Interprofessional collaboration in hospital-based services for victims of sexual violence in South Korea: participating professionals' different attitudes and their impacts on collaboration.

Human service professionals (HSPs) play important roles in supporting victims of sexual violence. When these professionals work together in various forms of collaboration, attitudes of professionals in different fields can sometimes facilitate or sometimes hinder collaboration. The effect of attitude can be further highlighted when HSPs collaborate with experts with different fields of sexual violence, such as police officers. This study examined the difference in the attitudes toward interprofessional collaboration and victims of sexual violence between HSPs and police officers in South Korea. Then, the effect of such attitudes on the degree of interprofessional collaboration was analyzed. Survey data were collected from 174 HSPs and 65 police officers at 34 hospital-based Sunflower Centers across South Korea. Results showed that HSPs had a more positive attitude toward the benefits of interprofessional collaboration, and had a less negative attitude toward victims of sexual violence, than police officers. The results further confirmed that collaboration can be strengthened by actively fostering interprofessional work and reducing prejudice against the victims. Based on these results, practical implications to promote the degree of interprofessional collaboration are suggested.

Spatial Prediction Filtering for Medical Ultrasound in Aberration and Random Noise.

While medical ultrasound imaging has become one of the most widely used imaging modalities in clinics, it often suffers from suboptimal image quality, especially in technically difficult patients with a large amount of fat content that induces severe phase aberration effects and decreases the signal-to-noise ratio. Several researchers have proposed various techniques, which can be broadly categorized as either a phase aberration correction (PAC) technique or a coherence-based imaging technique, to address the challenges in imaging technically difficult patients. Although both families of techniques have shown some success in improving the image quality in the presence of a mild level of phase aberration and/or random noise, they often fail to achieve meaningful improvements in the image quality and, in some cases, even create severe image artifacts. In this paper, we employ an adaptive filtering technique called frequency-space prediction filtering (FXPF), which we recently introduced in ultrasound imaging, to overcome the weaknesses of existing techniques and achieve image quality improvements more effectively under varying levels of phase aberration and random noise. Using simulated and experimental phantom data with varying levels of phase aberration and random noise, we evaluate and compare the performance of FXPF with the most representative technique for each category: nearest-neighbor cross correlation (NNCC)-based PAC and the generalized coherence factor (GCF). Our simulation, experimental phantom, and in vivo results demonstrate that FXPF is highly robust in varying levels of phase aberration and noise, and always outperforms both NNCC-based PAC and GCF in terms of the contrast-to-noise ratio (CNR) and the contrast when both random noise and phase aberration are present.

Performance Evaluation of Adaptive Imaging Based on Multiphase Apodization with Cross-correlation: A Pilot Study in Abdominal Ultrasound.

Degradation of image contrast caused by phase aberration, off-axis clutter, and reverberation clutter remains one of the most important problems in abdominal ultrasound imaging. Multiphase apodization with cross-correlation (MPAX) is a novel beamforming technique that enhances ultrasound image contrast by adaptively suppressing unwanted acoustic clutter. MPAX employs multiple pairs of complementary sinusoidal phase apodizations to intentionally introduce grating lobes that can be used to derive a weighting matrix, which mostly preserves the on-axis signals from tissue but reduces acoustic clutter contributions when multiplied with the beamformed radio-frequency (RF) signals. In this paper, in vivo performance of the MPAX technique was evaluated in abdominal ultrasound using data sets obtained from 10 human subjects referred for abdominal ultrasound at the USC Keck School of Medicine. Improvement in image contrast was quantified, first, by the contrast-to-noise ratio (CNR) and, second, by the rating of two experienced radiologists. The MPAX technique was evaluated for longitudinal and transverse views of the abdominal aorta, the inferior vena cava, the gallbladder, and the portal vein. Our in vivo results and analyses demonstrate the feasibility of the MPAX technique in enhancing image contrast in abdominal ultrasound and show potential for creating high contrast ultrasound images with improved target detectability and diagnostic confidence.

Spatial Prediction Filtering of Acoustic Clutter and Random Noise in Medical Ultrasound Imaging.

