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- Portuguese diagnostic reference levels national surveyPublication . Santos, Joana; Teles, P.M.; Sousa, M.C.; Paulo, Graciano; Venâncio, J.; Alves, F. Caseiro; Figueira, A.; Rosário, P.; Vaz, P.
- Impact of a radiological protection campaign in emergency paediatric radiology: a multicentric observational study in BrazilPublication . Oliveira Bernardo, Mônica; Morgado, Flávio; dos Santos, Alair Augusto Sarmet Moreira Damas; Foley, Shane; Paulo, Graciano; de Almeida, Fernando AntônioPurpose: To evaluate the impact of a paediatric radiological protection campaign, implemented in the emergency units of a healthcare provider network in Brazil. This campaign aimed to promote awareness among emergency department physicians, regarding justifcation of paediatric X-ray referrals for paranasal sinus, chest and CT exams, as a strategy to reduce exposure to ionising radiation. Method: Frequency analysis of common paediatric imaging referrals from 19 emergency departments was performed for a 3-year period (2015–2018) to coincide with before, during and after the implementation of the radiation protection campaign. The campaign was multifaceted and involved dissemination of educational materials and imaging referral guidelines along with quarterly meetings with participating centres’ leaderships. Additionally, patient dose cards were distributed to patients/carers. The Chi-Square test was used to examine the association between the type of examination and the patient’s age group. Exact-Fisher test was performed to check for an association between participant engagement and the existence of the radiation protection committee. Results: Referrals reduced by 25% following the campaign with no reports of misdiagnosis. Many referrals in the youngest age groups. In 15 units, a radiological protection committee was created to raise awareness and to create a multi professional team to communicate the risks and benefits of radiological procedure in children. Conclusion: The campaign resulted in a substantial reduction in radiological referrals while promoting a radiation protection culture. Simple education initiatives can contribute to savings in both finances and radiation doses, particularly important in radiosensitive cohorts.
- Radiography research: where should we be in 2030? (part 2)Publication . Paulo, Graciano
- Exploring the translational challenge for medical applications of ionising radiation and corresponding radiation protection researchPublication . Bockhold, Sophie; Foley, Shane J.; Rainford, Louise A.; Corridori, Riccardo; Eberstein, Annika; Hoeschen, Christoph; Konijnenberg, Mark W.; Molyneux-Hodgson, Susan; Paulo, Graciano; Santos, Joana; McNulty, Jonathan P.Background: Medical applications of ionising radiation and associated radiation protection research often encounter long delays and inconsistent implementation when translated into clinical practice. A coordinated efort is needed to analyse the research needs for innovation transfer in radiation-based high-quality healthcare across Europe which can inform the development of an innovation transfer framework tailored for equitable implementation of radiation research at scale. Methods: Between March and September 2021 a Delphi methodology was employed to gain consensus on key translational challenges from a range of professional stakeholders. A total of three Delphi rounds were conducted using a series of electronic surveys comprised of open-ended and closed-type questions. The surveys were disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the feld. Approximately 350 professionals were invited to participate. Participants’ level of agreement with each generated statement was captured using a 6-point Likert scale. Consensus was defined as median≥4 with≥60% of responses in the upper tertile of the scale. Additionally, the stability of responses across rounds was assessed. Results: In the first Delphi round a multidisciplinary panel of 20 generated 127 unique statements. The second and third Delphi rounds recruited a broader sample of 130 individuals to rate the extent to which they agreed with each statement as a key translational challenge. A total of 60 consensus statements resulted from the iterative Delphi process of which 55 demonstrated good stability. Ten statements were identifed as high priority challenges with≥80% of statement ratings either ‘Agree’ or ‘Strongly Agree’. Conclusion: A lack of interoperability between systems, insuficient resources, unsatisfactory education and training, and the need for greater public awareness surrounding the benefts, risks, and applications of ionising radiation were identifed as principal translational challenges. These findings will help to inform a tailored innovation transfer framework for medical radiation research.
- Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll projectPublication . Rainford, Louise; Santos, Joana; Alves, Francisco; Figueiredo, João; Hoeschen, Christoph; Damilakis, John; Frija, Guy; Andersson, Jonas; McNulty, Jonathan; Foley, Shane; Bacher, Klaus; Nestle, Ursula; Hierath, Monika; Paulo, GracianoBackground: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
- Dose na medida das necessidadesPublication . Paulo, Graciano