<p>The protection of the unborn child in pregnant women from ionizing radiation is very important because the foetus is particularly sensitive to the effects of radiation. In case of pregnant members of staff working with ionising radiation, the unborn child is treated as a member of the general public, and a dose limit of 1 mSv during pregnancy is applied in order to protect the foetus.</p><p>The purpose of this work was to collect relevant information on exposure conditions and entrance doses of occupationally exposed workers in diagnostic radiology and nuclear medicine, and to give guidelines on how to estimate foetal doses for pregnant staff in such workplaces.</p><p>With X-ray procedures, an accumulated dose of 2 mSv during pregnancy, measured on the trunk (breast or waist) and behind a lead apron, is sufficient to ensure a foetal dose below 1 mSv. For staff working with nuclear medicine, the corresponding limit is 1.5 mSv taking into account external exposure from 99mTc. When internal contamination cannot be neglected, additional precautions need to be considered.</p>

The protection of the unborn child in pregnant women from ionizing radiation is very important because the foetus is particularly sensitive to the effects of radiation. In case of pregnant members of staff working with ionising radiation, the unborn child is treated as a member of the general public, and a dose limit of 1 mSv during pregnancy is applied in order to protect the foetus. The purpose of this work was to collect relevant information on exposure conditions and entrance doses of occupationally exposed workers in diagnostic radiology and nuclear medicine, and to give guidelines on how to estimate foetal doses for pregnant staff in such workplaces. With X-ray procedures, an accumulated dose of 2 mSv during pregnancy, measured on the trunk (breast or waist) and behind a lead apron, is sufficient to ensure a foetal dose below 1 mSv. For staff working with nuclear medicine, the corresponding limit is 1.5 mSv taking into account external exposure from 99mTc. When internal contamination cannot be neglected, additional precautions need to be considered.

Medical Imaging era is coming. The volume of business of the Department of Radiation Diagnosis is flourishing, and it drives overall hospital revenue to increase greatly. Thus, it is more important to maintain and promote the quality of medical services in hospital management. In this study, it used PZB model and referred to the SERVQUAL to design the questionnaire. It got the five dimensions for "tangible", "guaranteed", "reliability", "reactive" and "care" and twenty factors to explore the quality of service. A Department of Diagnostic Radiology of regional teaching hospital in Kaohsiung area as the scope of the study, it will be an important basis and reference to improve the quality of service according to the valid questionnaires to analyze the gap of the attention degree between medical staffs and patients for the medical service quality(gap 1), and the gap of the attention degree and the satisfaction to the medical service quality(gap 5), and the relationships between basic information of patients and satisfaction with the IPA analysis showing the service quality items distribution. In gap one, only the "reliability" and "tangible" dimensions in the five dimensions have positive gap and the dimension of "tangible" has the biggest. And ten results in 20 factors show that the attention degree of the subjects is greater than that of the medical staff, but there are no significant differences. In gap five, the five dimensions are all positive gaps and "reactive" dimensions is the biggest. In 20 factors, the subjects with the attention degree of the quality of medical services are greater than satisfaction, and in which there are 17 significant differences. Gap one and gap five have the maximum gap value both in the factor of "convenient transportation and easy parking to the hospital.¡¨ In addition, for the IPA analysis, "medical staffs can satisfy my immediate needs¡¨ fell to the quadrant of ¡§Concentrate Here¡¨. Finally, according to the results, we have the following conclusions: First, patients attach more importance to intangible service. Second, service of the medical staff begins from the heart. Third, mental cognitive of the medical staff will influence their work performance. We also have the following five suggestions: First, Improve traffic convenience. Second, strengthen the learning courses for the quality of health care personnel service. Third, implement the mechanism of service performance. Fourth, arrange the opportunities to service sharing and review. Fifth, establish a feedback way for patints.

