ASSESSMENT OF OCCUPATIONAL EXPOSURE OF RADIATION WORKERS AT A TERTIARY HOSPITAL IN ANHUI PROVINCE, CHINA, DURING 2013–18

2020 ◽  
Vol 190 (3) ◽  
pp. 237-242
Author(s):  
Guoliang Zhang ◽  
Jianmin Shen ◽  
Pin Bao ◽  
Ziqin Yao ◽  
Yuan Yuan ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Individual Dose ◽  
Radiologic Technologists ◽  
Female Workers ◽  
Significant Difference ◽  
Radiation Workers ◽  
Effective Doses ◽  
The Individual ◽  
Occupational Radiation ◽  
Average Individual

Abstract Data on occupational radiation exposure of radiation workers at a tertiary hospital in China during 2013–18 were analyzed to provide decision-making advice for hospitals and health administrative departments. A total of 1255 exposure records of radiation workers were collected. The average annual effective doses of radiation workers during 2013–18 was 0.4977 mSv, with 1150 (91.63%) records ranging between 0 and 1 mSv, 91 (7.25%) between 1 and 2 mSv, 10 (0.80%) between 2 and 5 mSv and 4 (0.32%) records exceeding 5 mSv. There was a significant difference in the average annual effective dose of radiation workers among different occupational categories except in 2015 indicating that hospitals and administrative authorities should pay more attention to the radiation workers in the nuclear medicine and intervention department. The average annual effective doses did not show significant differences between male and female workers except in 2017; in that year the average individual dose of female workers was higher than male workers’. There were no significant differences in the average annual effective doses among doctors, nurses and radiologic technologists except in 2016 and 2017; during that period the individual dose of nurses was higher than doctors’ and radiologic technologists’.

Recommendation of dose banding of cytotoxics according to pharmacokinetic criteria.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2549-2549
Author(s):  
Etienne Chatelut ◽  
Melanie White-Koning ◽  
Ron H.J. Mathijssen ◽  
Sharyn D. Baker ◽  
Alex Sparreboom
Keyword(s):  
Capacity Planning ◽  
Simple Procedure ◽  
Drug Stability ◽  
Exposure Dose ◽  
Analytical Control ◽  
Individual Dose ◽  
Significant Difference ◽  
Patient Waiting Time ◽  
The Individual

2549 Background: Dose-banding has been recently suggested in order to optimize chemotherapy preparation. Ranges (or bands) of body surface area (BSA) are predefined. The individual dose of a particular patient is calculated according to a single BSA value per band, usually the mid-point of the BSA band in which the actual BSA of the patient lies. Thanks to this simple procedure, chemotherapy provision can be rationalized and chemotherapies can be prepared in advance for drugs with sufficient long-term drug stability. The primary purpose of dose-banding is to reduce patient waiting time and improve capacity planning of the pharmacy production, but additional benefits can also be found, such as reduced potential for medication errors, reduced drug wastage, and prospective quality control of preparations. The objective of this analysis was to compare dose-banding to individual BSA-dosing (current practice) according to pharmacokinetic (PK) criteria. Methods: Dose-banding was defined according to three bands of BSA: BSA<1.7m², 1.7m²≤BSA<1.9m², and BSA≥1.9m² for which the values of 1.55m², 1.80m², and 2.05m² were allocated, respectively. By using individual actual values of clearance of six drugs (cisplatin, docetaxel, paclitaxel, doxorubicin, topotecan, and irinotecan) from a total of 1,206 adult cancer patients, the AUCs corresponding to the two dosing methods were compared to a target value of AUC for each drug. Results: Over all 6 drugs, by using dose-banding the percent change of individual dose in comparison with BSA dosing ranged between -14% and +22%. In terms of capacity to attain the target AUC, there was no significant difference in precision when using dose-banding as compared to BSA-dosing for all drugs except paclitaxel (precision of 23.2% versus 21.8%, respectively). For all drugs including paclitaxel, distributions of AUC values were very similar with both dosing methods. Conclusions: For these 6 drugs and maybe others, dose-banding may be implemented without any risk of increasing interindividual plasma exposure. Dose-banding would make it possible to anticipate chemotherapy preparation and analytical control without any delay for the patients.

