Research Proposal (Non-Granted) Case Study
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
- PROJECT SUMMARY
Evaluate the knowledge and assess the practice of pain medicine fellows regarding the radiation safety in their daily practice. We will distribute survey and compare the result to other published data from other countries. This study will evaluate the current practice of pain physicians and their knowledge in KSA and will suggest how to improve the safety of practitioners according to the results.
- BACKGROUND
Health risks from exposure to ionizing radiation considered a concern to patients and many healthcare practitioners in different specialties e.g interventional radiology, cardiology, pain physicians…etc. and that include skin diseases, cancer such thyroid cancer, brain tumor, and leukemia, genetic effects, cataract and many other diseases that may occur years after exposure to radiation1. The main concern of the U.S. Nuclear Regulatory Commission (NRC) is the delayed incidence of cancer which believed to be dependent on how much radiation dose a person gets. The probability of serious genetic effects in the future children of workers is estimated in the BIER report which based on animal studies, at less than one-third that of delayed cancer2. Skin cancer may develop after 20 to 40 years from exposure to ionizing radiation and same to solid tumors usually take up to 40 years to become clinically manifest, but radiation induced leukemias usually require 2 – 10 years to appear 3. The development of such side effects from radiation cost the institute and the government and put the burden of treatment. For that reason, many international guidelines have been published to minimized and early discover those at high risk.
X-ray and CT scan is commonly used among pain physicians to accurately localize the needle during the procedures. That led to increased risk of direct and indirect biological effect for both patient and personnel in the room1. With the increase in the number of patients, the radiation to pain physicians is unavoidable because of his close position to the patient during the procedure and the main source is the scattered radiation. The radiation dose is considered safe to some extent if protective measures and equipment are used properly4,5. The radiation dosimeter is used to measure the expose to ionizing radiation. The principle of as low as reasonably achievable (ALARA) should be practiced to minimizing the cumulative dose of radiation and that depend mainly on time, distance, and shielding6. Several radiations protective equipment are available to minimize the radiation dose including apron, glove, thyroid protective cover, googles, and lead barriers.
- PROJECT OBJECTIVES
To evaluate the knowledge of pain medicine fellows in Saudi Arabia about radiation safety and their use of radiation protective equipment in practice to minimize the risk of radiation.
- LITERATURE SURVEY
• Up to the date of preparing this proposal there is no single study evaluation the radiation safety practice among interventional pain physicians but there is on done in Taif and conclude the need for more knowledge and to improve the practice. 7 Another study also done on medical student in Jeddah has shown same. 8 When we look to other similar study in the field of pain medicine there are few studies evaluating same matter. One study has evaluated the 27 pain physicians who applied for the final test to become an expert in pain medicine in 2011 and showed inadequate knowledge of radiation safety. 9 One more study in the same field surveyed 49 pain specialists was conducted anonymously in 2016 and showed pain physicians seem to lack knowledge of radiation safety and the number of physicians receiving radiation safety education is low and conclude pain physicians should receive regular radiation safety education and the education should be mandatory. 10 More specifically radiation exposure has been evaluate for specific procedures in pain medicine like caudal epidural steroid injection and the result was reassuring and came within safety limits when he/she adheres to proper technique.11 Another interesting studies showed different in radiation exposure between university hospital and private hospital for same spine interventions. 12 In more detail the factors that have major role in determining the dose of radiation to patient and practitioners many papers has addressed that and one of that was during lumbar spine interventions and conclude there is a significant difference of radiation dose depending on whether a physician or a radiographer operates the fluoroscopy unit. 13
• This can be explained by that
• direct control of the fluoroscopy unit can lead to shorten fluoroscopy time
• Image magnification increases radiation dose. The selective use of fluoroscopy and non-use of magnification does depend upon the physician, therefore, physicians should perform procedures using fluoroscopy carefully in order to minimize radiation exposure.
