No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Accurate determination of working length during endodontic therapy is a crucial step in achieving a predictable outcome. This is determined by the use of electronic apex locators, tactile perception, and knowledge of average tooth lengths and/or dental radiography whether digital or conventional is utilized. It is the aim of this study to determine if there is a difference between Schick digital radiography and Kodak Insight conventional film in accurately determining working lengths when modifying exposure time and source-film/sensor distance. Twelve teeth with size 15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. Each tooth was radiographed while varying the source-film/sensor distance and exposure 122 time. Four dental professionals examined the images and films independently. Ten images and 10 films were selected at random and re-examined to determine each examiner?s repeatability. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, distance, exposure time, and all two-way and three-way interactions. The repeatability of each examiner for each film type was assessed by estimating the intra-class correlation coefficient (ICC). The repeatability of each examiner on digital film was good with ICCs ranging from 0.67 to 1.0. Repeatability on the conventional film was poor with ICCs varying from -0.29 to 0.55.We found there was an overall difference between the conventional and digital films (p < 0.001). After adjusting for the effects of distance and exposure time, the error in the working length from the digital image was 0.1 mm shorter (95% CI: 0.06, 0.14) than the error in the working length from the film image. There was no difference among distances (p = 0.999) nor exposure time (p = 0.158) for film or images. Based on the results of our study we conclude that although there is a statistically significant difference, there is no clinically significant difference between digital radiography and conventional film when exposure time and source-film/sensor distance are adjusted.

Indiana University-Purdue University Indianapolis (IUPUI) / Accurate determination of working length during endodontic therapy is critical in achieving a predictable and successful outcome. Working length is determined by the use of electronic apex locators, tactile perception, knowledge of average tooth lengths and dental radiography. Due to the increasing use of digital radiography in clinical practice, a comparison with conventional film in working length determination is justified. The purpose of this study is to determine if there is a difference between Schick digital radiography and Kodak Ultra-speed film in the accurate determination of working lengths when vertical angulation of the object is variable. Twelve teeth with #15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. A mounting jig for the standardization of projection geometries allowed for exact changes in vertical angulation as it related to the object (tooth) and the film/sensor. Each tooth was imaged using Schick CDR and Kodak Ultra-speed film at varying angles with a consistent source-film distance and exposure time. Four dental professionals examined the images and films independently and measured the distance from the tip of the file to radiographic apex and recorded their results. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, vertical angulation, and the interaction of angle and film type. Tooth type and examiner were included in the model as random effects assuming a compound symmetry covariance structure. The repeatability of each examiner, for each film type, was assessed by estimating the intra-class correlation coefficient (ICC). The ICC was determined when 12 randomly selected images and radiographs were reevaluated 10 days after initial measurements. The repeatability of each examiner for Schick CDR was good with ICCs ranging from 0.67 to 1.0. Repeatability for the conventional film was poor with ICCs varying from -0.29 to 0.55. We found the error in the working length was not significantly different between film types (p = 0.402). After adjusting for angle, we found that error in the working length from the digital image was only 0.02 mm greater (95-percent CI: -0.03, 0.06) than the conventional film. Furthermore, there was not a significant difference among the angles (p = 0.246) nor in the interaction of image type with angle (p = 0.149). Based on the results of our study, we conclude that there is not a statistically significant difference in determining working length between Schick CDR and Kodak Ektaspeed film when vertical angulation is modified.

A mathematical model which is used to detect bone edges accurately is described in this thesis. This model is derived by assuming the X-ray source to be a square region. It is shown that for an ideal X-ray source (point source), the bone edge lies exactly at the location of maximum first derivative of the imaged object's transmission function. However, for the non-ideal case, it is shown that the bone edge does not lie at the maximum first derivative location. Also, it is shown that an offset can be calculated from the edge parameters. The Marr- Hildreth edge detector is used to detect the initial estimates for edge location. Precise estimates are obtained by using the facet model. The offset is then calculated and applied to these estimates. / Master of Science

No description available.

No description available.

