Knowledge, attitude and perception on radiation imaging among children's caregivers in the pediatric dental clinic

OBJECTIVE: Nuclear medicine provides important clinical information for diagnostic and therapeutic purposes. Use of medical imaging has gradually increased in the United States and this has raised health concerns about the potential future risks associated with radiation exposure in children. While studies have evaluated the adverse effects of imaging procedures, there is insufficient evidence about communicating radiation risks. The overall purpose of this paper is to review radiation risks in pediatric imaging using published evidence by the World Health Organization and to evaluate the knowledge and attitude of caregivers towards radiation risks in pediatric imaging. Specifically, we aim to determine whether an educational brochure improves parental knowledge of radiation and/or changes in attitude and perception to allow their children to undergo dental radiographs. METHODS: A prospective sample survey was performed of caregivers who presented with their child to the Boston University Pediatric Oral Healthcare Center. Parents or legal guardians (18 years or older) who accompanied a child were eligible for inclusion and approached for enrollment. Pre- and post-survey questionnaires were used to evaluate parents’ or guardians’ level of knowledge and attitude about the risks and benefits of dental radiographs. Parents were also asked their comfort level to allow their child to undergo dental radiographs. After completing the pre-survey questionnaire, parents were asked to read the English-language informational handout. Statistical analysis was performed through Microsoft Excel 2013. Descriptive analysis was conducted to summarize the survey responses. RESULTS: Among 30 parents who were surveyed, a small proportion (30%) of parents were very comfortable with dentist using dental radiographs on their child, versus 57% after reading the handout. Results showed that the informational handout improved the parental knowledge of risks and benefits of ionizing radiation. Most parents indicated that the handout was helpful and they reported increased level of comfort and willingness in their children receiving radiation imaging during dental treatment procedures. DISCUSSION: Educating parents or caregivers through an informational handout is a helpful resource in improving their knowledge and in relieving their concerns. Informing parents about the risks of ionizing radiation does not change parental willingness for their children to undergo dental radiographs

Diagnosis of childhood tuberculosis and host RNA expression in Africa

Improved diagnostic tests for tuberculosis in children are needed. We hypothesized that transcriptional signatures of host blood could be used to distinguish tuberculosis from other diseases in African children who either were or were not infected with the human immunodeficiency virus (HIV

AAPM medical physics practice guideline 10.a.: Scope of practice for clinical medical physics.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline (MPPG) represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiation requires specific training, skills, and techniques as described in each document. As the review of the previous version of AAPM Professional Policy (PP)-17 (Scope of Practice) progressed, the writing group focused on one of the main goals: to have this document accepted by regulatory and accrediting bodies. After much discussion, it was decided that this goal would be better served through a MPPG. To further advance this goal, the text was updated to reflect the rationale and processes by which the activities in the scope of practice were identified and categorized. Lastly, the AAPM Professional Council believes that this document has benefitted from public comment which is part of the MPPG process but not the AAPM Professional Policy approval process. The following terms are used in the AAPM's MPPGs: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances

Space shuttle: Structural integrity and assessment study

A study program was conducted to determine the nondestructive evaluation (NDE) requirements and to develop a preliminary nondestructive evaluation manual for the entire space shuttle vehicle. The rationale and guidelines for structural analysis and NDE requirements development are discussed. Recommendations for development of NDE technology for the orbiter thermal protection system and certain structural components are included. Recommendations to accomplish additional goals toward space shuttle inspection are presented

The detection of tightly closed flaws by nondestructive testing (NDT) methods

Liquid penetrant, ultrasonic, eddy current and X-radiographic techniques were optimized and applied to the evaluation of 2219-T87 aluminum alloy test specimens in integrally stiffened panel, and weld panel configurations. Fatigue cracks in integrally stiffened panels, lack-of-fusion in weld panels, and fatigue cracks in weld panels were the flaw types used for evaluation. A 2319 aluminum alloy weld filler rod was used for all welding to produce the test specimens. Forty seven integrally stiffened panels containing a total of 146 fatigue cracks, ninety three lack-of-penetration (LOP) specimens containing a total of 239 LOP flaws, and one-hundred seventeen welded specimens containing a total of 293 fatigue cracks were evaluated. Nondestructive test detection reliability enhancement was evaluated during separate inspection sequences in the specimens in the 'as-machined or as-welded', post etched and post proof loaded conditions. Results of the nondestructive test evaluations were compared to the actual flaw size obtained by measurement of the fracture specimens after completing all inspection sequences. Inspection data were then analyzed to provide a statistical basis for determining the flaw detection reliability

The Pattern of Oral and Maxillofacial Injuries Among Patients Attending Muhimbili National Hospital, Dar es salaam, Tanzania