One of the major challenges in array-based medical ultrasound imaging is the image quality degradation caused by sidelobes and off-axis clutter, which is an inherent limitation of the conventional delay-and-sum (DAS) beamforming operating on a finite aperture. Ultrasound image quality is further degraded in imaging applications involving strong tissue attenuation and/or low transmit power. In order to effectively suppress acoustic clutter from off-axis targets and random noise in a robust manner, we introduce in this paper a new adaptive filtering technique called frequency-space (F-X) prediction filtering or FXPF, which was first developed in seismic imaging for random noise attenuation. Seismologists developed FXPF based on the fact that linear and quasilinear events or wavefronts in the time-space (T-X) domain are manifested as a superposition of harmonics in the frequency-space (F-X) domain, which can be predicted using an auto-regressive (AR) model. We describe the FXPF technique as a spectral estimation or a direction-of-arrival problem, and explain why adaptation of this technique into medical ultrasound imaging is beneficial. We apply our new technique to simulated and tissue-mimicking phantom data. Our results demonstrate that FXPF achieves CNR improvements of 26% in simulated noise-free anechoic cyst, 109% in simulated anechoic cyst contaminated with random noise of 15 dB SNR, and 93% for experimental anechoic cyst from a custom-made tissue-mimicking phantom. Our findings suggest that FXPF is an effective technique to enhance ultrasound image contrast and has potential to improve the visualization of clinically important anatomical structures and diagnosis of diseased conditions.

Ultrasonic Reverberation Clutter Suppression Using Multiphase Apodization With Cross Correlation.

Despite numerous recent advances in medical ultrasound imaging, reverberation clutter from near-field anatomical structures, such as the abdominal wall, ribs, and tissue layers, is one of the major sources of ultrasound image quality degradation. Reverberation clutter signals are undesirable echoes, which arise as a result of multiple reflections of acoustic waves between the boundaries of these structures, and cause fill-in to lower image contrast. In order to mitigate the undesirable reverberation clutter effects, we present, in this paper, a new beamforming technique called multiphase apodization with cross correlation (MPAX), which is an improved version of our previous technique, dual apodization with cross correlation (DAX). While DAX uses a single pair of complementary amplitude apodizations, MPAX utilizes multiple pairs of complementary sinusoidal phase apodizations to intentionally introduce grating lobes from which an improved weighting matrix can be produced to effectively suppress reverberation clutter. Our experimental sponge phantom and preliminary in vivo results from human subjects presented in this paper suggest that MPAX is a highly effective technique in suppressing reverberation clutter and has great potential for producing high contrast ultrasound images for more accurate diagnosis in clinics.

Harmonic imaging with fresnel beamforming in the presence of phase aberration.

Fresnel beamforming is a beamforming method with a delay profile similar in shape to a physical Fresnel lens. The advantage of Fresnel beamforming is the reduced channel count, which consists of four to eight transmit and two analog-to-digital receive channels. Fresnel beamforming was found to perform comparably to conventional delay-and-sum beamforming. However, the performance of Fresnel beamforming is highly dependent on focal errors. These focal errors result in high side-lobe levels and further reduce the performance of Fresnel beamforming in the presence of phase aberration. With the advantages of lower side-lobe levels and suppression of aberration effects, harmonic imaging offers an effective solution to the limitations of Fresnel beamforming. We describe the implementation of tissue harmonic imaging and pulse inversion harmonic imaging in Fresnel beamforming, followed by dual apodization with cross-correlation, to improve image quality. Compared with conventional delay-and-sum beamforming, experimental results indicated contrast-to-noise ratio improvements of 10%, 49% and 264% for Fresnel beamforming using tissue harmonic imaging in the cases of no aberrator, 5-mm pork aberrator and 12-mm pork aberrator, respectively. These improvements were 22%, 57% and 352% for Fresnel beamforming using pulse inversion harmonic imaging. Moreover, dual apodization with cross-correlation was found to further improve the contrast-to-noise ratios in all cases. Harmonic imaging was also found to narrow the lateral beamwidth and shorten the axial pulse length by at least 25% and 21%, respectively, for Fresnel beamforming at different aberration levels. These results suggest the effectiveness of harmonic imaging in improving image quality for Fresnel beamforming, especially in the presence of phase aberration. Even though this combination of Fresnel beamforming and harmonic imaging does not outperform delay-and-sum beamforming combined with harmonic imaging, it provides the benefits of reduced channel count and potentially reduced cost and size of ultrasound systems.

