How much resources are reasonable to spend on radiological protection?

In short terms, a society's available resources are finite and must be prioritised. The more resources that are spent on radiological protection, the lesser resources are available for other needs. The ALARA principle states that exposure of ionising radiation should be kept as low as reasonably achievable, taking into account economic and societal factors.

An Estimation of the Monetary Value of the Person-Sievert Useful for Occupational Radiological Protection within the Healthcare System of Sweden.

The As Low As Reasonably Achievable (ALARA) principle includes taking into account economic and societal factors. To consider these factors, decision-aiding techniques such as cost-benefit analysis were introduced by the International Commission on Radiological Protection (ICRP) 50 y ago. Over the years, developments in health economics have led to new ways of deriving the concept of a value of a statistical life (VSL), which now is influencing the monetary value assigned to a unit of collective dose for radiological protection purposes (the α value) used in cost-benefit analyses.

Evaluation of novel radiation protection devices during radiologically guided interventions.

Background: In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure.

Method: An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room.

Lead aprons and thyroid collars: to be, or not to be?

Wearing lead aprons and thyroid collars for long periods of time has a subjective component: to balance the effective dose reduction with the effort of carrying a heavy load. Occupational radiation exposure has decreased dramatically in the last century within the health care system. During the same period the use of lead aprons and thyroid collars has also gone up.

Women's experiences with unexpected induction of labor: A qualitative study.

Introduction: Induction of labor is the most common intervention in modern obstetrics and is a growing phenomenon worldwide. Research on women's experiences with the induction of labor is scarce, especially on being unexpectedly induced. The purpose of this study is to explore women's experiences with unexpected induction of labor.

Movers and Stayers: A Study of Emigration from Sweden 1993-2014.

Unlabelled: A standard proposition in the migration literature is that emigrants are not drawn randomly from their source population, but rather compose a self-selected group in terms of labour market characteristics. Such self-selection refers to observed characteristics, such as education, or occupation, as well as unobserved characteristics such as cognitive abilities. However, due to data limitations, most previous studies on selectivity have analysed immigrants' characteristics at destinations rather than using data from their source countries.

A case study of cost-benefit analysis in occupational radiological protection within the healthcare system of Sweden.

The aim of the present study was to demonstrate cases of cost-benefit analysis within healthcare, of how economic factors can be considered in occupational radiological protection, in agreement with the as low as reasonably achievable principle and present Swedish legislations. In the first part of the present study, a comparison of examples within health economics used by authorities and institutes in Sweden was made. The comparison focused on value of a statistical life, quality-adjusted life year, and monetary cost assigned to a unit of collective dose for radiation protection purposes (α-value).

ALIGNING VIDEO-AND STRUCTURED DATA FOR IMAGING OPTIMISATION.

Imaging optimisation can benefit from combining structured data with qualitative data in the form of audio and video recordings. Since video is complex to work with, there is a need to find a workable solution that minimises the additional time investment. The purpose of the paper is to outline a general workflow that can begin to address this issue.

A MODEL FOR EVALUATING THE USE OF IMAGING IN IMAGE-GUIDED INTERVENTIONAL PROCEDURES-POSSIBLE IMPLICATIONS ON OPTIMISATION OF RADIATION PROTECTION.

The present study focuses on introducing the concept of optimisation and proposing a model, including evaluation of image quality, to be used in the clinical routines where image-guided intervention is being performed. The overall aim of the study was to develop a model for evaluating the use of imaging in X-ray-guided interventional procedures and its possible implications on optimisation of radiation protection. In the search for an adequate evaluation model, data from endovascular interventions of the aorta (EVAR procedures) were used.

Selectivity and Internal Migration: A Study of Refugees' Dispersal Policy in Sweden.

Following the intensified waves of refugees entering Europe, dispersal policies for newly arrived refugees have been proposed to speed up their integration and to share the financial burden across and within the EU countries. The effectiveness of dispersal policies depends, among other factors, on the extent to which refugees tend to stay in the initial location they are assigned to live in, and on their patterns of self-selectivity during subsequent moves of internal migration. Economic theories of migration suggest that economic immigrants are self-selected to destinations based on their abilities.

Challenges assessing radiation risk in image-guided treatments-implications on optimisation of radiological protection.

The present work explores challenges when assessing organ dose and effective dose concerning image-guided treatments. During these treatments considerable x-ray imaging is employed using technically advanced angiographic x-ray equipment. Thus, the radiation dose to organs and the related radiation risk are relatively difficult to assess.

OPTIMISATION OF OCCUPATIONAL RADIATION PROTECTION IN IMAGE-GUIDED INTERVENTIONS: EXPLORING VIDEO RECORDINGS AS A TOOL IN THE PROCESS.