OCCUPATIONAL EXPOSURE TO EXTERNAL IONISING RADIATION IN TANZANIA (2011–17)

2019 ◽  
Vol 185 (2) ◽  
pp. 208-214
Author(s):  
Wilbroad Edward Muhogora ◽  
Firm Paul Banzi ◽  
Justin Emanuel Ngaile ◽  
Wilson Maliyatabu Ngoye ◽  
Usha Sara Lema ◽  
...  
Keyword(s):  
Effective Dose ◽  
Distribution Ratio ◽  
Dose Distribution ◽  
Individual Dose ◽  
Regulatory Enforcement ◽  
Exposed Population ◽  
The Individual ◽  
The Impact ◽  
Occupational Radiation ◽  
Average Effective Dose

Abstract The objectives of this paper were to evaluate the occupational radiation exposure data from 2011 to 2017 and to compare the results with status in 1996–2010 periods. The evaluation was performed in terms of annual collective effective dose, the average annual effective dose, the individual dose distribution ratio and the annual collective effective dose distribution ratio. Irrespective of work category, the results indicate that the average effective dose ranged from 0.64 to 1.55 mSv and broadly comparable to data in the previous analysis. Over seven year period, the maximum annual individual dose was 4 mSv and therefore below the dose limit of 20 mSv y−1. The impact of radiological practice on the exposed population was &lt;1.1 person.Sv. The results demonstrate satisfactory radiation protection conditions at workplaces, a situation which is mainly explained by the existing effective regulatory enforcement and improved workers’ awareness.

Writing in Aphasia Rehabilitation: Cursive vs Manuscript

1976 ◽  
Vol 41 (4) ◽  
pp. 523-529 ◽  
Author(s):  
Daniel R. Boone ◽  
Harold M. Friedman
Keyword(s):  
Correct Response ◽  
The Other ◽  
Read Aloud ◽  
Writing Style ◽  
Reading And Writing ◽  
Manual Responses ◽  
Significant Difference ◽  
Written Form ◽  
The Individual ◽  
Read Number

Reading and writing performance was observed in 30 adult aphasic patients to determine whether there was a significant difference when stimuli and manual responses were varied in the written form: cursive versus manuscript. Patients were asked to read aloud 10 words written cursively and 10 words written in manuscript form. They were then asked to write on dictation 10 word responses using cursive writing and 10 words using manuscript writing. Number of words correctly read, number of words correctly written, and number of letters correctly written in the proper sequence were tallied for both cursive and manuscript writing tasks for each patient. Results indicated no significant difference in correct response between cursive and manuscript writing style for these aphasic patients as a group; however, it was noted that individual patients varied widely in their success using one writing form over the other. It appeared that since neither writing form showed better facilitation of performance, the writing style used should be determined according to the individual patient’s own preference and best performance.

EVALUATION OF OCCUPATIONAL RADIATION EXPOSURE IN A RADIO-DIAGNOSTIC FACILITY IN KATSINA- NIGERIA

2020 ◽  
Vol 4 (2) ◽  
pp. 722-729
Author(s):  
Usman Sani ◽  
Bashir Gide Muhammad ◽  
Dimas Skam Joseph ◽  
D. Z. Joseph
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Short Exposure ◽  
Skin Dose ◽  
Continuous Training ◽  
Short Exposure Time ◽  
Occupational Dose ◽  
Dose Limits ◽  
Radiation Workers ◽  
Occupational Radiation

Poor implementation of quality assurance programs in the radiation industry has been a major setback in our locality. Several studies revealed that occupational workers are exposed to many potential hazards of ionizing radiation during radio-diagnostic procedures, yet radiation workers are often not monitored. This study aims to evaluate the occupational exposure of the radiation workers in Federal Medical Centre Katsina, and to compare the exposure with recommended occupational radiation dose limits. The quarterly readings of 20 thermo-luminescent dosimeters (TLDs') used by the radiation workers from January to December, 2019 were collected from the facility's radiation monitoring archive, and subsequently assessed and analyzed. The results indicate that the average annual equivalent dose per occupational worker range from 0.74 to 1.20 mSv and 1.28 to 2.21 mSv for skin surface and deep skin dose, measured at 10 mm and 0.07 mm tissue depth respectively. The occupational dose was within the recommended national and international limits of 5 mSv per annum or an average of 20 mSv in 5 years. Therefore, there was no significant radiation exposure to all the occupational workers in the study area. Though, the occupational radiation dose is within recommended limit, this does not eliminate stochastic effect of radiation. The study recommended that the occupational workers should adhere and strictly comply with the principles of radiation protection which includes distance, short exposure time, shielding and proper monitoring of dose limits. Furthermore, continuous training of the radiation workers is advised.