Scattered x-radiation levels associated with various diagnostic procedures were measured with ionization chamber instruments in the small and large animal radiology facilities at the Ontario Veterinary College of the University of Guelph. The occupational radiation exposures incurred by veterinary radiography personnel were monitored using McMaster University's Panasonic UD-702E TLD system. The stray radiation levels and the dosimetric information are compared and discussed. An optimum protocol for radiological health protection surveillance is described. / Thesis / Master of Science (MSc)

Os sistemas de radiologia digital, entre eles os baseados em fósforos fotoestimuláveis (sistemas CR como sao conhecidos em radiologia), são cada vez mais comuns na pratica radiológica da cidade de Sao Paulo, seguindo uma tendência mundial. O uso desta tecnologia, que vem substituindo o conjunto tela-filme como sistema de detecção e produção de imagem, permite o uso de uma faixa dinâmica de detecção mais ampla e pode ser prejudicial ou benéfico do ponto de vista da dose absorvida pelo paciente, pois possibilita a obtenção de imagens para superexposições ou subexposições. Para avaliar o contraste obtido na imagem, e, ao mesmo tempo, obter uma estimativa da dose absorvida pelo paciente, todos os fabricantes de sistemas CR incluem no software de analise da imagem um indicador de exposição, que deve se relacionar com a dose absorvida pela placa de fosforo foto-estimulável (Image Plate IP). Estudos que relacionam a razão sinal ruído (SNR) e Dose de Entrada na Pele (DEP), avaliada com câmara de ionização e dosimetria TL, para radiografias de torax (frente e perfil) foram conduzidos empregando técnicas clinicas. Valores de dose (DEP e dose de saída) foram comparados com valores de níveis de cinza e de indicadores de exposição obtidos para as imagens com o CR Agfa CR30-X. Para isso foram utilizados dois simuladores: um simulador homogêneo, com paredes PMMA e preenchido com agua; e um simulador antropomórfico sem os membros superiores e inferiores (RANDO Phantom), no qual foi possível também medir doses internas com dosimetria TL, com irradiações realizadas em laboratório e em ambiente hospitalar. Os resultados mostraram uma relação logarítmica entre o indicador de exposição da Agfa (log of median of histogram - lgM) e a dose de saída do simulador, e uma relação logarítmica da DEP com a mediana dos níveis de cinza de uma regiao da imagem (SAL - Scan Average Level) para ambas as projeções. Também foi possível relacionar o lgM com a DEP, porem, tal relação e dependente da qualidade do feixe. Com o uso de filtros, verificamos que e possível diminuir a DEP mantendo a mesma qualidade da imagem. Neste trabalho foram obtidos valores de DEP na faixa de 0,0995(50) 1,657(51) mGy, e de doses internas entre 0,0074(18) e 0,90(13) mGy. Com isso concluímos que e possível relacionar os indicadores de exposição com a dose absorvida (DEP e dose de saída), e usar o CR como um avaliador de dose absorvida no paciente, quando a qualidade do feixe e conhecida. / The digital radiology systems, among them the system based on photostimulable phosphors (CR systems as they are known in radiology) are increasingly common in radiological practice in Sao Paulo, following a worldwide trend. Using this technology, which is replacing the screen-film as detection system for production of the image, can be detrimental or beneficial in terms of the absorbed dose to the patient, because the dynamic range of these detectors is much wider than the radiographic films, and it is possible to obtain an image with overexposure or underexposure. To evaluate the contrast obtained in the image, and at the same time, obtain an estimate of the absorbed dose to the patient, all manufacturers of CR systems include the evaluation of an exposure index in the image analysis software. This index should be related to the absorbed dose to the phosphor plate (Image Plate- IP). Studies that relate the signal to noise ratio (SNR) and Entrance Skin Dose (ESD), measured with ionization chamber and TL dosimetry for chest X-rays were conducted using clinical techniques, and typical values of dose (ESD and exit dose) were compared with values of gray levels and exposure index obtained with the CR. For this we used two simulators: a homogeneous one made with PMMA walls and filled with water, and an anthropomorphic phantom without the upper and lower limbs (RANDO Phantom), in which it was also possible to measure internal doses with TL dosimetry. The results showed a logarithmic relationship between the Agfa index IgM (log of median of histogram) and the simulator exit dose, and a log relationship between the ESD and the mean gray level of a region of the image (SAL - Scan Average Level ). It was also possible to relate the IgM with ESD, but the relation is dependent on the beam quality. With the use of different filtrations, we verified the possibility of decrease the ESD keeping the same image quality. In this work we obtained ESD values in the range 0.0995(50) 1.657(51) mGy, and internal doses from 0.0074(18) to 0.90(13) mGy.

