Preoperative therapeutic neuroscience education for lumbar radiculopathy: a single-case fMRI report

Abstract

Therapeutic neuroscience education (TNE) has been shown to be effective in the treatment of mainly chronic musculoskeletal pain conditions. This case study aims to describe the changes in brain activation on functional magnetic resonance imaging (fMRI) scanning, before and after the application of a newly-designed preoperative TNE program. A 30-year-old female with a current acute episode of low back pain (LBP) and radiculopathy participated in a single preoperative TNE session. She completed pre- and post-education measures including visual analog scale (VAS) for LBP and leg pain; Oswestry Disability Index (ODI); Fear Avoidance Beliefs Questionnaire (FABQ); Pain Catastrophizing Scale (PCS) and a series of Likert-scale questions regarding beliefs and attitudes to lumbar surgery (LS). After a 30-minute TNE session, ODI decreased by 10%, PCS decreased by 10 points and her beliefs and attitudes shifted positively regarding LS. Immediately following TNE straight leg raise increased by 7° and forward flexion by 8?cm. fMRI testing following TNE revealed 3 marked differences compared to pre-education scanning: (1) deactivation of the periaqueductal gray area; (2) deactivation of the cerebellum; and (3) increased activation of the motor cortex. The immediate positive fMRI, psychometric and physical movement changes may indicate a cortical mechanism of TNE for patients scheduled for LS.     

超声医学年轻医生教育培训亟待转型和加强

随着超声医学的飞速发展和就诊模式的改变,以及无创伤性、可重复性等优势,临床医生及患者对超声的需求急剧增加,超声检查已成为临床常规检查方法之一。但是超声医生培养模式已远远跟不上时代需要,因此迫切需要转型和加强。本文根据多年来培养研究生、住院医生、社区医生的经验和教训,以及本院关于住院医师医学影像专业培训计划,制定超声医生超声医学科一、三、五年轮转规划,实施以年轻超声医师为中心的超声医学人才培养模式。     

融合成果导向教育理念的“线上+线下”混合式数字图像处理课程教学设计与实施

介绍成果导向教育教学理念,详细阐述“线上+线下”混合式教学设计过程,包括设计流程、教学目标、课程实施、学习成果及教学评价等,以期激发学生学习兴趣,提高教学效果。     

医学技能实验教学改革的思考

围绕“综合性、设计性、创新性”实验改革思想,中南大学机能试验中心在教学中开展了一系列实验教学改革的探索,以加强学生实践能力和创新能力培养,加快实验室建设,并取得了显著的教学效果。     

Insufficient knowledge and inapproriate physiotherapy management of Relative Energy Deficiency in Sport (RED-S) in lightweight rowers

ObjectiveTo investigate the knowledge and management of Relative Energy Deficiency in Sport (RED-S), from the perspective of lightweight rowers and physiotherapists.DesignSemi-structured individual qualitative interviews.MethodsPhysiotherapists who had worked with lightweight rowers, and current and former lightweight rowers (who had experienced at least one symptom of RED-S), undertook audio-recorded semi-structured telephone interviews. An inductive thematic analysis was performed, facilitated by NVivo software.ResultsTwelve physiotherapists (n = 6 females, 1–20 years of experience managing lightweight rowers) and twelve lightweight rowers (n = 8 females, 1–8 years lightweight rowing experience, intermediate to elite/international level) were interviewed. Five key themes were identified: insufficient knowledge of RED-S, inadequate RED-S education, inappropriate management of RED-S, referral to other health professionals, prioritising performance over health. Participants provided suggestions for improving knowledge and management of RED-S in lightweight rowers, including formal physiotherapy education and training, and targeted education for athletes and coaches.ConclusionsThere was a significant lack of awareness of RED-S amongst physiotherapists and lightweight rowers. Most physiotherapists were not confident discussing or managing RED-S in athletes, and lightweight rowers were dissatisfied with the management they received. Improving RED-S education for physiotherapists and athletes may have important health implications for lightweight rowers.     

Large differences in education and training of radiographers in Europe and Central Asia: Results from an IAEA coordinated study

IntroductionEducation and training of radiographers is known to be diverse between countries and regions. Under an IAEA project, this work collected data on radiographer education for the Europe and Central Asia region with a particular focus on radiation protection gaps and potential actions.MethodsFollowing piloting, an electronic questionnaire was distributed to all national counterparts for the IAEA Technial Coopearation (TC) Europe region (n = 33 countries) and nominated national representatives. Contacts were additionally invited to a virtual workshop to discuss and rank common problems in education and training of radiographers and to propose potential solutions.ResultsResponses were received from 31 countries, including 14 from the European Union. Just over half of countries reported radiographer education being in higher education with 71% having program durations more than 3 years (range: 1 month-4 years). Programs included a spectrum of both clinical training and radiation protection hours with ten-fold variations noted across the region. Inclusion of core radiation protection topics within curricula varied similarly, as did radiographers’ clinical involvement in both justification and optimisation between countries. Workshop participants identified five common training problems, namely education availability, lack of standardisation, radiation protection course quality, teamwork problems and lack of equipment.ConclusionRadiographer education in the IAEA Europe region is heterogeneous with substantial differences in duration and quality of training programs between countries, which likely impact on quality of patient care delivered. Common problems have been identified and potential solutions proposed to focus quality improvement initiatives.Implications for practiceRadiographer education and training is diverse throughout the IAEA TC Europe region, with likely impacts on radiation protection practices applied. Clinical involvement of radiographers in justification and optimisation differs, potentially limiting adherence to radiation protection principles.     

