scholarly journals Study of scattered radiation during fluoroscopy in hip surgery

2016 ◽  
Vol 49 (4) ◽  
pp. 234-240
Author(s):  
Oksana Lesyuk ◽  
Patrick Emmanuel Sousa ◽  
Sónia Isabel do Espirito Santo Rodrigues ◽  
António Fernando Abrantes ◽  
Rui Pedro Pereira de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Operating Room ◽  
Health Care Professionals ◽  
Scattered Radiation ◽  
Hip Surgery ◽  
Whole Body ◽  
X Ray ◽  
Dose Rates ◽  
Orthopedic Surgical Procedures ◽  
Low Levels

Abstract Objective: To measure the scattered radiation dose at different positions simulating hip surgery. Materials and Methods: We simulated fluoroscopy-assisted hip surgery in order to study the distribution of scattered radiation in the operating room. To simulate the patient, we used a anthropomorphic whole-body phantom, and we used an X-ray-specific detector to quantify the radiation. Radiographs were obtained with a mobile C-arm X-ray system in continuous scan mode, with the tube at 0º (configuration 1) or 90º (configuration 2). The operating parameters employed (voltage, current, and exposure time) were determined by a statistical analysis based on the observation of orthopedic surgical procedures involving the hip. Results: For all measurements, higher exposures were observed in configuration 2. In the measurements obtained as a function of height, the maximum dose rates observed were 1.167 (± 0.023) µSv/s and 2.278 (± 0.023) µSv/s in configurations 1 and 2, respectively, corresponding to the chest level of health care professionals within the operating room. Proximal to the patient, the maximum values were recorded in the position occupied by the surgeon. Conclusion: We can conclude that, in the scenario under study, health care professionals workers are exposed to low levels of radiation, and that those levels can be reduced through the use of personal protective equipment.

scholarly journals Creating Low-Cost 360-Degree Virtual Reality Videos for Hospitals: A Technical Paper on the Dos and Don�ts (Preprint)

2017 ◽  
Author(s):  
Benjamin O'Sullivan ◽  
Fahad Alam ◽  
Clyde Matava
Keyword(s):  
Health Care ◽  
Virtual Reality ◽  
Operating Room ◽  
Health Care Professionals ◽  
Low Cost ◽  
Adult Patients ◽  
Technical Aspects ◽  
Technical Paper ◽  
Virtual Experience ◽  
Children And Parents

UNSTRUCTURED This article will provide a framework for producing immersive 360-degree videos for pediatric and adult patients in hospitals. This information may be useful to hospitals across the globe who may wish to produce similar videos for their patients. Advancements in immersive 360-degree technologies have allowed us to produce our own “virtual experience” where our children can prepare for anesthesia by “experiencing” all the sights and sounds of receiving and recovering from an anesthetic. We have shown that health care professionals, children, and their parents find this form of preparation valid, acceptable and fun. Perhaps more importantly, children and parents have self-reported that undertaking our virtual experience has led to a reduction in their anxiety when they go to the operating room. We provide definitions, and technical aspects to assist other health care professionals in the development of low-cost 360-degree videos.

From the Ordinary to Corruption in Higher Education

2016 ◽  
Vol 26 (3) ◽  
pp. 270-279 ◽  
Author(s):  
Mildred A. Schwartz
Keyword(s):  
Higher Education ◽  
United States ◽  
Health Care ◽  
Health Care Professionals ◽  
Environmental Changes ◽  
The United States ◽  
Large State ◽  
Formal Organizations ◽  
Low Levels

Major environmental changes and recurring pressures have made universities in the United States that educate health care professionals vulnerable to corruption. Based on the experiences of one large, state-supported university, this essay argues that, in adapting to pressures, universities rely on the ordinary structures and processes characteristic of large formal organizations. Hierarchy becomes an opening to corruption when it is associated with low levels of transparency, a culture of deference that discourages questioning, and the absence of countervailing centers of authority. Where the need for resources is great and access is uncertain, these can become incentives to ensure access through corrupt means. Embeddedness opens opportunities for misconduct by fostering relations based on narrow loyalties. The ordinariness of the pathways to corruption in higher education can obscure timely recognition of misconduct even by members working in affected organizations. But, once recognized, it is also possible to find equally ordinary solutions.

