Rural radiology: training

About half of the population of many countries live in rural areas and in these countries about half of the rural hospitals do not have X-ray services. Among the reasons for such a deficiency are the high cost and sophistication of radiological equipment, requiring fully trained technicians, and the high standard required for a radiologist's training, none of which a rural hospital can afford. Simplified equipment makes it possible for locally recruited auxiliary personnel to obtain radiographs of consistently acceptable quality after a short training period. The training of physicians in radiographic interpretation could also be abbreviated if it were directed at a limited range of basic X-ray examinations that provide essential diagnostic information in most clinical conditions. The activities of the World Health Organization in these areas is discussed.     

Laboratory technicians; the Clinical Laboratory Law and its meaning to private physicians

The present laws and regulations relating to clinical laboratories in California are the outcome of over a quarter century of cooperative development. The medical profession, public health department, laboratory workers, and the legislature have worked together in this development.At first the system of certifying technicians and laboratories was on a voluntary basis. The clinical laboratory law in effect legalized and made generally applicable a system which had already been accepted voluntarily. The application of the clinical laboratory law provides physicians a reasonable assurance that competence and reliability will prevail in clinical laboratory operation. Of great importance is the conduct of proper training programs by approved laboratories. Since modern medical practice is so dependent on accurate clinical laboratory work it is essential that special effort be directed by physicians toward influencing young people to enter the profession of medical technology.     

Comparison of curricula in radiation technology in the field of radiotherapy in selected European Union countries

Background

Radiation technology is a discipline of medical science which deals with diagnostics, imaging and radiotherapy, that is treatment by ionizing radiation.

Aim

To present and compare the existing curricula of radiation technology in selected EU countries.

Materials and methods

The research work done for the purpose of the comparative analysis was based on the methods of diagnostic test and document analysis.

Results

The comparison of curricula in selected countries, namely Austria, France, the Netherlands and Poland, showed that admission criteria to radiation technology courses are varied and depend on regulations of respective Ministries of Health. The most restrictive conditions, including written tests in biology, chemistry and physics, and psychometric test, are those in France. Contents of basic and specialist subject groups are very similar in all the countries. The difference is in the number of ECT points assigned to particular subjects and the number of course hours offered. The longest practical training is provided in the Netherlands and the shortest one in Poland. The duration of studies in the Netherlands is 4 years, while in Poland it is 3 years. Austria is the only country to offer extra practical training in quality management.

Conclusion

Graduates in the compared EU countries have similar level of qualifications in the fields of operation of radiological equipment, radiotherapy, nuclear medicine, foreign language and specialist terminology in the field of medical and physical sciences, general knowledge of medical and physical sciences, and detailed knowledge of radiation technology.     

Local technicians in long-term research projects: evaluation of 25 years experience in an active tropical research station

Most field ecology is conceived and financed by scientists from urban areas but is actually carried out in rural areas. Field staff can either be imported from urban areas or recruited from local residents. We evaluated the advantages and disadvantages of involving rural residents as local technicians over a 25- year period at active field research site in Costa Rica. We defined "local technicians" as local residents with no university education who acquired significant experience in field data collection, data management and/or laboratory work. We analyzed the experiences of incorporating these technicians into field research in developing countries from the points of view of scientist and of the local technicians themselves. Primary data were written responses from to a standardized survey of 19 senior scientists and Ph.D. students,and results from standardized personal interviews with 22 local technicians. Researchers highlighted the advantages of highly-skilled technicians with minimal staff turnover, as well as the technicians' knowledge of local ecological conditions. Local technicians considered the primary advantages of their jobs to be opportunities for continuing education training in science as well as cultural enrichment through interactions with people of different cultures. The main challenges identified by researchers were the lack of long-term funding for projects and extended training required for local technicians. Local technicians can be of great benefit to research projects by providing high-quality data collection at reasonable costs with low staff turnover. Over the last 25 years the research model at the field station we studied has evolved to the point that most long-term projects now depend heavily on local technicians. This model of involving local technicians in long-term research has multiple benefits for the researchers, the technicians and the local community, and could be adapted to a variety of settings in rural areas of developing countries.     

