Core curriculum for medical physicists in radiology. Recommendations from an EFOMP/ESR working group

Some years ago it was decided that a European curriculum should be developed for medical physicists professionally engaged in the support of clinical diagnostic imaging departments. With this in mind, EFOMP (European Federation of Organisations for Medical Physics) in association with ESR (European Society of Radiology) nominated an expert working group. This curriculum is now to hand. The curriculum is intended to promote best patient care in radiology departments through the harmonization of education and training of medical physicists to a high standard in diagnostic radiology. It is recommended that a medical physicist working in a radiology department should have an advanced level of professional expertise in X-ray imaging, and additionally, depending on local availability, should acquire knowledge and competencies in overseeing ultrasound imaging, nuclear medicine, and MRI technology. By demonstrating training to a standardized curriculum, medical physicists throughout Europe will enhance their mobility, while maintaining local high standards of medical physics expertise. This document also provides the basis for improved implementation of articles in the European medical exposure directives related to the medical physics expert. The curriculum is divided into three main sections: The first deals with general competencies in the principles of medical physics. The second section describes specific knowledge and skills required for a medical physicist (medical physics expert) to operate clinically in a department of diagnostic radiology. The final section outlines research skills that are also considered to be necessary and appropriate competencies in a career as medical physicist

The impact of frailty on oral care behavior of older people: a qualitative study

BACKGROUND: Frailty has been demonstrated to negatively influence dental service-use and oral self-care behavior of older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use and oral self-care behavior of frail older people. METHODS: We conducted a qualitative study through 51 open interviews with elders of varying frailty in the East-Netherlands, and used a thematic analysis to code transcripts, discussions and reviews of the attributes and meaning of the themes to the point of consensus among the researchers. RESULTS: Three major themes and five sub-themes emerged from our analyses. The major themes indicate that frail elders: A) favor long-established oral hygiene routines to sustain a sense of self-worth; B) discontinue oral hygiene routines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and C) experience psychological and social barriers to oral health care when institutionalized. The subthemes associated with the discontinuation of oral care suggest that the elders accept more oral pain or discomfort because they: B1) lack belief in the results of dental visits and tooth cleaning; B2) trivialize oral health and oral care in the general context of their impaired health and old age; and B3) consciously use their sparse energy for priorities other than oral healthcare. Institutionalized elderly often discontinue oral care because of C1) disorientation and C2) inconveniencing social supports. CONCLUSION: The level and type of frailty influences people’s perspectives on oral health and related behaviors. Frail elders associate oral hygiene with self-worth, but readily abandon visits to a dentist unless they feel that a dentist can relieve specific problems. When interpreted according to the Motivational Theory of Life Span Development, discontinuation of oral care by frail elderly could be viewed as a manifestation of adaptive development. Simple measures aimed at recognizing indicators for poor oral care behavior, and providing appropriate information and support, are discussed

Experimental assessment of MRI-induced temperature change and SAR distributions in phantoms

During an MR procedure, most of the transmitted RF power is transformed into heat within the patients’ tissue resulting from resistive losses, referred to as the specific energy absorption rate(SAR) (2). The EU standardisation has mandated that all scanners must measure SAR in patients and develop system safeguards to ensure that the limits(IEC60602-3-33) are not exceeded. Accurate estimation of SAR is critical in safeguarding patients who may be unconscious/sedated, have implants or are pregnant. Modern MRI systems can easily exceed safe SAR levels (1) requiring the independent verification of manufacturers SAR estimations.non-peer-reviewe

Experimental and numerical assessment of MRI-induced temperature change and SAR distributions in phantoms

During an MR procedure, most of the transmitted RF power is transformed into heat within the patient’s tissue and implants as a result of resistive losses which is referred to as the specific energy absorption rate (SAR) (1). The European committee for electrotechnical standardisation (CENELEC) has mandated that all scanners must measure the specific absorption rate of radiofrequency in patients and develop system safeguards to ensure that the limits set out IEC 60602-3-33 are not exceeded. Accurate estimation of SAR is critical to safeguard in unconscious/sedated patients, patients with compromised thermoregulation, implant patients, pregnant patients and neonates who require an MRI procedure. The increased static field strength and RF duty cycle capabilities in modern MRI scanners means that systems can easily exceed safe SAR levels for patients (2). Advisory protocols routine used to establish QA protocols do not have advise on the testing of SAR levels in MRI and this is not routinely measured in annual medical physics QA. There is increasing need to verify the manufacturers SAR estimations.2018-12-3

Experimental and numerical assessment of MRI-induced temperature change and SAR distributions in phantoms

During an MR procedure, most of the transmitted RF power is transformed into heat within the patient’s tissue and implants as a result of resistive losses which is referred to as the specific energy absorption rate (SAR) (1). The European committee for electrotechnical standardisation (CENELEC) has mandated that all scanners must measure the specific absorption rate of radiofrequency in patients and develop system safeguards to ensure that the limits set out IEC 60602-3-33 are not exceeded. Accurate estimation of SAR is critical to safeguard in unconscious/sedated patients, patients with compromised thermoregulation, implant patients, pregnant patients and neonates who require an MRI procedure. The increased static field strength and RF duty cycle capabilities in modern MRI scanners means that systems can easily exceed safe SAR levels for patients (2). Advisory protocols routine used to establish QA protocols do not have advise on the testing of SAR levels in MRI and this is not routinely measured in annual medical physics QA. There is increasing need to verify the manufacturers SAR estimations.peer-reviewed2018-12-3

Experimental assessment of MRI-induced temperature change and SAR distributions in phantoms

During an MR procedure, most of the transmitted RF power is transformed into heat within the patients’ tissue resulting from resistive losses, referred to as the specific energy absorption rate(SAR) (2). The EU standardisation has mandated that all scanners must measure SAR in patients and develop system safeguards to ensure that the limits(IEC60602-3-33) are not exceeded. Accurate estimation of SAR is critical in safeguarding patients who may be unconscious/sedated, have implants or are pregnant. Modern MRI systems can easily exceed safe SAR levels (1) requiring the independent verification of manufacturers SAR estimations

An analysis of the impact on trends in automation on human error potential in brachytherapy

AbstractTechnologies under development in the field of radiotherapy offer the possibility of automating many of the remaining functions that are currently carried out by radiotherapy staff. If adopted, they are likely to significantly change the roles of health care professionals and modify the potential error profile of specific radiotherapy procedures. In this paper, a combination of allocation of functions methods, including Levels of Automation (LOA) [1] and Meister's prescriptive method [2], and the Human Error Analysis and Reduction Technique (HEART) [3] were used as the basis for an evaluation of the impact of increasing automation on the potential for human error in Low-Dose Rate Prostate Brachytherapy (LDRPB). An IDEFØ model of the brachytherapy treatment process previously developed by the authors was the starting point for the analysis. The process “Perform Implant” which currently has sub-processes that are under direct human control and others that utilize advanced technology was selected for analysis. The LOA model was applied to “Perform Implant” for three scenarios: current set-up, mixed-automaton and full automation. A modified set of risk criteria specified by the Irish Health Service Executive (HSE) [4] were used in conjunction with Meister's method to select the most appropriate mix of automation for further analysis. HEART was then applied to both the current set-up scenario and the selected scenario and the outcomes were compared. The HEART analysis provided one justification for the selection of a particular human-automation mix, though caution should be exercised as HEART requires further validation in the context of healthcare systems