The impact of health system reform plan on the hospital\\'s performance indicators of Lorestan University of Medical Sciences

Directory of Open Access Journals (Sweden)

Reza Dadgar

2017-10-01

Conclusion: The health system  reform plan has been positive changes in indicators of hospital performance. Therefore, while considering the current trend of continuous improvement, the continuity of the project was advised based on the results of this study.

21 CFR 872.1850 - Lead-lined position indicator.

Science.gov (United States)

2010-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1850 Lead-lined position indicator. (a... dental x-ray tube and intended to aid in positioning the tube, to prevent the misfocusing of the x-rays by absorbing divergent radiation, and to prevent leakage of radiation. (b) Classification. Class I...

Digital, electromagnetic rod position indicator with compensation

International Nuclear Information System (INIS)

Feilchenfeld, M.M.; Geis, C.G.

1985-01-01

A digital rod position indicator having discrete coils L 0 , L 1 , L 2 ..... spaced along the travel path of an elongate magnetically permeable member stores in digital form compensation signals for automatically adjusting the location relative to the coils at which a digital output signal representative of the position of the end of the elongate member transitions from one code to the next. The appropriate compensation signal is addressed using the digital output signal and a correction factor which takes into account the direction of movement including reversals. Reference is made to the positioning of the control rods in a pressurized water reactor. (author)

46 CFR 169.555 - Emergency position indicating radio beacon (EPIRB).

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency position indicating radio beacon (EPIRB). 169.555 Section 169.555 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS... Emergency position indicating radio beacon (EPIRB). (a) Each vessel certificated for exposed waters must...

46 CFR 169.744 - Emergency position indicating radio beacon (EPIRB).

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency position indicating radio beacon (EPIRB). 169.744 Section 169.744 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS... position indicating radio beacon (EPIRB). Each EPIRB must be marked with the vessel's name. ...

Mobility as a positional good : implications for transport policy and planning

Energy Technology Data Exchange (ETDEWEB)

Litman, T. [Victoria Transport Policy Institute, Victoria, BC (Canada)

2007-01-17

Social position refers to a person's social rank. Many goods have positional value because they increase the status of their consumers. Positional goods include fashionable jewellery and clothing, luxurious homes and vehicles, and extravagant entertainment. Many motorists choose vehicles with greater potential speeds and off-road abilities than actually needed because these features are considered prestigious. This paper examined how positional value affects transportation decisions and investigated the resulting economic impacts. These included impacts on social welfare and external costs. The paper also discussed implications for transport policy and planning. The paper discussed the science of happiness and included an excerpt from a newspaper article on money and happiness. The paper also included an analysis of popular television shows and Internet blogs. Transportation impacts were also examined, with reference to motor vehicle ownership, luxury vehicles, mode choice, long-distance recreation travel, planning practices, and industrial development policy. A table was also presented that summarized the categories of prestige value travel impacts. The paper also presented possible offsetting benefits and implications for planning. 40 refs., 1 tab., 11 figs.

Improving IMRT-plan quality with MLC leaf position refinement post plan optimization

International Nuclear Information System (INIS)

Niu Ying; Zhang Guowei; Berman, Barry L.; Parke, William C.; Yi Byongyong; Yu, Cedric X.

2012-01-01

Purpose: In intensity-modulated radiation therapy (IMRT) planning, reducing the pencil-beam size may lead to a significant improvement in dose conformity, but also increase the time needed for the dose calculation and plan optimization. The authors develop and evaluate a postoptimization refinement (POpR) method, which makes fine adjustments to the multileaf collimator (MLC) leaf positions after plan optimization, enhancing the spatial precision and improving the plan quality without a significant impact on the computational burden. Methods: The authors’ POpR method is implemented using a commercial treatment planning system based on direct aperture optimization. After an IMRT plan is optimized using pencil beams with regular pencil-beam step size, a greedy search is conducted by looping through all of the involved MLC leaves to see if moving the MLC leaf in or out by half of a pencil-beam step size will improve the objective function value. The half-sized pencil beams, which are used for updating dose distribution in the greedy search, are derived from the existing full-sized pencil beams without need for further pencil-beam dose calculations. A benchmark phantom case and a head-and-neck (HN) case are studied for testing the authors’ POpR method. Results: Using a benchmark phantom and a HN case, the authors have verified that their POpR method can be an efficient technique in the IMRT planning process. Effectiveness of POpR is confirmed by noting significant improvements in objective function values. Dosimetric benefits of POpR are comparable to those of using a finer pencil-beam size from the optimization start, but with far less computation and time. Conclusions: The POpR is a feasible and practical method to significantly improve IMRT-plan quality without compromising the planning efficiency.

Indicators' role: How do they influence Strategic Environmental Assessment and Sustainable Planning - The Chinese experience.

Science.gov (United States)

Gao, Jingjing; Christensen, Per; Kørnøv, Lone

2017-08-15

As an information carrier and communication medium, indicators provide useful decision-making assistance in setting process goals and effectively reaching the goals. The main focus of this article is to investigate indicators' role in influencing planning through Strategic Environmental Assessment (SEA) especially related to Chinese experiences. From the perspective of planning and decision-making theory, the influence on planning is studied as influence of planning structure and influence of planning actors. Such a conceptual framework is applied in order to demonstrate how the use of indicators can influence planning through a SEA process. The study holds two empirical levels. On a general level, based on an online survey, this article investigates SEA practitioners' experiences in using indicators. On a case level, two urban plans are selected to provide more detailed experiences. The case level investigation is based on a documentary study and individual interviews with SEA practitioners/planners. By exploring how indicators influence planning through the structure of and the actors within SEA, this study tries to provide an overview of indicators' role in SEA. The results indicate that indicators are perceived as a useful tool in the Chinese SEA system. By improving and simplifying the procedures of SEA, the indicators exert more structural influence on SEA and on plan making. On the other hand, indicators are also shown to have more influence through political actors than found among technical actors. Copyright © 2017. Published by Elsevier B.V.

Indicators for management of planned outages in nuclear power plants

International Nuclear Information System (INIS)

2006-04-01

The outages considered within the scope of this publication are planned refuelling outages (PWR and BWR nuclear power plants) and planned outages associated with major maintenance, tests and inspections (PHWR and LWGR nuclear power plants). The IAEA has published some valuable reports providing guidance and assistance to operating organizations on outage management. This TECDOC outlines main issues to be considered in outage performance monitoring and provides guidance to operating organizations for the development and implementation of outage programmes which could enhance plant safety, reliability and economics. It also complements the series of reports published by the IAEA on outage management and on previous work related to performance indicators developed for monitoring different areas of plant operation, such as safety, production, reliability and economics. This publication is based upon the information presented at a technical meeting to develop a standardized set of outage indicators for outage optimization, which was organised in Vienna, 6-9 October 2003. At this meeting, case studies and good practices relating to performance indicator utilization in the process of planned outage management were presented and discussed

Economic evaluation of reprocessing - Indicative Belgian position

International Nuclear Information System (INIS)

1979-05-01

This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for Belgium is presented. Other factors which influence the Belgian viewpoint and which are not included on the phase diagram are given

Development of methods of key performance indicators formation for corporate planning

International Nuclear Information System (INIS)

Chebotarev, A.N.

2011-01-01

A theoretical proposition, a model of enterprise performance management and a concept of balanced key performance indicators as a method to control the enterprise strategy have been systematized and presented. An algorithm that increases the efficiency of action plans' formation has been developed and implemented. In particular, a set of criteria for the selection of events and parameters necessary for the formation of an action plan has been created. A method of control of the business processes, allowing the experts to establish the relationship between the business processes performance indicators and the enterprise's key indicators has been developed [ru

Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit

Energy Technology Data Exchange (ETDEWEB)

Correa, Diogo Goulart; Doring, Thomas M.; Wilner, Nina Ventura; Cabral, Rafael Ferracini; Gasparetto, Emerson Leandro [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Zimmermann, Nicolle; Fonseca, Rochele Paz [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Pontifical Catholic University of Rio Grande do Sul, Department of Psychology, Rio Grande do Sul (Brazil); Leite, Sarah C.B.; Bahia, Paulo R.V. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil)

2015-05-01

The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits. (orig.)

Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit

International Nuclear Information System (INIS)

Correa, Diogo Goulart; Doring, Thomas M.; Wilner, Nina Ventura; Cabral, Rafael Ferracini; Gasparetto, Emerson Leandro; Zimmermann, Nicolle; Fonseca, Rochele Paz; Leite, Sarah C.B.; Bahia, Paulo R.V.

2015-01-01

The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits. (orig.)

Tri-code inductance control rod position indicator with several multi-coding-bars

International Nuclear Information System (INIS)

Shi Jibin; Jiang Yueyuan; Wang Wenran

2004-01-01

A control rod position indicator named as tri-code inductance control rod position indicator with multi-coding-bars, which possesses simple structure, reliable operation and high precision, is developed. The detector of the indicator is composed of K coils, a compensatory coil and K coding bars. Each coding bar consists of several sections of strong magnetic cores, several sections of weak magnetic cores and several sections of non-magnetic portions. As the control rod is withdrawn, the coding bars move in the center of the coils respectively, while the constant alternating current passes the coils and makes them to create inductance alternating voltage signals. The outputs of the coils are picked and processed, and the tri-codes indicating rod position can be gotten. Moreover, the coding principle of the detector and its related structure are introduced. The analysis shows that the indicator owns more advantage over the coils-coding rod position indicator, so it can meet the demands of the rod position indicating in nuclear heating reactor (NHR). (authors)

Position indicating split toroid for the RACE experiment

International Nuclear Information System (INIS)

Hurst, B.; Folkman, K.

2007-01-01

Aspects of the recent reactor accelerator coupled experiments (RACE) carried out at University of Texas Nuclear Engineering Teaching Laboratory will be discussed. In particular, a compact instrument that allowed a continuous non-invasive means of determining the relative electron beam position was developed. The operation of the instrument is similar to an inductive current pick up toroid except that the core is sectioned radially, which allows spatial information to be derived from the induced voltages. Results of initial tests, both in beam and with a pulser, will be presented along with plans to optimize future designs

Preliminary performance test of control rod position indicator for ballscrew type CEDM

International Nuclear Information System (INIS)

Yoo, J. Y.; Kim, J. H.; Hu, H.; Lee, J. S.; Kim, J. I.

2003-01-01

The reliability and accuracy of the information on control rod position are very important to the reactor safety and the design of the core protection system. A survey on the RSPT(Reed Switch Position Transmitter) type control rod position indication system and its actual implementation in the exiting nuclear power plants in Korea was performed first. The prototype of control rod position indicator having the high performance for the ballscrew type CEDM was developed on the basis of RSPT technology identified through the survey. The characteristics of control rod position indicator was defined and documented through design procedure and preliminary performance test

MDOT implementation plan for global positioning systems (GPS) technology in planning, design, and construction delivery.

Science.gov (United States)

2010-09-13

Global Positioning System (GPS) technology offers advantages to transportation agencies in the planning, design and construction stages of project delivery. This research study will develop a guide for Mississippi Department of Transportation (MDOT) ...

New approach for control rod position indication system for light water power reactor

International Nuclear Information System (INIS)

Bahuguna, Sushil; Dhage, Sangeeta; Nawaj, S.; Salek, C.; Lahiri, S.K.; Marathe, P.P.; Mukhopadhyay, S.; Taly, Y.K.

2015-01-01

Control rod position indication system is an important system in a nuclear power plant to monitor and display control rod position in all regimes of reactor operation. A new approach to design a control rod position indication system for sensing absolute position of control rod in Light Water Power Reactor has been undertaken. The proposed system employs an inductive type, hybrid measurement strategy providing both analog position as well as digital zone indication with built-in temperature compensation. The new design approach meets single failure criterion through redundancy in design without sacrificing measurement resolution. It also provides diversity in measurement technique by indirect position sensing based on analysis of drive coil current signature. Prototype development and qualification at room temperature of the control rod position indication system (CRPIS) has been demonstrated. The article presents the design philosophy of control rod position indication system, the new measurement strategy for sensing absolute position of control rod, position estimation algorithm for both direct and indirect sensing and a brief account associated processing electronics. (author)

Economic evaluation of reprocessing. Indicative Netherlands position

International Nuclear Information System (INIS)

1979-05-01

The paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for the Netherlands is presented. Two alternative scenarios have been assumed for the variation of uranium price in the future; a 2% per annum price rise and a 5% per annum price rise

Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

Science.gov (United States)

Nickenig, Hans-Joachim; Eitner, Stephan

2007-01-01

We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

Study on Structures of Aggressive Tax Planning and Indicators

DEFF Research Database (Denmark)

Meldgaard, Henrik; Bundgaard, Jakob; Weber, Katja Dyppel

As a response to the increasing sophistication of tax planners in identifying and exploiting the legal arbitrage opportunities and the boundaries of acceptable tax planning, policy makers across OECD, G20 and EU countries have taken steps to ensure that taxation duly takes place where economic...... value is generated and where the economic activity is actually carried out. In this context, the European Commission sees a strong need to obtain increased knowledge of the tax laws and practices of Member States of the European Union, which may expose particular jurisdictions to aggressive tax planning...... (ATP). The present study was commissioned with the aim to: 1. Identify model ATP structures; 2. Identify ATP indicators which facilitate or allow ATP; 3. Review the corporate income tax systems of the EU Member States by means of the ATP indicators, in order to identify those tax rules and practices...

Impact of MLC leaf position errors on simple and complex IMRT plans for head and neck cancer

International Nuclear Information System (INIS)

Mu, G; Ludlum, E; Xia, P

2008-01-01

The dosimetric impact of random and systematic multi-leaf collimator (MLC) leaf position errors is relatively unknown for head and neck intensity-modulated radiotherapy (IMRT) patients. In this report we studied 17 head and neck IMRT patients, including 12 treated with simple plans ( 100 segments). Random errors (-2 to +2 mm) and systematic errors (±0.5 mm and ±1 mm) in MLC leaf positions were introduced into the clinical plans and the resultant dose distributions were analyzed based on defined endpoint doses. The dosimetric effect was insignificant for random MLC leaf position errors up to 2 mm for both simple and complex plans. However, for systematic MLC leaf position errors, we found significant dosimetric differences between the simple and complex IMRT plans. For 1 mm systematic error, the average changes in D 95% were 4% in simple plans versus 8% in complex plans. The average changes in D 0.1cc of the spinal cord and brain stem were 4% in simple plans versus 12% in complex plans. The average changes in parotid glands were 9% in simple plans versus 13% for the complex plans. Overall, simple IMRT plans are less sensitive to leaf position errors than complex IMRT plans

Fertility desire and family-planning demand among HIV-positive ...

African Journals Online (AJOL)

Little information exists about desire to have children and family-planning use among HIV-positive individuals and how this may vary according to individual, social, health and demographic characteristics, especially in developing countries. To assess these topics in Ethiopia, a facility-based cross-sectional study was ...

Treatment plan ranking using physical and biological indices

International Nuclear Information System (INIS)

Ebert, M. A.; University of Western Asutralia, WA

2001-01-01

Full text: The ranking of dose distributions is of importance in several areas such as i) comparing rival treatment plans, ii) comparing iterations in an optimisation routine, and iii) dose-assessment of clinical trial data. This study aimed to investigate the influence of choice of objective function in ranking tumour dose distributions. A series of physical (mean, maximum, minimum, standard deviation of dose) dose-volume histogram (DVH) reduction indices and biologically-based (tumour-control probability - TCP; equivalent uniform dose -EUD) indices were used to rank a series of hypothetical DVHs, as well as DVHs obtained from a series of 18 prostate patients. The distribution in ranking and change in distribution with change in indice parameters were investigated. It is found that not only is the ranking of DVHs dependent on the actual model used to perform the DVH reduction, it is also found to depend on the inherent characteristics of each model (i.e., selected parameters). The adjacent figure shows an example where the 18 prostate patients are ranked (grey-scale from black to white) by EUD when an α value of 0.8 Gy -1 is used in the model. The change of ranking as α varies is evident. Conclusion: This study has shown that the characteristics of the model selected in plan optimisation or DVH ranking will have an impact on the ranking obtained. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Position indicating systems and reed contact unit assemblies for such systems

International Nuclear Information System (INIS)

Foxworthy, M.K.

1980-01-01

Specifications are given for a position indicating system for determining the position of a movable member inside a sealed container such as the position of a control rod in a nuclear reactor. The system comprises a magnetic flux producing member mounted to the movable member so as to move with it, a series of magnetic reed contact units mounted along the outside of the sealed container to be individually actuated by the flux producer as the movable member moves within the sealed container to indicate the position of this member. Each of the reed contact units is connected to a source of alternating electric current to produce a magnetic flux field to minimize the flux differential between the actuated and unactuated reed contact positions. A second aspect of the invention provides for a low operating flux differential reed contact unit assembly for a position indicating system such that it is actuated by the magnetic member at one magnetic flux level and deactivated at a second level. There is a source of alternating current connected to a coil surrounding the reed contact unit so as to produce an alternating magnetic flux with amplitude less than the difference between the two levels. Variations are given, also diagrams and benefits. (U.K.)

Economic evaluation of reprocessing. Indicative UK position

International Nuclear Information System (INIS)

1979-05-01

This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic assessment of reprocessing. The indicative national position and illustrative ''phase diagram'' for the United Kingdom is presented. Under conditions pertaining in the United Kingdom the diagram suggests that: if uranium prices rise rapidly the fast reactor would become economic in the decade 1990-2000, if uranium prices rise more slowly, the fast reactor would become economic in the decade 2000-2010

Independent position correction on tumor and lymph nodes; consequences for bladder cancer irradiation with two combined IMRT plans

Energy Technology Data Exchange (ETDEWEB)

Rooijen, Dominique C van; Pool, René; Kamer, Jeroen B van de; Hulshof, Maarten CCM; Koning, Caro CE; Bel, Arjan [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands)

2010-06-15

The application of lipiodol injections as markers around bladder tumors combined with the use of CBCT for image guidance enables daily on-line position correction based on the position of the bladder tumor. However, this might introduce the risk of underdosing the pelvic lymph nodes. In this study several correction strategies were compared. For this study set-up errors and tumor displacements for ten complete treatments were generated; both were based on the data of 10 bladder cancer patients. Besides, two IMRT plans were made for 20 patients, one for the elective field and a boost plan for the tumor. For each patient 10 complete treatments were simulated. For each treatment the dose was calculated without position correction (option 1), correction on bony anatomy (option 2), on tumor only (option 3) and separately on bone for the elective field (option 4). For each method we analyzed the D{sub 99%} for the tumor, bladder and lymph nodes and the V{sub 95%} for the small intestines, rectum, healthy part of the bladder and femoral heads. CTV coverage was significantly lower with options 1 and 2. With option 3 the tumor coverage was not significantly different from the treatment plan. The ΔD{sub 99%} (D{sub 99%,} {sub option} {sub n} - D{sub 99%,} {sub treatment} {sub plan}) for option 4 was small, but significant. For the lymph nodes the results from option 1 differed not significantly from the treatment plan. The median ΔD{sub 99%} of the other options were small, but significant. ΔD{sub 99%} for PTV{sub bladder} was small for options 1, 2 and 4, but decreased up to -8.5 Gy when option 3 was applied. Option 4 is the only method where the difference with the treatment plan never exceeds 2 Gy. The V{sub 95%} for the rectum, femoral heads and small intestines was small in the treatment plan and this remained so after applying the correction options, indicating that no additional hot spots occurred. Applying independent position correction on bone for the elective

Independent position correction on tumor and lymph nodes; consequences for bladder cancer irradiation with two combined IMRT plans

Directory of Open Access Journals (Sweden)

Hulshof Maarten CCM

2010-06-01

Full Text Available Abstract Background The application of lipiodol injections as markers around bladder tumors combined with the use of CBCT for image guidance enables daily on-line position correction based on the position of the bladder tumor. However, this might introduce the risk of underdosing the pelvic lymph nodes. In this study several correction strategies were compared. Methods For this study set-up errors and tumor displacements for ten complete treatments were generated; both were based on the data of 10 bladder cancer patients. Besides, two IMRT plans were made for 20 patients, one for the elective field and a boost plan for the tumor. For each patient 10 complete treatments were simulated. For each treatment the dose was calculated without position correction (option 1, correction on bony anatomy (option 2, on tumor only (option 3 and separately on bone for the elective field (option 4. For each method we analyzed the D99% for the tumor, bladder and lymph nodes and the V95% for the small intestines, rectum, healthy part of the bladder and femoral heads. Results CTV coverage was significantly lower with options 1 and 2. With option 3 the tumor coverage was not significantly different from the treatment plan. The ΔD99% (D99%, option n - D99%, treatment plan for option 4 was small, but significant. For the lymph nodes the results from option 1 differed not significantly from the treatment plan. The median ΔD99% of the other options were small, but significant. ΔD99% for PTVbladder was small for options 1, 2 and 4, but decreased up to -8.5 Gy when option 3 was applied. Option 4 is the only method where the difference with the treatment plan never exceeds 2 Gy. The V95% for the rectum, femoral heads and small intestines was small in the treatment plan and this remained so after applying the correction options, indicating that no additional hot spots occurred. Conclusions Applying independent position correction on bone for the elective field and on

Independent position correction on tumor and lymph nodes; consequences for bladder cancer irradiation with two combined IMRT plans

International Nuclear Information System (INIS)

Rooijen, Dominique C van; Pool, René; Kamer, Jeroen B van de; Hulshof, Maarten CCM; Koning, Caro CE; Bel, Arjan

2010-01-01

The application of lipiodol injections as markers around bladder tumors combined with the use of CBCT for image guidance enables daily on-line position correction based on the position of the bladder tumor. However, this might introduce the risk of underdosing the pelvic lymph nodes. In this study several correction strategies were compared. For this study set-up errors and tumor displacements for ten complete treatments were generated; both were based on the data of 10 bladder cancer patients. Besides, two IMRT plans were made for 20 patients, one for the elective field and a boost plan for the tumor. For each patient 10 complete treatments were simulated. For each treatment the dose was calculated without position correction (option 1), correction on bony anatomy (option 2), on tumor only (option 3) and separately on bone for the elective field (option 4). For each method we analyzed the D 99% for the tumor, bladder and lymph nodes and the V 95% for the small intestines, rectum, healthy part of the bladder and femoral heads. CTV coverage was significantly lower with options 1 and 2. With option 3 the tumor coverage was not significantly different from the treatment plan. The ΔD 99% (D 99%, option n - D 99%, treatment plan ) for option 4 was small, but significant. For the lymph nodes the results from option 1 differed not significantly from the treatment plan. The median ΔD 99% of the other options were small, but significant. ΔD 99% for PTV bladder was small for options 1, 2 and 4, but decreased up to -8.5 Gy when option 3 was applied. Option 4 is the only method where the difference with the treatment plan never exceeds 2 Gy. The V 95% for the rectum, femoral heads and small intestines was small in the treatment plan and this remained so after applying the correction options, indicating that no additional hot spots occurred. Applying independent position correction on bone for the elective field and on tumor for the boost separately gives on average the best

Development of control rod position indicator using seismic-resistance reed switches for integral reactor

International Nuclear Information System (INIS)

Yu, Je Yong; Kim, Ji Ho; Huh, Hyung; Choi, Myoung Hwan; Sohn, Dong Seong

2008-01-01

The Reed Switch Position Transmitter (RSPT) is used as a position indicator for the control rod in commercial nuclear power plants made by ABB-CE. But this position indicator has some problems when directly adopting it to the integral reactor. The Control Element Drive Mechanism (CEDM) for the integral reactor is designed to raise and lower the control rod in steps of 2mm in order to satisfy the design features of the integral reactor which are the soluble boron free operation and the use of a nuclear heating for the reactor start-up. Therefore the resolution of the position indicator for the integral reactor should be achieved to sense the position of the control rod more precisely than that of the RSPT of the ABB-CE. This paper adopts seismic resistance reed switches to the position indicator in order to reduce the damages or impacts during the handling of the position indicator and earthquake

Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

Directory of Open Access Journals (Sweden)

H. Orpana

2016-01-01

Full Text Available Introduction: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. Methods: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada’s definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. Results: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada’s strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course.

An Exploratory Qualitative Inquiry of Key Indicators on IT Disaster Recovery Planning

Science.gov (United States)

Gardner, Brian

2016-01-01

Disaster recovery planning is a crucial component to maintaining a business's economic stability. However, it is unclear how key performance indicators (KPIs) are perceived in the emergency medical service (EMS) industry during the disaster recover planning process. The problem addressed in this study was to understand KPIs and their components.…

Performance estimation of control rod position indicator due to aging of magnet

International Nuclear Information System (INIS)

Yu, Je Yong; Kim, Ji Ho; Huh, Hyung; Choi, Myoung Hwan; Sohn, Dong Seong

2009-01-01

The Control Element Drive Mechanism (CEDM) for the integral reactor is designed to raise and lower the control rod in steps of 2mm in order to satisfy the design features of the integral reactor which are the soluble boron free operation and the use of a nuclear heating for the reactor start-up. The actual position of the control rod could be achieved to sense the magnet connected to the control rod by the position indicator around the upper pressure housing of CEDM. It is sufficient that the actual position information of control rod at 20mm interval from the position indicator is used for the core safety analysis. As the magnet moves upward along the position indicator assembly from the bottom to the top in the upper pressure housing, the output voltage increases linearly step-wise at 0.2VDC increments. Between every step there are transient areas which occur by a contact closing of three reed switches which is the 2-3-2 contact closing sequence. In this paper the output voltage signal corresponding to the position of control rod was estimated on the 2-1-2 contact closing sequence due to the aging of the magnet.

Positive behavioral support planning in the inpatient treatment of severe disruptive behaviors: A description of service features.

Science.gov (United States)

Hamlett, Nakia M; Carr, Erika R; Hillbrand, Marc

2016-05-01

Positive behavior support (PBS) plans are increasingly used on inpatient units to assess and treat serious and dangerous behaviors displayed by patients with serious psychiatric impairment. A contemporary extension of traditional applied behavior analytic procedures, PBS plans integrate theories from several domains with perspectives on community psychology, positive psychology, and recovery-oriented care. Because there is little evidence to suggest that more invasive, punitive disciplinary strategies lead to long-term positive behavioral change (Parkes, 1996), PBS plans have emerged as an alternative to the use of seclusion and restraint or other forms of restrictive measures typically used on inpatient psychiatric units (Hammer et al., 2011). Moreover, PBS plans are a preferred method of intervention because more invasive interventions often cause more harm than good to all involved (Elliott et al., 2005). This article seeks to provide an integrated framework for the development of positive behavior support plans in inpatient psychiatric settings. In addition to explicating the philosophy and core elements of PBS plans, this work includes discussion of the didactic and pragmatic aspects of training clinical staff in inpatient mental health settings. A case vignette is included for illustration and to highlight the use of PBS plans as a mechanism for helping patients transition to less restrictive settings. This work will add to the scant literature examining the use of positive behavioral support plans in inpatient psychiatric settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

78 FR 979 - Petition for Positive Train Control Safety Plan Approval and System Certification of the...

Science.gov (United States)

2013-01-07

...] Petition for Positive Train Control Safety Plan Approval and System Certification of the Electronic Train... the Federal Railroad Administration (FRA) for Positive Train Control (PTC) Safety Plan (PTCSP) approval and system certification of the Electronic Train Management System (ETMS) as required by 49 U.S.C...

Towards automatic patient positioning and scan planning using continuously moving table MR imaging.

Science.gov (United States)

Koken, Peter; Dries, Sebastian P M; Keupp, Jochen; Bystrov, Daniel; Pekar, Vladimir; Börnert, Peter

2009-10-01

A concept is proposed to simplify patient positioning and scan planning to improve ease of use and workflow in MR. After patient preparation in front of the scanner the operator selects the anatomy of interest by a single push-button action. Subsequently, the patient table is moved automatically into the scanner, while real-time 3D isotropic low-resolution continuously moving table scout scanning is performed using patient-independent MR system settings. With a real-time organ identification process running in parallel and steering the scanner, the target anatomy can be positioned fully automatically in the scanner's sensitive volume. The desired diagnostic examination of the anatomy of interest can be planned and continued immediately using the geometric information derived from the acquired 3D data. The concept was implemented and successfully tested in vivo in 12 healthy volunteers, focusing on the liver as the target anatomy. The positioning accuracy achieved was on the order of several millimeters, which turned out to be sufficient for initial planning purposes. Furthermore, the impact of nonoptimal system settings on the positioning performance, the signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) was investigated. The present work proved the basic concept of the proposed approach as an element of future scan automation. (c) 2009 Wiley-Liss, Inc.