The role of the sonographer – An investigation into the scope of practice for the sonographer internationally

IntroductionThere is global variance in the role of a practicing sonographer. Literature examining global sonographic roles and scope of practice is limited, despite the international applicability of ultrasound imaging. This study aimed to examine the common and divergent features of a practicing sonographer internationally, and their impact upon the development of a global standard of practice.MethodsAn ethically approved mixed-methods online survey was conducted. The purposive sample included all 75 current elected council members of the ISRRT [International Society of Radiographers and Radiological Technologists], an international professional organisation.ResultsThirty-six individuals from at least 32 different countries responded, reflecting the sonography profession in all four ISRRT regions. The results suggest that sonographer education requirements differ widely, from on the job training (16%, 6/36) to undergraduate or postgraduate schooling (44%, 16/36). Registration and accreditation bodies were present in the jurisdiction of 41% (14/34) and 35% (12/33) of respondents respectively, though many were voluntary, physician-focused or non-specific to sonographers. Five of 11 (45%) respondents suggested that the sonographer–radiologist relationship is individual-dependent, and not primarily positive or negative. Ten of 28 (36%) suggested that other professionals do not know the role of the sonographer.ConclusionThe majority of ISRRT council member respondents believe that an international scope of practice could benefit and be implemented in their jurisdiction (26/28, 93% and 22/33, 67%). The key advantages noted were standardisation of education and improved professional mobility. However, lack of sonographer education and radiologist acceptance are important potential barriers.Implications for practiceAn international scope of practice could be beneficial and implementable in most ISRRT jurisdictions. Professional mobility and education standardization are the primary advantages. Insufficient sonographer education and physician acceptance are the key potential obstacles.     

UK reporting radiographers’ perceptions of AI in radiographic image interpretation – Current perspectives and future developments

IntroductionRadiographer reporting is accepted practice in the UK. With a national shortage of radiographers and radiologists, artificial intelligence (AI) support in reporting may help minimise the backlog of unreported images. Modern AI is not well understood by human end-users. This may have ethical implications and impact human trust in these systems, due to over- and under-reliance. This study investigates the perceptions of reporting radiographers about AI, gathers information to explain how they may interact with AI in future and identifies features perceived as necessary for appropriate trust in these systems.MethodsA Qualtrics® survey was designed and piloted by a team of UK AI expert radiographers. This paper reports the third part of the survey, open to reporting radiographers only.Results86 responses were received. Respondents were confident in how an AI reached its decision (n = 53, 62%). Less than a third of respondents would be confident communicating the AI decision to stakeholders. Affirmation from AI would improve confidence (n = 49, 57%) and disagreement would make respondents seek a second opinion (n = 60, 70%). There is a moderate trust level in AI for image interpretation. System performance data and AI visual explanations would increase trust.ConclusionsResponses indicate that AI will have a strong impact on reporting radiographers’ decision making in the future. Respondents are confident in how an AI makes decisions but less confident explaining this to others. Trust levels could be improved with explainable AI solutions.Implications for practiceThis survey clarifies UK reporting radiographers’ perceptions of AI, used for image interpretation, highlighting key issues with AI integration.     

Qualitative content analysis of image interpretation education in UK pre-registration diagnostic radiography programmes

IntroductionImage interpretation is a required capability for all UK pre-registration programmes in diagnostic radiography to meet the needs of graduate practice. It also provides a potential educational foundation for future advanced clinical practice. The aim of this study was to explore how image interpretation education is designed, delivered, and assessed within contemporary UK pre-registration diagnostic radiography programmes.MethodsQualitative content analysis of open-source image interpretation curriculum data extracted from UK Higher Education Institute (HEI) websites.ResultsExtracted search data was initially coded and three overarching themes emerged, image interpretation education vision, operationalisation, and delivery and assessment.ConclusionThis study identified significant heterogeneity in all aspects of UK pre-registration image interpretation education which may suggest an equal heterogeneity can be expected in the image interpretation knowledge, skill, confidence between newly registered practitioners.Implications for practiceThere may be a need for clearer expectations on HEIs by professional and regulatory bodies to ensure consistency in pre-registration image interpretation education.