminescent detectors. The estimated exposure analysis identifies the cases when the maximum annual value of the personal dose equivalent, in terms of Hp(3), exceeds threefold the new limit value (20 mSv yr -1 ). It is recommended that Hp(3) doses be routinely monitored in the group of radiopharmacists who label pharmaceuticals with the radionuclide 99m Tc and in chemists working in 18 F-FDG quality control departments in production units, where this is carried out manually.

Orienting to Medicine: Scripting Professionalism, Hierarchy, and Social Difference at the Start of Medical School.

PubMed

Craig, Sienna R; Scott, Rebekah; Blackwood, Kristy

2018-04-23

Nascent medical students' first view into medical school orients them toward what is considered important in medicine. Based on ethnography conducted over 18 months at a New England medical school, this article explores themes which emerged during a first-year student orientation and examines how these scripts resurface across a four-year curriculum, revealing dynamics of enculturation into an institution and the broader profession. We analyze orientation activities as discursive and embodied fields which serve "practical" purposes of making new social geographies familiar, but which also frame institutional values surrounding "soft" aspects of medicine: professionalism; dynamics of hierarchy and vulnerability; and social difference. By examining orientation and connecting these insights to later, discerning educational moments, we argue that orientation reveals tensions between the overt and hidden curricula within medical education, including what being a good doctor means. Our findings are based on data from semi-structured interviews, focus groups, and participant-observation in didactic and clinical settings. This article answers calls within medical anthropology and medical education literature to recognize implicit values at play in producing physicians, unearthing ethnographically how these values are learned longitudinally via persisting gaps between formal and hidden curricula. Assumptions hidden in plain sight call for ongoing medical education reform.

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

Combating poor-quality anti-malarial medicines: a call to action.

PubMed

Bassat, Quique; Tanner, Marcel; Guerin, Philippe J; Stricker, Kirstin; Hamed, Kamal

2016-06-01

The circulation of poor-quality medicines continues to undermine the fight against many life-threatening diseases. Anti-malarial medicines appear to have been particularly compromised and present a major public health threat in malaria-endemic countries, negatively affecting individuals and their communities. Concerted collaborative efforts are required from global, regional and national organizations, involving the public and private sectors, to address the problem. While many initiatives are underway, a number of unmet needs deserve urgent and increased multisector attention. At the global level, there is a need for an international public health legal framework or treaty on poor-quality medicines, with statutes suitable for integration into national laws. In addition, increased international efforts are required to strengthen the governance of global supply chains and enhance cooperation between national medicine regulation authorities and law enforcement bodies. Increased investment is needed in innovative technologies that will enable healthcare teams to detect poor-quality medicines at all levels of the supply chain. At the regional level, a number of initiatives would be beneficial-key areas are standardization, simplification, and reciprocal recognition of registration processes and development of quality control capacity in regional centres of excellence that are better aligned with public health needs; improved surveillance methods and creation of a framework for compulsory and transparent reporting of poor-quality medicines; additional support for national medicine regulation authorities and other national partner authorities; and an increase in support for regional laboratories to boost their capabilities in detecting poor-quality medicines. It is vital that all stakeholders involved in efforts against poor-quality anti-malarial medicines extend and strengthen their actions in these critical areas and thus effectively support global health development

Study of nuclear medicine practices in Portugal from an internal dosimetry perspective.

PubMed

Bento, J; Teles, P; Neves, M; Santos, A I; Cardoso, G; Barreto, A; Alves, F; Guerreiro, C; Rodrigues, A; Santos, J A M; Capelo, C; Parafita, R; Martins, B

2012-05-01

Nuclear medicine practices involve the handling of a wide range of pharmaceuticals labelled with different radionuclides, for diagnostic and therapeutic purposes. This work intends to evaluate the potential risks of internal contamination of nuclear medicine staff in several Portuguese nuclear medicine services and to conclude about the requirement of a routine internal monitoring. A methodology proposed by the International Atomic Energy Agency (IAEA), providing a set of criteria to determine the need, or not, for an internal monitoring programme, was applied. The evaluation of the risk of internal contaminations in a given set of working conditions is based on the type and amount of radionuclides being handled, as well as the safety conditions with which they are manipulated. The application of the IAEA criteria showed that 73.1% of all the workers included in this study should be integrated in a routine monitoring programme for internal contaminations; more specifically, 100% of workers performing radioimmunoassay techniques should be monitored. This study suggests that a routine monitoring programme for internal exposures should be implemented in Portugal for most nuclear medicine workers.

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.

International Perspectives on Quality Assurance and New Techniques in Radiation Medicine: Outcomes of an IAEA Conference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon

2008-05-01

The International Atomic Energy Agency organized an international conference called, 'Quality Assurance and New Techniques in Radiation Medicine' (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging andmore » radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?.« less

International perspectives on quality assurance and new techniques in radiation medicine: outcomes of an IAEA conference.

PubMed

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon; Dondi, Maurizio; Andreo, Pedro

2008-01-01

The International Atomic Energy Agency organized an international conference called, "Quality Assurance and New Techniques in Radiation Medicine" (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging and radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?

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

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

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

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

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

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

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

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

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.

Medical History in the Hellenic Journal of Nuclear Medicine.

PubMed

Otte, Andreas

2017-01-01

The Hellenic Journal of Nuclear Medicine is about to celebrate its 20th anniversary end of 2017. On board of the editorial team since 2003, this journal has influenced me like a good friend over the many past years. From time to time, the journal has published interesting and valuable historical notes. They show that nuclear medicine has a history and that medicine is its basis. They also teach us today, and some of the ancient perspectives and approaches are still valid. The reader of HJNM may be interested in these historical contributions, as they are timeless. Therefore, it was our idea to summarize these in the following pages. Where there is a link to the free article, this is noted. Upon opening all articles, you will find out that these are a book or so of its own. In thanks to the editor-in-chief of the Journal for his continuing support on the historical section. Below we refer to the historical papers of the Journal: History of Nuclear Medicine. Nuclear Medicine and History of Science and Philosophy: Atomic Theory of the Matter. G.N. Sfakianakis, 2001; 4(3); 155-60. Editorial. Pioneers of nuclear medicine, Madame Curie. P.C. Grammaticos. 2004; 7(1); 29-30. http://nuclmed.web.auth.gr/ magazine/eng/jan04/editorial.htm Editor's note. Hippocrates' Oath. The editor. 2004; 7(1); 31. Editorial. Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus. P. Grammaticos, A. Diamantis. 2008; 11(1): 2-4. http://nuclmed.web.auth.gr/magazine/eng/jan08/2.pdf Special Article. The contribution of Maria Sklodowska-Curie and Pierre Curie to Nuclear and Medical Physics. A hundred and ten years after the discovery of radium. A. Diamantis, E. Magiorkinis, 2008; 11(1): 33-8. http://nuclmed.web.auth.gr/magazine/ eng/jan08/33.pdf Brief Historical Review. Lymphatic system and lymphoscintigraphy. P. Valsamaki. 2009; 12(1): 87-89. http://nuclmed.web. auth.gr/magazine/eng/jan09/89.pdf (In Greek) Historical Review. The philosophic and

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.

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

[Quality criteria in medicine: which limits?].

PubMed

Minvielle, E

2006-06-01

This article aims to develop a critical appraisal of the criteria's development in medicine. The COMPAQH (Coordination for Measuring Performance and Assuring Quality in Hospitals) project (Ministry of Health/ High Authority of Health/ National Institute of Medical Research) helps to support this analysis. This project based on the test of 42 Quality indicators (QI) gives findings not only about the manner to build criteria, but also to interpret and diffuse results among physicians and hospital managers. Criteria must be elaborated in a pragmatic way. They must be in compliance with practice guidelines supported by scientific evidences. The associated risk is to create and develop a normative medicine. Collaboration with professional societies may be useful in preventing this risk.

Nuclear Technology Series. Course 14: Introduction to Quality Assurance/Quality Control.

ERIC Educational Resources Information Center

Technical Education Research Center, Waco, TX.

This technical specialty course is one of thirty-five courses designed for use by two-year postsecondary institutions in five nuclear technician curriculum areas: (1) radiation protection technician, (2) nuclear instrumentation and control technician, (3) nuclear materials processing technician, (4) nuclear quality-assurance/quality-control…

The Importance of Quality in Ventilation-Perfusion Imaging.

PubMed

Mann, April; DiDea, Mario; Fournier, France; Tempesta, Daniel; Williams, Jessica; LaFrance, Norman

2018-06-01

As the health care environment continues to change and morph into a system focusing on increased quality and evidence-based outcomes, nuclear medicine technologists must be reminded that they play a critical role in achieving high-quality, interpretable images used to drive patient care, treatment, and best possible outcomes. A survey performed by the Quality Committee of the Society of Nuclear Medicine and Molecular Imaging Technologist Section demonstrated that a clear knowledge gap exists among technologists regarding their understanding of quality, how it is measured, and how it should be achieved by all practicing technologists regardless of role and education level. Understanding of these areas within health care, in conjunction with the growing emphasis on evidence-based outcomes, quality measures, and patient satisfaction, will ultimately elevate the role of nuclear medicine technologists today and into the future. The nuclear medicine role now requires technologists to demonstrate patient assessment skills, practice safety procedures with regard to staff and patients, provide patient education and instruction, and provide physicians with information to assist with the interpretation and outcome of the study. In addition, the technologist must be able to evaluate images by performing technical analysis, knowing the demonstrated anatomy and pathophysiology, and assessing overall quality. Technologists must also be able to triage and understand the disease processes being evaluated and how nuclear medicine diagnostic studies may drive care and treatment. Therefore, it is imperative that nuclear medicine technologists understand their role in the achievement of a high-quality, interpretable study by applying quality principles and understanding and using imaging techniques beyond just basic protocols for every type of disease or system being imaged. This article focuses on quality considerations related to ventilation-perfusion imaging. It provides insight on

Impact of Nuclear Laboratory Personnel Credentials & Continuing Education on Nuclear Cardiology Laboratory Quality Operations.

PubMed

Malhotra, Saurabh; Sobieraj, Diana M; Mann, April; Parker, Matthew W

2017-12-22

Background/Objectives: The specific credentials and continuing education (CME/CE) of nuclear cardiology laboratory medical and technical staff are important factors in the delivery of quality imaging services that have not been systematically evaluated. Methods: Nuclear cardiology accreditation application data from the Intersocietal Accreditation Commission (IAC) was used to characterize facilities performing myocardial perfusion imaging by setting, size, previous accreditation and credentials of the medical and technical staff. Credentials and CME/CE were compared against initial accreditation decisions (grant or delay) using multivariable logistic regression. Results: Complete data were available for 1913 nuclear cardiology laboratories from 2011-2014. Laboratories with initial positive accreditation decisions had a greater prevalence of Certification Board in Nuclear Cardiology (CBNC) certified medical directors and specialty credentialed technical directors. Certification and credentials of the medical and technical directors, respectively, staff CME/CE compliance, and assistance of a consultant with the application were positively associated with accreditation decisions. Conclusion: Nuclear cardiology laboratories directed by CBNC-certified physicians and NCT- or PET-credentialed technologists were less likely to receive delay decisions for MPI. CME/CE compliance of both the medical and technical directors was associated with accreditation decision. Medical and technical directors' years of experience were not associated with accreditation decision. Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Evidence-based medicine and quality of care.

PubMed

Dickenson, Donna; Vineis, Paolo

2002-01-01

In this paper we set out to examine the arguments for and against the claim that Evidence-Based Medicine (EBM) will improve the quality of care. In particular, we examine the following issues: 1. Are there hidden ethical assumptions in the methodology of EBM? 2. Is there a tension between the duty of care and EBM? 3. How can patient preferences be incorporated into quality guidelines and effectiveness studies? 4. Is there a tension between the quality of a particular intervention and overall quality of care? 5. Are certain branches of medicine and patient groups innately or prima facie disadvantaged by a shift to EBM? In addition we consider a case study in the ethics of EBM, on a clinical trial concerning the collection of umbilical cord blood in utero and ex utero, during or after labour in childbirth.

Monitoring the Quality of Medicines: Results from Africa, Asia, and South America

PubMed Central

Hajjou, Mustapha; Krech, Laura; Lane-Barlow, Christi; Roth, Lukas; Pribluda, Victor S.; Phanouvong, Souly; El-Hadri, Latifa; Evans, Lawrence; Raymond, Christopher; Yuan, Elaine; Siv, Lang; Vuong, Tuan-Anh; Boateng, Kwasi Poku; Okafor, Regina; Chibwe, Kennedy M.; Lukulay, Patrick H.

2015-01-01

Monitoring the quality of medicines plays a crucial role in an integrated medicines quality assurance system. In a publicly available medicines quality database (MQDB), the U.S. Pharmacopeial Convention (USP) reports results of data collected from medicines quality monitoring (MQM) activities spanning the period of 2003–2013 in 17 countries of Africa, Asia, and South America. The MQDB contains information on 15,063 samples collected and tested using Minilab® screening methods and/or pharmacopeial methods. Approximately 71% of the samples reported came from Asia, 23% from Africa, and 6% from South America. The samples collected and tested include mainly antibiotic, antimalarial, and antituberculosis medicines. A total of 848 samples, representing 5.6% of total samples, failed the quality test. The failure proportion per region was 11.5%, 10.4%, and 2.9% for South America, Africa, and Asia, respectively. Eighty-one counterfeit medicines were reported, 86.4% of which were found in Asia and 13.6% in Africa. Additional analysis of the data shows the distribution of poor-quality medicines per region and by therapeutic indication as well as possible trends of counterfeit medicines. PMID:25897073

Quality transitivity and traceability system of herbal medicine products based on quality markers.

PubMed

Liu, Changxiao; Guo, De-An; Liu, Liang

2018-05-15

Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.

SURVEY OF DENTAL STUDENTS' ATTITUDE REGARDING ORIENTAL MEDICINE/COMPLEMENTARY AND ALTERNATIVE MEDICINE: COMPARISON BETWEEN TWO JAPANESE DENTAL SCHOOLS.

PubMed

Kameyama, Atsushi; Toda, Kazuo

2017-01-01

The present study aimed to examine the impact of "curricula for undergraduate education in oriental medicine (OM)/complementary and alternative medicine (CAM)" on student awareness of OM. A questionnaire survey was conducted involving the Nagasaki University School of Dentistry (NUSD), a university that implements education in OM as part of its undergraduate curriculum, and Tokyo Dental College (TDC), which does not teach OM. The third- and fifth-year students of both NUSD and TDC underwent the anonymous questionnaire survey, which included questions regarding their knowledge of OM and CAM, interests in these subjects, and their opinions on the necessity of teaching OM in the undergraduate dental education, and the results were collected for analysis. Whereas 33% of 5 th year NUSD students had knowledge of OM/CAM was 33%, only 10% of 5 th year TDC students reported knowledge on the subject. 69% of 5 th year NUSD students interested in OM/CAM, while 5 th year TDC students who interest them were only 45%. Although 77% of 5 th year NUSD students were in favor of OM education implemented in the Faculty of Dentistry, the percentages of TDC students of that were smaller (46% in 3 rd year and 48% in 5 th year). Whereas 26% of 5 th year TDC students did not recognize the necessity of oriental medicine education, only one 5 th year NUSD student (2%) did not so. Introduction of education in OM in the undergraduate dental education program helps students to increase their interests in dental clinical applications.

Estimated collective effective dose to the population from nuclear medicine examinations in Slovenia

PubMed Central

Skrk, Damijan; Zontar, Dejan

2013-01-01

Background A national survey of patient exposure from nuclear medicine diagnostic procedures was performed by Slovenian Radiation Protection Administration in order to estimate their contribution to the collective effective dose to the population of Slovenia. Methods A set of 36 examinations with the highest contributions to the collective effective dose was identified. Data about frequencies and average administered activities of radioisotopes used for those examinations were collected from all nuclear medicine departments in Slovenia. A collective effective dose to the population and an effective dose per capita were estimated from the collected data using dose conversion factors. Results The total collective effective dose to the population from nuclear medicine diagnostic procedures in 2011 was estimated to 102 manSv, giving an effective dose per capita of 0.05 mSv. Conclusions The comparison of results of this study with studies performed in other countries indicates that the nuclear medicine providers in Slovenia are well aware of the importance of patient protection measures and of optimisation of procedures. PMID:24133396

Advanced strategies for quality control of Chinese medicines.

PubMed

Zhao, Jing; Ma, Shuang-Cheng; Li, Shao-Ping

2018-01-05

Quality control is always the critical issue for Chinese medicines (CMs) with their worldwide increasing use. Different from western medicine, CMs are usually considered that multiple constituents are responsible for the therapeutic effects. Therefore, quality control of CMs is a challenge. In 2011, the strategies for quantification, related to the markers, reference compounds and approaches, in quality control of CMs were reviewed (Li, et al., J. Pharm. Biomed. Anal., 2011, 55, 802-809). Since then, some new strategies have been proposed in these fields. Therefore, the review on the strategies for quality control of CMs should be updated to improve the safety and efficacy of CMs. Herein, novel strategies related to quality marker discovery, reference compound development and advanced approaches (focused on glyco-analysis) for quality control, during 2011-2016, were summarized and discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

[Recertification and continuing education of NCCAOM Diplomates of Acupuncture and Oriental Medicine].

PubMed

Tian, Kaiyu; Tian, Yunyi; Li, Susu; Chen, Qiang; Yuan, Teng

2017-05-12

Diplomates certificated by National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) are needed to be recertified every four years. The certificate will be valid after 60 points of provided professional development activity (PDA). The different validity status of NCCAOM certificates, ways of participating continuing education and the requirements of PDA points including core competencies and professional enhancement (PE) are introduced in this paper.

The standardization methods of radioactive sources (125I, 131I, 99mTc, and 18F) for calibrating nuclear medicine equipment in Indonesia

NASA Astrophysics Data System (ADS)

Wurdiyanto, G.; Candra, H.

2016-03-01

The standardization of radioactive sources (125I, 131I, 99mTc and 18F) to calibrate the nuclear medicine equipment had been carried out in PTKMR-BATAN. This is necessary because the radioactive sources used in the field of nuclear medicine has a very short half-life in other that to obtain a quality measurement results require special treatment. Besides that, the use of nuclear medicine techniques in Indonesia develop rapidly. All the radioactive sources were prepared by gravimetric methods. Standardization of 125I has been carried out by photon- photon coincidence methods, while the others have been carried out by gamma spectrometry methods. The standar sources are used to calibrate a Capintec CRC-7BT radionuclide calibrator. The results shows that calibration factor for Capintec CRC-7BT dose calibrator is 1,03; 1,02; 1,06; and 1,04 for 125I, 131I, 99mTc and 18F respectively, by about 5 to 6% of the expanded uncertainties.

The 2011 nuclear medicine technology job analysis project of the American Registry of Radiologic Technologists.

PubMed

Anderson, Dan; Hubble, William; Press, Bret A; Hall, Scott K; Michels, Ann D; Koenen, Roxanne; Vespie, Alan W

2010-12-01

The American Registry of Radiologic Technologists (ARRT) conducts periodic job analysis projects to update the content and eligibility requirements for all certification examinations. In 2009, the ARRT conducted a comprehensive job analysis project to update the content specifications and clinical competency requirements for the nuclear medicine technology examination. ARRT staff and a committee of volunteer nuclear medicine technologists designed a job analysis survey that was sent to a random sample of 1,000 entry-level staff nuclear medicine technologists. Through analysis of the survey data and judgments of the committee, the project resulted in changes to the nuclear medicine technology examination task list, content specifications, and clinical competency requirements. The primary changes inspired by the project were the introduction of CT content to the examination and the expansion of the content covering cardiac procedures.

A computer program for calculation of approximate embryo/fetus radiation dose in nuclear medicine applications.

PubMed

Bayram, Tuncay; Sönmez, Bircan

2012-04-01

In this study, we aimed to make a computer program that calculates approximate radiation dose received by embryo/fetus in nuclear medicine applications. Radiation dose values per MBq-1 received by embryo/fetus in nuclear medicine applications were gathered from literature for various stages of pregnancy. These values were embedded in the computer code, which was written in Fortran 90 program language. The computer program called nmfdose covers almost all radiopharmaceuticals used in nuclear medicine applications. Approximate radiation dose received by embryo/fetus can be calculated easily at a few steps using this computer program. Although there are some constraints on using the program for some special cases, nmfdose is useful and it provides practical solution for calculation of approximate dose to embryo/fetus in nuclear medicine applications. None declared.

Ethnobotanical survey of medicinal plants used by people in Oriental Morocco to manage various ailments.

PubMed

Jamila, Fakchich; Mostafa, Elachouri

2014-05-28

This document presents the uses of plants in traditional herbal medicines in Oriental Morocco. It also determines the homogeneity of informant knowledge in medicinal plants suitable for different ailment categories and the most preferred plant species used to treat each illness category in the study area. The ethnobotanical information was obtained from 3151 inhabitants who were 20 years and older in five different areas of Oriental Morocco region. The data were analyzed through informant consensus factor (ICF) and frequency of uses (FC). The results indicated that 65.7% of the participants interviewed used medicinal plants to treat 23 ailments. The inventory of medicinal plants is summarized in a synoptic table, which contains the scientific and vernacular names of the plant, the part of the plant and the preparation used and the therapeutic indication. Extensive investigations have brought to light 148 medicinal plants belonging to 60 families; of these, 108 are used for the disorders of the digestive system, 74 for diabetes, 73 for dermatological problems, 66 for allergy, 66 for cardiovascular disorders and 63 for respiratory problems. In this region, the most frequently used plants including Origanum compactum Benth., Trigonella foenum graecum L., Lavandula dentata L., Mentha pulegium L., Nigella sativa L., Rosmarinus officinalis L., Lippia citriodora L., Tetraclinis articulata Benth., and Atemisia herba-alba Asso. Lamiaceae and Asteraceae are the dominant locally used families. Most medicines were prepared in the form of powder and used orally. Leaves were the most frequently used plant part. Gastro-intestinal ailments have high ICF (0.92) whereas pathologies of the circulatory and ophthalmological uses have low ICF (0.22 and 0.24, respectively). Oriental Morocco boasts an extensive phytotherapy knowledge base and ICF values indicated that there was high agreement in the use of plants in gastro-intestinal ailment category among the users. The frequency use

A U.S. Multicenter Study of Recorded Occupational Radiation Badge Doses in Nuclear Medicine.

PubMed

Villoing, Daphnée; Yoder, R Craig; Passmore, Christopher; Bernier, Marie-Odile; Kitahara, Cari M

2018-05-01

Purpose To summarize occupational badge doses recorded for a sample of U.S. nuclear medicine technologists. Materials and Methods Nine large U.S. medical institutions identified 208 former and current nuclear medicine technologists certified after 1979 and linked these individuals to historic badge dose records maintained by a commercial dosimetry company (Landauer), yielding a total of 2618 annual dose records. The distributions of annual and cumulative occupational doses were described by using summary statistics. Results Between 1992 and 2015, the median annual personal dose equivalent per nuclear medicine technologist was 2.18 mSv (interquartile range [IQR], 1.25-3.47 mSv; mean, 2.69 mSv). Median annual personal dose equivalents remained relatively constant over this period (range, 1.40-3.30 mSv), while maximum values generally increased over time (from 8.00 mSv in 1992 to 13.9 mSv in 2015). The median cumulative personal dose equivalent was 32.9 mSv (IQR, 18.1-65.5 mSv; mean, 51.4 mSv) for 45 technologists who had complete information and remained employed through 2015. Conclusion Occupational radiation doses were well below the established occupational limits and were consistent with those observed for nuclear medicine technologists worldwide and were greater than those observed for nuclear and general medical workers in the United States These results should be informative for radiation monitoring and safety efforts in nuclear medicine departments. © RSNA, 2018 Online supplemental material is available for this article.

Schizophrenia, depression, and sleep disorders: their traditional Oriental medicine equivalents.

PubMed

Bosch, Peggy; de Rover, Peter; Staudte, Heike; Lim, Sabina; van den Noort, Maurits

2015-02-01

Psychiatric disorders can be described and treated from both a Western (allopathic) and an Eastern perspective, which should be taken into account when conducting research. Patients with schizophrenia or depression are likely to be undergoing Western treatment when they are referred to an acupuncturist for (add-on) treatment, and knowledge of both types of treatments is necessary to integrate them successfully. In this study, the different Traditional Oriental Medicine (TOM) diagnostic patterns in patients with a Western diagnosis of schizophrenia, depression, or sleep disorders are described from a literature and a clinical perspective. The data on 30 depression and 30 schizophrenia patients from a German study are presented. Our results show that if a psychiatric group, sorted in accordance to Western diagnostic principles, is diagnosed on the basis of TOM diagnostic patterns, it can be categorized into different groups of patients with psychiatric disorders; this finding has far-reaching consequences in scientific research on acupuncture. Moreover, we found a high prevalence of sleep disorders in patients with both schizophrenia and depression, which could be explained from the perspective of a TOM diagnostic pattern. Finally, we discuss sleep quality as a treatment objective that may play a crucial role in mediating acupuncture-induced treatment effects in patients with schizophrenia and depression. Copyright © 2015. Published by Elsevier B.V.

[Effect and regulation of drying on quality of traditional Chinese medicine pills].

PubMed

Qi, Ya-Ru; Li, Yuan-Hui; Han, Li; Wu, Zhen-Feng; Yue, Peng-Fei; Wang, Xue-Cheng; Xiong, Yao-Kun; Yang, Ming

2017-06-01

The dry quality of traditional Chinese medicine pills is the hot spot of pills research, because their quality has a crucial effect on the efficacy and development of dosage forms. Through literature research and statistical analysis, we would review the current problems on the drying of traditional Chinese medicine pills in this paper, and surrounding the evaluation system for traditional Chinese medicine pills, analyze the characteristics of common drying equipment and processes as well as their effect on quality of pills, discuss the problems in drying equipment and process as well as quality, and put forward the corresponding strategies, hoping to provide new ideas and new methods for the quality improvement of traditional Chinese medicine pills and quality standards. Copyright© by the Chinese Pharmaceutical Association.

Autonomous Quality Control of Joint Orientation Measured with Inertial Sensors.

PubMed

Lebel, Karina; Boissy, Patrick; Nguyen, Hung; Duval, Christian

2016-07-05

Clinical mobility assessment is traditionally performed in laboratories using complex and expensive equipment. The low accessibility to such equipment, combined with the emerging trend to assess mobility in a free-living environment, creates a need for body-worn sensors (e.g., inertial measurement units-IMUs) that are capable of measuring the complexity in motor performance using meaningful measurements, such as joint orientation. However, accuracy of joint orientation estimates using IMUs may be affected by environment, the joint tracked, type of motion performed and velocity. This study investigates a quality control (QC) process to assess the quality of orientation data based on features extracted from the raw inertial sensors' signals. Joint orientation (trunk, hip, knee, ankle) of twenty participants was acquired by an optical motion capture system and IMUs during a variety of tasks (sit, sit-to-stand transition, walking, turning) performed under varying conditions (speed, environment). An artificial neural network was used to classify good and bad sequences of joint orientation with a sensitivity and a specificity above 83%. This study confirms the possibility to perform QC on IMU joint orientation data based on raw signal features. This innovative QC approach may be of particular interest in a big data context, such as for remote-monitoring of patients' mobility.

