Presentation Thesis Assignment | Get Paper Help

Description

Required Resources Read/review the following resources for this activity: Textbook: ( McLean Scott, (2018). Exploring Interpersonal Communication (2nd ed.) Boston, MA: Flatworld)Chapter 10 Lesson File (Word doc): Week 3 Assignment 2 Template Instructions Think about the communication topic that you chose in your Week 2 Assignment. Your instructor should have already approved this. If not, contact your instructor right away for your presentation topic. Now for this part of the assignment, you will begin preparing for the Week 6 Assignment (individual PowerPoint presentation). Research your chosen topic in the textbook, and then address and submit the following: Write a good thesis statement. The thesis must be only one sentence. Brainstorm (You do not have to show your brainstorming in the assignment submission.) Write at least 3 main ideas concerning your topic. (Write in full sentences) Next week you will be researching, adding to this draft, and submitting additional outline Writing Requirements (APA format) 4-6 sentences 1-inch margins Double spaced 12-point Times New Roman font References page (as needed) Templated will be attached to files

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Table of Contents

Abstract                                                                                                                                            3

Introduction                                                                                                                                      4

Research Question                                                                                                                            5

Literature Review                                                                                                                             5

Research Design and Methods                                                                                                       11

The rationale of Study                                                                                                                11

Objectives                                                                                                                                   12

Methods and Materials                                                                                                               12

Data Analysis                                                                                                                              13

Data Presentation                                                                                                                        13

Sample Size Determination                                                                                                         13

Timeframe                                                                                                                                       13

Ethical Considerations                                                                                                                    14

Implications of Study                                                                                                                     15

Study Limitations                                                                                                                           15

References                                                                                                                                      17

Abstract

            Gonad shielding alludes to a fundamental strategy that helps in the protection of reproductive organs for the patients who are receiving conventional radiological examinations. When the reproductive organs are insufficiently shielded, or are not shielded at all, there is an increased exposure to the gonads, which may affect offspring. This study aims to investigate the prevalence of gonad shielding in patients receiving conventional radiological assessments, examines the availability of gonad shields, and assesses gonad shielding protocols in the radiology departments. This study applied a retrospective cross-sectional, observational approach to investigate the application of gonad shielding, the availability of gonad shields, and the protocols that exist for gonad shielding in the radiology departments. The research will be carried out in four major health institutions in Ottawa, Canada.  Add the major conclusions that were drawn due to this study….a summary of your conclusion basicly. 

GONADAL SHIELDING USED DURING X-RAY

Introduction

In radiology, gonad shielding has become a very regular practice and has been recommended by credible international and national bodies (Zabihzadeh, & Karami, 2016). While more than ten million radiological diagnoses are carried out across the globe each day, the utilization of ionizing radiation is consistently expanding for imaging patients. Danger to the gonads is a developing issue due to the stochastic and non-stochastic impacts of ionizing radiation (a non-x-ray student reading this would not know what stochastic is – you must explain).[1]  No exposure to radiation is safe, as indicated by Karami, Zabihzadeh, Shams, & Sarikhani (2016).

The gonadal region is exceptionally sensitive to radiation. There is high potential for malignant and genetic harmemerging from radiation exposure, with a factor of 0.08 in tissue weighting (needs to be cited – 0.08 is a fact)[2] . Moreover, genetic mutations can occur immediately after radiation exposure. Absence of, or insufficient shielding the gonads can expand the organ exposures in the future offspring both hereditarily and genetically[3] .

Various investigations in pelvic x-rays, direct observations, and surveys have been carried out to examine the use of gonadal shielding during radiologic tests. There are two types of barriers used to protect the gonads: shadow shields and contact shields[4] . Shadow shields are housed in the x-ray tube and are placed between the tube and the patient. The patients’ reproductive organs are protected by the shadow it creates when the light from the collimator is turnt on. Contact shields are flat vinyl covered lead and are mainly used when the patients are laying on their back.  require palpation of the anatomic structures to place the gonadal shield properly and are generally more significant because of the greater reduction in dose to the gonadal area (Karami and Zabihzadeh, 2015).

Depending upon the patient’s age and sex, various designs of gonadal shields are accessible. Kaplan et al. (2018) argue that if close or inside the minimal beam of 5 cm[5] , the gonadal shields need  to consistently be done, except if considerable anatomical details are upset by the shield[6] . Appropriate shielding of the gonads will diminish the portion of testicles and ovaries by about 95 and 50%.

