Pension plans of radiology practices

Despite the ubiquity of pension plans in radiology practices and their importance to employees and radiologists, no data on pension plans are available. This lack of information is particularly unfortunate given proposed government actions that would require radiology practices to extend their pension plans to cover employees of hospital radiology departments. To develop information on pension plans and to show the adverse consequences of such actions, the American College of Radiology conducted a stratified telephone survey of 120 radiology practices in the United States. Some 88% of radiology practices have retirement plans. Results indicate that 91% of hospitals already have pension plans for their employees. Under the proposed government regulations, each radiologist would be required to provide pension coverage for an average of 7.4 hospital employees who assist radiologists in their hospital-located work. Concerns about these regulations had led radiology practices to freeze or terminate 23% of their pension plans by late 1990. The negative consequences of the proposed regulations are therefore quite serious.     

Information literacy skills of undergraduate medical radiation students

Undergraduate education is undergoing a shift away from the traditional transmission of a fixed body of knowledge to a learning approach where the emphasis is on supporting learners to learn. Central to this change is recognition that undergraduate education programmes should aim to develop independent learners who become effective lifelong learning practitioners. Successful independent learning as an undergraduate student or as a lifelong learner requires the learner to have well developed information literacy skills. An Online Electronic Information Skills (OEIS) intervention was designed to develop the information literacy skills in a cohort of second year undergraduate radiography students. An evaluation focused on learning outcomes was used to provide evidence of development of information literacy within the undergraduate course. The evaluation clearly demonstrated substantial skill development in students' ability to access scholarly information in their discipline area. The reported continued use of database searching by this cohort of students seven months after the OEIS intervention provides evidence that they are continuing to access and use scholarly information, information literacy skills necessary for their future work context.     

Should technologists tell everything they know?

Students and staff technologists used to be taught to give no information to patients, an easy stance but hardly justifiable. Today's technologists are professional practicing in advanced settings; today's patients want and often demand information. How do we ensure that the pendulum of providing healthcare information does not swing from telling patients nothing to telling patients everything? Only recently have patient-care texts begun to recognize this as a dilemma, with the unanswered question remaining: how much do we tell them when they ask? The desire to look like an expert may lead technologists, particularly those who are newly graduated and enthusiastic, into providing information to a patient before evaluating its appropriateness. Technologists working with anxious or worried patients may also give out information to ease both their own and the patient's feelings of anxiety. Many patients are really looking for reasonable reassurance about their tests and illness, not detailed information. There are three types of technologists: the revealer, the hider and the expert. The latter has learned to evaluate information for its appropriateness for patients to hear and their ability to receive it. As part of the ongoing learning process, technologists need to consider how to evaluate a patient's motive for asking a question, to decide the answer's effect on the patient, determining who is the most appropriate person to answer the question, and finally, judging how much information is best for the patient to hear. For the most apprehensive patient, distraction may be a useful technique.     

The security of patient identifiable information in doctors' homes

Ethically and legally doctors bear a responsibility to ensure the security of patient identifiable information in their possession. Many doctors, especially those in forensic medicine, hold paper or computerised medical records at home. This survey was conducted to assess the level of security for these records and awareness of the issues. Fifty-six forensic physicians (30 male, 26 female) answered a questionnaire. KEY FINDINGS: Eighty-nine percent used a computer to write patient notes and reports, but only 26 of these were on the Data Protection Register, and only 24 password-protected their files. Few doctors took steps to protect data on old computers they had stopped using. Of those responding, 88% held paper records at home but only of these had lockable filing cabinets. Burglar alarms were fitted in 77% of homes, yet 36% of homes had been burgled. No participants had written instructions for disposal of records and reports after their death. Older participants were more likely to have been burgled, yet less likely to have antiviral software than their younger counterparts. Participants expressed the need for information, education and training in data security.     