Influence on Visual Quality of Intraoperative Orientation of Asymmetric Intraocular Lenses.

PubMed

Bonaque-González, Sergio; Ríos, Susana; Amigó, Alfredo; López-Gil, Norberto

2015-10-01

To evaluate visual quality when changing the intraocular orientation of the Lentis Mplus LS-312MF nonrotational symmetric +3.00 diopters aspheric multifocal intraocular lens ([IOL] Oculentis GmbH, Berlin, Germany) in normal eyes. An artificial eye was used to measure the in vitro wavefront of the IOL. The corneal topography of 20 healthy patients was obtained. For each eye, a computational analysis simulated the implantation of the IOL. The modulation transfer function (MTF) and an image quality parameter (visually modulated transfer function [VSMTF] metric) were calculated for a 5.0-mm pupil and for three conditions: distance, intermediate, and near vision. The procedure was repeated for each eye after a rotation of the IOL with respect to the cornea from 0° to 360° in 1° steps. Statistical analysis showed significant differences in mean VSMTF values between orientations for distance vision. Optimal orientation of the IOL (different for each eye) showed a mean improvement of 58% ± 19% (range: 20% to 121%) in VSMTF values with respect to the worst possible orientation. For these orientations, intermediate and near vision quality were statistically indistinguishable. The MTFs were different between orientations, showing a mean difference of approximately 5 cycles per degree in the maximum spatial frequencies that can be transferred between the best and the worst orientations for distance vision. The results suggest that implantation of this nonrotational symmetric IOL should improve visual outcomes if it is oriented to coincide with a customized meridian. A simple, practical method is proposed to find an approximation to the angle that an Mplus IOL should be inserted. Copyright 2015, SLACK Incorporated.

A process-oriented guided inquiry approach to teaching medicinal chemistry.

PubMed

Brown, Stacy D

2010-09-10

To integrate process-oriented guided-inquiry learning (POGIL) team-based activities into a 1-semester medicinal chemistry course for doctor of pharmacy (PharmD) students and determine the outcomes. Students in the fall 2007 section of the Medicinal Chemistry course were taught in a traditional teacher-centered manner, with the majority of class time spent on lectures and a few practice question sets. Students in the fall 2008 and fall 2009 sections of Medicinal Chemistry spent approximately 40% of class time in structured self-selected teams where they worked through guided-inquiry exercises to supplement the lecture material. The mean examination score of students in the guided-inquiry sections (fall 2008 and fall 2009) was almost 3 percentage points higher than that of students in the fall 2007 class (P < 0.05). Furthermore, the grade distribution shifted from a B-C centered distribution (fall 2007 class) to an A-B centered distribution (fall 2008 and fall 2009 classes). The inclusion of the POGIL style team-based learning exercises improved grade outcomes for the students, encouraged active engagement with the material during class time, provided immediate feedback to the instructor regarding student-knowledge deficiencies, and created a classroom environment that was well received by students.

E-Learning Quality Assurance: A Process-Oriented Lifecycle Model

ERIC Educational Resources Information Center

Abdous, M'hammed

2009-01-01

Purpose: The purpose of this paper is to propose a process-oriented lifecycle model for ensuring quality in e-learning development and delivery. As a dynamic and iterative process, quality assurance (QA) is intertwined with the e-learning development process. Design/methodology/approach: After reviewing the existing literature, particularly…

[Research progress on identification and quality evaluation of glues medicines].

PubMed

Li, Hui-Hu; Ren, Gang; Chen, Li-Min; Zhong, Guo-Yue

2018-01-01

Glues medicines is a special kind of traditional Chinese medicine.As the market demand is large, the raw materials are in short supply and lacks proper quality evaluation technology, which causes inconsistent quality of products on the market. Its authentic identification and evaluation stay a problem to be solved. In this paper, the research progress of the methods and techniques of the evaluation of the identification and quality of glues medicines were reviewed. The researches of medicinal glue type identification and quality evaluation mainly concentrated in four aspects of medicinal materials of physical and chemical properties, trace elements, organic chemicals and biological genetic methods and techniques. The methods of physicochemical properties include thermal analysis, gel electrophoresis, isoelectric focusing electrophoresis, infrared spectroscopy, gel exclusion chromatography, and circular dichroism. The methods including atomic absorption spectrometry, X-ray fluorescence spectrometry, plasma emission spectrometry and visible spectrophotometry were used for the study of the trace elements of glues medicines. The organic chemical composition was studied by methods of composition of amino acids, content detection, odor detection, lipid soluble component, organic acid detection. Methods based on the characteristics of biogenetics include DNA, polypeptide and amino acid sequence difference analysis. Overall, because of relative components similarity of the glues medicines (such as amino acids, proteins and peptides), its authenticity and quality evaluation index is difficult to judge objectively, all sorts of identification evaluation methods have different characteristics, but also their limitations. It indicates that further study should focus on identification of evaluation index and various technology integrated application combining with the characteristics of the production process. Copyright© by the Chinese Pharmaceutical Association.

Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

PubMed Central

Censullo, Andrea

2017-01-01

Abstract In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine’s “Choosing Wisely” campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning offer the most promise in facilitating rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs). However, radiologists at different institutions may have varying degrees of expertise with these modalities. Regardless, infectious disease consultants would benefit from knowing what nuclear medicine tests to order when considering patients with complex infectious disease syndromes. PMID:28480283

Nuclear medicine in clinical urology and nephrology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tauxe, W.N.; Dubousky, E.V.

This book presents explanations of current procedures involving the kidney with information of the performance of each test, its rationale, and interpretation. The information covers all currently used radiopharmaceuticals, radiation dosimetry, instrumentation, test protocols, and mathematical principles of pathophysiology as they relate to nuclear medicine studies. Information is provided on which radiopharmaceutical, instrument, or computer application to use, and when.

Trade-off Between Quality, Price, and Profit Orientation in Germany's Nursing Homes.

PubMed

Geraedts, Max; Harrington, Charlene; Schumacher, Daniel; Kraska, Rike

International data suggest that for-profit nursing homes tend to provide lower quality than not-for-profit nursing homes. In Germany, the relationships between profit orientation, price and quality of nursing homes have not been investigated. We performed an observational study using secondary data from statutory quality audits of all nursing homes in Germany. The relationships were analyzed bivariately via Mann-Whitney U -Test and Kruskal-Wallis Test respectively, followed by a multivariate variance analysis which also covered the interaction effect between quality, price and type of ownership. 41 % of 10,168 German nursing homes were for-profit charging on average about 10 % less than not-for-profit homes. In five out of six quality categories under study, for-profit nursing homes provided lower quality than not-for-profit homes. Quality of care in all quality categories improved with increasing prices per day. However, for four out of six quality categories examined, the quality difference between for-profit and non-profit nursing homes existed independent of the price charged. When selecting a nursing home it is therefore advisable to consider the profit orientation of the institution. German legislation should require that statutory public quality reports contain details on the profit orientation of nursing homes.

Nuclear analytical techniques in medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cesareo, R.

1988-01-01

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

Position of nuclear medicine techniques in the diagnostic work-up of neuroendocrine tumors.

PubMed

Bombardieri, E; Seregni, E; Villano, C; Chiti, A; Bajetta, E

2004-06-01

In recent years nuclear medicine has contributed to the impressive development of the knowledge of neuroendocrine tumors in terms of biology (receptor scintigraphy), pharmacology (development of new tracers), and therapy (radiometabolic therapy). At present, it is impossible to plan the management of a patient affected by a neuroendocrine tumor without performing nuclear medicine examinations. The contribution of nuclear medicine had affected and improved the management of these patients by offering various important options that are part of the modern diagnosis and treatment protocols. The clinical experience and the literature confirm that, among the wide variety of tracers and nuclear medicine modalities available today, metaiodobenzylguanidine (MIBG) and DTPA-D-Phe-octreotide (pentetreotide) are the radiopharmaceuticals of current clinical use. Several new somatostatin analogues are under investigation. Positron emission tomography (PET) supplies a range of labelled compounds to be used for the visualization of tumor biochemistry. In addition to the first routinely used PET tracer in oncology, 18F-labelled deoxyglucose (FDG), a number of radiopharmaceuticals based on different precursors such as fluorodopamine and 5-hydroxytryptophan (5-HTP) are going to gain a clinical role. Of course, the diagnosis of neuroendocrine tumors has to be based on integrated information derived from different examinations including nuclear medicine studies. The clinical presentation of neuroendocrine tumors is highly variable: sometimes they manifest typical or atypical symptoms but they may also be detected by chance during an X-ray or ultrasound examination carried out for other reasons. At disease presentation nuclear medicine modalities are sometimes able to direct physicians towards the clinical diagnosis thanks to the specificity of their imaging mechanisms. They also play a role in disease staging and restaging, patient follow-up and treatment monitoring. In addition, the

Stochastic online appointment scheduling of multi-step sequential procedures in nuclear medicine.

PubMed

Pérez, Eduardo; Ntaimo, Lewis; Malavé, César O; Bailey, Carla; McCormack, Peter

2013-12-01

The increased demand for medical diagnosis procedures has been recognized as one of the contributors to the rise of health care costs in the U.S. in the last few years. Nuclear medicine is a subspecialty of radiology that uses advanced technology and radiopharmaceuticals for the diagnosis and treatment of medical conditions. Procedures in nuclear medicine require the use of radiopharmaceuticals, are multi-step, and have to be performed under strict time window constraints. These characteristics make the scheduling of patients and resources in nuclear medicine challenging. In this work, we derive a stochastic online scheduling algorithm for patient and resource scheduling in nuclear medicine departments which take into account the time constraints imposed by the decay of the radiopharmaceuticals and the stochastic nature of the system when scheduling patients. We report on a computational study of the new methodology applied to a real clinic. We use both patient and clinic performance measures in our study. The results show that the new method schedules about 600 more patients per year on average than a scheduling policy that was used in practice by improving the way limited resources are managed at the clinic. The new methodology finds the best start time and resources to be used for each appointment. Furthermore, the new method decreases patient waiting time for an appointment by about two days on average.

Simultaneous fluoroscopic and nuclear imaging: impact of collimator choice on nuclear image quality.

PubMed

van der Velden, Sandra; Beijst, Casper; Viergever, Max A; de Jong, Hugo W A M

2017-01-01

hole geometries. This results in higher contrast-to-noise ratios for parallel hole geometries. Smaller spheres can thus be detected with parallel hole collimators than with pinhole collimators (17 mm vs 28 mm). Pinhole geometries show larger image deformations than parallel hole geometries. Spatial resolution varied between 1.25 cm for the 3 mm pinhole and 4 cm for the LEAP collimator. The simulation method was successfully validated by the experiments with the physical prototype. A real-time hybrid fluoroscopic and nuclear imaging device is currently being developed. Image quality of nuclear images obtained with different collimators was compared in terms of contrast, noise, and detectability. Parallel hole collimators showed lower noise and better detectability than pinhole collimators. © 2016 American Association of Physicists in Medicine.

Trends of population radiation adsorbed dose from diagnostic nuclear medicine procedures in Iran: 1985-1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohammadi, H.; Tabeie, F.; Saghari, M.

1995-04-01

In view of the rapid expansion of diagnostic nuclear medicine procedures in Iran, this study was undertaken to examine trends of nuclear medicine practice in the country and to determine the mean effective dose equivalent per patient and per capita. Comprehensive national data covering 93% of all nuclear medicine centers in 1985-1989 were obtained. The total number of nuclear medicine examinations inc teased by 42% during these years. The relative frequency of thyroid investigations was 84% followed by liver/spleen and bone procedures (7% and 6%, respectively). {sup 99m}Tc was the radionuclide of choice for 86% of investigation while {sup 131}Imore » alone accounted for 59% of collective effective dose equivalent. The annual average number of nuclear medicine procedures per 1,000 people was 1.9. For the thyroid, the highest number (48%) of patients investigated was in the 15-29 y age group and the lowest (3%) was in the >64 y age group. The male to female ratio of thyroid and cardiac patient was 0.18 and 3.64, respectively. The numbers of males and females studied for the remaining eight procedures were less frequent and about the same. The mean effective dose equivalent per patient and per capita was about 4.3 mSv and 8 {mu}Sv, respectively. {sup 131}I was responsible for most of collective effective dose equivalent produced by nuclear medicine. Therefore, future efforts should be concentrated on dose reduction for diagnostic {sup 131}I tests.« less

What is the purpose of emission computed tomography in nuclear medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phelps, M.E.

1977-01-01

ECT is a mathematical and physical concept, an instrument, a radionuclide tracer technique, a research procedure and it is certainly both an old (Kuhl began his work in the late fifties) and a new concept. It also has great and unique potential as a diagnostic technique. It is interesting that the basic principles of medical CT were exemplified and developed in Nuclear Medicine by Kuhl and coworkers and the concept of ''physiologic or function tomography'' provides a technique to advance the original charter of Nuclear Medicine in the use of radionuclides for the measure of metabolism and physiologic function.

Manager personality, manager service quality orientation, and service climate: test of a model.

PubMed

Salvaggio, Amy Nicole; Schneider, Benjamin; Nishii, Lisa H; Mayer, David M; Ramesh, Anuradha; Lyon, Julie S

2007-11-01

This article conceptually and empirically explores the relationships among manager personality, manager service quality orientation, and climate for customer service. Data were collected from 1,486 employees and 145 managers in grocery store departments (N = 145) to test the authors' theoretical model. Largely consistent with hypotheses, results revealed that core self-evaluations were positively related to managers' service quality orientation, even after dimensions of the Big Five model of personality were controlled, and that service quality orientation fully mediated the relationship between personality and global service climate. Implications for personality and organizational climate research are discussed. (c) 2007 APA

Structural determinants of nuclear export signal orientation in binding to exportin CRM1

DOE PAGES

Fung, Ho Yee Joyce; Fu, Szu -Chin; Brautigam, Chad A.; ...

2015-09-08

The Chromosome Region of Maintenance 1 (CRM1) protein mediates nuclear export of hundreds of proteins through recognition of their nuclear export signals (NESs), which are highly variable in sequence and structure. The plasticity of the CRM1-NES interaction is not well understood, as there are many NES sequences that seem incompatible with structures of the NES-bound CRM1 groove. Crystal structures of CRM1 bound to two different NESs with unusual sequences showed the NES peptides binding the CRM1 groove in the opposite orientation (minus) to that of previously studied NESs (plus). A comparison of minus and plus NESs identified structural and sequencemore » determinants for NES orientation. The binding of NESs to CRM1 in both orientations results in a large expansion in NES consensus patterns and therefore a corresponding expansion of potential NESs in the proteome.« less

Self-assessment of current knowledge in nuclear medicine (second edition)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Selby, J.B.; Frey, G.D.; Cooper, J.F.

1981-01-01

In this updated second edition, the order of contents of the textbook has been reorganized. It has been divided into main parts: Basic Science and Clinical Nuclear Medicine. Basic Science, Part I, encompasses basic physics, radiation protection, interaction of radiation with matter and radiation detection, imaging, nuclear pharmacy, and radiation biology. Part II, Clinical Nuclear Medicine, covers the central nervous system, bone, gastroenterology (liver/spleen), cardiovascular system, pulmonary system, genitourinary system, thyroid and endocrine systems, gallium studies, radioassay, hematology, and therapy. The total number of pages of the current edition is increased to 250 from the 213 of the first editionmore » but there are fewer questions because those in the basic science area have been carefully selected to 60 of the original 98 questions. Compared with the previous edition, there are two advantages in the current one: (1) the addition of explanatory answers; and (2) the inclusion of up-to-date scintiphotos replacing rectilinear scan illustrations.« less

Pitfalls in classical nuclear medicine: myocardial perfusion imaging

NASA Astrophysics Data System (ADS)

Fragkaki, C.; Giannopoulou, Ch

2011-09-01

Scintigraphic imaging is a complex functional procedure subject to a variety of artefacts and pitfalls that may limit its clinical and diagnostic accuracy. It is important to be aware of and to recognize them when present and to eliminate them whenever possible. Pitfalls may occur at any stage of the imaging procedure and can be related with the γ-camera or other equipment, personnel handling, patient preparation, image processing or the procedure itself. Often, potential causes of artefacts and pitfalls may overlap. In this short review, special interest will be given to cardiac scintigraphic imaging. Most common causes of artefact in myocardial perfusion imaging are soft tissue attenuation as well as motion and gating errors. Additionally, clinical problems like cardiac abnormalities may cause interpretation pitfalls and nuclear medicine physicians should be familiar with these in order to ensure the correct evaluation of the study. Artefacts or suboptimal image quality can also result from infiltrated injections, misalignment in patient positioning, power instability or interruption, flood field non-uniformities, cracked crystal and several other technical reasons.

Considerations for setting up an order entry system for nuclear medicine tests.

PubMed

Hara, Narihiro; Onoguchi, Masahisa; Nishida, Toshihiko; Honda, Minoru; Houjou, Osamu; Yuhi, Masaru; Takayama, Teruhiko; Ueda, Jun

2007-12-01

Integrating the Healthcare Enterprise-Japan (IHE-J) was established in Japan in 2001 and has been working to standardize health information and make it accessible on the basis of the fundamental Integrating Healthcare Enterprise (IHE) specifications. However, because specialized operations are used in nuclear medicine tests, online sharing of patient information and test order information from the order entry system as shown by the scheduled workflow (SWF) is difficult, making information inconsistent throughout the facility and uniform management of patient information impossible. Therefore, we examined the basic design (subsystem design) for order entry systems, which are considered an important aspect of information management for nuclear medicine tests and needs to be consistent with the system used throughout the rest of the facility. There are many items that are required by the subsystem when setting up an order entry system for nuclear medicine tests. Among these items, those that are the most important in the order entry system are constructed using exclusion settings, because of differences in the conditions for using radiopharmaceuticals and contrast agents and appointment frame settings for differences in the imaging method and test items. To establish uniform management of patient information for nuclear medicine tests throughout the facility, it is necessary to develop an order entry system with exclusion settings and appointment frames as standard features. Thereby, integration of health information with the Radiology Information System (RIS) or Picture Archiving Communication System (PACS) based on Digital Imaging Communications in Medicine (DICOM) standards and real-time health care assistance can be attained, achieving the IHE agenda of improving health care service and efficiently sharing information.

[Quality by design approaches for pharmaceutical development and manufacturing of Chinese medicine].

PubMed

Xu, Bing; Shi, Xin-Yuan; Wu, Zhi-Sheng; Zhang, Yan-Ling; Wang, Yun; Qiao, Yan-Jiang

2017-03-01

The pharmaceutical quality was built by design, formed in the manufacturing process and improved during the product's lifecycle. Based on the comprehensive literature review of pharmaceutical quality by design (QbD), the essential ideas and implementation strategies of pharmaceutical QbD were interpreted. Considering the complex nature of Chinese medicine, the "4H" model was innovated and proposed for implementing QbD in pharmaceutical development and industrial manufacture of Chinese medicine product. "4H" corresponds to the acronym of holistic design, holistic information analysis, holistic quality control, and holistic process optimization, which is consistent with the holistic concept of Chinese medicine theory. The holistic design aims at constructing both the quality problem space from the patient requirement and the quality solution space from multidisciplinary knowledge. Holistic information analysis emphasizes understanding the quality pattern of Chinese medicine by integrating and mining multisource data and information at a relatively high level. The batch-to-batch quality consistence and manufacturing system reliability can be realized by comprehensive application of inspective quality control, statistical quality control, predictive quality control and intelligent quality control strategies. Holistic process optimization is to improve the product quality and process capability during the product lifecycle management. The implementation of QbD is useful to eliminate the ecosystem contradictions lying in the pharmaceutical development and manufacturing process of Chinese medicine product, and helps guarantee the cost effectiveness. Copyright© by the Chinese Pharmaceutical Association.

Dictionary/handbook of nuclear medicine and clinical imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iturralde, M.P.

This book covers the following topics: Fundamentals of English medical etymology, Abbreviations, acronyms, symbols, denotations, and signs commonly used or defined in the dictionary, Characteristics of the elements, Characteristics of practicable radioisotopes and of selected radionuclides commonly used in nuclear medicine, Properties and production of radionuclides, Radioactive decay, Radiopharmaceuticals, and Radiation dosimetry.

Nuclear Technology Series. Course 31: Quality-Assurance Practices.

ERIC Educational Resources Information Center

Center for Occupational Research and Development, Inc., Waco, TX.

This technical specialty course is one of thirty-five courses designed for use by two-year postsecondary institutions in five nuclear technician curriculum areas: (1) radiation protection technician, (2) nuclear instrumentation and control technician, (3) nuclear materials processing technician, (4) nuclear quality-assurance/quality-control…

Bringing the Flipped Classroom to Day 1: A Novel Didactic Curriculum for Emergency Medicine Intern Orientation

PubMed Central

Barrie, Michael G.; Amick, Christopher; Mitzman, Jennifer; Way, David P.; King, Andrew M.

2018-01-01

Most emergency medicine (EM) residency programs provide an orientation program for their incoming interns, with the lecture being the most common education activity during this period. Our orientation program is designed to bridge the gap between undergraduate and graduate medical education by ensuring that all learners demonstrate competency on Level 1 Milestones, including medical knowledge (MK). To teach interns core medical knowledge in EM, we reformulated orientation using the flipped-classroom model by replacing lectures with small group, case-based discussions. Interns demonstrated improvement in medical knowledge through higher scores on a posttest. Evaluation survey results were also favorable for the flipped-classroom teaching format. PMID:29383072

Bringing the Flipped Classroom to Day 1: A Novel Didactic Curriculum for Emergency Medicine Intern Orientation.

PubMed

Barrie, Michael G; Amick, Christopher; Mitzman, Jennifer; Way, David P; King, Andrew M

2018-01-01

Most emergency medicine (EM) residency programs provide an orientation program for their incoming interns, with the lecture being the most common education activity during this period. Our orientation program is designed to bridge the gap between undergraduate and graduate medical education by ensuring that all learners demonstrate competency on Level 1 Milestones, including medical knowledge (MK). To teach interns core medical knowledge in EM, we reformulated orientation using the flipped-classroom model by replacing lectures with small group, case-based discussions. Interns demonstrated improvement in medical knowledge through higher scores on a posttest. Evaluation survey results were also favorable for the flipped-classroom teaching format.

One-year clinical experience with a fully digitized nuclear medicine department: organizational and economical aspects

NASA Astrophysics Data System (ADS)

Anema, P. C.; de Graaf, C. N.; Wilmink, J. B.; Hall, David R.; Hoekstra, A. G.; van Rijk, P. P.; Van Isselt, J. W.; Viergever, Max A.

1991-07-01

At the department of nuclear medicine of the University Hospital Utrecht a single-modality PACS has been operational since mid-1990. After one year of operation the functionality, the organizational and economical consequences, and the acceptability of the PACS were evaluated. The functional aspects reviewed were: viewing facilities, patient data management, connectivity, reporting facilities, archiving, privacy, and security. It was concluded that the improved quality of diagnostic viewing and the potential integration with diagnosis, reporting, and archiving are highly appreciated. The many problems that have occurred during the transition period, however, greatly influence the appreciation and acceptability of the PACS. Overall, it is felt that in the long term there will be a positive effect on the quality and efficiency of the work.

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. © The International Society for Prosthetics and Orthotics.

Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 2. Results: Primary care management and community orientation.

PubMed

Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

2010-03-01

At the WONCA Europe conference 2009 the recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' was presented. It is a background paper and reference manual, providing advocacy of general practice/family medicine (GP/FM) in Europe. The Research Agenda summarizes the evidence relating to the core competencies and characteristics of the WONCA Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In this second article, the results for the core competencies 'primary care management' and 'community orientation' are presented. Though there is a large body of research on various aspects of 'primary care management', it represents a very scattered rather than a meta view. Many studies focus on care for specific diseases, the primary/secondary care interface, or the implications of electronic patient records. Cost efficiency or process indicators of quality are current outcomes. Current literature on community orientation is mainly descriptive, and focuses on either care for specific diseases, or specific patient populations, or on the uptake of preventive services. Most papers correspond poorly to the WONCA concept. For both core competencies, there is a lack of research with a longitudinal perspective and/or relevant health or quality of life outcomes as well as research on patients' preferences and education for organizational aspects of GP/FM.

Sources and magnitude of occupational and public exposures from nuclear medicine procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

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.

Employee Perceptions of Quality Management: Effects of Employee Orientation Training

ERIC Educational Resources Information Center

Akdere, Mesut; Schmidt, Steven W.

2008-01-01

This empirical study examines employee perceptions of quality management at three different time periods. New employees at a large United States manufacturing organization were surveyed regarding their perceptions of their organization's quality management practices before they attended a new employee orientation training, immediately after the…

Audit of nuclear medicine scientific and technical standards.

PubMed

Jarritt, Peter H; Perkins, Alan C; Woods, Sandra D

2004-08-01

The British Nuclear Medicine Society has developed a process for the service-specific organizational audit of nuclear medicine departments. This process identified the need for a scheme suitable for the audit of the scientific and technical standards of a department providing such a service. This document has evolved following audit visits of a number of UK departments. It is intended to be used as a written document to facilitate the audit procedure and may be used for both external and self-audit purposes. Scientific and technical standards have been derived from a number of sources, including regulatory documents, notes for guidance and peer-reviewed publications. The audit scheme is presented as a series of questions with responses graded according to legal and safety obligations (A), good practice (B) and desirable aspects of service delivery (C). This document should be regarded as part of an audit framework and should be kept under review as the process evolves to meet the future demands of this high-technology-based clinical service.

Six sigma tools for a patient safety-oriented, quality-checklist driven radiation medicine department.

PubMed

Kapur, Ajay; Potters, Louis

2012-01-01

The purpose of this work was to develop and implement six sigma practices toward the enhancement of patient safety in an electronic, quality checklist-driven, multicenter, paperless radiation medicine department. A quality checklist process map (QPM), stratified into consultation through treatment-completion stages was incorporated into an oncology information systems platform. A cross-functional quality management team conducted quality-function-deployment and define-measure-analyze-improve-control (DMAIC) six sigma exercises with a focus on patient safety. QPM procedures were Pareto-sorted in order of decreasing patient safety risk with failure mode and effects analysis (FMEA). Quantitative metrics for a grouped set of highest risk procedures were established. These included procedural delays, associated standard deviations and six sigma Z scores. Baseline performance of the QPM was established over the previous year of usage. Data-driven analysis led to simplification, standardization, and refinement of the QPM with standard deviation, slip-day reduction, and Z-score enhancement goals. A no-fly policy (NFP) for patient safety was introduced at the improve-control DMAIC phase, with a process map interlock imposed on treatment initiation in the event of FMEA-identified high-risk tasks being delayed or not completed. The NFP was introduced in a pilot phase with specific stopping rules and the same metrics used for performance assessments. A custom root-cause analysis database was deployed to monitor patient safety events. Relative to the baseline period, average slip days and standard deviations for the risk-enhanced QPM procedures improved by over threefold factors in the NFP period. The Z scores improved by approximately 20%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. The number of computed potential no-fly delays per month dropped from 60 to 20 over a total of 520 cases. The fraction of computed

Analysis of the Status Quo of Humanistic Quality-Oriented Education in Medical Colleges and Universities

ERIC Educational Resources Information Center

Liu, Shulei; Li, Yamin

2012-01-01

With transformation of contemporary modern medical educational modes and improvement of requirement upon doctors' humanistic quality, it seems quite important to strengthen humanistic quality-oriented education in medical colleges and universities. Medical humanistic quality-oriented education in China started late, which determines that there are…

MO-AB-207-00: ACR Update in MR, CT, Nuclear Medicine, and Mammography

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date asmore » the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.« less

The status of acupuncture and oriental medicine in the United States.

