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Computed tomography simulator conversion curve dependence on scan parameters and phantom dimension
Get PDFIntroduction: Using computed tomography (CT) and treatment planning systems (TPS) in radiotherapy, due to the difference in photon beam energy on CT and linear accelerator, it is necessary to convert Hounsfield units (HU) to relative electron density (RED) values. The aim of this dosimetric study was to determine whether there is a significant effect of potential in the CT tube, field of view size (FOV), and phantom dimensions on the CT conversion curve CT-RED. The second aim is whether there are significant differences between the CT-RED obtained by the Computerized Imaging Reference Systems (CIRS) Thorax 002LFC phantom and the “reference” curve in the TPS, obtained by the CIRS 062M pelvis phantom, at the same CT conditions.Methods: Heterogeneous CIRS 062M and CIRS Thorax 002LFC phantoms were used, which anatomically and dimensionally represent the human pelvis, head, and thorax, with a set of known RED inserts. They were scanned on a CT LightSpeed GE simulator and obtained CT-RED.Results: The high voltage in the CT tube had a significant effect on the HU (t = 10.72, p < 0.001) for RED values >1.1, while FOV as a parameter did not show statistical significance for the 062M pelvis phantom. Comparing the slopes (062M pelvis and head) of the CT-RED for RED ≥ 1.1, the obtained value is t = 1.404 (p = 0.163). In the case of a 062M pelvis and a 002LFC phantom, we have seen a difference in RED values (for the same HU value) of 5 % in the RED region ≥ 1.1 (bone).Conclusion: Patients should be imaged on a CT simulator only at the potential of the CT tube on which the conversion curve was recorded. The influence of the FOV and scanned phantom dimensions is not statistically significant on the appearance of the calibration curve (RED ≥ 1.1)
Radiography student comparison performing lumbar and thoracic spine imaging
Get PDFIntroduction: General radiography is a common imaging technique and X-ray examinations of the thoracic and lumbar spine are among the most frequent procedures undertaken. The aim of this research was to investigate the success rate, dose-area product (DAP), and effective dose values of 1st and 2nd cycle radiographer students performing X-ray imaging of the thoracic and lumbar spine using a phantom.
Methods: The students were divided into four groups according to the year of study (1st, 2nd, and 3rd years of 1st cycle degree, and all 2nd cycle degree students). They were asked to perform imaging of thoracic and lumbar spine on the phantom in both anteroposterior and lateral projections where IQ and DAP measurements were collated. The study was blind, so they did not know about the purpose of the study.
Results: First, we have inspected the acceptability rate of the images performed. The highest success rate of performing an optimal image was discovered with the 2nd cycle degree students where the 1st year students had the most difficulties there. In the second part, DAP and effective dose values were compared, only for the acceptable images in which case the 1st and 2nd years, students of the 1st cycle degree were most successful.
Conclusion: Based on that, we can conclude, that the 2nd cycle degree students had the lowest rejection rate regarding the optimal image quality, which was the price of using a larger primary X-ray field which leads to higher dose values
Predictors of anxiety and depressive symptoms among Greek nurses
Get PDFIntroduction: The increasing needs of an aging population and the shortage of nursing personnel have a negative impact on the workload of nurses increasing the risk of developing anxiety and depressive symptoms. This research aims to evaluate the strength of occupational and demographic characteristics in predicting anxiety and depression among nurses.
Methods: In this cross-sectional study, a sample of 164 Greek nurses from three hospitals employed full-time participated. Anxiety and depression were measured using the validated Greek versions of the State-Trait Anxiety Inventory – State and Trait Y forms and the Centre for Epidemiological Studies Depression scale, respectively. The statistical analysis of the data was performed using the statistical program SPSS version 19.0. The statistical significance level was set up at 0.05.