Sports Medicine Directory 1987

This is the eighth edition of the annual list of sports medicine treatment centers that was published originally in September 1980. We have added information about a number of centers not previously listed and have also rechecked the listings for accuracy. We have not tried to verify the information supplied, nor do we recommend or endorse any of the clinics listed. Those using this list as a guide for referral should check the codes carefully to ascertain whether a particular clinic will fit their needs.

We anticipate that the directory will continue to be updated annually. Centers that are not listed but wish to be added next year should contact THE PHYSICIAN AND SPORTSMEDICINE, Centers Project, 4530 W 77th St, Minneapolis 55435.

Centers are listed alphabetically by state and by zip code within the states. If a director is listed, the name follows the zip code. The following key summarizes available information about the centers:     

Internet-based social networking and its role in the evolution of chronic cerebrospinal venous insufficiency

The Internet is being seen as a growing resource for health-related information for a large number of patients. It is undeniable that its widespread presence has led to the growth of awareness that chronic cerebrospinal venous insufficiency (CCSVI) as an entity that may contribute to the symptoms experienced by patients with multiple sclerosis (MS). Social networking and file-sharing Web sites have brought patients with MS together from all over the world and have facilitated the distribution of personal experiences and information derived from medical research as it relates to CCSVI. As a result, there has been an accelerated growth in the number of patients seeking treatment for this syndrome in light of the possibility that it may improve their present condition. This article will review this phenomenon, the Internet-based resources available to MS patients seeking information about CCSVI, and the responsibilities of physicians as they participate in these online discussions.     

Noninvasive measurements of bone mass, structure, and strength: current methods and experimental techniques

Current methods for assessing osteoporotic fracture risk involve measuring the content and/or density of bone at a number of skeletal sites and relating the measurement to that in either age-matched or young control subjects measured at the same site with the same technique. These densitometric methods have been used to predict several types of fractures; however, engineering principles verify that the bone structure and loading conditions also affect skeletal strength. Many densitometric measurements inherently contain information about skeletal structure and bone distribution, yet this information is not clinically used. In this paper, the currently available techniques for assessing bone content and density, namely, single-photon absorptiometry, dual-photon absorptiometry, dual-energy X-ray absorptiometry, and quantitative CT, and their usefulness in assessing fracture risk and distinguishing between patients with and without osteoporosis are reviewed. Extensions of conventional densitometry that have been developed by several researchers to include information in addition to bone mass also are presented. Results from recent studies using new applications of ultrasound techniques and MR imaging are reviewed. Preliminary studies show the value of these new techniques in noninvasive measurement of bone structure in order to estimate bone strength and assess fracture risk more accurately. However, to become clinically useful, many of these methods require further investigation to increase their ease of use and decrease their cost.     

Sports Medicine Directory 1986

This is the seventh edition of the annual list of sports medicine treatment centers that was published originally in September 1980. We have added information about a number of centers not previously listed and have also rechecked the listings for accuracy. We have not tried to verify the information supplied, nor do we recommend or endorse any of the clinics listed. Those using this list as a guide for referral should check the codes carefully to ascertain whether a particular clinic will fit their needs.

We anticipate that the directory will continue to be updated annually. Centers that are not listed but wish to be added next year should contact: THE PHYSICIAN AND SPORTSMEDICINE, Centers Project, 4530 W 77th St, Minneapolis 55435.

Centers are listed alphabetically by state and by zip code within the states. If a director is listed, the name follows the zip code. The following key summarizes available information about the centers:     

Radiologische Informationssuche im Internet: Datenbanken, Suchmaschinen und intelligente Agenten

The Internet plays an important role in a growing number of medical applications. Finding relevant information is not always easy as the amount of available information on the Web is rising quickly. Even the best search engines can only collect links to a fraction of all existing Web pages. In addition, many of these indexed documents have been changed or deleted. The vast majority of information on the Web is not searchable with conventional methods. New search strategies, technologies and standards are combined in intelligent search agents (ISA) and robots, which can retrieve desired information in a specific approach. CONCLUSION: The article describes differences between ISAs and conventional search engines and how communication between agents improves their ability to find information. Examples of existing ISAs are given and the possible influences on the current and future work in radiology is discussed.     