PubMed

Stone, Jennifer A M

2014-04-01

Since its first mention in U.S. media in the early 1970s, the practice of acupuncture and Oriental medicine (AOM) has grown in stature from a fringe, counter-culture movement to a valid, evidenced-based treatment option for patients. In the last 40 years, AOM schools and colleges have been accredited by the U.S. Department of Education, offering both masters and doctoral degree programs. To date, forty-seven states and the District of Columbia license or certify acupuncturists based on competency proven through state examination or professional certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). As acceptance of AOM in the U.S. has increased through both the assurance of psychometrically sound certification and the education of the American public on this topic, many challenges have emerged. Problems such as the underemployment of AOM clinicians, methodological hurdles for the investigation of mechanisms, and efficacy of acupuncture and other AOM treatment techniques have been observed. Investigative challenges also include gaps in research training as well as a dearth of the basic resources needed to conduct randomized controlled trials (RCTs). As AOM research has sought integration into the Western research model, problems have been identified in the design of AOMRCTs, and strategies for their resolution through methods such as translational research have been examined. Incorporating these strategies as well as efficacy, effectiveness, and qualitative measures will strengthen the evidence base and thus provide clinical decision makers with more tools that can be used to design patient treatment regimens.

Selecting clinical quality indicators for laboratory medicine.

PubMed

Barth, Julian H

2012-05-01

Quality in laboratory medicine is often described as doing the right test at the right time for the right person. Laboratory processes currently operate under the oversight of an accreditation body which gives confidence that the process is good. However, there are aspects of quality that are not measured by these processes. These are largely focused on ensuring that the most clinically appropriate test is performed and interpreted correctly. Clinical quality indicators were selected through a two-phase process. Firstly, a series of focus groups of clinical scientists were held with the aim of developing a list of quality indicators. These were subsequently ranked in order by an expert panel of primary and secondary care physicians. The 10 top indicators included the communication of critical results, comprehensive education to all users and adequate quality assurance for point-of-care testing. Laboratories should ensure their tests are used to national standards, that they have clinical utility, are calibrated to national standards and have long-term stability for chronic disease management. Laboratories should have error logs and demonstrate evidence of measures introduced to reduce chances of similar future errors. Laboratories should make a formal scientific evaluation of analytical quality. This paper describes the process of selection of quality indicators for laboratory medicine that have been validated sequentially by deliverers and users of the service. They now need to be converted into measureable variables related to outcome and validated in practice.

Online video bridges gap between orientation and first session for arts in medicine volunteers.

PubMed

Gregory, Dianne

2009-01-01

An online video assignment was developed to facilitate transition from the orientation session to the first contact with hospital patients for music therapy majors and other students enrolled in an Arts in Medicine service learning course (AIMS). All students (N = 84) completed a 2 hour hospital orientation session. After the orientation session the experimental group (n = 42) completed an online video assignment before volunteering at the hospital The control group (n = 42) began volunteering after the orientation session without completing the video assignment. Analysis indicates the majority of both groups initiated their first session independently without assistance from other AIMS volunteers, an experienced AIM volunteer, an AIM assistant, or hospital staff member. The majority of both groups also engaged at least one patient during their first visit at the hospital. Content analysis of "first contact" weekly reports, however, indicated experimental group students wrote longer reports and included more positive comments, particularly about patients, compared to control group students. Volunteers in the experimental group also began their contacts as scheduled on the course calendar compared to later starting dates of control group volunteers.

Quality of generic medicines in South Africa: perceptions versus reality - a qualitative study.

PubMed

Patel, Aarti; Gauld, Robin; Norris, Pauline; Rades, Thomas

2012-09-03

Generic Medicines are an important policy option allowing for access to affordable, essential medicines. Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities. Existing negative perceptions surrounding the quality of generic medicines must be addressed to ensure that people use them with confidence. Campaigns to increase the uptake of generic medicines by consumers and providers of healthcare need to be informed by local norms and practices. This study sought to compare South African consumers' and healthcare providers' perceptions of quality of generics to the actual quality of selected products. The study was conducted at the local level in three cities of South Africa: Johannesburg, Durban and Cape Town. Purposive sampling was used to recruit consumer participants (n = 73) and random sampling used to recruit healthcare providers from public and private sectors (n = 15). Data were obtained through twelve focus group discussions with consumers and semi-structured interviews (n = 15) with healthcare providers in order to gain familiarity with perceptions of quality. One hundred and thirty five products comprising paracetamol tablets (n = 47), amoxicillin capsules (n = 45) and hydrochlorothiazide tablets (n = 43) were sourced from public and private sector healthcare providers. These products were subjected to in vitro dissolution, uniformity of weight and identity (Fourier Transformed Infrared Spectroscopy) tests using prescribed methods from the British (2005) and United States Pharmacopeias (2006). Respondents described drug quality in relation to the effect on symptoms. Procurement and use behavior of healthcare providers was influenced by prior experience, manufacturers' names and consumers' ability to pay. All formulations passed the in vitro tests for quality. This study showed clear differences between perceptions of quality and actual quality of medicines suggesting

[The technological innovation strategy for quality control of Chinese medicine based on Big Data].

PubMed

Li, Zhen-hao; Qian, Zhong-zhi; Cheng, Yi-yu

2015-09-01

The evolution of the quality control concepts of medical products within the global context and the development of the quality control technology of Chinese medicine are briefly described. Aimed at the bottlenecks in the regulation and quality control of Chinese medicine, using Big Data technology to address the significant challenges in Chinese medicine industry is proposed. For quality standard refinements and internationalization of Chinese medicine, a technological innovation strategy encompassing its methodology, and the R&D direction of the subsequent core technology are also presented.

The effectiveness of wastewater treatment in nuclear medicine: Performance data and radioecological considerations.

PubMed

Sudbrock, F; Schomäcker, K; Drzezga, A

2017-01-01

For planned and ongoing storage of liquid radioactive waste in a designated plant for a nuclear medicine therapy ward (decontamination system/decay system), detailed knowledge of basic parameters such as the amount of radioactivity and the necessary decay time in the plant is required. The design of the plant at the Department of Nuclear Medicine of the University of Cologne, built in 2001, was based on assumptions about the individual discharge of activity from patients, which we can now retrospectively validate. The decontamination factor of the plant is at present in the order of 10 -9 for 131 I. The annual discharges have been continuously reduced over the period of operation and are now in the region of a few kilobecquerels. This work emphasizes the high efficacy of the decontamination plant to reduce the amount of radioactivity released from the nuclear medicine ward into the environment to almost negligible levels. Copyright © 2016 Elsevier Ltd. All rights reserved.

[New idea of traditional Chinese medicine quality control based on "composition structure" theory].

PubMed

Liu, Dan; Jia, Xiaobin; Yu, Danhong

2012-03-01

On the road of the modern Chinese medicine developing internationally, there is a key issues that setting up a reasonable, accurate and be quantified quality evaluation system which is comply with the basic theory of Chinese medicine. Based on the overall understanding of the role of traditional Chinese medicine components, author suggested that the idea of "structural components" theory should be embedded into the system and thought the Chinese medicine play a multi-target, multi-channel pharmacodynamic effects founded on the specific microcosmic structural relationship between the components and the components within the group. At present, the way of Chinese pharmacopoeia checking the quality of Chinese medicine is mainly depends on controlling the single or multiple targets of ingredients. In fact, this way is out of the overall effectiveness of the Chinese medicine, so we can not thoroughly controlling the quality of Chinese medicine from the essence of the Chinese medicine. Secondly, it's only macro-structural quantity that the Chinese pharmacopoeia just controlling the less effective ingredients, this is not enough to reflect the internal microstructure of the integrity and systematic. In other words, this cannot reflect the structural components of the Chinese medicine (the essence of traditional Chinese medicine). In view of above mentioned reasons, the author propose the new idea on the quality control in the medicine that quantify the ratio structural relationship in component and the ingredients of the components, set the optimal controlling proportion between the components and ingredients. At the same time, author thought we should conduct the depth study in the micro-quantified the multi-component and multi-ingredient, in the process of studying the material basis of Chinese medicine. Therefore, it could establish a more rational basis for the Chinese medicine quality controlling system.

Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary

PubMed Central

2012-01-01

Background In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study. Methods Gated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not. Results The nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617). Conclusions The nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve. PMID:22947251

Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

PubMed

Whitson, Heather E; Hastings, S Nicole; McConnell, Eleanor S; Lekan-Rutledge, Deborah A

2006-09-01

To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. Descriptive pilot project. Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

Understanding the molecular aspects of oriental obesity pattern differentiation using DNA microarray.

PubMed

Hong, Sun Woo; Yoo, Jae-Wook; Bose, Shambhunath; Park, Jung-Hyun; Han, Kyungsun; Kim, Soyoun; Lim, Chi-Yeon; Kim, Hojun; Lee, Dong-Ki

2015-10-19

Human constitution, the fundamental basis of oriental medicine, is categorized into different patterns for a particular disease according to the physical, physiological, and clinical characteristics of the individuals. Obesity, a condition of metabolic disorder, is classified according to six patterns in oriental medicine, as follows: spleen deficiency syndrome, phlegm fluid syndrome, yang deficiency syndrome (YDS), food accumulation syndrome (FAS), liver depression syndrome (LDS), and blood stasis syndrome. In oriental medicine, identification of the disease pattern for individual obese patients is performed on the basis of differentiation in obesity syndrome index and, accordingly, personalized treatment is provided to the patients. The aim of the current study was to understand the obesity patterns in oriental medicine from the genomic point of view via determining the gene expression signature of obese patients using peripheral blood mononuclear cells as the samples. The study was conducted in 23 South Korean obese subjects (19 female and four male) with BMI ≥25 kg/m(2). Identification of oriental obesity pattern was based on the software-guided evaluation of the responses of the subjects to a questionnaire developed by the Korean Institute of Oriental Medicine. The expression profiles of genes were determined using DNA microarray and the level of transcription of genes of interest was further evaluated using quantitative real-time PCR (qRT-PCR). Gene clustering analysis of the microarray data from the FAS, LDS, and YDS subjects exhibited disease pattern-specific upregulation of expression of several genes in a particular cluster. Further analysis of transcription of selected genes using qRT-PCR led to identification of specific genes, including prostaglandin endoperoxide synthase 2, G0/G1 switch 2, carcinoembryonic antigen-related cell adhesion molecule 3, cystein-serine-rich nuclear protein 1, and interleukin 8 receptor, alpha which were highly expressed in

[Analysis and countermeasure for quality risk in process of traditional Chinese medicine preparations].

PubMed

Yang, Ming; Yang, Yuan-Zhen; Wang, Ya-Qi; Wu, Zhen-Feng; Wang, Xue-Cheng; Luo, Jing

2017-03-01

Product quality relies on not only testing methods,but also the design and development, production control and product manufacturing all aspects of logistics management. Quality comes from the process control level.Therefore, it is very important to accurately identify the factors that may induce quality risk in the production process and quality control measures correspondingly.This article systematically analyzes the source of the quality risk of all aspects of the production process in traditional Chinese medicine preparation. Discussing ways and methods of quality risk identification of traditional Chinese medicine preparation and providing references for perfecting the whole process quality management of traditional Chinese medicine preparation. Copyright© by the Chinese Pharmaceutical Association.

Impact of poor-quality medicines in the 'developing' world.

PubMed

Newton, Paul N; Green, Michael D; Fernández, Facundo M

2010-03-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in 'developing' countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a 'crevasse' between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. 2009 Elsevier Ltd. All rights reserved.

Research scholars program: a faculty development initiative at the Oregon College of Oriental Medicine.

PubMed

Hammerschlag, Richard; Lasater, Kathie; Salanti, Sonya; Fleishman, Susan

2008-05-01

The Research Scholars Program (RSP) was created at the Oregon College of Oriental Medicine (OCOM) to provide faculty development in research literacy, research-informed clinical practice, and research participation skills. The RSP is part of a broad effort, funded by a National Institutes of Health/National Center for Complementary and Alternative Medicine R25 education grant, to infuse an evidence-based perspective into the curriculum at schools of complementary and alternative medicine. The RSP arose from the realization that this curriculum reform would first necessitate faculty training in both research appreciation and pedagogy. OCOM's grant, Acupuncture Practitioner Research Education Enhancement, is a partnership with the Oregon Health & Science University School of Nursing (OHSU SON). The RSP was developed initially as a collaborative effort among the OCOM Dean of Research (R.H.), OCOM Director of Research Education (S.F.), and an OHSU SON education specialist (K.L.). The 9-month, 8 hours per month seminar-style RSP provides the opportunity for a cohort of OCOM faculty and staff to explore research-related concepts and content as well as pedagogical practices that emphasize interactive, learner-centered teaching. The RSP adheres to a competency-based approach as developed by the Education Committee of the grant. As a tangible outcome, each Research Scholar designs a sustainable learning activity that infuses a research perspective into their courses, clinic supervision, or other sphere of influence at the college. In this paper, we describe the creative process and the lessons learned during the planning and initial implementation of the RSP. We view the early successes of the RSP as encouraging signs that research literacy and an evidence-based perspective are becoming increasingly accepted as needed skill sets for present-day practitioners of acupuncture and Oriental medicine.

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

... technologist credentialed in nuclear medicine technology. 2. Instructional Staff—(a) Responsibilities. The...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... certificate documenting completion of the program. 2. Educational programs may be established in: (a...

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

... technologist credentialed in nuclear medicine technology. 2. Instructional Staff—(a) Responsibilities. The...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... certificate documenting completion of the program. 2. Educational programs may be established in: (a...

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

... technologist credentialed in nuclear medicine technology. 2. Instructional Staff—(a) Responsibilities. The...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... certificate documenting completion of the program. 2. Educational programs may be established in: (a...

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

... technologist credentialed in nuclear medicine technology. 2. Instructional Staff—(a) Responsibilities. The...—Standards for Accreditation of Educational Programs for Nuclear Medicine Technologists A. Sponsorship 1... certificate documenting completion of the program. 2. Educational programs may be established in: (a...

Nutritional quality and child-oriented marketing of breakfast cereals in Guatemala.

PubMed

Soo, J; Letona, P; Chacon, V; Barnoya, J; Roberto, C A

2016-01-01

Food marketing has been implicated as an important driver of obesity. However, few studies have examined food marketing in low- and middle-income countries (LMICs). This study documents the prevalence of advertising on cereal boxes in Guatemala and examines associations between various marketing strategies and nutritional quality. One box from all available cereals was purchased from a supermarket located in an urban area in Guatemala City, Guatemala. A content analysis was performed to document child-oriented marketing practices, product claims and health-evoking images. The Nutrient Profile Model (NPM) was used to calculate an overall nutrition score for each cereal (the higher the score, the lower the nutritional quality). In all, 106 cereals were purchased, and half of the cereals featured child-oriented marketing (54, 50.9%). Cereals had a mean (±s.d.) of 5.10±2.83 product claims per cereal, and most cereals (102, 96.2%) contained health-evoking images. Child-oriented cereals had, on average, higher NPM scores (13.0±0.55 versus 7.90±0.74, P<0.001) and sugar content (10.1±0.48 versus 6.19±0.50 g/30 g, P<0.001) compared with non-child oriented cereals. Cereals with health claims were not significantly healthier than those without claims. In Guatemala, cereals targeting children were generally of poor nutritional quality. Cereals displaying health claims were also not healthier than those without such claims. Our findings support the need for regulations restricting the use of child-oriented marketing and health claims for certain products.

Radiation dose to technologists per nuclear medicine examination and estimation of annual dose.

PubMed

Bayram, Tuncay; Yilmaz, A Hakan; Demir, Mustafa; Sonmez, Bircan

2011-03-01

Conventional diagnostic nuclear medicine applications have been continuously increasing in most nuclear medicine departments in Turkey, but to our knowledge no one has studied the doses to technologists who perform nuclear medicine procedures. Most nuclear medicine laboratories do not have separate control rooms for technologists, who are quite close to the patient during data acquisition. Technologists must therefore stay behind lead shields while performing their task if they are to reduce the radiation dose received. The aim of this study was to determine external radiation doses to technologists during nuclear medicine procedures with and without a lead shield. Another aim was to investigate the occupational annual external radiation doses to Turkish technologists. This study used a Geiger-Müller detector to measure dose rates to technologists at various distances from patients (0.25, 0.50, 1, and 2 m and behind a lead shield) and determined the average time spent by technologists at these distances. Deep-dose equivalents to technologists were obtained. The following conventional nuclear medicine procedures were considered: thyroid scintigraphy performed using (99m)Tc pertechnetate, whole-body bone scanning performed using (99m)Tc-methylene diphosphonate, myocardial perfusion scanning performed using (99m)Tc-methoxyisobutyl isonitrile, and (201)Tl (thallous chloride) and renal scanning performed using (99m)Tc-dimercaptosuccinic acid. The measured deep-dose equivalent to technologists per procedure was within the range of 0.13 ± 0.05 to 0.43 ± 0.17 μSv using a lead shield and 0.21 ± 0.07 to 1.01 ± 0.46 μSv without a lead shield. Also, the annual individual dose to a technologist performing only a particular scintigraphic procedure throughout a year was estimated. For a total of 95 clinical cases (71 patients), effective external radiation doses to technologists were found to be within the permissible levels. This study showed that a 2-mm lead shield

The legal framework governing the quality of (traditional) herbal medicinal products in the European Union.

PubMed

Kroes, Burt H

2014-12-02

In the European Union a complex regulatory framework is in place for the regulation of (traditional) herbal medicinal products. It is based on the principle that a marketing authorisation granted by the competent authorities is required for placing medicinal products on the market. The requirements and procedures for acquiring such a marketing authorisation are laid down in regulations, directives and scientific guidelines. This paper gives an overview of the quality requirements for (traditional) herbal medicinal products that are contained in European pharmaceutical legislation. Pharmaceutical quality of medicinal product is the basis for ensuring safe and effective medicines. The basic principles governing the assurance of the quality of medicinal products in the European Union are primarily defined in the amended Directive 2001/83/EC and Directive 2003/63/EC. Quality requirements of herbal medicinal products are also laid down in scientific guidelines. Scientific guidelines provide a basis for practical harmonisation of how the competent authorities of EU Member States interpret and apply the detailed requirements for the demonstration of quality laid down in regulations and directives. Detailed quality requirements for herbal medicinal products on the European market are contained in European Union (EU) pharmaceutical legislation. They include a system of manufacturing authorisations which ensures that all herbal medicinal products on the European market are manufactured/imported only by authorised manufacturers, whose activities are regularly inspected by the competent authorities. Additionally, as starting materials only active substances are allowed which have been manufactured in accordance with the GMP for starting materials as adopted by the Community. The European regulatory framework encompasses specific requirements for herbal medicinal products. These requirements are independent from the legal status. Thus, the same quality standards equally apply

Recommendations for Nuclear Medicine Technologists Drawn from an Analysis of Errors Reported in Australian Radiation Incident Registers.

PubMed

Kearney, Nicole; Denham, Gary

2016-12-01

When a radiation incident occurs in nuclear medicine in Australia, the incident is reported to the relevant state or territory authority, which performs an investigation and sends its findings to the Australian Radiation Protection and Nuclear Safety Agency. The agency then includes these data in its Australian Radiation Incident Register and makes them available to the public as an annual summary report on its website. The aim of this study was to analyze the radiation incidents included in these annual reports and in the publically available state and territory registers, identify any recurring themes, and make recommendations to minimize future incidents. A multidisciplinary team comprising a nuclear medicine technologist, a radiation therapist, and a diagnostic radiographer analyzed all nuclear medicine technology-, radiation therapy-, and diagnostic radiography-related incidents recorded in the Australian Radiation Incident Register and in the registers of New South Wales, Western Australia, Victoria, South Australia, and Tasmania between 2003 and 2015. Each incident was placed into 1 of 18 categories, and each category was examined to determine any recurring causes of the incidents. We analyzed 209 nuclear medicine incidents. Their primary cause was failure to comply with time-out protocols (85.6%). By analyzing both the causes and the rates of radiation incidents, we were able to recommend ways to help prevent them from being repeated. Information drawn from the Australian Radiation Incident Register and 5 state registers has revealed steps that can be taken by any nuclear medicine department to prevent repetition of the incidents that have already occurred. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Organizational Culture in Community Colleges: Connecting Market Orientation, Quality, and Student Engagement

ERIC Educational Resources Information Center

McManimon, Debra J.

2012-01-01

To enhance their competitive advantage in the marketplace, many business leaders develop market orientation strategies designed to increase customer engagement. These market orientation strategies include improvement in service delivery, relationship management, customer satisfaction, and quality control methods. There is a lack of understanding…

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.

[Packaging: the guarantee of medicinal quality].

PubMed

Chaumeil, J-C

2003-01-01

Primary packaging guarantees the pharmaceutical quality of the medicinal preparation received by the patient. Glass bottles containing parenteral solutions for example ensure that sterility, quality and optimal stability are preserved until administration. Recent innovations in materials research has lead to improvements in parenteral infusions. Multicompartmental bags, allowing extemporaneous mixtures without opening the container, constitute an extremely beneficial advance for the patient, allowing administration of mixtures with solutions and emulsions which would be unstable if stored. Metered dose pressurized inhalers are an excellent example of drug administration devices designed specifically to ensure quality and bioavailability. These examples illustrate the important role of primary packaging and demonstrate the usefulness of research and development in this area.

[Adrenal incidentaloma and nuclear medicine examination].

PubMed

Tenenbaum, F

2009-03-01

In the setting of adrenal incidentaloma, nuclear medicine evaluation is only indicated after biological and imaging work-up has been completed. MIBG scintigraphy is helpful to characterize pheochromocytomas. In lesions without MIBG uptake, 18F FDG or 18F DOPA PET can be considered to characterize chromaffin cell tumours. To characterize lesions of the adrenal cortex, iodocholesterol scintigraphy is performed to confirm the origin of the adenoma and the benign or malignant nature of the lesion since benign adenomas show tracer uptake and malignant lesions show no tracer uptake. 18F FDG PET only characterizes the lesion as benign or malignant.

Two signs indicative of successful access in nuclear medicine cerebrospinal fluid diversionary shunt studies.

PubMed

Bermo, Mohammed S; Khalatbari, Hedieh; Parisi, Marguerite T

2018-05-08

Successful shunt access is the first step in a properly performed nuclear medicine cerebrospinal fluid (CSF) shunt study. To determine the significance of the radiotracer configuration at the injection site during initial nuclear medicine CSF shunt imaging and the lack of early systemic radiotracer activity as predictors of successful shunt access. With Institutional Review Board approval, three nuclear medicine physicians performed a retrospective review of all consecutive CSF shunt studies performed in children at our institution in 2015. Antecedent nuclear medicine CSF shunt studies in these patients were also assessed and included in the review. The appearance of the reservoir site immediately after radiotracer injection was classified as either figure-of-eight or round/ovoid configuration. The presence or absence of early systemic distribution of the tracer on the 5-min static images was noted and separately evaluated. A total of 98 nuclear medicine ventriculoperitoneal CSF shunt studies were evaluated. Figure-of-eight configuration was identified in 87% of studies and, when present, had 93% sensitivity, 78% specificity, 92% accuracy, 98% positive predictive value (PPV) and 54% negative predictive value (NPV) as a predictor of successful shunt access. Early systemic activity was absent in 89 of 98 studies. Lack of early systemic distribution of the radiotracer had 98% sensitivity, 78% specificity, 96% accuracy, 98% PPV and 78% NPV as a predictor of successful shunt access. Figure-of-eight configuration in conjunction with the absence of early systemic tracer activity had 99% PPV for successful shunt access. Figure-of-eight configuration at the injection site or lack of early systemic radiotracer activity had moderate specificity for successful shunt access. Specificity and PPV significantly improved when both signs were combined in assessment.

Effective Dose in Nuclear Medicine Studies and SPECT/CT: Dosimetry Survey Across Quebec Province.

PubMed

Charest, Mathieu; Asselin, Chantal

2018-06-01

The aims of the current study were to draw a portrait of the delivered dose in selected nuclear medicine studies in Québec province and to assess the degree of change between an earlier survey performed in 2010 and a later survey performed in 2014. Methods: Each surveyed nuclear medicine department had to complete 2 forms: the first, about the administered activity in selected nuclear medicine studies, and the second, about the CT parameters used in SPECT/CT imaging, if available. The administered activities were converted into effective doses using the most recent conversion factors. Diagnostic reference levels were computed for each imaging procedure to obtain a benchmark for comparison. Results: The distributions of administered activity in various nuclear medicine studies, along with the corresponding distribution of the effective doses, were determined. Excluding 131 I for thyroid studies, 67 Ga-citrate for infectious workups, and combined stress and rest myocardial perfusion studies, the remainder of the 99m Tc-based studies delivered average effective doses clustered below 10 mSv. Between the 2010 survey and the 2014 survey, there was a statistically significant decrease in delivered dose from 18.3 to 14.5 mSv. 67 Ga-citrate studies for infectious workups also showed a significant decrease in delivered dose from 31.0 to 26.2 mSv. The standardized CT portion of SPECT/CT studies yielded a mean effective dose 14 times lower than the radiopharmaceutical portion of the study. Conclusion: Between 2010 and 2014, there was a significant decrease in the delivered effective dose in myocardial perfusion and 67 Ga-citrate studies. The CT portions of the surveyed SPECT/CT studies contributed a relatively small fraction of the total delivered effective dose. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

The role of learning and customer orientation for delivering service quality to patients.

PubMed

Bellou, Victoria

2010-01-01

This study seeks to investigate the impact that learning orientation, internal and external customer orientation have on quality of care delivered to patients. Additionally, given the differences between managerial and non-managerial employees regarding organizational value perception and focus on the needs of internal customers and patients, the study aims to examine potential variations in these relationships. The study took place in ten out of 31 public hospitals operating in the five largest districts in continental Greece. Hospitals were chosen on a random basis. Out of 800 questionnaires that were personally administered, 499 usable responses were gathered. The extent to which employees create and use knowledge and focus on satisfying the needs of both internal customers and patients is indicative of the quality of care provided. In addition, only managerial employees believe that learning orientation reinforces quality of care. The fact that employees rated quality of care delivered to patients and that most employees had extended tenure should be taken into consideration when interpreting these findings. Top management needs to create a strong and clear culture that emphasizes learning, as well as internal customer and patient orientation, and infuse them among all organizational members. Moreover, human resource management policies should be aligned to meeting or exceeding patients' requests and expectations. The paper enhances existing knowledge with regard to the antecedents of offering medical care of high quality.