Aftermath Effect Of GST On Consumer Purchasing Power

2019 ◽  
Vol 118 (5) ◽  
pp. 122-131
Author(s):  
S. Thowseaf ◽  
M. Ayisha Millath ◽  
K. Malik Ali
Keyword(s):  
Living Standard ◽  
Purchasing Power ◽  
Percentage Increase ◽  
Defense System ◽  
Key Factors ◽  
Predominant Role ◽  
Tax System ◽  
Significant Difference ◽  
The Individual ◽  
Taxation System

Tax is an important source of income for the country. It is through tax; country strengthens its defense system, infrastructure, and government. Hence, tax system plays a predominant role in developing country’s economy. The complication in taxation system and liberty for taxpayers are key factors generating loopholes for corruption. GST is superior taxation system over VAT but, if neither properly implemented nor scrutinized according to the economy, it is people residing get affected.  GST taxation system is capable of increasing legal transaction, reducing corruption and complexity that exists in current taxation. India is 166th country to adopt GST and GST taxation slab in India is 0%, 5%, 12%, 18% and 28%.  Although average Tax levied is 14.8750% in India, it is 28% tax that is levied for most of the commodities, which are directly or indirectly used in everyday life of common individuals. Despite, GST being favorable to distributor in-terms of profit and government to attain tax by increasing legal transaction through invoice. It is noted that for the same percentage of taxation, the amount does not vary for VAT and GST. The tax slab decreased for 71 commodities and no change in 21 commodities; there has been an increase in tax slab for 60 commodities. 26% taxation was levied for most commodities considered was currently levied by 28% taxation which is greater than before. It was found that average tax percentage reduced was calculated to be 6.07143. The average tax percentage increase was calculated to be 4.7833 percentage for the considered commodities. The overall tax average tax percentage is estimated to be 14.8750% which does not have a significant difference concerning tax levied before GST, which was calculated to be 15.7829% for considered commodities. Therefore, the consumer purchasing power and overall living standard of the individual in India will remain almost same.

scholarly journals Effect of Surgical Setting on Hospital-Reported Outcomes for Elective Lumbar Spinal Procedures: Tertiary Versus Community Hospitals

2019 ◽  
Vol 10 (4) ◽  
pp. 375-383 ◽  
Author(s):  
Tristan B. Weir ◽  
Neil Sardesai ◽  
Julio J. Jauregui ◽  
Ehsan Jazini ◽  
Michael J. Sokolow ◽  
...  
Keyword(s):  
Pay For Performance ◽  
Linear Regression Analysis ◽  
Degenerative Spondylolisthesis ◽  
Hospital Costs ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Community Hospitals ◽  
Single Level ◽  
Significant Difference ◽  
Reported Data

Study Design: Retrospective cohort study. Objective: As hospital compensation becomes increasingly dependent on pay-for-performance and bundled payment compensation models, hospitals seek to reduce costs and increase quality. To our knowledge, no reported data compare these measures between hospital settings for elective lumbar procedures. The study compares hospital-reported outcomes and costs for elective lumbar procedures performed at a tertiary hospital (TH) versus community hospitals (CH) within a single health care system. Methods: Retrospective review of a physician-maintained, prospectively collected database consisting of 1 TH and 4 CH for 3 common lumbar surgeries from 2015 to 2016. Patients undergoing primary elective microdiscectomy for disc herniation, laminectomy for spinal stenosis, and laminectomy with fusion for degenerative spondylolisthesis were included. Patients were excluded for traumatic, infectious, or malignant pathology. Comparing hospital settings, outcomes included length of stay (LOS), rates of 30-day readmissions, potentially preventable complications (PPC), and discharge to rehabilitation facility, and hospital costs. Results: A total of 892 patients (n = 217 microdiscectomies, n = 302 laminectomies, and n = 373 laminectomy fusions) were included. The TH served a younger patient population with fewer comorbid conditions and a higher proportion of African Americans. The TH performed more decompressions ( P < .001) per level fused; the CH performed more interbody fusions ( P = .007). Cost of performing microdiscectomy ( P < .001) and laminectomy ( P = .014) was significantly higher at the TH, but there was no significant difference for laminectomy with fusion. In a multivariable stepwise linear regression analysis, the TH was significantly more expensive for single-level microdiscectomy ( P < .001) and laminectomy with single-level fusion ( P < .001), but trended toward significance for laminectomy without fusion ( P = .052). No difference existed for PPC or readmissions rate. Patients undergoing laminectomy without fusion were discharged to a facility more often at the TH ( P = .019). Conclusions: We provide hospital-reported outcomes between a TH and CH. Significant differences in patient characteristics and surgical practices exist between surgical settings. Despite minimal differences in hospital-reported outcomes, the TH was significantly more expensive.

