Percorrer por autor "Paulo, Graciano"
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- From variability to accountability: rethinking radiation exposure in pediatric osteoid osteoma ablationPublication . Paulo, GracianoInterventional radiology has rightfully claimed osteoid osteoma (OO) ablation as a success story. Minimally invasive, highly effective, and reproducible, CT-guided thermal ablation has largely replaced surgery as the standard of care. Yet, in pediatric patients, this success is accompanied by a persistent and important concern: the management of ionizing radiation exposure. Despite increasing awareness, radiation dose in pediatric interventional radiology continues to show considerable variability, with limited standardization and few meaningful benchmarks. In this context, the multicenter registry analysis by Wintergerst et al. provides a timely and relevant contribution by systematically evaluating radiation exposure, procedural outcomes, and practice patterns in CT-guided OO ablation.
- Incident learning systems to improve patient safety in nuclear medicine across Europe: results of the MARLIN studyPublication . Prieto, Carlos; Geao, Ana; Nekolla, Stephan G.; Mille, Erik Björn; Israel, Ora; Brusadin, Gianfranco; Andersson, Jonas; Kearney, Maeve; Rogers, Andy; Akata, Deniz; Pourel, Nicolas; Paulo, Graciano; Pellerin, Olivier; Hallinan, Barry; Hierath, Monika; Peld, Nathan; Kelly, ColinPurpose: To enhance patient safety in nuclear medicine (NM) across Europe by operationalising MARLIN recommendations for implementing incident learning systems (ILSs), including barriers/enablers and practical implementation guidance. Methods: A mixed‑methods study (combining a survey, semi‑structured interviews, and a targeted literature review) was performed within the MARLIN project. This was a 24‑month initiative conducted under the European Commission's Strategic Agenda for Medical Ionising Radiation Applications (SAMIRA) Action Plan, involving European organisations such as EANM, EIBIR, ESTRO, and EFOMP. Surveys were distributed to Clinical Facilities (CFs), Competent Authorities (CAs), and professional societies (PSs). Interviews were used to explore implementation barriers and examples of good practice. Data were analysed using descriptive statistics and thematic analysis. Results: The study revealed significant variability in the criteria used to define and report significant radiation events in NM across Europe. While all surveyed countries had designated authorities for managing reported events, only 11 of 23 had specific criteria for NM. The study identified key enablers and barriers to ILS implementation, including the need for a just culture to encourage reporting without fear of punitive measures. The guidelines recommended criteria for significant radiation events in NM and the organisation of ILSs. Conclusion: The MARLIN study provides a comprehensive framework for the systematic implementation of ILSs in NM, highlighting the importance of standardised reporting criteria in several categories, multidisciplinary involvement, and a culture of safety. Addressing the identified barriers and promoting a coordinated effort among stakeholders are crucial for enhancing patient safety in NM across Europe.
- Overview of the tuning template for radiography in EuropePublication . Harris, Phil; Vinorum, Agnes; Henner, Anja; Lança, Luís; Ribeiro, Margarida; Paulo, Graciano; Vieira, Luísa; Pellicano, Gianni; Eaton, Carena; Laanelaid, Zinaaida; Woeginger, Irene; Solstad, HjordisThe following is an overview of the Tuning Template for Radiography Education in Europe developed by subgroup 1 of the HENRE II Thematic Network. In this context, a template provides a description of a subject area (in this case radiography) as a guide for subject specialists to develop their own programme of study and for others to identify the scope of the subject area. Tuning Educational Structures in Europe (Tuning), an EU funded Socrates Life Long Learning project, developed a methodology to design and to deliver degree programmes using a learning outcomes and competence framework approach linked to ECTS credits based on student workload. The Tuning methodology consists of 5 lines: Line 1. Generic Competences; Line 2. Subject Specific competences; Line 3. The role of ECTS as a credit transfer and accumulation system; Line 4. Approaches to learning, teaching and assessment; Line 5. The role of quality enhancement in the educational process. The Tuning Template for radiography, which deals with the Lines 1 to 4 inclusive, therefore provides particular reference points which allow for flexibility and autonomy in curriculum design and construction providing a common language and thus understanding to permit points of convergence in radiography programme development. Programmes of study therefore should become comparable, compatible and transparent. Across Europe. The Higher Education Network for Radiography in Europe (HENRE) has been instrumental in developing this template for the development of radiography degree courses thus making considerable strides in relation to the Bologna process. The Bologna process aims to create a European Higher Education Area (EHEA) by 2010 making academic degree standards and quality assurance standards more comparable and compatible throughout Europe to enable students choice from a wide range of quality courses. It is named after the University of Bologna, when in 1999, the Bologna declaration was signed by Ministers of Education from 29 European countries.
- Strengthening incident learning in radiotherapy practice: insights from the MARLIN studyPublication . Prieto, C.; Kelly, C.; Brusadin, G.; Kearney, M.; Pourel, N.; Rogers, A.; Geao, Ana; Akata, D.; Andersson, J.; Paulo, Graciano; Nekolla, S. G.; Mille, E.; Pellerin, O.; Israel, O.; Hallinan, B.; Peld, N.; Hierath, M.Background and purpose: Incident Learning Systems (ILSs) are central to patient safety in radiotherapy, enabling learning from adverse events and near misses. Despite EU regulatory requirements, substantial variability persists across Europe in the implementation and effectiveness of ILSs in radiotherapy. This paper presents radiotherapy-specific recommendations derived from the MARLIN study to support harmonised, risk-informed implementation of ILSs. Methods: The 24-month MARLIN study, conducted under the SAMIRA Action Plan, employed a structured literature review, an online European survey of clinical facilities, competent authorities and professional societies, expert interviews, and a multi-stakeholder consensus workshop. Survey data from 172 respondents in 28 countries were analysed to identify current practices, barriers and enabling factors for ILS implementation in radiotherapy. Results: Although all responding countries reported transposition of the Directive, substantial variability was observed in criteria for reporting significant radiotherapy events, feedback mechanisms and use of international databases. Fear of punitive actions, limited resources, lack of training in incident analysis, and insufficient dissemination of lessons learned were identified as key barriers. External-beam radiotherapy showed more mature ILS implementation than brachytherapy. Findings from the MARLIN study informed recommendations on category-based event classification, radiotherapy-specific taxonomies, multidisciplinary incident-learning committees, and collaboration between clinical facilities, competent authorities, and professional societies. Conclusion: The MARLIN recommendations provide a practical framework to strengthen ILS implementation in radiotherapy, promote a just culture, enhance learning from incidents and support regulatory compliance, ultimately improving patient safety and quality of care across Europe, while the broader RP-208 report extends these principles to all medical fields using ionising radiation, supporting cross-disciplinary harmonisation.