Effects of dual apodization with cross-correlation on tissue harmonic and pulse inversion harmonic imaging in the presence of phase aberration.

Dual apodization with cross-correlation (DAX) is a relatively new beamforming technique which can suppress side lobes and clutter to enhance ultrasound image contrast. However, previous studies have shown that with increasing aberrator strength, contrast enhancements with DAX diminish and DAX becomes more prone to image artifacts. In this paper, we propose integrating DAX with tissue harmonic imaging (THI) or pulse inversion harmonic imaging (PIHI) to overcome their shortcomings and achieve higher image contrast. Compared with conventional imaging, our experimental results showed that DAX with THI allows for synergistic enhancements of image contrast with improvements of more than 231% for a 5-mm pork aberrator and 703% for a 12-mm pork aberrator. With PIHI, improvements of 238% and 890% were observed for the two pork tissue samples. Our results suggest that the complementary contrast enhancement mechanism employed by the proposed method may be useful in improving imaging of technically difficult patients in clinics.

Synergistic enhancements of ultrasound image contrast with a combination of phase aberration correction and dual apodization with cross-correlation.

Dual apodization with cross-correlation (DAX) is a novel adaptive beamforming technique which utilizes two distinct apodization functions in suppressing side lobes and clutter. Previous studies have shown that the performance of DAX in minimizing the effects of phase aberration diminishes with increasing aberrator strength. To achieve greater improvement in image contrast, we propose, in this paper, to combine DAX with a phase aberration correction algorithm based on nearest-neighbor cross-correlation (NNCC). Our simulation and experimental results presented in this work showed that the proposed method allows for synergistic enhancements of image contrast and achieves greater improvement in image quality than using DAX alone or phase aberration correction alone in the presence of weak and strong aberrators. Compared with standard delay-and-sum (DAS) beamforming, using the proposed method on simulated data with weak and strong aberrations increased the contrast-to-noise ratio (CNR) values from 4.10 to 10.96 and from 1.69 to 9.80, respectively. Experimental results were obtained using pork tissues of 4 and 10 mm thickness and a tissue-mimicking phantom. The CNR values increased from 3.74 to 9.72 for the 4-mm pork aberrator and from 1.27 to 8.17 for the 10-mm pork aberrator.

Client violence and its negative impacts on work attitudes of child protection workers compared to community service workers.

This study investigated the prevalence of client violence toward child protection workers and its negative impacts on the work attitudes of those workers compared with community service workers in South Korea. This study is based on the assumption that child protection workers are more vulnerable to violence than are community service workers because of the unique characteristics of the roles they play. Results of the data, drawn from a sample of 413 child protection workers and community service workers, found that client violence was more prevalent against child protection workers and that the negative impacts of this violence on work attitudes were more clearly highlighted for child protection workers. Based on the results of this study, implications for preventing client violence and lessening its negative impacts on work attitudes of child protection workers were identified.

Korean version of the notification policy on sexual offenders: did it enhance public awareness of sexual crimes against minors?

This study reviewed the public notification policy of sexual offenders against minors in South Korea as compared to community notification programs in the United States. The study then examined the policy's impact on increasing the general public's awareness of such sexual crimes. This is based on the assumption that heightening public awareness can be a starting point in combating such crimes. Results of the data, drawn from a sample of 1,409 Koreans across the nation, showed that the notification policy enhanced public awareness. Factors related to this increase in awareness were people's concern about or familiarity with the policy and people's experience in identifying the existence of known sexual offenders in their communities. Based on the results of this study, strategies for enhancing public awareness of sexual crimes on minors were formulated. The need to develop treatment programs for sexual offenders was likewise highlighted.