Results: Younger nurses, unmarried, those without children, those with less work experience, and working in the general medical units were more vulnerable. The average number of patients per nurse during the day shift may not predict anxiety or depression scores. Strong positive correlation between state and trait anxiety (r [162] = 0.77, p < 0.001), state anxiety and depression (r [162] = 0.62, p < 0.001), and trait anxiety and depression (r [162] = 0.63, p < 0.001) was revealed.
Conclusion: Anxiety and depression are prevalent among nurses. Demographic and working characteristics are strong predictors of anxiety and depression among nurses. Nursing managers should emphasize emotional interventions (cognitive behavioral therapy, training on emotional intelligence, strengthening coping skills, and development of high resilience) in supporting nurses at higher risk
Determination of adaptation levels and applications for fistulas care and protection to disease of patients with arteriovenous fistula
Get PDFIntroduction: The aims of this study were to the determinate adaptation to chronic disease, applications for arteriovenous fistula (AVF) care, protection of hemodialysis (HD) patients with an AVF, and to determine the relationships between adaptation and application.
Methods: This research is a prospective, descriptive, and cross-sectional type of research. Sample of the study accounted for 180 patients who underwent HD. Research was completed with 114 patients. The research was conducted from July 2019 to September 2019, in two different dialysis centers in Osmaniye Province. The data were collected using The Patient Identification Form and Adaptation to Chronic Illness Scale. Mean ± Standard deviation, percentages, and independent samples t-test analysis was used.
Results: When the scale scores of the patients participating in the study were evaluated, determined to level of total adaptation with chronic disease and physical adaptation was to above the average score (40.24 ± 5.99). Social adaptation (21.82 ± 6.39) and psychological adaptation (22.91 ± 5.39) levels can be said to be moderate. Individuals who exercised with the ball to mature the fistula, who was careful to dress and keep the area dry on the 1st day of the operation, who was careful not to apply lotion to the fistula area, and who complied with the fluid restriction were found to have higher levels of adaptation with the disease.
Conclusion: As a result, it is observed that the general and physical adaptation levels to chronic disease are above the average and social and psychological adaptation levels are medium-level. However, it is observed that the adaptation level of the participants who stated that they performed all applications for AVF care and protection properly is higher. In line with these findings, the adaptation level of patients should be increased by a patient-centred and multifaceted approach
Nasal carriage rate and antimicrobial resistance pattern of Staphylococcus aureus among the food handlers in Canton Sarajevo, Bosnia and Herzegovina
Get PDFIntroduction: The nasals and hand carriage of Staphylococcus aureus in food handlers (FHs) represent a significant source of Staphylococcal food contamination and food poisoning. Antimicrobial resistance (AMR) is a microorganism’s ability to resist the action of one or more antimicrobial agents. S. aureus has demonstrated the ability to rapidly respond to each new antimicrobial with the development of a resistance mechanism. The aim of the study was to assess the prevalence of nasal carriage rate and AMR pattern of isolated strains S. aureus among FHs in Canton Sarajevo, Bosnia and Herzegovina.
Methods: The retrospective study included laboratory results of 11.139 tested subjects between January 2014 and December 2018. The study was conducted in the laboratory of the Institute of Public Health of the Federation of Bosnia and Herzegovina in Sarajevo. Samples of nasal swabs were collected from FHs, employees in companies located in Canton Sarajevo, during sanitary surveillance prescribed by applicable legal standards. S. aureus isolates were identified according to conventional microbiological methods and antimicrobial susceptibility testing was performed by the agar disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing; 2013 standard.
Results: Among the 11.138 subjects, 792 (7.1%) were carriers of S. aureus. Isolated strains were tested on eight different antibiotics, and the resistance to penicillin, ampicillin, and amoxicillin was 788 (99.5%), 776 (97.9%), and 752 (94.9%), retrospectively. In total, 86.36% of isolated strains were multidrug-resistant.
