Individual monitoring of medical staff working in interventional radiology in Switzerland using double dosimetry

Physicians who frequently perform fluoroscopic examinations are exposed to high intensity radiation fields. The exposure monitoring is performed with a regular personal dosimeter under the apron in order to estimate the effective dose. However, large parts of the body are not protected by the apron (e.g. arms, head). Therefore, it is recommended to wear a supplemental dosimeter over the apron to obtain a better representative estimate of the effective dose. The over-apron dosimeter can also be used to estimate the eye lens dose. The goal of this study was to investigate the relevance of double dosimetry in interventional radiology. First the calibration procedure of the dosimeters placed over the apron was tested. Then, results of double dosimetry during the last five years were analyzed. We found that the personal dose equivalent measured over a lead apron was underestimated by ∼20% to ∼40% for X-ray beam qualities used in radiology. Measurements made over five-year period confirm that the use of a single under-apron dosimeter is inadequate for personnel monitoring. Relatively high skin dose (>10 mSv/month) would have remained undetected without a second dosimeter placed on the apron.

Stop, Look and Cook: recipe book for schools in Northern Ireland

Nutrition is central to health and children's diets can be an important influence now and in the future. Stop, Look and Cook is a new recipe book for use by catering staff in all grant-aided nursery, primary and post-primary schools in Northern Ireland.�Recipes have been collected from school caterers across the region. These recipes have been checked to ensure that they are compliant with nutritional standards for school lunches and have been tested in schools for taste and suitability. In addition all the recipes have been analysed by the PHA using a nutritional software package, with a particular focus on fat, salt and sugar.�This recipe book provides approximately 280 recipes, giving schools more choice for menus. It also contains useful advice for dealing with food allergies and supplying alternative meals for pupils from other cultures.For more information on Stop, Look and Cook please contact the school meals catering manager at your local Education and Library Board.�

Exploring the use of the Swiss medical tariffication codes (TARMED) in the establishment of the frequency of radiodiagnostic examinations.

In population surveys of the exposure to medical X-rays both the frequency of examinations and the effective dose per examination are required. The use of the Swiss medical tariffication system (TARMED) for establishing the frequency of X-ray medical examinations was explored. The method was tested for radiography examinations performed in 2008 at the Lausanne University Hospital. The annual numbers of radiographies determined from the "TARMED" database are in good agreement with the figures extracted from the local RIS (Radiology Information System). The "TARMED" is a reliable and fast method for establishing the frequency of radiography examination, if we respect the context in which the "TARMED" code is used. In addition, this billing context provides most valuable information on the average number of radiographs per examination as well as the age and sex distributions. Radiographies represent the major part of X-ray examinations and are performed by about 4,000 practices and hospitals in Switzerland. Therefore this method has the potential to drastically simplify the organisation of nationwide surveys. There are still some difficulties to overcome if the method is to be used to assess the frequency of computed tomography or fluoroscopy examinations; procedures that deliver most of the radiation dose to the population. This is due to the poor specificity of "TARMED" codes concerning these modalities. However, the use of CT and fluoroscopy installations is easier to monitor using conventional survey methods since there are fewer centres. Ways to overcome the "TARMED" limitations for these two modalities are still being explored.

An analysis of the components of pain, function, and health-related quality of life in patients with failed back surgery syndrome treated with spinal cord stimulation or conventional medical management

Objectives: Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. Materials and Methods: The international multicenter PROCESS trial collected detailed HRQoL (EuroQol-5D; Short-Form 36) and function (Oswestry Disability Index) information on 100 FBSS patients. Results: At baseline, patients reported moderate-to-severe leg and back pain adversely affecting all dimensions of function and HRQoL. Compared with conventional medical management alone, patients also receiving spinal cord stimulation (SCS) reported superior pain relief, function, and HRQoL at six months on overall and most sub-component scores. The majority of these improvements with SCS were sustained at 24 months. Nonetheless, 36-40% of patients experienced ongoing marked disability (standing, lifting) and HRQoL problems (pain/discomfort). Conclusions: Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.

Guidance on infection control in schools and other childcare settings

Prevent the spread of infections by ensuring: routine immunisation, high standards of personal hygiene and practice, particularly handwashing, and maintaining a clean environment. �

Engagement Plan: Review of AHP Support for Children with Statements of Special Educational Needs in Special Schools and Mainstream Education

This engagement plan outlines the collaborative and partnership approach with key stakeholders in the first phase of the Review of AHP Support for Children with Statements of Special Educational Needs in Special Schools and Mainstream Education. It provides detail on how communication objectives will be met.It gives information on:Stakeholder Analysis for Phase One of the ReviewMembership of the Project BoardMembership of the Professional Stakeholder Reference Group

Project Initiation Document Phase One: Scoping Exercise within special schools

This Project Initiation Document outlines the purpose and plan of Phase One of the Review of AHP Support for Children with Statements of Special Educational Needs in Special Schools and Mainstream Education.

Terms of Reference for Project: Review of AHP Support for Children with Statements of Special Educational Needs in Special Schools and Mainstream Education

This is the Terms of Reference for the review of Allied Health Professional (AHP) support for children/young people with statements of special educational needs.It outlines expectations of the review and should be read in conjunction with the Project Initiation Document (PID) for Phase 1of the review, the Terms of Reference for the Project Board and the Engagement Plan for phase 1.

Terms of reference for Project Board: Review of AHP Support for Children with Statements of Special Educational Needs in Special Schools and Mainstream Education

This is the Terms of Reference for the Project Board of the review of Allied Health Professions (AHP) support for children/young people with statements of special educational needs.It outlines the:Purpose of the Project BoardResponsibilities of the Project BoardMembership of the Project Board

School food: top marks - A summary report on food in schools research in Northern Ireland

This�report highlights�the barriers that schools in Northern Ireland have experienced in implementingnutritional standards. In particular, it identifies the potential adverse impact that external sourcesof food may have on pupils��' healthy eating practices within the school setting. It also illustrateshow the accessibility of food and drinks contradicting the standards, within the school, may limitthe success of the standards. This report further emphasises how practical constraints within the

Nutritional standards for other food and drinks in schools: a guide for implementation

This publication details the nutritional standards for other food and drinks in schools that are adhered to by all grant-aided schools. It explains why the nutritional standards have been introduced�and offers practical advice on how to implement them.Nutritional standards for other food and drinks in schools: a guide for implementation is also available in Irish, on request.

Control of urinary schistosomiasis on Zanzibar (Unguja Island): a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

To improve health education within primary schools, the health education booklet Juma na kichocho was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA) towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls) of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact.