bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of a porcine model of post‐operative pain
Authors: Castel D. , Willentz E. , Doron O. , Brenner O. , Meilin S. 
Published: October 2013

AbstractBackgroundManagement of acute pain related to surgical intervention, termed post‐operative pain or POP, continues to be a major healthcare challenge. While the rat plantar incision model provides valuable data to researchers about the mechanisms mediating POP, the development of topical and localized treatments in small animal models is limited. To help address these issues, we describe here the characterization of a large animal model of incisional pain.MethodsPigs underwent full‐skin incision or full‐skin and muscle incision and retraction (SMIR). Withdrawal thresholds were determined using the Von Frey test at baseline, 0.5–12 h post‐surgery and on days 1, 2, 3, 5 and 7 post‐surgery. The analgesic effects of systemic morphine [0.1 or 1.0 mg/kg intramuscular (i.m.) dose] and local anaesthetic ropivacaine were studied. Spontaneous pain‐like behaviours were scored and analysed. The effects on wound healing were evaluated by gross observation and by histopathological examination.ResultsPigs incurring SMIR demonstrated significantly increased mechanical hypersensitivity compared with pigs that underwent full‐skin incision only (p < 0.05). Maximal analgesia was achieved with morphine (1 mg/kg i.m. dose) at 0.5 h post‐treatment. Local treatment with ropivacaine was effective at increasing the withdrawal threshold to Von Frey filaments compared with saline control (p < 0.05) for a period of at least 6 h. Wounds healed normally with no signs of infection, redness or swelling.ConclusionsWe propose that the pig model of incisional pain can provide an appropriate translational model for validating new topical and localized treatments for POP in humans.
Radiographer Reporting: Discussion and Australian workplace trial
Authors: Cook Aiden P. , Oliver Tanya , Ramsay Lester 
Published: October 2013

ABSTRACTThis paper reports an investigation into the accuracy and effectiveness of two (2) senior Australian radiographers in the reporting of appendicular musculo‐skeletal radiographs in the adult trauma situation. and discusses the international debate on radiographer role extension into plain film reporting.The study of 540 patients referred to a large metropolitan emergency imaging department demonstrated high rates of diagnostic accuracy (sensitivity = 98.00% specificity = 99.11%) in the assessment of appendicular musculo‐skeletal radiographs. 294 out of 300 positive examinations were identified correctly (FPR=0.88%) as were 225 out of 227 negative or normal examinations (FNR=2.00%). A discussion on relevant statistical measures and their definitions is outlined. In the study radiologist reports are used as the comparative gold standard.The findings demonstrate an ability of clinically experienced radiographers to accurately and effectively provide diagnostic opinions on musculoskeletal radiographs. A formalised approach to radiographer reporting can be justified and a formal program to train appropriately experienced radiographers is recommended.
Patient positioning and treatment instructions used during radiation therapy of the prostate: results of an Australian and New Zealand survey
Authors: Knight Kellie 
Published: October 2013

AbstractNational standards for patient positioning and treatment instructions for radiation therapy of prostate cancer are non‐existent. To maximise daily reproducibility of the patient's position, immobilisation and stabilisation devices are often used. To minimise prostate motion, patients may be given instructions to regulate rectal and bladder volumes. However, the use of these patient positioning devices and the provision of patient treatment instructions vary between radiation therapy centres. In May 2003 a survey was sent to all radiation therapy chiefs throughout Australia and New Zealand requesting information regarding the treatment of prostate cancer patients. This comprehensive review of current practices clearly demonstrates differences between centres on the use of patient instructions to regulate rectal and bladder contents, however, stabilisation and immobilisation methods proved to be more consistent. The results will be discussed in light of the current international literature regarding patient positioning and patient treatment instructions used during radiation therapy of the prostate. This review has identified limited areas of consensus, and highlighted the need to develop common protocols and benchmarking of standards in order to improve treatment delivery.
Needs of cancer patients treated in rural and urban cancer departments
Authors: Mercuri Angelina , Kallady Susannah 
Published: October 2013

AbstractLiterature indicates that cancer patients experience high levels of unmet needs, particularly in relation to health information, psychological requirements and physical and daily living needs. It suggests that the needs of patients living in rural areas are likely to be higher than those of urban patients due to geographical factors and health service accessibility issues. This paper will explore the needs of cancer patients with particular focus on the impact of location (rural vs. urban), present the basis of these needs and identify strategies that address the needs expressed, by reviewing current literature.
A review of the benefits and rationale of viewing liver window settings for abdominal computed tomography scans
Authors: Dang Tan , Mandarano Giovanni 
Published: October 2013