Drug quality in South Africa: perceptions of key players involved in medicines distribution.

PubMed

Patel, Aarti; Norris, Pauline; Gauld, Robin; Rades, Thomas

2009-01-01

Substandard medicines contribute to poor public health and affect development, especially in the developing world. However knowledge of how manufacturers, distributors and providers understand the concept of drug quality and what strategies they adopt to ensure drug quality is limited, particularly in the developing world. The purpose of this paper is to explore pharmaceutical manufacturers', distributors' and providers' perceptions of drug quality in South Africa and how they ensure the quality of drugs during the distribution process. The approach taken was qualitative data collection through key informant interviews using a semi-structured interview guide. Transcripts were analysed thematically in Johannesburg, Pretoria and Durban, South Africa. Participants were recruited purposefully from a South African pharmaceutical manufacturer, SA subsidiaries of international manufacturers, national distribution companies, national wholesaler, public and private sector pharmacists, and a dispensing doctor. In total, ten interviews were conducted. Participants described drug quality in terms of the product and the processes involved in manufacturing and handling the product. Participants identified purchasing registered medicines from licensed suppliers, use of standard operating procedures, and audits between manufacturer and distributor and/or provider as key strategies employed to protect medicine quality. Effective communication amongst all stakeholders, especially in terms of providing feedback regarding complaints about medicine quality, appears as a potential area of concern, which would benefit from further research. The paper hightlights that ensuring medicine quality should be a shared responsibility amongst all involved in the distribution process to prevent medicines moving from one distribution system (public) into another (private).

Determining the pregnancy status of patients before diagnostic nuclear medicine procedures: the Australian experience.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2011-09-01

Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients. Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded. Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation. This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.

Are we doing enough to prevent poor-quality antimalarial medicines in the developing world?

PubMed

Walker, Erin J; Peterson, Gregory M; Grech, James; Paragalli, Evie; Thomas, Jackson

2018-05-15

Malaria is a deadly parasitic disease that affects more than 3 billion people worldwide, in predominantly resource-poor countries. Despite malaria being preventable and treatable, a large number of adults and children, mostly in Africa, die from this disease each year. One contributor to needless morbidity and mortality is the production and distribution of poor-quality antimalarial medicines; indeed, it is estimated that over 122,000 deaths of children under 5 years of age in sub-Saharan countries were caused by poor-quality antimalarial medicines, in 2013 alone. Poor-quality medicines include those that are deliberately falsified for monetary gain and may contain incorrect amounts or even no active ingredients at all, as well as products that are inadequate due to poor compliance to conventional quality standards and medicines that have degraded over time. Across a number of studies it has been reported that 4-92% of antimalarials tested are poor quality. This represents a massive risk to the population subjected to the use of these medicines, in the form of more severe and prolonged illness, additional costs to individuals who already have very little money, and lack of confidence in treatments. The continuing circulation of poor-quality medicines results from a number of factors, including insufficient regulatory capacity in susceptible countries, inadequate funding to perform regulatory functions, poor coordination between regulatory authorities, and inefficient import/export control systems. To combat the distribution of poor-quality medicines a number of organisations have developed guidelines for the procurement of antimalarials, and programs to educate consumers about the risks of poor-quality medicines and incentivise retailers to identify and report falsified medicines. The development of new technologies to quickly identify poor-quality medicines in the field is also essential, and some significant advances have been made. There has been considerable

TH-AB-206-00: Challenges and Opportunities for Nuclear Medicine Theranostics

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describesmore » preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.« less

Nuclear Medicine and Resources for Patients: How Complex are Online Patient Educational Materials?

PubMed

Hansberry, David R; Shah, Kush; Agarwal, Nitin; Kim, Sung M; Intenzo, Charles M

2018-02-02

The Internet is a major source of healthcare information for patients. The American Medical Association and National Institutes of Health recommend that consumer healthcare websites be written between a 3rd and 7th grade level. The purpose of this study is to evaluate the level of readability of patient education websites pertaining to nuclear medicine. Methods: Ten search terms were Googled and the top 10 links for each term were collected and analyzed for their level of readability using 10 well-established readability scales. Results: Collectively the 99 articles were written at an 11.8 grade level (standard deviation of 3.4). Only 5 of the 99 articles were written at the NIH and AMA recommended 3rd to 7th grade. Conclusion: There is a clear discordance between the readability level of nuclear medicine related imaging terms with the NIH and AMA guidelines. This disconnect may negatively impact patient understanding contributing to poor health outcomes. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

The Bottom Line: Quality/Consumer-Oriented Child Care.

ERIC Educational Resources Information Center

Jackson, Cheryl D.

Arguing that the provision of child care services is consistent with the role of the community college, this paper provides an overview of the current demand for and delivery of child care services and briefly discusses ways in which community colleges can assist in the development and provision of consumer-oriented, high-quality child care.…

A Social Network System Based on an Ontology in the Korea Institute of Oriental Medicine

NASA Astrophysics Data System (ADS)

Kim, Sang-Kyun; Han, Jeong-Min; Song, Mi-Young

We in this paper propose a social network based on ontology in Korea Institute of Oriental Medicine (KIOM). By using the social network, researchers can find collaborators and share research results with others so that studies in Korean Medicine fields can be activated. For this purpose, first, personal profiles, scholarships, careers, licenses, academic activities, research results, and personal connections for all of researchers in KIOM are collected. After relationship and hierarchy among ontology classes and attributes of classes are defined through analyzing the collected information, a social network ontology are constructed using FOAF and OWL. This ontology can be easily interconnected with other social network by FOAF and provide the reasoning based on OWL ontology. In future, we construct the search and reasoning system using the ontology. Moreover, if the social network is activated, we will open it to whole Korean Medicine fields.

Quality of generic medicines in South Africa: Perceptions versus Reality – A qualitative study

PubMed Central

2012-01-01

Background Generic Medicines are an important policy option allowing for access to affordable, essential medicines. Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities. Existing negative perceptions surrounding the quality of generic medicines must be addressed to ensure that people use them with confidence. Campaigns to increase the uptake of generic medicines by consumers and providers of healthcare need to be informed by local norms and practices. This study sought to compare South African consumers’ and healthcare providers’ perceptions of quality of generics to the actual quality of selected products. Methods The study was conducted at the local level in three cities of South Africa: Johannesburg, Durban and Cape Town. Purposive sampling was used to recruit consumer participants (n = 73) and random sampling used to recruit healthcare providers from public and private sectors (n = 15). Data were obtained through twelve focus group discussions with consumers and semi-structured interviews (n = 15) with healthcare providers in order to gain familiarity with perceptions of quality. One hundred and thirty five products comprising paracetamol tablets (n = 47), amoxicillin capsules (n = 45) and hydrochlorothiazide tablets (n = 43) were sourced from public and private sector healthcare providers. These products were subjected to in vitro dissolution, uniformity of weight and identity (Fourier Transformed Infrared Spectroscopy) tests using prescribed methods from the British (2005) and United States Pharmacopeias (2006). Results Respondents described drug quality in relation to the effect on symptoms. Procurement and use behavior of healthcare providers was influenced by prior experience, manufacturers’ names and consumers’ ability to pay. All formulations passed the in vitro tests for quality. Conclusions This study showed clear differences between perceptions of quality

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.

Perceptual market orientation gap and its impact on relationship quality and patient loyalty: the role of internal marketing.

PubMed

Huang, Jin-An; Weng, Rhay-Hung; Lai, Chi-Shiun; Hu, Jer-San

2013-06-01

The purpose of this study was to explore the perceptual market orientation gaps between physician and patients and its impact on relationship quality and patient loyalty, and to verify the critical role of internal marketing on developing market orientation. Self-administered questionnaires were then employed to collect the data. We used a convenience sample of physicians and patients at a medical center in central Taiwan, and 90 usable questionnaires from physicians and 450 usable questionnaires from patients were returned. Hierarchical multiple regression analyses were used to validate the research hypotheses. Physicians' perceptual market orientation had a positive influence on physician-patient relationship quality, hospital-patient relationship quality, and patient loyalty, but the perceptual market orientation gap between physicians and their patients had a direct negative impact on these constructs. Finally, internal marketing was found to have an influence on relationship quality and patient loyalty through the mediation of market orientation. In order to enhance relationship quality and patient loyalty, hospital managers should focus their efforts on improving employees' market orientation and reducing patients' perceptual market orientation gap. In addition, internal marketing was found to be a useful pathway in developing market orientation.

Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

PubMed

Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

2017-03-28

Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and

Future orientation and health quality of life in primary care: vitality as a mediator.

PubMed

Hirsch, Jameson K; Molnar, Danielle; Chang, Edward C; Sirois, Fuschia M

2015-07-01

Temporal perspective, including views about future goals, may influence motivational processes related to health. An adaptive sense of future orientation is linked to better health, but little research has examined potential underlying factors, such as vitality. In a sample of 101 primary care patients, we examined whether belief in the changeability of the future was related to mental and physical energization and, in turn, to health-related quality of life. Participants were working, uninsured primary care patients, who completed self-report measures of future orientation, vitality, and health-related quality of life. Mediation models, covarying age, sex, and race/ethnicity indicated that vitality significantly mediated the association between future orientation and the outcomes of general health, mental health, social functioning, bodily pain, and role limitations due to emotional and physical reasons. Vitality exerted an indirect-only effect on the relation between future orientation and physical functioning. Our findings suggest that adaptive beliefs about the future may promote, or allow access to, physical and mental energy and, in turn, may result in better mental and physical health functioning. Individual-level and public health interventions designed to promote future orientation and vitality may beneficially influence quality of life and well-being.

Team effort: the nuclear medicine decision making process. Part II.

PubMed

Tsuchiyama, S

1991-06-01

This two part article examines the nuclear medicine purchase of Baptist Memorial Hospital in Memphis, the largest private hospital in the nation. Part I (May 1991) focused on what their needs were. This concluding installment looks at the committee mechanism itself and the reasoning that went behind their decisions.

[Clinical orientation and thought on several problems in post-marketed reassessment of traditional Chinese medicine].

PubMed

Wang, Xin; Su, Xia; Yu, Jie; Xie, Yanming; Wang, Yongyan

2011-10-01

The post-marketed reassessment is an important link to ensure the safety and effectiveness of traditional chinese medicine. It is also the expansion and stretch of new drug evaluation. Through the systematic, standard, rigorous post-marketed reassessment, the enterprise can full access to drugs after listing the efficacy and safety information, evaluate the interests and risk of the drug and provide the scientific basis for the drug use. It can also provide timely, scientific technology basis for government health decisions, the enterprise marketing decision and public health security. This paper mainly discussed the thought on clinical orientation of traditional chinese medicine in the post-marketed reassessment and how to reach the goal through systematic consideration and overall plan.

Impact of poor-quality medicines in the ‘developing’ world

PubMed Central

Newton, Paul N.; Green, Michael D.; Fernández, Facundo M.

2010-01-01

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in ‘developing’ countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a ‘crevasse’ between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines. PMID:20117849

Value of case-based learning in a nuclear medicine clerkship.

PubMed

Lee, Bi-Fang; Chiu, Nan-Tsing; Li, Chung-Yi

2013-02-01

Medical imaging, including nuclear medicine, is a powerful tool for supporting learning in human morphology and physiology and understanding the nature of disease and response to treatment. The purposes of this study were to create a new case-based learning (CBL) model and to compare CBL and the traditional instructional approach (TIA) in a nuclear medicine clerkship. Internal consistency and expert validity were assessed for the instrument. A quasi-experimental, two-group pretest-posttest design was used for this study. A combination of CBL and the TIA was applied to the experimental group and the TIA only to the control group. Subjects were 70 undergraduate year 5 medical students in a clerkship curriculum. Before and after the educational intervention, students were tested with the instrument. Cronbach's α coefficients of the instrument ranged from 0.79 to 0.95, indicating acceptable to strong internal consistency. For expert validity, the suitability and fitness of the instrument were verified. The overall score was significantly improved for the experimental group (from 3.51 to 3.65, P = .03) but not for the control group (from 3.48 to 3.44, P = .49). The experimental group also showed significantly improved scores in teacher assessment and learning satisfaction, the latter the only domain showing a significant difference of the differences (P = .020). The integration of CBL, allied with the TIA, into clinical clerkships provides medical students with the opportunity to learn a nuclear medicine curriculum in an interactive and case-based format tailored specifically for medical students. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

Pregnancy screening strategies for diagnostic nuclear medicine: survey results from Australia and New Zealand.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2013-09-01

The ionizing radiation used in diagnostic nuclear medicine procedures has the potential to cause biologic harm to a fetus. Although the risks are relatively small, it is recommended that all female patients of childbearing age be questioned regarding their pregnancy status before administration of the radiopharmaceutical. This can be a sensitive situation especially for certain types of patients, such as teenagers. Currently, there are no guidelines that detail how to question the patient. Previous studies have revealed the lack of a consistent approach in this area. The aim of this study was to investigate current practice for pregnancy screening before diagnostic nuclear medicine procedures in Australia and New Zealand and to determine whether a standardized practice guideline is required. An online survey was administered via SurveyMonkey from October to December 2011. Members of the Australian and New Zealand Society of Nuclear Medicine were invited to participate. The survey consisted of 30 questions divided into 4 sections: demographics, policy and regulations, current practice, and open-ended clinical scenarios. Three hundred thirty-five responses were recorded from participants in all states and territories of Australia and New Zealand; 90% were nuclear medicine technologists. Participants reported a low awareness of radiation policy and regulations but demonstrated good knowledge of the relative risk to the fetus from commonly performed procedures. The most common minimum and maximum age to question patients was 12 y (32%) and 55 y (42%), respectively, although the range was from 10 to 60 y. Verbal questioning (44%) was the most commonly used approach. Pregnancy testing was used by 72%, usually if the patient indicated she was unsure of her pregnancy status. Responses to clinical scenarios were varied, and these will be discussed in a subsequent paper. The survey revealed a lack of awareness of government regulations and departmental policy regarding

Advancing Precision Nuclear Medicine and Molecular Imaging for Lymphoma.

PubMed

Wright, Chadwick L; Maly, Joseph J; Zhang, Jun; Knopp, Michael V

2017-01-01

PET with fluorodeoxyglucose F 18 ( 18 F FDG-PET) is a meaningful biomarker for the detection, targeted biopsy, and treatment of lymphoma. This article reviews the evolution of 18 F FDG-PET as a putative biomarker for lymphoma and addresses the current capabilities, challenges, and opportunities to enable precision medicine practices for lymphoma. Precision nuclear medicine is driven by new imaging technologies and methodologies to more accurately detect malignant disease. Although quantitative assessment of response is limited, such technologies will enable a more precise metabolic mapping with much higher definition image detail and thus may make it a robust and valid quantitative response assessment methodology. Copyright © 2016 Elsevier Inc. All rights reserved.

Dose equivalent rate constants and barrier transmission data for nuclear medicine facility dose calculations and shielding design.

PubMed

Kusano, Maggie; Caldwell, Curtis B

2014-07-01

A primary goal of nuclear medicine facility design is to keep public and worker radiation doses As Low As Reasonably Achievable (ALARA). To estimate dose and shielding requirements, one needs to know both the dose equivalent rate constants for soft tissue and barrier transmission factors (TFs) for all radionuclides of interest. Dose equivalent rate constants are most commonly calculated using published air kerma or exposure rate constants, while transmission factors are most commonly calculated using published tenth-value layers (TVLs). Values can be calculated more accurately using the radionuclide's photon emission spectrum and the physical properties of lead, concrete, and/or tissue at these energies. These calculations may be non-trivial due to the polyenergetic nature of the radionuclides used in nuclear medicine. In this paper, the effects of dose equivalent rate constant and transmission factor on nuclear medicine dose and shielding calculations are investigated, and new values based on up-to-date nuclear data and thresholds specific to nuclear medicine are proposed. To facilitate practical use, transmission curves were fitted to the three-parameter Archer equation. Finally, the results of this work were applied to the design of a sample nuclear medicine facility and compared to doses calculated using common methods to investigate the effects of these values on dose estimates and shielding decisions. Dose equivalent rate constants generally agreed well with those derived from the literature with the exception of those from NCRP 124. Depending on the situation, Archer fit TFs could be significantly more accurate than TVL-based TFs. These results were reflected in the sample shielding problem, with unshielded dose estimates agreeing well, with the exception of those based on NCRP 124, and Archer fit TFs providing a more accurate alternative to TVL TFs and a simpler alternative to full spectral-based calculations. The data provided by this paper should assist

"This body does not want free medicines": South African consumer perceptions of drug quality.

PubMed

Patel, Aarti; Gauld, Robin; Norris, Pauline; Rades, Thomas

2010-01-01

OBJECTIVES Like many other developing countries, South Africa provides free medicines through its public health care facilities. Recent policies encourage generic substitution in the private sector. This study explored South African consumer perceptions of drug quality and whether these perceptions influenced how people procured and used their medicines. METHODS The study was undertaken in Durban, Cape Town and Johannesburg in South Africa between December 2005 and January 2006. A combination of purposive and snowball sampling was used to recruit participants from low and middle socio-economic groups as well as the elderly and teenagers. Data were collected through 12 focus group discussions involving a total of 73 participants. Interviews were tape-recorded. Thematic analysis was performed on the transcripts. RESULTS Irrespective of socio-economic status, respondents described medicine quality in terms of the effect the medicine produced on felt symptoms. Generic medicines, as well as medicines supplied without charge by the state, were considered to be poor quality and treated with suspicion. Respondents obtained medicines from three sources: public sector hospitals and/or clinics, dispensing doctors and community pharmacies. Cost, avoidance of feeling 'second-class', receiving individualized care and choice in drug selection were the main determinants influencing their procurement behaviour. Selection of over-the-counter medicines was influenced by prior knowledge of products, through advertising and previous use. Participants perceived that they had limited influence on selection of prescription medicines. Generic substitution would be supported if the doctor, rather than the pharmacist, recommended it. CONCLUSIONS Our findings emphasize the importance of meaningful consumer involvement in the development of national medicines policies, and strategic campaigns targeting consumers and prescribers regarding the quality of generic and essential medicines. Where

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety

PubMed Central

Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

2017-01-01

Background Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. Methods We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Results Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Conclusions Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. PMID:27707869

A list of nuclear medicine radionuclides and potential contaminants for operators of in-vivo counters.

PubMed

Stabin, M; Schlafke-Stelson, A

1991-09-01

Operators of in-vivo counters often encounter unusual photopeaks, some of which may be attributed to nuclear medicine radiopharmaceuticals recently received by the subject. This article lists the most common radiopharmaceuticals used in nuclear medicine, their common uses, their half-lives and principal decay energies, and the half-lives and decay energies of any contaminants or daughter products they may contain. The purpose is to help the in-vivo counter operator track down and eliminate causes of such unusual photopeaks.

[A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

PubMed

Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

2017-01-01

The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is

Nuclear Medicine in the Philippines: A Glance at the Past, a Gaze at the Present, and a Glimpse of the Future

PubMed Central

Bautista, Patricia A.; Luis, Teofilo O.L. San

2016-01-01

While the introduction of radioactive tracers in the study of metabolic pathways has been well-documented in clinical thyroidology as early as 1924, the widespread utilization in other clinical specialties has been hampered by slow developments in radiation-detecting devices and in the production of appropriate radiopharmaceuticals, in addition to the morbid fear of radiation. In the Philippines, the first radioisotope laboratory was established in 1956. Ten years later, the Philippine Society of Nuclear Medicine was formed. Through the years, challenges were overcome, foundations were laid down, growth was encouraged, friendships with other organizations were built, adjustments were made, and rules were enforced. To date, there are approximately 58 nuclear medicine centers randomly distributed from north to south of the Philippines, 7 accredited nuclear medicine training institutions, 95 board-certified nuclear medicine physicians (a few of whom are also internationally recognized), and a regionally-indexed Philippine Journal of Nuclear Medicine. Qualifying examinations for technologists were also recently instated. International relations are constantly strengthened by sending trainees abroad and accepting foreign trainees here, as well as participating in conferences and other endeavors. While the cost of putting up nuclear medicine centers in the Philippines is still prohibitive, it should not pose too much of a constraint as there are foreign and local parties willing to help. With appropriate instrumentation, targeting radiopharmaceuticals and trained human resources, nuclear medicine can indeed contribute much to health care delivery. PMID:27408901

Quality assesment of medical education at faculty of medicine of Sarajevo University.

PubMed

Masic, Izet

2012-01-01

Goal of measurement of the quality assessment of students' satisfaction is identification of weak and outdated sections of medical education. By finding out the unnecessary aspects, it is possible to start with improvement of the educational system. The survey was conducted on the sample of 108 students of the final year of the study of Medical faculty in Sarajevo in December 2011. Questionnaire has 24 process and outcome variables for the purpose of quality assessment of the education at the Medical faculty. The measurement of quality of realized lectures of final year of Medical faculty in Sarajevo with formatted questionnaires determined that above 90% students rated it very low with grades under 3 of possible 5, compared with average 3 in survey from 2008. Unpreparedness of independent service after finished medical education has raised to 70% of questioned students, compared to 53% in 2008. Ratio of educators and assistents to students was graded mostly with grades under 3 of possible 5 by more then 80% questioned participants. Students grading satisfaction with concept of preclinical training has peaked in low levels of grade 1 by 44% survey participants, what are similar results compared to 2008. The measurement of satisfaction with concept of clinical education determined even lower and embarassing values of 94% negative attitudes and opinions by questioned students, compared with 83% in 2008. Availability of modern technical equipment at Faculty of Medicine is very low rated with grades under 2 by 87% of students. The problems and weak points in medical education of Faculty of Medicine University of Sarajevo have persisted during period of more then a decade what comparsion of survey results clearly show. There is urgent need of improving and reforming the educational system which will bring more practical clinical and preclincal work, patient-student contact and interaction with bigger full attendance of educators and tutors, all supported by new modern

Epitaxial growth of single-orientation high-quality MoS2 monolayers

NASA Astrophysics Data System (ADS)

Bana, Harsh; Travaglia, Elisabetta; Bignardi, Luca; Lacovig, Paolo; Sanders, Charlotte E.; Dendzik, Maciej; Michiardi, Matteo; Bianchi, Marco; Lizzit, Daniel; Presel, Francesco; De Angelis, Dario; Apostol, Nicoleta; Das, Pranab Kumar; Fujii, Jun; Vobornik, Ivana; Larciprete, Rosanna; Baraldi, Alessandro; Hofmann, Philip; Lizzit, Silvano

2018-07-01

We present a study on the growth and characterization of high-quality single-layer MoS2 with a single orientation, i.e. without the presence of mirror domains. This single orientation of the MoS2 layer is established by means of x-ray photoelectron diffraction. The high quality is evidenced by combining scanning tunneling microscopy with x-ray photoelectron spectroscopy measurements. Spin- and angle-resolved photoemission experiments performed on the sample revealed complete spin-polarization of the valence band states near the K and -K points of the Brillouin zone. These findings open up the possibility to exploit the spin and valley degrees of freedom for encoding and processing information in devices that are based on epitaxially grown materials.

Nuclear orientation of antimony and bromine isotopes

NASA Astrophysics Data System (ADS)

Barham, Christopher G.

The technique of Low Temperature Nuclear Orientation has been used to study neutron deficient antimony and bromine isotopes. The antimony and bromine isotopes were produced using Daresbury Laboratory's Nuclear Sctructure Facility by the reactions [28]Si([93]Nb) and [28]Si([54]Fe) respectively, both at 150 MeV. Further anisotropy measurements on [72.74m,75]Br at lower temperature have been used to extend previous data. The magnetic moment of [72]Br has been limited to be within the range 0.54mu[N]

131I INTERNAL CONTAMINATION AND COMMITTED DOSE ASSESSMENT AMONG NUCLEAR MEDICINE MEDICAL PERSONNEL.

PubMed

Brudecki, K; Kluczewska-Galka, A; Mróz, T; Jarzab, B; Zagrodzki, P; Janowski, P

2018-05-01

This study presents 131I thyroid activity measurements of 56 employees of the Department of Nuclear Medicine and Endocrine Oncology, Centre for Oncology in Gliwice. The research instrument was a whole-body spectrometer. In 44 out of 56 examined staff members, the determined 131I activity was found to be above the detection limit. The measured activities ranged from 6 ± 2 to 457 ± 118 Bq. The maximum estimated committed effective dose reached was 1.5 mSv/y. The results were compared with previous measurements conducted in another Polish nuclear medical unit. From this comparison, we can see that radiological safety among nuclear medicine personnel can be improved by appropriate work organisation. Reducing exposure of workers can be achieved by properly organised turnovers concerning the most vulnerable worksites. In addition, to lower the radiation risk, it is essential to comply strictly with the isolation regime for the patients.

The American College of nuclear physicians 18th annual meeting and scientific sessions DOE day: Substance abuse and nuclear medicine abstracts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-02-01

Despite the enormous personal and social cost Of substance abuse, there is very little knowledge with respect to the mechanisms by which these drugs produce addiction as well as to the mechanisms of toxicity. Similarly, there is a lack of effective therapeutic intervention to treat the drug abusers. In this respect, nuclear medicine could contribute significantly by helping to gather information using brain imaging techniques about mechanisms of drug addiction which, in turn, could help design better therapeutic interventions, and by helping in the evaluation and diagnosis of organ toxicity from the use of drugs of abuse. This volume containsmore » six short descriptions of presentations made at the 18th Meeting of the American College of Nuclear Physicians -- DOE Day: Substance Abuse and Nuclear Medicine.« less

Inhibitory effect of traditional oriental medicine-derived monoamine oxidase B inhibitor on radioresistance of non-small cell lung cancer.

PubMed

Son, Beomseok; Jun, Se Young; Seo, HyunJeong; Youn, HyeSook; Yang, Hee Jung; Kim, Wanyeon; Kim, Hyung Kook; Kang, ChulHee; Youn, BuHyun

2016-02-24

Increased survival of cancer cells mediated by high levels of ionizing radiation (IR) reduces the effectiveness of radiation therapy for non-small cell lung cancer (NSCLC). In the present study, danshensu which is a selected component of traditional oriental medicine (TOM) compound was found to reduce the radioresistance of NSCLC by inhibiting the nuclear factor-κB (NF-κB) pathway. Of the various TOM compounds reported to inhibit the IR activation of NF-κB, danshensu was chosen as a final candidate based on the results of structural comparisons with human metabolites and monoamine oxidase B (MAOB) was identified as the putative target enzyme. Danshensu decreased the activation of NF-κB by inhibiting MAOB activity in A549 and NCI-H1299 NSCLC cells. Moreover, it suppressed IR-induced epithelial-to-mesenchymal transition, expressions of NF-κB-regulated prosurvival and proinflammatory genes, and in vivo radioresistance of mouse xenograft models. Taken together, this study shows that danshensu significantly reduces MAOB activity and attenuates NF-κB signaling to elicit the radiosensitization of NSCLC.