scholarly journals POS1492-HPR EVALUATION OF A VIRTUAL REALITY-BASED APPLICATION TO EDUCATE HEALTHCARE PROFESSIONALS AND MEDICAL STUDENTS ABOUT INFLAMMATORY ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1030.1-1031
Author(s):  
P. Klemm ◽  
A. Kleyer ◽  
K. Tascilar ◽  
L. Schuster ◽  
T. Meinderink ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Health Care ◽  
Virtual Reality ◽  
Medical Students ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Three Dimensional ◽  
Research Support ◽  
X Ray ◽  
Deutschland Gmbh

Background:Inflammatory arthritides (IA), such as rheumatoid arthritis or psoriatic arthritis, are disorders that can be difficult to comprehend for health professionals and students in terms of the heterogeneity of clinical symptoms and pathologies. New didactic approaches using innovative technologies such as Virtual Reality (VR) applications could be helpful to demonstrate disease manifestations as well as joint pathologies in a more comprehensive way. However, the potential of using a VR education concept in IA has not yet been evaluated.Objectives:We evaluated the feasibility of a VR application to educate healthcare professionals and medical students about IA.Methods:We developed a VR application using IA patients data as well as two- and three-dimensional visualized pathological joints from X-ray and computed tomography generated images (1). This VR application (called Rheumality) allows the user to interact with representative arthritic joint and bone pathologies of IA patients (Figure 1 A, B). In a consensus meeting an online questionnaire was designed to collect basic demographic data (age, sex), profession of the participants, and their feedback on the general impression, knowledge gain and potential areas of application of the VR application. The VR application was subsequently tested and evaluated by healthcare professionals (physicians, researchers, and other healthcare professionals) and medical students at predefined events (two annual rheumatology conferences and academic teaching seminars at two sites in Germany).Results:125 individuals participated in this study (56% female, 43% male, 1% non-binary). 59% of the participants were between 18-30 years of age, 18% between 31-40, 10% between 41-50, 8% between 51-60 and 5% were between 61-70. Of the participants, 50 were physicians, five researchers and four other health care professionals, the remaining were medical students (66). The participants rated the application as excellent (Figure 1 C, D), the mean rating of the VR application was 9.0/10 (SD 1.2) and many participants would recommend the use of the application, with a mean recommendation score of 3.2/4 (SD 1.1). A large majority stated that the presentation of pathological bone formation improves the understanding of the disease (120 out of 125 (96%)).Conclusion:The data show that IA-targeting innovative teaching approaches based on VR technology are feasible. The use of VR applications enables a disease-specific knowledge visualization and may add a new educational pillar to conventional educational approaches.References:[1]Kleyer A et al. Z Rheumatol 78, 112–115 (2019)Figure 1.Illustration of the VR application and evaluation resultsTwo- and three-dimensional visualized pathological joints from X-ray and computed tomography generated images in a patient with long-standing (inadequately treated) RA (A) and a patient with early RA (B). Overall rating (range 0-10) on the VR application divided into four different professional subgroups (C); recommendations of VR application in the four different professional subgroups (D). HC, health care professionals; Boxplot explanation: Crossbars represent medians, whiskers represent 5-95 percentiles (points below the whiskers are drawn as individual points), box always extends from the 25th to 75th percentiles (hinges of the plot).Disclosure of Interests:Philipp Klemm Consultant of: Lilly Deutschland GmbH, Arnd Kleyer Speakers bureau: Lilly Deutschland GmbH, Consultant of: Lilly Deutschland GmbH, Grant/research support from: Lilly Deutschland GmbH, Koray Tascilar: None declared, Louis Schuster: None declared, Timo Meinderink: None declared, Florian Steiger: None declared, Uwe Lange: None declared, Ulf Müller-Ladner: None declared, Johannes Knitza Speakers bureau: Lilly Deutschland GmbH, Philipp Sewerin Speakers bureau: Lilly Deutschland GmbH, Paid instructor for: Lilly Deutschland GmbH, Johanna Mucke Consultant of: Lilly Deutschland GmbH, Alexander Pfeil Speakers bureau: Lilly Deutschland GmbH, Paid instructor for: Lilly Deutschland GmbH, Consultant of: Lilly Deutschland GmbH, Georg Schett: None declared, Fabian Hartmann Consultant of: Lilly Deutschland GmbH, Axel Hueber Consultant of: Lilly Deutschland GmbH, Grant/research support from: Lilly Deutschland GmbH, David Simon Speakers bureau: Lilly Deutschland GmbH, Paid instructor for: Lilly Deutschland GmbH, Consultant of: Lilly Deutschland GmbH, Grant/research support from: Lilly Deutschland GmbH

