A patient journey audit tool (PJAT) to assess quality indicators in a nuclear medicine service.

PURPOSE: To develop a nuclear medicine specific patient journey audit tool (PJAT) to survey and audit patient journeys in a nuclear medicine department such as staff interaction with patients, equipment, quality of imaging and laboratory procedures, patient protection, infection control and radiation safety, with a view to optimising patient care and providing a high-quality nuclear medicine service. METHODS: The PJAT was developed specifically for use in nuclear medicine practices. Thirty-two questions were formulated in the PJAT to test the department's compliance to the Australian National Safety and Quality Health Service Standards, namely clinical governance, partnering with consumers, preventing and controlling health care infection, medication safety, comprehensive care, communicating for safety, blood management and recognising and responding to acute deterioration. The PJAT was also designed to test our department's adherence to diagnostic reference levels (DRL). A total of 60 patient journey audits were completed for patients presenting for nuclear medicine, positron emission tomography and bone mineral density procedures during a consecutive 4-week period to audit the range of procedures performed. A further 120 audits were captured for common procedures in nuclear medicine and positron emission tomography during the same period. Thus, a total of 180 audits were completed. A subset of 12 patients who presented for blood labelling procedures were audited to solely assess the blood management standard. RESULTS: The audits demonstrated over 85% compliance for the Australian national health standards. One hundred percent compliance was noted for critical aspects such as correct patient identification for the correct procedure prior to radiopharmaceutical administration, adherence to prescribed dose limits and distribution of the report within 24 h of completion of the imaging procedure. CONCLUSION: This PJAT can be applied in nuclear medicine departments to enhance quality programmes and patient care. Austin Health has collaborated with the IAEA to formulate the IAEA PJAT, which is now available globally for nuclear medicine departments to survey patient journeys.

High incidence of concussion, but low knowledge levels among young adults.

Cerebral concussion is a brain injury, that involves a complex pathophysiological process that affects the brain as a result of biomechanical forces. With the increasing prevalence, it is important that the public is knowledgeable about concussion and its symptoms, so that they can bring attention to individuals with concussion symptoms soon after onset, for appropriate care. The aim of this study was to determine the knowledgeability of young adults. Secondary aims were to compare the knowledgeability of young adults of different age, of different countries of residence, of different sex, and of different perceived knowledge about concussions. An online survey was circulated to young adults in Canada, the US and the UK. The survey consisted of three components - a consent form, respondent demographics and eight questions to assess each respondent's knowledgeability of concussions. The knowledgeability of each respondent was determined by the summation of the number of correct responses to the knowledge questions. A total of 307 respondents consented and completed the survey in its entirety. The mean knowledge score was 4.25 out of 8. None of the cohort analyses based on demographics - 19 years old and under vs. 20 years and older; North Americans vs. non-North Americans; females vs. males - suggested that one group was more knowledgeable than the other group. These results suggest that educational programs can be developed to increase awareness of concussions. As each cohort seems to have similar starting knowledge levels, it seems appropriate to develop a uniform program to first try to increase knowledgeability, and then produce specialised programs to raise knowledge of certain cohorts. However, prior to the establishment of programs, further studies should be conducted to verify the results disclosed herein.

The Ti3 AlC2 MAX Phase as an Efficient Catalyst for Oxidative Dehydrogenation of n-Butane.

Dehydrogenation or oxidative dehydrogenation (ODH) of alkanes to produce alkenes directly from natural gas/shale gas is gaining in importance. Ti3 AlC2 , a MAX phase, which hitherto had not been used in catalysis, efficiently catalyzes the ODH of n-butane to butenes and butadiene, which are important intermediates for the synthesis of polymers and other compounds. The catalyst, which combines both metallic and ceramic properties, is stable for at least 30 h on stream, even at low O2 :butane ratios, without suffering from coking. This material has neither lattice oxygens nor noble metals, yet a unique combination of numerous defects and a thin surface Ti1-y Aly O2-y/2 layer that is rich in oxygen vacancies makes it an active catalyst. Given the large number of compositions available, MAX phases may find applications in several heterogeneously catalyzed reactions.

Plasma-Assisted Synthesis of Monodispersed and Robust Ruthenium Ultrafine Nanocatalysts for Organosilane Oxidation and Oxygen Evolution Reactions.

We report a facile and general approach for preparing ultrafine ruthenium nanocatalysts by using a plasma-assisted synthesis at <100 °C. The resulting Ru nanoparticles are monodispersed (typical size 2 nm) and remain that way upon loading onto carbon and TiO2 supports. This gives robust catalysts with excellent activities in both organosilane oxidation and the oxygen evolution reaction.

Unusual Presentation of Spinal Gout: 2 Cases Report and Literature Review.

INTRODUCTION: Gouty spondyloarthropathy is generally believed to be uncommon. Together with the fact that it can mimic a variety of disease entities, it imposes significant diagnostic challenge in our clinical practice. In this article, we report two patients diagnosed with spinal gout, and both were initially suspected to have a pyogenic infection. CASE REPORTS: The first patient, a 66-year-old man, was admitted for fever and a short history of bilateral upper limb weakness. Clinical, biochemical, and radiological investigation results were suggestive of C5/6 infective spondylodiscitis with resultant cervical myelopathy. The second patient, a 68-year-old man, was admitted for fever and bilateral lower limb weakness and numbness compatible with cauda equina syndrome. Imaging showed L4/5 lytic spondylolisthesis with suspected abscesses formation around the pars defects. Both underwent emergency operations. Histological examinations of intraoperative specimens in both cases revealed tophaceous gout and microbiological studies were all negative. Urate-lowering agent was started for hyperuricemia. They both had partial neurological recovery. CONCLUSION: These two cases highlight how axial gout can mimic infective spondyloarthropathy clinically. In patients with multiple risk factors for gout presenting with back conditions, spinal gout should be considered as one ofthe differential diagnosis. With the availability of advanced imaging modality, dual-energy computed tomography scan, pre-operative diagnosis of axial gout is now possible which may have implications on subsequent surgical approaches and medical treatment. Collaboration with the medical team to achieve good serum urate control is important to prevent disease recurrence.