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Initiative Launched to Help Providers Reduce Radiation Dose Received from Medical Imaging Scans

By MedImaging International staff writers
Posted on 21 Dec 2010

As medical imaging exams have replaced more invasive procedures, benefiting patients and transforming medicine, people's exposure to medical radiation has increased. More...

Imaging providers are concerned that radiation exposure over time could have adverse effects for patients. They continue to act to ensure that patients receive only required scans and to reduce radiation dose used in these exams.

Image Wisely, a collaborative initiative of the American College of Radiology (ACR; Reston, VA, USA), the Radiological Society of North America (RSNA; Oak Brook, IL, USA), the American Society of Radiologic Technologists (ASRT; Albuquerque, NM, USA), and the American Association of Physicists in Medicine (AAPM; College Park, MD, USA), encourages imaging providers to (1) Optimize imaging examinations to use only the radiation necessary to produce diagnostic quality images. (2) Convey the principles of the Image Wisely Program to the imaging team in order to ensure that the facility optimizes its use of radiation when imaging patients. (3) Communicate optimal patient imaging strategies to referring physicians, and be available for consultation. (4) Lastly, routinely review imaging protocols to ensure the use of the least amount of radiation necessary to acquire a diagnostic quality image for each exam.

Image Wisely also urges providers to demonstrate to patients that they "image wisely” by: "As the stewards of nearly 100 years of radiology safety knowledge, radiologists are committed to ensuring that patients receive safe, necessary imaging care,” said John A. Patti, MD, FACR, chair of the ACR Board of Chancellors. "The Image Wisely campaign is an important opportunity for radiologists to help referring physicians and medical imaging professionals understand which exams may be most appropriate and how these exams may be carried out in a safe, effective manner.”

The Image Wisely campaign will initially focus on computed tomography (CT) scans. There were approximately 87 million CT scans performed in 2009 as rapidly evolving CT technology replaced more invasive and frequently more expensive techniques. The Image Wisely campaign is an effort to help ensure that medical imaging protocols keep pace with this advancing technology.

"Through educational forums and research published in scientific journals, radiology professionals continually strive to develop and stay informed about the latest technological and clinical improvements for patient safety,” said George S. Bisset III, MD, chairman of the RSNA board of directors. "Image Wisely is radiology's effort to reach out and proactively deliver that knowledge to our physician colleagues. The Image Wisely website is also linked to the public information site RadiologyInfo (please see Related Links below) to help patients understand complex aspects of their medical imaging examinations.”

The Image Wisely website contains the latest research and educational materials to aid radiologists, radiologic technologists, medical physicists, and other imaging professionals in determining the appropriate technical parameters to be used in imaging, and how the radiation received from these exams may affect patients over time. In addition, the "My Medical Imaging History” card, codeveloped by Image Wisely and the US Food and Drug Administration (FDA), is downloadable from the site. This allows patients to keep track of their exams over time.

"Although CT provides outstanding images that are critical to the management of patient care, the images require more radiation than simple X-rays,” said Michael Herman, PhD, president of the AAPM. "For this reason, it is most important that physicians have a firm understanding of the physics and technology of CT to enable them to judiciously select imaging parameters to eliminate unnecessary radiation to patients.”

The four charter members of Image Wisely--the ACR, RSNA, ASRT and AAPM-- represent more than 200,000 physicians, radiologic technologists, and medical physicists who play key roles in medical imaging.

"Radiologic technologists are the final link in the chain of exposure as they perform CT scans,” concluded James Temme, MPA, RT, (R)(QM), ASRT president. "The Image Wisely campaign provides a powerful forum for the ASRT to communicate to its members the importance of applying the correct protocol for size and body type of the patient.”

Related Links:
Image Wisely
American College of Radiology
Radiological Society of North America
American Society of Radiologic Technologists
American Association of Physicists in Medicine
RadiologyInfo.org

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59 (100.13580322266): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

60 (525.95138549805): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

61 (!!!!! 1655.101776123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

62 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

63 (173.09188842773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

64 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

65 (147.10426330566): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

66 (504.97055053711): SELECT fid FROM jos_deeppockets WHERE id=294732609 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732609 AND published='1' LIMIT 1

67 (58.889389038086): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

68 (50.067901611328): select jos_twitters.link from jos_twitters where cat=10

69 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

70 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

71 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

72 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294732609 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732609 AND published='1' LIMIT 1

73 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

74 (267.98248291016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (176.19132995605): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (47.922134399414): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (70.095062255859): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (36.001205444336): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (34.093856811523): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (71.048736572266): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

109 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

110 (92.983245849609): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (82.015991210938): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

113 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

114 (69.141387939453): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (645.87593078613): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (599.14588928223): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (334.9781036377): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

119 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

120 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

121 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

122 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

123 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

124 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

125 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

126 (245.09429931641): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

127 (!!!!! 25171.995162964): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

128 (434.87548828125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732609 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732609 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 8021.8315124512): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (153.0647277832): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (63.896179199219): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

133 (47.922134399414): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

135 (223.87504577637): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (37.193298339844): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

137 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

139 (406.98051452637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (329.97131347656): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (48.87580871582): SELECT name FROM jos_deeppockets WHERE id=211

142 (36.001205444336): SELECT name FROM jos_deeppockets WHERE id=211

143 (679.01611328125): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (576.01928710938): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

145 (121.11663818359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

146 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

147 (!!!!! 13222.932815552): TRUNCATE TABLE jos_trademed_module

148 (118.97087097168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (64.13459777832): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294732609 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (550.98533630371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

153 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

154 (!!!!! 1446.9623565674): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

155 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

156 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

157 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732609 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732609 AND type='deeppockets_item' AND published='1' LIMIT 1

158 (36.954879760742): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

159 (41.961669921875): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

160 (46.014785766602): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

161 (170.94612121582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

162 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732609 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732609 AND published='1' LIMIT 1

163 (52.928924560547): select jos_twitters.link from jos_twitters where cat=10

164 (41.961669921875): select jos_facebook.link from jos_facebook where cat=10

165 (35.762786865234): select jos_google_plus.link from jos_google_plus where cat=10

166 (38.862228393555): select jos_linkedin.link from jos_linkedin where cat=10

167 (409.12628173828): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

168 (!!!!! 1343.0118560791): insert into jos_banners_delta values (14615,'2025-08-20 14:45:11','216.73.216.0','view'),(14202,'2025-08-20 14:45:11','216.73.216.0','view'),(14203,'2025-08-20 14:45:11','216.73.216.0','view')

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