Quality assurance of radiodiagnostic equipment -Overview of literature since 2004

Het Britse handboek voor de kwaliteitsborging (Quality Assurance) van CT-scanners en andere rontgentoestellen, kan met enkele aanpassingen ook in Nederland gebruikt worden. Dit blijkt uit een literatuurstudie van het RIVM naar de kwaliteitsborging van deze apparaten. Beelden van CT-scanners en andere rontgentoestellen moeten goed genoeg zijn om een juiste diagnose te kunnen stellen. Ze worden gemaakt met rontgenstraling en die is schadelijk voor de gezondheid. De beelden worden echter vaak beter als er meer straling wordt gebruikt. Om goede beelden te krijgen met een zo laag mogelijke stralingsdosis is er veel aandacht nodig voor het optimaal laten functioneren van de apparatuur. Het geheel van maatregelen die hieraan bijdragen wordt kwaliteitsborging genoemd. Er is in Nederland geen algemeen handboek voor de kwaliteitsborging van CT-scanners en andere rontgenapparaten. Uit het onderzoek van het RIVM blijkt dat het Britse handboek, aangevuld met enkele andere documenten, vrij eenvoudig naar de Nederlandse praktijk vertaald kan worden. Wel is er nog een enkele toevoeging nodig en moeten grenswaarden worden aangepast aan de Nederlandse regelgeving.The British handbook on quality assurance of CT and other x-ray equipment may, with some adaptations, also be used in the Netherlands. This is the main conclusion of a literature study by RIVM on quality assurance of such equipment. Images from CT scanners and other x-ray equipment must have sufficient quality to enable a correct diagnosis. They are obtained using x-rays, which have adverse health effects. However, in diagnostic imaging, higher x-ray doses often lead to better image quality. To obtain good images while keeping the radiation dose as low as reasonably achievable, much attention is needed for the optimal performance of the equipment. Quality assurance is the complex of all measures needed to achieve this. A general handbook on quality assurance of CT and other x-ray equipment adapted to the Dutch practice does not exist. The literature study by RIVM shows that it should be relatively straightforward to adapt, with some additions, the British handbook to the Dutch practice and legislation.Inspectie voor de Gezondheidszor

Comment on the Shiner-Davison-Landsberg Measure

The complexity measure from Shiner et al. [Physical Review E 59, 1999, 1459-1464] (henceforth abbreviated as SDL-measure) has recently been the subject of a fierce debate. We discuss the properties and shortcomings of this measure, from the point of view of our recently constructed fundamental, statistical mechanics-based measures of complexity Cs(γ,β) [Stoop et al., J. Stat. Phys. 114, 2004, 1127-1137]. We show explicitly, what the shortcomings of the SDL-measure are: It is over-universal, and the implemented temperature dependence is trivial. We also show how the original SDL-approach can be modified to rule out these points of critique. Results of this modification are shown for the logistic parabol

Quality assurance for the optimization of patient dose in interventional radiology

Drie maatregelen kunnen de dosis straling optimaliseren die patienten ontvangen tijdens radiologische interventies. Ten eerste moderne apparatuur gebruiken die speciaal geschikt is voor interventies. Ten tweede extra aandacht schenken aan stralingsbescherming tijdens opleidingen op het gebied van de interventieradiologie. En tot slot complicaties van straling opnemen in het complicatieregister van de sectie Interventieradiologie van de Nederlandse Vereniging voor Radiologie. Dit blijkt uit onderzoek dat het RIVM in opdracht van de Inspectie voor de Gezondheidszorg heeft uitgevoerd naar de kwaliteitsborging van de interventieradiologie in Nederland. De opdracht is ingegeven door de relatief hoge stralingsdosis waaraan patienten kunnen worden blootgesteld tijdens radiologische interventies. Bij interventieradiologie worden medische behandelingen uitgevoerd via een kleine opening in de huid, terwijl die ingreep in beeld wordt gebracht met behulp van rontgen, CT, MRI of echografie. Bij gebruik van rontgen of CT kan de stralingsdosis leiden tot nadelige effecten voor de gezondheid, zoals roodheid, verbranding van de huid, (tijdelijke) ontharing of op de lange termijn kanker.Three measures may optimize the radiation dose that patients receive during interventional radiology procedures. The first is by using modern equipment that is appropriate for interventional radiology procedures, while the second involves paying extra attention to radiation protection in courses in the field of interventional radiology. A final measure is to incorporate radiation-related complications into the complication register of the Interventional Radiology section of the Dutch Association for Radiology. This was found in an investigation of quality assurance in interventional radiology in the Netherlands that was assigned to RIVM by the Dutch Health Inspectorate. The investigation was motivated by the relatively high radiation dose that patients undergoing an interventional radiology procedure may be exposed to. In interventional radiology, medical treatment is applied through a small opening in the skin, while the procedure is monitored using medical imaging such as X-ray, CT, MRI or ultrasound. In the case of X-ray or CT, the radiation dose may cause adverse health effects such as erythema, burnt skin, (temporary) epilation or, in the long term, cancer.Inspectie voor de Gezondheidszor

Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma.