Economic evaluation of reprocessing - Indicative Canadian position

International Nuclear Information System (INIS)

1979-05-01

This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for Canada is presented. Three fuel cycles are considered. (1) CANDU operating on the natural uranium, once-through fuel cycle. (2) CANDU operating with low enrichment (1.2%) once-through fuel cycle. (3) CANDU operating with recycle of plutonium and depleted uranium which has been extracted from spent CANDU natural uranium fuel. The diagrams show that reprocessing and recycle of fuel can be used to reduce further the sensitivity of CANDU fuelling costs to increasing uranium ore price

Economic evaluation of reprocessing - Indicative German position

International Nuclear Information System (INIS)

1979-05-01

This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic assessment of reprocessing. The indicative national position and illustrative ''phase diagram'' for the Federal Republic of Germany is presented. Advantages to be gained from the recycling of plutonium in thermal reactors are identified and it is concluded that many of these are not explicitly taken into account in the ''phase diagram''. Under the conditions pertaining in the Federal Republic of Germany thermal recycle will be economic under present day uranium prices. On the other hand the fast breeder reactor might become commercially economic around the year 2000

Positioning pharmacists' roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada.

Science.gov (United States)

Hughes, Christine A; Breault, Rene R; Hicks, Deborah; Schindel, Theresa J

2017-11-23

A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists' roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists' Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists' roles were constructed in communications about the Compensation Plan. In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists' changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists' roles as: (1) expanding to include services such as medication management for chronic diseases, (2) contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3) collaborating with other health care team members. Pharmacists' changing roles were positioned in alignment with the

Positioning pharmacists’ roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada

Directory of Open Access Journals (Sweden)

Christine A. Hughes

2017-11-01

Full Text Available Abstract Background A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists’ roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Methods Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists’ Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists’ roles were constructed in communications about the Compensation Plan. Results In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists’ changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists’ roles as: (1 expanding to include services such as medication management for chronic diseases, (2 contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3 collaborating with other health care team members

Statistical model of planning technological indicators for oil extraction

Energy Technology Data Exchange (ETDEWEB)

Galeyev, R G; Lavushchenko, V P; Sheshnev, A S

1979-01-01

The efficiency of the process of oil extraction is determined by the effect of a number of interrelated technological indicators. Analytical expression of the interrelationships of the indicators was represented by an econometric model consisting of a system of linear regression equations. The basic advantage of these models is the possibility of calculating in them different, significantly important interrelationships. This makes it possible to correlate all calculations into a single logically noncontradictory balanced system. The developed model of the technological process of oil extraction makes it possible to significantly facilitate calculation and planning of its basic indicators with regard for system and balance requirements, makes it possible to purposefully generate new variants. In this case because of the optimal distribution of the volumes of geological-technical measures, a decrease in the total outlays for their implementation is achieved. Thus for the Berezovskiy field, this saving was R 150,000.

An interactive water indicator assessment tool to support land use planning

NARCIS (Netherlands)

Hellegers, P.J.G.J.; Jansen, H.C.; Bastiaanssen, W.G.M.

2012-01-01

This paper presents an interactive web-based rapid assessment tool that generates key water related indicators to support decision making by stakeholders in land use planning. The tool is built on a consistent science based method that combines remote sensing with hydrological and socioeconomic

Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya

Directory of Open Access Journals (Sweden)

Rachel L. Steinfeld

2013-01-01

Full Text Available This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women.

Comparison of CPR1000 and AP1000 rod position indication systems

International Nuclear Information System (INIS)

Lei Qing

2009-01-01

This paper introduces the structure, the function, the digital detection principle of reactor control rod position and monitoring systems in CPR1000 and AP1000, comparing with the characteristics of the system design. The results show that the operation mode and function of AP1000 Rod position indication system are similar to that of CPR1000, but AP1000 rod position system provides higher reliability, and reduces the numbers of containment electrical penetrations and is with better characteristics than that of CPR1000, since it incorporated the redundancy design and data communication. (authors)

Node-positive left-sided breast cancer. Does VMAT improve treatment plan quality with respect to IMRT?

Energy Technology Data Exchange (ETDEWEB)

Pasler, M.; Bartelt, S.; Lutterbach, J. [Lake Constance Radiation Oncology Center Singen, Friedrichshafen (Germany); Georg, D. [Medical University Vienna/AKH Wien, Vienna (Austria). Dept. of Radiooncology; Medical University Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology

2013-05-15

Purpose: The aim of the present work was to explore plan quality and dosimetric accuracy of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for lymph node-positive left-sided breast cancer. Methods: VMAT and IMRT plans were generated with the Pinnacle{sup 3} V9.0 treatment planning system for 10 lymph node-positive left-sided breast cancer patients. VMAT plans were created using a single arc and IMRT was performed with 4 beams using 6, 10, and 15 MV photon energy, respectively. Plans were evaluated both manually and automatically using ArtiView trademark. Dosimetric plan verification was performed with a 2D ionization chamber array placed in a full scatter phantom. Results: Photon energy had no significant influence on plan quality for both VMAT and IMRT. Large variability in low doses to the heart was found due to patient anatomy (range V{sub 5} {sub Gy} 26.5-95 %). Slightly more normal tissue dose was found for VMAT (e.g., V{sub Tissue30%} = 22 %) than in IMRT (V{sub Tissue30%} = 18 %). The manual and ArtiView trademark plan evaluation coincided very accurately for most dose metrics (difference < 1 %). In VMAT, 96.7 % of detector points passed the 3 %/3 mm gamma criterion; marginally better accuracy was found in IMRT (98.3 %). Conclusion: VMAT for node-positive left-sided breast cancer retains target homogeneity and coverage when compared to IMRT and allows maximum doses to organs at risk to be reduced. ArtiView trademark enables fast and accurate plan evaluation. (orig.)

Indicator based controlling of cantonal guiding planning in Switzerland: A model for more efficient sustainable planning instruments at the regional level

Directory of Open Access Journals (Sweden)

Keiner Marco

2003-01-01

Full Text Available In the actual Swiss cantonal planning practice every 10 years in general, there is a review of the guiding plan. The plan’s evaluation typically takes place shortly before the revision process. In the interstitial time, the guiding plan’s effectiveness can only be anticipated. In the review, a survey of both, the desired and unwanted spatial effects are often absent. As a result, a thorough analysis of the effects and the direction of the spatial development cannot be accomplished. A spatial plan that is geared to the principle of sustainability needs the outputs of such an analysis. Development assessments are required to verify the plans’ effects, well-defined goals to assist in rectifying deviations, key indicators to identify efficiency potentials, and precautionary measures to allow for an adaptable and responsive planning methodology. The instruments, which might assist in the cantonal guiding plan objectives implementation, do exist. Such instruments are monitoring, controlling and benchmarking (with the support of indicators. These tools can assist in ensuring the plan’s overall value and the effectiveness and appropriateness of the ensuing development. By using these tools and a sound planning methodology, unsustainable spatial development can be tracked early and rectified with appropriated measures. The control as this system’s central instrument is presented here and its application opportunities in the cantonal guiding planning are discussed. In order to achieve a sustainable spatial development and a more dynamic guiding planning, the application of control and benchmarking is crucial.

Computer-aided position planning of miniplates to treat facial bone defects.

Directory of Open Access Journals (Sweden)

Jan Egger

Full Text Available In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.

Computer-aided position planning of miniplates to treat facial bone defects

Science.gov (United States)

Wallner, Jürgen; Gall, Markus; Chen, Xiaojun; Schwenzer-Zimmerer, Katja; Reinbacher, Knut; Schmalstieg, Dieter

2017-01-01

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon’s desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time. PMID:28817607

46 CFR 169.831 - Emergency position indicating radio beacon (EPIRB).

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency position indicating radio beacon (EPIRB). 169.831 Section 169.831 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS... radio beacon (EPIRB). The master shall ensure that— (a) The EPIRB required in § 169.555 of this...

Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study.

Science.gov (United States)

Walch, Gilles; Vezeridis, Peter S; Boileau, Pascal; Deransart, Pierric; Chaoui, Jean

2015-02-01

Glenoid component positioning is a key factor for success in total shoulder arthroplasty. Three-dimensional (3D) measurements of glenoid retroversion, inclination, and humeral head subluxation are helpful tools for preoperative planning. The purpose of this study was to assess the reliability and precision of a novel surgical method for placing the glenoid component with use of patient-specific templates created by preoperative surgical planning and 3D modeling. A preoperative computed tomography examination of cadaveric scapulae (N = 18) was performed. The glenoid implants were virtually placed, and patient-specific guides were created to direct the guide pin into the desired orientation and position in the glenoid. The 3D orientation and position of the guide pin were evaluated by performing a postoperative computed tomography scan for each scapula. The differences between the preoperative planning and the achieved result were analyzed. The mean error in 3D orientation of the guide pin was 2.39°, the mean entry point position error was 1.05 mm, and the mean inclination angle error was 1.42°. The average error in the version angle was 1.64°. There were no technical difficulties or complications related to use of patient-specific guides for guide pin placement. Quantitative analysis of guide pin positioning demonstrated a good correlation between preoperative planning and the achieved position of the guide pin. This study demonstrates the reliability and precision of preoperative planning software and patient-specific guides for glenoid component placement in total shoulder arthroplasty. Copyright © 2015. Published by Elsevier Inc.

Arrangement of permanent magnet and reed switches for control rod position indicator of SMART CEDM

International Nuclear Information System (INIS)

Yoo, J. Y.; Kim, J. I.; Kim, J. H.; Hur, H.; Jang, M. H.

2001-01-01

The reliability and accuracy of the information on control rod position are very important to the reactor safety and the design of the core protection system. A survey on the RSPT(Reed Switch Position Transmitter) type control rod position indication system and its actual implementation in the exiting nuclear power plants in Korea was performed first. The control rod position indicator having the high performance for SMART was developed on the basis of RSPT technology identified through the survey. The arrangement of permanent magnet and reed switches is the most important procedure in the design of control rod position indication. In this study, the characteristics of permanent magnet and reed switches are introduced and the calculation method for arrangement of permanent magnet and reed switch is presented

Measures of safeguard and rehabilitation for landscape protection planning: a qualitative approach based on diversity indicators.

Science.gov (United States)

La Rosa, Daniele; Privitera, Riccardo; Martinico, Francesco; La Greca, Paolo

2013-09-01

Maintaining existing levels of landscape diversity is becoming more and more important for planning considering the increasing pressures on agricultural ecosystems due to soil sealing, sprawl processes and intensive agriculture. Norms for land-use regulation and measures for landscape Safeguard and Rehabilitation have to take into consideration these threats in landscape planning. Evaluating the diversity of agricultural ecosystems is a fundamental step for proposing sound approaches to planning and managing both soil and landscape, as well as maintaining the related ecosystem services. The paper proposes a method aimed at the qualitative evaluation of spatial diversity of agricultural landscapes using a reduced set of ecological indicators based on land-use vector data. Indicators are calculated for defined landscape units characterized by landscape homogeneity. GIS geoprocessing and spatial analysis functions are employed. The study area is the Province of Enna in Sicily (Italy), which is characterized by cultivation mosaics in its southern region, cereal cultivation in the central region and prevailing natural environments in the northern region. Results from the indicator calculations are used to define measures to be included in a Landscape Protection Plan. Safeguard and Rehabilitation measures are introduced, which link indicator scores to planning protection aims. The results highlight the relevance of some agricultural mosaics in proximity to streams and seasonal fluvial environments, where some undamaged natural environments are still present. For these areas, specific landscape safeguard measures are proposed to preserve their diversity features together with their original agricultural functions. The work shows that even with a reduced number of indicators, a differentiated set of measures can be proposed for a Landscape Protection Plan. Copyright © 2013 Elsevier Ltd. All rights reserved.

Report to Congress : recapitalization plan for the nationwide differential global positioning system (NDGPS).

Science.gov (United States)

2010-06-01

The U.S. Department of Transportation (DOT) has developed a recpitlaization plan to reduce technical, cost, and programmatic risks of the DOT-funded inland segment of the Nationwide Differential Global Positioning System (NDGPS)

Social position and health in old age: the relevance of different indicators of social position

DEFF Research Database (Denmark)

Avlund, Kirsten; Holstein, Bjørn E; Osler, Merete

2003-01-01

for men and women. In men the odds ratios of housing tenure on four health variables were strong and unaffected by education and occupation while in women the odds ratios of income on three health variables were strong and unaffected by education and occupation. CONCLUSION: This study demonstrates strong......AIMS: An analysis was undertaken to investigate social inequalities in health among old men and women in relation to five indicators of social position. METHODS: The study is based on a population-based cross-sectional survey among 748 75-year-old men and women, which was performed as clinical......, consistent associations between variables of material wealth indicators and various measures of health among 75-year-old men and women....

Dosimetric impact of systematic MLC positional errors on step and shoot IMRT for prostate cancer: a planning study

International Nuclear Information System (INIS)

Ung, N.M.; Harper, C.S.; Wee, L.

2011-01-01

Full text: The positional accuracy of multileaf collimators (MLC) is crucial in ensuring precise delivery of intensity-modulated radiotherapy (IMRT). The aim of this planning study was to investigate the dosimetric impact of systematic MLC positional errors on step and shoot IMRT of prostate cancer. A total of 12 perturbations of MLC leaf banks were introduced to six prostate IMRT treatment plans to simulate MLC systematic positional errors. Dose volume histograms (DVHs) were generated for the extraction of dose endpoint parameters. Plans were evaluated in terms of changes to the defined endpoint dose parameters, conformity index (CI) and healthy tissue avoidance (HTA) to planning target volume (PTV), rectum and bladder. Negative perturbations of MLC had been found to produce greater changes to endpoint dose parameters than positive perturbations of MLC (p 9 5 of -1.2 and 0.9% respectively. Negative and positive synchronised MLC perturbations of I mm in one direction resulted in median changes in D 9 5 of -2.3 and 1.8% respectively. Doses to rectum were generally more sensitive to systematic MLC en-ors compared to bladder (p < 0.01). Negative and positive synchronised MLC perturbations of I mm in one direction resulted in median changes in endpoint dose parameters of rectum and bladder from 1.0 to 2.5%. Maximum reduction of -4.4 and -7.3% were recorded for conformity index (CI) and healthy tissue avoidance (HT A) respectively due to synchronised MLC perturbation of 1 mm. MLC errors resulted in dosimetric changes in IMRT plans for prostate. (author)

Fate of indicator microorganisms under nutrient management plan conditions.

Science.gov (United States)

Bradford, Scott A; Segal, Eran

2009-01-01

Nutrient management plans (NMPs) for application of wastewater from concentrated animal feeding operations are designed to meet crop water and nutrient requirements, but implicitly assume that pathogenic microorganisms in the wastewater will be retained and die-off in the root zone. A NMP was implemented on a field plot to test this assumption by monitoring the fate of several fecal indicator microorganisms (Enterococcus, fecal coliforms, somatic coliphage, and total Escherichia coli). When well-water and wastewater were applied to meet measured evapotranspiration (ET), little advective transport of the indicator microorganisms occurred below the root zone and the remaining microorganisms rapidly died-off (within 1 mo). Additional experiments were conducted in the laboratory to better quantify microorganism transport and survival in the field soil. Batch survival experiments revealed much more rapid die-off rates for the bacterial indicator microorganisms in native than in sterilized soil, suggesting that biotic factors controlled survival. Saturated column experiments with packed field soil, demonstrated much greater transport potential for somatic coliphage than bacterial indicators (Enterococcus and total E. coli) and that the retention rates for the indicator microorganisms were not log-linear with depth. A worst case transport scenario of ponded infiltration on a large undistributed soil column from the field was also initiated and indicator microorganisms were not detected in the column outflow or in the soil at a depth of 65 cm. All of these observations support the hypothesis that a NMP at this site will protect groundwater supplies from microorganism contamination, especially when applied water and wastewater meet ET.

Does the urethral angle change with leg position? Implications for urethral-based CT-planned transperineal prostate implants

International Nuclear Information System (INIS)

Bednarz, Greg; Ning, Yue; Waterman, Frank M.; Corn, Benjamin W.; Dicker, Adam P.

1997-01-01

Purpose: CT based treatment planning for transperineal prostate implants allows for angulation of transperineal needles to avoid the pubic bones by changing the template angle. It requires fluoroscopic guidance and utilizes identification of the urethra by radiopaque markers inside the Foley catheter at the time of the implant. The needle trajectory is relative to the urethral angle as visualized by lateral fluoroscopic views. Patients who have a treatment planning CT in preparation for a transperineal prostate implant are typically scanned in the leg-down/straight position. However, the implant is done in the lithotomy position and changes in the template angle to adapt to the new urethral angle are often required. We have evaluated the relationship between leg position and the position of the prostatic urethra to predict the change in the planned template angle. Material and Methods: To duplicate the lithotomy position a custom designed foot holder was constructed that attached to a flatbed CT scanner. A Foley catheter was inserted with radio-opaque contrast placed in the balloon. Bladder contrast was also utilized. A catheter with 1 cm spaced dummy seeds was placed inside the Foley catheter. A radio-opaque catheter was inserted into the rectum. Fifteen patients had pre-implant scans performed in the leg-down/straight and lithotomy position. The prostate, urethra, bladder and rectum were contoured utilizing a 3D-brachytherapy software system and analyzed. Results: Fourteen of the patients (93%) had changes in urethral angle when evaluated in the lithotomy relative to the led-down/straight position. The mean angle change was - 9.8 degrees (Std. Error 1.47 degrees; p < 0.0001) when in the lithotomy position. The changes were not correlated with prostatic volume or clinical stage. All patients who had urethral angle changes would have required adjustments in the template angle. Conclusions: 1) The objective of treatment planning for prostate implants is to

When daily planning improves employee performance: The importance of planning type, engagement, and interruptions.

Science.gov (United States)

Parke, Michael R; Weinhardt, Justin M; Brodsky, Andrew; Tangirala, Subrahmaniam; DeVoe, Sanford E

2018-03-01

Does planning for a particular workday help employees perform better than on other days they fail to plan? We investigate this question by identifying 2 distinct types of daily work planning to explain why and when planning improves employees' daily performance. The first type is time management planning (TMP)-creating task lists, prioritizing tasks, and determining how and when to perform them. We propose that TMP enhances employees' performance by increasing their work engagement, but that these positive effects are weakened when employees face many interruptions in their day. The second type is contingent planning (CP) in which employees anticipate possible interruptions in their work and plan for them. We propose that CP helps employees stay engaged and perform well despite frequent interruptions. We investigate these hypotheses using a 2-week experience-sampling study. Our findings indicate that TMP's positive effects are conditioned upon the amount of interruptions, but CP has positive effects that are not influenced by the level of interruptions. Through this study, we help inform workers of the different planning methods they can use to increase their daily motivation and performance in dynamic work environments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Design of magnetic flux concentrator of permancent magnet for control rod position indicator of SMART CEDM

International Nuclear Information System (INIS)

Yoo, J. Y.; Kim, J. H.; Hur, H.; Kim, J. I.

2002-01-01

The reliability and accuracy of the information on control rod position are very important to the reactor safety and the design of the core protection system. A survey on the RSPT(Reed Switch Position Transmitter) type control rod position indication system and its actual implementation in the exiting nuclear power plants in Korea was performed first. The control rod position indicator having the high performance for SMART was developed on the basis of RSPT technology identified through the survey. The arrangement of permanent magnet and reed switches is the most important procedure in the design of control rod position indication. In this study, the magnetic flux concentrator of permanent magnet is introduced and the calculation method for effective flux area for reed switch is presented

Domestic water service delivery indicators and frameworks for monitoring, evaluation, policy and planning: a review.

Science.gov (United States)

Kayser, Georgia L; Moriarty, Patrick; Fonseca, Catarina; Bartram, Jamie

2013-10-11

Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator--service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.

Evaluation according to criteria and indicators of sustainable forest management: Saçinka Forest Planning Unit

Directory of Open Access Journals (Sweden)

Burak Çavdar

2015-04-01

Full Text Available The reasons such as; decrease in forest areas, deterioration in the structure, fragmented structures, decrease in water sources, environmental pollution and increase in carbon level in air are considered as the main sources of problems like global warming and global climate change. Countries have been trying to develop cooperative solutions for these problems since the mid-20th century. Sustainable forest management criteria and indicators, which were outcomes of Biological Diversity Agreement and the processes afterwards, have also been specified in Turkey based on Pan-European process indicators. According to this set of criteria and indicators, data are collected in the scale of Forest Enterprises and the current situation is evaluated in the meetings held by Regional Directorates of Forestry. Most of the data to be evaluated are obtained from forest management plans in the scale of Forest Planning Units and a great deal of economic indicators are dealt in the scale of Forestry Enterprises. Starting from this point of view; this study analyzes the SFM criteria and indicators set data of Saçinka Forest Planning Unit. Accordingly, it examines whether forest ecosystem is conducted in a sustainable way or not.

Orthognathic positioning system: intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery.

Science.gov (United States)

Polley, John W; Figueroa, Alvaro A

2013-05-01

To introduce the concept and use of an occlusal-based "orthognathic positioning system" (OPS) to be used during orthognathic surgery. The OPS consists of intraoperative occlusal-based devices that transfer virtual surgical planning to the operating field for repositioning of the osteotomized dentoskeletal segments. The system uses detachable guides connected to an occlusal splint. An initial drilling guide is used to establish stable references or landmarks. These are drilled on the bone that will not be repositioned adjacent to the osteotomy line. After mobilization of the skeletal segment, a final positioning guide, referenced to the drilled landmarks, is used to transfer the skeletal segment according to the virtual surgical planning. The OPS is digitally designed using 3-dimensional computer-aided design/computer-aided manufacturing technology and manufactured with stereolithographic techniques. Virtual surgical planning has improved the preoperative assessment and, in conjunction with the OPS, the execution of orthognathic surgery. The OPS has the possibility to eliminate the inaccuracies commonly associated with traditional orthognathic surgery planning and to simplify the execution by eliminating surgical steps such as intraoperative measuring, determining the condylar position, the use of bulky intermediate splints, and the use of intermaxillary wire fixation. The OPS attempts precise translation of the virtual plan to the operating field, bridging the gap between virtual and actual surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

77 FR 36579 - Establishing Indicators to Determine Whether State Plan Operations Are at Least as Effective as...

Science.gov (United States)

2012-06-19

...] Establishing Indicators to Determine Whether State Plan Operations Are at Least as Effective as Federal OSHA... establishing definitions and measures to determine whether OSHA-approved State Plans for occupational safety and health (State Plans) are at least as effective as the Federal OSHA program as required by the...

Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review

Directory of Open Access Journals (Sweden)

Jamie Bartram

2013-10-01

Full Text Available Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.

Typology and indicators of ecosystem services for marine spatial planning and management.

Science.gov (United States)

Böhnke-Henrichs, Anne; Baulcomb, Corinne; Koss, Rebecca; Hussain, S Salman; de Groot, Rudolf S

2013-11-30

The ecosystem services concept provides both an analytical and communicative tool to identify and quantify the link between human welfare and the environment, and thus to evaluate the ramifications of management interventions. Marine spatial planning (MSP) and Ecosystem-based Management (EBM) are a form of management intervention that has become increasingly popular and important globally. The ecosystem service concept is rarely applied in marine planning and management to date which we argue is due to the lack of a well-structured, systematic classification and assessment of marine ecosystem services. In this paper we not only develop such a typology but also provide guidance to select appropriate indicators for all relevant ecosystem services. We apply this marine-specific ecosystem service typology to MSP and EBM. We thus provide not only a novel theoretical construct but also show how the ecosystem services concept can be used in marine planning and management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Analysis of magnetic field and hysteresis of reed switches for control rod position indicator of SMART CEDM

International Nuclear Information System (INIS)

Yoo, J. W.; Kim, J. H.; Heo, H.; Kim, J. I.; Jang, M. H.

2002-01-01

The reliability and accuracy of the information on control rod position are very important to the reactor safety and the design of the core protection system. A survey on the RSPT(Reed Switch Position Transmitter) type control rod position indication system and its actual implementation in the exiting nuclear power plants in Korea was performed first. The control rod position indicator having the high performance for SMART was developed on the basis of RSPT technology identified through the survey. The hysteresis of reed switches is one of the important factors in a repeat accuracy of control rod position indication. In this study, the hysteresis of reed switches is introduced and the design method using the magnetic analysis of reed switches in presented

Fault tolerant, multiplexed control rod position detection and indication system for nuclear power plants

International Nuclear Information System (INIS)

Dufek, W.L.; Jelovich, J.J.; Neuner, J.A.

1977-01-01

The majority of Westinghouse nuclear plants placed in service thus far have incorporated a Rod Position Indication system based upon an analog design philosophy. This system, while meeting all functional and accuracy requirements, has proven somewhat cumbersome, particularly in the area of initial field calibration and maintenance. This paper describes a new Digital Rod Position Indication system (DRPI) developed for use with pressurized water reactors. The system is based upon a digital design philosophy and meets all previous design constraints and environmental requirements. Further, fault tolerance, improved accuracy, interference from adjacent rods and the elimination of adjustments and calibration has been provided

Comparison of Radiation Treatment Plans for Breast Cancer between 3D Conformal in Prone and Supine Positions in Contrast to VMAT and IMRT Supine Positions

Science.gov (United States)

Bejarano Buele, Ana Isabel

The treatment regimen for breast cancer patients typically involves Whole Breast Irradiation (WBI). The coverage and extent of the radiation treatment is dictated by location of tumor mass, breast tissue distribution, involvement of lymph nodes, and other factors. The current standard treatment approach used at our institution is a 3D tangential beam geometry, which involves two fields irradiating the breast, or a four field beam arrangement covering the whole breast and involved nodes, while decreasing the dose to organs as risk (OARs) such as the lung and heart. The coverage of these targets can be difficult to achieve in patients with unfavorable thoracic geometries, especially in those cases in which the planning target volume (PTV) is extended to the chest wall. It is a well-known fact that exposure of the heart to ionizing radiation has been proved to increase the subsequent rate of ischemic heart disease. In these cases, inverse planned treatments have become a proven alternative to the 3D approach. The goal of this research project is to evaluate the factors that affect our current techniques as well as to adapt the development of inverse modulated techniques for our clinic, in which breast cancer patients are one of the largest populations treated. For this purpose, a dosimetric comparison along with the evaluation of immobilization devices was necessary. Radiation treatment plans were designed and dosimetrically compared for 5 patients in both, supine and prone positions. For 8 patients, VMAT and IMRT plans were created and evaluated in the supine position. Skin flash incorporation for inverse modulated plans required measurement of the surface dose as well as an evaluation of breast volume changes during a treatment course. It was found that prone 3D conformal plans as well as the VMAT and IMRT plans are generally superior in sparing OARs to supine plans with comparable PTV coverage. Prone setup leads to larger shifts in breast volume as well as in

241-AN-A valve pit manifold valves and position indication acceptance test procedure

Energy Technology Data Exchange (ETDEWEB)

VANDYKE, D.W.

1999-08-25

This document describes the method used to test design criteria for gear actuated ball valves installed in 241-AN-A Valve Pit located at 200E Tank Farms. The purpose of this procedure is to demonstrate the following: Equipment is properly installed, labeled, and documented on As-Built drawings; New Manifold Valves in the 241-AN-A Valve Pit are fully operable using the handwheel of the valve operators; New valve position indicators on the valve operators will show correct valve positions; New valve position switches will function properly; and New valve locking devices function properly.

Is a positive L-dimer result a sufficient indication for performing a V/Q lung scan?

International Nuclear Information System (INIS)

Salanitri, G.C.; Kelly, M.J.; O'Donnell, M.; Kalff, V.