Este estudo teve como finalidade principal avaliar a qualidade de vida (QV) dos profissionais de saúde que compõem o serviço de radiodiagnóstico de um hospital da cidade de São Paulo. Além disso, objetivou conhecer o perfil desses profissionais, identificando as variáveis que podem influenciar a QV desses profissionais. Trata-se de um estudo descritivo e exploratório com abordagem quali-quantitativa. Os dados foram coletados usando os questionários: o instrumento abreviado de avaliação de QV - World Health Organization Quality of Life Instrument bref (WHOQOL-bref) da Organização Mundial da Saúde e um questionário sobre as variáveis de interesse: sociodemográficas, condições de trabalho e estilo de vida, ambos questionários auto-aplicáveis. A amostra foi constituída de 118 profissionais nas categorias de: médicos, tecnólogos/técnicos de radiologia, enfermeiros, técnicos e auxiliares de enfermagem, entre outros. A análise dos dados envolveu estatística descritiva, testes não paramétricos e o uso de um modelo de regressão linear. O grau de confiabilidade do instrumento foi avaliado por meio do Coeficiente Alfa de Cronbach (&alpha;). O WHOQOL-bref demonstrou ser um instrumento adequado, de aplicação fácil e rápida para a aferição da qualidade de vida; mostrou bom desempenho psicométrico e boa consistência interna (&alpha;=0,884). O estudo permitiu conhecer a percepção de qualidade de vida do grupo estudado. / The main objective of this study was to evaluate the quality of life (QOL) of diagnostic radiology services workers at a hospital of São Paulo city. It aimed also to draw the profile of these workers identifying the variables, as its influence on their quality of life. A descriptive exploratory study with qualitative and quantitative approaches was carried out. The data were collected using the questionnaires: the abbreviated instrument for the assessment of the QOL, World Health Organization Quality of Life Instrument bref (WHOQOL-bref) and a questionnaire including the social demographic variables, work conditions and the variables that express the lifestyle of individuals, both questionnaires self-applied. The sample was formed by 118 workers, among them: physicians, technologists/technicians in radiology, nurses, technicians and assistants in nursing, and others health professionals. The data analysis included descriptive statistics, nonparametric tests and the use of a linear regression model. The reliability of the instrument for the studied sample was verified by Cronbachs Alpha Coefficient (&alpha;). The WHOQOL-bref proved to be an adequate instrument, with a good level of internal consistency (&alpha;=0.884), being easily and quickly administrated for the evaluation of the QOL. The study provided an overview of the perception of quality of life of the studied group.