Research Question

This retrospective observational cross-sectional research study seeks to assess the prevalence of gonad shielding in patients that are receiving conventional radiological examinations in four major health institutions in Ottawa, Canada. The study will also examine the availability of gonadal shields,and the protocols that these hospitals follow regarding  gonad shielding in their radiology departments. This research also attempts to underpin the answers to the following questions:

  1. Is the use of gonad shielding consistent in patients going through conventional radiological examinations in Ottawa hospitals?
  2. Are gonad shields available during the process of radiology?
  3. What are the protocols regarding the use of gonadal shields in the departments of radiology?

 


 

Literature Review

A significant component of the medical physicists  profession is ensuring that the patients and staff are well protected during diagnostic imaging examinations. Besides the huge rules and reports given by radiation protection experts, various professional societies, and associations, the functional value and viability of this dose reduction approach in characteristic radiological imaging methods remains questionable for patients[7] [8] . As affirmed by Kaplan et al. (2018), it is the duty of physicists to back facilities of diagnostic imaging and take an interest in logical endeavors and to talk about basic issues related to the origin of ideal dose diminishing strategies to protect  the patient against superfluous ionizing radiation. The capacity of gonadal shielding in radiology to offer protection to the genital organs of the patient is examined over an extensive stretch without arriving at accord[9] , prompting conflicting core values on its materialness in clinical exercise (Pasieka, Żelechowicz, and Milewski, 2017). Regardless of the contradictions of gonad protection in scientific literature, most patients assert that the use of gonadal shielding is frequently used in protecting them against ionizing radiation and that in their absence, they are exposed to an increased exposure to radiation.

According to Karami and Zabihzadeh (2015), gonad shielding made strides during the 1950s against the negative perceived effects of diagnostic x-rays. The clarifications incorporated the expanded familiarity with radiation brought about by widely known studies of the hereditary impacts of irradiated birds and the higher occurrence of malignant growth among casualties of the nuclear bomb survivors of Japan. Without a thress portion [10] (Kaplan et al., 2018), the two impacts should be actuated. The  protection of gonads in radiology has become the regular practice, and the national and worldwide associations prescribe it for every examination (Karami, Zabihzadeh, Shams, and Sarikhani, 2016). The application requirements include the following: (a) the gonads are found close or inside to the primary X-ray field (5 cm), (b) the assessment’s clinical goals won’t be endangered, (c) the productive limit with regards to an individual is reasonable[11] .

Shielding the gonads proves useful as indicated by Kaplan et al. (2018), as it can lessen the dose to the testes  by roughly 95% and the ovaries by around 50 percent. This is mostly as a result of a large expansion of the area of the ovaries, including regions from the midline that lie in front of the pelvic life systems to show up in the image (Karami and Zabihzadeh, 2015). The conceivable dose decrease in the early years was likewise high on account of the high dosages required for imaging at that time. Karami, Zabihzadeh, Shams, and Sarikhani (2016) enlisted a section level patient portion [12] of around 12 mGy for an x-ray in 1953 and an entry-level portion recurrence of 100–200 mGy/min during fluoroscopy. Fluoroscopy on the classical fluorescent screens around then [13] and was regularly utilized rather than radiography, which effectively brought about two or three hundred mGy, a large increase over static radiographic images. Diverse dosage values have just been distinguished by different specialists (Karami, Zabihzadeh, Shams, and Malehi, 2017), however quiet portion decrease measures (Kaplan et al., 2018) have been progressing[14] .

Sadly, it isn’t desirable to utilize gonadal protection consistently because most studies show that gonadal shielding use grows weaker after every day (Karami, Zabihzadeh, Shams, and Malehi, 2017). The correct situating of the x-ray shield is by all accounts troublesome as the whole gonadal  zone ought to be protected; however, not the significant life structures[15] . Therefore, numerous images are created that are imperfect or even worse, causing a loss in diagnostic data that influences the work of the radiologist. Besides, the dose reduction can likewise be restricted, or the dosage increment can happen.[16]  More so, in males, there can be an incomplete coverage of the gonads (McKenney, Gingold, & Zaidi, 2019). More importantly, the imaging may need to be redone because the crucial landmarks may be obscured. Lastly, there may be an increase in the dose when the active AEC-chamber is shielded as the equipment is now trying to penetrate the lead shielding and remains on for too long.  