Stochastic Resonance Whole-Body Vibration Improves Postural Control in Health Care Professionals

2014 ◽  
Vol 62 (5) ◽  
pp. 187-196 ◽  
Author(s):  
Achim Elfering ◽  
Volker Schade ◽  
Lukas Stoecklin ◽  
Simone Baur ◽  
Christian Burger ◽  
...  
Keyword(s):  
Health Care ◽  
Postural Control ◽  
Stochastic Resonance ◽  
Health Care Professionals ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Body Vibration

scholarly journals Health Care Providers’ Knowledge, Attitudes, and Self-efficacy for Working With Patients With Spinal Cord Injury Who Have Diverse Sexual Orientations

2008 ◽  
Vol 88 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Annlee Burch
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Self Efficacy ◽  
Diversity Training ◽  
Care Providers ◽  
Confidence Levels ◽  
Cord Injury ◽  
Low Levels

Background and Purpose This study, using an evaluative, cross-sectional design, explored the self-efficacy, knowledge, and attitudes of health care providers who treat people with spinal cord injury (SCI) who may be gay, lesbian, bisexual, or transgender (GLBT). The study also designed and implemented a diversity training program and measured its effect on participants’ perceptions of their ability to change their knowledge levels, attitudes, and self-efficacy with regard to sexual orientation diversity. Subjects and Methods Health care professionals (N=402) participated in a diversity training program that included a pre-briefing questionnaire, a videotape, a post-briefing questionnaire, and discussion. Descriptive and chi-square analyses were performed on all variables of interest. Results The majority of the participants reported low levels of knowledge, attitudes of tolerance versus respect, and 0% to 20% confidence levels for providing culturally sensitive services for patients with diverse sexual orientations. Three hundred seventeen participants strongly agreed that watching the videotape increased their confidence levels in providing services for people who may be GLBT. Discussion and Conclusion Health care providers who treat people with SCI self-report low levels of knowledge, tolerance versus respect, and low levels of self-efficacy with regard to sexual orientation diversity. If a health care provider has a low level of knowledge, tolerance versus respect, and a low level of diversity self-efficacy toward others, there may be direct physical and mental health consequences for the patient. A limitation of the study was that social desirability bias may have increased the number of participants who reported increased levels of self-efficacy following the videotape. Further research is recommended (1) to determine whether current diversity training for health care professionals includes diversity of sexual orientation and (2) to examine the knowledge levels, attitudes, and self-efficacy of health care professionals with regard to sexual orientation diversity while attempting to control for social desirability bias in participants’ responses.

scholarly journals Implementation of the Operating Room Black Box Research Program at the Ottawa Hospital Through Patient, Clinical, and Organizational Engagement: Case Study (Preprint)

2019 ◽  
Author(s):  
Sylvain Boet ◽  
Nicole Etherington ◽  
Sandy Lam ◽  
Maxime Lê ◽  
Laurie Proulx ◽  
...  
Keyword(s):  
Health Care ◽  
Operating Room ◽  
Direct Observation ◽  
Health Care Professionals ◽  
Clinical Performance ◽  
Implementation Process ◽  
Black Box ◽  
Innovative Technology ◽  
Surgical Patient ◽  
Best Interest

