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1.
Br Dent J ; 2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37186109

RESUMO

Introduction Orthodontic service provision relies on good organisational systems for high standards of patient care and safety. Human factors (HFs) are non-technical skills associated with communication, leadership and teamwork, important for safe patient care. This investigation explored attitudes and understanding of HFs within orthodontic clinical training in the United Kingdom.Materials and methods A questionnaire-based qualitative and quantitative analysis including members of the orthodontic clinical team was undertaken at two teaching centres. A modified Operating Rooms Managements Attitudes questionnaire was used with a 5-point Likert scale. Participants indicated agreement or disagreement with statements around nine themes: leadership structure; confidence assertion; information sharing; stress; fatigue; teamwork; work values; error-procedural compliance; and organisational climate. Internal consistency among themes was assessed with Cronbach's alpha and differences in responses with chi-squared tests at 5%.Results In total, 80 responses were received from 96 invitees. Positive attitudes towards teamwork, error-procedural compliance, and organisational climate were found. Orthodontic consultants, trainees, and nurses recognised that human error is not a sign of incompetence. Stress and fatigue were less acknowledged by consultants and trainee groups. Trainees, nurses and therapists valued information sharing over the consultant group. Orthodontic trainees and nurse responses suggested further training might be required in leadership structure, confidence assertion, and work values.Conclusions Differences in attitudes and understanding of HFs within different professional groups in the orthodontic team exist.

2.
Pediatr Radiol ; 43(7): 820-6, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23344916

RESUMO

BACKGROUND: Maximum intensity projection (MIP) images might be useful in helping to differentiate small pulmonary nodules from adjacent vessels on thoracic multidetector CT (MDCT). OBJECTIVE: The aim was to evaluate the benefits of axial MIP images over axial source images for the paediatric chest in an interobserver variability study. MATERIALS AND METHODS: We included 46 children with extra-pulmonary solid organ malignancy who had undergone thoracic MDCT. Three radiologists independently read 2-mm axial and 10-mm MIP image datasets, recording the number of nodules, size and location, overall time taken and confidence. RESULTS: There were 83 nodules (249 total reads among three readers) in 46 children (mean age 10.4 ± 4.98 years, range 0.3-15.9 years; 24 boys). Consensus read was used as the reference standard. Overall, three readers recorded significantly more nodules on MIP images (228 vs. 174; P < 0.05), improving sensitivity from 67% to 77.5% (P < 0.05) but with lower positive predictive value (96% vs. 85%, P < 0.005). MIP images took significantly less time to read (71.6 ± 43.7 s vs. 92.9 ± 48.7 s; P < 0.005) but did not improve confidence levels. CONCLUSION: Using 10-mm axial MIP images for nodule detection in the paediatric chest enhances diagnostic performance, improving sensitivity and reducing reading time when compared with conventional axial thin-slice images. Axial MIP and axial source images are complementary in thoracic nodule detection.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Posicionamento do Paciente/métodos , Intensificação de Imagem Radiográfica/métodos , Radiografia Torácica/métodos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
3.
Pediatr Hematol Oncol ; 27(5): 380-6, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20469974

RESUMO

This investigation was undertaken to evaluate the significance of solitary bony abnormalities on bone scintigrams of children with known or suspected malignancy. A total of 215 bone scans were performed in 183 children in order to look for possible metastasis over a 10-year period. Forty-nine scans (22.8%) were found to have single lesions, of which 18 were due to uptake at the primary site and were excluded from further consideration. Of the remaining 31 lesions, 13 (41.9%) were confirmed as metastases, 17 lesions were proved to be benign, and 1 indeterminate. Solitary hot spots in children with known or suspected malignancy are common and therefore have to be taken seriously due to their higher malignant potential.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Metástase Neoplásica/diagnóstico , Adolescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Humanos , Lactente , Recém-Nascido , Cintilografia/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Medronato de Tecnécio Tc 99m
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