There have been significant enhancements in x-ray scanning and radiation protection design since the initial  gonad protection innovation. The improved innovation and refinement of imaging conventions prompted a lot of lower portions [17] (Karami, Zabihzadeh, Shams, and Sarikhani, 2016), with a lower than recently expected (Karami and Zabihzadeh, 2015) danger of heritable ailment. At that point,  the proposed decrease of the risk of radiation with  the use of gonad protection was debated with the incidences of its negative results was valid. Scientists have not yet had the option to approve the discontinue of gonadal shields based on the possibility of negative effects of use. As a result, it could majorly affect ordinary work (Kaplan et al., 2018) if we choose to reevaluate the advantages of radiation risk being decreased with gonadal protecting and the possible related loss of indicative data which could affect outcomes of the exams.

The clinical imaging gear and human insight into radiation physiology have not advanced in the act of gonadal blindness[18] . Medical physicists are utilized by doctors to underpin nuclear security gauges through their experience and comprehension (NG, Tse, Lee, Li, & Lam, 2019). Material science does not bolster the training of the medical physicists. It is the ideal opportunity now for gonadal safeguards to be reconsidered  and progressively dynamic strategies brought into use instead. Previously, the gonads are believed to be radiosensitive. However, the ICRP Report 1031 currently shows an altogether lower risk than originally stated. Another estimate diminishes these derivations [19] and consolidates reports on the basic machines of the hereditary adjustments, in light of extrapolated hereditary cell shifts, discovered mostly in mice experiments in the 1990s (Frantzen et al., 2012). In the ICRP study, the gonadal material augmentation factor is diminished from 0.2 to 0.08, [20] and the risk of 1 in other weighted species regarding  the stomach pelvis is 6-to8-crease[21] . This demonstrates mechanical endeavors to decrease radiation have improved effectiveness over the years (Karami, Zabihzadeh, Shams, and Malehi, 2017).

Karami, Zabihzadeh, Shams, and Sarikhani (2016) propose the solid maltreatment of gonadal protection. Endeavoring to diminish patient dose with gonadal shields also potentially causes increased dose when there is insufficient protection of gonads (McKenney, Gingold, and Zaidi, 2019) or clouding[22]  of vital anatomy (Karami and Zabihzadeh, 2015) could prompt repetitive x-rays. Regardless of whether the shield is correctly placed  on the body, the phototiming cells can be ensured by the robotized introduction screen[23] , which implies that pediatrics have improved their radiation creation by 63 percent to 147 percent for grown-ups (Jeukens et al., 2020).

In 85 percent of female patients, three low shieldings are required to be placed correctly, where the location of the ovaries are hard to gauge. Additionally, shielding the patient does not protect them from inside scattered radiation (Mekis, & Starc, 2016). Dissipated radiation may contribute strongly to the radiation dose to the ovaries, contingent upon the size of the patient. While maintaining equivalent treatment, blindly using gonadal shields  is simply a sincere goal for female patients. In the mid-twentieth century, gonadal protection had been presented for use with film x-rays. Electronic image detectors have since been developed that in turn are progressively more powerful with a reduction in technical factors needed to create the image.  This in turn creates less dose for the patient.  They have prompted a change to a more grounded beam, and a 2.7% decline in the radiation strength between previous  film and newer digital units.

Electronic x-ray gadgets are currently being utilized to decrease the dose rate acquired with  gonadal protection. Advanced imaging diminishes dose while diverting missteps in situating the lead properly (Clement, 2016). How can the risks be assessed? The extra danger of radiation-induced malignant growth with the straight non-limit strategy [24] fluctuates between 0.01 percent and 0.001 percent from pelvic X-ray screening. Quite possibly, the wrong position would shield men from failure[25] , which is somewhere in the range of 53% and 85% for ladies (Teferi, Tequabo, & Bedane, 2017). The article suggests that the dosage and related danger of radiation to the uncovered gonadal region is significantly increased with repetitive exposure. Science uses logic, and specialists need to secure the accurate and genuine protection of the patient (McKenney, Gingold, and Zaidi, 2019).