Multimodality imaging: an update on PET/CT technology

Introduction  

Since their introduction in 2001, PET/CT systems have gained wide acceptance primarily due to their inherent ability to combine functional and structural information about the underlying disease state of the patient in a single imaging session. Their significance has also been documented with regard to their short imaging times, which minimize patient anxiety and image blurring due to patient motion. In the past seven years, PET/CT systems have replaced dedicated PET systems as the imaging modality of choice for diagnostic evaluation of oncology patients.     

Single-Organ Patients

Physicians walk a fine line when deciding whether to recommend that youngsters who have only one of a paired set of organs participate in sports. Increasingly, courts are ruling in favor of letting the athlete compete. To make the best decision for the health of their patients, physicians can learn about the risks specific sports pose and the protective gear that's available— and pass that information on to patients and their families.     

The consent process in interventional radiology: the role of specialist nurses

AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52) but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased.     

Patient satisfaction in radiation oncology

As part of a quality improvement exercise at the Perth Radiation Oncology Centre, a survey was undertaken to ascertain the current level of patient satisfaction with the information they were receiving from their treating radiation oncologist. In addition, the effect of radiation on patients' anxiety levels was investigated. Two questionnaires were given to patients having radical radiotherapy for malignancy. The first questionnaire consisted of the Information Satisfaction Questionnaire and the State Trait Anxiety Index. It was given to patients before the commencement of their course of radiotherapy. The second questionnaire consisted of the State Trait Anxiety Index and was given at the completion of their radiotherapy. A total of 120 patients completed both the questionnaires. The majority of patients were satisfied/very satisfied with the explanation of their illness and radiation toxicities. Fewer patients were satisfied with the explanation of lifestyle (e.g. diet, exercise, smoking) and practical issues such as parking and treatment costs. The patients showed a statistically significant reduction in both their State and Trait Anxiety scores following radiotherapy. Following this study, we have developed new information booklets addressing lifestyle and practical issues, which were not being adequately addressed as shown in this study. Our next study will assess the effect of these new information booklets.     

On-call radiology 2020: Where trainees look for help in a high stakes and time sensitive environment

BackgroundThe radiology trainee on-call experience has undergone many changes in the past decade. The development of numerous online information sources has changed the landscape of opportunities for trainees seeking information while on-call. In this study, we sought to understand the current on-call information seeking behaviors of radiology trainees.MethodsWe surveyed radiology fellows and residents at three major metropolitan area academic institutions. Survey topics included demographic information, on-call volumes, on-call resource seeking behaviors, preferred first and second line on-call resources and rationale for particular resource usage.ResultsA total of 78 responses from trainees were recorded, 30.5% of the entire surveyed population. 70.5% of trainees preferred Radiopaedia as their first line resource. 26.9% of trainees preferred StatDx as their second line resource. 75.6% of respondents preferred their first line resource because it was easiest and fastest to access. 70.3% of respondents assigned a rating of 4 out of 5 when asked how often information they look for is found while on-call. There was a statistically significant difference according to gender (p = 0.002) with a higher percentage of males listing Radiopaedia as their first line resource compared to females.DiscussionThe radiology trainee on-call experience is influenced by various factors. Over the past decade, online resources, particularly the open access resource Radiopaedia and the paid service StatDx, have overwhelmingly become the preferred first and second line options, as demonstrated by our study results.     

Enabling people with learning disabilities to manage their own health and well-being

People with learning disabilities have both increased mortality and an increased morbidity; there is poor uptake of health promotion, unrecognized health needs and poor access to health care. They also have a reduced ability to understand, retain and implement advice and information and have difficulty in both identifying and communicating health care problems. There is a great disparity between their health and that of people in the general population. A Health Action Plan is a personalized plan that states the health needs of a person with a learning disability and how these needs should be met; it can support the person in managing their own health needs, and identify which ordinary healthcare services and professionals are needed to enable people to have the necessary support to stay healthy. Including people with disabilities is an essential step in creating sustainable communities.     

