European Atlas of Natural Radiation

Natural ionizing radiation is considered as the largest contributor to the collective effective dose received by the world population. The human population is continuously exposed to ionizing radiation from several natural sources that can be classified into two broad categories: high-energy cosmic rays incident on the Earth’s atmosphere and releasing secondary radiation (cosmic contribution); and radioactive nuclides generated during the formation of the Earth and still present in the Earth’s crust (terrestrial contribution). Terrestrial radioactivity is mostly produced by the uranium and thorium radioactive families together with potassium. In most circumstances, radon, a noble gas produced in the radioactive decay of uranium, is the most important contributor to the total dose. This Atlas aims to present the current state of knowledge of natural radioactivity, by giving general background information, and describing its various sources. This reference material is complemented by a collection of maps of Europe displaying the levels of natural radioactivity caused by different sources. It is a compilation of contributions and reviews received from more than 80 experts in their field: they come from universities, research centres, national and European authorities and international organizations. This Atlas provides reference material and makes harmonized datasets available to the scientific community and national competent authorities. In parallel, this Atlas may serve as a tool for the public to: • familiarize itself with natural radioactivity; • be informed about the levels of natural radioactivity caused by different sources; • have a more balanced view of the annual dose received by the world population, to which natural radioactivity is the largest contributor; • and make direct comparisons between doses from natural sources of ionizing radiation and those from man-made (artificial) ones, hence to better understand the latter.JRC.G.10-Knowledge for Nuclear Security and Safet

Job (dis-)satisfaction in pay-for-performance health care contexts: A meta-synthesis of qualitative literature

Abstract Purpose Drawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to investigate the effect of a P4P-based system on job satisfaction and dissatisfaction among health care workers. Design/methodology/approach A meta-synthesis of the qualitative literature was conducted to investigate health care workers' opinions, perceptions and behaviors and fully understand what processes generate job satisfaction or dissatisfaction under P4P systems. Findings The findings suggest that P4P systems impact the job (dis-)satisfaction of health care workers based on the institutional, organizational, geographic and cultural context of reference. Specifically, job satisfaction – and thus motivation, occupational well-being and work engagement – can occur when the context is supportive, whereas job dissatisfaction – and thus work stress and pressure, burnout and work-life balance issues and distraction – is generated in the case of unsupportive contexts. Moreover, the findings suggest a virtuous/vicious circle whereby job satisfaction leads to positive performance and further fuels job satisfaction, while conversely job dissatisfaction generates worse performance, and this further worsens worker satisfaction. Originality/value There is a lack of studies comparing and analyzing current evidence on the job (dis-)satisfaction of health care workers operating in different contexts based on the reward system. This is the first research to analyze a significant number of studies with reference to the relation between P4P and job (dis-)satisfaction, which are topics in need of further study and investigation in health care settings around the world

Ultrasound-guided parasternal injection in dogs: a cadaver study

Objectives: To describe the technique of performing an ultrasound-guided distal parasternal intercostal block and to determine the distribution of two volumes of methylene blue dye solution injected in canine cadavers. Study design: Prospective cadaver study. Animals: A group of seven canine cadavers weighing 12–34 kg. Methods: The space between the transversus thoracic and the internal intercostal muscles is a virtual cavity. Ultrasound-guided injections in the distal (parasternal) intercostal space were performed using dye solution at 0.05 mL kg–1 in each intercostal space from the second to seventh (LV, low volume, six injections per dog) in one hemithorax, and 0.1 mL kg–1 in the third, fifth and seventh intercostal spaces (HV, high volume, three injections in each dog) on the contralateral side. Anatomical dissection was carried out to describe dye spread characteristics and staining of intercostal nerves. Results: The ultrasonographic landmarks for injection were identified in each cadaver. In the LV group the solution was found in every intercostal space (36/36), whereas the HV injection stained six intercostal spaces in two dogs, five in two, and in two dogs the solution was found in four and three spaces, respectively, demonstrating multisegmental distribution. Intrapleural staining was observed after two injections. Conclusions and clinical relevance: Ultrasound-guided injection of 0.05 mL kg–1 at the distal intercostal space resulted in staining of the intercostal nerve in all dogs when performed in every space and may be an appropriate alternative to previously reported techniques. A single injection of 0.1 mL kg–1 may anaesthetize more than one intercostal nerve, but not consistently. Clinical investigations are warranted to better characterize and to refine this locoregional technique

New economic challenges for managing disease prevention and monitoring

Managing disease prevention and monitoring its progression benefits professionals facing the challenge of acquiring new knowledge and information for fighting the many diseases that negatively affect the life of people in areas such as public health systems, families, economic and business systems. From economic and operational points of view, Cancer Registries as organisations managing information by collecting, storing, reporting and interpreting data to improve cancer monitoring which is needed to plan health policies evaluation and design. Sustaining the role of the Cancer Registry as information system for fighting against cancer relies on paying attention on regulatory and ethical aspects with regard to the protection of confidential data, understanding and meeting the organisational challenges, learning from theory and practice emerging from the comparison of international experiences, bringing together voluntary, private initiatives of associations and public programs for sustaining the relevance of gathering and collecting data, information for knowledge about managing prevention and monitoring of the disease as core competence for driving public health systems towards sustainable development.Regulatory and organizational infrastructures help improve both information and knowledge management and design and implement effective measures and initiatives leading to efficacy in preventing and monitoring cancer disease as support to medical scientific research for cancer cure

New economic challenges for managing disease prevention and monitoring

Managing disease prevention and monitoring its progression benefits professionals facing the challenge of acquiring new knowledge and information for fighting the many diseases that negatively affect the life of people in areas such as public health systems, families, economic and business systems. From economic and operational points of view, Cancer Registries as organisations managing information by collecting, storing, reporting and interpreting data to improve cancer monitoring which is needed to plan health policies evaluation and design. Sustaining the role of the Cancer Registry as information system for fighting against cancer relies on paying attention on regulatory and ethical aspects with regard to the protection of confidential data, understanding and meeting the organisational challenges, learning from theory and practice emerging from the comparison of international experiences, bringing together voluntary, private initiatives of associations and public programs for sustaining the relevance of gathering and collecting data, information for knowledge about managing prevention and monitoring of the disease as core competence for driving public health systems towards sustainable development.Regulatory and organizational infrastructures help improve both information and knowledge management and design and implement effective measures and initiatives leading to efficacy in preventing and monitoring cancer disease as support to medical scientific research for cancer cure