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Michelle Linda Ferderbar Thomas E. Doyle Reza Samavi David Koff 《Journal l'Association canadienne des radiologistes》2019,70(2):119-124
Several regulatory bodies have agreed that low-dose radiation used in medical imaging is a weak carcinogen that follows a linear, non-threshold model of cancer risk. While avoiding radiation is the best course of action to mitigate risk, computed tomography (CT) scans are often critical for diagnosis. In addition to the as low as reasonably achievable principle, a more concrete method of dose reduction for common CT imaging exams is the use of a diagnostic reference level (DRL). This paper examines Canada's national DRL values from the recent CT survey and compares it to published provincial DRLs as well as the DRLs in the United Kingdom and the United States of America for the 3 most common CT exams: head, chest, and abdomen/pelvis. Canada compares well on the international scale, but it should consider using more electronic dose monitoring solutions to create a culture of dose optimization. 相似文献
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OBJECTIVE: To assess the improvement of obstetric and gynecologic training brought about by peer influence in Europe. METHODS: In 1996, the European Board and College of Obstetrics and Gynecology (EBCOG) initiated a visiting process by international and local peers to improve training and decrease differences in health care standards. RESULTS: A large number of visits of obstetrics and gynecology departments have been conducted across Europe at teaching hospitals by the Hospital Visiting Committee. Compliance with the structured approach of the visiting policy and problems met during these visits are reported. CONCLUSION: The program focuses on the continuous improvement of the competencies of all persons trained in the obstetrics and gynecology departments of teaching hospitals throughout Europe. It also increases the understanding of diversity in training methods and can gradually lead to the convergence of training and health care standards in Europe. 相似文献
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Lizbeth Laureano-Prez R. Coll R. Fitzgerald Iisa Outola L. Pibida 《Applied radiation and isotopes》2007,65(12):1368-1380
A new radioactivity solution standard of 210Pb has been developed and will be disseminated by the National Institute of Standards and Technology (NIST) as standard reference material (SRM) 4337. This new 210Pb solution standard is contained in a 5 mL flame-sealed borosilicate glass ampoule, consists of (5.133±0.002) g of a nominal 1 mol L−1 nitric acid solution, has a density of (1.028±0.002) g mL−1 at 20 °C, has carrier ion concentrations of about 11 μg Pb2+ and 21 μg Bi3+ per gram of solution, and is certified to contain a massic activity (9.037±0.22) kBq g−1 as of the reference time 1200 EST, 15 June 2006. All of the uncertainties cited above correspond to standard uncertainties multiplied by a coverage factor k=2. The standardization for the 210Pb content of the solution was based on 4πβ liquid scintillation (LS) measurements using CIEMAT/NIST 3H-standard efficiency tracing (CNET). Confirmatory determinations were also performed by high-resolution HPGe γ-ray spectrometry, by 2π spectrometry with a Si surface barrier detector of separated 210Po, and by 4πβ(LS)–γ(NaI) anticoincidence counting. 相似文献
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手术室是医学技术与工程技术结合的产物。随着医疗技术和新的手术工具的不断涌现,带动了手术量的迅猛上升。旧的手术室空间布局、实施标准、功能配置等方面已经无法满足新技术的应用要求,同时人们对手术环境和手术质量也提出了更高的标准。而今第四代手术室已开始步入我们的时代。洁净化、数字化和人性化则是其主要代表特征。本文分别从洁净手术室、数字化手术室和人性化手术室三个方面来探讨现代医院手术室建设中应注意的问题及动态研究。层流手术室已经是手术室建设不可逆转的发展趋势,除了按照《医院洁净手术部建筑技术规范》来建造外,其布局、人流、物流、质量监控等等都要进行合理的安排才能达到最优的手术环境。数字化手术室是将温度、湿度、压力、通风量、新风量等一切参数系统的由计算机来分配统筹,从而实现精确高效的手术管理。人性化手术室则是手术室建设的软件部分,是一种“以病人为中心”的服务理念,它打破了传统的生物医学模式,转变为生物—心理—社会模式,这是病人需求与市场竞争的必然选择。 相似文献
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O.J. Dyar B. Beović C. Pulcini E. Tacconelli M. Hulscher B. Cookson 《Clinical microbiology and infection》2019,25(1):13-19
Objective
To develop a consensus-based set of generic competencies in antimicrobial prescribing and stewardship for European prescribers through a structured consensus procedure.Methods
The RAND-modified Delphi procedure comprised two online questionnaire rounds, a face-to-face meeting between rounds, and a final review. Our departure point was a set of competencies agreed previously by consensus among a UK multi-disciplinary panel, and which had been subsequently revised through consultation with ESCMID Study Group representatives. The 46 draft competency points were reviewed by an expert panel consisting of specialists in infectious diseases and clinical microbiology, and pharmacists. Each proposed competency was assessed using a nine-point Likert scale, for relevance as a minimum standard for all independent prescribers in all European countries.Results
A total of 65 expert panel members participated, from 24 European countries (one to six experts per country). There was very high satisfaction (98%) with the final competencies set, which included 35 competency points, in three sections: core concepts in microbiology, pathogenesis and diagnosing infections (11 points); antimicrobial prescribing (20 points); and antimicrobial stewardship (4 points).Conclusions
The consensus achieved enabled the production of generic antimicrobial prescribing and stewardship competencies for all European independent prescribers, and of possible global utility. These can be used for training and can be further adapted to the needs of specific professional groups. 相似文献9.
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《Gaceta sanitaria / S.E.S.P.A.S》2021,35(2):123-129
ObjectiveTo systematically describe the school nutritional policies of the 17 autonomous communities of Spain.MethodThrough a search of bibliographic databases, web pages and other official information systems, 183 documents of interest were identified. Information was systematically collected with the SNIPE (school nutrition index of programme effectiveness) questionnaire, adapted to Spain, and validated by reference staff of the regional government's health and education ministries.ResultsThe main objective of the policies is to prevent obesity and improve the nutrition of schoolchildren. The 17 autonomous communities cover the school canteen service, 11 cafeteria and vending machines, and 9 the breakfast service. All communities use the Consensus Document on School Food as a reference for the content of the menu and the nutritional quality of the products offered at the school; however, only 4 of them have regulated these aspects. The evaluation of policy objectives ranges from 58.8% of the autonomous communities for food supply to 5.9% for rotation and menu quality.ConclusionAlthough all the autonomous communities have standards for the school menu, the standards for the rest of the food supply vary across them; also, evaluation of objectives is scarce and only 4 communities have approved mandatory regulations. Nutritional standards should be reviewed according to current scientific knowledge and enacted by law, in compliance with the current legislation (Act 17/2011). 相似文献