Study Design:Retrospective cohort study. Objectives:(1) To assess patient-reported outcomes-physical function, pain, and quality of life-in patients who underwent resection of a mobile spine chondrosarcoma. (2) To assess complications (90 days), readmissions, reoperations, oncological outcomes, and neurologic status. Methods:Thirty-three patients with spinal conventional chondrosarcoma resection between 1984 and 2014 at one hospital were included. The primary outcome measures were-minimally 6 months after surgery-the EuroQol 5 Dimensions (EQ5D), PROMIS-Physical Function, PROMIS-Pain Intensity, and Oswestry (ODI) Disability Index, or Neck (NDI) Disability established in 14 out of 20 alive (70.0%) patients. Complications, readmission, reoperations, oncological outcomes, and neurological status were reported for the complete cohort of 33 patients. Results:After spine chondrosarcoma resection, patients (n = 14) reported worse physical function (median 43, range 22-61, P = .026), worse quality of life (median EQ5D 0.70, range 0.04-1, P = .022), and comparable pain intensity (median 47, range 31-56, P = .362) when compared with US general population values. The median NDI/ODI was 25 (range 0-72) indicating mild to moderate disability. Patients undergoing reoperation had worse patient-reported outcomes than those who did not. Eighteen (55.5%) out of 33 patients suffered complications (90 days), 14 (42.4%) had unplanned readmission, and 13 (39.4%) underwent reoperation. Intralesional resection was associated with increased readmission, reoperation, and recurrence rate. Conclusions:Chondrosarcoma affects quality of life and physical function and its treatment frequently results in complications and reoperations. Our findings can be used to inform future patients about expected outcomes

Мои воспоминания об Иване Георгиевиче Спасском

Стислі спогади автора про відомого вченого-нумізмата й музейника І.Г. Спаського та його сім’ю.Краткие воспоминания автора об известном ученом-нумизмате и музейщике И.Г. Спасском и его семье.Short author’s memories about known scientist-numismatist and museum-worker I.G. Spassky and his family

The use of mid-infrared spectrometry to predict body energy status of Holstein cows

Energy balance, especially in early lactation, is known to be associated with subsequent health and fertility in dairy cows. However, its inclusion in routine management decisions or breeding programs is hindered by the lack of quick, easy, and inexpensive measures of energy balance. The objective of this study was to evaluate the potential of mid-infrared (MIR) analysis of milk, routinely available from all milk samples taken as part of large-scale milk recording and milk payment operations, to predict body energy status and related traits in lactating dairy cows. The body energy status traits investigated included energy balance and body energy content. The related traits of body condition score and energy intake were also considered. Measurements on these traits along with milk MIR spectral data were available on 17 different test days from 268 cows (418 lactations) and were used to develop the prediction equations using partial least squares regression. Predictions were externally validated on different independent subsets of the data and the results averaged. The average accuracy of predicting body energy status from MIR spectral data was as high as 75% when energy balance was measured across lactation. These predictions of body energy status were considerably more accurate than predictions obtained from the sometimes proposed fat-to-protein ratio in milk. It is not known whether the prediction generated from MIR data are a better reflection of the true (unknown) energy status than the actual energy status measures used in this study. However, results indicate that the approach described may be a viable method of predicting individual cow energy status for a large scale of application

Psychology students’ perception of and engagement with feedback as a function of year of study

Undergraduate students’ perception of feedback and level of engagement with the feedback they receive have gained increasing attention in the educational literature recently to identify areas which require educators’ attention. However, research in this area has generally been based on limited self-selecting samples, and has not considered how students’ relationship with feedback may alter depending on their year of study. To address this, a survey measuring students’ views and practices regarding feedback was completed at a higher education institution by 447 first-, second- and third-year psychology students, representing 77% of the cohort. Findings revealed that third years responded more negatively in both areas than their first- and second-year counterparts, whose ratings on these aspects themselves were far from optimal. These findings highlight the need for early interventions to improve students’ perception of and engagement with feedback in the earlier years, and to prevent the recorded deterioration later on in the degree course

Inter-organisational communication networks in healthcare: centralised versus decentralised approaches

Background: To afford efficient and high quality care, healthcare providers increasingly need to exchange patient data. The existence of a communication network amongst care providers will help them to exchange patient data more efficiently. Information and communication technology (ICT) has much potential to facilitate the development of such a communication network. Moreover, in order to offer integrated care interoperability of healthcare organizations based upon the exchanged data is of crucial importance. However, complications around such a development are beyond technical impediments. Objectives: To determine the challenges and complexities involved in building an Inter-organisational Communication network (IOCN) in healthcare and the appropriations in the strategies. Case study: Interviews, literature review, and document analysis were conducted to analyse the developments that have taken place toward building a countrywide electronic patient record and its challenges in The Netherlands. Due to the interrelated nature of technical and non-technical problems, a socio-technical approach was used to analyse the data and define the challenges. Results: Organisational and cultural changes are necessary before technical solutions can be applied. There are organisational, financial, political, and ethicolegal challenges that have to be addressed appropriately. Two different approaches, one ‘‘centralised’’ and the other ‘‘decentralised’’ have been used by Dutch healthcare providers to adopt the necessary changes and cope with these challenges. Conclusion: The best solutions in building an IOCN have to be drawn from both the centralised and the decentralised approaches. Local communication initiatives have to be supervised and supported centrally and incentives at the organisations’ interest level have to be created to encourage the stakeholder organisations to adopt the necessary changes