2002-01-01

Full text: At our institution there has developed a practice of referring some patients for assessment of pulmonary embolism (PE) because of a positive L-dimer test but without standard clinical indications. Therefore this study aimed to determine whether a positive L-dimer test result by itself is a sufficient indication to perform a ventilation/perfusion V/Q study. V/Q lung scan results, L-dimer test results and appropriate radiology results of 949 consecutive patients from August 2000 to October 2001 were retrospectively reviewed. Prediction of V/Q results by L-dimer results was compared with that of clinical risk factors for PE (Risk factor + or -) These factors were dyspnoea, current deep vein thrombosis (DVT), recent orthopaedic procedure or a past history of PE/DVT, Of the 949 patients in the study population, 254 patients had an L-dimer study, with 206 positive and 48 negative L-dimer results. Helical CT was performed in 8 patients with an equivocal V/Q - 4 showed PE and 4 did not. In the 27 patients with a positive L-dimer result and PE on either V-Q scan or CT, 25 (92.6%) had additional recognised major risk factors for PE. A positive L-dimer test is a poor predictor of a positive V/Q scan compared to conventional clinical indications. Thus, a positive L-dimer test result in isolation does not constitute an appropriate indication to perform a V/Q scan. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

The U.S. National Action Plan to Improve Health Literacy: A Model for Positive Organizational Change.

Science.gov (United States)

Baur, Cynthia; Harris, Linda; Squire, Elizabeth

2017-01-01

This chapter presents the U.S. National Action Plan to Improve Health Literacy and its unique contribution to public health and health care in the U.S. The chapter details what the National Action Plan is, how it evolved, and how it has influenced priorities for health literacy improvement work. Examples of how the National Action Plan fills policy and research gaps in health care and public health are included. The first part of the chapter lays the foundation for the development of the National Action Plan, and the second part discusses how it can stimulate positive organizational change to help create health literate organizations and move the nation towards a health literate society.

Influence of Peer Social Experiences on Positive and Negative Indicators of Mental Health among High School Students

Science.gov (United States)

Suldo, Shannon M.; Gelley, Cheryl D.; Roth, Rachel A.; Bateman, Lisa P.

2015-01-01

Modern definitions of complete mental health include both positive and negative indicators of psychological functioning. We examined the associations between peer relationships (victimization and receipt of prosocial acts) and multiple indicators of mental health that represent subjective well-being (i.e., life satisfaction, positive and negative…

Associations of women's position in the household and food insecurity with family planning use in Nepal.

Science.gov (United States)

Diamond-Smith, Nadia; Raj, Anita; Prata, Ndola; Weiser, Sheri D

2017-01-01

Women in Nepal have low status, especially younger women in co-resident households. Nepal also faces high levels of household food insecurity and malnutrition, and stagnation in uptake of modern family planning methods. This study aims to understand if household structure and food insecurity interact to influence family planning use in Nepal. Using data on married, non-pregnant women aged 15-49 with at least one child from the Nepal 2011 Demographic and Health Survey (N = 7,460), we explore the relationship between women's position in the household, food insecurity as a moderator, and family planning use, using multi-variable logistic regressions. We adjust for household and individual factors, including other status-related variables. In adjusted models, living in a food insecure household and co-residing with in-laws either with no other daughter-in-laws or as the eldest or youngest daughter-in-law (compared to not-co-residing with in-laws) are all associated with lower odds of family planning use. In the interaction model, younger-sisters-in-law and women co-residing with no sisters-in-law in food insecure households have the lowest odds of family planning use. This study shows that household position is associated with family planning use in Nepal, and that food insecurity modifies these associations-highlighting the importance of considering both factors in understanding reproductive health care use in Nepal. Policies and programs should focus on the multiple pathways through which food insecurity impacts women's reproductive health, including focusing on women with the lowest status in households.

Hydro-Quebec : positioning and strategic planning

International Nuclear Information System (INIS)

Lanoue, R.

1998-01-01

Hydro-Quebec's corporate concerns for 1998-2002 were highlighted. The Corporation's strategic plan envisages that within the next decade, the utility will boost sales by 25 per cent with an investment of $13.2 billion in new generation projects. The electric utility plans to build on past experience and maintain its electricity rates and service quality. Sustaining environmental quality while developing into a world class enterprise remains a major objective of the utility. Research and development will also continue to be an integral part of the utility's operations. Tabs., figs

Factors that enable nurse-patient communication in a family planning context: a positive deviance study.

Science.gov (United States)

Kim, Young Mi; Heerey, Michelle; Kols, Adrienne

2008-10-01

Family planning programmes in developing countries need a better understanding of nurse-patient communication in order to improve the quality of counselling. To identify factors in the clinic and in the community that enable nurses and patients to communicate effectively with one another. The study explored the personal experiences of nurses and patients who communicate especially effectively during family planning consultations (so-called "positive deviants"). Sixty-four randomly selected public clinics located in East Java, Indonesia. Seven positive deviant nurses and 32 positive deviant patients were identified from among 64 nurses and 768 patients who participated in an earlier patient coaching study. Flooding prevented 5 patients from participating in the study, reducing their number to 27. Investigators conducted: (1) a content analysis of qualitative data collected by structured in-depth interviews and focus-group discussions (FGDs) with positive deviant nurses and patients, and (2) analyses of variance (ANOVA) of quantitative data on clinic, nurse, and patient characteristics. Positive deviant nurses identified four factors, listed in rough order of importance, that helped them communicate effectively: independent study to strengthen their knowledge and skills; communication aids; feedback from colleagues; and motivation stemming from a desire to help people, patients' appreciation, husband's support, and increased income. Positive deviant patients identified five enabling factors: motivation due to their need for a service; confidence in their own communication skills; positive feedback from nurses; belief in patients' right and responsibility to communicate with nurses; and communication aids. Insights from positive deviant nurses and patients suggest that efforts to improve nurse-patient communication should go beyond conventional communication skills training. Managers should consider a mix of clinic-based interventions (such as peer feedback

Body indices and basic vital signs in Helicobacter pylori positive and negative persons

International Nuclear Information System (INIS)

Kopacova, Marcela; Bures, Jan; Koupil, Ilona; Rejchrt, Stanislav; Vorisek, Viktor; Seifert, Bohumil; Pozler, Oldrich; Zivny, Pavel; Douda, Tomas; Palicka, Vladimir; Holcik, Jan

2007-01-01

It has been hypothesized that Helicobacter pylori (Hp) infection may contribute to reduced stature, risk of hypertension or obesity. The aim was to evaluate body indices in Hp positive and negative persons. A total of 2436 subjects (4-100 years old) were tested for Hp status by 13 C-urea breath test. Data on height and weight were collected for 84%, and blood pressure for 80% of the study subjects. The prevalence of Hp infection was 41.6%. The odds ratio for a 10-year increase in age was 1.21 (95% CI 1.17-1.25, p-value <0.001). Statistically significant negative association of Hp positivity with body height was most pronounced in the younger age groups, while a positive association of Hp positivity with body mass index was only seen in those aged 15+ years. There was a negative effect of Hp positivity on systolic and diastolic blood pressure in subjects below 25 and a relatively strong positive effect on blood pressure in subjects over 65 years. Residual confounding by social characteristics as a possible explanation for the associations of Hp positivity with height and blood pressure cannot be excluded. Unmeasured factors related to social and family environment may cause the apparent association between Hp positivity and children's growth and blood pressure

Different nutritional-state indicators of HIV-positive individuals undergoing antiretroviral therapy

Directory of Open Access Journals (Sweden)

J. Geraix

2008-01-01

Full Text Available This study aimed at learning about the nutritional profile of HIV-positive individuals undergoing antiretroviral therapy and at comparing the performance of nutritional-state indicators. A transversal study was performed on 94 patients attending the Tropical Diseases Outpatient Hospital of Botucatu Medical School (FMB - UNESP. The body mass index (BMI and the classification by Papini-Berto (PB were used to evaluate nutritional state, aiming at detecting malnutrition and obesity. The waist-to-hips ratio (W/HR and waist circumference (WC were adopted for identification of abdominal obesity and lipodystrophy. According to BMI, most of the individuals were eutrophic, followed by 30.9% overweight and 6.4% malnourished. By using the PB classification, the frequency of malnourished increased (22.3%. The analysis of the PB classification in relation to BMI indicated that the former presented high sensitivity and good specificity for malnutrition diagnosis, namely 100% and 83%, respectively. The prevalence of abdominal obesity was 7.44% according to WC, and a higher prevalence (38.3% was observed when taking W/HR into account. There was significant positive association between nutritional diagnosis according to PB and T CD4+ lymphocyte. The results support the use of PB classification for malnutrition detection as well as that of BMI and W/HR for overweight and fat redistribution.

Geographic specificity and positionality of public input in transportation: a rural transportation planning case from Central Texas

Directory of Open Access Journals (Sweden)

Greg P. Griffin

2014-01-01

Full Text Available Current transportation planning processes often incorporate public input, but the types of engagement techniques can affect the ability of practitioners to meaningfully include local ideas. This study incorporates literature integrating communicative rationality with participatory mapping, supported by a case study focusing on two public engagement techniques. A transportation planning process in Central Texas is evaluated in terms of the geographic specificity and positionality of comments received from open-ended responses on a questionnaire and a facilitated mapping session, and reviews this input for relevance to developing a transportation plan. Although all input received from the public can be valuable in the process, location-based comments may be more actionable by transportation planners. Participants’ perceived roles likely affect their level of engagement, which planners can facilitate to maximize the quality of involvement. Planners are advised to understand the positionality of project stakeholders and professionals, designing involvement methods considering geographic specificity appropriate for each project.

Pluri annual indicative plan of the investments in the gas sector

International Nuclear Information System (INIS)

2007-03-01

This indicative plan constitutes the first report to the Parliament. It is a prospective document for the period 2006-2015 containing: a forecast of the gas demand increase, a description of main investments decided in matter of gas infrastructures, a diagnostic concerning the adequation between the supplying capacities in natural gas and the national needs, a series of recommendations on the State tools to guarantee the national supplying security and on the investment. The four parts deal with the stakes and perspectives of the national natural gas supplying, the demand evolution, the offer evolution and the equilibrium offer. (A.L.B.)

A component analysis of positive behaviour support plans.

Science.gov (United States)

McClean, Brian; Grey, Ian

2012-09-01

Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness. Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up. There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions. Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour.

Staff Concerns in Schools Planning for and Implementing School-Wide Positive Behavior Interventions and Supports

Science.gov (United States)

Tyre, Ashli D.; Feuerborn, Laura L.; Woods, Leslie

2018-01-01

Understanding staff concerns about a systemic change effort allows leadership teams to better anticipate and address staff needs for professional development and support. In this study, staff concerns in nine schools planning for or implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) were explored using the…

Does the Strategic Planning of Local Development Result from the Motives Indicated in Literature? Contemporary Motivation of Polish Small Towns’ Authorities for Strategic Planning of Local Development

Directory of Open Access Journals (Sweden)

Andrzej SZTANDO

2017-06-01

Full Text Available The international literature offers a numberof motives which should incline local authoritiestoward strategic planning of local development;it also emphasizes that they should be stronglymotivated to do that. Meanwhile, their actualmotivation for such planning can remain low anddominated by motives so far unrecognized in theliterature. The article presents research confi rmingthis assumption, conducted in 2014 amongthe authorities of Polish small towns.The results reveal that the general motivationfor strategic planning of local developmentamong 37.7% of the authorities of Polish smalltowns is low. It also disclosed that the motivefor obtaining means from the EU funds (so farunrecognized in literature was and is motivatingstrongly at least 68.6% of these authorities forthe discussed planning and, moreover, that it is ashort-lived motive. The article indicates that thissituation may also refer to other local authorities,not just the Polish ones. It also indicates that itis an unintended effect of the dependence ofmunicipal development projects’ support by themeans from the EU funds on including them inthe local development strategy. The fi nal part ofthe article presents recommendations of actionsto rectify such an unfavorable situation and forfurther studies of planning motives followed bylocal authorities.

Comprehensive highway corridor planning with sustainability indicators.

Science.gov (United States)

2011-10-01

"The Maryland State Highway Administration (SHA) has initiated major planning efforts to improve transportation : efficiency, safety, and sustainability on critical highway corridors through its Comprehensive Highway Corridor : (CHC) program. This pr...

On the use of an energy certification database to create indicators for energy planning purposes: Application in northern Italy

International Nuclear Information System (INIS)

Dall’O’, Giuliano; Sarto, Luca; Sanna, Nicola; Tonetti, Valeria; Ventura, Martina

2015-01-01

Energy certification of buildings, mandatory under the European Directive EPBD provides interesting data on the thermo-physical properties and geometry of existing buildings. Although the energy certificate is intended to provide the characteristics of individual buildings, so stimulating the real estate market toward ever better energy performance, data management of the certificates issued over time, using a national or regional energy cadastre, makes available a data base which is useful for energy planning in the building sector. This paper provides the needed results of a benchmarking study on data from the energy cadastre of the Lombardy Region, northern Italy. By integrating data from the energy cadastre (175.778 energy certificates) with the statistical data obtained from the national census, indicators were obtained on the energy performance of existing buildings. The energy indicators obtained, characterised by building type and construction period, normalised as a function of Degree-Days, become an effective tool for energy planning at local and regional scales. In the specific case, the energy indicators have been used to estimate the potential for energy retrofit of existing buildings in the Lombardy Region. The same indicators can also be used by municipalities for energy planning at the municipal or district level. -- Highlights: •A methodology in order to obtain energy performance indicators from an energy cadastre. •Data contained in the energy certificates can be used to understand the thermo-physical properties of an existing building. •Energy indicators on existing buildings are used as a tool for energy planning. •The analysis of the energy cadastre (official register) can detect errors in the registered energy certificates. •The energy indicators are used in order to quantify the energy retrofit potential in existing building stocks

Examination of the Locus of Positional Effects on Children's Production of Plural -"s": Considerations from Local and Global Speech Planning

Science.gov (United States)

Theodore, Rachel M.; Demuth, Katherine; Shattuck-Hufnagel, Stefanie

2015-01-01

Purpose: Prosodic and articulatory factors influence children's production of inflectional morphemes. For example, plural -"s" is produced more reliably in utterance-final compared to utterance-medial position (i.e., the positional effect), which has been attributed to the increased planning time in utterance-final position. In previous…

The feminist position on family planning in Spain.

Science.gov (United States)

Navarro, M V

1984-04-01

The Spanish feminist movement had its origins in the early 1970; in 1975 the first offical feminist conference made the following demands on the public authorities; 1) to abolish all sections of the Criminal Code which restrict women's freedom to control of their own bodies through making illegal information on and the purchase of contraceptives, 2) to decriminalize abortion, 3) to create family planning centers and to legalize contraceptives and provide them through the social security system, and 4) to include sex information in study courses. The distribution and sale of contraceptives was not legalized until 1978 and induced abortion is still a criminal offense. Nevertheless, after the 1975 meetins, a Coordinating Organization was established for the family planning committees that were functioning in the different feminist organizations. The problem of where to obtain contraceptives was solved by a group of feminist women which opened the 1st family planning center in Spain in 19779 This center was managed directly by members of the group. This and similar efforts culminated in the origin of the Movement for Movement for Family Planning that demanded in 1978; 1) the provision of sex information confronting the dominant sexual ideology and which is made a ccompulsory subject from school age, for both sexes; 2) free access to contraception for everyone; 3) the legalization of abortion, 4) the development of extensive information campaign on the problems of conception and contraception; and 5) the creation of independent, self-managed, family planning centers. There is now a Coordinating Organization of Family Planning Centers that was established in 1982. The socialist government is determined to create a public network of family planning centers.

Developing an indicators plan and software for evaluating Street Cleanliness and Waste Collection Services

Directory of Open Access Journals (Sweden)

Iago López

2017-12-01

Full Text Available An app to evaluate the Street Cleanliness and Waste Collection Service was developed. This app is based on a Plan of Indicators that can be used to evaluate the Street Cleanliness and Waste Collection Service of Santander municipality. Specific methodologies for calculating and evaluating 59 indicators have been developed to obtain information regarding the status of the different elements of the service. The Plan of Indicators has been applied to Santander city. The app was designed to address, but is not limited to, the following goals: i to obtain, store and calculate information regarding the above indicators and ii to disseminate the results of the status of the elements of the Service to the public sector. The app that was developed can provide a quick view of the results obtained for each indicator in each district, which is useful for making an appropriate diagnosis of the city’s cleanliness and is the first step in the decision making and Service optimisation processes. Detailed results for the Street Cleanliness Index are shown for each district of Santander city. The Street Cleanliness Index values are also related to the Frequency Street Cleanliness Services parameters. Pearson correlation coefficient results suggest that an inverse relationship between the Street Cleanliness Index values and the Frequency Street Cleanliness Services/population density ratio exists (R2 = −0.63. The results show that Street Cleanliness Index worst values exist for those districts that have a lower Frequency Street Cleanliness Services /population density parameter. The results are useful for designing and optimising the Street Cleanliness Service. For the decision making process, resources should be allocated where necessary, which seems to be those districts with lower Frequency Street Cleanliness Services /population density ratios.

A Preliminary Study on the Effects of Training Using Behavior Support Plan Quality Evaluation Guide (BSP-QE) to Improve Positive Behavioral Support Plans

Science.gov (United States)

Wright, Diana Browning; Mayer, G. Roy; Cook, Clayton R.; Crews, S. Dean; Kraemer, Bonnie Rawlings; Gale, Bruce

2007-01-01

The purpose of this research was to evaluate the effects of two trainings designed to increase the competencies of professionals to develop high quality positive behavior support plans for students that engage in problem behaviors that interfere with theirs and/or others' ability to learn. Training one consisted of training attendees on six key…

Feature-based plan adaptation for fast treatment planning in scanned ion beam therapy

International Nuclear Information System (INIS)

Chen Wenjing; Gemmel, Alexander; Rietzel, Eike

2013-01-01

We propose a plan adaptation method for fast treatment plan generation in scanned ion beam therapy. Analysis of optimized treatment plans with carbon ions indicates that the particle number modulation of consecutive rasterspots in depth shows little variation throughout target volumes with convex shape. Thus, we extract a depth-modulation curve (DMC) from existing reference plans and adapt it for creation of new plans in similar treatment situations. The proposed method is tested with seven CT serials of prostate patients and three digital phantom datasets generated with the MATLAB code. Plans are generated with a treatment planning software developed by GSI using single-field uniform dose optimization for all the CT datasets to serve as reference plans and ‘gold standard’. The adapted plans are generated based on the DMC derived from the reference plans of the same patient (intra-patient), different patient (inter-patient) and phantoms (phantom-patient). They are compared with the reference plans and a re-positioning strategy. Generally, in 1 min on a standard PC, either a physical plan or a biological plan can be generated with the adaptive method provided that the new target contour is available. In all the cases, the V95 values of the adapted plans can achieve 97% for either physical or biological plans. V107 is always 0 indicating no overdosage, and target dose homogeneity is above 0.98 in all cases. The dose received by the organs at risk is comparable to the optimized plans. The plan adaptation method has the potential for on-line adaptation to deal with inter-fractional motion, as well as fast off-line treatment planning, with either the prescribed physical dose or the RBE-weighted dose. (paper)

Dosimetric impact of systematic MLC positional errors on step and shoot IMRT for prostate cancer: a planning study

International Nuclear Information System (INIS)

Ung, N.M.; Wee, L.; Harper, C.S.

2010-01-01

Full text: The positional accuracy of multi leaf collimators (MLC) is crucial in ensuring precise delivery of intensity-modulated radiotherapy (IMRT). The aim of this planning study was to investigate the dosimetric impact of systematic MLC errors on step and shoot IMRT of prostate cancer. Twelve MLC leaf banks perturbations were introduced to six prostate IMRT treatment plans to simulate MLC systematic errors. Dose volume histograms (OYHs) were generated for the extraction of dose endpoint parameters. Plans were evaluated in terms of changes to the defined endpoint dose parameters, conformity index (CI) and healthy tissue avoidance (HTA) to planning target volume (PTY), rectum and bladder. Negative perturbations of MLC had been found to produce greater changes to endpoint dose parameters than positive perturbations of MLC (p < 0.05). Negative and positive synchronized MLC perturbations of I mm resulted in median changes of -2.32 and 1.78%, respectively to 095% of PTY whereas asynchronized MLC perturbations of the same direction and magnitude resulted in median changes of 1.18 and 0.90%, respectively. Doses to rectum were generally more sensitive to systematic MLC errors compared to bladder. Synchronized MLC perturbations of I mm resulted in median changes of endpoint dose parameters to both rectum and bladder from about I to 3%. Maximum reduction of -4.44 and -7.29% were recorded for CI and HTA, respectively, due to synchronized MLC perturbation of I mm. In summary, MLC errors resulted in measurable amount of dose changes to PTY and surrounding critical structures in prostate LMRT. (author)

Voltage directive drive with claw pole motor and control without rotor position indicator

Science.gov (United States)

Stroenisch, Volker Ewald

Design and testing of a voltage directive drive for synchronous variable speed claw pole motor and control without rotor position indicator is described. Economic analysis of the designed regulation is performed. Computations of stationary and dynamic behavior are given and experimental operational behavior is determined. The motors can be used for electric transportation vehicles, diesel motors, and electric railway engines.

SU-F-T-388: Comparison of Biophysical Indices in Hippocampal-Avoidance Whole Brain VMAT and IMRT Radiation Therapy Treatment Plans

International Nuclear Information System (INIS)

Kendall, E; Ahmad, S; Algan, O; Higby, C; Hossain, S

2016-01-01

Purpose: To compare biophysical indices of Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) treatment plans for whole brain radiation therapy following the NRG-CC001 protocol. Methods: In this retrospective study, a total of fifteen patients were planned with Varian Eclipse Treatment Planning System using VMAT (RapidArc) and IMRT techniques. The planning target volume (PTV) was defined as the whole brain volume excluding a uniform three-dimensional 5mm expansion of the hippocampus volume. Prescribed doses in all plans were 30 Gy delivered over 10 fractions normalized to a minimum of 95% of the target volume receiving 100% of the prescribed dose. The NRG Oncology protocol guidelines were followed for contouring and dose-volume constraints. A single radiation oncologist evaluated all treatment plans. Calculations of statistical significance were performed using Student’s paired t-test. Results: All VMAT and IMRT plans met the NRG-CC001 protocol dose-volume criteria. The average equivalent uniform dose (EUD) for the PTV for VMAT vs. IMRT was respectively (19.05±0.33 Gy vs. 19.38±0.47 Gy) for α/β of 2 Gy and (19.47±0.30 Gy vs. 19.84±0.42 Gy) for α/β of 10 Gy. For the PTV, the average mean and maximum doses were 2% and 5% lower in VMAT plans than in IMRT plans, respectively. The average EUD and the normal tissue complication probability (NTCP) for the hippocampus in VMAT vs. IMRT plans were (15.28±1.35 Gy vs. 15.65±0.99 Gy, p=0.18) and (0.305±0.012 Gy vs. 0.308±0.008 Gy, p=0.192), respectively. The average EUD and NTCP for the optic chiasm were both 2% higher in VMAT than in IMRT plans. Conclusion: Though statistically insignificant, VMAT plans indicate a lower hippocampus EUD than IMRT plans. Also, a small variation in NTCP was found between plans.

SU-F-T-388: Comparison of Biophysical Indices in Hippocampal-Avoidance Whole Brain VMAT and IMRT Radiation Therapy Treatment Plans

Energy Technology Data Exchange (ETDEWEB)

Kendall, E; Ahmad, S; Algan, O; Higby, C; Hossain, S [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

2016-06-15

Purpose: To compare biophysical indices of Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) treatment plans for whole brain radiation therapy following the NRG-CC001 protocol. Methods: In this retrospective study, a total of fifteen patients were planned with Varian Eclipse Treatment Planning System using VMAT (RapidArc) and IMRT techniques. The planning target volume (PTV) was defined as the whole brain volume excluding a uniform three-dimensional 5mm expansion of the hippocampus volume. Prescribed doses in all plans were 30 Gy delivered over 10 fractions normalized to a minimum of 95% of the target volume receiving 100% of the prescribed dose. The NRG Oncology protocol guidelines were followed for contouring and dose-volume constraints. A single radiation oncologist evaluated all treatment plans. Calculations of statistical significance were performed using Student’s paired t-test. Results: All VMAT and IMRT plans met the NRG-CC001 protocol dose-volume criteria. The average equivalent uniform dose (EUD) for the PTV for VMAT vs. IMRT was respectively (19.05±0.33 Gy vs. 19.38±0.47 Gy) for α/β of 2 Gy and (19.47±0.30 Gy vs. 19.84±0.42 Gy) for α/β of 10 Gy. For the PTV, the average mean and maximum doses were 2% and 5% lower in VMAT plans than in IMRT plans, respectively. The average EUD and the normal tissue complication probability (NTCP) for the hippocampus in VMAT vs. IMRT plans were (15.28±1.35 Gy vs. 15.65±0.99 Gy, p=0.18) and (0.305±0.012 Gy vs. 0.308±0.008 Gy, p=0.192), respectively. The average EUD and NTCP for the optic chiasm were both 2% higher in VMAT than in IMRT plans. Conclusion: Though statistically insignificant, VMAT plans indicate a lower hippocampus EUD than IMRT plans. Also, a small variation in NTCP was found between plans.

Implication of spot position error on plan quality and patient safety in pencil-beam-scanning proton therapy

Energy Technology Data Exchange (ETDEWEB)

Yu, Juan; Beltran, Chris J., E-mail: beltran.chris@mayo.edu; Herman, Michael G. [Division of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

2014-08-15

Purpose: To quantitatively and systematically assess dosimetric effects induced by spot positioning error as a function of spot spacing (SS) on intensity-modulated proton therapy (IMPT) plan quality and to facilitate evaluation of safety tolerance limits on spot position. Methods: Spot position errors (PE) ranging from 1 to 2 mm were simulated. Simple plans were created on a water phantom, and IMPT plans were calculated on two pediatric patients with a brain tumor of 28 and 3 cc, respectively, using a commercial planning system. For the phantom, a uniform dose was delivered to targets located at different depths from 10 to 20 cm with various field sizes from 2{sup 2} to 15{sup 2} cm{sup 2}. Two nominal spot sizes, 4.0 and 6.6 mm of 1 σ in water at isocenter, were used for treatment planning. The SS ranged from 0.5 σ to 1.5 σ, which is 2–6 mm for the small spot size and 3.3–9.9 mm for the large spot size. Various perturbation scenarios of a single spot error and systematic and random multiple spot errors were studied. To quantify the dosimetric effects, percent dose error (PDE) depth profiles and the value of percent dose error at the maximum dose difference (PDE [ΔDmax]) were used for evaluation. Results: A pair of hot and cold spots was created per spot shift. PDE[ΔDmax] is found to be a complex function of PE, SS, spot size, depth, and global spot distribution that can be well defined in simple models. For volumetric targets, the PDE [ΔDmax] is not noticeably affected by the change of field size or target volume within the studied ranges. In general, reducing SS decreased the dose error. For the facility studied, given a single spot error with a PE of 1.2 mm and for both spot sizes, a SS of 1σ resulted in a 2% maximum dose error; a SS larger than 1.25 σ substantially increased the dose error and its sensitivity to PE. A similar trend was observed in multiple spot errors (both systematic and random errors). Systematic PE can lead to noticeable hot

The solvent management plan as a source of eco-efficiency indicators

International Nuclear Information System (INIS)

D'Amico, Flaviano; Valardi, Maria; Buleandra, Marian Mihai; Tanase, Ion

2006-01-01

Reducing emissions of VOCs (volatil organic compounds) is a top-priority environmental goal, because when they react in the atmosphere with NO X , CO and solar radiation, they form tropospheric ozone, a pollutant that has a large environmental impact and contributes to world climate change. The most innovative part of the solvent directive concerns the Solvent Management Plan (SMP): a very useful tool, especially for small and medium-sized enterprises. With relatively small changes, the SMP can be turned into a Solvent Management System (SMS) having the features of an Environmental Management System. By applying an SMP-SMS, a great number of indicators can be developed, analysed and used to improve eco-efficiency; furthermore, the SMP-SMS can help local authorities in charge of environmental control procedures, in decision-making processes [it

Indicators and SEA

DEFF Research Database (Denmark)

Gao, Jingjing; Kørnøv, Lone; Christensen, Per

Abstract: Indicators are widely used in SEA to measure, communicate and monitor impacts from a proposed policy, plan or programme, and can improve the effectiveness for the SEA by simplifying the complexity of both assessment and presentation. Indicators can be seen as part of the implementation...... and if the information requirement for different target groups is not addressed. Indicators are widely used in SEA to measure, communicate and monitor impacts from a proposed policy, plan or programme, and can improve the effectiveness for the SEA by simplifying the complexity of both assessment and presentation...... process helping to understand, communicate and, integrate important environmental issues in planning and decision-making. On the other hand, use of indicators can also limit SEA effectiveness, if the ones chosen are biased or limited, if the aggregation gives incorrect interpretation...