To determine the pattern of oral and maxillofacial injuries among patients attended at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Descriptive cross-sectional hospital based study. The study was done at oral and maxillofacial surgery firm and emergency medicine department of Muhimbili National Hospital (MNH). All patients who attended the Oral and Maxillofacial Surgery firm and Emergency Medicine departments of MNH for treatment of oral and maxillofacial injuries during the period of the study and consented were included in the study. An interview of the patients with oral and maxillofacial injuries was done through structured questionnaire to obtain relevant information from the patient. Social-demographic information (age, sex, address, education level and marital status), patient’s main complaint, type of injury, place where injury took place, cause of injury, general condition of patient immediately after injury and afterwards and the time interval from injury to reporting to hospital were recorded. Clinical findings were recorded as follows: type of injury, site of injury, single or multiple, soft tissue or hard tissue injury. Soft tissue injuries were categorized as bruises, abrasions, cut wound, contusion, lacerations, avulsions, and burn. Hard tissue injury was categorized as fracture of facial bones such as nasal bone, maxilla, mandible, zygoma, frontal palatal and orbital bones. Accompanying injuries to the TMJ were also recorded. Radiological investigations including plain skull radiography (posterior anterior view, Water’s view, submental vertex view), orthopantomograph and where necessary a computed tomography (CT) were ordered. The interpretation of the radiological investigations was done by the principal investigator with the assistance of an experienced clinician and was recorded in a special form as fracture or no fracture, site and type of fracture. Treatment offered and treatment outcomes were also recorded. For admitted patients the number of days spent in hospital was recorded against the type of injury and treatment done. The data was entered into computer and analysis was done using Statistical Package for Social Sciences programme (SPSS) Version 15. Association of maxillofacial injury parameters vii (demographic factors, aetiology, treatment and complications) and type of injuries was evaluated using Chi –square test (X2). Significant level p<0.05 was used to draw out conclusion. A total of 137 patients, 123 (89.8%) males and 14 (10.2%) females with the male- female ratio of 9:1 were included in this study. The age range was from 4 to 70 years with a mean age of 30.13 years. The 21-30 and 31-40 years age groups were the most affected. Road traffic accidents (RTA) were the most (64.2%) common causes of oral and maxillofacial injuries. The most common soft tissue injury was laceration in 63 (26.9%) patients followed by bruises in 57 (24.4%) and cut wounds in 54 (23.1%). Ninety-three patients (67.9%) had sustained fractures of either the mandible, mid face or both and of those 93 patients who sustained fracture, most had mandibular fractures 42 (45.2%). All patients received basic resuscitation procedures, for stabilization of the patient. Almost all (97.8%) patients with oral and maxillofacial injuries were given analgesics for pain control and prophylaxis antibiotics (96.4%). Surgical wound debridement and wound suturing were the most (62.8% and 53.3% respectively) common treatment for soft tissue injuries, while intermaxillary or mandibulomaxillary fixation was the most (51%) common hard tissue injuries treatment. A total of 27 (19.7%) patients suffered some complications after treatment. Infection was the most (59.3%) common complication followed by malunion (33.3%). This study showed that road traffic accidents were the most common cause of maxillofacial injuries. Assaults/interpersonal violence were the second most common cause of maxillofacial trauma. These findings should alert the authorities, particularly the government and the road safety commission to the need for improvement of our roads, enforcement of existing traffic laws, and improvement of socio-economic conditions of the general population

Experimental Demonstration of Multiple Monoenergetic Gamma Radiography for Effective Atomic Number Identification in Cargo Inspection

The smuggling of special nuclear materials (SNM) through international borders could enable nuclear terrorism and constitutes a significant threat to global security. This paper presents the experimental demonstration of a novel radiographic technique for quantitatively reconstructing the density and type of material present in commercial cargo containers, as a means of detecting such threats. Unlike traditional techniques which use sources of bremsstrahlung photons with a continuous distribution of energies, multiple monoenergetic gamma radiography (MMGR) utilizes monoenergetic photons from nuclear reactions, specifically the 4.4 and 15.1 MeV photons from the $^{11}$B(d,n$\gamma$)$^{12}$C reaction. By exploiting the $Z$-dependence of the photon interaction cross sections at these two specific energies it is possible to simultaneously determine the areal density and the effective atomic number as a function of location for a 2D projection of a scanned object. The additional information gleaned from using and detecting photons of specific energies for radiography substantially increases the resolving power between different materials. This paper presents results from the imaging of mock cargo materials ranging from $Z\approx5$--$92$, demonstrating accurate reconstruction of the effective atomic number and areal density of the materials over the full range. In particular, the system is capable of distinguishing pure materials with $Z\gtrsim70$, such as lead and uranium --- a critical requirement of a system designed to detect SNM. This methodology could be used to screen commercial cargoes with high material specificity, to distinguish most benign materials from SNM, such as uranium and plutonium.Comment: 15 pages, 12 figures, version 2 includes language/typographical edits and changes (chiefly additions) in response to reviewer