Influence of Examinations Oriented Approaches on Quality Education in Primary Schools in Kenya

ERIC Educational Resources Information Center

Mackatiani, Caleb Imbova

2017-01-01

This paper provides a critical appraisal of the influence of examinations oriented approaches on quality education in primary schools in Kenya. The purpose of the study was to determine effects of examination oriented teaching approaches on learning achievement among primary school pupils in Kakamega County, Kenya. It explored the assumptions…

[Quality process control system of Chinese medicine preparation based on "holistic view"].

PubMed

Wang, Ya-Qi; Jiao, Jiao-Jiao; Wu, Zhen-Feng; Zheng, Qin; Yang, Ming

2018-01-01

"High quality, safety and effectiveness" are the primary principles for the pharmaceutical research and development process in China. The quality of products relies not only on the inspection method, but also on the design and development, process control and standardized management. The quality depends on the process control level. In this paper, the history and current development of quality control of traditional Chinese medicine (TCM) preparations are reviewed systematically. Based on the development model of international drug quality control and the misunderstanding of quality control of TCM preparations, the reasons for impacting the homogeneity of TCM preparations are analyzed and summarized. According to TCM characteristics, efforts were made to control the diversity of TCM, make "unstable" TCM into "stable" Chinese patent medicines, put forward the concepts of "holistic view" and "QbD (quality by design)", so as to create the "holistic, modular, data, standardized" model as the core of TCM preparation quality process control model. Scientific studies shall conform to the actual production of TCM preparations, and be conducive to supporting advanced equipment and technology upgrade, thoroughly applying the scientific research achievements in Chinese patent medicines, and promoting the cluster application and transformation application of TCM pharmaceutical technology, so as to improve the quality and effectiveness of the TCM industry and realize the green development. Copyright© by the Chinese Pharmaceutical Association.

Java-based remote viewing and processing of nuclear medicine images: toward "the imaging department without walls".

PubMed

Slomka, P J; Elliott, E; Driedger, A A

2000-01-01

In nuclear medicine practice, images often need to be reviewed and reports prepared from locations outside the department, usually in the form of hard copy. Although hard-copy images are simple and portable, they do not offer electronic data search and image manipulation capabilities. On the other hand, picture archiving and communication systems or dedicated workstations cannot be easily deployed at numerous locations. To solve this problem, we propose a Java-based remote viewing station (JaRViS) for the reading and reporting of nuclear medicine images using Internet browser technology. JaRViS interfaces to the clinical patient database of a nuclear medicine workstation. All JaRViS software resides on a nuclear medicine department server. The contents of the clinical database can be searched by a browser interface after providing a password. Compressed images with the Java applet and color lookup tables are downloaded on the client side. This paradigm does not require nuclear medicine software to reside on remote computers, which simplifies support and deployment of such a system. To enable versatile reporting of the images, color tables and thresholds can be interactively manipulated and images can be displayed in a variety of layouts. Image filtering, frame grouping (adding frames), and movie display are available. Tomographic mode displays are supported, including gated SPECT. The time to display 14 lung perfusion images in 128 x 128 matrix together with the Java applet and color lookup tables over a V.90 modem is <1 min. SPECT and PET slice reorientation is interactive (<1 s). JaRViS could run on a Windows 95/98/NT or a Macintosh platform with Netscape Communicator or Microsoft Intemet Explorer. The performance of Java code for bilinear interpolation, cine display, and filtering approaches that of a standard imaging workstation. It is feasible to set up a remote nuclear medicine viewing station using Java and an Internet or intranet browser. Images can be made

[Standardization of cancer biobank in precision medicine era].

PubMed

Ji, Jiafu

2016-05-25

Tumor specimens have a great role in basic and clinical translational researches on cancer, especially in the era of precision medicine. Thus the standardization of cancer biobank is of high importance. The establishment and maintenance of cancer biobank require comprehensive quality management, so as to provide high quality service for basic and clinical researches. At present, sample-oriented collection and management, and clinical and pathological data annotation are the main focuses of biobank standardization in China.

[Investigation on production process quality control of traditional Chinese medicine--Banlangen granule as an example].

PubMed

Tan, Manrong; Yan, Dan; Qiu, Lingling; Chen, Longhu; Yan, Yan; Jin, Cheng; Li, Hanbing; Xiao, Xiaohe

2012-04-01

For the quality management system of herbal medicines, intermediate and finished products it exists the " short board" effect of methodologies. Based on the concept of process control, new strategies and new methods of the production process quality control had been established with the consideration of the actual production of traditional Chinese medicine an the characteristics of Chinese medicine. Taking Banlangen granule as a practice example, which was effective and widespread application, character identification, determination of index components, chemical fingerprint and biometrics technology were sequentially used respectively to assess the quality of Banlangen herbal medicines, intermediate (water extraction and alcohol precipitation) and finished product. With the transfer rate of chemical information and biological potency as indicators, the effectiveness and transmission of the above different assessments and control methods had been researched. And ultimately, the process quality control methods of Banlangen granule, which were based on chemical composition analysis-biometric analysis, had been set up. It can not only validly solute the current status that there were many manufacturers varying quality of Banlangen granule, but also ensure and enhance its clinical efficacy. Furthermore it provided a foundation for the construction of the quality control of traditional Chinese medicine production process.

Application for internal dosimetry using biokinetic distribution of photons based on nuclear medicine images.

PubMed

Leal Neto, Viriato; Vieira, José Wilson; Lima, Fernando Roberto de Andrade

2014-01-01

This article presents a way to obtain estimates of dose in patients submitted to radiotherapy with basis on the analysis of regions of interest on nuclear medicine images. A software called DoRadIo (Dosimetria das Radiações Ionizantes [Ionizing Radiation Dosimetry]) was developed to receive information about source organs and target organs, generating graphical and numerical results. The nuclear medicine images utilized in the present study were obtained from catalogs provided by medical physicists. The simulations were performed with computational exposure models consisting of voxel phantoms coupled with the Monte Carlo EGSnrc code. The software was developed with the Microsoft Visual Studio 2010 Service Pack and the project template Windows Presentation Foundation for C# programming language. With the mentioned tools, the authors obtained the file for optimization of Monte Carlo simulations using the EGSnrc; organization and compaction of dosimetry results with all radioactive sources; selection of regions of interest; evaluation of grayscale intensity in regions of interest; the file of weighted sources; and, finally, all the charts and numerical results. The user interface may be adapted for use in clinical nuclear medicine as a computer-aided tool to estimate the administered activity.

[Physical fingerprint for quality control of traditional Chinese medicine extract powders].

PubMed

Zhang, Yi; Xu, Bing; Sun, Fei; Wang, Xin; Zhang, Na; Shi, Xin-Yuan; Qiao, Yan-Jiang

2016-06-01

The physical properties of both raw materials and excipients are closely correlated with the quality of traditional Chinese medicine preparations in oral solid dosage forms. In this paper, based on the concept of the chemical fingerprint for quality control of traditional Chinese medicine products, the method of physical fingerprint for quality evaluation of traditional Chinese medicine extract powders was proposed. This novel physical fingerprint was built by the radar map, and consisted of five primary indexes (i.e. stackablity, homogeneity, flowability, compressibility and stability) and 12 secondary indexes (i.e. bulk density, tap density, particle size<50 μm percentage, relative homogeneity index, hausner ratio, angle of repose, powder flow time, inter-particle porosity, Carr index, cohesion index, loss on drying, hygroscopicity). Panax notoginseng saponins (PNS) extract was taken for an example. This paper introduced the application of physical fingerprint in the evaluation of source-to-source and batch-to-batch quality consistence of PNS extract powders. Moreover, the physical fingerprint of PNS was built by calculating the index of parameters, the index of parametric profile and the index of good compressibility, in order to successfully predict the compressibility of the PNS extract powder and relevant formulations containing PNS extract powder and conventional pharmaceutical excipients. The results demonstrated that the proposed method could not only provide new insights into the development and process control of traditional Chinese medicine solid dosage forms. Copyright© by the Chinese Pharmaceutical Association.

Knowledge about the availability of the pharmacist in the Nuclear Medicine Department: A questionnaire-based study among health-care professionals

PubMed Central

Parasuraman, Subramani; Mueen Ahmed, K.K.; Bin Hashim, Tin Soe @ Saifullah; Muralidharan, Selvadurai; Kumar, Kalaimani Jayaraja; Ping, Wu Yet; Syamittra, Balakrishnan; Dhanaraj, Sokkalingam Arumugam

2014-01-01

Objective: The objective of this study was to analyze the knowledge about the availability of the pharmacist in the nuclear medicine department among health-care professionals through a prospective cohort study. Methods: A total of 741 health-care professionals participated in the study by answering 10 simple questions about the role of the pharmacist in the nuclear medicine department and the availability of pharmacist in the nuclear medicine department. An online questionnaire system was used to conduct the study, and participants were invited to participate through personal communications and by promoting the study through social websites including Facebook, LinkedIn and Google (including Gmail and Google+). The study was conducted between April 2013 and March 2014 using the http://www.freeonlinesurveys.com/Webserver. Finally, the data provided by 621 participants was analyzed. Group frequency analysis was performed using Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. USA). Results: The participants were from Malaysia, India, Pakistan, Sri Lanka, Bangladesh, UAE and Nepal. In total, 312 (50.2%) female health-care professionals and 309 (49.8%) male health-care professionals participated in the study. Of the 621 participants, 390 were working in hospitals, and 231 were not working in hospitals. Of the participants who were working in hospitals, 57.6% were pharmacists. The proportion of study participants who were aware of nuclear pharmacists was 55.39%. Awareness about the role of the pharmacist in nuclear medicine was poor. Conclusion: The role of the pharmacist in a nuclear medicine unit needs to be highlighted and promoted among health-care professionals and hence that the nuclear medicine team can provide better pharmaceutical care. PMID:25538467

ARRONAX, a high-energy and high-intensity cyclotron for nuclear medicine.

PubMed

Haddad, Ferid; Ferrer, Ludovic; Guertin, Arnaud; Carlier, Thomas; Michel, Nathalie; Barbet, Jacques; Chatal, Jean-François

2008-07-01

This study was aimed at establishing a list of radionuclides of interest for nuclear medicine that can be produced in a high-intensity and high-energy cyclotron. We have considered both therapeutic and positron emission tomography radionuclides that can be produced using a high-energy and a high-intensity cyclotron such as ARRONAX, which will be operating in Nantes (France) by the end of 2008. Novel radionuclides or radionuclides of current limited availability have been selected according to the following criteria: emission of positrons, low-energy beta or alpha particles, stable or short half-life daughters, half-life between 3 h and 10 days or generator-produced, favourable dosimetry, production from stable isotopes with reasonable cross sections. Three radionuclides appear well suited to targeted radionuclide therapy using beta ((67)Cu, (47)Sc) or alpha ((211)At) particles. Positron emitters allowing dosimetry studies prior to radionuclide therapy ((64)Cu, (124)I, (44)Sc), or that can be generator-produced ((82)Rb, (68)Ga) or providing the opportunity of a new imaging modality ((44)Sc) are considered to have a great interest at short term whereas (86)Y, (52)Fe, (55)Co, (76)Br or (89)Zr are considered to have a potential interest at middle term. Several radionuclides not currently used in routine nuclear medicine or not available in sufficient amount for clinical research have been selected for future production. High-energy, high-intensity cyclotrons are necessary to produce some of the selected radionuclides and make possible future clinical developments in nuclear medicine. Associated with appropriate carriers, these radionuclides will respond to a maximum of unmet clinical needs.

Precision Medicine and a Patient-Orientated Approach: Is this the Future for Tracking Cardiovascular Disorders?

PubMed

Pretorius, Etheresia

2017-01-01

The latest statistics from the 2016 heart disease and stroke statistics update shows that cardiovascular disease is the leading global cause of death, currently accounting for more than 17.3 million deaths per year. Type II diabetes is also on the rise with out-of-control numbers. To address these pandemics, we need to treat patients using an individualized patient care approach, but simultaneously gather data to support the precision medicine initiative. Last year the NIH announced the precision medicine initiative to generate novel knowledge regarding diseases, with a near-term focus on cancers, followed by a longer-term aim, applicable to a whole range of health applications and diseases. The focus of this paper is to suggest a combined effort between the latest precision medicine initiative, researchers and clinicians; whereby novel techniques could immediately make a difference in patient care, but long-term add to knowledge for use in precision medicine. We discuss the intricate relationship between individualized patient care and precision medicine and the current thoughts regarding which data is actually suitable for the precision medicine data gathering. The uses of viscoelastic techniques in precision medicine are discussed and how these techniques might give novel perspectives on the success of treatment regimes of cardiovascular patients are explored. Thrombo-embolic stroke, rheumathoid arthritis and type II diabetes are used as examples of diseases where precision medicine and a patient-orientated approach can possibly be implemented. In conclusion it is suggested that if all role players work together by embracing a new way of thought in treating and managing cardiovascular disease and diabetes will we be able to adequately address these out-ofcontrol conditions. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record

PubMed Central

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-01-01

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software—over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. PMID:24872343

Using AGREE II to Evaluate the Quality of Traditional Medicine Clinical Practice Guidelines in China.

PubMed

Deng, Wei; Li, Le; Wang, Zixia; Chang, Xiaonan; Li, Rui; Fang, Ziye; Wei, Dang; Yao, Liang; Wang, Xiaoqin; Wang, Qi; An, Guanghui

2016-03-15

To evaluate/assess the quality of the Clinical Practice Guidelines (CPGs) of traditional medicine in China. We systematically searched the literature databases WanFang Data, VIP, CNKI and CBM for studies published between 1978 and 2012 to identify and select CPGs of traditional medicine. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate these guidelines. A total of 75 guidelines were included, of which 46 guidelines (62%) were on Traditional Chinese Medicine, 19 (25%) on Chinese Integrated Medicine, and 10 (13%) on Uyghur Medicine. Most traditional medicine CPGs published in domestic journals scored <20% (range: 0-63%). Eleven (14%) CPGs were developed following the methodology of evidence-based medicine. In each domain of AGREE II, traditional Medicine CPGs performed clearly better than international CPGs. The same trend was seen in guidelines of Modern Medicine. An increasing amount of CPGs are being published, but their quality is low. Referring to the key points of international guidelines development, supervision through AGREE II, cooperating with international groups and exploring the strategy of guideline development could improve the quality of CPGs on traditional medicine. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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.

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.

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. Copyright © 2011 Elsevier Inc. All rights reserved.

Nuclear Medicine in Diagnosis of Prosthetic Valve Endocarditis: An Update

PubMed Central

Musso, Maria; Petrosillo, Nicola

2015-01-01

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

Issues affecting the motivation of nuclear medicine technologists in Kuwait.

PubMed

Ali, Layla; Abdelsalam, Amal; Muddei, Sara; Brindhaban, Ajit

2013-01-01

The demand for nuclear medicine technologists (NMTs) in Kuwait has increased, especially with the introduction of multimodality imaging systems. In order to increase the number of NMTs in the workforce and retain the existing NMTs, there should be a better way to motivate them. To find out how satisfied NMTs are and the factors that motivate them. An interview was conducted with 40 randomly selected NMTs to explore deep-seated emotions and attitudes that were related to motivation. Questions about the recognition NMTs receive from the general public, whether they are acknowledged as significant contributors to health services, ways to improve the standing of NMTs in society, and the clarity of the job description were included. A questionnaire survey was then conducted with 100 randomly selected NMTs. The questions were designed to elicit wider perspective of the information obtained from the interviews. The results show a need for attention in the Ministry of Health to NMTs for recognition, motivation, and improvement. Giving the NMTs their own identity and opportunities to be part of decision-making in the health team would influence more students to join nuclear medicine departments and give more self-confidence to the existing NMTs.

A cross-sectional investigation of the quality of selected medicines in Cambodia in 2010

PubMed Central

2014-01-01

Background Access to good-quality medicines in many countries is largely hindered by the rampant circulation of spurious/falsely labeled/falsified/counterfeit (SFFC) and substandard medicines. In 2006, the Ministry of Health of Cambodia, in collaboration with Kanazawa University, Japan, initiated a project to combat SFFC medicines. Methods To assess the quality of medicines and prevalence of SFFC medicines among selected products, a cross-sectional survey was carried out in Cambodia. Cefixime, omeprazole, co-trimoxazole, clarithromycin, and sildenafil were selected as candidate medicines. These medicines were purchased from private community drug outlets in the capital, Phnom Penh, and Svay Rieng and Kandal provinces through a stratified random sampling scheme in July 2010. Results In total, 325 medicine samples were collected from 111 drug outlets. Non-licensed outlets were more commonly encountered in rural than in urban areas (p < 0.01). Of all the samples, 93.5% were registered and 80% were foreign products. Samples without registration numbers were found more frequently among foreign-manufactured products than in domestic ones (p < 0.01). According to pharmacopeial analytical results, 14.5%, 4.6%, and 24.6% of the samples were unacceptable in quantity, content uniformity, and dissolution test, respectively. All the ultimately unacceptable samples in the content uniformity tests were of foreign origin. Following authenticity investigations conducted with the respective manufacturers and medicine regulatory authorities, an unregistered product of cefixime collected from a pharmacy was confirmed as an SFFC medicine. However, the sample was acceptable in quantity, content uniformity, and dissolution test. Conclusions The results of this survey indicate that medicine counterfeiting is not limited to essential medicines in Cambodia: newer-generation medicines are also targeted. Concerted efforts by both domestic and foreign manufacturers, wholesalers

The Quality of Written Feedback by Attendings of Internal Medicine Residents.

PubMed

Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

2015-07-01

Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p <0.0005 for all), and had a greater range of scores. Negative comments on medical knowledge were associated with lower in-service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge

Quality use of antipsychotic medicines inresidential aged care facilities in New Zealand.

PubMed

Ndukwe, Henry C; Nishtala, Prasad S; Wang, Ting; Tordoff, June M

2016-12-01

INTRODUCTION Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM The aim of this study was to examine 'quality use' of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year's relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported 'managing behavioural symptoms' (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents' target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents' behaviour. DISCUSSION Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.

[Quality assurance systems and occupational medicine system: an history twenty years along].

PubMed

Apostoli, Pietro

2014-01-01

Along the last tventy years, in our country the quality assurance systems and the occupational medicine deeply interacted both in theoretical and practical fields of interest at three levels: (i) the need of preventive and therefore of occupational medicine in quality assurance systems; (ii) the need on reverse of quality in prevention and occupational mnedicine mainly in qualification and updating process; (iii) the evidence, proofs of efficacy or appropriateness of different preventive procedures and occupational physician activities; (iv) the connection with European and national legal directives and with technical or good practice norms. Finally we discuss about the role of occupational physician as the global consultant for enterprise, as a mandatory strategic technical figure in a typical multidisciplinary processes as the implementation of the quality systems.

Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India

PubMed Central

Aivalli, Praveen Kumar; Elias, Maya Annie; Pati, Manoj Kumar; Bhanuprakash, Srinath; Munegowda, Chikkagollahalli; Shroff, Zubin Cyrus

2017-01-01

Introduction Generic medicines are an important policy option to reduce out-of-pocket expenditure on medicines. However, negative perceptions of their quality affect utilisation and raise issues of confidence and trust in medicines and health services. The aim of the study was to test the quality of generic and branded medicines and explain negative perceptions towards generic medicines. Methods The study was part of a larger study on access to medicines. Information on various quality parameters was collected for branded medicines and branded and unbranded generic versions of the same medicines from government and private pharmacies in Karnataka in Southern India. To assess perceptions related to quality and drivers of preferred point of care (public vs private), focus group discussions were conducted with diabetes and hypertension patients, health workers and private pharmacists. The results of the quality tests were assessed and thematic analysis was conducted on the qualitative data to develop a conceptual framework to explain perceptions of medicine and care quality in the local health system. Results The generic and branded variants of the medicines tested were of comparable quality. Contrary to the quality test results, patients’ and health workers’ perceptions of quality were largely in favour of branded medicines. Negative perceptions of medicine quality along with other drivers contribute towards choosing more expensive medicines in the private sector. Trust in the health system emerged as an underlying central theme that explained and drove choice of medicines and providers within the local health system. Conclusion Negative perceptions of generic medicines and preferential promotion of branded medicines over generics by pharmaceutical companies could influence prescriber behaviour and affect trust in healthcare provided in public services. To succeed, access to medicines programmes need to systematically invest in information on quality of medicines

Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India.

PubMed

Aivalli, Praveen Kumar; Elias, Maya Annie; Pati, Manoj Kumar; Bhanuprakash, Srinath; Munegowda, Chikkagollahalli; Shroff, Zubin Cyrus; Srinivas, Prashanth N

2017-01-01

Generic medicines are an important policy option to reduce out-of-pocket expenditure on medicines. However, negative perceptions of their quality affect utilisation and raise issues of confidence and trust in medicines and health services. The aim of the study was to test the quality of generic and branded medicines and explain negative perceptions towards generic medicines. The study was part of a larger study on access to medicines. Information on various quality parameters was collected for branded medicines and branded and unbranded generic versions of the same medicines from government and private pharmacies in Karnataka in Southern India. To assess perceptions related to quality and drivers of preferred point of care (public vs private), focus group discussions were conducted with diabetes and hypertension patients, health workers and private pharmacists. The results of the quality tests were assessed and thematic analysis was conducted on the qualitative data to develop a conceptual framework to explain perceptions of medicine and care quality in the local health system. The generic and branded variants of the medicines tested were of comparable quality. Contrary to the quality test results, patients' and health workers' perceptions of quality were largely in favour of branded medicines. Negative perceptions of medicine quality along with other drivers contribute towards choosing more expensive medicines in the private sector. Trust in the health system emerged as an underlying central theme that explained and drove choice of medicines and providers within the local health system. Negative perceptions of generic medicines and preferential promotion of branded medicines over generics by pharmaceutical companies could influence prescriber behaviour and affect trust in healthcare provided in public services. To succeed, access to medicines programmes need to systematically invest in information on quality of medicines and develop strategies to build trust in

In Vitro Evaluation of Molecular Tumor Targets in Nuclear Medicine: Immunohistochemistry Is One Option, but Under Which Conditions?

PubMed

Reubi, Jean Claude

2017-12-01

The identification of new molecular targets for diagnostic and therapeutic applications using in vitro methods is an important challenge in nuclear medicine. One such method is immunohistochemistry, increasingly popular because it is easy to perform. This review presents the case for conducting receptor immunohistochemistry to evaluate potential molecular targets in human tumor tissue sections. The focus is on the immunohistochemistry of G-protein-coupled receptors, one of the largest families of cell surface proteins, representing a major class of drug targets and thus playing an important role in nuclear medicine. This review identifies common pitfalls and challenges and provides guidelines on performing such immunohistochemical studies. An appropriate validation of the target is a prerequisite for developing robust and informative new molecular probes. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Application for internal dosimetry using biokinetic distribution of photons based on nuclear medicine images*

PubMed Central

Leal Neto, Viriato; Vieira, José Wilson; Lima, Fernando Roberto de Andrade

2014-01-01

Objective This article presents a way to obtain estimates of dose in patients submitted to radiotherapy with basis on the analysis of regions of interest on nuclear medicine images. Materials and Methods A software called DoRadIo (Dosimetria das Radiações Ionizantes [Ionizing Radiation Dosimetry]) was developed to receive information about source organs and target organs, generating graphical and numerical results. The nuclear medicine images utilized in the present study were obtained from catalogs provided by medical physicists. The simulations were performed with computational exposure models consisting of voxel phantoms coupled with the Monte Carlo EGSnrc code. The software was developed with the Microsoft Visual Studio 2010 Service Pack and the project template Windows Presentation Foundation for C# programming language. Results With the mentioned tools, the authors obtained the file for optimization of Monte Carlo simulations using the EGSnrc; organization and compaction of dosimetry results with all radioactive sources; selection of regions of interest; evaluation of grayscale intensity in regions of interest; the file of weighted sources; and, finally, all the charts and numerical results. Conclusion The user interface may be adapted for use in clinical nuclear medicine as a computer-aided tool to estimate the administered activity. PMID:25741101

Systematic reviews involving complementary and alternative medicine interventions had higher quality of reporting than conventional medicine reviews.

PubMed

Lawson, Margaret L; Pham, Ba'; Klassen, Terry P; Moher, David

2005-08-01

To compare the quality of systematic reviews reported in English and in languages other than English, and to determine whether there are differences between conventional medicine (CM) and complementary and alternative medicine (CAM) reports. We used the Oxman and Guyatt (OG) scale to assess the quality of reporting in 130 systematic reviews: 50 were language-restricted, 32 were language-inclusive but only English-language (EL) trials contained (inclusive-EL), and 48 were language-inclusive and included trials published in languages other than English (inclusive-LOE). Of the 130 reviews, 105 addressed CM interventions and 25 addressed CAM interventions. Comparison of the systematic reviews showed that the quality of reporting and reporting characteristics are not affected by inclusion or exclusion of LOE; however, the quality of reporting of systematic reviews involving CAM interventions is higher than that of reviews focusing on CM interventions. Informal comparison of the OG scale with the data collected on quality assessments showed that the OG scale performs well overall but may not identify important differences in comprehensiveness of the search strategy and avoidance of bias in study selection. Further research is required to determine the best methods for assessing quality of systematic reviews and whether the effect of language restrictions is dependent on the type of intervention (CM or CAM).

Striving for quality use of medicines: how effective is Australia's ban on direct-to-consumer prescription medicine advertising?

PubMed

Brown, Sonja

2009-02-01

The potential for both positive and negative effects arising from direct-to-consumer advertising of prescription medicines challenges health policymakers to develop regulatory schemes which selectively capture the positive aspects of the practice. Australia has dealt with this quandary by banning the practice, while New Zealand and the United States permit it. However, in recent times pharmaceutical companies have been increasingly successful in introducing promotional materials into the Australian market. This article demonstrates that the Australian ban is consistent with striving for the major policy goal of quality use of medicines, thus providing the basis for arguing that solutions to strengthen the ban against the identified threats ought to be implemented. Quality use of medicines can be most effectively achieved via the combined effect of the strengthened ban and the mimicking of the limited positive aspects of direct-to-consumer advertising by government provision of non-promotional information to consumers.

The Mealiness and Quality of Herbal Medicine: Licorice for Example.

PubMed

Liu, Xueying; Hou, Weilong; Dou, Deqiang

2017-01-01

The morphological identification is an effective and simple quality evaluation method in Chinese drugs, and the traits of mealiness and color were widely used in the commercial market of Chinese drugs. The objective of this study was to explore the correlation between mealiness of herbal drugs and its quality; licorice was selected as an example. The mealiness of licorice was graded by its weight; meanwhile, the content of glycyrrhizic acid and liquiritin was determined by high-performance liquid chromatography-diode-array detection method; the content of polysaccharides, soluble sugars, pectin, total starch, amylose, and amylopectin was measured by colorimetric method; and the number and diameter of starch granule were observed by microscope. The results showed that the mealiness of licorice which collected from wild and cultivated plants is positively correlated with the content of glycyrrhizic acid, liquiritin, the ratio of amylose to total starch, and the number of starch granules whose diameter was over 5 μm. However, the mealiness is negatively correlated with the total starch. Further, the formation mechanism of starch granule was discussed. It is for the first time to report the positive correlation between the mealiness and the starch granule size, the ratio of amylose to total starch, which can provide rationality for the quality evaluation using the character of mealiness in herbal medicine. It is a convenient method to justify the quality of herbal medicine. To explore the correlation between mealiness of herbal drugs and its quality, licorice was selected as an example. The result indicated that the effective constituent is correlated with mealiness of licorice. Abbreviations Used: TCM: Traditional Chinese Medicine.