Este estudo teve como finalidade principal avaliar a qualidade de vida (QV) dos profissionais de saúde que compõem o serviço de radiodiagnóstico de um hospital da cidade de São Paulo. Além disso, objetivou conhecer o perfil desses profissionais, identificando as variáveis que podem influenciar a QV desses profissionais. Trata-se de um estudo descritivo e exploratório com abordagem quali-quantitativa. Os dados foram coletados usando os questionários: o instrumento abreviado de avaliação de QV - World Health Organization Quality of Life Instrument bref (WHOQOL-bref) da Organização Mundial da Saúde e um questionário sobre as variáveis de interesse: sociodemográficas, condições de trabalho e estilo de vida, ambos questionários auto-aplicáveis. A amostra foi constituída de 118 profissionais nas categorias de: médicos, tecnólogos/técnicos de radiologia, enfermeiros, técnicos e auxiliares de enfermagem, entre outros. A análise dos dados envolveu estatística descritiva, testes não paramétricos e o uso de um modelo de regressão linear. O grau de confiabilidade do instrumento foi avaliado por meio do Coeficiente Alfa de Cronbach (&alpha;). O WHOQOL-bref demonstrou ser um instrumento adequado, de aplicação fácil e rápida para a aferição da qualidade de vida; mostrou bom desempenho psicométrico e boa consistência interna (&alpha;=0,884). O estudo permitiu conhecer a percepção de qualidade de vida do grupo estudado. / The main objective of this study was to evaluate the quality of life (QOL) of diagnostic radiology services workers at a hospital of São Paulo city. It aimed also to draw the profile of these workers identifying the variables, as its influence on their quality of life. A descriptive exploratory study with qualitative and quantitative approaches was carried out. The data were collected using the questionnaires: the abbreviated instrument for the assessment of the QOL, World Health Organization Quality of Life Instrument bref (WHOQOL-bref) and a questionnaire including the social demographic variables, work conditions and the variables that express the lifestyle of individuals, both questionnaires self-applied. The sample was formed by 118 workers, among them: physicians, technologists/technicians in radiology, nurses, technicians and assistants in nursing, and others health professionals. The data analysis included descriptive statistics, nonparametric tests and the use of a linear regression model. The reliability of the instrument for the studied sample was verified by Cronbachs Alpha Coefficient (&alpha;). The WHOQOL-bref proved to be an adequate instrument, with a good level of internal consistency (&alpha;=0.884), being easily and quickly administrated for the evaluation of the QOL. The study provided an overview of the perception of quality of life of the studied group.

To increase medical service quality for medical ecology is necessary nowadays, it provides not only customers satisfaction and ensure patent s¡¦ willing for next visit, but also have the requirements of the hospital accreditation. Furthermore, medical service quality has become the main purchasing direction for hospital administrators. This survey is based on ¡§5Q model for different dimensions¡¨ by Zineldin (2006), including quality of object, quality of processes, quality of infrastructure, quality of interaction, quality of atmosphere. However, it evaluates which medical service quality that may affect patient¡¦s satisfaction and loyalty for having examination check in radiological department. The result of this research can be used by the hospital to provide the medial service quality, hospital competitiveness, sustainable development, and to supply more effective strategies in future direction. This survey investigated the patients for the examination of medical imaging from the biggest military hospital in southern, which was assessed as a regional Teaching Hospital by department of Health, the executive Yuan. A total of 600 questionnaires were sent out to patients, with 586 valid samples, and with 14 uncompleted invalid samples. The effective response rate is about 97.9%. In this study, the quality of medical service is based on five dimensions analysis, respectively patient satisfaction and patient loyalty. In addition, the patient satisfaction provided analysis and discussion for patient loyalty. The research was the participants with medical treatment from military hospital and was carried the analysis in order to further understand the significant difference in the causes for medical treatment, medical service quality, patient satisfaction and royalty. The research is summarized as follows: 1.The medical service quality ¡§quality of object, quality of processes, quality of infrastructure, quality of interaction, quality of atmosphere. ¡§ were all positive and significant influence on patient satisfaction, particularly quality of atmosphere and quality of interaction. 2. The quality of object, quality of interaction, quality of atmosphere had also strong and positive impact on the loyalty of the patients, but the quality of process, and the quality of infrastructure hadn¡¦t affect the patients¡¦ loyalty remarkably. 3. In addition, patient satisfaction appeared a relevant and significant impact on patient loyalty. 4. For treatment reasons, people who were military and military dependents were significant higher than the patients who live closely to hospital for quality of object, quality of infrastructure, quality of interaction, quality of atmosphere and patient satisfaction.