As a routine procedure, gonadal and fetal defense of patients should be stopped during x-ray diagnostic imaging. The benefit of radiological imaging may be jeopardized by patient protection (Kaplan et al., 2018). During x-ray diagnostic imaging, the use of these shields may obscure anatomy or impede an image system’s automatic exposure control. Such effects may affect the diagnostic efficacy of the test or contribute to an increase in the radiation dose of the patient. Due to these risks, and because fetal and gonadal coverage is limited or non-existent, AAPM recommends the use of these protective measures be discontinued (Karami & Zabihzadeh, 2015).[26] 

The use of gonadal and potential fetal shielding will relax the patient and reassure them which will improve the examination results, especially in patients and guardians feeling fear and anxiety about exposure to radiation (Karami, Zabihzadeh, Shams, & Malehi, 2017). This can be taken into account when developing policies and procedures for protection[27] . Current evidence (Karami & Zabihzadeh, 2015), however, does not support blanket statements requiring the use of such shielding. Also, AAPM advises the provision of data on the limited utility and possible disadvantages of fetal and gonadal shielding in radiological technical educational programs.

Kaplan et al. (2018) provide a [28] substantive rationale on the ?????????. According to the researchers, x-ray imaging with fetal and gonadal defense in the form of shielding was considered consistent with the ALARA rule for decades and therefore is a good practice. In view of technological advancements and current evidence of radiation exposure, the effectiveness of gonadal and fetal protection has been revisited by the AAPM. The benefit to patients’ health (McKenney, Gingold, & Zaidi, 2019), with the use of gonadal and fetal shielding is negligible. The diagnostic dose of radiation does not relate to measurable harm to the gonads or fetuses. An increased risk of genetic consequences has been the main concern with radiation exposure to reproductive organs. However, consistent with the International Commission for Radiological Protection (ICRP) Publication 103 of 2007, “no human research has direct evidence of an excess of heritable disease associated with radiation” (Karami, Zabihzadeh, Shams, & Sarikhani, 2016).

Notably, in its approval by ACOG (American College of Obstetricians and Gynecologists), “the radiographic exposure by means of x-ray, computed tomography or nuclear medicine imaging techniques with few exceptions is much lower than the dose of exposure associated with fetal damage” (Karami, Zabihzadeh, Shams, & Malehi, 2017). In reducing internal dispersion, patient protection is inefficient. In medical radiographic imaging, x-rays that scatter inside the body are the main source of radiation to the inner organs outside the visual field of imaging. Nevertheless, this dispersal is not affected by  the contact shielding protecting these organs.

The application of gonadal and fetal protective systems can adversely influence the effectiveness of the examination (Karami & Zabihzadeh, 2015). Defending may make anatomy opaque, leading to repeated tests or risk data on the diagnosis. Shielding within the visual field of imaging or shielding into the visual field of imagery can obscure anatomy or pathology. In such situations, you will lose valuable diagnostic information if the procedure is not repeated; the dosage would increase substantially if repeated. Evidence demonstrates that this scenario  is more severe than normal (McKenney, Gingold, & Zaidi, 2019). Shielding may adversely affect automatic control exposure and image quality as stated by  Karami and Zabihzadeh (2015). The presence of shielding in the field of diagnostic  imaging will dramatically increase x-ray performance, increase the patient dose of x-ray radiation and increase degrading pictorial value (Kaplan et al., 2018) through all modern X-ray imaging systems.

 

Research Design and Methods

The research design is a retrospective observational cross-sectional study design. It will be quite essential in defining the problem, getting the outcome, and examining the associative relation. According to Karami, Zabihzadeh, Shams, and Sarikhani (2016), the data collection and research design to be employed in this study, if well used, can provide a valid foundation for policymakers to design a relevant intervention[29] .

Rationale

The protection of radiosensitive organs, such as gonads, has grounded primarily through the extrapolation of existing data from different parts of the world in the course of medical imaging (Davies, Manning–Stanley, Hughes, & Ward, 2020). Researchers will be able to show a link between gonadal radiation and cancer by investigating the prevalence of shielding in patients undergoing conventional radiological tests in four hospitals in Ottawa, Canada, and the availability of gonad shielding protocols in radiological departments. The results of this survey will educate the clinical radiology departments and give recommendations on the use of x-ray diagnostics with gonad shielding. The results can also demonstrate how to successfully reduce the possibility of genetic effects in future generations. A basic method is to reduce the sensitivity of patients to radiation [30] during routine diagnostic imaging (Fawcett, & Barter, 2019). Reducing patient radiation exposure is underlined throughout all  procedures in the radiology industry and is currently considered good practice for gonadal shielding.