Family Medicine Panel Size with Care Teams: Impact on Quality.

PubMed

Angstman, Kurt B; Horn, Jennifer L; Bernard, Matthew E; Kresin, Molly M; Klavetter, Eric W; Maxson, Julie; Willis, Floyd B; Grover, Michael L; Bryan, Michael J; Thacher, Tom D

2016-01-01

The demand for comprehensive primary health care continues to expand. The development of team-based practice allows for improved capacity within a collective, collaborative environment. Our hypothesis was to determine the relationship between panel size and access, quality, patient satisfaction, and cost in a large family medicine group practice using a team-based care model. Data were retrospectively collected from 36 family physicians and included total panel size of patients, percentage of time spent on patient care, cost of care, access metrics, diabetic quality metrics, patient satisfaction surveys, and patient care complexity scores. We used linear regression analysis to assess the relationship between adjusted physician panel size, panel complexity, and outcomes. The third available appointments (P < .01) and diabetic quality (P = .03) were negatively affected by increased panel size. Patient satisfaction, cost, and percentage fill rate were not affected by panel size. A physician-adjusted panel size larger than the current mean (2959 patients) was associated with a greater likelihood of poor-quality rankings (≤25th percentile) compared with those with a less than average panel size (odds ratio [OR], 7.61; 95% confidence interval [CI], 1.13-51.46). Increased panel size was associated with a longer time to the third available appointment (OR, 10.9; 95% CI, 1.36-87.26) compared with physicians with panel sizes smaller than the mean. We demonstrated a negative impact of larger panel size on diabetic quality results and available appointment access. Evaluation of a family medicine practice parameters while controlling for panel size and patient complexity may help determine the optimal panel size for a practice. © Copyright 2016 by the American Board of Family Medicine.

Highlights lecture EANM 2016: "Embracing molecular imaging and multi-modal imaging: a smart move for nuclear medicine towards personalized medicine".

PubMed

Aboagye, Eric O; Kraeber-Bodéré, Françoise

2017-08-01

The 2016 EANM Congress took place in Barcelona, Spain, from 15 to 19 October under the leadership of Prof. Wim Oyen, chair of the EANM Scientific Committee. With more than 6,000 participants, this congress was the most important European event in nuclear medicine, bringing together a multidisciplinary community involved in the different fields of nuclear medicine. There were over 600 oral and 1,200 poster or e-Poster presentations with an overwhelming focus on development and application of imaging for personalized care, which is timely for the community. Beyond FDG PET, major highlights included progress in the use of PSMA and SSTR receptor-targeted radiopharmaceuticals and associated theranostics in oncology. Innovations in radiopharmaceuticals for imaging pathologies of the brain and cardiovascular system, as well as infection and inflammation, were also highlighted. In the areas of physics and instrumentation, multimodality imaging and radiomics were highlighted as promising areas of research.

Java-based PACS and reporting system for nuclear medicine

NASA Astrophysics Data System (ADS)

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

2000-05-01

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

Improving the Level and Quality of Ethics Review in Chinese Medicine and Integrative Medicine.

PubMed

Zhang, Cheng-Bin; Li, En-Chang

2018-04-01

Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.

Air contamination measurements for the evaluation of internal dose to workers in nuclear medicine departments

NASA Astrophysics Data System (ADS)

De Massimi, B.; Bianchini, D.; Sarnelli, A.; D'Errico, V.; Marcocci, F.; Mezzenga, E.; Mostacci, D.

2017-11-01

Radionuclides handled in nuclear medicine departments are often characterized by high volatility and short half-life. It is generally difficult to monitor directly the intake of these short-lived radionuclides in hospital staff: this makes measuring air contamination of utmost interest. The aim of the present work is to provide a method for the evaluation of internal doses to workers in nuclear medicine, by means of an air activity sampling detector, to ensure that the limits prescribed by the relevant legislation are respected. A continuous air sampling system measures isotope concentration with a Nal(TI) detector. Energy efficiency of the system was assessed with GEANT4 and with known activities of 18F. Air is sampled in a number of areas of the nuclear medicine department of the IRST-IRCCS hospital (Meldola- Italy). To evaluate committed doses to hospital staff involved (doctors, technicians, nurses) different exposure situations (rooms, times, radionuclides etc) were considered. After estimating the intake, the committed effective dose has been evaluated, for the different radionuclides, using the dose coefficients mandated by the Italian legislation. Error propagation for the estimated intake and personal dose has been evaluated, starting from measurement statistics.

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005-2010 period.

PubMed

Pribluda, Victor S; Barojas, Adrian; Añez, Arletta; López, Cecilia G; Figueroa, Ruth; Herrera, Roxana; Nakao, Gladys; Nogueira, Fernando Ha; Pianetti, Gerson A; Povoa, Marinete M; Viana, Giselle Mr; Gomes, Margarete S Mendonça; Escobar, Jose P; Sierra, Olga L Muñoz; Norena, Susana P Rendon; Veloz, Raúl; Bravo, Marcy Silva; Aldás, Martha R; Hindssemple, Alison; Collins, Marilyn; Ceron, Nicolas; Krishnalall, Karanchand; Adhin, Malti; Bretas, Gustavo; Hernandez, Nelly; Mendoza, Marjorie; Smine, Abdelkrim; Chibwe, Kennedy; Lukulay, Patrick; Evans, Lawrence

2012-06-15

Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country's Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly

Sexual orientation in the 2013 national health interview survey: a quality assessment.

PubMed

Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S; Ward, Brian W

2014-12-01

Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented. Methods-NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers for Disease Control and Prevention's National Center for Health Statistics. Analyses in this report were based on NHIS data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Data from the 2006-2010 NSFG and 2009-2012 NHANES were used for the comparisons. Results-Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay/lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to answer. Responses to follow-up questions suggest that the sexual orientation question is producing little classification error. In addition, largely similar patterns of association between sexual orientation and health were observed for NHIS and NSFG. Analyses of item nonresponse rates revealed few data quality issues, although item response times suggest possible shortcutting of the question and comprehension problems for select respondents. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

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.

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety.

PubMed

Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

2017-06-01

Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

ScienceCinema

Budinger, Thomas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Dept. of Nuclear Medicine & Functional Imaging

2018-01-23

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.

Redundant array of independent disks: practical on-line archiving of nuclear medicine image data.

PubMed

Lear, J L; Pratt, J P; Trujillo, N

1996-02-01

While various methods for long-term archiving of nuclear medicine image data exist, none support rapid on-line search and retrieval of information. We assembled a 90-Gbyte redundant array of independent disks (RAID) system using 10-, 9-Gbyte disk drives. The system was connected to a personal computer and software was used to partition the array into 4-Gbyte sections. All studies (50,000) acquired over a 7-year period were archived in the system. Based on patient name/number and study date, information could be located within 20 seconds and retrieved for display and analysis in less than 5 seconds. RAID offers a practical, redundant method for long-term archiving of nuclear medicine studies that supports rapid on-line retrieval.

Quality Issues Identified During the Evaluation of Biosimilars by the European Medicines Agency's Committee for Medicinal Products for Human Use.

PubMed

Cilia, Mark; Ruiz, Sol; Richardson, Peter; Salmonson, Tomas; Serracino-Inglott, Anthony; Wirth, Francesca; Borg, John Joseph

2018-02-01

The aim of this study was to identify trends in deficiencies raised during the EU evaluation of the quality part of dossiers for marketing authorisation applications of biosimilar medicinal products. All adopted day 120 list of questions on the quality module of 22 marketing authorisation applications for biosimilars submitted to the European Medicines Agency and concluded by the end of October 2015 was analysed. Frequencies of common deficiencies identified were calculated and summarised descriptions included. Frequencies and trends on quality deficiencies were recorded and presented for 22 biosimilar applications. Thirty-two 'major objections' for 9 products were identified from 14 marketing authorisation applications with 15 raised for drug substance and 17 for drug product. In addition, 547 'other concerns' for drug substance and 495 for drug product were also adopted. The frequencies and trends of the identified deficiencies together with their impact were discussed from a regulatory perspective and how these impact key manufacturing processes and key materials used in the production of biosimilars. This study provides an insight to the regulatory challenges prospective companies need to consider when developing biosimilars; it also helps elucidate common pitfalls in the development and production of biosimilars and in the submission of dossiers for their marketing authorisations. The results are expected to be of interest to pharmaceutical companies but also to regulators to obtain consistent information on medicinal products based on transparent rules safeguarding the necessary pharmaceutical quality of medicinal products.

[How to adapt to the requirements of "clinical value-oriented drug innovation" for pharmaceutical research in application process of new traditional Chinese medicine].

PubMed

Jin, Fang

2017-05-01

On August 9, 2015, the State Council promulgated the "Opinions of the State Council on the reform of drug and medical device review and approval system" (Guofa 2015 No. 44), and established the "clinical value-oriented drug innovation" model to encourage the research and development of new drugs. Following that, China Food and Drug Administration (CFDA) promulgated the "Notice on several policies for drug registration review and approval" (2015 No. 230 ) on November 11, 2015, clearly specifying that CFDA would "implement one-time approval for clinical trials application of the new drugs, and no longer take a phased declaration, review and approval system; for the new drugs that apply for clinical trials, mainly review the scientific natureof the clinical protocols and the risk control of the new drugs to guarantee the safety of subjects". Accordingly, the evaluation ideas and forms of new drug registration have also been adjusted greatly. For example, issues like the rationality of the drug manufacturing process, whether the scale can reflect the stability of the process, whether the preparation process is sufficient, and whether the choice of dosage form is reasonable are no longer the focus of evaluation before clinical trials. Issues regarding whether the preparation process design is reasonable, whether the effective components can be transferred to the preparation to a maximum extent, whether the process parameters determined in small and middle pilot trials can adapt to the requirements of mass production, no longer act as the reasons for refusing the clinical trials. The corresponding risks shall be borne by the applicant as the subject of liability. The focus in registration evaluation is mainly transferred to how to ensure the consistence of quality between clinical trial samples and the samples already available on market by guaranteeing stable sources of drug raw materials and stable quality of medicines as well as control of the whole preparation

The Rockford School of Medicine Undergraduate Quality Assurance Program

ERIC Educational Resources Information Center

Barr, Daniel; And Others

1976-01-01

An undergraduate program of ambulatory care quality assurance is described which has been operational at the Rockford School of Medicine for three years. Focus is on involving students in peer review and related audit activities. Results of preliminary evaluation are reported and generalizations offered. (JT)

MO-AB-206-00: Nuclear Medicine Physics and Testing

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This education session will cover the physics and operation principles of gamma cameras and PET scanners. The first talk will focus on PET imaging. An overview of the principles of PET imaging will be provided, including positron decay physics, and the transition from 2D to 3D imaging. More recent advances in hardware and software will be discussed, such as time-of-flight imaging, and improvements in reconstruction algorithms that provide for options such as depth-of-interaction corrections. Quantitative applications of PET will be discussed, as well as the requirements for doing accurate quantitation. Relevant performance tests will also be described. Learning Objectives: Bemore » able to describe basic physics principles of PET and operation of PET scanners. Learn about recent advances in PET scanner hardware technology. Be able to describe advances in reconstruction techniques and improvements Be able to list relevant performance tests. The second talk will focus on gamma cameras. The Nuclear Medicine subcommittee has charged a task group (TG177) to develop a report on the current state of physics testing of gamma cameras, SPECT, and SPECT/CT systems. The report makes recommendations for performance tests to be done for routine quality assurance, annual physics testing, and acceptance tests, and identifies those needed satisfy the ACR accreditation program and The Joint Commission imaging standards. The report is also intended to be used as a manual with detailed instructions on how to perform tests under widely varying conditions. Learning Objectives: At the end of the presentation members of the audience will: Be familiar with the tests recommended for routine quality assurance, annual physics testing, and acceptance tests of gamma cameras for planar imaging. Be familiar with the tests recommended for routine quality assurance, annual physics testing, and acceptance tests of SPECT systems. Be familiar with the tests of a SPECT/CT system that include the CT

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

PubMed Central

Ballinger, J R

2010-01-01

Most nuclear medicine studies use 99Tcm, which is the decay product of 99Mo. The world supply of 99Mo 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 99Mo supply will rely on a combination of replacing conventional reactors and developing new technologies. PMID:20965898

Small, Task-Oriented Groups: Conflict, Conflict Management, Satisfaction, and Decision Quality.

ERIC Educational Resources Information Center

Wall, Victor D., Jr.; And Others

1987-01-01

Examined relationship among amount of conflict experienced, the style of its management, individual satisfaction, and decision quality of small, task-oriented groups using 129 college student subjects in 24 groups. Data suggest a curvilinear relationship between the number of conflict episodes experienced by group members and the subsequent…

Total quality management in blood transfusion.

PubMed

Smit-Sibinga, C T

2000-01-01

Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator.

Nuclear Medicine Imaging in the Dentomaxillofacial Region.

PubMed

Wassef, Heidi R; Colletti, Patrick M

2018-07-01

Nuclear medicine studies evaluate physiology on a molecular level providing earlier detection of lesions before morphologic change is evident. 99m Tc-MDP and 18 F-fluoride bone scans detect osteomyelitis earlier than radiographs and computed tomography (CT); aid in diagnosis of temporomandibular joint disorder; and evaluate activity of condylar hyperplasia, extent of Paget disease, and viability of bone grafts. 18 F-FDG PET/CT distinguish between soft tissue and bone infections and diagnose osteomyelitis complicated by fracture or surgery. FDG PET is more accurate than CT alone and has a major role in staging, restaging, and assessing response to therapy for head and neck malignancies and in detecting sequelae of therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

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.

The production of radionuclides for nuclear medicine from a compact, low-energy accelerator system.

PubMed

Webster, William D; Parks, Geoffrey T; Titov, Dmitry; Beasley, Paul

2014-05-01

The field of nuclear medicine is reliant on radionuclides for medical imaging procedures and radioimmunotherapy (RIT). The recent shut-downs of key radionuclide producers have highlighted the fragility of the current radionuclide supply network, however. To ensure that nuclear medicine can continue to grow, adding new diagnostic and therapy options to healthcare, novel and reliable production methods are required. Siemens are developing a low-energy, high-current - up to 10 MeV and 1 mA respectively - accelerator. The capability of this low-cost, compact system for radionuclide production, for use in nuclear medicine procedures, has been considered. The production of three medically important radionuclides - (89)Zr, (64)Cu, and (103)Pd - has been considered, via the (89)Y(p,n), (64)Ni(p,n) and (103)Rh(p,n) reactions, respectively. Theoretical cross-sections were generated using TALYS and compared to experimental data available from EXFOR. Stopping power values generated by SRIM have been used, with the TALYS-generated excitation functions, to calculate potential yields and isotopic purity in different irradiation regimes. The TALYS excitation functions were found to have a good agreement with the experimental data available from the EXFOR database. It was found that both (89)Zr and (64)Cu could be produced with high isotopic purity (over 99%), with activity yields suitable for medical diagnostics and therapy, at a proton energy of 10MeV. At 10MeV, the irradiation of (103)Rh produced appreciable quantities of (102)Pd, reducing the isotopic purity. A reduction in beam energy to 9.5MeV increased the radioisotopic purity to 99% with only a small reduction in activity yield. This work demonstrates that the low-energy, compact accelerator system under development by Siemens would be capable of providing sufficient quantities of (89)Zr, (64)Cu, and (103)Pd for use in medical diagnostics and therapy. It is suggested that the system could be used to produce many other

MAGIC-f Gel in Nuclear Medicine Dosimetry: study in an external beam of Iodine-131

NASA Astrophysics Data System (ADS)

Schwarcke, M.; Marques, T.; Garrido, C.; Nicolucci, P.; Baffa, O.

2010-11-01

MAGIC-f gel applicability in Nuclear Medicine dosimetry was investigated by exposure to a 131I source. Calibration was made to provide known absorbed doses in different positions around the source. The absorbed dose in gel was compared with a Monte Carlo Simulation using PENELOPE code and a thermoluminescent dosimetry (TLD). Using MRI analysis for the gel a R2-dose sensitivity of 0.23 s-1Gy-1was obtained. The agreement between dose-distance curves obtained with Monte Carlo simulation and TLD was better than 97% and for MAGIC-f and TLD was better than 98%. The results show the potential of polymer gel for application in nuclear medicine where three dimensional dose distribution is demanded.

Dose rate constants for the quantity Hp(3) for frequently used radionuclides in nuclear medicine.

PubMed

Szermerski, Bastian; Bruchmann, Iris; Behrens, Rolf; Geworski, Lilli

2016-12-01

According to recent studies, the human eye lens is more sensitive to ionising radiation than previously assumed. Therefore, the dose limit for personnel occupationally exposed to ionising radiation will be lowered from currently 150 mSv to 20 mSv per year. Currently, no data base for a reliable estimation of the dose to the lens of the eye is available for nuclear medicine. Furthermore, the dose is usually not monitored. The aim of this work was to determine dose rate constants for the quantity H p (3), which is supposed to estimate the dose to the lens of the eye. For this, H p (3)-dosemeters were fixed to an Alderson Phantom at different positions. The dosemeters were exposed to radiation from nuclides typically used in nuclear medicine in their geometries analog to their application in nuclear medicine, e.g. syringe or vial. The results show that the handling of high-energy beta (i.e. electron or positron) emitters may lead to a relevant dose to the lens of the eye. For low-energy beta emitters and gamma emitters, an exceeding of the lowered dose limit seems to be unlikely. Copyright © 2015. Published by Elsevier GmbH.

Associations between quality indicators of internal medicine residency training programs

PubMed Central

2011-01-01

Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p < 0.05). PGY3 IM-ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

X-ray imaging physics for nuclear medicine technologists. Part 1: Basic principles of x-ray production.

PubMed

Seibert, J Anthony

2004-09-01

The purpose is to review in a 4-part series: (i) the basic principles of x-ray production, (ii) x-ray interactions and data capture/conversion, (iii) acquisition/creation of the CT image, and (iv) operational details of a modern multislice CT scanner integrated with a PET scanner. Advances in PET technology have lead to widespread applications in diagnostic imaging and oncologic staging of disease. Combined PET/CT scanners provide the high-resolution anatomic imaging capability of CT with the metabolic and physiologic information by PET, to offer a significant increase in information content useful for the diagnostician and radiation oncologist, neurosurgeon, or other physician needing both anatomic detail and knowledge of disease extent. Nuclear medicine technologists at the forefront of PET should therefore have a good understanding of x-ray imaging physics and basic CT scanner operation, as covered by this 4-part series. After reading the first article on x-ray production, the nuclear medicine technologist will be familiar with (a) the physical characteristics of x-rays relative to other electromagnetic radiations, including gamma-rays in terms of energy, wavelength, and frequency; (b) methods of x-ray production and the characteristics of the output x-ray spectrum; (c) components necessary to produce x-rays, including the x-ray tube/x-ray generator and the parameters that control x-ray quality (energy) and quantity; (d) x-ray production limitations caused by heating and the impact on image acquisition and clinical throughput; and (e) a glossary of terms to assist in the understanding of this information.

Nuclear medicine technologist education and training in Europe: literature and web-based findings.

PubMed

Matos, Ana C; Massa, Raquel C; Lucena, Filipa M; Vaz, Tânia R

2015-06-01

The education and training of a nuclear medicine technologist (NMT) is not homogeneous among European countries, which leads to different scope of practices and, therefore, different technical skills are assigned. The goal of this research was to characterize the education and training of NMT in Europe. This study was based on a literature research to characterize the education and training of NMT and support the historical evolution of this profession. It was divided into two different phases: the first phase included analysis of scientific articles and the second phase included research of curricula that allow health professionals to work as NMT in Europe. The majority of the countries [N=31 (89%)] offer the NMT curriculum integrated into the high education system and only in four (11%) countries the education is provided by professional schools. The duration in each education system is not equal, varying in professional schools (2-3 years) and high education level system (2-4 years), which means that different European Credit Transfer and Accumulation System, such as 240, 230, 222, 210 or 180 European Credit Transfer and Accumulation System, are attributed to the graduates. The professional title and scope of the practice of NMT are different in different countries in Europe. In most countries of Europe, nuclear medicine training is not specific and curriculum does not demonstrate the Nuclear Medicine competencies performed in clinical practice. The heterogeneity in education and training for NMT is an issue prevalent among European countries. For NMT professional development, there is a huge need to formalize and unify educational and training programmes in Europe.

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

[Quality Management in Medicine: What the Surgeon Needs to Know].

PubMed

Holtel, M; Roßmüller, T; Frommhold, K

2016-10-01

Quality management (QM) is a method used in the field of economics that was adopted late by the medical sector. The coincidence of quality management and what is referred to as economisation in medicine frequently leads to QM being - incorrectly - perceived as part of the economisation problem rather than as part of its solution. Quality assurance defines and observes key performance indicators for the achievement of quality objectives. QM is a form of active management that intends to systematically exclude the effects of chance. It is supposed to enable those in charge of an institution to deal with complex processes, to influence them and achieve quality even under unfavourable circumstances. Clearly defined written standards are an important aspect of QM and allow for 80 % of patients to be treated faster and less labour-intensively and thus to create more capacity for the individual treatment of the 20 % of patients requiring other than routine care. Standards provide a framework to rely on for department heads and other staff alike. They reduce complexity, support processes in stress situations and prevent inconsistent decisions in the course of treatment. Document management ensures transparent and up-to-date in-house standards and creates continuity. Good documents are short, easy to use, and, at the same time, comply with requirements. Specifications describe in-house standards; validation documents provide a forensically sound documentation. Quality management has a broad impact on an institution. It helps staff reflect on their daily work, and it initiates a reporting and auditing system as well as the systematic management of responses to surveys and complaints. Risk management is another aspect of QM; it provides structures to identify, analyse, assess and modify risks and subject them to risk controlling. Quality management is not necessarily associated with certification. However, if certification is intended, it serves to define requirements

Survey of physician requirements in six specialties: manpower needs in anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, radiology. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wills, J.

1980-07-01

This report was prepared to assist the Graduate Medical Education National Advisory Committee (GMENAC) in its efforts to model physician manpower requirements in six specialties: anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology. The purpose of this report is to (1) survey and present the existing literature on manpower requirements in each of these six specialties, and (2) discuss the special problems present in each specialty in modeling manpower requirements, and where possible, suggest possible avenues of resolution.

An overview of the European Organization for External Quality Assurance Providers in Laboratory Medicine (EQALM)

PubMed Central

Stavelin, Anne; Albe, Xavier; Meijer, Piet; Sarkany, Erika; MacKenzie, Finlay

2017-01-01

The European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) was founded in 1996 and currently has members from 29 European countries and 6 countries from outside Europe. EQALM provides a forum for co-operation and exchange of knowledge on quality-related matters in laboratory medicine, especially with regard to external quality assessment (EQA) programs in Europe. In addition, EQALM represent the EQA providers in laboratory medicine at European level vis-ŕ-vis political, professional, scientific and other bodies, including patients’ organisations. To this end EQALM promotes activities such as organizing meetings with scientific and practical themes for members and other interested parties, issuing scientific publications, developing EQA projects and representing laboratory medicine EQA activities within other organisations and networks. EQALM is active in scientific and educational activity in different fields such as survey frequency, haematology, haemostasis, microbiology, nomenclature, virtual microscopy, traceability, accreditation, and quality assurance of the total testing process. The aim of this paper is to give an overview of the EQALM organisation. PMID:28392724

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature

PubMed Central

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R.; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature.

PubMed

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general

EC Project 'GUIDELINES ON MPE': proposed qualification and curriculum frameworks and the MPE in nuclear medicine

NASA Astrophysics Data System (ADS)

Caruana, C. J.

2011-09-01

The objectives of EC project 'Guidelines on Medical Physics Expert' are to provide for improved implementation of the provisions relating to the Medical Physics Expert within Council Directive 97/43/EURATOM and the proposed recast Basic Safety Standards directive. This includes harmonisation of the mission statement for Medical Physics Services as well as the education and training of the MPE. It also includes detailed knowledge-skills-competence inventories for the Medical Physics Expert in each of Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy. This paper presents the proposed Qualification and Curriculum Frameworks and their application to the Medical Physics Expert in Nuclear Medicine.

[The social role of the faculties of medicine: physicians' perception of the dominant orientation of their medical studies and social involvement].

PubMed

Dopelt, Keren; Yahav, Zehava; Urkin, Jacob; Bachner, Yaacov; Davidovitch, Nadav

2014-02-01

Medical education, based on the principles of social medicine, has the ability to contribute to reducing health disparities through the "creation" of doctors who are more involved in community programs. To compare the social and community orientation of graduates from the various medical schools. An online cross-sectional survey among 12,000 physicians who are graduates of Israeli medical schools was conducted in May 2011. The study encompassed 1,050 physicians, Israeli medical school graduates living in Israel and practicing medicine: 36% were Hebrew University graduates, 26% were Tel Aviv University graduates, 22% were Technion graduates and 16% were Ben-Gurion University (BGU) graduates. Higher rates of physicians who studied at the Technion and BGU are working or have worked in the periphery (approximately 50% vs. approximately 30% average of Hebrew and Tel-Aviv University schools). Among BGU graduates, 47% are active in community programs vs. 34-38% in other schools. Among physicians active in community programs, 32% of BGU alumni estimated that their medical education greatly influenced their community involvement vs. 8-15% in other schools. Hebrew University alumni graded their studies as having a higher research orientation. In contrast, BGU graduates graded their studies as having a higher social orientation, and had more positive attitudes on the role of the physician in reducing health disparities. Medical education with a social orientation will induce a socialization process that reinforces human values regarding the doctor-patient relationship and produce positive attitudes among future doctors regarding their social involvement. The findings emphasize the need to develop educational programs with a social orientation and to strengthen medical schools in the periphery.

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005–2010 period

PubMed Central

2012-01-01

Background Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Methods Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country’s Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

PubMed

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-01-01

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Radiation risk and nuclear medicine: An interview with a Nobel Prize winner

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 ismore » not dangerous.« less

Value-based medicine: evidence-based medicine and beyond.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay

2003-09-01

Value-based medicine is the practice of medicine emphasizing the value received from an intervention. Value is measured by objectively quantifying: 1) the improvement in quality of life and/or 2) the improvement in length of life conferred by an intervention. Evidence-based medicine often measures the improvement gained in length of life, but generally ignores the importance of quality of life improvement or loss. Value-based medicine incorporates the best features of evidence-based medicine and takes evidence-based data to a higher level by incorporating the quality of life perceptions of patients with a disease in concerning the value of an intervention. Inherent in value-based medicine are the costs associated with an intervention. The resources expended for the value gained in value-based medicine is measured with cost-utility analysis in terms of the US dollars/QALY (money spent per quality-adjusted life-year gained). A review of the current status and the likely future of value-based medicine is addressed herein.