Present status of experimental animals in Japan (author's transl)]

The movement for modernization of experimental animals in Japan started around 1950. Since that time, a quarter of a century has passed. This article outlines the present status of experimental animals in Japan and makes comparisons with various other countries. Number of animals used: According to three surveys performed in the past (1956, 1960 and 1970), the numbers used of many species are increasing (Table 1). However, it can not be said simply that the numbers are increasing every year. Taking the United States where surveys are performed every year as an example (Table 3), it is evident that the peaks for use of some species are past (the same tendencies were seen in India and Sweden which have conducted more than four surveys in the past (Table 4). The same tendencies would probably also be seen in Japan if surveys were conducted annually. Quality of animals: It is easy to procure genetically and microbiologically controlled rats and mice. However, investigations into the establishment, production and supply of other species of such high quality are insufficient. This situation is almost the same as that in European countries. Miscellaneous: The present status of other items related to experimental animals is as follows: Facilities and equipment: Higher level facilities were first provided in companies, followed by testing and research institutes. At present, medical universities are providing such facilities. Feed: Pellet type diets are widely used for the various species. Care and management: In April, 1974, "The Law for the Protection and Control of Animals" came into force. This law includes regulations concerning animal experimentation but investigations concerning these standards have just begun. Training of technicians and specialists: The Japan Experimental Animal Research Association provides a correspondence course, tests and recognition for technicians. About 10 veterinary colleges have undergraduate or postgraduate courses for the training of specialists but these are elective except in two or three cases.     

新时代植保植检工作新探索

植保植检工作如何适应社会发展的需要,不断更新工作思路,不断提高植保植检工作水平与效率,是现代植保人必须面对与解决的现实而迫切的课题.本文以重庆市秀山县为例,分析了植保植检技术人员年龄老化、队伍能力整体弱化以及经费保障问题、体制问题、管理问题等植保植检工作面临的困局和问题;提出了植保植检法制化、队伍稳定化、职能专业化、技术研究前沿化、技术应用推广适用化与集成化、农作物病虫害防治协作化、装备现代化、投入多元化、宣传培训常态化等植保植检工作新思路.     

Diagnostic laboratory parasitology--a stepping stone to medical research in tropical Africa.

African countries can concentrate mainly on operational and problem-solving type of medical research using as a basis routine diagnostic laboratory parasitology which can be elevated to research level by incorporating all relevant techniques backed by statistically-based programming. Because of high incidence of parasitic infections and the peculiar host-parasite relationship, co-operation between all departments of any major hospital will be required to deal with the diseases due to them. Longitudinal studies on some parasites will enable generalisation and specific views to be formed on some infections. Multiplicity and wide variety of available techniques offer several research possibilities of clinico-pathological and epidemiological significance. Routine laboratory-based research offers the right environment for training various types of laboratory workers from technicians to medical parasitologists, through on-the-job training on techniques, investigative studies and research, backed by formal lectures and practicals at various levels. Trainee medical parasitologists can obtain higher degrees locally or abroad. The research can be organised around micro and mini research units. This approach is cost-beneficial because it minimises administrative difficulties and so avoids wastage. The results can be used to monitor impact of national development on parasitic infection prevalence and to formulate a policy on parasitic disease management.     

Training strategies for animal care technicians and veterinary technical staff

An institutional training program for animal care and veterinary technicians should be planned and implemented to provide these individuals with knowledge and skills for performing their duties within a laboratory animal care and use program. The complexity in the regulatory and scientific features of the animal research environment necessitates a strong training program on diverse topics according to staff duties. Orientation training should include ethics and compliance with relevant laws, policies, and guidelines. Depending on specific staff responsibilities, training may be general or in depth on topics of species-specific biology and behavior, animal facility equipment and operations, animal health procedures, animal research policies, occupational health and safety equipment and practices, computer usage, training, and management. Staff training should be an ongoing mission for incorporating new equipment, practices, and procedures in the laboratory animal program; for providing periodic refresher training to maintain a high level of staff qualifications; and for retraining when skills or knowledge are found deficient. Large institutions often have a dedicated training staff to implement the institutional training program.     

Evaluation of medical physics training in radiology residency in 67 countries

PurposeThe main aim of medical physics training in radiology residency is to have appropriate and safer imaging of patients and safety of personnel. The need to have adequate coverage of medical physics and radiation safety in curricula of radiology residency is well perceived, but it is not known how far it is implemented in practice.MethodsWe have analysed the data from 67 countries on medical physics teaching and assessment of residents in radiology programs, considering differences between countries in function of their human development index (HDI).ResultsThe results indicate that teaching of medical physics by radiologists rather than by medical physicists is very common and there is relationship with the developmental status of a country. The majority of countries with very high HDI used a written test (69%) for medical physics topics, often in combination with other subjects (63%). Further, there is lack of direct involvement of medical physicists during the examination phase of residents. Geographically, it can be seen that Latin American countries in particular lack involvement of medical physicists during both the teaching and examination phase.ConclusionThe lack of adequate involvement of medical physicists in training and in the formal examination of radiology residents in both developed and developing countries is a matter of concern with likely implications on patient and staff safety.     

