RESUMO
PURPOSE: RENEB, 'Realising the European Network of Biodosimetry and Physical Retrospective Dosimetry,' is a network for research and emergency response mutual assistance in biodosimetry within the EU. Within this extremely active network, a number of new dosimetry methods have recently been proposed or developed. There is a requirement to test and/or validate these candidate techniques and inter-comparison exercises are a well-established method for such validation. MATERIALS AND METHODS: The authors present details of inter-comparisons of four such new methods: dicentric chromosome analysis including telomere and centromere staining; the gene expression assay carried out in whole blood; Raman spectroscopy on blood lymphocytes, and detection of radiation-induced thermoluminescent signals in glass screens taken from mobile phones. RESULTS: In general the results show good agreement between the laboratories and methods within the expected levels of uncertainty, and thus demonstrate that there is a lot of potential for each of the candidate techniques. CONCLUSIONS: Further work is required before the new methods can be included within the suite of reliable dosimetry methods for use by RENEB partners and others in routine and emergency response scenarios.
Assuntos
Bioensaio/métodos , Planejamento em Desastres/métodos , Laboratórios , Exposição à Radiação/análise , Monitoramento de Radiação/métodos , Gestão da Segurança/métodos , União Europeia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Integração de SistemasRESUMO
PURPOSE: To identify and assess, among the participants in the RENEB (Realizing the European Network of Biodosimetry) project, the emergency preparedness, response capabilities and resources that can be deployed in the event of a radiological or nuclear accident/incident affecting a large number of individuals. These capabilities include available biodosimetry techniques, infrastructure, human resources (existing trained staff), financial and organizational resources (including the role of national contact points and their articulation with other stakeholders in emergency response) as well as robust quality control/assurance systems. MATERIALS AND METHODS: A survey was prepared and sent to the RENEB partners in order to acquire information about the existing, operational techniques and infrastructure in the laboratories of the different RENEB countries and to assess the capacity of response in the event of radiological or nuclear accident involving mass casualties. The survey focused on several main areas: laboratory's general information, country and staff involved in biological and physical dosimetry; retrospective assays used, the number of assays available per laboratory and other information related to biodosimetry and emergency preparedness. Following technical intercomparisons amongst RENEB members, an update of the survey was performed one year later concerning the staff and the available assays. CONCLUSIONS: The analysis of RENEB questionnaires allowed a detailed assessment of existing capacity of the RENEB network to respond to nuclear and radiological emergencies. This highlighted the key importance of international cooperation in order to guarantee an effective and timely response in the event of radiological or nuclear accidents involving a considerable number of casualties. The deployment of the scientific and technical capabilities existing within the RENEB network members seems mandatory, to help other countries with less or no capacity for biological or physical dosimetry, or countries overwhelmed in case of a radiological or nuclear accident involving a large number of individuals.
Assuntos
Pesquisa Biomédica/organização & administração , Planejamento em Desastres/organização & administração , Monitoramento de Radiação/métodos , Proteção Radiológica/métodos , Liberação Nociva de Radioativos , Gestão da Segurança/organização & administração , Europa (Continente) , Modelos Organizacionais , Radiobiologia/organização & administraçãoRESUMO
PURPOSE: Two quality controlled inter-laboratory exercises were organized within the EU project 'Realizing the European Network of Biodosimetry (RENEB)' to further optimize the dicentric chromosome assay (DCA) and to identify needs for training and harmonization activities within the RENEB network. MATERIALS AND METHODS: The general study design included blood shipment, sample processing, analysis of chromosome aberrations and radiation dose assessment. After manual scoring of dicentric chromosomes in different cell numbers dose estimations and corresponding 95% confidence intervals were submitted by the participants. RESULTS: The shipment of blood samples to the partners in the European Community (EU) were performed successfully. Outside the EU unacceptable delays occurred. The results of the dose estimation demonstrate a very successful classification of the blood samples in medically relevant groups. In comparison to the 1st exercise the 2nd intercomparison showed an improvement in the accuracy of dose estimations especially for the high dose point. CONCLUSIONS: In case of a large-scale radiological incident, the pooling of ressources by networks can enhance the rapid classification of individuals in medically relevant treatment groups based on the DCA. The performance of the RENEB network as a whole has clearly benefited from harmonization processes and specific training activities for the network partners.