Objectives

The goal of the study will be to examine the prevalence of gonad shielding in the radiological radiation division of the IAEA (International Atomic Energy Agency) [31] in radiology, Ottawa, Canada, and the availability of gonad shields  and departmental gonad shielding protocols.

Methods and Materials

The research will be done in four different hospitals, including twenty radiography rooms, in Ottawa City, Canada, from February 2020 to June 2020 via retrospective observational cross-sectional study. This examination will include researchers (students of radiology technology). As observers, the researchers will go to the radiology departments and make an observation regarding the use of gonadal shielding in the rooms. They will involve traditional radiological examinations of patients who will undergo exposures  to the gonads directly or indirectly during two working shifts (8:30 am-8:30 pm). 

In the study, privacy will be respected. To assess the existence and the subsequent details of the written gonadal shielding  instructions, the head of each department shall be interviewed. Afterward, the availability of different types and sizes of gonad shields will be examined in all radiography rooms. Entered into a table will be  the patient’s sex, age, and their numbers. By means of descriptive statistics, the collected data will be evaluated with the use of the SPSS software (version 26).[32] 

Data Analysis

Prior to analysis, all the available information will have to go through a quality check process. Then, the facts collected will be managed in a database, where the information will be entered for further manipulation. The data will be analyzed using tests of hypothesis and SPSS software (version 26[33] ).

Data Presentation

Data will be presented in the form of text, percentages, tables, graphs, and charts.

Sample Size Determination

The hospitals sampled for this survey will be drawn purely from the hospitals in Ottawa City, Canada. The assessment, through a retrospective, observational cross-sectional study, will seek to investigate gonadal shielding prevalence in patients going through conventional radiological examinations in four hospitals in the region. There are four major hospitals in Ottawa. There are also several specialist hospitals and clinics in the city, but the four major hospitals will be used in this survey.   

Timeframe

The research will be carried out between February 2020 and June 2020. In order to observe and collect data, the researcher and the research helpers will begin hospital visits. An extensive data analysis will start during the study period after data collection. The methodical review will be completed in June 2020 and submitted for entry into their research competition at OAMRS[34]  (Ontario Association of Medical Radiation Technologists). The researchers will visit the radiology departments during the survey period and observe the X-ray examination processes. This will involve conventional radiological monitoring for patients who are directly or indirectly exposed over their gonadal region. There will be two shifts during the study, cumulatively ranging from 8:30 to 20:30. See Appendix ???

ActivityTime      [35] 
 November 2019February 2020March 2020April 2020May 2020June 2020June  2020
Proposal         
Data collection         
Data analysis         
Report writing         
Report Submission       

Ethical Considerations

Ethics should discuss interest issues at different levels in this study. The standardized professional practice policy regarding the shielding of gonads is being proposed worldwide. Typically, non-maleficence, autonomy, justice, and beneficence are four fundamental principles of ethics (Pasieka, Żelechowicz, & Milewski, 2017). The particular ethical question of this study will be important for gonadal shielding, mainly due to the unique limitations in x-ray exams and the risks posed in this specific study by the experimental methodologies. In the development of this gonadal shielding study, sensitivity will, therefore, be required. Although the importance of community guidance and the assistance offered by research ethics committees would be quite high, the research assistants themselves will be responsible solely for maintaining high standards of scientific conduct.  The Ethics boards of all hospitals participating in this study will also need to be contacted with their participation in this study requiring approval and compliance.

Implications of the Study

Being aware of the dangers of radiation is a critical practical aspect of this study. The emphasis  on the execution of gonad shields throughout the years has encouraged the supposition that serious dangers exist in x-ray imaging. Patients are accustomed to being protected with the goal that it isn’t underestimated. Also, it can’t be denied that young men’s average risk is around 305 less and young ladies 10% less than previously considered (Karami, Zabihzadeh, Shams, and Sarikhani, 2016) so why quit shielding gonads? The aftereffects of the study give a reaction to the hazard thought for dangers inside the 10−6-10-7 range[36] . Through the examination report, “x-rayers” will compare  the dangers of conceivable loss of clinical information versus the very advantage of the gonad protecting. At long last, the perils of exposures generally acknowledged as innocuous could be suggested for clinicians[37] .

