BackgroundAs a member of a pharmacy organization, a pharmacist is not only bound to fulfill his/her professional obligations but is also affected by different personal and organizational factors that may influence his/her behavior and, consequently, the quality of the services he/she provides to patients. The main purpose of the research was to test a hypothesized model of the relationships among several organizational variables, and to investigate whether any of these variables affects the service of provision of medication information at community pharmacies.MethodsDuring the survey, pharmacists working at community pharmacies in Lithuania were asked to express their opinions on the community pharmacies at which they worked and to reflect on their actions when providing information on medicines to their patients. The statistical data were analyzed by applying a structural equation modeling technique to test the hypothesized model of the relationships among the variables of Perceived Organizational Support, Organizational Commitment, Turnover Intention, and Provision of Medication Information.ResultsThe final model revealed that Organizational Commitment had a positive direct effect on Provision of Medication Information (standardized estimate = 0.27) and a negative direct effect (standardized estimate = −0.66) on Turnover Intention. Organizational Commitment mediated the indirect effects of Perceived Organizational Support on Turnover Intention (standardized estimate = −0.48) and on Provision of Medication Information (standardized estimate = 0.20). Pharmacists’ Turnover Intention had no significant effect on Provision of Medication Information.ConclusionsCommunity pharmacies may be viewed as encouraging, to some extent, the service of provision of medication information. Pharmacists who felt higher levels of support from their organizations also expressed, to a certain extent, higher commitment to their organizations by providing more consistent medication information to patients. However, the effect of organizational variables on the variable of Provision of Medication Information appeared to be limited.

The aim of this study was to measure entrance skin doses on patients undergoing cone-beam computed tomography (CBCT) examinations, to establish conversion factors between skin and organ doses, and to estimate cancer risk from CBCT exposures. 266 patients (age 8-83) were included, involving three imaging centres. CBCT scans were acquired using the SCANORA 3D (Soredex, Tuusula, Finland) and NewTom 9000 (QR, Verona, Italy). Eight thermoluminescent dosimeters were attached to the patient's skin at standardized locations. Using previously published organ dose estimations on various CBCTs with an anthropomorphic phantom, correlation factors to convert skin dose to organ doses were calculated and applied to estimate patient organ doses. The BEIR VII age- and gender-dependent dose-risk model was applied to estimate the lifetime attributable cancer risk. For the SCANORA 3D, average skin doses over the eight locations varied between 484 and 1788 µGy. For the NewTom 9000 the range was between 821 and 1686 µGy for Centre 1 and between 292 and 2325 µGy for Centre 2. Entrance skin dose measurements demonstrated the combined effect of exposure and patient factors on the dose. The lifetime attributable cancer risk, expressed as the probability to develop a radiation-induced cancer, varied between 2.7 per million (age >60) and 9.8 per million (age 8-11) with an average of 6.0 per million. On average, the risk for female patients was 40% higher. The estimated radiation risk was primarily influenced by the age at exposure and the gender, pointing out the continuing need for justification and optimization of CBCT exposures, with a specific focus on children.

Intestinal blood flow Dopplerography can be a useful tool for diagnosing and predicting NEC.

The assessment of eye lens doses for workers during interventional radiology (IR) procedures was performed using a new eye lens dosemeter. In parallel, the results of routine individual monitoring were analysed and compared with the results obtained from measurements with a new eye lens dosemeter. The eye lens doses were assessed using Hp(3) measured at the level of the eyes and were compared with Hp(10) measured with the whole-body dosemeter above the lead collar. The information about use of protective measures, the number of performed interventional procedures per month and their fluoroscopy time was also collected. The assessment of doses to the lens of the eye was done for 50 IR workers at 9 Lithuanian hospitals for the period of 2012-2013. If the use of lead glasses is not taken into account, the estimated maximum annual dose equivalent to the lens of the eye was 82 mSv.

Management of patient doses and determination of national or local diagnostic reference levels (DRLs) are important parts of a quality control program in X-ray diagnostics. In Lithuania, national DRLs for specific radiographic examinations are comparatively higher than those recommended by the European Commission (EC) and the International Atomic Energy Agency (IAEA). A survey of entrance surface doses (ESDs) was performed to investigate the reasons for exceeding the European and the IAEA DRLs. The first measurements showed that the average ESD for standard patients and for all examinations exceeded DRLs at approximately 25 % of the hospitals. The main problems were the use of low kilovolt technique, the lack of automatic exposure control systems or improper adjustment of them as well as inadequate training of the staff. After corrective actions, the ESD measurements were repeated. The results showed that the average patient doses were reduced almost everywhere. An additional patient dose survey for establishing new DRLs in radiography taking into account the advantages of new equipment to indicate directly the kerma area product (KAP) values was done. The ESD values were calculated from the KAP-values. The data were analysed, and the average and third quartile values were calculated. The new DRLs, in terms of ESDs, were reduced significantly in almost all radiography examinations. They are equal or lower than the IAEA and EC DRLs. Especially at thorax spine LAT, lumbar spine LAT, hip joint AP, pelvis AP and abdomen AP they are half the IAEA DRLs.