Assuntos
Bioensaio/métodos , Aberrações Cromossômicas/efeitos da radiação , Testes para Micronúcleos/métodos , Garantia da Qualidade dos Cuidados de Saúde , Exposição à Radiação/análise , Monitoramento de Radiação/métodos , Bioensaio/normas , Europa (Continente) , Humanos , Linfócitos/efeitos da radiação , Monitoramento de Radiação/normas , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Resumo Contexto: O uso do dissulfiram no tratamento da Perturbação de Uso de Álcool (PUA) é uma estratégia importante na manutenção da abstinência. As sessões de psicoeducação, realizadas pelos enfermeiros, têm a finalidade de preparar o utente/família para a toma segura do dissulfiram, monitorizando os seus efeitos. Objetivo: Avaliar o conhecimento de pessoas com PUA internadas sobre os cuidados a ter com a alimentação e produtos de higiene durante a toma de dissulfiram identificando as necessidades de intervenções de enfermagem psicoeducativas. Métodos: Estudo transversal e descritivo. Na colheita de dados utilizou-se um questionário sociodemográfico e um instrumento desenvolvido pelos autores com questões de avaliação do conhecimento acerca dos cuidados a ter durante a toma de dissulfiram indicando os aspetos sobre os quais devem incidir as sessões de psicoeducação. Resultados: Amostra constituída por 31 participantes com uma média de idades de 49 anos (DP=8,87). Destaca-se o conhecimento não demonstrado, sobre o consumo de pickles, maionese e mostarda (48,4%), de doces confecionados com álcool (38,8%), a utilização de xaropes e elixires com álcool (41,9%) e de aftershave, perfumes ou tónicos com álcool (35,5%). 12,9% dos participantes não reconhece os sintomas, toracalgia, tonturas, taquicardia e cefaleias, como reações adversas aquando da junção de álcool com dissulfiram. Conclusões: Uma percentagem significativa da amostra não sabe quais os cuidados a ter com a alimentação e com a seleção dos produtos de higiene pelo que é necessário realizar intervenções psicoeducativas, tendo os enfermeiros especialistas em saúde mental um papel fundamental.
Abstract Background: The use of disulfiram in the treatment of Alcohol Use Disorder (AUD) is an important strategy to the maintenance of abstinence. The psychoeducation sessions conducted by nurses are intended to prepare the patient / family for the safe use of disulfiram and to monitor its effects. Aim: To evaluate the knowledge of hospitalized people with AUD about the care to be taken with food and hygiene products during the taking of disulfiram and to identify the need for psychoeducational nursing interventions. Methods: Cross-sectional and descriptive. Data were collected using a form with sociodemographic data and an instrument developed by the authors with questions about knowledge about the care to be taken during the taking of disulfiram and identify the aspects on which psychoeducation sessions should focus. Results: Sample consisting of 31 participants with an average age of 49 years (SD = 8.87). It stands out the knowledge not demonstrated, about the consumption of pickles, mayonnaise and mustard (48.4%), of sweets made with alcohol (38.8%), the use of syrups and elixirs with alcohol (41.9%) and aftershave, perfum or tonics with alcohol (35.5%). 12.9% of the participants do not recognize the symptoms, chest pain, dizziness, tachycardia and headache, as adverse reactions when the addition of alcohol with disulfiram. Conclusions: A significant percentage of the sample does not know what precautions to take with food and of hygiene products selection, so it is necessary to carry out psychoeducational interventions, having the nurse specialists in mental health a fundamental role.
Resumen Contexto: El uso de disulfiram en el tratamiento del Trastorno por Uso de Alcohol (TUA) es una estrategia importante para el mantenimiento de la abstinencia. Las sesiones psicoeducativas realizadas por enfermeras están destinadas a preparar al paciente / familia para el uso seguro de disulfiram y controlar sus efectos. Objetivo(s): Evaluar el conocimiento de personas hospitalizadas con TUA sobre el cuidado que se debe tener con los cuidados alimentarios, productos higiénicos durante la toma de disulfiram, identificando la necesidad de intervenciones psicoeducativas de enfermería. Métodos: Estudio transversal y descriptivo. Los datos se recopilaron mediante un formulario sociodemográfico, y un instrumento desarrollado por los autores con preguntas de evaluación del conocimiento sobre el cuidado a tener durante la toma de disulfiram, indicando aspectos en los que deben centrarse las sesiones de psicoeducación. Resultados: Muestra compuesta por 31 participantes con edad promedio de 49 años (DE = 8,87). Destaca conocimiento insuficientes sobre el consumo de encurtidos, mayonesa y mostaza (48.4%), dulces hechos con alcohol (38.8%), el uso de jarabes y elixires con alcohol (41.9%) y después del afeitado, perfume o tónicos con alcohol (35.5%). El 12,9% de los participantes descalifican los síntomas, dolor de pecho, mareos, taquicardia y dolor de cabeza, como reacciones adversas cuando se agrega alcohol con disulfiram. Conclusiones: Un porcentaje significativo de la muestra no sabe qué precauciones tomar con los alimentos y selección de productos higiénicos, siendo necesario efeto intervenciones psicoeducativas, con enfermeros especializadas en salud mental que desempeñan un papel fundamental.