An educational intervention designed to promote the use of mammography among women at risk of developing breast cancer was conducted in Blacksburg, Virginia in the spring of 1989. The intervention employed the theories of planned behavior and diffusion to raise women's intention to seek a mammogram. The study employed a posttest-only control group design and was delivered at a hairstyling salon. Eight hairstylists were trained to promote mammography as a breast cancer early detection method and to provide educational materials about the importance of early detection and the advantages of mammography. Eighty-seven women (35 or older), were subjects in the study. At follow-up, independent t-tests showed that women randomly assigned to the experimental group (n=43) had higher breast cancer early detection knowledge scores (p=O.03), stronger belief scores about their control over obtaining a mammogram (p=O.03), and higher behavioral intention scores to seek a mammogram appointment Cp<O.OOl) than controls (n=44). Direct benefits for the experimental group were an increased awareness about the risks of developing breast cancer, a stronger perception of affordability of mammography, and a stronger perception of their ability to fit a mammogram into their schedule. The results of the intervention show that hairstylists trained as lay health educators may be valuable change agents in promoting breast cancer early detection in community educational interventions focusing on mammography. / Master of Science

Background- Diagnostic radiography is an established method of investigating child safeguarding concerns. The role of the radiographer in identifying signs that represent safeguarding concerns and acting as a conduit between the patient and other professionals is less well understood. Aims- To evaluate the role of the radiographer in child safeguarding. Establish the contributory factors that influence that role and identify the measures that can be taken to maximise the contribution that could be made to protect patients. Methods- A multimethod approach of two studies (KAP survey and semi-structured interviews) was implemented sequentially to permit the second study to be influenced by the results of the first. Results - An inconsistent knowledge base in terms of child safeguarding exists. A positive attitude towards the profession’s role was identified and an inference that the profession does contribute to the escalation process, albeit only exceptionally. Conclusion- Those in the earlier stages of their career are most in need of recognising suspicious appearances. Radiographic appearances are commensurate with the modality utilised and needs accounting for within education. Contemporary practice makes assessment of more abstract appearances of child safeguarding concerns challenging. The systems of escalating concerns are known, and the profession is willing and able to contribute. Recommendations- Educational focus on the recognition of pathognomonic signs of abuse and aetiology to permit recognition of occasions when injury and clinical history disagree. Education should also include child safeguarding concerns commensurate with the modality utilised and as part of image reporting. Further research is needed to promote the role of the profession and to evaluate the impact of technological advancement on the profession’s capability to contribute effectively.

To determine the accuracy of radiographer plain radiograph reporting in clinical practice. MATERIALS AND METHODS Studies were identified from electronic sources and by hand searching journals, personal communication and checking reference lists. Eligible studies assessed radiographers' plain radiograph reporting in clinical practice compared with a reference standard, and provided accuracy data to construct 2×2 contingency tables. Data were extracted on study eligibility and characteristics, quality and accuracy. Summary estimates of sensitivity and specificity and receiver operating characteristic curves were used to pool the accuracy data. RESULTS Radiographers compared with a reference standard, report plain radiographs in clinical practice at 92.6% (95% CI: 92.0¿93.2) and 97.7% (95% CI: 97.5¿97.9) sensitivity and specificity, respectively. Studies that compared selectively trained radiographers and radiologists of varying seniority against a reference standard showed no evidence of a difference between radiographer and radiologist reporting accuracy of accident and emergency plain radiographs. Selectively trained radiographers were also found to report such radiographs as accurately as those not solely from accident and emergency, although some variation in reporting accuracy was found for different body areas. Training radiographers improved their accuracy when reporting normal radiographs. CONCLUSION This study systematically synthesizes the literature to provide an evidence-base showing that radiographers can accurately report plain radiographs in clinical practice.

Yes / Increasing diagnostic capacity is a national priority to expedite the timeliness and appropriateness of patient treatment interventions. Imaging—encompassing a range of technologies including X-ray, CT, MRI, nuclear medicine and ultrasound—is a key diagnostic service and central to decision-making in most, if not all, disease pathways. However, imaging is an expensive discipline accounting for an estimated 3–5% of the annual NHS budget. As a result, it is imperative that we maximise service efficiency while optimising patient outcomes. / The manuscript version differs from the published version.