Is decreased diameter of renal pelvis in prone position an indicator of successful pyeloplasty?

International Nuclear Information System (INIS)

Sharma, Gyanendra; Sharma, Anshu; Leung, Vivian Yee-Fong; Chu, Winnie Chiu-Wing

2016-01-01

To evaluate patients who had undergone pyeloplasty for pelviureteric junction obstruction, by measuring the anteroposterior diameter (APD) of the renal pelvis in supine and prone positions, and determine whether a decrease in APD in prone position can exclude obstruction in dilated renal system. From January 2012 to December 2013, patients who had undergone pyeloplasty were evaluated by ultrasound in two centers. The difference of APD of the renal pelvis in supine and prone positions was obtained. Correlation was made with the pre- and post-pyeloplasty renal function by radionuclide renogram. There were 42 patients (31 males, 11 females; age range 5 months to 18 years). Residual hydronephrosis was detected in 41 patients of whom 35 patients (85%) showed decrease in APD by >10% in prone position. These patients and the one without hydronephrosis showed either no deterioration or improvement in renal function. Six patients (15%) showed either no change or increase in APD in prone position. Three patients (7.5%) were confirmed to have decrease in renal function indicating obstruction. Three patients (7.5%) showed no deterioration of renal function, but sluggish drainage on radionuclide renogram. Demonstration of decreased APD of renal pelvis in prone position by ultrasound is useful to differentiate obstructed from non-obstructed dilated renal system, and it correctly identified 85% candidates with successful pyeloplasty. In patients with no decrease or increase in APD at prone position, further follow-up is recommended to rule out obstruction

Social impact assessment and management methodology using social indicators and planning strategies

International Nuclear Information System (INIS)

Olsen, M.E.; Curry, M.G.; Greene, M.R.; Melber, B.D.; Merwin, D.J.

1978-08-01

The scope of environmental impact statements prepared during the past few years has steadily expanded to incorporate all aspects of the social as well as the natural environment, including demographic, economic, social, political, and cultural conditions. Broadly conceived, social impacts are alterations in people's living conditions that occur in conjunction with a new policy, program, or project, and that (1) are in addition to all other concurrent changes produced by other factors, and (2) are seen by those affected as significant social events. Since any social environment is constantly changing, the crucial problems in analyzing social impacts are to identify those social alterations that are a direct or indirect result of the specific action under examination, apart from all other events and changes, and to determine which of these alterations are having significant social effects on the people involved. Three features of this conception of social impacts are especially noteworthy. First, although impacts are often thought of as undesirable or detrimental in nature, they may also be desirable or beneficial. Second, although impacts are often described as caused by prior intervening innovations, in reality they always interact with their original causes in a reciprocal process, either immediately or after some time lag. Third, the purpose of social impact assessment is to enable policy makers to anticipate and plan for potential impacts before they occur, and then act to prevent or mitigate undesired impacts. A new methodology for performing social impact assessment and management studies that meet current needs by emphasizing standardized social indicators and social planning techniques is proposed. We refer to our approach as the Social Impact and Planning (SIP) method of social impact assessment

Key Performance Indicators for the Impact of Cognitive Assembly Planning on Ramp-Up Process

Directory of Open Access Journals (Sweden)

Christian Buescher

2012-01-01

Full Text Available Within the ramp-up phase of highly automated assembly systems, the planning effort forms a large part of production costs. Due to shortening product lifecycles, changing customer demands, and therefore an increasing number of ramp-up processes, these costs even rise. So assembly systems should reduce these efforts and simultaneously be flexible for quick adaption to changes in products and their variants. A cognitive interaction system in the field of assembly planning systems is developed within the Cluster of Excellence “Integrative production technology for high-wage countries” at RWTH Aachen University which integrates several cognitive capabilities according to human cognition. This approach combines the advantages of automation with the flexibility of humans. In this paper the main principles of the system's core component—the cognitive control unit—are presented to underline its advantages with respect to traditional assembly systems. Based on this, the actual innovation of this paper is the development of key performance indicators. These refer to the ramp-up process as a main objective of such a system is to minimize the planning effort during ramp-up. The KPIs are also designed to show the impact on the main idea of the Cluster of Excellence in resolving the so-called Polylemma of Production.

Home continuous positive airway pressure for cardiopulmonary indications in infants and children.

Science.gov (United States)

Al-Iede, Montaha; Kumaran, Radhagini; Waters, Karen

2018-04-30

A number of reports exist regarding the use of continuous positive airway pressure (CPAP) to manage obstructive sleep apnoea (OSA) in children, which we term 'conventional CPAP'. In contrast, there are few reports of home CPAP use for other indications, which we have grouped under the term 'cardiopulmonary'. The aims of this study were to (1) document cardiopulmonary indications for CPAP use in a cohort of infants and children, and (2) evaluate its effectiveness in this group. Hospital records were reviewed for 645 patients who were commenced on long-term CPAP over a 10-year period at a single-tertiary hospital (Children's Hospital at Westmead). This study evaluated the group where the primary indication for CPAP was not OSA ('cardiopulmonary CPAP'). Data evaluated included: demographics, diagnoses, indications for CPAP, hours of use (compliance) and sleep study results at baseline and on CPAP. Of 645 children, 148 (23%) used home CPAP for cardiopulmonary indications; and 130 (87.8%) of these were included. For this group, mean age at CPAP initiation was 18.6 ± 33.6 months (range one week to 16.8 years). Cardiopulmonary indications for CPAP use included: primary airway diseases 65 (50%), chronic lung diseases 33 (25.4%), congenital heart disease (CHD) 20 (15.4%), and both CHD and airway malacia 12 (9.2%). All sleep study variables improved on CPAP relative to the diagnostic sleep study (p 4 h/night). Interstitial lung diseases and other cardiorespiratory disorders, often of congenital origin, can be effectively treated with home CPAP whether they are associated with OSA or not. Sleep studies demonstrated improved gas exchange, sleep and reduced work of breathing with CPAP use. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of MLC leaf position, collimator rotation angle, and gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Bai, Sen; Li, Guangjun; Wang, Maojie; Jiang, Qinfeng; Zhang, Yingjie [State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan (China); Wei, Yuquan, E-mail: yuquawei@vip.sina.com [State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan (China)

2013-07-01

The purpose of this study was to investigate the effect of multileaf collimator (MLC) leaf position, collimator rotation angle, and accelerator gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma. To compare dosimetric differences between the simulating plans and the clinical plans with evaluation parameters, 6 patients with nasopharyngeal carcinoma were selected for simulation of systematic and random MLC leaf position errors, collimator rotation angle errors, and accelerator gantry rotation angle errors. There was a high sensitivity to dose distribution for systematic MLC leaf position errors in response to field size. When the systematic MLC position errors were 0.5, 1, and 2 mm, respectively, the maximum values of the mean dose deviation, observed in parotid glands, were 4.63%, 8.69%, and 18.32%, respectively. The dosimetric effect was comparatively small for systematic MLC shift errors. For random MLC errors up to 2 mm and collimator and gantry rotation angle errors up to 0.5°, the dosimetric effect was negligible. We suggest that quality control be regularly conducted for MLC leaves, so as to ensure that systematic MLC leaf position errors are within 0.5 mm. Because the dosimetric effect of 0.5° collimator and gantry rotation angle errors is negligible, it can be concluded that setting a proper threshold for allowed errors of collimator and gantry rotation angle may increase treatment efficacy and reduce treatment time.

Which characteristics of planning matter? Individual and dyadic physical activity plans and their effects on plan enactment.

Science.gov (United States)

Keller, Jan; Fleig, Lena; Hohl, Diana Hilda; Wiedemann, Amelie U; Burkert, Silke; Luszczynska, Aleksandra; Knoll, Nina

2017-09-01

Past research supports individual planning as an effective intervention strategy to increase physical activity in individuals. A similar strategy, dyadic planning, adds a planning partner who supports an individual's planning processes. Whether the two planning formats differ in terms of participants' entered plan content and whether and how different content characteristics are linked to plan enactment remains unknown. By investigating the content of generated plans, this study aimed at distinguishing plan characteristics of the two planning formats and examining their role as predictors of later plan enactment. Secondary analyses of a three-arm RCT with German couples (data collection between 2013 and 2015). Couples were assigned to an individual (IPC, n = 114) or dyadic planning condition (DPC, n = 111) and formulated up to 5 physical activity plans for a target person. Couples assigned to a control condition were not included as they did not generate plans. The following characteristics were distinguished and coded for each plan: number of planned opportunities, presence of a planned routine, planned cue- or activity-related specificity, activity-related intensity, and chronological plan rank. One week before (T0) and two weeks following (T2) the intervention (T1), increase vs. no increase of the planned activity was coded as a dichotomous plan enactment variable. Multilevel logistic regressions were fit. Plan enactment was higher in dyadic than in individual planners. Findings indicated that routines (e.g., after work) were positively related to plan enactment, whereas a high specificity of when-cues (e.g., Friday at 6.30 p.m.) showed a negative relationship. None of the examined plan characteristics could explain differences in enactment between IPC and DPC. Linking health behaviours to other behavioural routines seems beneficial for subsequent plan enactment. Dyadic planning was linked with higher enactment rates than individual planning. However, as

Israel's position on non-proliferation

International Nuclear Information System (INIS)

Marom, R.

1986-01-01

Israel maintained that the complex international system and worldwide political tension created a situation in which comprehensive plans of disarmament could not produce any positive result. The deadlock in the field of general and complete disarmament has brought Israel to the realization that one possible way to alleviate the stalemate could be progress by stages through partial measures of disarmament. Israel's position on non-proliferation indicates that the establishment of a nuclear-weapon-free-zone (NWFZ), as it relates to the Middle-East, could serve as a credible alternative to the unilateral adherence to the Non-Proliferation of Nuclear Weapon (NPT) and an effective measure of non-proliferation in the region. (Author)

Bridging centrality: A new indicator to measure the positioning of actors in R&D networks

Energy Technology Data Exchange (ETDEWEB)

Scherngell, T.; Wanzenboeck, I.; Berge, L.

2016-07-01

In the recent past, we can observe growing interest in the STI community in the notion of positioning indicators, shifting emphasis to actors in the innovation process and their R&D inter-linkages with other actors. In relation to this, we suggest a new approach for assessing the positioning of actors relying on the notion of bridging centrality (BC). Based on the concept of bridging paths, i.e. a set of two links connecting three actors across three different aggregate nodes (e.g. organisations, regions or countries), we argue that triangulation in networks is a key issue for knowledge recombinations and the extension of an actor's knowledge base. As bridges are most often not empirically observable at the individual level of research teams, we propose an approximated BC measure that provides a flexible framework for dealing with the aggregation problem in positioning actors. Hereby, BC is viewed as a function of an aggregate node's (i) participation intensity in the network, (ii) its openness to other nodes (i.e. the relative outward orientation of network links), and iii) the diversification of links to other nodes. In doing so, we provide an integrative perspective that enables us to achieve a better understanding of the positioning of certain actors in R&D networks. An illustrative example on the co-patent network of European regions demonstrates the performance and usefulness of our BC measure for networks constructed at the aggregated level, i.e. regions in our example. A region's outward orientation and the diversification of its network links moderates the influence of regional scale on network centrality. This is a major strength of the measure, and it paves the way for future studies to examine the role of certain aggregate node's, and, by this, contributes to the debate on positioning indicators in the STI context. (Author)

On correlations in IMRT planning aims

Science.gov (United States)

Roy, Arkajyoti; Das, Indra J.

2016-01-01

The purpose was to study correlations amongst IMRT DVH evaluation points and how their relaxation impacts the overall plan. 100 head‐and‐neck cancer cases, using the Eclipse treatment planning system with the same protocol, are statistically analyzed for PTV, brainstem, and spinal cord. To measure variations amongst the plans, we use (i) interquartile range (IQR) of volume as a function of dose, (ii) interquartile range of dose as a function of volume, and (iii) dose falloff. To determine correlations for institutional and ICRU goals, conditional probabilities and medians are computed. We observe that most plans exceed the median PTV dose (average D50 = 104% prescribed dose). Furthermore, satisfying D50 reduced the probability of also satisfying D98, constituting a negative correlation of these goals. On the other hand, satisfying D50 increased the probability of satisfying D2, suggesting a positive correlation. A positive correlation is also observed between the PTV V105 and V110. Similarly, a positive correlation between the brainstem V45 and V50 is measured by an increase in the conditional median of V45, when V50 is violated. Despite the imposed institutional and international recommendations, significant variations amongst DVH points can occur. Even though DVH aims are evaluated independently, sizable correlations amongst them are possible, indicating that some goals cannot be satisfied concurrently, calling for unbiased plan criteria. PACS number(s): 87.55.dk, 87.53.Bn, 87.55.Qr, 87.55.de. PMID:27929480

On the Methodology of Formulation and Assessment of Implementing Strategies and Indicative Plans for Regional Development

Directory of Open Access Journals (Sweden)

Suspitsyn S. A.

2009-06-01

Full Text Available Issues of the content and tools for formulating strategic documents for regional socio-economic development are studied. The research findings in the area of indicative planning and medium-term forecasting of development of multilayer regional systems by the example of the Siberian Federal District, Novosibirsk Region and the city of Novosibirsk are given

A new dimension in urban planning: the Big Data as a source for shared indicators of discomfort.

Directory of Open Access Journals (Sweden)

Paolo Scattoni

2014-10-01

Full Text Available The web has been used for years as a means of expression for the local communities in highlighting their problems, needs and hopes, often in the form of organized group discussions and fora. The enormous amount of information currently available, Big Data, is already used for business purposes in the private sector, but has never been truly available to decision makers who operate in urban planning and would represent an invaluable help for those communities that undertake the path of selfconstruction of their Community Strategic Frameworks. This paper elaborates methodological and operational proposals to identify sequences of words and common occurrences in sets of documents that would help understanding the problems of the communities on a geographicallylocated basis, creating the search engine “Social Debate” and devising new indicators for indices of disadvantage. Such tool could drastically change the perspective of public participation and planning practice and improve the quality of local public policies and decision making processes.

Excessive lateral patellar translation on axial computed tomography indicates positive patellar J sign.

Science.gov (United States)

Xue, Zhe; Song, Guan-Yang; Liu, Xin; Zhang, Hui; Wu, Guan; Qian, Yi; Feng, Hua

2018-03-20

The purpose of the study was to quantify the patellar J sign using traditional computed tomography (CT) scans. Fifty-three patients (fifty-three knees) who suffered from recurrent patellar instability were included and analyzed. The patellar J sign was evaluated pre-operatively during active knee flexion and extension. It was defined as positive when there was obvious lateral patellar translation, and negative when there was not. The CT scans were performed in all patients with full knee extension; and the parameters including bisect offset index (BOI), patellar-trochlear-groove (PTG) distance, and patellar lateral tilt angle (PLTA) were measured on the axial slices. All the three parameters were compared between the J sign-positive group (study group) and the J sign-negative group (control group). In addition, the optimal thresholds of the three CT scan parameters for predicting the positive patellar J sign were determined with receiver operating characteristic (ROC) curves, and the diagnostic values were assessed by the area under the curve (AUC). Among the fifty-three patients (fifty-three knees), thirty-seven (70%) showed obvious lateral patellar translation, which were defined as positive J sign (study group), and the remaining sixteen (30%) who showed no lateral translation were defined as negative J sign (control group). The mean values of the three CT parameters in the study group were all significantly larger compared to the control group, including BOI (121 ± 28% vs 88 ± 12%, P = 0.038), PTG distance (5.2 ± 6.6 mm vs - 4.4 ± 5.2 mm, P J sign was 97.5% (Sensitivity = 83.3%, Specificity = 87.5%). In this study, the prevalence of positive patellar J sign was 70%. The BOI measured from the axial CT scans of the knee joint can be used as an appropriate predictor to differentiate the positive J sign from the negative J sign, highlighting that the excessive lateral patellar translation on axial CT scan indicates positive

Measuring socio-economic position in dietary research: is choice of socio-economic indicator important?

Science.gov (United States)

Turrell, Gavin; Hewitt, Belinda; Patterson, Carla; Oldenburg, Brian

2003-04-01

To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour. The sample was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables. Brisbane City, Australia, 2000. : Non-institutionalised residents of private dwellings located in 50 small areas (Census Collectors Districts). When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices; however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant; income, however, showed a strong, graded association with food choice. The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet

Tracking sentence planning and production.

Science.gov (United States)

Kemper, Susan; Bontempo, Daniel; McKedy, Whitney; Schmalzried, RaLynn; Tagliaferri, Bruno; Kieweg, Doug

2011-03-01

To assess age differences in the costs of language planning and production. A controlled sentence production task was combined with digital pursuit rotor tracking. Participants were asked to track a moving target while formulating a sentence using specified nouns and verbs and to continue to track the moving target while producing their response. The length of the critical noun phrase (NP) as well as the type of verb provided were manipulated. The analysis indicated that sentence planning was more costly than sentence production, and sentence planning costs increased when participants had to incorporate a long NP into their sentence. The long NPs also tended to be shifted to the end of the sentence, whereas short NPs tended to be positioned after the verb. Planning or producing responses with long NPs was especially difficult for older adults, although verb type and NP shift had similar costs for young and older adults. Pursuit rotor tracking during controlled sentence production reveals the effects of aging on sentence planning and production.

The Client Risk and The Audit Planning: Influence of Acceptance of Audit Engagement

Directory of Open Access Journals (Sweden)

Deby Suryani

2018-03-01

Full Text Available This study briefly aims to extend the relationship between client risks with the audit planning by proposes the acceptance of audit engagement as a mediate variable to fill a gap research, furthermore to determine the effect of client risk toward the audit planning in Public Accounting Firm in Jakarta, Indonesia. This research is a quantitative causal with primary data obtained by questionnaires. The population of this study is the auditors of Public Accounting Firm registered in the Directory Indonesian Institute of Accountants (Certified 2016 in Jakarta and to obtain the sample used purposive sampling technique and obtained samples of 197 respondents from 45 Public Accounting Firms spread in Jakarta. The analysis of data is using Structural Equation Modeling. The results of this research shows; (1. The Client risks directly may affect the audit planning in a positive but not significantly, (2. The Client risk directly affects the acceptance of audit positively and significantly, (3. The acceptance of audit engagement has positively and significantly influence on audit planning. Therefore the acceptance of audit engagement perfectly can act as mediate variable between client's risks with the audit planning, whereas the acceptance of audit engagement indicated by Time Budget Pressure, Audit Fee. Letter of Auditing and all indicator have a high loading factor.

Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation.

Science.gov (United States)

Boonen, Bert; Schotanus, Martijn G M; Kerens, Bart; Hulsmans, Frans-Jan; Tuinebreijer, Wim E; Kort, Nanne P

2017-09-01

To assess whether there is a significant difference between the alignment of the individual femoral and tibial components (in the frontal, sagittal and horizontal planes) as calculated pre-operatively (digital plan) and the actually achieved alignment in vivo obtained with the use of patient-specific positioning guides (PSPGs) for TKA. It was hypothesised that there would be no difference between post-op implant position and pre-op digital plan. Twenty-six patients were included in this non-inferiority trial. Software permitted matching of the pre-operative MRI scan (and therefore calculated prosthesis position) to a pre-operative CT scan and then to a post-operative full-leg CT scan to determine deviations from pre-op planning in all three anatomical planes. For the femoral component, mean absolute deviations from planning were 1.8° (SD 1.3), 2.5° (SD 1.6) and 1.6° (SD 1.4) in the frontal, sagittal and transverse planes, respectively. For the tibial component, mean absolute deviations from planning were 1.7° (SD 1.2), 1.7° (SD 1.5) and 3.2° (SD 3.6) in the frontal, sagittal and transverse planes, respectively. Absolute mean deviation from planned mechanical axis was 1.9°. The a priori specified null hypothesis for equivalence testing: the difference from planning is >3 or plan in all planes, except for the tibial rotation in the transverse plane. Possible explanations for outliers are discussed and highlight the importance for adequate training surgeons before they start using PSPG in their day-by-day practise. Prospective cohort study, Level II.

Technical Note: Dosimetric effects of couch position variability on treatment plan quality with an MRI-guided Co-60 radiation therapy machine

Energy Technology Data Exchange (ETDEWEB)

Chow, Phillip E., E-mail: pechow@mednet.ucla.edu; Thomas, David H.; Agazaryan, Nzhde; Cao, Minsong; Low, Daniel A.; Yang, Yingli; Steinberg, Michael L.; Lee, Percy; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 (United States)

2016-08-15

Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that pass through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.

Accuracy of a computer-assisted planning and placement system for anatomical femoral tunnel positioning in anterior cruciate ligament reconstruction

NARCIS (Netherlands)

Luites, J.W.H.; Wymenga, A.B.; Blankevoort, L.; Eygendaal, D.; Verdonschot, Nicolaas Jacobus Joseph

2014-01-01

Background Femoral tunnel positioning is a difficult, but important factor in successful anterior cruciate ligament (ACL) reconstruction. Computer navigation can improve the anatomical planning procedure besides the tunnel placement procedure. Methods The accuracy of the computer-assisted femoral

A machine learning approach to the accurate prediction of multi-leaf collimator positional errors

Science.gov (United States)

Carlson, Joel N. K.; Park, Jong Min; Park, So-Yeon; In Park, Jong; Choi, Yunseok; Ye, Sung-Joon

2016-03-01

Discrepancies between planned and delivered movements of multi-leaf collimators (MLCs) are an important source of errors in dose distributions during radiotherapy. In this work we used machine learning techniques to train models to predict these discrepancies, assessed the accuracy of the model predictions, and examined the impact these errors have on quality assurance (QA) procedures and dosimetry. Predictive leaf motion parameters for the models were calculated from the plan files, such as leaf position and velocity, whether the leaf was moving towards or away from the isocenter of the MLC, and many others. Differences in positions between synchronized DICOM-RT planning files and DynaLog files reported during QA delivery were used as a target response for training of the models. The final model is capable of predicting MLC positions during delivery to a high degree of accuracy. For moving MLC leaves, predicted positions were shown to be significantly closer to delivered positions than were planned positions. By incorporating predicted positions into dose calculations in the TPS, increases were shown in gamma passing rates against measured dose distributions recorded during QA delivery. For instance, head and neck plans with 1%/2 mm gamma criteria had an average increase in passing rate of 4.17% (SD  =  1.54%). This indicates that the inclusion of predictions during dose calculation leads to a more realistic representation of plan delivery. To assess impact on the patient, dose volumetric histograms (DVH) using delivered positions were calculated for comparison with planned and predicted DVHs. In all cases, predicted dose volumetric parameters were in closer agreement to the delivered parameters than were the planned parameters, particularly for organs at risk on the periphery of the treatment area. By incorporating the predicted positions into the TPS, the treatment planner is given a more realistic view of the dose distribution as it will truly be

Indicator taxa revisited: useful for conservation planning?

DEFF Research Database (Denmark)

Larsen, Frank Wugt; Bladt, Jesper; Rahbek, Carsten

2009-01-01

Aim:  Indicators for biodiversity are needed to facilitate the identification of complementary reserve networks for biodiversity conservation. One widely adopted approach is to use indicator taxa, i.e. a single taxon such as birds or butterflies, despite the ongoing debate regarding their usefuln......Aim:  Indicators for biodiversity are needed to facilitate the identification of complementary reserve networks for biodiversity conservation. One widely adopted approach is to use indicator taxa, i.e. a single taxon such as birds or butterflies, despite the ongoing debate regarding...

Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

International Nuclear Information System (INIS)

Jang, Na Young; Lee, Keun-Wook; Ahn, Soon-Hyun; Kim, Jae-Sung; Ah Kim, In

2012-01-01

The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy

Biochemical aspects of the neoplastic cell in relation to positive indicators

International Nuclear Information System (INIS)

Strom, R.

1975-01-01

In scintigraphic diagnoses with positive indicators, the capacity of these indicators to fix themselves or to selectively concentrate in the neoplastic tissue is utilized. This selectivity could be due to several biochemical peculiarities of the tumor cells in relation to surrounding cells: the presence on the membrane of particular chemical groups which allow these cells to invade adjacent tissue without being subject to contact inhibition; the presence on these same membranes of antigenic determinants which are particular to these cells and which can be revealed with specific antibodies; a high concentration of nucleic acid in tumor cells, with the associated possibility of fixing substances having a particular tropism for nucleic acids or for their chemical constituents; an elevated rate of nucleic acid synthesis, with an associated increase in the incorporation of precursors and also of substances which specifically interfere with this biochemical pathway; in numerous cases, tumor cells produce high quantities of acidic metabolites which must be neutralized by equivalent quantities of anions, the latter entering the cells by active transport phenomena; in tumors which develop particularly rapidly, there is a development of degenerative processes with an accumulation of degradation products; in metastatic tumors, the cells have metabolic and biosynthetic activities which are a function of the original tissue, with the possiblity of a clear metabolic difference in relation to adjacent tissues [fr

Acid sphingomyelinase activity as an indicator of the cell stress in HPV-positive and HPV-negative head and neck squamous cell carcinoma.

Science.gov (United States)

Gerle, Mirko; Medina, Tuula Peñate; Gülses, Aydin; Chu, Hanwen; Naujokat, Hendrik; Wiltfang, Jörg; Açil, Yahya

2018-03-21

Human papillomavirus (HPV) infection, especially HPV-16 and HPV-18, has been increasingly associated with head and neck squamous cell carcinoma. The treatment of HPV-positive squamous cell carcinoma has a better response to both radiotherapy and chemotherapy and presents a better prognosis for the patient. Defining the underlying mechanism of the difference might help in developing future treatment options and could be an important factor in personal therapy planning. Endogenously secreted acid sphingomyelinase (ASMase) levels in the cellular stress caused by irradiation and cisplatin were investigated. MTT assay was performed to evaluate the viability of the treated cells. Keratinocytes were used to evaluate the effects of radiation on normal tissues. Irradiation caused a dose-dependent increase in ASMase activity in both SCC9 HPV-negative, and UDSCC2 HPV-positive cells. ASMase activity in UDSCC2 cells was significantly higher than that in SCC9 cells. UDSCC cells were more sensitive to cisplatin treatment than SCC cells, and the dose-response in the activity was observed in long-time treatments when high doses of cisplatin were used. The results of the current study have clearly showed that HPV positivity should be considered as one of the determinative factors which should be considered when tumor treatments are planned. However, further studies are needed to determine the differences in cellular responses and pathways among HPV-negative and HPV-positive cells.

What contributes to action plan enactment? Examining characteristics of physical activity plans.

Science.gov (United States)

Fleig, Lena; Gardner, Benjamin; Keller, Jan; Lippke, Sonia; Pomp, Sarah; Wiedemann, Amelie U

2017-11-01

Individuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so-called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user-specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental. The study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation. The content of 619 action plans from 229 participants was evaluated by two independent raters (i.e., qualitative analyses and ratings of specificity) and by participants themselves (i.e., instrumentality and viability). Plan enactment was also measured via self-reports. Multilevel analyses examined the relationship between these plan characteristics and subsequent plan enactment, and between plan enactment and aggregated physical activity. Participants preferred to plan leisure-time physical activities anchored around time-based cues. Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment. Interestingly, individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans. Plan enactment was positively associated with aggregated behaviour. Interventions should not only emphasize the importance of planning, but also the benefits of formulating specific contextual cues. Planning of the behavioural response seems to require less precision. Allowing for some flexibility in executing the anticipated target behaviour seems to aid successful plan enactment. Statement of Contribution What is already known on this subject? Action planning interventions are efficacious in promoting health behaviour. Characteristics of plan content (i.e., specificity) matter for unconditional behaviour

Financial Therapy and Planning for Families with Special Needs Children

Directory of Open Access Journals (Sweden)

Mitzi Lauderdale

2012-06-01

Full Text Available This study examines factors associated with the likelihood of having a plan that includes a special needs trust among families that have disabled minor children. Descriptive analyses indicate that the top two reasons families provide for not having a plan are the inability to save and no perceived need. Among families that do indicate having a plan, most do not include a special needs trust. Multivariate analyses reveal that professional involvement (financial, legal, and mental health professionals is a key factor to increasing the likelihood of having a plan with a special needs trust. Families that have met with a financial advisor are 23 times more likely, and families who are encouraged to create a plan by a mental health professional are almost three times more likely, to have a plan that includes a special needs trust. Results from this study suggest that financial therapists are uniquely positioned to educate and ensure that appropriate plans are in place to provide for the future of children with special needs.