BACKGROUND A large proportion of surgical patient harm is preventable; yet, our ability to systematically learn from these incidents and improve clinical practice remains limited. The Operating Room Black Box was developed to address the need for comprehensive assessments of clinical performance in the operating room. It captures synchronized audio, video, patient, and environmental clinical data in real time, which are subsequently analyzed by a combination of expert raters and software-based algorithms. Despite its significant potential to facilitate research and practice improvement, there are many potential implementation challenges at the institutional, clinician, and patient level. This paper summarizes our approach to implementation of the Operating Room Black Box at a large academic Canadian center. OBJECTIVE We aimed to contribute to the development of evidence-based best practices for implementing innovative technology in the operating room for direct observation of the clinical performance by using the case of the Operating Room Black Box. Specifically, we outline the systematic approach to the Operating Room Black Box implementation undertaken at our center. METHODS Our implementation approach included seeking support from hospital leadership; building frontline support and a team of champions among patients, nurses, anesthesiologists, and surgeons; accounting for stakeholder perceptions using theory-informed qualitative interviews; engaging patients; and documenting the implementation process, including barriers and facilitators, using the consolidated framework for implementation research. RESULTS During the 12-month implementation period, we conducted 23 stakeholder engagement activities with over 200 participants. We recruited 10 clinician champions representing nursing, anesthesia, and surgery. We formally interviewed 15 patients and 17 perioperative clinicians and identified key themes to include in an information campaign run as part of the implementation process. Two patient partners were engaged and advised on communications as well as grant and protocol development. Many anticipated and unanticipated challenges were encountered at all levels. Implementation was ultimately successful, with the Operating Room Black Box installed in August 2018, and data collection beginning shortly thereafter. CONCLUSIONS This paper represents the first step toward evidence-guided implementation of technologies for direct observation of performance for research and quality improvement in surgery. With technology increasingly being used in health care settings, the health care community should aim to optimize implementation processes in the best interest of health care professionals and patients.

scholarly journals An assessment of scattered radiation during fluoroscopic procedures in diagnostic radiology

2009 ◽  
Vol 24 (3) ◽  
pp. 204-208 ◽  
Author(s):  
Olivera Ciraj-Bjelac ◽  
Danijela Arandjic ◽  
Dusko Kosutic ◽  
Djordje Lazarevic
Keyword(s):  
Dose Rate ◽  
Scattered Radiation ◽  
Ionization Chamber ◽  
Diagnostic Radiology ◽  
X Ray ◽  
Dose Rates ◽  
Tube Arrangement ◽  
Vertical Beam ◽  
Exposure Conditions

The results of measurements of scattered radiation in the vicinity of a fluoroscopic X-ray facility are presented in this paper. Two different fluoroscopic systems, one with an undercouch tube and one with an overcouch tube, were compared. The dose rate was measured during the simulation of a fluoroscopy procedure, using an ionization chamber as a dosemeter. The distribution of scattered radiation has been determined and results show a much higher dose rate in cases of an overcouch tube arrangement. When X-ray units with an undercouch tube are concerned, under same exposure conditions, the dose rate is higher in cases of a vertical beam. Prior to the measurements, the ionization chamber was examined in order to evaluate its suitability as a survey meter used in diagnostic radiology. Measurements show that below 1.2 s, the ionization chamber gives an underestimation of dose rates. Therefore, in order to perform accurate measurements using this instrument, exposure times should be above 1.2 s.

scholarly journals Features of radiation protection equipment for the staff of X-ray operating rooms

2021 ◽  
Vol 14 (4) ◽  
pp. 76-84
Author(s):  
S. S. Sarycheva
Keyword(s):  
Operating Room ◽  
Radiation Protection ◽  
Scattered Radiation ◽  
Rapid Development ◽  
Operating Rooms ◽  
Protection System ◽  
Protective Equipment ◽  
X Ray ◽  
Radiation Distribution ◽  
International Regulations

This survey is devoted to the staff radiation protection in X-ray operating rooms. For self-safety staff must regularly and correctly use the protective equipment, which is ensured by their availability, convenience and manoeuvrability during procedures performing. The rapid development of interventional radiology led to the fact that the staff work in this area have one of the highest levels of occupational exposure. Unfortunately, domestic radiation protection system does not keep pace with such a rapid development of this branch of medicine. The article shows the basic principles of the distribution of scattered radiation in the X-ray operating room during the procedures performing. The distribution of scattered radiation around the patient for various modes of C-arm angiographic systems is shown. Graphical examples of scattered radiation distribution in X-ray operating rooms are given. Collective and individual protective equipment specifically designed for staff radiation protection in X-ray operating room are considered in detail. The common data on the protection features of the recommended staff protection equipment are presented. Most of the considered protection equipment is mandatory in many European countries, but not mentioned in domestic regulatory documents yet. The proposals for the modernization of the domestic radiation protection system for staff of X-ray operating rooms have been made. These recommendations focused on providing X-ray operating rooms with relevant radiation protection equipment, including eye protection, following the accumulated world experience and international regulations.

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