Conclusions: The low percentage of S. aureus carriers indicates that preventive measures of carrier control are being actively implemented within the legally prescribed measures. The emergence of numerous isolated strains with multidrug-resistance characteristics is a significant public health problem and consequently limits the range of antibiotics available for therapeutic purposes. The results of this research indicate that AMR has increased in Sarajevo Canton and it is following the trend of global growth
Prevalence and classification of anatomical variations of mandibular canal in panoramic radiographies
Get PDFIntroduction: Dental surgeries involving structures adjacent to the mandibular canal require greater knowledge of the intraosseous path, anatomical structure, and its variables, reducing the risk of injuries to this region. This research aimed to verify on the panoramic radiographs the anatomical characteristics of the mandibular canal, as well as to analyze and classify its pathways.Methods: The classification of anatomical variations of the mandibular canal was divided into four types: Class A (inferior direction); Class B (mesial direction); Class C (alveolar direction); and Class D (retromolar direction). The sample consisted of 500 exams, 207 (41.4%) males and 293 (58.6%) females, with a mean age of 29.51 years.Results: A prevalence of 30 anatomical variations of the mandibular canal was observed. The most prevalent classifications were Class B (43.6%) followed by Class C (23.1%) and D (33.3%). In no case was the presence of bifid canals classified as Class A. The anatomical variations of the mandibular canal appeared both unilaterally and bilaterally, in which unilaterally the prevalence was on the left side (50%), on the right side (20%), and bilaterally (30%).Conclusions: According to the results obtained in this study, a prevalence of 6% of bifid mandibular canals was found. The most prevalent types of the bifid canal were Class B and Class D, and the highest occurrence of bifid mandibular canals was left unilateral. It is concluded that the appearance of mandibular canal anatomical variations in panoramic radiographs is frequent and that additional care must be taken to approach the region
Geospatial clustering of newly diagnosed HIV infected adults in Cross River State helps define new “hotspots”
Get PDFIntroduction: A hotspot is a geographical location having evidence of high STIs/HIV prevalence, and/or behaviors that put people at high risk of becoming infected. Therefore, Nigeria, with almost two million people living with HIV, could be considered a giant “hotspot.” The main aim was to describe how the geospatial clustering of newly diagnosed HIV-infected adults in Cross River State helps define new “hotspots.”Methods: Secondary data collected between January 2020 and March 2020, identified and mapped around a presumed hotspot’s radius of influence (ROI), were analyzed using a “Hotspot Analysis” plugin in QGIS software. With a sample size of 3019, both seropositive and seronegative results were geo-referenced and the resultant map was analyzed to determine HIV-positive clusters.Results: From the 3019 spatial locations mapped, 720 (23.9%) were positive cases. Of these, 328 (45.6%) were thus estimated as being associated with the presumed hotspots. The remaining 392 (54.4%) were positive cases identified outside of the ROI of the originally presumed hotspots. The total number of mapped HIV testing services (HTS) points (both negative and positive cases) within the hotspot ROI was 1319, while those outside of the hotspot ROI were 1700.Conclusion: Unique hotspots where social gatherings occur tended to have a wider ROI. Targeted testing in these hard-to-reach communities is recommended
Canton Sarajevo journey through COVID-19 pandemic
Get PDFIntroduction: Sarajevo is the capital city of Bosnia and Herzegovina, with the population in Canton Sarajevo of 438,443 people. The first cases of COVID-19 in Canton Sarajevo were on 20th March. On that day, we had three positive cases. These days at the beginning of the COVID-19 epidemic in Canton of Sarajevo around 2500 citizens were in self-isolation at home. The aim of this paper is to show the journey of Canton Sarajevo in the fight against COVID-19 infection, the impact of measurements that were taken to stop the infection spreading and to compare pre- and post-lockdown stats.Methods: During the period March-July 2020, we have analyzed daily newly cases and followed them through the period of at least 14 days. All data were analyzed using SPSS 25.0 (IBM Corp. Released in 2019. IBM SPSS Statistics for Windows, NY: IBM Corp.) and MS Office 2019 suite (Excel). For comparison, we have used the Chi-square test.Results: In the period of 10 weeks from the beginning of March to the 25th of May in Canton of Sarajevo, we had a total of 113 cases of COVID-19 infection. The number of conducted tests was 7515. In total, with positive retests, we had only 161 positive tests, which is 2.14% of all analyzed tests. From that number of patients, 58 (51.3%) were male and 55 (48.7%) were female. Regarding age distribution, under 65 years were 91.1% of patients.Conclusion: Choosing the best method to fight against COVID-19 is hard to determine. Staying at home would decrease the infection rate, but in the long term, it is not sustainable. Perhaps the mix of methods that we had in Sarajevo is the best option. Fighting against one epidemic cannot be the source for other epidemics
Nursing Practice guidelines for needling of A.V Fistula/grafts: Beni-Suef City, Egypt.