Social position and health in old age. The relevance of different indicators of social position

DEFF Research Database (Denmark)

Avlund, Kirsten; Holstein, Bjørn Evald; Osler, Merete

2002-01-01

Social medicine, social position, chronic diseases, material wealth, income, tenure, oral health, functional ability, well-being, mobility......Social medicine, social position, chronic diseases, material wealth, income, tenure, oral health, functional ability, well-being, mobility...

Positive Result by Serology Indicates Active Helicobacter pylori Infection in Patients with Atrophic Gastritis

OpenAIRE

Kokkola, Arto; Rautelin, Hilpi; Puolakkainen, Pauli; Sipponen, Pentti; Färkkilä, Martti; Haapiainen, Reijo; Kosunen, Timo U.

1998-01-01

Patients with atrophic corpus gastritis and elevated Helicobacter pylori antibody titers but 13C-urea breath test (13C-UBT) and histology results negative for H. pylori were randomized into eradication therapy or follow-up only. Antibody levels decreased significantly in six out of seven patients in the eradication group, while in the follow-up group, the titers declined in only one out of eight patients. In patients with atrophic corpus gastritis, positive serology results may indicate an on...

SU-F-T-617: Remotely Pre-Planned Stereotactic Ablative Radiation Therapy: Validation of Treatment Plan Quality

International Nuclear Information System (INIS)

Juang, T; Bush, K; Loo, B; Gensheimer, M

2016-01-01

Purpose: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors. Methods: Target/normal structures were contoured on dxCT; a plan was created and approved by the physician. Structures were transferred to simCT using deformable image registration and the plan was re-optimized on simCT. Plan quality was evaluated through comparison to gold-standard structures contoured on simCT and a gold-standard plan based on these structures. Workflow-generated plan quality in this study represents a worst-case scenario as these patients were not treated using custom immobilization to match dxCT position as would be done when the workflow is implemented clinically. Results: 5/6 plans created through the pre-planning workflow were clinically acceptable. For all six plans, the gold-standard GTV received full prescription dose, along with median PTV V95%=95.2% and median PTV D95%=95.4%. Median GTV DSC=0.80, indicating high degree of similarity between the deformed and gold-standard GTV contours despite small GTV sizes (mean=3.0cc). One outlier (DSC=0.49) resulted in inadequate PTV coverage (V95%=62.9%) in the workflow plan; in clinical practice, this mismatch between deformed/gold-standard GTV would be revised by the physician after deformable registration. For all patients, normal tissue doses were comparable to the gold-standard plan and well within constraints. Conclusion: Pre-planning SABR cases on diagnostic imaging generated

New Indicators of the Level of Social Dissatisfaction in the Planning of Social-Economic Development of the Region

Directory of Open Access Journals (Sweden)

Michel Yurevich Dolomatov

2017-03-01

Full Text Available The article is devoted to the urgent problem related to the development of the region, namely, the creation of tools for the assessment of the level of social dissatisfaction in the region. The assessment of the level of social dissatisfaction is one of the most important tasks of state organizations in political and social spheres. The article considers the concept of "social dissatisfaction" and associated terms, it substantiates the author's position on the content of this notion. The authors have investigated the existing national and international approaches to the assessing of social tensions of the population. The system of socio-economic development indicators doesn’t contain indicators allowing to assess the level of social dissatisfaction without the results of public polls. We propose two models in the article. In the first model, the assessment is basedon the single factor (the index of social dissatisfaction based on income differentiation. The second complex model takes into account a number of factors (the index of social dissatisfaction based on complex assessment. For the calculation of the proposed indicators, the authors use the statistical data of the Federal State Statistics Service. The methodological research tools include the mathematical methods of statistical data processing. We have evaluated the methodological tools on the example of the Republic of Ingushetia. The assessment has showed the dynamics of a decline in the level of social-economic dissatisfaction in the region (1995–2011. The models of social dissatisfaction constitute a tool for rapid and up-to-date assessment of socio-economic system sustainability, and of the willingness of the population to participate in protests. The application of the results of this study is the support of decision-making regions and state structures in working out plans of the socio-economic development of the regions.

[Social self-positioning as indicator of socioeconomic status].

Science.gov (United States)

Fernández, E; Alonso, R M; Quer, A; Borrell, C; Benach, J; Alonso, J; Gómez, G

2000-01-01

Self-perceived class results from directly questioning subjects about his or her social class. The aim of this investigation was to analyse self-perceived class in relation to other indicator variables of socioeconomic level. Data from the 1994 Catalan Health Interview Survey, a cross-sectional survey of a representative sample of the non-institutionalised population of Catalonia was used. We conducted a discriminant analysis to compute the degree of right classification when different socioeconomic variables potentially related to self-perceived class were considered. All subjects who directly answered the questionnaire were included (N = 12,245). With the aim of obtaining the discriminant functions in a group of subjects and to validate it in another one, the subjects were divided into two random samples, containing approximately 75% and 25% of subjects (analysis sample, n = 9,248; and validation sample, n = 2,997). The final function for men and women included level of education, social class (based in occupation) and equivalent income. This function correctly classified 40.9% of the subjects in the analysis sample and 39.2% in the validation sample. Two other functions were selected for men and women separately. In men, the function included level of education, professional category, and family income (39.2% of classification in analysis sample and 37.2% in validation sample). In women, the function (level of education, working status, and equivalent income) correctly classified 40.3% of women in analysis sample whereas the percentage was 38.9% in validation sample. The percentages of right classification were higher for the highest and lowest classes. These results show the utility of a simple variable to self-position within the social scale. Self-perceived class is related to education, income, and working determinants.

Comprehensive highway corridor planning with sustainability indicators : [research summary].

Science.gov (United States)

2013-04-01

The Maryland State Highway Administration (SHA) has initiated major planning : efforts to improve transportation efficiency, safety and sustainability on critical : highway corridors through its Comprehensive Highway Corridor (CHC) program. : It is i...

Comparison of reliability of five patellar position indices at various stifle joint angles in pelvic limbs obtained from cadavers of red foxes (Vulpes vulpes)

DEFF Research Database (Denmark)

Miles, James E; Nielsen, Dorte H; Jensen, Bente Rona

2012-01-01

To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use.......To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use....

Geo positioning application in pipeline repair and planning; Planejamento e reparo de dutos com a aplicacao de georreferenciamento

Energy Technology Data Exchange (ETDEWEB)

Sacramento, J. Paulo; S., Sandra A. Cirilo L. da; Freitas, Fabiano A.S. de [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil)

2003-07-01

The application of geo-position in the repair of pipelines, with the integration of GIS (Geographic Information Systems), inertial pig and GPS (Global Position Systems) make a change and advance in the procedures of correlation for the localization of defects informed by inspection pig. With this new procedure, already in application in pipelines of TRANSPETRO, we are getting profits with the planning to the repair services, through the anticipated knowledge of the places of intervention, reduction of the risks exposition hours in the hollowing of ditches and reduction of up to 25% in the cost of the pipeline repair. (author)

Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

Directory of Open Access Journals (Sweden)

Hilliard S

2014-12-01

Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

Changed planning for planned and unplanned change

NARCIS (Netherlands)

Woerkum, van C.; Aarts, N.; Herzele, Van A.

2011-01-01

Change, planned and unplanned, can be the product of events (change by chance), new language (change from societal interaction), and practices (track-bound change), and can involve many different societal actors. To position planning as an activity within this broader context, we present a model

Feasibility of identification of gamma knife planning strategies by identification of pareto optimal gamma knife plans.

Science.gov (United States)

Giller, C A

2011-12-01

The use of conformity indices to optimize Gamma Knife planning is common, but does not address important tradeoffs between dose to tumor and normal tissue. Pareto analysis has been used for this purpose in other applications, but not for Gamma Knife (GK) planning. The goal of this work is to use computer models to show that Pareto analysis may be feasible for GK planning to identify dosimetric tradeoffs. We define a GK plan A to be Pareto dominant to B if the prescription isodose volume of A covers more tumor but not more normal tissue than B, or if A covers less normal tissue but not less tumor than B. A plan is Pareto optimal if it is not dominated by any other plan. Two different Pareto optimal plans represent different tradeoffs between dose to tumor and normal tissue, because neither plan dominates the other. 'GK simulator' software calculated dose distributions for GK plans, and was called repetitively by a genetic algorithm to calculate Pareto dominant plans. Three irregular tumor shapes were tested in 17 trials using various combinations of shots. The mean number of Pareto dominant plans/trial was 59 ± 17 (sd). Different planning strategies were identified by large differences in shot positions, and 70 of the 153 coordinate plots (46%) showed differences of 5mm or more. The Pareto dominant plans dominated other nearby plans. Pareto dominant plans represent different dosimetric tradeoffs and can be systematically calculated using genetic algorithms. Automatic identification of non-intuitive planning strategies may be feasible with these methods.

Development of novel conformity indices for quantitative comparison of radiation treatment plans

Energy Technology Data Exchange (ETDEWEB)

Park, Jong Min; Park, So Yeon; Wu, Hong Gyun; Ye, Sung Joon; Kim, Jin Ho; Kim, Jung In [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

2013-11-15

The conformity index (CI) is an indicator to assess the degree of congruence between a shape of reference isodose volume (VRI) and a shape of the target volume (TV). Two concepts are included in the CI, which are the target coverage and the degree of normal tissue sparing in the proximity of the target. Even though this could be verified by a manual review of dose distributions calculated on patient CT images slice by slice, detailed comparisons among several treatment plans would be inconvenient. The conformity could be also verified by reviewing dose-volume histograms (DVHs) of each structure calculated by treatment planning system (TPS). The prerequisite for this is the contouring of not only organs at risk (OARs) but also every structure in a patient body, which is not practical in the clinic. Therefore, a value possible to quantify the conformity was needed, and various studies on CI have been performed. Various CIs have been developed since 1993. Most of them are based on the calculation of the volumes except for the CI suggested by Wu et al. and Cheung et al. which were based on the distance. The aim of this study was to develop new CIs based on the calculations of angles and distances. The CI angle based on the analysis of the angle differences as well as the CIabs{sub d}istance and the CIdistance based on the analysis of the distances between the TV and the VRI were developed and evaluated in this study. The CI distance with Sornatomedins better performances than the CIangle and the CIabs{sub d}istance as well as the conventional CIs in various situations.

Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

International Nuclear Information System (INIS)

Goddu, S. Murty; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N.; Low, Daniel A.

2009-01-01

Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 ± 1.3 Gy vs. 27.9 ± 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 ± 1.8 Gy vs. 37.5 ± 26.9 Gy). The mean percentage of the left lung volume receiving ≥20 Gy in the tomotherapy plans decreased from 32.6% ± 4.1% to 17.6% ± 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving ≥5 Gy for the total lung increased from 25.2% ± 4.2% for the three-dimensional technique to 46.9% ± 8.4% for the tomotherapy plan. The mean volume receiving ≥35 Gy for the heart decreased from 5.6% ± 4.8% to 2.2% ± 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 ± 3.4 Gy to 12.2 ± 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses

Anticipatory planning and control of grasp positions and forces for dexterous two-digit manipulation.

Science.gov (United States)

Fu, Qiushi; Zhang, Wei; Santello, Marco

2010-07-07

Dexterous object manipulation requires anticipatory control of digit positions and forces. Despite extensive studies on sensorimotor learning of digit forces, how humans learn to coordinate digit positions and forces has never been addressed. Furthermore, the functional role of anticipatory modulation of digit placement to object properties remains to be investigated. We addressed these questions by asking human subjects (12 females, 12 males) to grasp and lift an inverted T-shaped object using precision grip at constrained or self-chosen locations. The task requirement was to minimize object roll during lift. When digit position was not constrained, subjects could have implemented many equally valid digit position-force coordination patterns. However, choice of digit placement might also have resulted in large trial-to-trial variability of digit position, hence challenging the extent to which the CNS could have relied on sensorimotor memories for anticipatory control of digit forces. We hypothesized that subjects would modulate digit placement for optimal force distribution and digit forces as a function of variable digit positions. All subjects learned to minimize object roll within the first three trials, and the unconstrained device was associated with significantly smaller grip forces but larger variability of digit positions. Importantly, however, digit load force modulation compensated for position variability, thus ensuring consistent object roll minimization on each trial. This indicates that subjects learned object manipulation by integrating sensorimotor memories with sensory feedback about digit positions. These results are discussed in the context of motor equivalence and sensorimotor integration of grasp kinematics and kinetics.

How to use sustainability indicators for tourism planning: the case of rural tourism in Andalusia (Spain).

Science.gov (United States)

Blancas, F J; Lozano-Oyola, M; González, M; Guerrero, F M; Caballero, R

2011-12-15

This paper proposes an indicators system to analyse the sustainability of tourist activity at rural destinations in countries with a consolidated tourism sector. The proposed system aims at providing tourist managers and policy-makers with information to better understand the transition to sustainability at specific destinations and to encourage them to carry out corresponding policy and management responses. To illustrate how indicators can be quantified, we create a practical guideline on how to use the statistical information available. Likewise, we suggest a method for obtaining sustainability indexes by aggregation that reduces the subjectivity associated with the composite indicator. This procedure is based on the combination of principal component analysis and distance to a reference point. Together with the definition of sustainable tourism indicators, we explain how to use these systems and sustainability indexes to fulfil three practical uses in tourism sector planning: the comparison and characterisation of destinations, the definition of benchmarking practices, and the quantification of sustainable tourism objectives. Each practical use is illustrated using the case of rural zones in a consolidated destination such as Andalusia. Copyright © 2011 Elsevier B.V. All rights reserved.

Play and optimal welfare: Does play indicate the presence of positive affective states?

Science.gov (United States)

Ahloy-Dallaire, Jamie; Espinosa, Julia; Mason, Georgia

2017-11-16

Play is commonly used to assess affective states in both humans and non-human animals. Play appears to be most common when animals are well-fed and not under any direct threats to fitness. Could play and playfulness therefore indicate pre-existing positive emotions, and thence optimal animal welfare? We examine this question by surveying the internal and external conditions that promote or suppress play in a variety of species, starting with humans. We find that negative affective states and poor welfare usually do suppress play (although there are notable exceptions where the opposite occurs). Furthermore, research in children suggests that beyond the frequency or total duration of play, poor welfare may additionally be reflected in qualitative aspects of this heterogeneous behaviour (e.g. display of solitary over social play; and the 'fragmentation' of play bouts) that are often overlooked in animals. There are surprisingly few studies of play in subjects with pre-existing optimal welfare or in unambiguously highly positive affective states, making it currently impossible to determine whether play can distinguish optimal or good welfare from merely neutral welfare. This therefore represents an important and exciting area for future research. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-provider relationship predicts mental and physical health indicators for HIV-positive men who have sex with men.

Science.gov (United States)

Bankoff, Sarah M; McCullough, Mary B; Pantalone, David W

2013-06-01

We used secondary data analysis to examine associations among aspects of patient-provider relationships and mental and physical health indicators. Positive patient perceptions of patient-provider relationships were associated with fewer mental health symptoms in this outpatient sample of HIV-positive men who have sex with men (N = 171). Regression analyses revealed the role of anxiety and depression in explaining associations between two aspects of patient-provider relationships (i.e. quality of information offered and provider interactional style) and health-related quality of life. The findings demonstrated the importance of patient-provider relationships to improving physical health and functioning and maintaining engagement in care, among HIV-positive men who have sex with men.

Consequences for children of their birth planning status.

Science.gov (United States)

Baydar, N

1995-01-01

Of 1,327 children younger than two in 1986 whose mothers were participants in the National Longitudinal Survey of Youth, 61% were wanted, 34% were mistimed and 5% were unwanted. Planning status is associated with the level of developmental resources the child receives at home: At ages one and older, mistimed and unwanted children score significantly lower on a scale measuring opportunity for skill development and on a scale measuring nonauthoritarian parenting style than their wanted peers; by preschool age, they also have significantly less-positive relationships with their mothers. Measures of the direct effects of planning status on development also indicate that mistimed and unwanted children are at a disadvantage: Those younger than two have higher mean scores for fearfulness than wanted infants and lower scores for positive affect; unintended preschoolers score lower on a measure of receptive vocabulary.

Investigating Effects of Participatory Range Management Plans on Species Diversity in Semirum-Isfahan Province

Directory of Open Access Journals (Sweden)

M. Borhani

2016-05-01

Full Text Available In order to investigate the effects of range management plans on species diversity, richness and evenness in Semirum rangelands, 52 sites (28 with treated plan and 24 without treated plan were selected. The non-parametric indices for species richness (Margalof, Menhinick, Jacknife and counting method and species diversity (Simpson, Camargo, Smith and Wilson and modified Nee were compared in two management plans. The mean comparisons were made by independent T Student Test and Mann-Witheny U Test, and correlation was determined between diversity indices and vegetation parameters. Based on the results there was no significant difference between the two management systems regarding environmental features, while the implementation of range management plans caused significant reduction of stocking rate. Among the studied indices, evenness of species in sites without treated plan was significantly more than the sites with treated plan. The correlation matrix showed that there was a significant positive correlation between species richness and vegetation cover, production of perennial plans, and the rangeland condition and trend, while evenness showed significant negative correlation with these indices. Generally, implementation of range management plans has considerable effect on increasing climax species, dominance of Bromus tomentellus and it causes improvement of rangeland condition and reduction of evenness. This behavior could be explained by the balance between species competition and grazing pressure. Further, succession process of the studied communities demonstrates domination of some desirable species, high production and less diversity.

Influence of Lymphatic Invasion on Locoregional Recurrence Following Mastectomy: Indication for Postmastectomy Radiotherapy for Breast Cancer Patients With One to Three Positive Nodes

International Nuclear Information System (INIS)

Matsunuma, Ryoichi; Oguchi, Masahiko; Fujikane, Tomoko; Matsuura, Masaaki; Sakai, Takehiko; Kimura, Kiyomi; Morizono, Hidetomo; Iijima, Kotaro; Izumori, Ayumi; Miyagi, Yumi; Nishimura, Seiichiro; Makita, Masujiro; Gomi, Naoya; Horii, Rie; Akiyama, Futoshi; Iwase, Takuji

2012-01-01

Purpose: The indication for postmastectomy radiotherapy (PMRT) in breast cancer patients with one to three positive lymph nodes has been in discussion. The purpose of this study was to identify patient groups for whom PMRT may be indicated, focusing on varied locoregional recurrence rates depending on lymphatic invasion (ly) status. Methods and Materials: Retrospective analysis of 1,994 node-positive patients who had undergone mastectomy without postoperative radiotherapy between January 1990 and December 2000 at our hospital was performed. Patient groups for whom PMRT should be indicated were assessed using statistical tests based on the relationship between locoregional recurrence rate and ly status. Results: Multivariate analysis showed that the ly status affected the locoregional recurrence rate to as great a degree as the number of positive lymph nodes (p < 0.001). Especially for patients with one to three positive nodes, extensive ly was a more significant factor than stage T3 in the TNM staging system for locoregional recurrence (p < 0.001 vs. p = 0.295). Conclusion: Among postmastectomy patients with one to three positive lymph nodes, patients with extensive ly seem to require local therapy regimens similar to those used for patients with four or more positive nodes and also seem to require consideration of the use of PMRT.

Dosimetric study of RapidArc plans with flattened beam (FB and flattening filter-free (FFF beam for localized prostate cancer based on physical indices

Directory of Open Access Journals (Sweden)

Birendra Kumar Rout

2014-12-01

Full Text Available Purpose: To identify the continual diversity between flattening photon beam (FB and Flattening Filter Free (FFF photon beams for localized prostate cancer; and to determine potential benefits and drawbacks of using unflattened beam for this type of treatment.Methods: Eight prostate cases including seminal vesicles selected for this study. The primary planning target volume (PTVP and boost planning target volume (PTVB were contoured. The total prescription dose was 78 Gy (56 Gy to PTVP and an additional 22 Gy to PTVB. For all cases, treatment plans using 6MV with FB and FFF beams with identical dose-volume constraints, arc angles and number of arcs were developed. The dose volume histograms for both techniques were compared for primary target volume and critical structures.Results: A low Sigma index (FFF: 1.65 + 0.361; FB: 1.725 + 0.39 indicating improved dose homogeneity in FFF beam. Conformity index (FFF: 0.994 + 0.01; FB: 0.993 + 0.01 is comparable for both techniques. Minimal difference of Organ at risk mean dose was observed. Normal tissue integral dose in FB plan resulted 1.5% lower than FFF plan. All the plans displayed significant increase (1.18 times for PTVP and 1.11 for PTBB in the average number of necessary MU with FFF beam.Conclusion: Diversity between FB and FFF beam plans were found. FFF beam accelerator has been utilized to develop clinically acceptable Rapid Arc treatment plans for prostate cancer with 6 MV.---------------------------------Cite this article as: Rout BK, Muralidhar KR, Ali M, Shekar MC, Kumar A. Dosimetric study of RapidArc plans with flattened beam (FB and flattening filter-free (FFF beam for localized prostate cancer based on physical indices. Int J Cancer Ther Oncol 2014; 2(4:02046.  DOI: 10.14319/ijcto.0204.6

Ocean climate indicators: A monitoring inventory and plan for tracking climate change in the north-central California coast and ocean region

Science.gov (United States)

Duncan, Benet; Higgason, Kelley; Suchanek, Tom; Largier, John; Stachowicz, Jay; Allen, Sarah; Bograd, Steven; Breen, R.; Gellerman, Holly; Hill, Tessa; Jahncke, Jaime; Johnson, Rebecca L.; Lonhart, Steve I.; Morgan, Steven; Wilkerson, Frances; Roletto, Jan

2013-01-01

The impacts of climate change, defined as increasing atmospheric and oceanic carbon dioxide and associated increases in average global temperature and oceanic acidity, have been observed both globally and on regional scales, such as in the North-central California coast and ocean, a region that extends from Point Arena to Point Año Nuevo and includes the Pacific coastline of the San Francisco Bay Area. Because of the high economic and ecological value of the region’s marine environment, the Gulf of the Farallones National Marine Sanctuary (GFNMS) and other agencies and organizations have recognized the need to evaluate and plan for climate change impacts. Climate change indicators can be developed on global, regional, and site-specific spatial scales, and they provide information about the presence and potential impacts of climate change. While indicators exist for the nation and for the state of California as a whole, no system of ocean climate indicators exist that specifically consider the unique characteristics of the California coast and ocean region. To that end, GFNMS collaborated with over 50 regional, federal, and state natural resource managers, research scientists, and other partners to develop a set of 2 ocean climate indicators specific to this region. A smaller working group of 13 regional partners developed monitoring goals, objectives, strategies, and activities for the indicators and recommended selected species for biological indicators, resulting in the Ocean Climate Indicators Monitoring Inventory and Plan. The working group considered current knowledge of ongoing monitoring, feasibility of monitoring, costs, and logistics in selecting monitoring activities and selected species.

Planning oral narrative tasks: optimizing strategic planning condition through strategy instruction

Directory of Open Access Journals (Sweden)

André Luís Specht

2017-06-01

Full Text Available This article presents the results of a master thesis, which aimed at investigating the impact of strategic planning instruction on the speech performance of 6 L2 Brazilian learners. The participants, Letras-Inglês students, performed three now-and-there picture-cued narrative tasks under three different conditions: (1 no planning, (2 planning before instruction, and (3 planning after instruction. In addition, the participants filled in post-task questionnaires after the performance of each task, aiming at understanding their opinion on the conditions and tasks. Quantitative and qualitative analyses were conducted in order to examine participants’ oral production and perception, respectively. In general, there was no statistical evidence supporting the impact of instruction on participants’ oral planned performance; however, some statistical results approached significance, which may suggest some positive effects. Qualitative analyses provided positive evidence of the impact of strategic planning instruction on participant perception and their use of strategies during planning time. Moreover, the results of this study can contribute to the fields of Second Language Acquisition and Language Pegadogy.

FDG-PET-based radiotherapy planning in lung cancer. Optimum breathing protocol and patient positioning - an intraindividual comparison; FDG-PET-basierte Bestrahlungsplanung von nicht kleinzelligen Bronchialkarzinomen. Optimales Atemprotokoll und Patientenpositionierung - ein intraindividueller Vergleich

Energy Technology Data Exchange (ETDEWEB)

Grgic, A.; Schaefer-Schuler, A.; Kirsch, C.M.; Hellwig, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Nuklearmedizin; Nestle, U. [Universitaetsklinikum Freiburg (Germany). Klinik fuer Strahlenheilkunde; Kremp, S. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Strahlentherapie und Radioonkologie

2008-12-15

FDG-PET and PET / CT is increasingly used for radiotherapy (RT) planning in non-small-cell lung carcinoma (NSCLC). The planning process is often based on separately-acquired FDG-PET / CT and planning CT. We compared intraindividual differences between PET acquired in diagnostic and radiotherapy treatment position coregistered with planning CTs acquired using different breathing protocols. Sixteen patients with NSCLC underwent two PET acquisitions (diagnostic position-D-PET, radiotherapy position-RT-PET) and three planning-CT acquisitions (expiration-EXP, inspiration-INS, mid-breathhold-MID) on the same day. All scans were rigidly coregistered resulting in six fused datasets: D-INS, D-EXP, D-MID, RT-INS, RT-EXP and RT-MID. Fusion accuracy was assessed by three readers at eight anatomical landmarks: lung apices, aortic arch, heart, spine, sternum, carina, diaphragm and tumor using an alignment score ranging from 1 (no alignment) to 5 (exact alignment). RT-PET showed better alignment with any CT than D-PET (p < 0.001). With regard to breathing, RT-MID showed the best mean alignment score (3.7 {+-} 1.0) followed by RT-EXP (3.5 {+-} 0.9) and RT-INS (3.0 {+-} 0.8), all differences being significant (p < 0.001). Comparing the alignment scores with regard to anatomical landmarks, the largest deviations were found at diaphragm, heart and apices. Overall, there was a fair agreement (? = 0.48; p < 0.001) among the three readers. Significantly better fusion of PET and planning-CT can be reached with PET acquired in RT-position. The best intraindividual fusion results are obtained with the planning-CT performed during mid-breathhold. Our data justify the acquisition of a separate planning-PET in RT-treatment position if only a diagnostic PET-scan is available. (orig.)

Pluri annual indicative plan of the investments in the gas sector; Plan indicatif pluriannuel des investissements dans le secteur du gaz Periode 2006-2015

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-03-15

This indicative plan constitutes the first report to the Parliament. It is a prospective document for the period 2006-2015 containing: a forecast of the gas demand increase, a description of main investments decided in matter of gas infrastructures, a diagnostic concerning the adequation between the supplying capacities in natural gas and the national needs, a series of recommendations on the State tools to guarantee the national supplying security and on the investment. The four parts deal with the stakes and perspectives of the national natural gas supplying, the demand evolution, the offer evolution and the equilibrium offer. (A.L.B.)

Irradiation position-control equipment for the HIMAC

Energy Technology Data Exchange (ETDEWEB)

Higashi, Seiichi; Kuma, Shoichiro [Mitsubishi Electric Corp., Tokyo (Japan); Nomura, Kazuaki; Endo, Masahiro; Minohara, Shin-ichi

1995-02-01

Use of heavy-ion beams to mount a pinpoint attack on unhealthy tissue requires that the target tissue be placed in the precise location specified by the therapy planning equipment. The article reports on the detailed specifications, positioning mechanism, position verification method and the interface with the therapy planning equipment. (author).

Building Analysis for Urban Energy Planning Using Key Indicators on Virtual 3d City Models - the Energy Atlas of Berlin

Science.gov (United States)

Krüger, A.; Kolbe, T. H.