Os sistemas de radiologia digital, entre eles os baseados em fósforos fotoestimuláveis (sistemas CR como sao conhecidos em radiologia), são cada vez mais comuns na pratica radiológica da cidade de Sao Paulo, seguindo uma tendência mundial. O uso desta tecnologia, que vem substituindo o conjunto tela-filme como sistema de detecção e produção de imagem, permite o uso de uma faixa dinâmica de detecção mais ampla e pode ser prejudicial ou benéfico do ponto de vista da dose absorvida pelo paciente, pois possibilita a obtenção de imagens para superexposições ou subexposições. Para avaliar o contraste obtido na imagem, e, ao mesmo tempo, obter uma estimativa da dose absorvida pelo paciente, todos os fabricantes de sistemas CR incluem no software de analise da imagem um indicador de exposição, que deve se relacionar com a dose absorvida pela placa de fosforo foto-estimulável (Image Plate IP). Estudos que relacionam a razão sinal ruído (SNR) e Dose de Entrada na Pele (DEP), avaliada com câmara de ionização e dosimetria TL, para radiografias de torax (frente e perfil) foram conduzidos empregando técnicas clinicas. Valores de dose (DEP e dose de saída) foram comparados com valores de níveis de cinza e de indicadores de exposição obtidos para as imagens com o CR Agfa CR30-X. Para isso foram utilizados dois simuladores: um simulador homogêneo, com paredes PMMA e preenchido com agua; e um simulador antropomórfico sem os membros superiores e inferiores (RANDO Phantom), no qual foi possível também medir doses internas com dosimetria TL, com irradiações realizadas em laboratório e em ambiente hospitalar. Os resultados mostraram uma relação logarítmica entre o indicador de exposição da Agfa (log of median of histogram - lgM) e a dose de saída do simulador, e uma relação logarítmica da DEP com a mediana dos níveis de cinza de uma regiao da imagem (SAL - Scan Average Level) para ambas as projeções. Também foi possível relacionar o lgM com a DEP, porem, tal relação e dependente da qualidade do feixe. Com o uso de filtros, verificamos que e possível diminuir a DEP mantendo a mesma qualidade da imagem. Neste trabalho foram obtidos valores de DEP na faixa de 0,0995(50) 1,657(51) mGy, e de doses internas entre 0,0074(18) e 0,90(13) mGy. Com isso concluímos que e possível relacionar os indicadores de exposição com a dose absorvida (DEP e dose de saída), e usar o CR como um avaliador de dose absorvida no paciente, quando a qualidade do feixe e conhecida. / The digital radiology systems, among them the system based on photostimulable phosphors (CR systems as they are known in radiology) are increasingly common in radiological practice in Sao Paulo, following a worldwide trend. Using this technology, which is replacing the screen-film as detection system for production of the image, can be detrimental or beneficial in terms of the absorbed dose to the patient, because the dynamic range of these detectors is much wider than the radiographic films, and it is possible to obtain an image with overexposure or underexposure. To evaluate the contrast obtained in the image, and at the same time, obtain an estimate of the absorbed dose to the patient, all manufacturers of CR systems include the evaluation of an exposure index in the image analysis software. This index should be related to the absorbed dose to the phosphor plate (Image Plate- IP). Studies that relate the signal to noise ratio (SNR) and Entrance Skin Dose (ESD), measured with ionization chamber and TL dosimetry for chest X-rays were conducted using clinical techniques, and typical values of dose (ESD and exit dose) were compared with values of gray levels and exposure index obtained with the CR. For this we used two simulators: a homogeneous one made with PMMA walls and filled with water, and an anthropomorphic phantom without the upper and lower limbs (RANDO Phantom), in which it was also possible to measure internal doses with TL dosimetry. The results showed a logarithmic relationship between the Agfa index IgM (log of median of histogram) and the simulator exit dose, and a log relationship between the ESD and the mean gray level of a region of the image (SAL - Scan Average Level ). It was also possible to relate the IgM with ESD, but the relation is dependent on the beam quality. With the use of different filtrations, we verified the possibility of decrease the ESD keeping the same image quality. In this work we obtained ESD values in the range 0.0995(50) 1.657(51) mGy, and internal doses from 0.0074(18) to 0.90(13) mGy.

No description available.