Health professionals' overestimation of knowledge on snakebite management,a threat to the survival of snakebite victims—A cross-sectional study in Ghana

BackgroundAccording to the World Health Organization, snakebites, a common occupational hazard in developing countries accounts for an annual loss of between 81,000 and 138, 000 lives following 5 million bites of which 2.7 million results in envenomation. Since snakebite-associated morbidity and mortality are more prevalent in agricultural economies such as Ghana, health professionals should be optimally knowledgeable on how to manage the incidence of snakebites. Lack of knowledge or overestimation of a professional''s knowledge can affect heath delivery especially for emergencies such as snakebites. The three rurally situated Tongu districts in South-Eastern Ghana with agriculture as the major source of livelihood for their inhabitants, are prone to snakebites. This study, therefore, brings up the need to assess whether the health professionals in these districts are well-equipped knowledge-wise to handle such emergencies and whether they can rightly estimate their knowledge with regards to snakebite management.Methodology/Principal findingsData was collected using a de novo semi-structured questionnaire administered through google form whose link was sent via WhatsApp to 186 health workers made up of nurses, midwives, physician assistants, medical doctors, pharmacists, and pharmacy technicians. This data was analyzed using Statistical Package for the Social Sciences (SPSS) Version 25. Association between variables was determined using the appropriate tools where necessary, using a confidence interval of 95% and significance assumed when p ≤ 0.05. This study found male health workers significantly more knowledgeable about snakebite management (11.53±5.67 vs 9.64±5.46; p = 0.022) but it was the females who overestimated their knowledge level (27.9% vs 24.1%). The medical doctors exhibited the best knowledge on snakebite management with the registered general nurses least knowledgeable. Although most professionals overestimated their knowledge, the registered general nurses were the worst at that (53.7%). Overall knowledge of health care professionals on snakebite management was below average [10.60±5.62/22 (48.2%)] but previous in-service training and involvement in the management of snakebite were associated with better knowledge. Respondents who had no previous training overestimated their knowledge level compared to those who had some post-qualification training on snakebite management (38.1% vs 7.5%). The greatest knowledge deficit of respondents was on the management of ASV associated adverse reactions.ConclusionHealth workers in rural Ghana overestimated their knowledge about snakebite management although their knowledge was low. Training schools, therefore, need to incorporate snakebite management in their curriculum and health authorities should also expose health workers to more in-service training on this neglected tropical disease.     

医院医疗器械维修中存在的问题及维修管理对策研究

近几年来,随着科学技术的发展和医院规模的扩大,社会对医疗技术要求不断提高,因此,高端医疗器械和新型医疗设备需求加大,医疗器械管理与维修也需跟进。医疗器械的正常使用在医疗工作中有着举足轻重的作用,可提高医疗人员的工作效率,提升临床诊治的水平,但其在改善医疗条件的同时也存在一系列的问题,若无法保质和及时维修医疗器械,对正常医疗设备的使用具有严重影响,延误患者的就诊与治疗。目前医院医疗器械维修中存在的维修人员整体素质偏低、管理机制不健全、维修技术落后、医疗器械维修人员不足、缺乏积极性及再学习的机会、医疗器械缺乏定期保养和管理等实际问题,导致医疗器械维修效率低,本文就以上问题展开讨论,旨在为医院维修管理的制定提供参考。     

A new concept for medical imaging centered on cellular phone technology

According to World Health Organization reports, some three quarters of the world population does not have access to medical imaging. In addition, in developing countries over 50% of medical equipment that is available is not being used because it is too sophisticated or in disrepair or because the health personnel are not trained to use it. The goal of this study is to introduce and demonstrate the feasibility of a new concept in medical imaging that is centered on cellular phone technology and which may provide a solution to medical imaging in underserved areas. The new system replaces the conventional stand-alone medical imaging device with a new medical imaging system made of two independent components connected through cellular phone technology. The independent units are: a) a data acquisition device (DAD) at a remote patient site that is simple, with limited controls and no image display capability and b) an advanced image reconstruction and hardware control multiserver unit at a central site. The cellular phone technology transmits unprocessed raw data from the patient site DAD and receives and displays the processed image from the central site. (This is different from conventional telemedicine where the image reconstruction and control is at the patient site and telecommunication is used to transmit processed images from the patient site). The primary goal of this study is to demonstrate that the cellular phone technology can function in the proposed mode. The feasibility of the concept is demonstrated using a new frequency division multiplexing electrical impedance tomography system, which we have developed for dynamic medical imaging, as the medical imaging modality. The system is used to image through a cellular phone a simulation of breast cancer tumors in a medical imaging diagnostic mode and to image minimally invasive tissue ablation with irreversible electroporation in a medical imaging interventional mode.     

