Asunto(s)
Enfermedad Crónica/prevención & control , Atención a la Salud/métodos , Servicios Preventivos de Salud/métodos , Servicios de Salud para Mujeres , COVID-19/epidemiología , Diabetes Mellitus/prevención & control , Femenino , Humanos , Hipertensión/prevención & control , Neoplasias/prevención & control , Guías de Práctica Clínica como Asunto , SARS-CoV-2 , ConfianzaRESUMEN
OBJECTIVE: To assess the status and practice of kilovoltage (kV) radiotherapy in the UK. METHODS: 96% of the radiotherapy centres in the UK responded to a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical treatment sites, quality control (QC) testing and radiation dosimetry processes were undertaken. RESULTS: 73% of UK centres have at least one kV treatment unit, with 58 units installed across the UK. Although 35% of units are over 10 years old, 39% units have been installed in the last 5 years. Approximately 6000 patients are treated with kV units in the UK each year, the most common site (44%) being basal cell carcinoma. A benchmark of QC practice in the UK is presented, against which individual centres can compare their procedures, frequency of testing and acceptable tolerance values. We propose the use of internal "notification" and "suspension" levels for analysis. All surveyed centres were using recommended Codes of Practice for kV dosimetry in the UK; approximately the same number using in-air and in-water methodologies for medium energy, with two-thirds of all centres citing "clinical relevance" as the reason for choice of code. 64% of centres had hosted an external dosimetry audit within the last 3 years, with only one centre never being independently audited. The majority of centres use locally measured applicator factors and published backscatter factors for treatments. Monitor unit calculations are performed using software in only 36% of centres. CONCLUSION: A comprehensive review of current kV practice in the UK is presented. Advances in knowledge: Data and discussion on contemporary kV radiotherapy in the UK, with a particular focus on physics aspects.
Asunto(s)
Control de Calidad , Radiometría/instrumentación , Radiometría/estadística & datos numéricos , Radioterapia/instrumentación , Radioterapia/estadística & datos numéricos , Carga de Trabajo/estadística & datos numéricos , Humanos , Física , Dosificación Radioterapéutica , Reino UnidoRESUMEN
OBJECTIVE: The relationship of religion and schizophrenia is widely acknowledged, but often minimized by practitioners and under investigated by researchers. In striving to help fill this gap, this paper focuses on examining four aims: 1) how research has investigated the association between religiosity and schizophrenia; 2) how is religiosity associated with delusions and hallucinations; 3) what are the risk and protective factors associated with religiosity and schizophrenia; and 4) does religion influence treatment adherence with individuals diagnosed with schizophrenia. METHODS: A systematic literature search of PsycINFO and MEDLINE databases from January 1, 1980 through January 1, 2010 was conducted using the terms schizophrenia, schizoaffective, schizophreniform, psychotic disorder not otherwise specified (NOS) and religion, religiosity, spirituality, or faith. Seventy (n=70) original research studies were identified. RESULTS: Religion can act as both a risk and protective factor as it interacts with the schizophrenia symptoms of hallucination and delusions. Cultural influences tend to confound the association of religion and schizophrenia. Adherence to treatment has a mixed association with religiosity. CONCLUSION: The relationship between religion and schizophrenia may be of benefit to both clinicians and researchers through enhancing adherence to treatment, and enhancement of the protective aspects while minimizing associated risk. The relationship of religion and schizophrenia needs further research that is more nuanced and methodologically rigorous, specifically concerning its influence on engagement and adherence to treatment.