The validity and reliability of the exposure index as a metric for estimating the radiation dose to the patient

Introduction With the introduction of digital radiography, the feedback between image quality and over-exposure has been partly lost which in some cases has led to a steady increase in dose. Over the years the introduction of exposure index (EI) has been used to resolve this phenomenon referred to as ‘dose creep’. Even though EI is often vendor specific it is always a related of the radiation exposure to the detector. Due to the nature of this relationship EI can also be used as a patient dose indicator, however this is not widely investigated in literature. Methods A total of 420 dose-area-product (DAP) and EI measurements were taken whilst varying kVp, mAs and body habitus on two different anthropomorphic phantoms (pelvis and chest). Using linear regression, the correlation between EI and DAP were examined. Additionally, two separate region of interest (ROI) placements/per phantom where examined in order to research any effect on EI. Results When dividing the data into subsets, a strong correlation between EI and DAP was shown with all R-squared values > 0.987. Comparison between the ROI placements showed a significant difference between EIs for both placements. Conclusion This research shows a clear relationship between EI and radiation dose which is dependent on a wide variety of factors such as ROI placement, body habitus. In addition, pathology and manufacturer specific EI’s are likely to be of influence as well. Implications for practice The combination of DAP and EI might be used as a patient dose indicator. However, the influencing factors as mentioned in the conclusion should be considered and examined before implementation

Use of behaviour change techniques in lifestyle change interventions for people with intellectual disabilities: A systematic review

Background: People with intellectual disabilities (ID) experience more health problems and have different lifestyle change needs, compared with the general population. Aims: To improve lifestyle change interventions for people with ID, this review examined how behaviour change techniques (BCTs) were applied in interventions aimed at physical activity, nutrition or physical activity and nutrition, and described their quality. Methods and procedures: After a broad search and detailed selection process, 45 studies were included in the review. For coding BCTs, the CALO-RE taxonomy was used. To assess the quality of the interventions, the Physiotherapy Evidence Database (PEDro) scale was used. Extracted data included general study characteristics and intervention characteristics. Outcomes and results: All interventions used BCTs, although theory-driven BCTs were rarely used. The most frequently used BCTs were ‘provide information on consequences of behaviour in general’ and ‘plan social support/social change’. Most studies were of low quality and a theoretical framework was often missing. Conclusion and implications: This review shows that BCTs are frequently applied in lifestyle change interventions. To further improve effectiveness, these lifestyle change interventions could benefit from using a theoretical framework, a detailed intervention description and an appropriate and reliable intervention design which is tailored to people with ID

Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL

Non score-dependency: Theory and assessment

Untrained listeners demonstrate implicit knowledge of syntactic patterns and principles. Untrained generative music ability, for example singing, humming, and whistling, is a largely unconscious or intuitive application of these patterns and principles. From the viewpoint of embodied cognition, listening to music should evoke an internal representation or motor image which, together with the perception of organized music, should form the basis of musical cognition. Indeed, that is what listeners demonstrate when they sing, hum, or whistle familiar and unfamiliar tunes or when they vocally or orally improvise continuations to interrupted phrases. Research on vocal improvisation using continuations sung to an interrupted musical phrase, has shown that one’s cultural background influences the music generated. That should be the case for instrumentalists as well: when they play familiar or unfamiliar tunes by ear in different keys (transposition) or when they improvise variations, accompaniments, or continuations to interrupted phrases, the music they generate should reflect the same cognitive structures as their oral improvisations. This study is attempting to validate a test of (non) scoredependency that will enable assessment of the music student’s implicit knowledge of these structures during performance on the principal instrument