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.

Diagnostic Nuclear Medicine for Paediatric Patients in Australia: Assessing the Individual's Dose Burden.

PubMed

Bartlett, Marissa L; Forsythe, Anna; Brady, Zoe; Mathews, John D

2018-05-01

We report data for all Australians aged 0-19 y who underwent publicly funded nuclear medicine studies between 1985 and 2005, inclusive. Radiation doses were estimated for individual patients for 95 different types of studies. There were 374 848 occasions of service for 277 511 patients with a collective effective dose of 1123 Sievert (Sv). Most services were either bone scans (45%) or renal scans (29%), with renal scans predominating at younger ages and bone scans at older ages. This pattern persisted despite a 4-fold increase in the annual number of procedures. Younger children were more likely to experience multiple scans, with the third quartile of scans per patient dropping from two to one with patient age. The median effective dose per patient ranged from 1.3 mSv (4-7 y old) to 2.8 mSv (13-16 y old). This large data set provides valuable information on nuclear medicine services for young Australians in the period 1985-2005.

Quest for quality: department of laboratory medicine and pathology, Mayo Clinic.

PubMed

Arney, Kris R; Hopper, Mary H; Tran, Sheryl A; Ward, Melissa M; Hanson, Curtis A

2004-01-01

This article describes our journey for quality in the Department of Laboratory Medicine and Pathology (DLMP) at Mayo Clinic. It provides the background of the department and the process for the development and implementation of the quality program. In addition, a quality conference and the development of a quality school are outlined. Throughout the course of this process, valuable lessons were learned and are discussed. We are pleased with the success of the quality journey. However, we realize that the quest has just begun. We look forward to the future and the challenges that lie ahead.

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.

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

Tools Used to Evaluate Written Medicine and Health Information: Document and User Perspectives

ERIC Educational Resources Information Center

Luk, Alice; Aslani, Parisa

2011-01-01

This study aims to identify and review tools used to evaluate consumer-oriented written medicine (WMI) and health (WHI) information from a document and user perspective. Articles that met the following inclusion criteria were reviewed: studies evaluating readability, presentation, suitability, quality of WMI/WHI. A total of 152 articles were…

Radiographic Film Processing Quality Assurance: A Self-Teaching Workbook. Quality Assurance Series.

ERIC Educational Resources Information Center

Goldman, Lee W.

This workbook has been designed for use in conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical problems arising from the existence of variability and fluctuations in the automatic processing of radiographs, which unless corrected, can…

Development of departmental standard for traceability of measured activity for I-131 therapy capsules used in nuclear medicine.

PubMed

Ravichandran, Ramamoorthy; Binukumar, Jp

2011-01-01

International Basic Safety Standards (International Atomic Energy Agency, IAEA) provide guidance levels for diagnostic procedures in nuclear medicine indicating the maximum usual activity for various diagnostic tests in terms of activities of injected radioactive formulations. An accuracy of ± 10% in the activities of administered radio-pharmaceuticals is being recommended, for expected outcome in diagnostic and therapeutic nuclear medicine procedures. It is recommended that the long-term stability of isotope calibrators used in nuclear medicine is to be checked periodically for their performance using a long-lived check source, such as Cs-137, of suitable activity. In view of the un-availability of such a radioactive source, we tried to develop methods to maintain traceability of these instruments, for certifying measured activities for human use. Two re-entrant chambers [(HDR 1000 and Selectron Source Dosimetry System (SSDS)] with I-125 and Ir-192 calibration factors in the Department of Radiotherapy were used to measure Iodine-131 (I-131) therapy capsules to establish traceability to Mark V isotope calibrator of the Department of Nuclear Medicine. Special nylon jigs were fabricated to keep I-131 capsule holder in position. Measured activities in all the chambers showed good agreement. The accuracy of SSDS chamber in measuring Ir-192 activities in the last 5 years was within 0.5%, validating its role as departmental standard for measuring activity. The above method is adopted because mean energies of I-131 and Ir-192 are comparable.

[Current situations and problem analysis of influencing factors of traditional Chinese medicine tablets on forming quality].

PubMed

Li, Yan-Nian; Wu, Zhen-Feng; Wan, Na; Li, Yuan-Hui; Li, Hui-Ting; Yang, Ming

2018-04-01

The compressibility of tablets is the essential operating unit during the preparation of traditional Chinese medicine tablets, as well as a complicated process. Therefore, it is of great significance to comprehensively study the influencing factors on the formation process. This paper aimed to review the evaluation methods for the tablet forming quality and highlight the effects of material powder properties, excipients and preparation technology on the quality of traditional Chinese medicine tablets on the basis of relevant literatures. Furthermore, the common problems in tablet forming process are also analyzed to provide useful references for the development of tablet forming quality of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

Medicine information leaflets for non-steroidal anti-inflammatory drugs in Thailand.

PubMed

Phueanpinit, Pacharaporn; Pongwecharak, Juraporn; Krska, Janet; Jarernsiripornkul, Narumol

2016-02-01

The importance of promoting the use of patient-oriented medicines leaflets is recognized in many countries. Leaflets should include basic information plus specific warnings, and be provided with all medicines, but there is little attempt at enforcement of these requirements in Thailand. To determine content and availability of Thai information leaflets for nonsteroidal anti-inflammatory drugs (NSAIDs). Leaflets for all NSAIDs available for purchase from 34 pharmacies in a large city were evaluated against a checklist and number of leaflets assessed against number of medicine packs available in each pharmacy. Of the 76 leaflets for ten different NSAIDs, 67 (88 %) were for locally manufactured products. Only 22 % of 76 leaflets were sufficient in number for distribution with medicines, while only 4 % had patient-oriented leaflets. No leaflet covered all topics in the checklist. Less than half included safety information, such as contraindications (46 %), precautions (47 %), and adverse drug reactions (34 %). Locally-produced leaflets provided less information than those for originator products and no leaflet included all the warnings required by Thai regulations. This study illustrates the variable availability and quality of NSAID information leaflets. The lack of accessible essential information about medicines in Thailand requires urgent attention to enable patients to minimise adverse reactions.

Quality management of medical education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany.

PubMed

Dieter, Peter Erich

2008-12-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.

Radiation dose produced by patients during radiopharmaceutical incorporation in nuclear medicine diagnostic procedures.

PubMed

Morán, V; Prieto, E; García-García, B; Barbés, B; Ribelles, M J; Richter, J Á; Martí-Climent, J M

2016-01-01

The aim of this study was to assess the dose received by members of the public due to close contact with patients undergoing nuclear medicine procedures during radiopharmaceutical incorporation, and comparing it with the emitted radiation dose when the test was complete, in order to establish recommendations. A prospective study was conducted on 194 patients. H*(10) dose rates were measured at 0.1, 0.5, and 1.0m after the radiopharmaceutical administration, before the image acquisition, and at the end of the nuclear medicine procedure. Effective dose for different close contact scenarios were calculated, according to 95th percentile value (bone scans) and the maximum value (remaining tests). During the radiopharmaceutical incorporation, a person who stays with another injected patient in the same waiting room may receive up to 0.59 mSv. If the patient had a medical appointment, or went to a restaurant or a coffee shop, members of the public could receive 23, 43, and 22 μSv, respectively. After finishing the procedure, these doses are reduced by a factor 3. In most of the studies, the use of private instead of public transport may reduce the dose by more than a factor 6. It is recommended to increase the distance between the patients during the radiopharmaceutical incorporation and to distribute them according to the diagnostic procedure. Patients should be encouraged to use private instead of public transport. Depending on the number of nuclear medicine outpatients per year attended by a physician, it could be necessary to apply restrictions. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Quality assessment of clinical practice guidelines for integrative medicine in China: A systematic review.

PubMed

Yao, Sha; Wei, Dang; Chen, Yao-Long; Wang, Qi; Wang, Xiao-Qin; Zeng, Zhao; Li, Hui

2017-05-01

To assess the quality of integrative medicine clinical practice guidelines (CPGs) published before 2014. A systematic search of the scientific literature published before 2014 was conducted to select integrative medicine CPGs. Four major Chinese integrated databases and one guideline database were searched: the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data, and the China Guideline Clearinghouse (CGC). Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient (ICC). A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good [ICC: 0.928; 95% confifi dence interval (CI): 0.920 to 0.935]. The scores on the 6 AGREE domains were: 17% for scope and purpose (range: 6% to 32%), 11% for stakeholder involvement (range: 0 to 24%), 10% for rigor of development (range: 3% to 22%), 39% for clarity and presentation (range: 25% to 64%), 11% for applicability (range: 4% to 24%), and 1% for editorial independence (range: 0 to 15%). The quality of integrative medicine CPGs was low, the development of integrative medicine CPGs should be guided by systematic methodology. More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflfl icts of interest, and guideline updates in the process of developing integrative medicine CPGs in China.

Sexual orientation and quality of life among students of Obafemi Awolowo University (OAU), Nigeria.

PubMed

Boladale, Mapayi; Olakunle, Oginni; Olutayo, Aloba; Adesanmi, Akinsulore

2015-12-01

Sexual orientation is an individual's pattern of physical and emotional arousal toward members of the same and/or opposite gender. To determine the pattern of sexual orientation and the relationship between sexual orientation and quality of life among a sample of OAU students. A descriptive cross sectional study among 481 students of OAU using a multistage sampling technique. They completed a Socio-demographic data schedule, questions on sexual orientation and the World Health Organization Quality of Life Scale - Brief version (WHO QOL-BREF). 4.9% of the sample self-identified as bisexual while 0.1% self-identified as gay/lesbian. 11.8% of the respondents reported varying degrees of attraction to the opposite gender. The mean age of sexual debut was 17.62 (±4.05). Those who self-identified as gay/lesbian/bisexual had a lower average score on all domains of the WHO QOL-BREF. Same sex sexual attraction and practice occur among young people in Nigeria and this has sexual and reproductive health implications. GLB youth report a lower QOL compared to heterosexual counterparts and this may suggest some distress among this vulnerable group. More studies should be undertaken to explore issues raised in planning interventions and health services that would improve safe sexual practices within this group.

[Process orientation as a tool of strategic approaches to corporate governance and integrated management systems].

PubMed

Sens, Brigitte

2010-01-01

The concept of general process orientation as an instrument of organisation development is the core principle of quality management philosophy, i.e. the learning organisation. Accordingly, prestigious quality awards and certification systems focus on process configuration and continual improvement. In German health care organisations, particularly in hospitals, this general process orientation has not been widely implemented yet - despite enormous change dynamics and the requirements of both quality and economic efficiency of health care processes. But based on a consistent process architecture that considers key processes as well as management and support processes, the strategy of excellent health service provision including quality, safety and transparency can be realised in daily operative work. The core elements of quality (e.g., evidence-based medicine), patient safety and risk management, environmental management, health and safety at work can be embedded in daily health care processes as an integrated management system (the "all in one system" principle). Sustainable advantages and benefits for patients, staff, and the organisation will result: stable, high-quality, efficient, and indicator-based health care processes. Hospitals with their broad variety of complex health care procedures should now exploit the full potential of total process orientation. Copyright © 2010. Published by Elsevier GmbH.

Gap analysis survey: an aid in transitioning to standardized curricula for nuclear medicine technology.

PubMed

Bires, Angela Macci; Mason, Donna L; Gilmore, David; Pietrzyk, Carly

2012-09-01

This article discusses the process by which the Society of Nuclear Medicine Technology Section (SNMTS) is assisting educators as they transition to comply with the fourth edition of the Curriculum Guide for Educational Programs in Nuclear Medicine Technology. An electronic survey was sent to a list of nuclear medicine technology programs compiled by the educational division of the SNMTS. The collected data included committee member demographics, goals and objectives, conference call minutes, consultation discussions, transition examples, 4- and 2-y program curricula, and certificate program curricula. There were 56 responses to the survey. All respondents were program directors, with 3 respondents having more than one type of program, for a total of 59 programs. Of these, 19 (33.93%) were baccalaureate, 19 (28.57%) associate, and 21 (37.5%) certificate. Forty-eight respondents (85.71%) had accreditation through the Joint Review Commission on Educational Programs in Nuclear Medicine Technology, 6 (10.71%) had regional accreditation, and 2 (3.57%) were accredited through other entities. Thirteen categories of required general education courses were identified, and the existing program curricula of 9 (69.2%) courses were more than 50% compliant with the fourth edition Curriculum Guide. The fact that no measurable gap could be found within the didactic professional content across programs was due to the lack of a degree requirement and content standardization within the profession. The data indicated that the participating programs offer a minimum of 1-15 contact hours in emerging technology modalities. The required clinical hours ranged from 765 to 1,920 for degree or certificate completion. The average number of clinical hours required for all programs was 1,331.69. Standardization of the number and types of courses is needed both for current baccalaureate programs and for clinical education. This standardization will guide programs in transitioning from a

An assessment of implementation of Community-Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

PubMed Central

Shabani, Jacob; Taché, Stephanie; Mohamoud, Gulnaz; Mahoney, Megan

2016-01-01

Background and objectives Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Conclusions Our findings illustrate the expected learning outcomes and important community-based enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya. PMID:28155322

The Effects of an Orientation Program on Quality of Life of Patients with Thalassemia: a Quasi-Experimental Study.

PubMed

Rafii, Zahra; Ahmadi, Fazlollah; Nourbakhsh, Sayed Mohamad Kazem; Hajizadeh, Ebrahim

2016-09-01

Introduction: Medical advances have improved life expectancy and survival of patients with thalassemia. However, as getting older, patients with thalassemia experience different complications which impair their quality of life. The aim of this study was to examine the effects of a nurse-implemented orientation program on quality of life in patients with thalassemia. Methods: A convenience sample of 55 patients with thalassemia were recruited in this quasi-experimental study. Patients were randomly allocated to control or experimental groups. A demographic questionnaire, Thalassemia quality of life questionnaire, and 36-item short form health survey were used for data collection before and one month after the intervention. In the intervention group, 1.5-month orientation program including of the three steps of inauguration, implementation, and closure was implemented, while the control group received routine care. The Chi-square, independent t-test and paired-samples t-test were used for data analysis by using SPSS ver.13 software. Results: The intervention and control group did not differ significantly from each other regarding demographic characteristics. Moreover, no significant difference was observed between the two groups regarding the quality of life scores after the implementation of orientation program. Conclusion: Implementing a short-term orientation program was not effective in enhancing the quality of life in patients with thalassemia; hence, developing long-term multimodal strategies may result in better improvement.

Management of patients with coronary heart disease in family medicine: correlates of quality of care.

PubMed

Tušek-Bunc, Ksenija; Petek, Davorina

2018-04-10

Family medicine plays an important role in quality of care (QoC) of coronary heart disease (CHD) patients. This study's aim was to determine the quality of secondary cardiovascular disease prevention in the everyday practice of family physicians. This study was observational cross-sectional. About 36 randomly selected family medicine practices stratified by size and location in Slovenia. CHD patients randomly selected from a patient register available in family medicine practices. The instrument for assessment of quality included a form for collecting data from medical records, a general practice assessment questionnaire and a patient questionnaire. QoC was defined by two composite variables, namely risk factor registration and CHD patient process of care, as the two care outcomes. In multivariate analysis, we performed multilevel regression analysis to identify the associations between QoC, the patient and the practice characteristics. The final sample included 423 CHD patients from 36 family medicine practices. Risk factor registration was associated with the practice organisation score (P = 0.004), practice size (P = 0.042), presence of comorbid atherosclerotic diseases (P = 0.043) and a lower age of CHD patients (P = 0.001). CHD patient process of care was associated with the practice organisation score (0.045) and a lower age of CHD patients (P = 0.035). The most important factors affecting the quality of CHD patient care were linked to the organisational characteristics of the family medicine practices.

Evaluation of an internet-based e-learning module to introduce nuclear medicine to medical students: a feasibility study.

PubMed

Diessl, Stefanie; Verburg, Frederik A; Hoernlein, Alexander; Schumann, Martin; Luster, Markus; Reiners, Christoph

2010-12-01

The advent of electronic learning, the so-called e-learning, offers new possibilities for instruction in addition to the traditional face-to-face teaching in the education of medical students. To evaluate the additional educational value of a voluntary e-learning module in a nuclear medicine course for third-year medical students. Twenty exemplary nuclear medicine patient cases from our department were developed for e-learning purposes and presented on the internet using the web-based training program ‘CaseTrain’. Subsequently, three selected test cases were handled and evaluated by an unselected population of third-year medical students. One hundred and twenty-eight students studied the three patient cases and filled out the evaluation questionnaire completely. The most important result is that both the interest in and the subjective feeling of the knowledge level regarding the specialized field of nuclear medicine had increased significantly after working through the three e-learning cases. Ninety-seven percent of the evaluating students considered the use of computer-based learning useful. The subjective grading of the content of the cases and the handling of the software were graded with high marks by the participants, 1.9 and 2.0, respectively, on a linear scale with 1 being the best and 6 being the worst. The addition of e-learning to face-to-face teaching as a form of ‘blended learning’ is highly appreciated by medical students, and will provide an effective medium for bringing better understanding of nuclear medicine to future colleagues.

Nuclear resonant forward scattering of synchrotron radiation by randomly oriented iron complexes which exhibit nuclear Zeeman interaction

NASA Astrophysics Data System (ADS)

Haas, M.; Realo, E.; Winkler, H.; Meyer-Klaucke, W.; Trautwein, A. X.; Leupold, O.; Rüter, H. D.

1997-12-01

An expression for the amplitude of a pulse of synchrotron radiation (SR) coherently scattered in forward direction by a randomly oriented Mössbauer absorber is derived from the theory of γ optics. It is assumed that the hyperfine splittings present in the Mössbauer nuclei can be described in the framework of the spin-Hamiltonian formalism. In the general case of a thick Mössbauer sample, which consists of randomly oriented paramagnetic iron-containing molecules (for example, a frozen solution of a 57Fe protein) in an applied magnetic field, the response of this sample on an incident monochromatic and fully polarized SR beam cannot be given analytically because of the integrations involved. The way to evaluate nuclear forward-scattering spectra for this general case numerically is outlined and results of calculations with a corresponding program package called SYNFOS are shown and compared with experimental results obtained by measurements of the high-spin iron (II) ``picket-fence'' porphyrin [Fe(CH3COO)TPpivP]- in an applied field of 6 T.

Nuclear medicine and the failed joint replacement: Past, present, and future

PubMed Central

Palestro, Christopher J

2014-01-01

Soon after the introduction of the modern prosthetic joint, it was recognized that radionuclide imaging provides useful information about these devices. The bone scan was used extensively to identify causes of prosthetic joint failure. It became apparent, however, that although sensitive, regardless of how the images were analyzed or how it was performed, the test was not specific and could not distinguish among the causes of prosthetic failure. Advances in anatomic imaging, notably cross sectional modalities, have facilitated the diagnosis of many, if not most, causes of prosthetic failure, with the important exception of infection. This has led to a shift in the diagnostic paradigm, in which nuclear medicine investigations increasingly have focused on diagnosing infection. The recognition that bone scintigraphy could not reliably diagnose infection led to the development of combined studies, first bone/gallium and subsequently leukocyte/bone and leukocyte/marrow imaging. Labeled leukocyte imaging, combined with bone marrow imaging is the most accurate (about 90%) imaging test for diagnosing joint arthroplasty infection. Its value not withstanding, there are significant disadvantages to this test. In-vivo techniques for labeling leukocytes, using antigranulocyte antibodies have been explored, but have their own limitations and the results have been inconsistent. Fluorodeoxyglucose (FDG)-positron emission tomography (FDG-PET) has been extensively investigated for more than a decade but its role in diagnosing the infected prosthesis has yet to be established. Antimicrobial peptides bind to bacterial cell membranes and are infection specific. Data suggest that these agents may be useful for diagnosing prosthetic joint infection, but large scale studies have yet to be undertaken. Although for many years nuclear medicine has focused on diagnosing prosthetic joint infection, the advent of hybrid imaging with single-photon emission computed tomography

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

SUS in nuclear medicine in Brazil: analysis and comparison of data provided by Datasus and CNEN.

PubMed

Pozzo, Lorena; Coura Filho, George; Osso Júnior, João Alberto; Squair, Peterson Lima

2014-01-01

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). 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. 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. 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.

Human Resource Development Practices as Determinant of HRD Climate and Quality Orientation

ERIC Educational Resources Information Center

Hassan, Arif; Hashim, Junaidah; Ismail, Ahmad Zaki Hj

2006-01-01

Purpose: The aim of the study was to measure employees' perception of human resource development (HRD) practices, to explore whether ISO certification leads to any improvements in HRD system, and to examine the role of HRD practices on employees' development climate and quality orientation in the organization. Design/methodology/approach: A total…

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.

Progress and challenges of nuclear science development in Vietnam - an outlook on the occassion of the 10-th anniversary of the Dalat Nuclear Research Reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hien, P.D.

1994-12-31

Over ten years since the commissioning of the Dalat nuclear research reactor a number of nuclear techniques have been developed and applied in Vietnam Manufacturing of radioisotopes and nuclear instruments, development of isotope tracer and nuclear analytical techniques for environmental studies, exploitation of filtered neutron beams, ... have been major activities of reactor utilizations. Efforts made during ten years of reactor operation have resulted also in establishing and sustaining the applications of nuclear techniques in medicine, industry, agriculture, etc. The successes achieved and lessons teamed over the past ten years are discussed illustrating the approaches taken for developing the nuclearmore » science in the conditions of a country having a very low national income and experiencing a transition from a centrally planned to a market-oriented economic system.« less

[Establishment of design space for production process of traditional Chinese medicine preparation].

PubMed

Xu, Bing; Shi, Xin-Yuan; Qiao, Yan-Jiang; Wu, Zhi-Sheng; Lin, Zhao-Zhou

2013-03-01

The philosophy of quality by design (QbD) is now leading the changes in the drug manufacturing mode from the conventional test-based approach to the science and risk based approach focusing on the detailed research and understanding of the production process. Along with the constant deepening of the understanding of the manufacturing process, the design space will be determined, and the emphasis of quality control will be shifted from the quality standards to the design space. Therefore, the establishment of the design space is core step in the implementation of QbD, and it is of great importance to study the methods for building the design space. This essay proposes the concept of design space for the production process of traditional Chinese medicine (TCM) preparations, gives a systematic introduction of the concept of the design space, analyzes the feasibility and significance to build the design space in the production process of traditional Chinese medicine preparations, and proposes study approaches on the basis of examples that comply with the characteristics of traditional Chinese medicine preparations, as well as future study orientations.

Role of PET/CT for precision medicine in lung cancer: perspective of the Society of Nuclear Medicine and Molecular Imaging.

PubMed

Greenspan, Bennett S

2017-12-01

This article discusses the role of PET/CT in contributing to precision medicine in lung cancer, and provides the perspective of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) on this process. The mission and vision of SNMMI are listed, along with the guidance provided by SNMMI to promote best practice in precision medicine. Basic principles of PET/CT are presented. An overview of the use of PET/CT imaging in lung cancer is discussed. In lung cancer patients, PET/CT is vitally important for optimal patient management. PET/CT is essential in determining staging and re-staging of disease, detecting recurrent or residual disease, evaluating response to therapy, and providing prognostic information. PET/CT is also critically important in radiation therapy planning by determining the extent of active disease, including an assessment of functional tumor volume. The current approach in tumor imaging is a significant advance over conventional imaging. However, recent advances suggest that therapeutic response criteria in the near future will be based on metabolic characteristics and will include the evaluation of biologic characteristics of tumors to further enhance the effectiveness of precision medicine in lung cancer, producing improved patient outcomes with less morbidity.

Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq.

PubMed

Al-Dabbagh, Samim A; Al-Taee, Waleed G

2005-08-22

The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999-2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

TH-AB-206-02: Nuclear Medicine Theronostics: Wave of the Future; Pre-Clinical and Clinical Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Delpassand, E.

In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describesmore » preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.« less

Diagnostic reference level: an important tool for reducing radiation doses in adult and pediatric nuclear medicine procedures in Brazil.

PubMed

Willegaignon, José; Braga, Luis F E F; Sapienza, Marcelo T; Coura-Filho, George B; Cardona, Marissa A R; Alves, Carlos E R; Gutterres, Ricardo F; Buchpiguel, Carlos A

2016-05-01

This study aimed to establish a concise method for determining a diagnostic reference level (DRL) for adult and pediatric nuclear medicine patients on the basis of diagnostic procedures and administered radioisotope as a means of controlling medical exposure. A screening was carried out in all Brazilian Nuclear Medicine Service (NMS) establishments to support this study by collecting the average activities administered during adult diagnostic procedures and the rules applied to adjust these according to the patient's age and body mass. Percentile 75 was used in all the activities administered as a means of establishing DRL for adult patients, with additional correction factors for pediatric patients. Radiation doses from nuclear medicine procedures on the basis of average administered activity were calculated for all diagnostic exams. A total of 107 NMSs in Brazil agreed to participate in the project. From the 64 nuclear medicine procedures studied, bone, kidney, and parathyroid scans were found to be used in more than 85% of all the NMSs analyzed. There was a large disparity among the activities administered, when applying the same procedures, this reaching, in some cases, more than 20 times between the lowest and the highest. Diagnostic exams based on Ga, Tl, and I radioisotopes proved to be the major exams administering radiation doses to patients. On introducing the DRL concept into clinical routine, the minimum reduction in radiation doses received by patients was about 15%, the maximum was 95%, and the average was 50% compared with the previously reported administered activities. Variability in the available diagnostic procedures as well as in the amount of activities administered within the same procedure was appreciable not only in Brazil, but worldwide. Global efforts are needed to establish a concise DRL that can be applied in adult and pediatric nuclear medicine procedures as the application of DRL in clinical routine has been proven to be an important

Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

PubMed

Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-05-01

Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

Consumer-oriented interventions for evidence-based prescribing and medicines use: an overview of systematic reviews.

PubMed

Ryan, Rebecca; Santesso, Nancy; Hill, Sophie; Lowe, Dianne; Kaufman, Caroline; Grimshaw, Jeremy

2011-05-11

Numerous systematic reviews exist on interventions to improve consumers' medicines use, but this research is distributed across diseases, populations and settings. The scope and focus of reviews on consumers' medicines use also varies widely. Such differences create challenges for decision makers seeking review-level evidence to inform decisions about medicines use. To synthesise the evidence from systematic reviews on the effects of interventions which target healthcare consumers to promote evidence-based prescribing for, and medicines use, by consumers. We sought evidence on the effects on health and other outcomes for healthcare consumers, professionals and services. We included systematic reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. We identified relevant reviews by handsearching both databases from start date to Issue 3 2008. We screened and ranked reviews based on relevance to consumers' medicines use, using criteria developed for this overview. Standardised forms were used to extract data, and reviews were assessed for methodological quality using the AMSTAR instrument. We used standardised language to summarise results within and across reviews; and a further synthesis step was used to give bottom-line statements about intervention effectiveness. Two review authors selected reviews, extracted and analysed data. We used a taxonomy of interventions to categorise reviews. We included 37 reviews (18 Cochrane, 19 non-Cochrane), of varied methodological quality.Reviews assessed interventions with diverse aims including support for behaviour change, risk minimisation, skills acquisition and information provision. No reviews aimed to promote systems-level consumer participation in medicines-related activities. Medicines adherence was the most commonly reported outcome, but others such as clinical (health and wellbeing), service use and knowledge outcomes were also reported. Reviews rarely

Oral impacts on quality of life and problem-oriented attendance among South East London adults.