AbstractThere have been many different opinions over the efficacy of routinely incorporating liver window settings in abdominal computed tomography (CT) scans. As a result, different clinical centres have varying protocols for incorporating liver‐windows for abdominal CT scans. This investigation aims to explore and determine whether various clinical centres throughout Victoria use liver‐window settings selectively or routinely and their justification for doing so. An additional purpose is also to assess the benefits and rationale of liver‐window settings in supplementing routine soft‐tissue‐windows for abdominal CT examinations by reviewing evidenced‐based studies.Surveys were sent out to CT supervisors at various clinical centres, including private and public institutions. This achieved an overall response rate of 74 per cent. Results indicate that the majority of clinical centres throughout Victoria routinely incorporate liver‐window settings for all abdominal CT examinations. Forty four per cent (11/25) of respondents stated that they utilise liver‐window settings selectively for abdominal CT examinations. Most of these respondents (7/11 = 63 per cent) believed that soft‐tissue‐window settings alone are adequate to demonstrate hepatic lesions; particularly if intravenous contrast media is used and the liver is captured in the arterial, venous and/or delayed phases.The benefits and rationale of incorporating liver‐window settings for all abdominal computed tomography scans has been questioned by two well noted studies in the United States. These evidence‐based studies suggest that such additional settings do not offer further advantages in detecting hepatic disease, when compared to soft‐tissue‐windows alone.Review of the available literature provides additional evidence suggesting that the routine use of liver‐window settings in conjunction with soft‐tissue‐windows offers no further advantages in the detection of hepatic diseases. This investigation found, however, that the majority of respondents are currently recording liver‐windows routinely for all abdominal CT scans. This is performed even though many of these respondents agreed with established literature that liver‐windows should be reserved for patients with high clinical suspicion of hepatic disease, or when a lesion is detected on the standard soft‐tissue‐window.
Myth busting — in the world of x‐rays
Authors: Piotto Lino , Gent Roger , Bibbo Giovanni 
Published: October 2013

AbstractHave you seen the television show ‘MythBusters’? It was decided to carry out a radiographic version of ‘MythBusters’. The study involved the investigation of the urban myth about a female radiographer who accidentally x‐rayed her hand, only to discover that her diamond engagement ring was a fake. To prove or disprove the legend, a number of natural diamonds and cubic zirconia crystals were radiographed. Sure enough, there was a definite and consistent difference between the resultant images. The study confirmed part of the myth that radiography can differentiate between a diamond and a cubic zirconia fake diamond.
An investigation into the perceptions of radiographers in the Greater Sydney metropolitan area on performing intravenous contrast media administration
Authors: Toh Valerie , Reed Warren , Robinson John 
Published: October 2013

AbstractAim: To investigate the perceptions of radiographers in the Greater Sydney metropolitan area concerning the performance of intravenous contrast media injections by radiographers. Methods: 90 radiographers (corresponds to a 40.9% return) from five randomly selected private radiology practices and five randomly selected public hospitals within the Greater Sydney metropolitan area were surveyed. The survey was structured such that each section of the survey related to a specific objective of the study. This study focuses on training, departmental workflow and medico‐legal issues. Results: Radiographers from private practices were more in favour of performing intravenous contrast media administration, although the majority of the radiographers surveyed felt that it should be performed as part of their normal duties. They felt that it would greatly aid department workflow and patient throughput. However, there were concerns about the medico‐legal implications of this added responsibility. Conclusions: Most respondents were in favour of radiographers performing contrast media injections. Standardised and accredited training, including education on the medico‐legal coverage available to them, may be needed to allay their concerns and adequately prepare them to take on this extended role.
The current status of radiographers as screen readers in breast screening units: applications for Australia
Authors: Thompson WM , Pollard K 
Published: October 2013

AbstractIn the United Kingdom's National Health Service BreastScreen Program, three‐quarters of their screening units have radiographers as one of the two independent screen readers. This has been the case since the early 1990s. Multiple studies confirm the capabilities of radiographers as screen readers and the positive outcomes for the stakeholders. This is not the current practice in BreastScreen Australia, despite the chronic and increasing shortage of radiologists in general and in particular radiologists willing to be accredited in BreastScreen. This discrepancy in practice led to a qualitative investigation of the perceptions of radiographers, radiologists and directors involved in BreastScreen Australia and eligible users of the service, regarding the role of radiographers as screen readers. The perceptions of these Australian stakeholders were collected via interviews and personal correspondence. Thematic analysis was conducted on the data and then triangulated with a thematic analysis of the literature. This research demonstrated positive perceptions towards radiographers as screen readers for BreastScreen Australia by the Australian stakeholders. This was supported and reinforced by the literature review, in particular, the UK experience of radiographers as screen readers. Therefore, given the advantages of radiographer role extension and increased career opportunities, in conjunction with the increasing workload of the Australian radiologist, it would seem prudent to commence planning for the introduction of non‐radiology screen readers in to BreastScreen Australia. This paper provides an initial basis from which to commence discussion and planning by all the Stakeholders.
A 3D conformal radiation therapy class solution for dose escalated prostate irradiation
Authors: Runham Joshua , McDowall William , Bryant Daniel , Martin Jarad 
Published: October 2013