Limitations

The limitations of this investigation could incorporate the fact that the method used is longer and requires funds, as research aides the transportation to the emergency clinics where the overviews will be performed is fundamental for the procedure[38] . Although the study will be restricted as portrayed in this, the moral contemplations and the study strategies delineated above will give significant data on gonadal wellbeing that couldn’t have been in any case made throughout the x-ray investigation.[39]  The issue with low reaction rates could affect the study, and no simple arrangement could happen. In any case, it might be relieved in a specific way if the arrangement of that projection is considered in the example size, and little information about non-responsive divisions is acquired.

Missing:

  • Discussion:  The main part of the paper/literature review.  This part needs to be planned out based on proper paragraph structure and may be broken down even further based on specific topics.  Take the time here to map out or organize your thoughts, always relating it back to the specific question you are trying to answer.  Highlight the most significant or important results, being careful not to repeat what was just discussed in the results section.  Discuss inferences drawn from the data.  Include implications of the findings and their limitations, including implications for future research.  This may be a spot to include tables or graphs, being careful to cite them properly as well if they are not youroriginal work.  Ensure to discuss here any biases or controversies, different opinions, and how your results compare to other investigations.   If the results were unexpected, try to explain why, could your data be interpreted in another way? 
  • Conclusion:  Normally 2-3 pages in length,  it should be a reflection of the significance of what has been written with the aim to convey thoughts about the larger implications of the arguments presented or summarize the major topics of your paper with your opinion based on the analysis performed.  Address the topic in a way that would make the reader think.  Conclude with insight, evaluate the current thinking on your topi but make sure that the conclusions are supported by your data.   This should be an ‘answer’ to the initial question, or may suggest additional research areas if you have discovered gaps in the current research or published works.

Literature Cited

Ali, S., Felice, M. A., Kaplan, S. L., Magill, D., Xiao, R., & Zhu, X. (2018). Female gonadal shielding with automatic exposure control increases radiation risks. Pediatric radiology48(2), 227-234.

Karami, V., & Zabihzadeh, M. (2015). Prevalence of radiosensitive organ shielding in patients undergoing computed tomography examinations: an observational service audit in Ahvaz, Iran. Asian Biomedicine9(6), 771-775.

Karami, V., Malehi, A. S., Shams, N., & Zabihzadeh, M. (2017). Gonad Shielding during Pelvic Radiography: A Systematic Review and Meta-analysis. Archives of Iranian Medicine (AIM)20(2).

Karami, V., Sarikhani, S., Shams, N., & Zabihzadeh, M. (2016). Evaluation of the prevalence and utility of gonad shielding in pediatrics undergoing pelvic x-ray. International Journal of Pediatrics4(11), 3735-3740.

Gingold, E., McKenney, S., & Zaidi, H. (2019). Gonadal shielding should be discontinued for most diagnostic imaging exams. Medical Physics46(3), 1111-1114.

Milewski, R., Pasieka, E., & Żelechowicz, M. (2017). Analysis of frequency and effectiveness of gonad shield use during diagnostic hip radiology. EJMT1, 14.

Frantzen, M. J., Robben, S., Postma, A. A., Zoetelief, J., Wildberger, J. E., & Kemerink, G. J. (2012). Gonad shielding in pediatric pelvic radiography: disadvantages prevail over benefit. Insights into Imaging3(1), 23-32.

Fawcett, S. L., & Barter, S. J. (2019). The use of gonad shielding in pediatric hip and pelvis radiographs. The British Journal of Radiology82(977), 363-370.

Warlow, T., Walker-Birch, P., & Cosson, P. (2014). Gonad shielding in pediatric pelvic radiography: Effectiveness and practice. Radiography20(3), 178-182.

MacKay, M., Hancy, C., Crowe, A., D’Rozario, R., & Ng, C. K. C. (2012). Attitudes of medical imaging technologists on the use of gonad shielding in general radiography. Radiographer59(2), 35-39.

Karami, V., & Zabihzadeh, M. (2012). Ovarian shielding during pelvis radiography: risk versus benefit. Journal of Radiology85, 442-447.

Jeukens, C. R., Kütterer, G., Kicken, P. J., Frantzen, M. J., van Engelshoven, J. M., Wildberger, J. E., & Kemerink, G. J. (2020). Gonad shielding in pelvic radiography: modern, optimized X-ray systems might allow its discontinuation—insights into Imaging11(1), 15.