2012-07-01

In the context of increasing greenhouse gas emission and global demographic change with the simultaneous trend to urbanization, it is a big challenge for cities around the world to perform modifications in energy supply chain and building characteristics resulting in reduced energy consumption and carbon dioxide mitigation. Sound knowledge of energy resource demand and supply including its spatial distribution within urban areas is of great importance for planning strategies addressing greater energy efficiency. The understanding of the city as a complex energy system affects several areas of the urban living, e.g. energy supply, urban texture, human lifestyle, and climate protection. With the growing availability of 3D city models around the world based on the standard language and format CityGML, energy system modelling, analysis and simulation can be incorporated into these models. Both domains will profit from that interaction by bringing together official and accurate building models including building geometries, semantics and locations forming a realistic image of the urban structure with systemic energy simulation models. A holistic view on the impacts of energy planning scenarios can be modelled and analyzed including side effects on urban texture and human lifestyle. This paper focuses on the identification, classification, and integration of energy-related key indicators of buildings and neighbourhoods within 3D building models. Consequent application of 3D city models conforming to CityGML serves the purpose of deriving indicators for this topic. These will be set into the context of urban energy planning within the Energy Atlas Berlin. The generation of indicator objects covering the indicator values and related processing information will be presented on the sample scenario estimation of heating energy consumption in buildings and neighbourhoods. In their entirety the key indicators will form an adequate image of the local energy situation for

Association between red blood cell indices and CD4 count in HIV-positive reproductive women

Science.gov (United States)

Lumbanraja, S. N.; Siregar, D. I. S.

2018-03-01

Red blood cell indices, hemoglobin, and hematocrit reflect rapidity of HIV disease progression. This study aims to determine red blood cell indices and CD4 count in HIV-positive reproductive women. This study was a cross sectional study conducted at AIDS outpatient clinic at Haji Adam Malik General Hospital, Medan Indonesia. All seropositive reproductive women within antiretroviral therapy consented for blood count and CD4 examination. Data were collected and analyzed with SPSS 19. In subjects with CD4≤350 mm3, mean hemoglobin was 10.95 ± 2.01, hematocrit was 31.83 ± 5.04%, MCV was 84.17 ± 11.41, MCH was 25.98 ± 2.65, and MCHC was 32.18 ± 2.17. Mean hemoglobin, hematocrit, and MCH value was significantly lower in subjects with CD4 ≤350 mm3 (p=0.014; p=0.001; p=0.01; respectively). Lower Hb, Ht, and MCH associated with thelower CD4 count.

Positioning devices for patients

International Nuclear Information System (INIS)

Heavens, M.

1981-01-01

It has been suggested that it is very important to position patients reproducibly at different stages of radiotherapy treatment planning and treatment, or similar procedures. Devices have been described for positioning a patient's upper and lower thorax. This invention provides reproducible positioning for a female patient's breasts, for example in planning treatment of and treating breast tumours. The patient is placed prone, using for example an upper thorax device. A support device is placed central to and beneath her breasts to partially displace them outwards. The device may be triangular in section with one apex contacting the chest wall at the sternum. Restraining straps may be provided to hold the breasts against the support device. Means may be provided to take a healthy breast from the path of radiation through the tumour. (author)

Scientific journals in the SciELO database, indicators of impact and the relative position of Ambiente & Água

Directory of Open Access Journals (Sweden)

Nelson Wellausen Dias

2010-12-01

Full Text Available This editorial describes the process of periodic evaluation by CAPES, based on commercial indices proposed by companies such as the ISI FI by Thomson Reuters and SCImago by Scopus and public indices as proposed by SciELO and other freely calculated indices based on Google Scholar and investigates the impact position of the journal Ambiente & Agua compared with journals from the SciELO base. Results show that Ambiente & Agua is in the right path in the search for quality. Its editorial board strongly recommends that Brazilian public scientific agencies consider tools that are cost free and have large coverage for impact evaluation to allow the impact assessment of a range of emerging journals in a common and wide basis for all scientific journals.

Driver's mental workload prediction model based on physiological indices.

Science.gov (United States)

Yan, Shengyuan; Tran, Cong Chi; Wei, Yingying; Habiyaremye, Jean Luc

2017-09-15

Developing an early warning model to predict the driver's mental workload (MWL) is critical and helpful, especially for new or less experienced drivers. The present study aims to investigate the correlation between new drivers' MWL and their work performance, regarding the number of errors. Additionally, the group method of data handling is used to establish the driver's MWL predictive model based on subjective rating (NASA task load index [NASA-TLX]) and six physiological indices. The results indicate that the NASA-TLX and the number of errors are positively correlated, and the predictive model shows the validity of the proposed model with an R 2 value of 0.745. The proposed model is expected to provide a reference value for the new drivers of their MWL by providing the physiological indices, and the driving lesson plans can be proposed to sustain an appropriate MWL as well as improve the driver's work performance.

Impact of patient positioning on radiotherapy dose distribution: An assessment in parotid tumor

Directory of Open Access Journals (Sweden)

Seema Sharma

2016-03-01

Full Text Available Purpose: We intended to study the impact of patient positioning on the dose distribution within target volume and organs at risk in patients with parotid malignancies treated with 3D conformal radiotherapy (3D-CRT with photon wedge pair (WP or intensity modulated radiotherapy (IMRT.Methods: Three patients with a non-Hodgkin’s lymphoma of the right parotid gland were consecutively immobilized using thermoplastic cast in 2 positions: supine with head in neutral position (HN and with head turned 90° to the left side (HT. Images for treatment planning purpose were acquired in both positions. For both positions, photon WP plans and 5 field IMRT plans were generated, after contouring clinical target volume (CTV, planning target volume (PTV= CTV + 5 mm margin and organs at risk (OAR. All plans were evaluated for target coverage and dose to OARs.Results: Both CTV and PTV were apparently larger in HN compared with HT (31.76±8.89 cc, 30.31±7.83 cc and 62.49±19.01 cc, 58.89±15.33 cc respectively. The CI value for PTV was slightly better for HT compared to HN position in both the WP and IMRT plans. The homogeneity was comparable in both the head positions in case of WP plan. The mean HI of PTV was increased in case of IMRT plan at HT versus HN position (1.108 vs. 1.097. A change in head position from HN to HT with wedge pair plan resulted in a reduction of brainstem Dmax and Dmean. Lesser dose was observed in HN position for contralateral parotid. A difference of 0.9 Gy in the average Dmax to spinal cord was seen. The values of Dmean to mandible, oral cavity, ipsilateral and contralateral cochlea were higher in the HT position. A change in head position from HN to HT with IMRT plan resulted in a dose reduction in average Dmax to brainstem. The spinal cord Dmax increased at the HT position by 1.2 Gy. The dose to contralateral parotid and cochlea was comparable in both the positions. However, the Dmean to oral cavity was reduced at HT position. Whereas

Influence of metabolic indicators, smoking, alcohol and socioeconomic position on mortality after breast cancer

DEFF Research Database (Denmark)

Larsen, Signe Benzon; Kroman, Niels; Ibfelt, Else Helene

2015-01-01

BACKGROUND: Factors differently distributed among social groups like obesity, metabolic syndrome, diabetes, smoking, and alcohol intake predict survival after breast cancer diagnosis and therefore might mediate part of the observed social inequality in survival. MATERIAL AND METHODS: We conducted...... a cohort study among 1250 postmenopausal breast cancer patients identified among 29 875 women in the Danish Diet, Cancer and Health Study. Participants completed questionnaires and anthropometric measurements were made at enrollment. Information on survival, socioeconomic position, and comorbidity...... circumference and diabetes, and smoking and alcohol affected but did not explain the social gradient. CONCLUSION: The findings indicate that these factors explain some but not all the social inequality in survival after breast cancer and that improvement of lifestyle to some extent would improve survival among...

Robustness of IPSA optimized high-dose-rate prostate brachytherapy treatment plans to catheter displacements.

Science.gov (United States)

Poder, Joel; Whitaker, May

2016-06-01

Inverse planning simulated annealing (IPSA) optimized brachytherapy treatment plans are characterized with large isolated dwell times at the first or last dwell position of each catheter. The potential of catheter shifts relative to the target and organs at risk in these plans may lead to a more significant change in delivered dose to the volumes of interest relative to plans with more uniform dwell times. This study aims to determine if the Nucletron Oncentra dwell time deviation constraint (DTDC) parameter can be optimized to improve the robustness of high-dose-rate (HDR) prostate brachytherapy plans to catheter displacements. A set of 10 clinically acceptable prostate plans were re-optimized with a DTDC parameter of 0 and 0.4. For each plan, catheter displacements of 3, 7, and 14 mm were retrospectively applied and the change in dose volume histogram (DVH) indices and conformity indices analyzed. The robustness of clinically acceptable prostate plans to catheter displacements in the caudal direction was found to be dependent on the DTDC parameter. A DTDC value of 0 improves the robustness of planning target volume (PTV) coverage to catheter displacements, whereas a DTDC value of 0.4 improves the robustness of the plans to changes in hotspots. The results indicate that if used in conjunction with a pre-treatment catheter displacement correction protocol and a tolerance of 3 mm, a DTDC value of 0.4 may produce clinically superior plans. However, the effect of the DTDC parameter in plan robustness was not observed to be as strong as initially suspected.

Climate change policy position

International Nuclear Information System (INIS)

2002-11-01

The Canadian Association of Petroleum Producers (CAPP) is a firm believer in the need to take action to mitigate the risks associated with climate change, and that clear government policy is called for. The principles of sustainable development must guide this policy development effort. The initiatives required to address greenhouse gas emissions over both the short and long term must be carefully considered, and it is up to industries to ensure their production efficiency and emission intensity. Promoting improved performance of industries in Canada and developing technology that can be deployed internationally for larger global effects represents Canada's best contribution to progress on greenhouse gas emissions. The increase in energy demand along with increases in population and economic growth have contributed to an increase in greenhouse gas emissions despite improved energy efficiency in industry. Significant damage to the economy will result if Canada is to meet its commitment under the Kyoto Protocol, forcing the country to buy large quantities of foreign credits instead of using those funds for increased research and development. CAPP indicated that an effective plan must be: balanced, equitable, responsible, competitive, focused on technology and innovation, and based on agreements on sectoral plans. Each of these principles were discussed, followed by the fundamentals of approach for upstream oil and gas. The framework for climate change policy was described as well as the elements of a sector plan. CAPP wants to work with all levels of government on an appropriate plan for Canada, that considers our unique circumstances. Canada can play a significant role on the international stage by properly implementing the policy position proposed by the CAPP without unnecessary risks to the economy. refs

Using Balanced Time Perspective to Explain Well-Being and Planning in Retirement

Science.gov (United States)

Mooney, Anna; Earl, Joanne K.; Mooney, Carl H.; Bateman, Hazel

2017-01-01

The notion of whether people focus on the past, present or future, and how it shapes their behavior is known as Time Perspective. Fundamental to the work of two of its earliest proponents, Zimbardo and Boyd (2008), was the concept of balanced time perspective and its relationship to wellness. A person with balanced time perspective can be expected to have a flexible temporal focus of mostly positive orientations (past-positive, present-hedonistic, and future) and much less negative orientations (past-negative and present-fatalistic). This study measured deviation from balanced time perspective (DBTP: Zhang et al., 2013) in a sample of 243 mature adults aged 45 to 91 years and explored relationships to Retirement Planning, Depression, Anxiety, Stress, Positive Mood, and Negative Mood. Results indicate that DBTP accounts for unexplained variance in the outcome measures even after controlling for demographic variables. DBTP was negatively related to Retirement Planning and Positive Mood and positively related to Depression, Anxiety, Stress, and Negative Mood. Theoretical and practical implications regarding balanced time perspective are discussed. PMID:29081757

Using Balanced Time Perspective to Explain Well-Being and Planning in Retirement.

Science.gov (United States)

Mooney, Anna; Earl, Joanne K; Mooney, Carl H; Bateman, Hazel

2017-01-01

The notion of whether people focus on the past, present or future, and how it shapes their behavior is known as Time Perspective. Fundamental to the work of two of its earliest proponents, Zimbardo and Boyd (2008), was the concept of balanced time perspective and its relationship to wellness. A person with balanced time perspective can be expected to have a flexible temporal focus of mostly positive orientations (past-positive, present-hedonistic, and future) and much less negative orientations (past-negative and present-fatalistic). This study measured deviation from balanced time perspective (DBTP: Zhang et al., 2013) in a sample of 243 mature adults aged 45 to 91 years and explored relationships to Retirement Planning, Depression, Anxiety, Stress, Positive Mood, and Negative Mood. Results indicate that DBTP accounts for unexplained variance in the outcome measures even after controlling for demographic variables. DBTP was negatively related to Retirement Planning and Positive Mood and positively related to Depression, Anxiety, Stress, and Negative Mood. Theoretical and practical implications regarding balanced time perspective are discussed.

Using Balanced Time Perspective to Explain Well-Being and Planning in Retirement

Directory of Open Access Journals (Sweden)

Anna Mooney

2017-10-01

Full Text Available The notion of whether people focus on the past, present or future, and how it shapes their behavior is known as Time Perspective. Fundamental to the work of two of its earliest proponents, Zimbardo and Boyd (2008, was the concept of balanced time perspective and its relationship to wellness. A person with balanced time perspective can be expected to have a flexible temporal focus of mostly positive orientations (past-positive, present-hedonistic, and future and much less negative orientations (past-negative and present-fatalistic. This study measured deviation from balanced time perspective (DBTP: Zhang et al., 2013 in a sample of 243 mature adults aged 45 to 91 years and explored relationships to Retirement Planning, Depression, Anxiety, Stress, Positive Mood, and Negative Mood. Results indicate that DBTP accounts for unexplained variance in the outcome measures even after controlling for demographic variables. DBTP was negatively related to Retirement Planning and Positive Mood and positively related to Depression, Anxiety, Stress, and Negative Mood. Theoretical and practical implications regarding balanced time perspective are discussed.

Positive selection in octopus haemocyanin indicates functional links to temperature adaptation.

Science.gov (United States)

Oellermann, Michael; Strugnell, Jan M; Lieb, Bernhard; Mark, Felix C

2015-07-05

Octopods have successfully colonised the world's oceans from the tropics to the poles. Yet, successful persistence in these habitats has required adaptations of their advanced physiological apparatus to compensate impaired oxygen supply. Their oxygen transporter haemocyanin plays a major role in cold tolerance and accordingly has undergone functional modifications to sustain oxygen release at sub-zero temperatures. However, it remains unknown how molecular properties evolved to explain the observed functional adaptations. We thus aimed to assess whether natural selection affected molecular and structural properties of haemocyanin that explains temperature adaptation in octopods. Analysis of 239 partial sequences of the haemocyanin functional units (FU) f and g of 28 octopod species of polar, temperate, subtropical and tropical origin revealed natural selection was acting primarily on charge properties of surface residues. Polar octopods contained haemocyanins with higher net surface charge due to decreased glutamic acid content and higher numbers of basic amino acids. Within the analysed partial sequences, positive selection was present at site 2545, positioned between the active copper binding centre and the FU g surface. At this site, methionine was the dominant amino acid in polar octopods and leucine was dominant in tropical octopods. Sites directly involved in oxygen binding or quaternary interactions were highly conserved within the analysed sequence. This study has provided the first insight into molecular and structural mechanisms that have enabled octopods to sustain oxygen supply from polar to tropical conditions. Our findings imply modulation of oxygen binding via charge-charge interaction at the protein surface, which stabilize quaternary interactions among functional units to reduce detrimental effects of high pH on venous oxygen release. Of the observed partial haemocyanin sequence, residue 2545 formed a close link between the FU g surface and the

Quantitative Assessment of Orbital Implant Position--A Proof of Concept.

Directory of Open Access Journals (Sweden)

Ruud Schreurs

Full Text Available In orbital reconstruction, the optimal location of a predefined implant can be planned preoperatively. Surgical results can be assessed intraoperatively or postoperatively. A novel method for quantifying orbital implant position is introduced. The method measures predictability of implant placement: transformation parameters between planned and resulting implant position are quantified.The method was tested on 3 human specimen heads. Computed Tomography scans were acquired at baseline with intact orbits (t0, after creation of the defect (t1 and postoperatively after reconstruction of the defect using a preformed implant (t2. Prior to reconstruction, the optimal implant position was planned on the t0 and t1 scans. Postoperatively, the planned and realized implant position were compared. The t0 and t2 scans were fused using iPlan software and the resulting implant was segmented in the fused t2 scan. An implant reference frame was created (Orbital Implant Positioning Frame; the planned implant was transformed to the reference position using an Iterative Closest Point approach. The segmentation of the resulting implant was also registered on the reference position, yielding rotational (pitch, yaw, roll as well as translational parameters of implant position.Measurement with the Orbital Implant Positioning Frame proved feasible on all three specimen. The positional outcome provided more thorough and accurate insight in resulting implant position than could be gathered from distance measurements alone. Observer-related errors were abolished from the process, since the method is largely automatic.A novel method of quantifying surgical outcome in orbital reconstructive surgery was presented. The presented Orbital Implant Positioning Frame assessed all parameters involved in implant displacement. The method proved to be viable on three human specimen heads. Clinically, the method could provide direct feedback intraoperatively and could improve

Maintenance Business Plans.

Science.gov (United States)

Adams, Matt

2002-01-01

Discusses maintenance business plans, statements which provide accountability for facilities maintenance organizations' considerable budgets. Discusses the plan's components: statement of plan objectives, macro and detailed description of the facility assets, maintenance function descriptions, description of key performance indicators, milestone…

Relationship of condylar position to disc position and morphology

Energy Technology Data Exchange (ETDEWEB)

Incesu, L.; Taskaya-Yilmaz, N. E-mail: nergizy@omu.edu.tr; Oeguetcen-Toller, M.; Uzun, E

2004-09-01

Introduction/objective: The purpose of this study was to assess whether condylar position, as depicted by magnetic resonance imaging, was an indicator of disc morphology and position. Methods and material: One hundred and twenty two TMJs of 61 patients with temporomandibular joint disorder were examined. Condylar position, disc deformity and degree of anterior disc displacement were evaluated by using magnetic resonance imaging. Results and discussion: Posterior condyle position was found to be the main feature of temporomandibular joints with slight and moderate anterior disc displacement. No statistical significance was found between the condylar position, and reducing and nonreducing disc positions. On the other hand, superior disc position was found to be statistically significant for centric condylar position. Conclusion: It was concluded that posterior condyle position could indicate anterior disc displacement whereas there was no relation between the position of condyle and the disc deformity.

Open table-top device positioning technique to reduce small bowel obstruction. Positioning accuracy and impact on conformal radiation therapy techniques

International Nuclear Information System (INIS)

Rudat, V.; Flentje, M.; Engenhart, R.; Metzger, M.; Wannenmacher, M.

1995-01-01

The immobilization error of patients positioned on the opern table-top device in prone prosition as well as the movement of the small bowel out of the pelvis by this positioning technique was determined. The positioning error is of special importance for the 3-dimensional treatment planning for conformal radiotherapy. The positioning error was determined by superposing 106 portal films with the corresponding simultor films from 21 patients with carcinoma of the rectum who received 3D-planned conformal radiotherapy (o-field technique with irregular blocks). The movement of the small bowel out of the pelvis was studied by comparing simulator films after barium swallow in supine and open table-top position as well with 3D-treatment plans of the same patient in both positions in 3 cases. The positioning error along the medio-lateral, dorso-ventral und cranio-caudal axis was 1.4/-0.6/1.8 mm and the standard deviation 4.4/6.8/6.3 mm, respectively. In comparison to the supine position more rotation errors in the sagittal view were observed (37% and 9% respectively) with a media of 5.1 . Six out of 22 patients showed no adhesions of the small bowel and a complete movement out of the tratment field was achieved. 14 out of 16 Patients with adhesions revealed a partial movement of the small bowel out of the treatment field. Comparing 3D-treatment plans in both positions again demonstrated a marked reduction of the irradiated small bowel volume with the use of the open table-top decive. (orig.) [de

Approaches to integrating indicators into 3D landscape visualisations and their benefits for participative planning situations.

Science.gov (United States)

Wissen, Ulrike; Schroth, Olaf; Lange, Eckart; Schmid, Willy A

2008-11-01

In discussing issues of landscape change, the complex relationships in the landscape have to be assessed. In participative planning processes, 3D visualisations have a high potential as an aid in understanding and communicating characteristics of landscape conditions by integrating visual and non-visual landscape information. Unclear is, which design and how much interactivity is required for an indicator visualisation that would suit stakeholders best in workshop situations. This paper describes the preparation and application of three different types of integrated 3D visualisations in workshops conducted in the Entlebuch UNESCO Biosphere Reserve (CH). The results reveal that simple representations of a complex issue created by draping thematic maps on the 3D model can make problematic developments visible at a glance; that diagrams linked to the spatial context can help draw attention to problematic relationships not considered beforehand; and that the size of species as indicators of conditions of the landscape's production and biotope function seems to provide a common language for stakeholders with different perspectives. Overall, the of the indicators the functions required to assist in information processing. Further research should focus on testing the effectiveness of the integrated visualisation tools in participative processes for the general public.

Market and plan characteristics related to HMO quality and improvement.

Science.gov (United States)

Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Lee, Woolton

2006-12-01

Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.

Next-generation sequencing indicates false-positive MRD results and better predicts prognosis after SCT in patients with childhood ALL.

Science.gov (United States)

Kotrova, M; van der Velden, V H J; van Dongen, J J M; Formankova, R; Sedlacek, P; Brüggemann, M; Zuna, J; Stary, J; Trka, J; Fronkova, E

2017-07-01

Minimal residual disease (MRD) monitoring via quantitative PCR (qPCR) detection of Ag receptor gene rearrangements has been the most sensitive method for predicting prognosis and making post-transplant treatment decisions for patients with ALL. Despite the broad clinical usefulness and standardization of this method, we and others have repeatedly reported the possibility of false-positive MRD results caused by massive B-lymphocyte regeneration after stem cell transplantation (SCT). Next-generation sequencing (NGS) enables precise and sensitive detection of multiple Ag receptor rearrangements, thus providing a more specific readout compared to qPCR. We investigated two cohorts of children with ALL who underwent SCT (30 patients and 228 samples). The first cohort consisted of 17 patients who remained in long-term CR after SCT despite having low MRD positivity (SCT monitoring using qPCR. Only one of 27 qPCR-positive samples was confirmed to be positive by NGS. Conversely, 10 of 15 samples with low qPCR-detected MRD positivity from 13 patients who subsequently relapsed were also confirmed to be positive by NGS (P=0.002). These data show that NGS has a better specificity in post-SCT ALL management and indicate that treatment interventions aimed at reverting impending relapse should not be based on qPCR only.

Indication, organization, practical implementation and interpretation guidelines for retrospective CGM recording: A French position statement.

Science.gov (United States)

Joubert, M; Baillot-Rudoni, S; Catargi, B; Charpentier, G; Esvant, A; Franc, S; Guerci, B; Guilhem, I; Melki, V; Merlen, E; Penfornis, A; Renard, E; Riveline, J P; Schaepelynck, P; Sola-Gazagnes, A; Hanaire, H

2015-12-01

The benefits of retrospective continuous glucose monitoring (retroCGM) recording have been widely explored in clinical studies, and many diabetes physicians routinely use this examination. However, the method of interpretation of CGM recordings has never been precisely described. An expert French panel of physicians met for two days to discuss several aspects of retroCGM use and to produce a position statement. The guidelines cover the indications for retroCGM, the general organization and practical implementation of CGM recordings, a description of the different devices available and guidelines for the interpretation of retroCGM recordings. This consensus document should help clinicians in the proper use of retroCGM. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Selecting environmental indicator for use in strategic environmental assessment

International Nuclear Information System (INIS)

Donnelly, Alison; Jones, Mike; O'Mahony, Tadhg; Byrne, Gerry

2007-01-01

The primary aim of carrying out Strategic Environmental Assessment (SEA) is to provide for a high level of environmental protection and to integrate environmental considerations into the planning process. The SEA Directive (2001/42/EC) recommends monitoring to determine the environmental impact of the implementation of plans and programmes. Environmental indicators are a useful tool by which this impact may be measured. However, careful consideration must be given to developing a set of indicators in order to isolate, plan or programme specific impacts. Here, we demonstrate the effectiveness of a workshop-based approach to develop appropriate criteria for selecting environmental indicator for use in SEA. A multi-disciplinary team was used in the approach which consisted of representatives from each of four environmental fields i.e. biodiversity, water, air and climatic factors, together with SEA experts, planning experts, academics and consultants. The team reviewed various sets of criteria, already in existence, for environmental indicator development but not specifically for SEA indicators. The results of this review together with original criteria were applied to the final list agreed upon. Some of the criteria recommended includes, relevance to plan, ability to prioritise, and ability to identify conflict with other plan or SEA objectives

Resection planning for robotic acoustic neuroma surgery

Science.gov (United States)

McBrayer, Kepra L.; Wanna, George B.; Dawant, Benoit M.; Balachandran, Ramya; Labadie, Robert F.; Noble, Jack H.

2016-03-01

Acoustic neuroma surgery is a procedure in which a benign mass is removed from the Internal Auditory Canal (IAC). Currently this surgical procedure requires manual drilling of the temporal bone followed by exposure and removal of the acoustic neuroma. This procedure is physically and mentally taxing to the surgeon. Our group is working to develop an Acoustic Neuroma Surgery Robot (ANSR) to perform the initial drilling procedure. Planning the ANSR's drilling region using pre-operative CT requires expertise and around 35 minutes' time. We propose an approach for automatically producing a resection plan for the ANSR that would avoid damage to sensitive ear structures and require minimal editing by the surgeon. We first compute an atlas-based segmentation of the mastoid section of the temporal bone, refine it based on the position of anatomical landmarks, and apply a safety margin to the result to produce the automatic resection plan. In experiments with CTs from 9 subjects, our automated process resulted in a resection plan that was verified to be safe in every case. Approximately 2 minutes were required in each case for the surgeon to verify and edit the plan to permit functional access to the IAC. We measured a mean Dice coefficient of 0.99 and surface error of 0.08 mm between the final and automatically proposed plans. These preliminary results indicate that our approach is a viable method for resection planning for the ANSR and drastically reduces the surgeon's planning effort.

Clinical indications to the use of (99m)Tc-EDDA/HYNIC-TOC to detect somatostatin receptor-positive neuroendocrine tumors.

Science.gov (United States)

Parisella, M G; Chianelli, M; D'Alessandria, C; Todino, V; Mikolajczak, R; Papini, E; Dierckx, R A; Scopinaro, F; Signore, A

2012-02-01

The aim of this study was to define, retrospectively, the utility to perform (99m)Tc-EDDA/HYNIC-Tyr3-octreotide ((99m)Tc-EDDA/HYNIC-TOC) scan in patients with NET. We studied 50 consecutive patients affected by different types of NET and divided in two groups. Group 1: 34 patients with known lesions in which (99m)Tc-EDDA/HYNIC-TOC was performed for staging, characterisation or to choose the appropriate treatment. Group 2: 16 patients suspected of having NET or in follow up after surgery. Patients were injected with 370 MBq of (99m)Tc-EDDA/HYNIC-Tyr3-octreotide and whole-body and SPET images acquired 2-3 hours after injection. Overall, 29 patients (58%) had a positive scan, with a sensitivity, specificity and accuracy of 70.3%, 76.9% and 72%, respectively (78.1%, 50% and 76.5%, in group 1 and 20%, 81.2%, 62.5% in group 2). In patients from group 1 (99m)Tc-HYNIC-TOC scintigraphy showed a concordance of 68% with another imaging procedure and in 9 patients revealed a greater number of lesions. In the second group, false negative results were especially found in patients with medullary thyroid cancer with negative radiological findings and elevated calcitonin. In conclusion, (99m)Tc-EDDA/HYNIC-TOC is highly indicated for in vivo histological characterization of known NET lesions, previously identified by other imaging modalities or biopsy, to plan appropriate therapy especially for patients with inoperable disease. In patients with only biochemical suspicion of NET and in those with negative markers, this scintigraphy does not significantly modify the clinical management.

Economic Cognitions Among Older Adults: Parental Socialization Predicts Financial Planning for Retirement

Directory of Open Access Journals (Sweden)

Francisco Palaci

2017-11-01

Full Text Available Drawing on the model on financial planning for retirement (FPR, the aim of this work is to explore how parental economic socialization both directly and indirectly affects FPR through the mediation of financial literacy, financial planning decisions and financial management. Data from a sample of 280 participants aged between 45 and 63 years were used. The results show that parental economic socialization directly and indirectly influences FPR. Moreover, parental economic behavior acts as a positive model for the development of financial literacy and skills and for decisions about FPR. All the variables increased the explained variance of FPR. Lastly, we discuss the process by which parental economic socialization is positively related to financial literacy and skills that impact on FPR, indicating some implications and future lines of research.