Differentiating tobacco budworm and corn earworm using near-infrared spectroscopy

Near-infrared spectroscopy (NIRS) was used to develop a simple and quick technique to differentiate two economically important species, the tobacco budworm, Heliothis cirescens (F.), and corn earworm, Helicoverpa zea (Boddie), which are major pests of cotton, Gossypium hirsutum L., in the southern United States. In practice, it is difficult to distinguish the two species during their immature stages using morphological characteristics unless expensive microscopy equipment or trained technicians are available. The current studies demonstrated that the two species could be quickly and readily differentiated during early developmental stages, including egg and young larval (younger than third instar) stages, by using NIRS technology with up to 95% accuracy. NIRS technology could significantly improve pest diagnosis in cotton pest management.     

An interdisciplinary performance-based approach to training laboratory animal technicians

Experience has proven that comprehensive training and education make it easier to attract and retain highly qualified animal care technicians, as well as to ensure that research facilities reach maximum performance. The authors outline the training approach used at SoBran, Inc., by describing the subject matter covered in their initial orientation period and in ongoing training sessions. The authors also address recordkeeping methods and training-program assessment.     

Medical tourism: globalization of the healthcare marketplace

The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world.     

导入JCI标准提升医疗影像设备管理系统

引进JCI认证标准（Joint Commission Intemational国际医疗卫生机构认证联合委员会）,使医疗影像设备管理从结构导向到结果导向转变。当今传统的管理评审标准：结构、过程、结果这一程序来讲,最关注的是结构,如设备的故障率、检查病人次数、单机收入等,但JCI的理念认为应该关心的是结果,是安全、质量、整体绩效,这是一个从结构为中心的导向转为以结果为中心、以病人为中心的导向。对任何可能产生的风险都要提前考虑预警,更具前瞻性。学习这一国际先进医院管理体系,改进医疗影像设备管理系统,抓好医疗影像设备的管理,提升医院医疗服务质量。让医疗影像设备在医疗工作中充分发挥作用,提高社会效益和经济效益。     

Foreign medical school graduates problems of qualifying as competent to practice

It is financially and practically impossible to investigate thoroughly all the medical schools in the world and to keep the records current. There is at present no acceptable method for screening the graduates. The official policy of the American Medical Association regarding licensing to practice medicine in the United States is that it is a state right and that it is entirely under the jurisdiction of the governments of the individual states. Hospitals in this country have a great responsibility to the public and to their attending physicians not to engage incompetent physicians and not to exploit the physicians they engage. It is the obligation of all medical licensing boards to constantly help in elevating and improving the standards of medical care. The foreign - trained physicians who have received medical education and training comparable to that given in this country will always be welcome. The exchange of students and faculty members between schools in friendly foreign countries and the United States should be encouraged. The number of foreign physicians serving as interns and residents in this country is steadily increasing.     

FOREIGN MEDICAL SCHOOL GRADUATES—Problems of Qualifying as Competent to Practice

It is financially and practically impossible to investigate thoroughly all the medical schools in the world and to keep the records current.There is at present no acceptable method for screening the graduates. The official policy of the American Medical Association regarding licensing to practice medicine in the United States is that it is a state right and that it is entirely under the jurisdiction of the governments of the individual states.Hospitals in this country have a great responsibility to the public and to their attending physicians not to engage incompetent physicians and not to exploit the physicians they engage.It is the obligation of all medical licensing boards to constantly help in elevating and improving the standards of medical care. The foreign - trained physicians who have received medical education and training comparable to that given in this country will always be welcome.The exchange of students and faculty members between schools in friendly foreign countries and the United States should be encouraged.The number of foreign physicians serving as interns and residents in this country is steadily increasing.     

动物行为学实验带教探索与实践

目的：为提高实验教学和科研工作的质量和效果,结合国家重点实验室有利条件,从行为学实验培训角度以培养实验技术人员基本实验技能为重点。方法：安排学生学习行为医学发展史、熟练行为学动物生命观、基本实验仪器操作以及鼓励实验技术人员自行研制行为检测制仪器等课程。结果：实验技术人员了解了现代行为学的发展,掌握常规的实验方法,培养了科学的思维方式,同时也激发了实验技术人员发挥主观能动性,实现理论和技术的结合。结论：多途径带教培训有利于实验技术人员行为学实验工作打下牢固的基础。     

Product liability aspects of bioengineering

The introduction of the Consumer Protection Act 1987 brought the problems of product liability directly into hospital bioengineering and medical physics departments. This law makes great demands upon manufacturers, but also on suppliers and maintainers of medical equipment. Departments which manage medical equipment carry a responsibility for ensuring the requirements of product liability are known by all those whose actions may affect the potential of a piece of equipment to injure or damage a patient. This paper addresses these problems from a bioengineering, rather than a legal, viewpoint. The problems of design, manufacture, modification, maintenance and use are discussed and examples of potential problems are identified. The paper concludes that as long as good standards of quality control and professionalism are applied in bioengineering and medical physics departments then there is little to be feared from this piece of legislation.