No full textIntroduction: Vascular access is considering to the patient undergoing hemodialysis (HD) as his/her soul which indicating patient survival, moreover, vascular access can controlling, directing the dialysis regimen effectiveness. Cannulation techniques are a crucial skill for nurses to minimize arteriovenous fistula (AVF) or graft (AVG) complications.
Methods: A cross-sectional study was applied to assess vascular complication and related factors. The participants were 65 patients on maintenance HD therapy enrolled at the dialysis unit, central Ehnasa’ government hospital, Beni Suef City. Data were collected using developed questionnaires regard patients’ demographic data, clinical, and HD session characteristics, designed Nursing Practice guidelines for needling of AVF/AVG booklet.
Results: Statistically, the results show the most common cannulation technique which was demonstrated is an area method (65%) and needle direction is retrograde with bevel up (66.2%). whereas, the significant positive correlation shows between the cannulation techniques and vascular access complication, duration of dialysis and complication during the dialysis session. Furthermore, the most common complication related to needling practice is aneurysm (44.6%).
Conclusion: Following cannulation, technique guidelines will prevent potential complication, increase vascular access durability, and improve patients’ quality of life
Work-related musculoskeletal disorders among Slovenian physiotherapists
Get PDFIntroduction: Work-related musculoskeletal disorders (WMSDs) represent a major problem for society, employers, and employees. These kinds of problems can cause discomfort, pain, and poor work performance. Among physiotherapists, the 1-year prevalence of WMSD ranges from 28 to 96%. Most problems occur in the lower back, with a 1-year prevalence of up to 83%. This study aimed to determine the prevalence of WMSD on a sample of physiotherapists from Slovenia and to identify associations between demographic/anthropometric variables, job satisfaction, and physical activity with WRMD aiming to contribute to the development of effective prevention and control strategies.
Methods: The extended Nordic musculoskeletal questionnaire was used to obtain data from a sample of 102 physiotherapists. Data were presented with descriptive statistics and processing was performed with the Spearman’s rank correlation coefficient for non-parametric variables. The level of statistical significance was set as p ≤ 0.05.
Results: The 1-year prevalence of WMSD was 92.2%. One-year prevalence of WMSD was highest for the neck (64%) and lower back (63%). Higher age and more years of practice were correlated with WMSD for shoulders and ankles/feet areas. Several patients treated by a physiotherapist were a risk factor for difficulties in the neck and multiple body areas. The level of physical activity was not correlated with WMSD in different body areas.
Conclusion: The prevalence of WMSD found in our study sample was among the highest compared to other countries, despite probably having similar working conditions as elsewhere in Europe. The first WMSD of Slovenian physiotherapists mostly did not occur in the first 5 years of practice as other studies reported, which could be explained as a result of a good educational training of young physiotherapists. Possible reasons for the high prevalence of WMSD could be that our study sample represented only secondary and tertiary levels of health care; another reason could also be non-ergonomic and hard working conditions during their careers. Physiotherapists are mostly adequately physically active, however, that did not turn out to be effective WMSD prevention in our sample. The relatively high prevalence is indicating the need for better interventions and prevention of WMSD in Slovenian physiotherapists