Economic Cognitions Among Older Adults: Parental Socialization Predicts Financial Planning for Retirement.

Science.gov (United States)

Palaci, Francisco; Jiménez, Irene; Topa, Gabriela

2017-01-01

Drawing on the model on financial planning for retirement (FPR), the aim of this work is to explore how parental economic socialization both directly and indirectly affects FPR through the mediation of financial literacy, financial planning decisions and financial management. Data from a sample of 280 participants aged between 45 and 63 years were used. The results show that parental economic socialization directly and indirectly influences FPR. Moreover, parental economic behavior acts as a positive model for the development of financial literacy and skills and for decisions about FPR. All the variables increased the explained variance of FPR. Lastly, we discuss the process by which parental economic socialization is positively related to financial literacy and skills that impact on FPR, indicating some implications and future lines of research.

Planned neck dissection for oropharyngeal and hypopharyngeal cancers

International Nuclear Information System (INIS)

Hanai, Nobuhiro; Hasegawa, Yasuhisa; Terada, Akihiro; Ozawa, Taijiro; Hirakawa, Hitoshi; Kawakita, Daisuke; Maruo, Takashi; Mikami, Shinnji

2010-01-01

Recently, the use of chemoradiotherapy for preserving organs in the treatment of head and neck cancer is increasing. However, there is controversy about advanced neck node management in post-chemoradiation cases. We retrospectively analyzed our 119 cases of chemoradiotherapy for oropharyngeal and hypopharyngeal cancer to examine the effectiveness and indications of planned neck dissection. Regional control rate and survival rate were superior in the neck dissection group. If the cases did not achieve complete response (CR) in imaging, planned neck dissection improved the regional control rate significantly. We should perform planned neck dissection immediately rather than 'wait and see' for this persistent disease. However, in the cases achieving radiological CR, it is possible to omit planned neck dissection because of the high salvage rate of neck disease. However, in these cases, careful observation is essential. We clarified that the presence of pathologically positive lymph node is a prognostic factor. For evaluating persistent disease of cervical lymph nodes, positron emission tomography (PET)-CT was the most accurate method of imaging. (author)

Dynamics in self-regulation : Plan execution self-efficacy and mastery of action plans

OpenAIRE

Scholz, Urte; Sniehotta, Falco F.; Schüz, Benjamin; Oeberst, Andries

2007-01-01

This study investigated whether an individual's plan execution self-efficacy precedes mastery of the respective action plan or vice versa. Study participants were 122 cardiac rehabilitation patients. Plan execution self-efficacy and mastery of a personal action plan on physical activity were assessed each week for 6 weeks after discharge from rehabilitation. Physical exercise was assessed 2 months after discharge. Multilevel cross-lagged panel analyses resulted in a positive effect of mastery...

IPIP: A new approach to inverse planning for HDR brachytherapy by directly optimizing dosimetric indices

International Nuclear Information System (INIS)

Siauw, Timmy; Cunha, Adam; Atamtuerk, Alper; Hsu, I-Chow; Pouliot, Jean; Goldberg, Ken

2011-01-01

Purpose: Many planning methods for high dose rate (HDR) brachytherapy require an iterative approach. A set of computational parameters are hypothesized that will give a dose plan that meets dosimetric criteria. A dose plan is computed using these parameters, and if any dosimetric criteria are not met, the process is iterated until a suitable dose plan is found. In this way, the dose distribution is controlled by abstract parameters. The purpose of this study is to develop a new approach for HDR brachytherapy by directly optimizing the dose distribution based on dosimetric criteria. Methods: The authors developed inverse planning by integer program (IPIP), an optimization model for computing HDR brachytherapy dose plans and a fast heuristic for it. They used their heuristic to compute dose plans for 20 anonymized prostate cancer image data sets from patients previously treated at their clinic database. Dosimetry was evaluated and compared to dosimetric criteria. Results: Dose plans computed from IPIP satisfied all given dosimetric criteria for the target and healthy tissue after a single iteration. The average target coverage was 95%. The average computation time for IPIP was 30.1 s on an Intel(R) Core TM 2 Duo CPU 1.67 GHz processor with 3 Gib RAM. Conclusions: IPIP is an HDR brachytherapy planning system that directly incorporates dosimetric criteria. The authors have demonstrated that IPIP has clinically acceptable performance for the prostate cases and dosimetric criteria used in this study, in both dosimetry and runtime. Further study is required to determine if IPIP performs well for a more general group of patients and dosimetric criteria, including other cancer sites such as GYN.

Strategic considerations in planning a counterevacuation

International Nuclear Information System (INIS)

Chester, C.V.; Cristy, G.A.; Haaland, C.M.

1975-12-01

The Soviet Union has highly developed plans to evacuate their population centers in a nuclear confrontation. Their plans include construction of expedient shelters in the outlying areas and continued operation of their essential industry by commuting workers. If they should successfully implement their plan, a subsequent nuclear exchange with the United States would cost them far fewer casualties than they suffered in World War II. Without a corresponding evacuation, the US could lose from 50 to 70 percent of its population. This asymmetry in vulnerability, if allowed to persist, would seriously weaken the bargaining position of the US President. To restore the balance, a great reduction in vulnerability can be achieved most economically by planning a US counterevacuation as a response to a Soviet evacuation. Russian historical experience with murderous invaders, most recently in World War II, has made authoritarian defense measures involving civilians and property in peacetime quite acceptable in their culture. In the US, widescale use of private property and civilian participation in defense activity are not feasible until the development of a grave crisis. Hence US evacuation plans must differ in several important respects from the Soviet plans. However, this preliminary study indicates that the US has ample material resources to move and shelter its population at least as effectively as the Soviet Union. Perhaps the most critical disadvantage of the US is in morale, as evidenced by the widespread misconception that effective survival measures are not possible

Mapping Environmental Inequalities Relevant for Health for Informing Urban Planning Interventions-A Case Study in the City of Dortmund, Germany.

Science.gov (United States)

Flacke, Johannes; Schüle, Steffen Andreas; Köckler, Heike; Bolte, Gabriele

2016-07-13

Spatial differences in urban environmental conditions contribute to health inequalities within cities. The purpose of the paper is to map environmental inequalities relevant for health in the City of Dortmund, Germany, in order to identify needs for planning interventions. We develop suitable indicators for mapping socioeconomically-driven environmental inequalities at the neighborhood level based on published scientific evidence and inputs from local stakeholders. Relationships between socioeconomic and environmental indicators at the level of 170 neighborhoods were analyzed continuously with Spearman rank correlation coefficients and categorically applying chi-squared tests. Reclassified socioeconomic and environmental indicators were then mapped at the neighborhood level in order to determine multiple environmental burdens and hotspots of environmental inequalities related to health. Results show that the majority of environmental indicators correlate significantly, leading to multiple environmental burdens in specific neighborhoods. Some of these neighborhoods also have significantly larger proportions of inhabitants of a lower socioeconomic position indicating hotspots of environmental inequalities. Suitable planning interventions mainly comprise transport planning and green space management. In the conclusions, we discuss how the analysis can be used to improve state of the art planning instruments, such as clean air action planning or noise reduction planning towards the consideration of the vulnerability of the population.

Sustainable transport project evaluation and decision support: indicators and planning criteria for sustainable development

DEFF Research Database (Denmark)

Salling, Kim Bang; Pryn, Marie Ridley

2015-01-01

is adopted. The SUSTAIN-DSS model rests upon multi-criteria decision analysis and planning workshops in order to combine the use of qualitative and quantitative assessments. This article stresses the necessity of revising current planning paradigms such as cost-benefit analysis (CBA) but also to make clear......This article will expose the necessity for a sustainable planning and decision support framework for transport infrastructure assessment. This will be operationalized through a set of planning criteria and scenario alternatives, which is assessed in the SUSTAIN decision support system (SUSTAIN......-DSS) model. A part of the decision support framework will be tested in a case study in Denmark, concerning the problem of congestion on the current bridge crossing Roskilde Fjord in the city of Frederikssund. This article suggests including in a combination both reference class forecasting and quantitative...

Detention and positioning system for patient Treatment with conventional radiotherapy

International Nuclear Information System (INIS)

Hueso Bernad, Nuria; Tirado Porcar, Miriam; Del Castillo Arres, M. Jose; Broseta Tormos, M. Mercedes; Franch Martinez, Silvia; Suarez Dieguez, Raquel; Roures Ramos, M.Teresa

2009-01-01

The first step in what we call in radiotherapy S imulation and Planning o f radiation, is the correct choice of patient position and methods to use for this position is maintained along both the simulation and planning as the radiation treatment. The choice of position is directly linked to the choice of immobilizer to be used. (Author)

Accuracy of an infrared marker-based patient positioning system (ExacTrac®) for stereotactic body radiotherapy in localizing the planned isocenter using fiducial markers

Science.gov (United States)

Montes-Rodríguez, María de los Ángeles; Hernández-Bojórquez, Mariana; Martínez-Gómez, Alma Angélica; Contreras-Pérez, Agustín; Negrete-Hernández, Ingrid Mireya; Hernández-Oviedo, Jorge Omar; Mitsoura, Eleni; Santiago-Concha, Bernardino Gabriel

2014-11-01

Stereotactic Body Radiation Therapy (SBRT) requires a controlled immobilization and position monitoring of patient and target. The purpose of this work is to analyze the performance of the imaging system ExacTrac® (ETX) using infrared and fiducial markers. Materials and methods: In order to assure the accuracy of isocenter localization, a Quality Assurance procedure was applied using an infrared marker-based positioning system. Scans were acquired of an inhouse-agar gel and solid water phantom with infrared spheres. In the inner part of the phantom, three reference markers were delineated as reference and one pellet was place internally; which was assigned as the isocenter. The iPlan® RT Dose treatment planning system. Images were exported to the ETX console. Images were acquired with the ETX to check the correctness of the isocenter placement. Adjustments were made in 6D the reference markers were used to fuse the images. Couch shifts were registered. The procedure was repeated for verification purposes. Results: The data recorded of the verifications in translational and rotational movements showed averaged 3D spatial uncertainties of 0.31 ± 0.42 mm respectively 0.82° ± 0.46° in the phantom and the first correction of these uncertainties were of 1.51 ± 1.14 mm respectively and 1.37° ± 0.61°. Conclusions: This study shows a high accuracy and repeatability in positioning the selected isocenter. The ETX-system for verifying the treatment isocenter position has the ability to monitor the tracing position of interest, making it possible to be used for SBRT positioning within uncertainty ≤1mm.

Accuracy of an infrared marker-based patient positioning system (ExacTrac®) for stereotactic body radiotherapy in localizing the planned isocenter using fiducial markers

Energy Technology Data Exchange (ETDEWEB)

Montes-Rodríguez, María de los Ángeles, E-mail: angy24538@yahoo.com; Mitsoura, Eleni [Medical Physics Graduate Programme, Universidad Autónoma del Estado de México, Facultad de Medicina, Paseo Tollocan esquina Jesús Carranza Colonia Moderna de la Cruz, C.P. 50180, Toluca, Estado de México (Mexico); Hernández-Bojórquez, Mariana; Martínez-Gómez, Alma Angélica; Contreras-Pérez, Agustín; Negrete-Hernández, Ingrid Mireya; Hernández-Oviedo, Jorge Omar; Santiago-Concha, Bernardino Gabriel [Centro de Cáncer ABC, The American British Cowdray Medical Center I.A.P. (CMABC), Calle Sur 136, no. 116, Colonia las Américas, C.P. 01120, México, D.F. (Mexico)

2014-11-07

Stereotactic Body Radiation Therapy (SBRT) requires a controlled immobilization and position monitoring of patient and target. The purpose of this work is to analyze the performance of the imaging system ExacTrac® (ETX) using infrared and fiducial markers. Materials and methods: In order to assure the accuracy of isocenter localization, a Quality Assurance procedure was applied using an infrared marker-based positioning system. Scans were acquired of an inhouse-agar gel and solid water phantom with infrared spheres. In the inner part of the phantom, three reference markers were delineated as reference and one pellet was place internally; which was assigned as the isocenter. The iPlan® RT Dose treatment planning system. Images were exported to the ETX console. Images were acquired with the ETX to check the correctness of the isocenter placement. Adjustments were made in 6D the reference markers were used to fuse the images. Couch shifts were registered. The procedure was repeated for verification purposes. Results: The data recorded of the verifications in translational and rotational movements showed averaged 3D spatial uncertainties of 0.31 ± 0.42 mm respectively 0.82° ± 0.46° in the phantom and the first correction of these uncertainties were of 1.51 ± 1.14 mm respectively and 1.37° ± 0.61°. Conclusions: This study shows a high accuracy and repeatability in positioning the selected isocenter. The ETX-system for verifying the treatment isocenter position has the ability to monitor the tracing position of interest, making it possible to be used for SBRT positioning within uncertainty ≤1mm.

Examination of the Locus of Positional Effects on Children's Production of Plural -s: Considerations From Local and Global Speech Planning.

Science.gov (United States)

Theodore, Rachel M; Demuth, Katherine; Shattuck-Hufnagel, Stefanie

2015-06-01

Prosodic and articulatory factors influence children's production of inflectional morphemes. For example, plural -s is produced more reliably in utterance-final compared to utterance-medial position (i.e., the positional effect), which has been attributed to the increased planning time in utterance-final position. In previous investigations of plural -s, utterance-medial plurals were followed by a stop consonant (e.g., dogsbark), inducing high articulatory complexity. We examined whether the positional effect would be observed if the utterance-medial context were simplified to a following vowel. An elicited imitation task was used to collect productions of plural nouns from 2-year-old children. Nouns were elicited utterance-medially and utterance-finally, with the medial plural followed by either a stressed or an unstressed vowel. Acoustic analysis was used to identify evidence of morpheme production. The positional effect was absent when the morpheme was followed by a vowel (e.g., dogseat). However, it returned when the vowel-initial word contained 2 syllables (e.g., dogsarrive), suggesting that the increased processing load in the latter condition negated the facilitative effect of the easy articulatory context. Children's productions of grammatical morphemes reflect a rich interaction between emerging levels of linguistic competence, raising considerations for diagnosis and rehabilitation of language disorders.

Planning and Foucault

DEFF Research Database (Denmark)

Flyvbjerg, Bent; Richardson, Tim

In this paper we argue that the use of the communicative theory of Jürgen Habermas in planning theory is problematic because it hampers an understanding of how power shapes planning. We posit an alternative approach based on the power analytics of Michel Foucault which focuses on "what is actually...... done", as opposed to Habermas`  focus on "what should be done". We discuss how the Foucauldian stance problematises planning, asking difficult questions about the treatment of legitimacy, rationality, knowledge and spatiality. We conclude that Foucault offers a type of analytic planning theory which...... offers better prospects than does Habermas for those interested in understanding and bringing about democratic social change through planning....

Planning and Foucault

DEFF Research Database (Denmark)

Flyvbjerg, Bent; Richardson, Tim

2002-01-01

In this paper we argue that the use of the communicative theory of Jürgen Habermas in planning theory is problematic because it hampers an understanding of how power shapes planning. We posit an alternative approach based on the power analytics of Michel Foucault which focuses on ?what is actually...... done?, as opposed to Habermas?s focus on ?what should be done?. We discuss how the Foucauldian stance problematises planning, asking difficult questions about the treatment of legitimacy, rationality, knowledge and spatiality. We conclude that Foucault offers a type of analytic planning theory which...... offers better prospects than does Habermas for those interested in understanding and bringing about democratic social change through planning....

Selective‐logging and oil palm: multitaxon impacts, biodiversity indicators, and trade‐offs for conservation planning.

Science.gov (United States)

Edwards, David P; Magrach, Ainhoa; Woodcock, Paul; Ji, Yinqiu; Lim, Norman T -L; Edwards, Felicity A; Larsen, Trond H; Hsu, Wayne W; Benedick, Suzan; Khen, Chey Vun; Chung, Arthur Y C; Reynolds, Glen; Fisher, Brendan; Laurance, William F; Wilcove, David S; Hamer, Keith C; Yu, Douglas W

Strong global demand for tropical timber and agricultural products has driven large-scale logging and subsequent conversion of tropical forests. Given that the majority of tropical landscapes have been or will likely be logged, the protection of biodiversity within tropical forests thus depends on whether species can persist in these economically exploited lands, and if species cannot persist, whether we can protect enough primary forest from logging and conversion. However, our knowledge of the impact of logging and conversion on biodiversity is limited to a few taxa, often sampled in different locations with complex land-use histories, hampering attempts to plan cost-effective conservation strategies and to draw conclusions across taxa. Spanning a land-use gradient of primary forest, once- and twice-logged forests, and oil palm plantations, we used traditional sampling and DNA metabarcoding to compile an extensive data set in Sabah, Malaysian Borneo for nine vertebrate and invertebrate taxa to quantify the biological impacts of logging and oil palm, develop cost-effective methods of protecting biodiversity, and examine whether there is congruence in response among taxa. Logged forests retained high species richness, including, on average, 70% of species found in primary forest. In contrast, conversion to oil palm dramatically reduces species richness, with significantly fewer primary-forest species than found on logged forest transects for seven taxa. Using a systematic conservation planning analysis, we show that efficient protection of primary-forest species is achieved with land portfolios that include a large proportion of logged-forest plots. Protecting logged forests is thus a cost-effective method of protecting an ecologically and taxonomically diverse range of species, particularly when conservation budgets are limited. Six indicator groups (birds, leaf-litter ants, beetles, aerial hymenopterans, flies, and true bugs) proved to be consistently good

Clinical physics for charged particle treatment planning

International Nuclear Information System (INIS)

Chen, G.T.Y.; Pitluck, S.; Lyman, J.T.

1981-01-01

The installation of a computerized tomography (CT) scanner which can be used with the patient in an upright position is described. This technique will enhance precise location of tumor position relative to critical structures for accurate charged particle dose delivery during fixed horizontal beam radiotherapy. Pixel-by-pixel treatment planning programs have been developed to calculate the dose distribution from multi-port charged particle beams. The plan includes CT scans, data interpretation, and dose calculations. The treatment planning computer is discussed. Treatment planning for irradiation of ocular melanomas is described

[Relationships between Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in clinic couples].

Science.gov (United States)

Kong, Seong Sook

2010-06-01

The purpose of the study was to investigate the relationships between the Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in couple visiting a clinic. Couples (n=62) who visited "M" couple clinic participated in the study. Data were collected from March to June 2009 using the Marital Satisfaction Scale, Marital Status Inventory, Positive Affect Inventory, and Conflict Regulation Inventory. The couples showed no significant differences in marital satisfaction, positive affect, and conflict regulation according to similarities between spouses in MBTI types. However, they showed significant differences in divorce proneness of husband according to a similarity in the Sensing/Intuition indicator. They also showed significant differences in divorce proneness, positive affect, and conflict regulation between the couples for ISTJ (Introversion, Sensing, Thinking, Judging) or ESTJ (Extraversion, Sensing, Thinking, Judging) types compared to other couples. When nurses counsel couples, they should understand that differences in psychological type between spouses affects their marital relationship. In addition, nurses should educate couples on the characteristics of each type according to the couple's types and help them to understand each other, especially for couples where one spouse is the ISTJ/ESTJ type. These interventions will improve marital satisfaction and prevent the divorce in these couples.

Leaf position optimization for step-and-shoot IMRT

International Nuclear Information System (INIS)

Gersem, Werner de; Claus, Filip; Wagter, Carlos de; Duyse, Bart van; Neve, Wilfried de

2001-01-01

Purpose: To describe the theoretical basis, the algorithm, and implementation of a tool that optimizes segment shapes and weights for step-and-shoot intensity-modulated radiation therapy delivered by multileaf collimators. Methods and Materials: The tool, called SOWAT (Segment Outline and Weight Adapting Tool) is applied to a set of segments, segment weights, and corresponding dose distribution, computed by an external dose computation engine. SOWAT evaluates the effects of changing the position of each collimating leaf of each segment on an objective function, as follows. Changing a leaf position causes a change in the segment-specific dose matrix, which is calculated by a fast dose computation algorithm. A weighted sum of all segment-specific dose matrices provides the dose distribution and allows computation of the value of the objective function. Only leaf position changes that comply with the multileaf collimator constraints are evaluated. Leaf position changes that tend to decrease the value of the objective function are retained. After several possible positions have been evaluated for all collimating leaves of all segments, an external dose engine recomputes the dose distribution, based on the adapted leaf positions and weights. The plan is evaluated. If the plan is accepted, a segment sequencer is used to make the prescription files for the treatment machine. Otherwise, the user can restart SOWAT using the new set of segments, segment weights, and corresponding dose distribution. The implementation was illustrated using two example cases. The first example is a T1N0M0 supraglottic cancer case that was distributed as a multicenter planning exercise by investigators from Rotterdam, The Netherlands. The exercise involved a two-phase plan. Phase 1 involved the delivery of 46 Gy to a concave-shaped planning target volume (PTV) consisting of the primary tumor volume and the elective lymph nodal regions II-IV on both sides of the neck. Phase 2 involved a boost of

Strategic Planning: Shaping Future Success

Science.gov (United States)

2016-09-01

fielding, the PM may also be planning for future increments , sustainment and other long-term ef- forts. Strategic planning can help the PM position these...introduced the Planning, Programming, and Budgeting System (PPBS) to the DoD. Prior to that, the DoD’s budget - ing focused on areas such as overhead

Innovation indices: the need for positioning them where they properly belong.

Science.gov (United States)

Kozłowski, Jan

A specific quality of the discussion about innovation indices (scoreboards) is that more often than not the subject is dealt with from a purely technical point of view. Such a narrow approach silently assumes that indices used as a policy tool are an accurate reflection of the phenomenon and should not be questioned, and also that the whole discussion concerning them should refer to methodological aspects and is best left to the statisticians. This author is of the opinion that for an accurate evaluation of the value of indices as a policy tool, it is necessary to consider the matter from the broader point of view and from the context in which such indices are generated and used. This article puts forward the thesis that progress in science and innovation policy studies depends on a diversity of issues, approaches and perspectives. If that is the case, maintaining thematic and methodological variety may be more important than creating coherent and closed analytical tools, i.e. indices. The advantage of indices is that they focus attention on those variables which are deemed to be key. Among their disadvantages, however, are their highly abstract nature (in order to understand innovation-related phenomena, it is necessary to study them in tangible, composite forms); their tendency to skip unmeasurable determinants; their prior acceptance of definitions and concepts of innovation (instead of searching for them); the way they apply a single yardstick to diverse countries and regions, assumed linearity and causality in a complex and non-linear world, the way they direct policy towards implementing indicators (rather than identifying and solving problems). It is suggested that big data revolution will allow the emergence of a new measurement tools that will replace innovation indices.

Replacement Planning: A Starting Point for Succession Planning and Talent Management

Science.gov (United States)

Rothwell, William J.

2011-01-01

Replacement planning is a process of identifying short-term or long-term backups so that organizations have people who can assume responsibility for critical positions during emergencies. Individuals identified as "replacements" are not promised promotions; rather, they are prepared to the point where they can assume a critical position long…

Status of women and family planning: the Indian case.

Science.gov (United States)

Vaidyanathan, K E

1989-06-01

This article examines the extent to which the status of women is related to awareness, knowledge, and practice of family planning in India. It uses both macro-level data for the states of India and date from household surveys and field studies to assess the extent of interaction between the women's status indicators and family planning indicators. Results show a definite statistical relationship between women's status and women's ability to control fertility. The strongest relationship to adoption of family planning is the educational attainment of women, followed by age at marriage, and women's work participation, particularly in nonagricultural activities. Evidence from various surveys on the effects of crucial variables on reproductive behavior include 1) a marked reduction in fertility with increases in the educational level; 2) lower fertility for working women, and especially for non-manual workers; 3) a reduction in fertility with increases in age at marriage; and 4) a higher percentage of couples practicing family planning who have 2 or more surviving children, particularly if they have boys. A 1972 survey of 3 Indian states showed that 1) husbands impose a variety of restrictions on wives, with rural husbands placing more restrictions than urban husbands; 2) women's role in decision making in household affairs is positively correlated with the degree of awareness and knowledge of contraceptives as well as adoption of family planning; and 3) interspousal communication was significantly related to the practice of family planning in both rural and urban areas. In conclusion, to help encourage adoption of family planning and reduce fertility, India should 1) emphasize education for women, 2) enforce the legal minimum age at marriage, 3) promote employment opportunities for women, 4) improve women's role in decision making, and 5) encourage interspousal communication in family affairs.

TU-AB-201-05: Automatic Adaptive Per-Operative Re-Planning for HDR Prostate Brachytherapy - a Simulation Study On Errors in Needle Positioning

International Nuclear Information System (INIS)

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W; Van Vulpen, M; Moerland, M A; Senneville, B Denis de; Hautvast, G; Binnekamp, D

2015-01-01

Purpose: To develop adaptive planning with feedback for MRI-guided focal HDR prostate brachytherapy with a single divergent needle robotic implant device. After each needle insertion, the dwell positions for that needle are calculated and the positioning of remaining needles and dosimetry are both updated based on MR imaging. Methods: Errors in needle positioning may occur due to inaccurate needle insertion (caused by e.g. the needle’s bending) and unpredictable changes in patient anatomy. Consequently, the dose plan quality might dramatically decrease compared to the preplan. In this study, a procedure was developed to re-optimize, after each needle insertion, the remaining needle angulations, source positions and dwell times in order to obtain an optimal coverage (D95% PTV>19 Gy) without exceeding the constraints of the organs at risk (OAR) (D10% urethra<21 Gy, D1cc bladder<12 Gy and D1cc rectum<12 Gy). Complete HDR procedures with 6 needle insertions were simulated for a patient MR-image set with PTV, prostate, urethra, bladder and rectum delineated. Random angulation errors, modeled by a Gaussian distribution (standard deviation of 3 mm at the needle’s tip), were generated for each needle insertion. We compared the final dose parameters for the situations (I) without re-optimization and (II) with the automatic feedback. Results: The computation time of replanning was below 100 seconds on a current desk computer. For the patient tested, a clinically acceptable dose plan was achieved while applying the automatic feedback (median(range) in Gy, D95% PTV: 19.9(19.3–20.3), D10% urethra: 13.4(11.9–18.0), D1cc rectum: 11.0(10.7–11.6), D1cc bladder: 4.9(3.6–6.8)). This was not the case without re-optimization (median(range) in Gy, D95% PTV: 19.4(14.9–21.3), D10% urethra: 12.6(11.0–15.7), D1cc rectum: 10.9(8.9–14.1), D1cc bladder: 4.8(4.4–5.2)). Conclusion: An automatic guidance strategy for HDR prostate brachytherapy was developed to compensate

The Effect of Teacher Training on the Knowledge of Positive Behavior Support and the Quality of Behavior Intervention Plans: A Preliminary Study in Taiwan

Science.gov (United States)

Wu, Pei-Fang

2017-01-01

The purpose of this study was to investigate whether through a series of teacher training. The participants could acquire better knowledge on Positive Behavior Support (PBS), and develop high quality behavior intervention plans. Thirty-six teachers from three public schools participated in the study. The competency-based training consisted of 12…

Strategic planning for neuroradiologists.

Science.gov (United States)

Berlin, Jonathan W; Lexa, Frank J

2012-08-01

Strategic planning is becoming essential to neuroradiology as the health care environment continues to emphasize cost efficiency, teamwork and collaboration. A strategic plan begins with a mission statement and vision of where the neuroradiology division would like to be in the near future. Formalized strategic planning frameworks, such as the strengths, weaknesses, opportunities and threats (SWOT), and the Balanced Scorecard frameworks, can help neuroradiology divisions determine their current position in the marketplace. Communication, delegation, and accountability in neuroradiology is essential in executing an effective strategic plan. Copyright © 2012 Elsevier Inc. All rights reserved.