An overview of informed consent for radiologists

Because of the procedure-oriented nature of their specialty, radiologists obtain informed consent from patients daily. This paper attempts to help the radiologist obtain informed consent without incurring malpractice liability by discussing the important legal concept of simple consent as distinguished from informed consent, the elements a patient must prove to succeed in court with an allegation of lack of informed consent, the varying state requirements about the amount of information the patient must be given, the persons who must obtain consent from the patient, and the persons who can give consent for the patient. Consent for IV injections of contrast medium and consent forms are discussed because of the current controversy on these subjects. Courts and state legislatures have usually addressed only specific aspects of informed consent. However, except for the amount of information that must be given the patient, the courts have been relatively uniform in their requirements. Therefore, it is likely that a state court faced with issues of informed consent about which no law exists in their own state will use the existing law in other states as a precedent and adopt similar rules. However, each radiologist must be familiar with the specific rules for informed consent that have been developed by the courts and legislatures in the state in which he or she practices.     

Anabolic steroids: a review for the clinician

The number of athletes self-administering ergogenic pharmacological agents to increase their competitive edge continues to be a problem. Most athletes using anabolic steroids (AS) have acquired a crude pharmacological database regarding these drugs. Their opinions regarding steroids have been derived from their subjective experiences and anecdotal information. For this reason, traditional warnings regarding the lack of efficacy and potential dangers of steroid misuse are disregarded. A common widely held opinion among bodybuilders is that the anabolic steroid experts are the athletic gurus who for years have utilised themselves as the experimental participants and then dispensed their empirical findings. This review will address the common anabolic steroid misconceptions held by many of today's athletes by providing an evaluation of the scientific literature related to AS in athletic performance.     

A review of the results from the National Radiotherapy Patient Experience Survey in England

AimThe goal of the survey was to obtain a meaningful picture about patients' experiences across all radiotherapy centres within provider NHS trusts within England.MethodsA survey questionnaire was constructed to assess patients' views about their care, information and support at all stages of their radiotherapy pathway. The questionnaire was posted to patients who attended for radiotherapy within NHS trusts in England from April until December 2012.Key resultsMany of the results were positive, for example 99% of patients had either complete confidence or confidence to some extent in the health care professional undertaking their consent. 97% of patients said that the amount of information given to them before their radiotherapy was either excellent or satisfactory. However there were 10% of patients who were not invited to an information session before radiotherapy, 14% of patients who were not told how to communicate with their radiographers whilst their treatment was delivered and 13% of patients who were not given a contact number to ring if they had any problems relating to their radiotherapy after finishing.Conclusions and recommendationsThe results indicate that the majority of patients have experienced high quality care in many aspects of their radiotherapy pathway. However there are some areas where improvements could be made. It is recommended that all Radiotherapy Service Managers (RTSMs) review their local results and implement improvements where required and they re-audit on an annual basis. It is also recommended that the national survey is repeated at regular intervals to monitor progress.     

Predictive genetic tests for employment purposes: why not?

Given the uncertainty that characterizes genetic information in relation to the pressing ethical and deontological questions involved in their acquisition and subsequent use, and in the context of enormous social relevance, it is essential to have international legislation authorizing the use of such tests for genetic monitoring of employed persons compatible with the need to protect their privacy.     

Characteristics of drug misusers in custody and their perceptions of medical care

Substance misuse detainees in custody are a common problem for forensic physicians. Studies have shown that forensic physicians have negative attitudes towards misusers in custody. Inconsistent information may be given by the detainee to acquire some perceived secondary gain. Therefore, it is difficult for the examining physician to gain an impartial insight into the detainees' expectations of their medical management. This study was undertaken to explore the detainees' expectations of their medical management by administration of a questionnaire using drug referral workers who are independent of the police and the forensic physician. The practical difficulties of producing such a survey and the results are discussed.