Finally one paper has shown Operator Air Kerma during individual fluoroscopy-guided spine procedures can be approximated from the commonly and readily available information of the patient KAP. The estimated annual occupational dose of 0.64 mSv is lower than the current regulatory occupational dose limits. 14
- RESEARCH DESIGN
Questionnaire (attached)
- METHODS
Study design: Cross-sectional
Study setting: Saudi Arabia
Duration of study: one year (start 25 June 2018)
Study population: All pain fellows enrolled in the program or recently completed
Inclusion criteria current pain fellows practitioners in KSA and those recently
completed the training
Exclusion criteria: Those not in SCFHS training program or involved in other
international program
Data collection procedure: the data will be collected through phone call to maximize the number of the sample and get most accurate data. Data will be used confidentially and for the purpose of this study only.
Data analysis procedure: Data will be entered and analyzed by MS
Results will be expressed in ratios and percentage.
- REFERENCES
1. Zylberger, D. (2013). Radiation Safety for Patients and Pain Practitioners. Topics in Pain Management, 29(3), 1-8.
2. National Research Council. (2006). Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2 (Vol. 7). National Academies Press.
3. Radiation-induced cancer. (2018, April 07). Retrieved April 14, 2018, from https://en.wikipedia.org/wiki/Radiation-induced_cancer
4. Botwin, K. P., Freeman, E. D., Gruber, R. D., Torres-Rames, F. M., Bouchtas, C. G., Sanelli, J. T., & Hanna, A. F. (2001). Radiation exposure to the physician performing fluoroscopically guided caudal epidural steroid injections. Pain Physician, 4(4), 343-348.
5. Roccatagliata, L., Presilla, S., Pravatà, E., & Cianfoni, A. (2017). Radiation dose to the operator during fluoroscopically guided spine procedures. Neuroradiology, 59(9), 885-892.
6. Hendee, W. R., & Edwards, F. M. (1986, April). ALARA and an integrated approach to radiation protection. In Seminars in nuclear medicine (Vol. 16, No. 2, pp. 142-150). WB Saunders.
7. Ahmed, R. M., Elamin, A. M. T., Elsamani, M., & Hassan, W. B. (2015). Knowledge and performance of radiographers towards radiation protection, Taif, Saudi Arabia. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 14(3), 63-68.
8. Hagi, S., & Khafaji, M. (2011). Medical student’s knowledge of ionizing radiation and radiation protection. The Saudi Medical Journal, 32(5).
9. Park, P. E., Park, J. M., Kang, J. E., Cho, J. H., Cho, S. J., Kim, J. H., … & Kim, Y. C. (2012). Radiation safety and education in the applicants of the final test for the expert of pain medicine. The Korean journal of pain, 25(1), 16-21.
10. Kim, T. H., Hong, S. W., Woo, N. S., Kim, H. K., & Kim, J. H. (2017). The radiation safety education and the pain physicians’ efforts to reduce radiation exposure. The Korean journal of pain, 30(2), 104-115.
11. Botwin, Kenneth P., et al. “Radiation exposure to the physician performing fluoroscopically guided caudal epidural steroid injections.” Pain Physician 4.4 (2001): 343-348.
12. YiLi Zhou, M. D., Singh, N., Abdi, S., Wu, J., Crawford, J., & Furgang, F. A. (2005). Fluoroscopy radiation safety for spine interventional pain procedures in university teaching hospitals. Pain Physician, 8(1).
13. Choi, M. H., Choi, B. G., Jung, S. E., & Byun, J. Y. (2016). Factors related to radiation exposure during lumbar spine intervention. Journal of Korean medical science, 31(Suppl 1), S55-S58.
14. Kim, K. P., Miller, D. L., de Gonzalez, A. B., Balter, S., Kleinerman, R. A., Ostroumova, E., … & Linet, M. S. (2012). Occupational radiation doses to operators performing fluoroscopically-guided procedures. Health physics, 103(1), 80.
- APPENDICES
Questionnaire (attached)
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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