How to run successful tutor-training programs for radiographers: A systematic review and considerations for future perspectives.

INTRODUCTION: Healthcare professions differ from each other, therefore need different approaches in teaching clinical practices. While teaching and learning designs for medical students are widely present on databases, few information is available for radiographers. The aim of this research is to define tools and knowledge needed to develop successful tutor-training programs that can be cross-cutting and inter-disciplinary for radiography profession, taking inspiration from other healthcare professions' programs since the paucity of evidence for radiographers. METHODS: A systematic review (PubMed/Embase) was performed according to the PRISMA checklist. Original articles on learning environment related to healthcare practitioners were included. Inclusion criteria comprehended articles covering design and frameworks of peer-assisted-learning (PAL) programs and training-the-trainer (TTT) curricula, skills required to become tutors, tips to install successful tutor-training programs along with benefits for tutors involved. From 1618 retrieved articles, after two selection rounds, 15 articles met the inclusion criteria. RESULTS: Out of the 15 articles, none is addressed to radiographers and only 7 % (1/15) to other healthcare professions, opposed to the 93 % (14/15) addressed to medical students. All articles discuss feedback providing, 66 % (10/15) debates which the best behaviour to maintain towards students is to maximize learning, and 46 % (7/15) inform about the importance of briefing and de-briefing activities. An identical percentage (46 %, 7/15) underlines the advantages of tutoring experiences. 11 articles (73 %) enhance that tutors aren't adequately trained to carry out tutoring activities. DISCUSSION: Through curricula designed on TTT and PAL programs, radiographers are provided with necessary teachings and frameworks to set up effective training paths. Few institutes promote educational tutor-training courses, even though these are beneficial both for tutors and students, consolidating professionals' knowledge and maximizing students' practical skills. CONCLUSION: Offering tutor-training curricula contributes to the development of radiographers as teachers, providing them with guiding principles to improve their formative skills towards future colleagues, therefore optimizing efficacy and effectiveness of programs.

The environmental impact of energy consumption and carbon emissions in radiology departments: a systematic review.

OBJECTIVES: Energy consumption and carbon emissions from medical equipment like CT/MRI scanners and workstations contribute to the environmental impact of healthcare facilities. The aim of this systematic review was to identify all strategies to reduce energy use and carbon emissions in radiology. METHODS: In June 2023, a systematic review (Medline/Embase/Web of Science) was performed to search original articles on environmental sustainability in radiology. The extracted data include environmental sustainability topics (e.g., energy consumption, carbon footprint) and radiological devices involved. Sustainable actions and environmental impact in radiology settings were analyzed. Study quality was assessed using the QualSyst tool. RESULTS: From 918 retrieved articles, 16 met the inclusion criteria. Among them, main topics were energy consumption (10/16, 62.5%), life-cycle assessment (4/16, 25.0%), and carbon footprint (2/16, 12.5%). Eleven studies reported that 40-91% of the energy consumed by radiological devices can be defined as "nonproductive" (devices "on" but not working). Turning-off devices during idle periods 9/16 (56.2%) and implementing workflow informatic tools (2/16, 12.5%) were the sustainable actions identified. Energy-saving strategies were reported in 8/16 articles (50%), estimating annual savings of thousand kilowatt-hours (14,180-171,000 kWh). Cost-savings were identified in 7/16 (43.7%) articles, ranging from US $9,225 to 14,328 per device. Study quality was over or equal the 80% of high-quality level in 14/16 (87.5%) articles. CONCLUSION: Energy consumption and environmental sustainability in radiology received attention in literature. Sustainable actions include turning-off radiological devices during idle periods, favoring the most energy-efficient imaging devices, and educating radiological staff on energy-saving practices, without compromising service quality. RELEVANCE STATEMENT: A non-negligible number of articles - mainly coming from North America and Europe - highlighted the need for energy-saving strategies, attention to equipment life-cycle assessment, and carbon footprint reduction in radiology, with a potential for cost-saving outcome. KEY POINTS: • Energy consumption and environmental sustainability in radiology received attention in the literature (16 articles published from 2010 to 2023). • A substantial portion (40-91%) of the energy consumed by radiological devices was classified as "non-productive" (devices "on" but not working). • Sustainable action such as shutting down devices during idle periods was identified, with potential annual energy savings ranging from 14,180 to 171,000 kWh.

Sarcopenia and Patient's Body Composition: New Morphometric Tools to Predict Clinical Outcome After Ivor Lewis Esophagectomy: a Multicenter Study.

BACKGROUND: The impact of preoperative body composition as independent predictor of prognosis for esophageal cancer patients after esophagectomy is still unclear. The aim of the study was to explore such a relationship. METHODS: This is a multicenter retrospective study from a prospectively maintained database. We enrolled consecutive patients who underwent Ivor-Lewis esophagectomy in four Italian high-volume centers from May 2014. Body composition parameters including total abdominal muscle area (TAMA), visceral fat area (VFA), and subcutaneous fat area (SFA) were determined based on CT images. Perioperative variables were systematically collected. RESULTS: After exclusions, 223 patients were enrolled and 24.2% had anastomotic leak (AL). Sixty-eight percent of patients were sarcopenic and were found to be more vulnerable in terms of postoperative 90-day mortality (p = 0.028). VFA/TAMA and VFA/SFA ratios demonstrated a linear correlation with the Clavien-Dindo classification (R = 0.311 and 0.239, respectively); patients with anastomotic leak (AL) had significantly higher VFA/TAMA (3.56 ± 1.86 vs. 2.75 ± 1.83, p = 0.003) and VFA/SFA (1.18 ± 0.68 vs. 0.87 ± 0.54, p = 0.002) ratios. No significant correlation was found between preoperative BMI and subsequent AL development (p = 0.159). Charlson comorbidity index correlated significantly with AL (p = 0.008): these patients had a significantly higher index (≥ 5). CONCLUSION: Analytical morphometric assessment represents a useful non-invasive tool for preoperative risk stratification. The concurrent association of sarcopenia and visceral obesity seems to be the best predictor of AL, far better than simple BMI evaluation, and potentially modifiable if targeted with prehabilitation programs.