AbstractProstate cancer is a dose responsive neoplasm i.e. the higher the dose of radiation administered, the more likely it is to attain local tumour control. However, high doses without careful conformal treatment planning leads to increased complication rates. This study aims to determine the ideal dosimetric and clinically relevant 3D conformal radiation therapy (3D‐CRT) plan for 78 Gy dose escalated prostate treatment.A pilot study was performed on two patients using computed tomography (CT) images previously acquired to plan their treatment. The planning target volume in one patient encompasses the prostate only (PO) while the other had the prostate and seminal vesicles (PSV) contoured. Three senior radiation therapists and a radiation oncologist evaluated 10 optimised plans and recommended the top three techniques for further investigation. The top three techniques, 5‐field (0, 90, 120, 240, 270 gantry angles), 6‐field (30, 90, 120, 240, 270, 330 gantry angles) and 8‐field (30, 60, 100, 135, 225, 260, 295, 330 gantry angles) were further applied to previously acquired CT images of another three patients, each contoured according to a standardised protocol. The median dose volume histograms (DVH) of the organs at risk (OAR) from five patients were compared to determine the best plan.The 6‐field technique is the best option for dose escalated prostate irradiation. The 8‐field technique produced the highest rectal dose while the 5 and 6‐field techniques showed little variation (P = 0.239). The 6‐field technique produced a plan with significantly less dose to the femoral head and neck compared to the 5‐field technique (P = 0.001).
What effect does treating cancer patients have on radiation therapy students' identity development?
Authors: Dungey G M 
Published: October 2013

AbstractThe aim of this research was to determine what effect treating cancer patients has on the ability of radiation therapy students to develop their own identity. It is important that radiation therapists have a sense of self so they can enter fully into relationships with patients and other health professionals, and develop sound coping mechanisms to face the challenges of the clinical environment. This research was conducted utilising a qualitative case study approach, with a class of 30 Year Two young adult radiation therapy students. Twenty‐one of the 30 students completed an open‐ended questionnaire. The research findings show that this cohort of radiation therapy students is developing a new set of values, beliefs and goals, partially as a result of their interactions with cancer patients. Four main themes were identified: concern for family and friends, emotional aspects of treating cancer patients, the feeling of a sense of pride in their profession and a development of a greater awareness of themselves as individuals. Using the criteria of identity developed by James Marcia, some students expressed a strong sense of who they are as an individual with a sense of identity. However, for others, the clinical experience has caused them to actively struggle for a sense of who they are as a person as they searched for ways to cope. This research suggests that strategies such as counselling, supervision or mentorship could be useful for radiation therapy students so they can explore their feelings and be able to implement appropriate coping mechanisms.
Image and isocentre management in the paperless age: an automated decision making model
Authors: Middleton Mark , Hughes Amber , Sisson Toni , Frantzis Jim , Martin Jarad 
Published: October 2013

AbstractPurpose: The introduction of sophisticated imaging and image analysis tools into daily radiotherapy has made it feasible to undertake image guided radiation therapy (IGRT) on a daily basis. The aim of this paper is to outline that the introduction of a paperless automated decision making model to assess systematic trends in field placement can enhance the efficiency of a treating radiotherapy team. Methods: Automated custom reports were written using Infomaker (Sybase, Dublin, California, USA) to integrate with the ARIA (Varian, Palo Alto, California, USA) patient information system. This allowed automated systematic trend identification in treatment field set‐up. The efficiency and accuracy of an automated approach was then compared to manual field placement analysis and a statistical model (Newcastle model). Results: The automated decision making model has been shown to reduce the amount of time taken to analyse images and systematic trend analysis, when compared to manual methods, significantly (P < 0.001). In addition to the enhanced efficiency there is no trade off in accuracy with the automated decision making model. Discussion: An automated approach to trend analysis allows the treating radiotherapy team to manage field placement in a highly efficient manner, which is paramount in the era of increased image data. A paperless approach to image analysis and field placement trend analysis places the responsibility of accurate field placement on the radiation therapist and represents a vital link in the management of an IGRT protocol. Conclusion: In the era of IGRT with increased imaging data, efficient methods must be found to analyse and manage systematic trends. An automated decision making model represents an increase in efficiency with no trade off in accuracy.
Evidence based practice: an introduction and application for radiation therapy practice
Authors: Howson D , Scutter S , Hillier S 
Published: October 2013