scholarly journals A comparison between Asians and Caucasians in the dimensions of the femoral isthmus based on a 3D-CT analysis of 1189 adult femurs

2021 ◽  
Author(s):  
Darius M. Thiesen ◽  
Dimitris Ntalos ◽  
Alexander Korthaus ◽  
Andreas Petersik ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Strong Predictor ◽  
Matched Pair ◽  
3D Ct ◽  
Femur Fractures ◽  
Matched Pair Analysis ◽  
Significant Difference ◽  
Ct Analysis ◽  
Ct Data ◽  
The Individual

Abstract Introduction For successful intramedullary implant placement at the femur, such as nailing in unstable proximal femur fractures, the use of an implant that at least reaches or exceeds the femoral isthmus and yields sufficient thickness is recommended. A number of complications after intramedullary femoral nailing have been reported, particularly in Asians. To understand the anatomical features of the proximal femur and their ethnic differences, we aimed to accurately calculate the femoral isthmus dimensions and proximal distance of Asians and Caucasians. Methods In total, 1189 Asian and Caucasian segmented 3D CT data sets of femurs were analyzed. The individual femoral isthmus diameter was precisely computed to investigate whether gender, femur length, age, ethnicity or body mass index have an influence on isthmus diameters. Results The mean isthmus diameter of all femurs was 10.71 ± 2.2 mm. A significantly larger diameter was found in Asians when compared to Caucasians (p < 0.001). Age was a strong predictor of the isthmus diameter variability in females (p < 0.001, adjusted r2 = 0.299). With every year of life, the isthmus showed a widening of 0.08 mm in women. A Matched Pair Analysis of 150 female femurs showed a significant difference between isthmus diameter in Asian and Caucasian femurs (p = 0.05). In 50% of the cases the isthmus was found in a range of 2.4 cm between 16.9 and 19.3 cm distal to the tip of the greater trochanter. The female Asian femur differs from Caucasians as it is wider at the isthmus. Conclusions In absolute values, the proximal isthmus distance did not show much variation but is more proximal in Asians. The detailed data presented may be helpful in the development of future implant designs. The length and thickness of future standard implants may be considered based on the findings.

A Comparison of Colectomy Outcomes Utilizing Open, Laparoscopic, and Robotic Techniques

2020 ◽  
pp. 000313482097338
Author(s):  
Elizabeth McCarthy ◽  
Benjamin L. Gough ◽  
Michael S. Johns ◽  
Alexandra Hanlon ◽  
Sachin Vaid ◽  
...  
Keyword(s):  
Postoperative Recovery ◽  
Logistic Regression Models ◽  
Community Institution ◽  
Physical Status Classification ◽  
Estimated Blood Loss ◽  
Comparative Review ◽  
Significant Difference ◽  
American Society ◽  
The Individual ◽  
American Society Of Anesthesiologists

Introduction Robotic colectomy could reduce morbidity and postoperative recovery over laparoscopic and open procedures. This comparative review evaluates colectomy outcomes based on surgical approach at a single community institution. Methods A retrospective review of all patients who underwent colectomy by a fellowship-trained colon and rectal surgeon at a single institution from 2015 through 2019 was performed, and a cohort developed for each approach (open, laparoscopic, and robotic). 30-day outcomes were evaluated. For dichotomous outcomes, univariate logistic regression models were used to quantify the individual effect of each predictor of interest on the odds of each outcome. Continuous outcomes received a similar approach; however, linear and Poisson regression modeling were used, as appropriate. Results 115 patients were evaluated: 14% (n = 16) open, 44% (n = 51) laparoscopic, and 42% (n = 48) robotic. Among the cohorts, there was no statistically significant difference in operative time, rate of reoperation, readmission, or major complications. Robotic colectomies resulted in the shortest length of stay (LOS) (Kruskal-Wallis P < .0001) and decreased estimated blood loss (EBL) (Kruskal-Wallis P = .0012). Median age was 63 years (interquartile range [IQR] 53-72). 54% (n = 62) were female. Median American Society of Anesthesiologists physical status classification was 3 (IQR 2-3). Median body mass index was 28.67 (IQR 25.03-33.47). A malignant diagnosis was noted on final pathology in 44% (n = 51). Conclusion Among the 3 approaches, there was no statistically significant difference in 30-day morbidity or mortality. There was a statistically significant decreased LOS and EBL for robotic colectomies.