PubMed

Gaewkhiew, Piyada; Bernabé, Eduardo; Gallagher, Jennifer E; Klass, Charlotte; Delgado-Angulo, Elsa K

2017-04-26

Dental care seeking behaviour is often driven by symptoms. The value of oral health related quality of life (OHRQoL) measures to predict utilisation of dental services is unknown. This study aims to explore the association between OHRQoL and problem-oriented dental attendance among adults. We analysed cross-sectional data for 705 adults, aged 16 years and above, living in three boroughs of Inner South East London. Data were collected during structured interviews at home. The short form of the Oral Health Impact Profile (OHIP-14) was used to assess the frequency of oral impacts on daily life in the last year. Problem-oriented attendance was defined based on time elapsed since last visit (last 6 months) and reason for that visit (trouble with teeth). The association between OHIP-14 (total and domain) scores and problem-oriented attendance was tested in logistic regression models adjusting for participants' sociodemographic characteristics. Problem-oriented attenders had a higher OHIP-14 total score than regular attenders (6.73 and 3.73, respectively). In regression models, there was a positive association between OHIP-14 total score and problem-oriented attendance. The odds of visiting the dentist for trouble with teeth were 1.07 greater (95% Confidence Interval: 1.04-1.10) per unit increase in the OHIP-14 total score, after adjustment for participants' sociodemographic characteristics. In subsequent analysis by OHIP-14 domains, greater scores in all domains but handicap were significantly associated with problem-oriented attendance. This study shows that oral impacts on quality of life are associated with recent problem-oriented dental attendance among London adults. Six of the seven domains in the OHIP-14 questionnaire were also associated with dental visits for trouble with teeth.

Evolution of Quality Assurance for Clinical Immunohistochemistry in the Era of Precision Medicine: Part 4: Tissue Tools for Quality Assurance in Immunohistochemistry.

PubMed

Cheung, Carol C; D'Arrigo, Corrado; Dietel, Manfred; Francis, Glenn D; Fulton, Regan; Gilks, C Blake; Hall, Jacqueline A; Hornick, Jason L; Ibrahim, Merdol; Marchetti, Antonio; Miller, Keith; van Krieken, J Han; Nielsen, Soren; Swanson, Paul E; Taylor, Clive R; Vyberg, Mogens; Zhou, Xiaoge; Torlakovic, Emina E

2017-04-01

The numbers of diagnostic, prognostic, and predictive immunohistochemistry (IHC) tests are increasing; the implementation and validation of new IHC tests, revalidation of existing tests, as well as the on-going need for daily quality assurance monitoring present significant challenges to clinical laboratories. There is a need for proper quality tools, specifically tissue tools that will enable laboratories to successfully carry out these processes. This paper clarifies, through the lens of laboratory tissue tools, how validation, verification, and revalidation of IHC tests can be performed in order to develop and maintain high quality "fit-for-purpose" IHC testing in the era of precision medicine. This is the final part of the 4-part series "Evolution of Quality Assurance for Clinical Immunohistochemistry in the Era of Precision Medicine."

SU-C-9A-02: Structured Noise Index as An Automated Quality Control for Nuclear Medicine: A Two Year Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, J; Christianson, O; Samei, E

Purpose: Flood-field uniformity evaluation is an essential element in the assessment of nuclear medicine (NM) gamma cameras. It serves as the central element of the quality control (QC) program, acquired and analyzed on a daily basis prior to clinical imaging. Uniformity images are traditionally analyzed using pixel value-based metrics which often fail to capture subtle structure and patterns caused by changes in gamma camera performance requiring additional visual inspection which is subjective and time demanding. The goal of this project was to develop and implement a robust QC metrology for NM that is effective in identifying non-uniformity issues, reporting issuesmore » in a timely manner for efficient correction prior to clinical involvement, all incorporated into an automated effortless workflow, and to characterize the program over a two year period. Methods: A new quantitative uniformity analysis metric was developed based on 2D noise power spectrum metrology and confirmed based on expert observer visual analysis. The metric, termed Structured Noise Index (SNI) was then integrated into an automated program to analyze, archive, and report on daily NM QC uniformity images. The effectiveness of the program was evaluated over a period of 2 years. Results: The SNI metric successfully identified visually apparent non-uniformities overlooked by the pixel valuebased analysis methods. Implementation of the program has resulted in nonuniformity identification in about 12% of daily flood images. In addition, due to the vigilance of staff response, the percentage of days exceeding trigger value shows a decline over time. Conclusion: The SNI provides a robust quantification of the NM performance of gamma camera uniformity. It operates seamlessly across a fleet of multiple camera models. The automated process provides effective workflow within the NM spectra between physicist, technologist, and clinical engineer. The reliability of this process has made it the

Improving strand quality of upland oaks for use in oriented strand board

Treesearch

David B. DeValliance; Jody D. Gray; Shawn T. Grushecky

2013-01-01

Past research estimates that more than 1 million tons of oak logging residues go unused in West Virginia each year. Much research has been done investigating potential products and markets for this underutilized resource. West Virginia is home to an oriented strand board (OSB) producer that consumes large volumes of small diameter, low quality round wood. However, the...

Concurrent Study of Eastern and Western Medicine at the National College of Natural Medicine: Dual or Duel?

ERIC Educational Resources Information Center

Smith, Andrea Christine

2010-01-01

Students at the National College of Natural Medicine (NCNM) are eligible to concurrently study both Western medicine, as reflected by the Doctor of Naturopathic Medicine (ND) program, and Eastern medicine, as exhibited by the Master of Science in Oriental Medicine (MSOM) degree program. The dual track is unique in that the dominant Western…

When sex is more than just sex: attachment orientations, sexual experience, and relationship quality.

PubMed

Birnbaum, Gurit E; Reis, Harry T; Mikulincer, Mario; Gillath, Omri; Orpaz, Ayala

2006-11-01

The authors explored the contribution of individual differences in attachment orientations to the experience of sexual intercourse and its association with relationship quality. In Study 1, 500 participants completed self-report scales of attachment orientations and sexual experience. The findings indicated that whereas attachment anxiety was associated with an ambivalent construal of sexual experience, attachment avoidance was associated with more aversive sexual feelings and cognitions. In Study 2, 41 couples reported on their attachment orientations and provided daily diary measures of sexual experiences and relationship interactions for a period of 42 days. Results showed that attachment anxiety amplified the effects of positive and negative sexual experiences on relationship interactions. In contrast, attachment avoidance inhibited the positive relational effect of having sex and the detrimental relational effects of negative sexual interactions. The authors discuss the possibility that attachment orientations are associated with different sex-related strategies and goals within romantic relationships.

[Sampling in quality control of medicinal materials-A case of Epimedium].

PubMed

Wang, Chuanyi; Cao, Jinyi; Liang, Yun; Huang, Wenhua; Guo, Baolin

2009-04-01

To investigate the effect of the different individual number of sampling on the assay results of the medicinal materials. Epimedium pubescens and E. brevicornu were used as samples. The 6 sampling levels were formulated as 1 individual, 5, 10, 20, 30, 50 individuals mix, each level with 3 parallels and 1 individual level5 parallels. The contents of epimedin C and icariin, and the peak areas of epimedin A, epimedin B, rhamnosyl icarisid II and icarisid II in all samples were analyzed by HPLC. The variation degree varied with species and chemical constituents, but the RSD and the deviation from the true value decreased with the increase of individual number on the same chemical constituent. The sampling number should be more than 10 individuals in quality control of Epimedium, and 50 or more individuals would be better for representing the quality of medicinal materials.

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.

[QUALITY MEASURES IN MEDICINE-- A PLEA FOR NEW, VALUE BASED THINKING].

PubMed

Fisher, Menachem; Wagner, Oded; Keinarl, Talia; Solt, Ido

2015-09-01

Quality is an important and basic conduct of complex systems in general and health systems in particular. Quality is a cornerstone of medicine, necessary in the eyes of the community of consumers, caregivers, and the systems that manage both. In Israel, the Ministry of Health has set the quality issue on the agenda of healthcare organizations in all existing frameworks. In this article we seek to offer an acceptable alternative perspective, in examining the quality of public health. We suggest highlighting the ethical aspect of medical care, while reducing the quantitative monitoring component of existing quality metrics. Relying solely on indices has negative effects that might cause damage. The proposed alternative focuses on the personal responsibility of health care providers, using. values and moral reasonin.

A study of professional radiation hazards in CT scan and nuclear medicine workers using GTG-banding and solid stain.

PubMed

Changizi, Vahid; Alizadeh, Mohammad Hossein; Mousavi, Akbar

2015-01-01

CT scan and nuclear medicine exams deliver a great part of medical exposures. This study examined professional radiation hazards in CT scan and nuclear medicine workers. In a cross sectional study 30 occupationally exposed workers and 7 controls (all from personnel of a laboratory) were selected. Physical dosimetry was performed for exposed workers. Blood samples were obtained from the experimental and control groups. Three culture mediums for each one were prepared in due to routine chromosome analysis using G-banding and solid stain. There were significant increased incidence of chromatid gap (ctg) and chromatid break (ctb) with mean±SD frequencies of 3±0.84 and 3.1±1.40 per 100 cells respectively in the nuclear medicine workers versus controls with mean±SD frequencies of 1.9±0.69 and 1.3±0.84 for ctg and ctb, respectively. Chromosome gaps (chrg) were higher significantly in the nuclear medicine population (2.47±0.91) than in controls (1.4±0.9) (p< 0.05). In CT scan group the ctg and ctb were increased with a mean±SD frequency of 2.7±0.79 and 2.6±0.91 per 100 cells respectively compared with control group. The mean±SD frequencies of the chrb were 2.0±0.75 and 0.86±0.690 per 100 cells for exposed workers and control group, respectively. This study showed chromosome aberrations in peripheral lymphocytes using solid stain method are reasonable biomarker reflecting personnel radiation damage.

Quality of medicines in Canada: a retrospective review of risk communication documents (2005–2013)

PubMed Central

Almuzaini, Tariq; Sammons, Helen; Choonara, Imti

2014-01-01

Objective To explore the quality and safety of medicines in Canada. Design A retrospective review of drug recalls and risk communication documents conveying issues relating to defective (ie, substandard and falsified) medicines. Setting The Health Canada website search for drug recalls and risk communication documents issued between 2005 and 2013. Eligibility criteria Drug recalls and risk communication documents related to quality defect in medicinal products. Main outcome measure Relevant data about defective medicines reported in drug recalls and risk communication documents, including description of the defect, type of formulation, year of the recall and category of the recall or the document. Results There were 653 defective medicines of which 649 were substandard. The number of defective medicines reported by Health Canada increased from 42 in 2005 to 143 in 2013. The two most frequently reported types of defects were stability (205 incidents) and contamination issues (139 incidents). Some of these defects were found to be more prominent and repetitive over other types within some manufacturers. Tablet formulation (251 incidents) was the formulation most frequently compromised. No significant differences were observed between the manufacturers and distributors in the number of substandard medicines reported under each defect type. There were only four falsified medicines reported over the 9-year period. Conclusions Substandard medicines are a problem in Canada and have resulted in an increasing number of recalled medicines. Most of the failures were related to stability issues, raising the need to investigate the root causes and for stringent preventative measures to be implemented by manufacturers. PMID:25361839

Cardiac nuclear medicine, part II: diagnosis of coronary artery diseas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Polak, J.F.; Holman, B.L.

Diagnosing coronary artery disease is difficult and requires careful consideration of the roles and limitations of the tests used. Standard ECG tests are not reliable indicators of the presence of disease in asymptomatic patients. Thallium stress testing to assess ischemia and exercise ventriculography to assess functional status of the heart are limited in sensitivity and specificity. This is the second of a three-part series on cardiac nuclear medicine. Part I (Med. Instrum., May-June, 1981) focused on the commonly used examinations in cardiac physiology and pathophysiology. Part III will focus on myocardial infarction and other cardiac diseases.

Building a bridge for integrating Chinese medicine into conventional healthcare: observations drawn from the development of the Chinese quality of life instrument.

PubMed

Zhao, Li; Chan, Kelvin

2005-01-01

This paper describes the methods and theories of patient-reported outcomes, in particular to the health-related quality of life recently applied in Chinese medicine research. It begins with an investigation of the reasons for a patient-reported outcomes measure for Chinese medicine and the development of a new health-related quality of life instrument based on Chinese culture and Chinese medicine. Discussions on the importance and application of patient-reported outcomes as well as the relationship between quality of life and Chinese medicine are at the focus of this paper. Through a description of the Chinese Quality of Life Instrument and its development, the present work demonstrates an evidence-based approach using patient-reported outcomes or health-related quality of life measures to evaluate treatment efficacy of Chinese medicine, and thereby build a bridge for the integration of Chinese medicine into mainstream health care.

[Enhancement of quality by employing qualification-oriented staff and team-oriented cooperation].

PubMed

Meyenburg-Altwarg, Iris; Tecklenburg, Andreas

2010-01-01

Taking three practical examples from a university hospital the present article describes how quality can be improved by linking deployment of qualification-oriented staff with team-oriented cooperation, especially with regard to the professional groups of physicians and nurses. In the first example, a cross-professional work group defined tasks which--in a legally acceptable manner--allow selected activities to be transferred from physicians to nurses, improving the work processes of all persons concerned. Work and duty profiles, training and modified work processes were created and implemented according to the PDCA circle-based process. The first evaluation took place after nine months using interviews, questionnaires (patients, physicians, and nurses) as well as CIRS. In the second example, emphasis was placed on offers of supplementary services for private patients resulting in a lightening of the workload on the nursing staff. These supplementary services are intended to enhance the wellbeing of the patients. Special external-service staff provide high standard hotel services. These services consistently receive high ratings from the patients. The methods used for introduction and evaluation are analogous to those used in the first example. The third example is concerned with the extension of nursing care and patient empowerment beyond the boundaries of ward and hospital. The guidelines were the implementation of the national expert standard for discharge management according to the DNQP. The methods of introduction were analogous to those used in example 1. For the evaluation interviews were conducted with all participating groups. In all examples actual quantitative measures (key ratios) are not yet available; however, the data collected from the interviews and questionnaires of all the participants are promising.

Empirical evidence of the effectiveness of concept mapping as a learning intervention for nuclear medicine technology students in a distance learning radiation protection and biology course.

PubMed

Passmore, Gregory G; Owen, Mary Anne; Prabakaran, Krishnan

2011-12-01

Metacognitive learning strategies are based on instructional learning theory, which promotes deep, meaningful learning. Educators in a baccalaureate-level nuclear medicine technology program demonstrated that students enrolled in an online, distance learning section of an introductory radiation protection and radiobiology course performed better when traditional instruction was supplemented with nontraditional metacognitive learning strategies. The metacognitive learning strategy that was used is best known as concept mapping. The concept map, in addition to the standard homework problem assignment and opportunity for question-answer sessions, became the template for misconception identification and remediation interactions between the instructor and the student. The control group relied on traditional homework problems and question-answer sessions alone. Because students in both the "treatment" groups (i.e., students who used concept mapping) and the control group were distance learning students, all personal communications were conducted via e-mail or telephone. The final examination of the course was used to facilitate a quantitative comparison of the performance of students who used concept mapping and the performance of students who did not use concept mapping. The results demonstrated a significantly higher median final examination score for the concept mapping group than for the non-concept mapping group (z = -2.0381, P = 0.0415), with an appropriately large effect size (2.65). Concept mapping is a cognitive learning intervention that effectively enables meaningful learning and is suitable for use in the independent learner-oriented distance learning environments used by some nuclear medicine technology programs.

Precision manufacturing for clinical-quality regenerative medicines.

PubMed

Williams, David J; Thomas, Robert J; Hourd, Paul C; Chandra, Amit; Ratcliffe, Elizabeth; Liu, Yang; Rayment, Erin A; Archer, J Richard

2012-08-28

Innovations in engineering applied to healthcare make a significant difference to people's lives. Market growth is guaranteed by demographics. Regulation and requirements for good manufacturing practice-extreme levels of repeatability and reliability-demand high-precision process and measurement solutions. Emerging technologies using living biological materials add complexity. This paper presents some results of work demonstrating the precision automated manufacture of living materials, particularly the expansion of populations of human stem cells for therapeutic use as regenerative medicines. The paper also describes quality engineering techniques for precision process design and improvement, and identifies the requirements for manufacturing technology and measurement systems evolution for such therapies.

Network design and quality checks in automatic orientation of close-range photogrammetric blocks.

PubMed

Dall'Asta, Elisa; Thoeni, Klaus; Santise, Marina; Forlani, Gianfranco; Giacomini, Anna; Roncella, Riccardo

2015-04-03

Due to the recent improvements of automatic measurement procedures in photogrammetry, multi-view 3D reconstruction technologies are becoming a favourite survey tool. Rapidly widening structure-from-motion (SfM) software packages offer significantly easier image processing workflows than traditional photogrammetry packages. However, while most orientation and surface reconstruction strategies will almost always succeed in any given task, estimating the quality of the result is, to some extent, still an open issue. An assessment of the precision and reliability of block orientation is necessary and should be included in every processing pipeline. Such a need was clearly felt from the results of close-range photogrammetric surveys of in situ full-scale and laboratory-scale experiments. In order to study the impact of the block control and the camera network design on the block orientation accuracy, a series of Monte Carlo simulations was performed. Two image block configurations were investigated: a single pseudo-normal strip and a circular highly-convergent block. The influence of surveying and data processing choices, such as the number and accuracy of the ground control points, autofocus and camera calibration was investigated. The research highlights the most significant aspects and processes to be taken into account for adequate in situ and laboratory surveys, when modern SfM software packages are used, and evaluates their effect on the quality of the results of the surface reconstruction.

Radiation accidents and their management: emphasis on the role of nuclear medicine professionals

PubMed Central

Novruzov, Fuad; Vinjamuri, Sobhan

2014-01-01

Large-scale radiation accidents are few in number, but those that have occurred have subsequently led to strict regulation in most countries. Here, different accident scenarios involving exposure to radiation have been reviewed. A triage of injured persons has been summarized and guidance on management has been provided in accordance with the early symptoms. Types of casualty to be expected in atomic blasts have been discussed. Management at the scene of an accident has been described, with explanation of the role of the radiation protection officer, the nature of contaminants, and monitoring for surface contamination. Methods for early diagnosis of radiation injuries have been then described. The need for individualization of treatment according to the nature and grade of the combined injuries has been emphasized, and different approaches to the treatment of internal contamination have been presented. The role of nuclear medicine professionals, including physicians and physicists, has been reviewed. It has been concluded that the management of radiation accidents is a very challenging process and that nuclear medicine physicians have to be well organized in order to deliver suitable management in any type of radiation accident. PMID:25004166

Radiation accidents and their management: emphasis on the role of nuclear medicine professionals.

PubMed

Bomanji, Jamshed B; Novruzov, Fuad; Vinjamuri, Sobhan

2014-10-01

Large-scale radiation accidents are few in number, but those that have occurred have subsequently led to strict regulation in most countries. Here, different accident scenarios involving exposure to radiation have been reviewed. A triage of injured persons has been summarized and guidance on management has been provided in accordance with the early symptoms. Types of casualty to be expected in atomic blasts have been discussed. Management at the scene of an accident has been described, with explanation of the role of the radiation protection officer, the nature of contaminants, and monitoring for surface contamination. Methods for early diagnosis of radiation injuries have been then described. The need for individualization of treatment according to the nature and grade of the combined injuries has been emphasized, and different approaches to the treatment of internal contamination have been presented. The role of nuclear medicine professionals, including physicians and physicists, has been reviewed. It has been concluded that the management of radiation accidents is a very challenging process and that nuclear medicine physicians have to be well organized in order to deliver suitable management in any type of radiation accident.

A preliminary study for the production of high specific activity radionuclides for nuclear medicine obtained with the isotope separation on line technique.

PubMed

Borgna, F; Ballan, M; Corradetti, S; Vettorato, E; Monetti, A; Rossignoli, M; Manzolaro, M; Scarpa, D; Mazzi, U; Realdon, N; Andrighetto, A

2017-09-01

Radiopharmaceuticals represent a fundamental tool for nuclear medicine procedures, both for diagnostic and therapeutic purposes. The present work aims to explore the Isotope Separation On-Line (ISOL) technique for the production of carrier-free radionuclides for nuclear medicine at SPES, a nuclear physics facility under construction at INFN-LNL. Stable ion beams of strontium, yttrium and iodine were produced using the SPES test bench (Front-End) to simulate the production of 89 Sr, 90 Y, 125 I and 131 I and collected with good efficiency on suitable targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

A new era for Nuclear Medicine neuroimaging in Spain: Where do we start from in Spain?

PubMed

Balsa, M A; Camacho, V; Garrastachu, P; García-Solís, D; Gómez-Río, M; Rubí, S; Setoain, X; Arbizu, J

To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123 I-FP-CIT, followed by brain perfusion SPECT and PET with 18 F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were cognitive impairment and movement disorders. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Development of the quality assessment model of EHR software in family medicine practices: research based on user satisfaction.

PubMed

Kralj, Damir; Kern, Josipa; Tonkovic, Stanko; Koncar, Miroslav

2015-09-09

Family medicine practices (FMPs) make the basis for the Croatian health care system. Use of electronic health record (EHR) software is mandatory and it plays an important role in running these practices, but important functional features still remain uneven and largely left to the will of the software developers. The objective of this study was to develop a novel and comprehensive model for functional evaluation of the EHR software in FMPs, based on current world standards, models and projects, as well as on actual user satisfaction and requirements. Based on previous theoretical and experimental research in this area, we made the initial framework model consisting of six basic categories as a base for online survey questionnaire. Family doctors assessed perceived software quality by using a five-point Likert-type scale. Using exploratory factor analysis and appropriate statistical methods over the collected data, the final optimal structure of the novel model was formed. Special attention was focused on the validity and quality of the novel model. The online survey collected a total of 384 cases. The obtained results indicate both the quality of the assessed software and the quality in use of the novel model. The intense ergonomic orientation of the novel measurement model was particularly emphasised. The resulting novel model is multiple validated, comprehensive and universal. It could be used to assess the user-perceived quality of almost all forms of the ambulatory EHR software and therefore useful to all stakeholders in this area of the health care informatisation.

Power quality considerations for nuclear spectroscopy applications: Grounding

NASA Astrophysics Data System (ADS)

García-Hernández, J. M.; Ramírez-Jiménez, F. J.; Mondragón-Contreras, L.; López-Callejas, R.; Torres-Bribiesca, M. A.; Peña-Eguiluz, R.

2013-11-01

Traditionally the electrical installations are designed for supplying power and to assure the personnel safety. In nuclear analysis laboratories, additional issues about grounding also must be considered for proper operation of high resolution nuclear spectroscopy systems. This paper shows the traditional ways of grounding nuclear spectroscopy systems and through different scenarios, it shows the effects on the more sensitive parameter of these systems: the energy resolution, it also proposes the constant monitoring of a power quality parameter as a way to preserve or to improve the resolution of the systems, avoiding the influence of excessive extrinsic noise.

Curriculum for education and training of medical physicists in nuclear medicine: recommendations from the EANM Physics Committee, the EANM Dosimetry Committee and EFOMP.

PubMed

Del Guerra, Alberto; Bardies, Manuel; Belcari, Nicola; Caruana, Carmel J; Christofides, Stelios; Erba, Paola; Gori, Cesare; Lassmann, Michael; Lonsdale, Markus Nowak; Sattler, Bernhard; Waddington, Wendy

2013-03-01

To provide a guideline curriculum covering theoretical and practical aspects of education and training for Medical Physicists in Nuclear Medicine within Europe. National training programmes of Medical Physics, Radiation Physics and Nuclear Medicine physics from a range of European countries and from North America were reviewed and elements of best practice identified. An independent panel of experts was used to achieve consensus regarding the content of the curriculum. Guidelines have been developed for the specialist theoretical knowledge and practical experience required to practice as a Medical Physicist in Nuclear Medicine in Europe. It is assumed that the precondition for the beginning of the training is a good initial degree in Medical Physics at master level (or equivalent). The Learning Outcomes are categorised using the Knowledge, Skill and Competence approach along the lines recommended by the European Qualifications Framework. The minimum level expected in each topic in the theoretical knowledge and practical experience sections is intended to bring trainees up to the requirements expected of a Medical Physicist entering the field of Nuclear Medicine. This new joint EANM/EFOMP European guideline curriculum is a further step to harmonise specialist training of Medical Physicists in Nuclear Medicine within Europe. It provides a common framework for national Medical Physics societies to develop or benchmark their own curricula. The responsibility for the implementation and accreditation of these standards and guidelines resides within national training and regulatory bodies. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Poster - 03: How to manage a nuclear medicine PET-CT for radiation oncology patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hinse, Martin; Létourneau, Étienne; Duplan, Danny

Purpose: Development of an adapted multidisciplinary procedure designed to optimize the clinical workflow between radiation therapy (RT) and nuclear medicine (NM) for a PET-CT located in the NM department. Methods : The radiation oncologist (RO) prescribes the PET-CT exam and the clinical RT therapist gives all the necessary information to the patient prior to the exam. The immobilization accessories are prepared in the RT department. The RT and NM therapists work together for radiotracer injection, patient positioning and scan acquisition. The nuclear medicine physician (NMP) will study the images, draw Biological Target Volumes (BTVs) and produce a full exam report.more » Results : All tasks related to a planning PET-CT are done within 48 hours from the request by the RO to the reception of the images with the NMP contours and report. Conclusions : By developing a complete procedure collectively between the RT and NM departments, the patient benefits of a quick access to a RT planning PET-CT exam including the active involvement of every medical practitioners in these fields.« less

Nuclear Medicine Imaging of Prostate Cancer.

PubMed

Schreiter, V; Reimann, C; Geisel, D; Schreiter, N F

2016-11-01

The new tracer Gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) yields new promising options for the PET/CT diagnosis of prostate cancer (PCa) and its metastases. To overcome limitations of hybrid imaging, known from the use of choline derivatives, seems to be possible with the use of Ga-68 PSMA for PCa. The benefits of hybrid imaging with Ga-68 PSMA for PCa compared to choline derivatives shall be discussed in this article based on an overview of the current literature. Key Points: • Ga-68 PSMA PET/CT can achieve higher detection rates of PCa lesions than PET/CT performed with choline derivatives• The new tracer Ga-68 PSMA has the advantage of high specificity, independence of PSA-level and low nonspecific tracer uptake in surrounding tissue• The new tracer Ga-68 PSMA seems very suitable for MR-PET diagnostic Citation Format: • Schreiter V, Reimann C, Geisel D et al. Nuclear Medicine Imaging of Prostate Cancer. Fortschr Röntgenstr 2016; 188: 1037 - 1044. © Georg Thieme Verlag KG Stuttgart · New York.