Providing and Receiving Feedback: It Takes Two to Tango!

Effective feedback is essential for maximizing learning, improving teacher effectiveness, and ensuring optimal team performance. Despite how critical feedback is to patient care, many educators find it difficult to provide feedback, and learners sometimes feel uncomfortable receiving feedback

Pediatric imaging: Current and emerging techniques

Imaging has always been an important component of the clinical evaluation of pediatric patients. Rapid technological advances in imaging are making noninvasive evaluation of a wide range of pediatric diseases possible. Ultrasound and magnetic resonance imaging (MRI) are two imaging modalities that do not involve ionizing radiation and are preferred imaging modalities in the pediatric population. Computed tomography (CT) remains the imaging modality with the highest increase in utilization in children due to its widespread availability and rapid image acquisition. Emerging imaging applications to be discussed include MR urography, voiding urosonography with use of ultrasound contrast agents, CT dose reduction techniques, MR enterography for inflammatory bowel disease, and MR cine airway imaging

The role of imaging in gastrointestinal bleed.

Gastrointestinal (GI) bleed accounts for approximately 20% of emergency visits; 2% of hospital admissions and its incidence has been increasing. In patients where the GI bleed does not stop spontaneously, intervention is required to identify the source of bleeding and stop the hemorrhage. Although identifying the source of bleeding can be challenging due to the vast number of underlying etiologies, radiology plays a vital role in patients where endoscopy and/or medical management fail. Radiology offers both non-invasive and invasive options for the diagnosis as well as management of GI bleeds. Scintigraphy and computed tomography angiography (CTA) are the most important non-invasive imaging tests that can identify presence of and help locate the site of bleeding and are used when the patient is hemodynamically stable. If the patient is hemodynamically unstable, conventional angiography (CA) allows diagnosis of the presence, site of bleeding as well as the means of treating the bleed by embolization. Our review article focuses on the various etiologies of GI bleed, the role of imaging in diagnosis as well as treatment of these patients based on the underlying etiologies, the merits and disadvantages of each of these modalities with emphasis on triaging patients for the most appropriate imaging test to guide the most suitable management

Pediatric imaging: Current and emerging techniques

Imaging has always been an important component of the clinical evaluation of pediatric patients. Rapid technological advances in imaging are making noninvasive evaluation of a wide range of pediatric diseases possible. Ultrasound and magnetic resonance imaging (MRI) are two imaging modalities that do not involve ionizing radiation and are preferred imaging modalities in the pediatric population. Computed tomography (CT) remains the imaging modality with the highest increase in utilization in children due to its widespread availability and rapid image acquisition. Emerging imaging applications to be discussed include MR urography, voiding urosonography with use of ultrasound contrast agents, CT dose reduction techniques, MR enterography for inflammatory bowel disease, and MR cine airway imaging

Dose linearity and uniformity of Siemens ONCOR impression plus linear accelerator designed for step-and-shoot intensity-modulated radiation therapy

For step-and-shoot type delivery of intensity-modulated radiation therapy (IMRT), beam stability characteristics during the first few monitor units need to be investigated to ensure the planned dose delivery. This paper presents the study done for Siemens ONCOR impression plus linear accelerator before commissioning it for IMRT treatment. The beam stability for 6 and 15 MV in terms of dose monitor linearity, monitor unit stability and beam uniformity is investigated in this work. Monitor unit linearity is studied using FC65G chamber for the range 1-100 MU. The dose per MU is found to be linear for small monitor units down to 1 MU for both 6 and 15 MV beams. The monitor unit linearity is also studied with portal imaging device for the range 1-20 MU for 6 MV beam. The pixel values are within ±1σ confidence level up to 2 MU; for 1 MU, the values are within ±2σ confidence level. The flatness and symmetry analysis is done for both energies in the range of 1-10 MU with Kodak diagnostic films. The flatness and symmetry are found to be within ±3% up to 2 MU for 6 MV and up to 3 MU for 15 MV

Dosimetric and QA aspects of Konrad inverse planning system for commissioning intensity-modulated radiation therapy

The intensity-modulated radiation therapy (IMRT) planning is performed using the Konrad inverse treatment planning system and the delivery of the treatment by using Siemens Oncor Impression Plus linear accelerator (step and shoot), which has been commissioned recently. The basic beam data required for commissioning the system were generate. The quality assurance of relative and absolute dose distribution was carried out before clinical implementation. The salient features of Konrad planning system, like dependence of grid size on dose volume histogram (DVH), number of intensity levels and step size in sequencer, are studied quantitatively and qualitatively