Browsing by Author "Ribeiro, Luís Pedro"
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- Anode heel effect attenuation in lumbar spine radiography: can the use of aluminium filters improve clinical practice of radiographers?Publication . Ribeiro, Luís Pedro; Abrantes, António; Lesyuk, Oksana; Dores, Rúben; Sousa, Patrick; Rodrigues, Sónia; Almeida, Rui; Azevedo, Kevin; Soares, Joana; Aleixo, JoãoPurpose: The aim of this study was to design an aluminiumbased fi lter to reduce the anode heel eff ect in lumbar spine radiographs. Methods: Initially, lumbar spine examinations were observed in a public imaging department to determine standard exposure parameters. Then, the characterization of the anode heel eff ect was made using the Unfors Xi R/F detector and, based on the data collected, aluminium fi lters were designed with a wedge shape and thicknesses ranging from 0.1 to 4.0 mm. The assessment of the entrance skin dose (ESD) reduction was performed on the anthropomorphic phantom with and without fi lters, using the universal dosimeter UNIDOS E equipped with an ionization chamber. Finally, the image quality assessment was performed with the Pehamed Phantom Digrad A+K and image quality surveys were applied to radiographers and radiologists. Results and Discussion: Uniformity of the beam was achieved, especially with fi lter number 2, which presents a signifi cant variation of 9% between the cathodic and anodic side. This fi lter contributes to ESD reduction of 35% and 36% for AP and lateral projection, respectively. Also, according to radiographers and radiologists, it improves the image quality of lumbar spine radiography. Conclusion: The use of aluminium fi lters can be advantageous in the clinical practice of radiographers when performing lumbar spine radiographs since it allows the standardization of the anode heel eff ect, reduces the radiation dose to the patient and does not compromise image quality.
- Autonomia profissional das novas profissões da saúde em Portugal - Os técnicos superiores de radiologiaPublication . Abrantes, António; Almeida, Rui; Ribeiro, Luís Pedro; Vicente, Bianca; Azevedo, Kevin; Silva, Carlos Alberto da; Miranda, DulceO presente documento aborda os principais resultados e conclusões de um estudo sobre a autonomia dos técnicos superiores de radiologia, em Portugal. O estudo teve como objetivo principal, compreender e verificar o nível de autonomia dos técnicos superiores de radiologia, em Portugal, considerando o clima organizacional no qual, habitualmente, desempenham as suas funções. Para a concretização deste objetivo, foi realizado um estudo descritivo, através da aplicação de um inquérito por questionário aos técnicos superiores de radiologia de cinco unidades hospitalares públicas portuguesas. Para a análise e a interpretação dos resultados foram enquadrados reconhecidos contributos da sociologia das profissões, nomeadamente dos trabalhos de Larson, Maurice, Parson, Hughes, entre outros. Os principais resultados deste estudo verbalizam a ideia de um certo esvaziamento da autonomia funcional dos técnicos superiores de radiologia, verificando-se a inexistência de uma relação entre a sua autonomia e a satisfação profissional. Ressaltam igualmente nas conclusões que a autonomia dos técnicos superiores de radiologia pode ser conquistada no consagrado espaço profissional, maximizando as disputas entre as responsabilidades clínicas e as técnicas. Contudo, se a autonomia deste grupo profissional for entendida como a capacidade de realizar perfeitamente as funções a si já pertencentes, sem qualquer tipo de supervisão, aplicando o melhor do conhecimento teórico à prática mais correta, então os técnicos superiores de radiologia podem conquistar autonomia, e por sua vez mais poder profissional, explorando mais as suas tarefas que não se restringem às delegações médicas.
- Bone density and fall risk screening in Algarve: A preliminary studyPublication . Ribeiro, Luís Pedro; Pinheiro, João; Abrantes, António; Ribeiro, A.M.; Vicente, Bianca I. C.; Almeida, Rui; Gonçalves, Tânia; Ferreira, M. A. G. A.; Farinha, Maria Conceição; Azevedo, KevinOsteoporosis is a major cause of morbidity and mortality around the world and is a silent disease characterized by low bone strength that results in an increased risk of fracture. The benefits of being physically active in advanced ages to reduce the loss of bone mineral density (BMD) and improve functional capacities are well known. Quantitative ultrasound (QUS) is a peripheral bone densitometry technique that is rapidly gaining in popularity for the assessment of skeletal status, along with fall risk assessment. This chapter consists of a brief review of the literature on osteoporosis and describes ongoing activities on bone density and fall risk prevention in Algarve, Portugal as part of EIP AHA´s action group on fall prevention with the presentation of a preliminary study. This study aimed to demonstrate that the postmenopausal female seniors who adhere to the recommendations for the regular program of physical activity after osteoporosis screening one year later show a slower decrease in BMD.