The overall purpose of this work was to explore how video recordings can contribute to the process of optimising occupational radiation protection in image-guided interventions. Video-recorded material from two image-guided interventions was produced and used to investigate to what extent it is conceivable to observe and assess dose-affecting actions in video recordings. Using the recorded material, it was to some extent possible to connect the choice of imaging techniques to the medical events during the procedure and, to a less extent, to connect these technical and medical issues to the occupational exposure.

Eye dosimetry and protective eyewear for interventional clinicians.

Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eyewear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses.

Optimisation of occupational radiological protection in image-guided interventions: potential impact of dose rate measurements.

The optimisation of occupational radiological protection is challenging and a variety of factors have to be considered. Physicians performing image-guided interventions are working in an environment with one of the highest radiation risk levels in healthcare. Appropriate knowledge about the radiation environment is a prerequisite for conducting the optimisation process.

A management system integrating radiation protection and safety supporting safety culture in the hospital.

Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system.

Derivation and application of dose reduction factors for protective eyewear worn in interventional radiology and cardiology.

Doses to the eyes of interventional radiologists and cardiologists could exceed the annual limit of 20 mSv proposed by the International Commission on Radiological Protection. Lead glasses of various designs are available to provide protection, but standard eye dosemeters will not take account of the protection they provide. The aim of this study has been to derive dose reduction factors (DRFs) equal to the ratio of the dose with no eyewear, divided by that when lead glasses are worn.

Evaluation of the impact of a system for real-time visualisation of occupational radiation dose rate during fluoroscopically guided procedures.

Optimisation of radiological protection for operators working with fluoroscopically guided procedures has to be performed during the procedure, under varying and difficult conditions. The aim of the present study was to evaluate the impact of a system for real-time visualisation of radiation dose rate on optimisation of occupational radiological protection in fluoroscopically guided procedures. Individual radiation dose measurements, using a system for real-time visualisation, were performed in a cardiology laboratory for three cardiologists and ten assisting nurses.

Cultural dissimilarity and intermarriage. a longitudinal study of immigrants in Sweden, 1990–2005.

Intermarriage with natives is a key indicator of immigrant integration. This article studies intermarriage for 138 immigrant groups in Sweden, using longitudinal individual level data. It shows great variation in marriage patterns across immigrant populations, ranging from over 70 percent endogamy in some immigrants groups to below 5 percent in other groups.

Status homogamy in the preindustrial marriage market: partner selection according to age, social origin, and place of birth in nineteenth-century rural Sweden.

This article studies partner selection according to three dimensions: social origin, age, and place of birth. The authors use micro-level data from local population registers in five parishes in southern Sweden from 1815 to 1895. The results confirm that all three aspects were important but that socioeconomic status was the most important characteristic, structuring much of the selection process.

Radiation-induced thyroid stunning: differential effects of (123)I, (131)I, (99m)Tc, and (211)At on iodide transport and NIS mRNA expression in cultured thyroid cells.

Unlabelled: Recent clinical and experimental data demonstrate that thyroid stunning is caused by previous irradiation and may influence the efficacy of (131)I radiation therapy of thyroid cancer and possibly hyperthyroidism. To avoid stunning, many clinics have exchanged (131)I for (123)I for pretherapeutic diagnostic imaging and dose planning. Furthermore, recent in vitro studies indicate that (131)I irradiation reduces iodide uptake by downregulating the expression of the sodium iodide symporter (NIS).

Down-regulation of the sodium/iodide symporter explains 131I-induced thyroid stunning.

(131)I radiation therapy of differentiated thyroid cancer may be compromised by thyroid stunning (i.e., a paradoxical inhibition of radioiodine uptake caused by radiation from a pretherapeutic diagnostic examination).

Reduced iodide transport (stunning) and DNA synthesis in thyrocytes exposed to low absorbed doses from 131I in vitro.

Unlabelled: Thyroid stunning refers to reduced uptake of (131)I in the thyroid tissue (or tumor) during radioiodine ((131)I) therapy compared with the uptake measured after the previous administration of (131)I for diagnostic purposes. The phenomenon is clinically important, as it can potentially lead to the undertreatment of thyroid cancer or to unnecessarily high absorbed doses in critical organs. Previous clinical and experimental studies indicated that thyroid stunning is absorbed dose dependent.

Biodistribution of free 211At and 125I- in nude mice bearing tumors derived from anaplastic thyroid carcinoma cell lines.

Unlabelled: Free 211At has been proposed for therapy of anaplastic thyroid carcinoma (ATC). However, no extensive biodistribution study comparing tumor-bearing and nontumor-bearing mice has previously been performed. The aim of this study was to perform a complete evaluation of the biodistribution of 211At, both for normal and ATC-bearing mice.

To be a helpless helpoholic--GPs' experiences of women patients with non-specific muscular pain.

Objectives: To explore and describe what it means to be a GP meeting patients with non-specific symptoms.

Design: Focus group interviews analysed in a phenomenological approach.

Setting: GPs at two urban healthcare centres from a big city, a low socioeconomic area with mostly immigrants and a high socioeconomic area, and from a smaller town.