NG, G., Tse, D., Lee, V., Li, Y. L., & Lam, P. W. T. (2019, January). Gonad shielding in pediatric pelvic and hip radiography: from operator awareness to correct shielding placement. European Congress of Radiology 2019.

Davies, B. H., Manning–Stanley, A. S., Hughes, V. J., & Ward, A. J. (2020). The impact of gonad shielding in anteroposterior (AP) pelvis projections in an adult: A phantom study utilizing digital radiography (DR). Radiography.

Kaplan, S. L., Magill, D., Felice, M. A., Xiao, R., Ali, S., & Zhu, X. (2018). Female gonadal shielding with automatic exposure control increases radiation risks. Pediatric radiology48(2), 227-234.

Mekis, N., & Starc, T. (2016, March). The effect of male gonad shielding in plain abdominal imaging. European Congress of Radiology 2016.

McKenney, S., Gingold, E., & Zaidi, H. (2019). Gonadal shielding should be discontinued for most diagnostic imaging exams. Medical Physics46(3), 1111-1114.

Teferi, S., Tequabo, Y., & Bedane, D. (2017). Preliminary study on the practice of gonad shielding during pelvic radiography. Radiol Diagn1(1), 1-4.

Clement, C. H. (2016). The System of Radiation Protection. Radiation Protection in Medical Imaging and Radiation Oncology34, 23.

Seeram, E., & Brennan, P. C. (2016). Radiation protection in diagnostic X-ray imaging. Jones & Bartlett Publishers.

Zabihzadeh, M., & Karami, V. (2016). The challenge of unnecessary radiological procedures. Hong Kong Journal of Radiology19(3), E23-E24.


I agree with whomever wrote you this note….a brief explanation on the harmful effects of ionizing radiation is needed.

Again I agree…

There needs to be expansion of explanations here…. Why are the gonads so sensitive…. Rapidly dividing cells etc…. malignant pertains to cancer but it needs to be simply stated, genetic muttions can be carried forward to future offspring…genetic mutations that can be hereditary and passed forward through generations.

Needs expansion- how they work, how they differ in use and effectiveness… what they are made out of….pros and cons of both.

I think you mean ‘if close or inside the primary beam by a minimum of 5cm’  but you also need to explain what this means, just simple sentences about collimation and the intensity of the beam….I will need to read further to also determine if you need to discuss scattered radiation as well….

Add detail again about potentially blocking the area of interest and having a repeat which would be double the dose.

Questionable for patients infers that the patients are asking about its usefullness, stating questionable for technologists infers that we are questioning it…

Perhaps questionable for the protection of the patients…

Expand.  They did a study over a long period and had determined that it may not be useful?

This is a new term for me… do you mean a third point? This whole sentence seems to be lacking a specific point.

Add a concluding sentence here to indicate why these guidelines are important or how they have not changed for numerous years, use your own voice.

Unclear, rephrase

Be specific… in the 60s?

Unclear, rephrase….however advances in technology have been quietly progressing in regards to measures to decrease dose to gonadal regions?

Unclear- area of interest for the exam?

Unclear, reword.

Unclear…reword

As proven by the act of blindly still using gonadal shields?

….the decreased dose estimates and has consolidated reports on basic xray equipment with hereditary adjustments in llight of this new extrapolated data, discovered mostly in mice experiments from the 1990s.  ????

0.2 to .08? and what are the units?  mGy?

Reword, I cannot determine wat you are trying to say…

Covering?

Unclear, reword…phottiming cells can be disabled on the control panel to limit the amount of radiation from 63 % in pediatrics and 147% in adults.

Reword, unclear

Reword, unclear

If this is your opinion based on the articles you reviewed:  Move it to the conclusion.

If this is the opinion of one of the articles it can stay here but needs to be clarified whose opinion it is.

Again… your opinion?  Move it to the conclusion. Otherwise state whose opinion it is…

The next two paragraphs could be moved to the discussion or the conclusion….

Vague, reword.

How is this possible?  Reduce the fear and trepidation associated with radiaition???

First time this is mentioned….I thougt it was at various radiology departments in Ottawa?  Clarify…

Expand SPSS…. And this could be an appendix…along with an example of the other table you intend to use to collect data.

How many people will be analyzing the data?

CAMRT

This is a great table but should be as an Appendix after the literature cited.

Vague statement… reword.

Vague reword.

Reword- vague

This does not sound like your own words… and is difficult to follow. Reword.

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