scholarly journals Predicting mortality in adults with suspected infection in a Rwandan hospital: an evaluation of the adapted MEWS, qSOFA and UVA scores

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040361
Author(s):  
Amanda Klinger ◽  
Ariel Mueller ◽  
Tori Sutherland ◽  
Christophe Mpirimbanyi ◽  
Elie Nziyomaze ◽  
...  
Keyword(s):  
Decision Making ◽  
Quality Improvement ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Tertiary Hospital ◽  
Early Warning Score ◽  
Receiver Operating Curve ◽  
Predictive Capacity ◽  
Suspected Infection ◽  
Significant Difference

RationaleMortality prediction scores are increasingly being evaluated in low and middle income countries (LMICs) for research comparisons, quality improvement and clinical decision-making. The modified early warning score (MEWS), quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and Universal Vital Assessment (UVA) score use variables that are feasible to obtain, and have demonstrated potential to predict mortality in LMIC cohorts.ObjectiveTo determine the predictive capacity of adapted MEWS, qSOFA and UVA in a Rwandan hospital.Design, setting, participants and outcome measuresWe prospectively collected data on all adult patients admitted to a tertiary hospital in Rwanda with suspected infection over 7 months. We calculated an adapted MEWS, qSOFA and UVA score for each participant. The predictive capacity of each score was assessed including sensitivity, specificity, positive and negative predictive value, OR, area under the receiver operating curve (AUROC) and performance by underlying risk quartile.ResultsWe screened 19 178 patient days, and enrolled 647 unique patients. Median age was 35 years, and in-hospital mortality was 18.1%. The proportion of data missing for each variable ranged from 0% to 11.7%. The sensitivities and specificities of the scores were: adapted MEWS >4, 50.4% and 74.9%, respectively; qSOFA >2, 24.8% and 90.4%, respectively; and UVA >4, 28.2% and 91.1%, respectively. The scores as continuous variables demonstrated the following AUROCs: adapted MEWS 0.69 (95% CI 0.64 to 0.74), qSOFA 0.65 (95% CI 0.60 to 0.70), and UVA 0.71 (95% CI 0.66 to 0.76); there was no statistically significant difference between the discriminative capacities of the scores.ConclusionThree scores demonstrated a modest ability to predict mortality in a prospective study of inpatients with suspected infection at a Rwandan tertiary hospital. Careful consideration must be given to their adequacy before using them in research comparisons, quality improvement or clinical decision-making.

Causes of delayed exploration of the acute scrotum in a regional tertiary centre

2020 ◽  
pp. 205141582098119
Author(s):  
Benjamin Storey ◽  
Nathan Shugg ◽  
Alison Blatt
Keyword(s):  
Retrospective Review ◽  
Testicular Torsion ◽  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
Acute Scrotum ◽  
Tertiary Institution ◽  
Level Of Evidence ◽  
Scrotal Pain ◽  
Surgical Exploration ◽  
Significant Difference

Background: Testicular torsion is an organ-threatening surgical emergency with a limited timeframe for intervention. Objective: To identify the delays to surgical exploration of patients with an acute scrotum in a tertiary hospital to prevent adverse outcomes associated with this time critical emergency. Methods: A retrospective review of medical records for all patients who underwent scrotal exploration for acute scrotal pain in a tertiary hospital in regional New South Wales between January 2008 to December 2018 was performed. Results: Retrospective review identified 242 patients, of whom 161 had testicular torsion and 56 resultant orchidectomies. No statistically significant difference in pre-hospital delays between paediatric or adult populations was found. The average time from presentation to theatre was 4 h 36 min. Patients who were delayed > 6 h from presentation to surgical exploration had significantly increased rates of orchidectomy. Delays that significantly affected rates of orchidectomy were transfer from peripheral sites, late presentation, misdiagnosis and representation after discharge. Conclusion: The most common reason for delay was diagnostic error with the patient later re-presenting to hospital. Patient transfer from the primary hospital to a tertiary institution and subsequent delayed surgical exploration also contributed to significantly higher rates of orchidectomy. Level of Evidence: 3

Sign in / Sign up

Export Citation Format

Share Document