AbstractRadiation therapists, as professionals, need to maintain personal knowledge and inform organisational best practice according to latest international research. Evidence based practice is well established in health care and has a defined methodological process for locating, appraising and applying the best available evidence to clinical practice. Conducting a comprehensive search of published research to find the best evidence requires the appropriate skills and resources, including time. Radiation therapists in clinical practice may be limited in one or more of these areas. Systematic reviews and evidence based clinical practice guidelines provide systematically developed recommendations for clinical practice and further research. Radiation therapists can retrieve this higher level evidence even with limited access to resources. This paper provides some practical tips for applying evidence based practice in radiation therapy.
Can intensity modulated radiation therapy reduce cardiac dose in left‐sided breast patients?
Authors: Abeyaratne D 
Published: October 2013

AbstractPurpose: In recent years interest has grown in the investigation and clinical application of intensity modulated radiation therapy (IMRT) for adjuvant treatment of early stage breast cancer. A review of the current literature was conducted to establish if IMRT can reduce doses delivered to the heart and potentially minimise the likelihood of cardiac toxicities for early stage left‐sided breast cancer patients. Methods: A literature review was undertaken to identify recent studies (1999–2009) that compared IMRT with three‐dimensional conformal radiation therapy (3D CRT) techniques for left‐sided breast patients. Results: Based on the five reviewed articles, IMRT reduces the cardiac volume treated to high doses; however this is at the expense of an increase in the volume treated to low/intermediate doses. The maximum dose to the coronary arteries and left ventricle can be reduced with IMRT. Using radiobiological modelling some studies found a reduced risk of normal tissue complication probability (NTCP) for cardiac mortality with IMRT. Conclusion: The evidence provided in this review encourages the use of IMRT approaches in the treatment of early stage left‐sided breast cancer in order to minimise morbidity specifically to cardiac tissue. However, in order to ensure optimal use of resources, thought needs to be given as to which women will benefit most from complex treatment approaches.
Radiographers' ability to perceive and classify abnormalities on mammographic images — results of a pilot project
Authors: Holt JJ , Pollard K 
Published: October 2013

AbstractPurpose: The literature indicates that image interpretation as a developing role for radiographers is becoming more popular overseas. However, little is known about the ability of Australian radiographers to interpret radiographic images. The aim of this study is to provide pilot data to determine how well radiographers, without formal image interpretation training, can read mammograms. Methods: Twelve radiographers employed by the BreastScreen Queensland screening service were divided into two equal groups based on years of mammographic imaging experience. Each participant was asked to interpret a purposive image set containing 60 two‐view primary screening bilateral mammographic images. The participants were asked to determine if an abnormality was perceived, indicate the location on a breast diagram and then classify the image set according to a 5 point scale; no specific finding, benign finding, probably benign finding, probably malignant finding, highly suggestive of malignancy. Sensitivity and specificity rates for each group was calculated and compared. Results: Compared to the “Gold Standard” outcomes, the sensitivity of Group A in detecting abnormalities which had resulted in a positive screening result was 82.6% as compared to Group B at 77.5%. Specificity demonstrated Group B higher than A: 79.6% compared to 75.4 %. These results were minimally lower than those found in overseas studies. Conclusion: The results indicate that further work in this area is justified to support the training and role development of radiographers in the formal reporting role of screening mammograms.
Tumour in full motion; inspiration gating versus free breathing
Authors: Rains M 
Published: October 2013

AbstractThis case study compares and evaluates two treatment techniques for a lung cancer patient diagnosed with T1N0M0 non‐small cell lung carcinoma. Radiotherapy is planned to be delivered either without gating, i.e. during the patient's normal free breathing or to be delivered gated at the inspiration portion of the patient's respiratory cycle.
Radionuclide therapy
Authors: Wheat JM , Currie GM , Davidson R , Kiat H 
Published: October 2013

AbstractThis article follows the article An Introduction to Nuclear Medicine published in this issue of The Radiographer. Nuclear medicine is the injection, ingestion or inhalation of a radiopharmaceutical for the purpose of diagnosis or therapy. While the previous article focussed on the fundamental principles of diagnostic imaging, this paper focuses on the role of nuclear medicine in the treatment of disease.Radionuclide therapy differs from other forms of ionising radiation therapies, such as external beam radiation therapy and brachytherapy, in that photons are not the prime means damaging the target volume. Rather beta and sometimes alpha particles are used to deliver the dose to the target. Delivery methods and biodistribution of the radionuclides are important considerations for optimising the dose to the target volume and for minimising the radiation burden to non‐target tissues. One of the benefits associated with some radionuclides used in therapy is that imaging can occur at the concurrently if the radiopharmaceuticals emits both a particle and a photon.This article provides an overview of the mechanisms of dose delivery, types of radionuclides that are used in therapy, clinical applications, recent advances and the future of radionuclides therapies. An understanding of the technical and clinical aspects of radionuclide therapies can provide an improved understanding for medical radiation scientists and in doing so benefit the patient.