- Effect of maternal restricted diet during late gestation on muscle and bone development in sheep offspringPublication . Estêvão, Dulce; Harrison, Adrian; McKenzie, S. H.; Ribeiro, Luís Pedro; Tygesen, M. P.; Sancho, Teresa; Power, DeborahChanges in intrauterine environment, including nutrient availability, have been associated with fetal programming, contributing to different phenotypes which may determine health and susceptibility to disease throughout life. These changes seem to be mediated through alterations in both anabolic and catabolic hormone levels of maternal, placental and/or fetal origin. The present work aimed to evaluate how maternal under-nutrition during late pregnancy affects muscle and bone growth. Pregnant ewes were divided into two groups, one fed ad libitum and the other fed a restricted diet (50% of total energy requirements) during the last 6 weeks of gestation. Three twin carrying ewes from each feeding group were euthanized 6 days pre parturition. The remaining ewes gave birth normally and reared their lambs. At approximately day 30 post partum, 5 lambs from each of the feeding groups were euthanized and samples collected. Nutrient restriction during late gestation did not affect intrauterine axial growth, although weight at birth and the muscle weight were significantly lower than the ad libitum fed lamb fetuses. Bone development is less affected cf muscle development during periods of maternal feed restriction; however, catch-up growth of muscle occurs when lambs (30 days post-parturition) have access to adequate rations. In utero irrespective of maternal nutrient supply dry muscle mass is correlated (r=0.94) to bone development (bone weight, femur length and femur mineral density). In contrast, post partum growth of and skeleton are less tightly coupled and unaffected by the events in utero. A detailed examination of how maternal nutrient supply affects endocrine parameters in utero will be required to assess if it affects susceptibility post-partum to endocrine dysfunction.
- Estudo da dose nos exames de tomografia computadorizada abdominal em um equipamento de 6 cortesPublication . Rodrigues, Sónia; Abrantes, António; Ribeiro, Luís Pedro; Almeida, RuiObjective: To determine the effective dose in abdominal computed tomography imaging and to study the influence of patients’ characteristics on the received dose. Materials and Methods: Dose values measurements were performed with an ionization chamber on phantoms to check the agreement between dose values and those presented by the computed tomography apparatus, besides their compliance with the recommended reference dose levels. Later, values of dose received by physically able patients submitted to abdominal computed tomography (n = 100) were measured and correlated with their anthropometric characteristics. Finally, the dose to organs was simulated with the Monte Carlo method using the CT-Expo V 1.5 software, and the effect of automatic exposure control on such examinations. Results: The main characteristics directly influencing the dose include the patients’ body mass, abdominal perimeter and body mass index, whose correlation is linear and positive. Conclusion: The radiation dose received from abdominal CT scans depends on some patient’s characteristics, and it is important to adjust the acquisition parameters to their dimensions.
- Evidence-based radiography: A new methodology or the systematisation of an old practice?Publication . Abrantes, António; Ribeiro, Luís Pedro; da Silva, C.A.; England, A.; Azevedo, K. B.; Almeida, Rui; Reis, MónicaIntroduction: Evidence based radiography (EBR) is the logical development of evidence based practice applied to radiography. The aim of this study was to investigate the opinion of a cohort of Portuguese radiographers in Southern Portugal working in public hospitals regarding evidence based practice (EBP), namely about the levels of knowledge about EBR, how they access information and how they use it within daily practice. Methods: A self-administered questionnaire was applied to a sample of 40 radiographers in the Portuguese region of Algarve. This questionnaire was validated for Portuguese speakers using the translationretranslation method. Results: The final response rate was 69% (40/58). Results suggest that most radiographers trained EBR during their undergraduate training. Although, no statistically significant correlations were found in the practice of EBR against participant gender, age, training, career level, reading papers and workplace. The most frequent reason to read papers is the “interest” to do so, and national professional journals are read more often. It was found that radiographers that read scientific papers more frequently know more about research (p ¼ 0.005), understand the importance of research for the professional activity (p ¼ 0.023), and know more on how to conduct research papers (p ¼ 0.034). Conclusion: EBR within radiography is not yet well established, and radiographers' have varying viewpoints. Radiographers that read scientific papers more frequently understand better the philosophy behind this concept but it is very important to deepen the knowledge on this area. Implications for practice: When practicing radiography based on the best available scientific knowledge, professionals are ensuring the best for patients and for profession. To achieve this, and before taking any action, it is important to evaluate the current situation, and this research presents a way to do so.
- Formação e desenvolvimento profissional dos técnicos de diagnóstico e terapêutica em PortugalPublication . da Silva, Carlos; Abrantes, António; Soares, Paula; Silva, Tânia; Almeida, Rui; Ribeiro, Luís PedroNa atualidade, o ensino e a formação assumem uma significativa centralidade nas estratégias de desenvolvimento dos países europeus. No caso concreto da área da Saúde em Portugal, a necessidade de melhorar e otimizar as características da prestação de cuidados de saúde e a própria evolução do trabalho nos hospitais e centros de saúde têm apelado a uma renovação de conteúdos e das modalidades de educação e formação inicial e continua dos diferentes grupos profissionais (médicos, enfermeiros, dos técnicos superiores de diagnóstico e terapêutica, outros técnicos superiores da área da saúde). Isso supõe, por exemplo, que a educação e formação dos técnicos superiores de diagnóstico e terapêutica (TSDT) promova, entre outros aspetos, a adequação das qualificações profissionais às constantes mudanças dos estados de saúde e de doença dos cidadãos, para além de realizar a sua função fundamental de contribuir para o desenvolvimento e satisfação pessoal, bem como para fomentar o exercício da cidadania e as competências e habilidades nucleares em avaliação das tecnologias da saúde das diferentes categorias profissionais da saúde.
- Image quality assessment of head CT: Control charts as an useful instrumentPublication . Guiomar, Joana Reis; Ribeiro, Luís Pedro; Ribeiro, Anabela; Abrantes, António; Pinheiro, João; Almeida, Rui; Azevedo, KevinThemain objective of this research was to determine if the diagnostic image, acquired by CT scan, meets the quality criteria previously established for head CT exams. A total of 360 Head Computed Tomography exams were analyzed, using a checklist. For data collection, quality criteria were created, organized into four criteria groups, consisting of multiple items that must appear in the images studies. After data processing, a large number of non-conformexaminations were identified in than more than 50% of the sample. We concluded the main causes of these results are: the “incorrect or incomplete positioning”, the "lack of name of the radiographer and “motion artefacts”. Therefore it is essential to implement a checklist for a systematic evaluationof procedures.
- Image quality control in digital radiologyPublication . Cândido, Susana; Ribeiro, Luís Pedro; Ribeiro, Anabela; Abrantes, António; Pinheiro, João; Almeida, Rui; Azevedo, KevinImage Quality Control is an important factor that contributes to the improvement of patient care and overall diagnostic accuracy. Our purpose was to elaborate Quality Control Charts and demonstrate the importance of image quality control in a radiology department. A total of 37 random samples, composed of 30 x-ray exams each, were selected and analyzed. Primarily, data about image non-conformities were compiled to make three distinct Quality Control Charts. Secondly, improvement and corrective actions were suggested. Our results allowed us to identify and account for different types of non-conformities found on x-ray images. This illustrates the importance and necessity for the implementation of an adequate Image Quality Control in Digital Radiology.
- Interpretation of many-valuedness in quality-of-life instrumentsPublication . Ribeiro, Luís Pedro; Eklund, Patrik; Gomes Alves Ferreira, Maria Augusta; Magalhães Ribeiro, Anabela de; Farinha, Maria Conceição; Paiva, Maria Adelaide; Gonçalves, Tânia; de Almeida Fontes, Ana Paula; Pinheiro, JoãoAssessment instruments for functioning in general and quality of life in particular often involve discrete scales with three, four, or five values, or Visual Analogue Scales (VAS) with a range 0–100. VAS scales often need to be downsized and discretized using intervals or clusters. Cutoff points for these intervals/clusters need to be carefully selected and justified. Our objective was to underline the importance of providing clear interpretations of many-valuedness appearing in quality-of-life (QoL) instruments, and to present a methodology for the provision of such clearness. Doing so, we view QoL scales as originating within the World Health Organization (WHO).
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