Indicators and their functions

DEFF Research Database (Denmark)

Gudmundsson, Henrik; Joumard, Robert; Aschemann, Ralf

2010-01-01

indicators? How can several indicators be jointly considered? And how can indicators be used in planning and decision making? Firstly we provide definition of 'indicator of environmental sustainability in transport'. The functions, strengths and weaknesses of indicators as measurement tools, and as decision...... for indicators and assessments. As the decision making context influences the perceived and actual needs for indicators and methods, we also analysed the dimensions and context of decision making. We derived criteria and methods for the assessment and selection of indicators of environmental sustainability......This report is the final report of the action COST 356 'EST - Towards the definition of a measurable environmentally sustainable transport'. It tries to answer the following questions: How can environmental impacts of transport be measured? How can measurements be transformed into operational...

Buildings Indicators for Sustainable Mobility: the District of Naples

Directory of Open Access Journals (Sweden)

Pietro D'Amico

2011-07-01

Full Text Available Mobility is a major component in ensuring freedom of movement and good quality of life. It is strictly associated to the concept of sustainability, considering that more than 70% of European citizens live in urban areas.Traffic volumes and congestion, air quality, noise pollution, consumption of non renewable resources, greenhouse gas emissions, social exclusion and urban sprawl are significant challenges to achieve sustainable urban mobility. This is one of the most important goals of the Coordination Plan of the District of Naples (PTCP. In this paper, we show the process of research, selection, valuation, weighting and synthesis of a set of indicators to monitor sustainable mobility during the realization process of the PTCP.Two urban areas lacking infrastructure connections are considered: North Naples and Giuglianese. According to the Planning Code, the GIS Office and the Planning Office are responsible for choosing the set of indicators and its application, and for evaluating if the goals of the PTCP are achievable and if corrective actions should be undertaken as well.The Environmental Report attached to the Plan sets down to link each topic of the plan to a unique index resulting from a set of specific indicators. One of the results of this study was the selection of 22 indicators for sustainable mobility.They were the outcome of the intersection between the lists available in scientific literature and the databases available for the District of Naples. As set down by the PTCP Planning Code, a top down approach was adopted Therefore indicators were selected by technicians. However, a bottom up approach, i.e. citizenship and stakeholders select indicators, would have resulted in a more transparent process. This study applied a rating method named allocation of budget to weight indicators. Weights determined the importance of each indicator compared to the others.After the weighting procedure, the aggregation of indicators into a single

Pretty Easy Pervasive Positioning

DEFF Research Database (Denmark)

Hansen, Rene; Wind, Rico; Jensen, Christian Søndergaard

2009-01-01

With the increasing availability of positioning based on GPS, Wi-Fi, and cellular technologies and the proliferation of mobile devices with GPS, Wi-Fi and cellular connectivity, ubiquitous positioning is becoming a reality. While offerings by companies such as Google, Skyhook, and Spotigo render...... positioning possible in outdoor settings, including urban environments with limited GPS coverage, they remain unable to offer accurate indoor positioning. We will demonstrate a software infrastructure that makes it easy for anybody to build support for accurate Wi-Fi based positioning in buildings. All...... that is needed is a building with Wi-Fi coverage, access to the building, a floor plan of the building, and a Wi-Fi enabled device. Specifically, we will explain the software infrastructure and the steps that must be completed to obtain support for positioning. And we will demonstrate the positioning obtained...

Indicators for Nuclear Power Development

International Nuclear Information System (INIS)

2015-01-01

Considering the scale of nuclear power aspirations, the number of planned nuclear new builds and the prospects of a number of countries constructing their first nuclear power plants, there is a need to assess the broader context of nuclear energy programmes in areas of macro-and socioeconomic conditions, energy systems and nuclear power, and the environment. It is important to assess the degree to which introduction or expansion of nuclear power is beneficial under these specific circumstances. This publication provides a set of indicators for nuclear power development that can serve as a tool to help explore these issues. The indicators are meant to provide a first order assessment of the situation and identify the issues that present the benefits and challenges in a balanced and objective manner and thereby help guide more detailed evaluations in the next stage of planning and preparations. Methodology sheets are provided to help users in data collection, quantification and interpretation of the indicators. The application of the indicators set is flexible. Users can select a subset of indicators that are most relevant for the questions they wish to explore in a given study or decision making process

Surgical accuracy of three-dimensional virtual planning

DEFF Research Database (Denmark)

Stokbro, Kasper; Aagaard, Esben; Torkov, Peter

2016-01-01

This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy...... and transverse expansion. Furthermore, only a few have evaluated the precision and accuracy of genioplasty in placement of the chin segment. The virtual surgical plan was compared with the postsurgical outcome by using three linear and three rotational measurements. The influence of maxillary segmentation...

Territorial Indicative Budget Ceilings (PIK as Instrument of Technocracy of Regional Development Planning

Directory of Open Access Journals (Sweden)

Sarjiyanto Sarjiyanto

2017-03-01

Full Text Available This research aims at analyzing the local government policy related to the local budget posture in the each territorial. There are uncertainty methods in dividing and formulating the local budget posture in each territorial in Indonesia. It is not depend on the actual economic variables of each territorial. This study uses the literature studies to collect the data of planning and budgeting. The content analysis of this local government economic policy is based on of the planning and budgeting process itself. The detailed information is found by observations and in-depth interview with the informants about the planning and budgeting process in Rembang. The result shows the variables that can determine the fair instrument in formulating the local budget posture some of which are: the number of population, the number of drop out (DO, the illiteracy (IR, the infant mortality rate (IMR, the malnutrition data, the number of poor (HCI, the economic growth, the damaged road infrastructure, the damaged irrigation system, the damaged schools, the land building tax, and the amount of retribution.

Isohaline position as a habitat indicator for estuarine populations

Science.gov (United States)

Jassby, Alan D.; Kimmerer, W.J.; Monismith, Stephen G.; Armor, C.; Cloern, James E.; Powell, T.M.; Vedlinski, Timothy J.

1995-01-01

Populations of native and introduced aquatic organisms in the San Francisco Bay/Sacramento-San Joaquin Delta Estuary ("Bay/Delta") have undergone significant declines over the past two decades. Decreasedriver inflow due to drought and increased freshwater diversion have contributed to the decline of atleast some populations. Effective management of the estuary's biological resources requires a sensitive indicatorof the response to freshwater inflow that has ecological significance, can be measured accurately and easily,and could be used as a "policy" variable to set standards for managing freshwater inflow. Positioning of the2% (grams of salt per kilogram of seawater) bottom salinity value along the axis of the estuary was examinedfor this purpose.

Condition Indicators for Inspection Planning of Concrete Structures

DEFF Research Database (Denmark)

Faber, Michael Havbro; Sørensen, John Dalsgaard

2002-01-01

Based on previous work by the authors a Bayesian formulation of condition indicators is developed further whereby in conjunction with a systems modelling of concrete structures the experience and expertise of the inspection personnel may be fully utilized. It is shown how the predicted evolution ...

Prevalence of rape-related pregnancy as an indication for abortion at two urban family planning clinics.

Science.gov (United States)

Perry, Rachel; Zimmerman, Lindsay; Al-Saden, Iman; Fatima, Aisha; Cowett, Allison; Patel, Ashlesha

2015-05-01

We sought to estimate the prevalence of rape-related pregnancy as an indication for abortion at two public Chicago facilities and to describe demographic and clinical correlates of women who terminated rape-related pregnancies. We performed a cross-sectional study of women obtaining abortion at the Center for Reproductive Health (CRH) at University of Illinois Health Sciences Center and Reproductive Health Services (RHS) at John H. Stroger, Jr. Hospital between August 2009 and August 2013. Gestational age limits at CRH and RHS were 23+6 and 13+6weeks, respectively. We estimated the prevalence of rape-related pregnancy based on billing code (CRH) or data from an administrative database (RHS), and examined relationships between rape-related pregnancy and demographic and clinical variables. Included were 19,465 visits for abortion. The majority of patients were Black (85.6%). Prevalence of abortion for rape-related pregnancy was 1.9%, and was higher at CRH (6.9%) than RHS (1.5%). Later gestational age was associated with abortion for rape-related pregnancy (median 12days, prape-related pregnancy at CRH only (prape-related pregnancy than among those terminating for other indications. Rape-related pregnancy as an indication for abortion had a low, but clinically significant prevalence at two urban Chicago family planning centers. Later gestational age was associated with abortion for rape-related pregnancy. Rape-related pregnancy may occur with higher prevalence among some subgroups of women seeking abortion than others. Efforts to address rape-related pregnancy in the abortion care setting are needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Strategic planning--a plan for excellence for South Haven Health System.

Science.gov (United States)

Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

2011-01-01

South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

Typology and indicators of ecosystem services for marine spatial planning and management

NARCIS (Netherlands)

Bohnke-Henrichs, A.; Baulcomb, C.; Koss, R.; Hussain, S.; Groot, de R.S.

2013-01-01

The ecosystem services concept provides both an analytical and communicative tool to identify and quantify the link between human welfare and the environment, and thus to evaluate the ramifications of management interventions. Marine spatial planning (MSP) and Ecosystem-based Management (EBM) are a

The interventional radiology business plan.

Science.gov (United States)

Beheshti, Michael V; Meek, Mary E; Kaufman, John A

2012-09-01

Strategic planning and business planning are processes commonly employed by organizations that exist in competitive environments. Although it is difficult to prove a causal relationship between formal strategic/business planning and positive organizational performance, there is broad agreement that formal strategic and business plans are components of successful organizations. The various elements of strategic plans and business plans are not common in the vernacular of practicing physicians. As health care becomes more competitive, familiarity with these tools may grow in importance. Herein we provide an overview of formal strategic and business planning, and offer a roadmap for an interventional radiology-specific plan that may be useful for organizations confronting competitive and financial threats. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Adaptive prostate IGRT combining online re-optimization and re-positioning: a feasibility study

International Nuclear Information System (INIS)

Li Taoran; Zhu Xiaofeng; Lee, W Robert; Vujaskovic, Zeljko; Yin Fangfang; Wu, Q Jackie; Thongphiew, Danthai

2011-01-01

In prostate radiation therapy, inter-fractional organ motion/deformation has posed significant challenges on reliable daily dose delivery. To correct for this issue, off-line re-optimization and online re-positioning have been used clinically. In this paper, we propose an adaptive images guided radiation therapy (AIGRT) scheme that combines these two correction methods in an anatomy-driven fashion. The AIGRT process first tries to find a best plan for the daily target from a plan pool, which consists of the original CT plan and all previous re-optimized plans. If successful, the selected plan is used for daily treatment with translational shifts. Otherwise, the AIGRT invokes the re-optimization process of the CT plan for the anatomy of the day, which is afterward added to the plan pool as a candidate for future fractions. The AIGRT scheme is evaluated by comparisons with daily re-optimization and online re-positioning techniques based on daily target coverage, organs at risk (OAR) sparing and implementation efficiency. Simulated treatment courses for 18 patients with re-optimization alone, re-positioning alone and AIGRT shows that AIGRT offers reliable daily target coverage that is highly comparable to daily re-optimization and significantly improves from re-positioning. AIGRT is also seen to provide improved OAR sparing compared to re-positioning. Apart from dosimetric benefits, AIGRT in addition offers an efficient scheme to integrate re-optimization to current re-positioning-based IGRT workflow.

Direct reconstruction and associated uncertainties of 192Ir source dwell positions in ring applicators using gafchromic film in the treatment planning of HDR brachytherapy cervix patients

Science.gov (United States)

Awunor, O. A.; Dixon, B.; Walker, C.

2013-05-01

This paper details a practical method for the direct reconstruction of high dose rate 192Ir source dwell positions in ring applicators using gafchromic film in the treatment planning of brachytherapy cervix patients. It also details the uncertainties associated with such a process. Eight Nucletron interstitial ring applicators—Ø26 mm (×4), Ø30 mm (×3) and Ø34 mm (×1), and one 60 mm intrauterine tube were used in this study. RTQA2 and XRQA2 gafchromic films were irradiated at pre-programmed dwell positions with three successive 192Ir sources and used to derive the coordinates of the source dwell positions. The source was observed to deviate significantly from its expected position by up to 6.1 mm in all ring sizes. Significant inter applicator differences of up to 2.6 mm were observed between a subset of ring applicators. Also, the measured data were observed to differ significantly from commercially available source path models provided by Nucletron with differences of up to 3.7 mm across all ring applicator sizes. The total expanded uncertainty (k = 2) averaged over all measured dwell positions in the rings was observed to be 1.1 ± 0.1 mm (Ø26 mm and Ø30 mm rings) and 1.0 ± 0.3 mm (Ø34 mm ring) respectively, and when transferred to the treatment planning system, equated to maximum %dose changes of 1.9%, 13.2% and 1.5% at regions representative of the parametrium, lateral fornix and organs at risk respectively.

GRTgaz 10-year indicative development plan 2007-2016

International Nuclear Information System (INIS)

2007-01-01

GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. In accordance with the French Energy Code, GRTgaz publishes a 10-year development plan for its gas distribution network in France every year. This document is produced in line with European and French energy policies. It identifies the transport infrastructure that will need to be built over the next three years, and presents the main infrastructure that is likely to be developed within the next ten years. It incorporates the supply security obligations that TSOs are required to fulfil. It takes account of interested parties' needs and projects at the national, supranational and European levels. It is based on existing gas supply and demand and reasonable medium-term development forecasts for gas infrastructure, consumption and international trade

Key Performance Indicators for the Impact of Cognitive Assembly Planning on Ramp-Up Process

OpenAIRE

Buescher, Christian; Hauck, Eckart; Schilberg, Daniel; Jeschke, Sabina

2012-01-01

Within the ramp-up phase of highly automated assembly systems, the planning effort forms a large part of production costs. Due to shortening product lifecycles, changing customer demands, and therefore an increasing number of ramp-up processes, these costs even rise. So assembly systems should reduce these efforts and simultaneously be flexible for quick adaption to changes in products and their variants. A cognitive interaction system in the field of assembly planning systems is developed wi...

Portraying Temporal Dynamics of Urban Spatial Divisions with Mobile Phone Positioning Data: A Complex Network Approach

Directory of Open Access Journals (Sweden)

Meng Zhou

2016-12-01

Full Text Available Spatial structure is a fundamental characteristic of cities that influences the urban functioning to a large extent. While administrative partitioning is generally done in the form of static spatial division, understanding a more temporally dynamic structure of the urban space would benefit urban planning and management immensely. This study makes use of a large-scale mobile phone positioning dataset to characterize the diurnal dynamics of the interaction-based urban spatial structure. To extract the temporally vibrant structure, spatial interaction networks at different times are constructed based on the movement connections of individuals between geographical units. Complex network community detection technique is applied to identify the spatial divisions as well as to quantify their temporal dynamics. Empirical analysis is conducted using data containing all user positions on a typical weekday in Shenzhen, China. Results are compared with official zoning and planned structure and indicate a certain degree of expansion in urban central areas and fragmentation in industrial suburban areas. A high level of variability in spatial divisions at different times of day is detected with some distinct temporal features. Peak and pre-/post-peak hours witness the most prominent fluctuation in spatial division indicating significant change in the characteristics of movements and activities during these periods of time. Findings of this study demonstrate great potential of large-scale mobility data in supporting intelligent spatial decision making and providing valuable knowledge to the urban planning sectors.

Work environment perceptions following relocation to open-plan offices: A twelve-month longitudinal study.

Science.gov (United States)

Bergström, Jessica; Miller, Michael; Horneij, Eva

2015-01-01

A workplace's design can have various positive or negative effects on the employees and since the 1970s the advantages and disadvantages of open-plan offices have been discussed. The aim of this study was to investigate perceived health, work environment and self-estimated productivity one month before and at three, six and twelve months after relocation from individual offices to an open-plan office environment. Employees from three departments within the same company group and who worked with relatively similar tasks and who were planned to be relocated from private offices to open-plan offices were invited to participate. Questionnaires comprising items from The Salutogenic Health Indicator Scale, The Work Experience Measurement Scale, the questionnaire by Brennan et al. about perceived performance and one question from the Work Ability Index were sent to participants one month before relocation (baseline) to open-plan offices and then at three, six and twelve months after relocation. At baseline, 82 questionnaires were sent out. The response rate was 85%. At the follow-ups 77-79 questionnaires were sent out and the response-rate was 70%-81%. At follow-ups, perceived health, job satisfaction and performance had generally deteriorated. The results of the study indicate that employees' perception of health, work environment and performance decreased during a 12 month period following relocation from individual offices to open-plan offices.

Logistic regression analysis of financial literacy implications for retirement planning in Croatia

Directory of Open Access Journals (Sweden)

Dajana Barbić

2016-12-01

Full Text Available The relationship between financial literacy and financial behavior is important, as individuals are increasingly being asked to take responsibility for their financial wellbeing, especially their retirement. Analyzing of individual savings and attitudes towards retirement planning is important, as these types of investments are a way of preserving security during years of financial vulnerability. Research indicates that individuals who do not save adequately for their retirement, generally have a relatively low level of financial literacy. This research investigates the relationship between financial literacy and retirement planning in Croatia. To analyze the relationship between financial literacy and planning for retirement, maximum likelihood logistic regression analysis was used. The paper shows that those who answer financial literacy questions correctly are more likely to have a positive attitude towards retirement planning and are more likely to save for retirement, ensuring them of higher levels of financial security in retirement. The Goodness-of-Fit evaluation for the estimated logit model was performed using the Andrews and Hosmer-Lemeshow Tests.

Trophic position of soil nematodes in boreal forests as indicated by stable isotope analysis

Science.gov (United States)

Kudrin, Alexey; Tsurikov, Sergey

2016-04-01

Despite the well-developed trophic classification of soil nematodes, their position in soil food webs is still little understood. Observed deviations from the typical feeding strategy indicate that a simplified trophic classification probably does not fully reflect actual trophic interactions. Furthermore, the extent and functional significance of nematodes as prey for other soil animals remains unknown. Stable isotope analysis (SIA) is powerful tool for investigating the structure of soil food webs, but its application to the study of soil nematodes has been limited to only a few studies. We used stable isotope analysis to gain a better understanding of trophic links of several groups of soil nematodes in two boreal forests on albeluvisol. We investigated four taxonomic groups of nematodes: Mononchida, Dorylaimida, Plectidae and Tylenchidae (mostly from the genus Filenchus), that according to the conventional trophic classification represent predators, omnivores, bacterivores and root-fungal feeders, respectively. To assess the trophic position of nematodes, we used a comparison against a set of reference species including herbivorous, saprophagous and predatory macro-invertebrates, oribatid and mesostigmatid mites, and collembolans. Our results suggest that trophic position of the investigated groups of soil nematodes generally corresponds to the conventional classification. All nematodes were enriched in 13C relative to Picea abies roots and litter, and mycorrhizal fungal mycelium. Root-fungal feeders Tylenchidae had δ15N values similar to those of earthworms, enchytraeids and Entomobrya collembolans, but slightly lower δ13C values. Bacterivorous Plectidae were either equal or enriched in 15N compared with saprophagous macroinvertebrates and most mesofauna species. Omnivorous Dorylaimida and predatory Mononchida were further enriched in 15N and their isotopic signature was similar to that of predatory arthropods. These data confirm a clear separation of

Performance indicators for roadway bridges

OpenAIRE

Strauss, A.; Vidovic, A.; Zambon, I.; Dengg, F.; Tanasic, N.; Matos, José C.

2016-01-01

Publicado em "Maintenance, monitoring, safety, risk and resilience of bridges and bridge networks". ISBN 978-1-138-02851-7 The performance indicators should, by its definition, allow capturing the life-cycle degradation processes affecting maintenance plans or the remaining lifetime. The qualitative or quantitative performance indicators are obtained through visual inspections, non-destructive tests or monitoring systems. After their quantification and the comparison with the resp...

Optimal grasp planning for a dexterous robotic hand using the volume of a generalized force ellipsoid during accepted flattening

Directory of Open Access Journals (Sweden)

Peng Jia

2017-01-01

Full Text Available A grasp planning method based on the volume and flattening of a generalized force ellipsoid is proposed to improve the grasping ability of a dexterous robotic hand. First, according to the general solution of joint torques for a dexterous robotic hand, a grasping indicator for the dexterous hand—the maximum volume of a generalized external force ellipsoid and the minimum volume of a generalized contact internal force ellipsoid during accepted flattening—is proposed. Second, an optimal grasp planning method based on a task is established using the grasping indicator as an objective function. Finally, a simulation analysis and grasping experiment are performed. Results show that when the grasping experiment is conducted with the grasping configuration and positions of contact points optimized using the proposed grasping indicator, the root-mean-square values of the joint torques and contact internal forces of the dexterous hand are at a minimum. The effectiveness of the proposed grasping planning method is thus demonstrated.

Rotec Theory: planning tool to position hospitals on the technology curve.

Science.gov (United States)

Roberts, R

1990-06-01

The mission statement of a prominent California hospital has been revised as part of a strategic planning process less than two years before the hospital began experiencing substantial financial difficulties. When the "red numbers" began to appear, management was quick to blame changing demographic patterns and the competitive environment. Those were not the only problems. A major contributing factor that management failed to recognize was a delay in how quickly the hospital moved to adopt high technology or new medical procedures. In a few short years, it had changed from being the first community hospital to implement state-of-the-art programs to one that was slow to introduce technology. In retrospect, the hospital's mission statement did not address the role of technology and therefore it could not detect the movement away from one of its critical success factors. The Rotec Theory was developed to assist this hospital to understand the economics of technology on its current and planned operations.

Marketing planning by learning: "Plearning" approach

Directory of Open Access Journals (Sweden)

Ilić Milovan M.

2006-01-01

Full Text Available This work emphasizes that the final outcome of planning is not only the benefit of having the ready plan but showing that the very process of planning through which a business goes through, is important. Here we consider the process of learning in order to get a complete picture of current and future business processes. Three stages of learning are included. The first stage describes the current position of the business; the second stage describes the position of the business in the future and the last stage shows how the business will achieve these objectives. The focus of planning should be deciding on internal communication which form the basis for gaining the competitive advantage. One of the ways for carrying out this analysis is creating the matrix based on gaining competitive advantage through using resources.

Planning for positive clinical & financial returns with telemonitoring.

Science.gov (United States)

Wright, Kristy

2003-10-01

Telemonitoring is a burgeoning market in the home care industry. Making the decision to invest in telemonitoring technology can be difficult in the best situations. The financial investment is significant, the risks can be high, and the need to achieve a positive return is critical to future success. In spite of the risks, this relatively new technology in home care holds the promise for the redefinition of the industry.

Business planning for scientists and engineers

Energy Technology Data Exchange (ETDEWEB)

Servo, J.C.; Hauler, P.D.

1992-03-01

Business Planning for Scientists and Engineers is a combination text/workbook intended for use by individuals and firms having received Phase II SBIR funding (Small Business Innovation Research). It is used to best advantage in combination with other aspects of the Commercialization Assistance Project developed by Dawnbreaker for the US Department of Energy. Although there are many books on the market which indicate the desired contents of a business plan, there are none which clearly indicate how to find the needed information. This book focuses on the how of business planning: how to find the needed information; how to keep yourself honest about the market potential; how to develop the plan; how to sell and use the plan.

A new plan quality index for nasopharyngeal cancer SIB IMRT.

Science.gov (United States)

Jin, X; Yi, J; Zhou, Y; Yan, H; Han, C; Xie, C

2014-02-01

A new plan quality index integrating dosimetric and radiobiological indices was proposed to facilitate the evaluation and comparison of simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) plans for nasopharyngeal cancer (NPC) patients. Ten NPC patients treated by SIB-IMRT were enrolled in the study. Custom software was developed to read dose-volume histogram (DVH) curves from the treatment planning system (TPS). A plan filtering matrix was introduced to filter plans that fail to satisfy treatment protocol. Target plan quality indices and organ at risk (OAR) plan quality indices were calculated for qualified plans. A unique composite plan quality index (CPQI) was proposed based on the relative weight of these indices to evaluate and compare competing plans. Plan ranking results were compared with detailed statistical analysis, radiation oncology quality system (ROQS) scoring results and physician's evaluation results to verify the accuracy of this new plan quality index. The average CPQI values for plans with OAR priority of low, normal, high, and PTV only were 0.22 ± 0.08, 0.49 ± 0.077, 0.71 ± 0.062, and -0.21 ± 0.16, respectively. There were significant differences among these plan quality indices (One-way ANOVA test, p plans were selected. Plan filtering matrix was able to speed up the plan evaluation process. The new matrix plan quality index CPQI showed good consistence with physician ranking results. It is a promising index for NPC SIB-IMRT plan evaluation. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Training and plant performance: a strategic planning partnership

International Nuclear Information System (INIS)

Coe, R.P.

1987-01-01

The nuclear industry as a whole, and specifically GPU Nuclear, is refocusing its attention on performance indicators. This standardized assessment of plant operational performance surfaces numerous examples of how performance-based training positively impacts plant performance. Numerous examples of high dollar savings range from scram reduction programs to reducing personnel rem exposures. The deeper the authors look the more they find that training is making a difference. The question now is, how long can they continue to afford the ever increasing demands of the pursuit of excellence. Early in 1985, the Training and Education Department at GPU Nuclear proactively began its strategic planning effort in order to address the increasing industry initiatives while facing flat or reduced commitments of resources. The Training Strategic Plan addresses detailed plans for each of the following areas: curriculum planning; program development; training and education organizational structure; training and education administrative procedures; training advisory structure and priority process; financial strategies. All of the above strategies are designed to assure training effectiveness. With the nuclear option under such strong public scrutiny, it is in the best interest of all of the nuclear utilities to assure the most cost effective approach to successful operation while achieving their standards of excellence

An anatomic study of nipple position and areola size in Asian men.

Science.gov (United States)

Kasai, Shogo; Shimizu, Yusuke; Nagasao, Tomohisa; Ohnishi, Fumio; Minabe, Toshiharu; Momosawa, Akira; Kishi, Kazuo

2015-02-01

In planning gender-reassignment surgery for biological women and treating men with gynecomastia, surgeons must have a thorough understanding of anatomically correct nipple positions and appropriate areola sizes in men. The authors sought to determine whether body height or body mass index (BMI) affects nipple position or areola size in men. Anatomic measurements of the nipples and areolae of 50 Japanese men were obtained. A relative coordinate system was defined, where the medial-lateral and superior-inferior positions of the nipple were quantitatively indicated by distance ratios between anatomic landmarks. Nipple positions were evaluated for each patient by referring to this coordinate system, and the positions were compared between groups categorized by body height or BMI. Nipple position was not significantly affected by body height. However, the nipple tended to be located more laterally in participants with higher BMI. The vertical nipple position differed between standing and supine positions. Tall men had larger areolae than short men; however, areola size did not differ with respect to BMI. Nipple position and areola size vary by body shape. Consideration of the differences is recommended when performing procedures such as female-to-male gender-reassignment surgery or correction of gynecomastia. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Unintended pregnancy among HIV positive couples receiving integrated HIV counseling, testing, and family planning services in Zambia.

Science.gov (United States)

Wall, Kristin M; Haddad, Lisa; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-01-01

We describe rates of unintended pregnancy among HIV positive couples in Lusaka, Zambia. We also identify factors associated with unintended pregnancy among oral contraceptive pill (OCP) using couples in this cohort. Data were analyzed from couples randomized in a factorial design to two family planning intervention videos. Rates of unintended pregnancy were stratified by contraceptive method used at time of pregnancy. Predictors of time to unintended pregnancy among OCP users were determined via multivariate Cox modeling. The highest rates of unintended pregnancy were observed among couples requesting condoms only (26.4/100CY) or OCPs (20.7/100CY); these rates were not significantly different. OCP users accounted for 37% of the couple-years (CY) observed and 87% of unintended pregnancies. Rates of unintended pregnancy for injectable (0.7/100CY) and intrauterine device (1.6/100CY) users were significantly lower relative to condom only users. No pregnancies occurred among contraceptive implant users or after tubal ligation. Factors associated (psex without a condom. Long-acting reversible contraceptive methods were effective in the context of integrated couples HIV prevention and contraceptive services. Injectable methods were also effective in this context. Given the high user failure rate of OCPs, family planning efforts should promote longer-acting methods among OCP users wishing to avoid pregnancy. Where other methods are not available or acceptable, OCP adherence counseling is needed, especially among younger and new OCP users. ClinicalTrials.gov NCT00067522.

Satisfaction with work-life balance and the career and retirement plans of US oncologists.

Science.gov (United States)

Shanafelt, Tait D; Raymond, Marilyn; Kosty, Michael; Satele, Daniel; Horn, Leora; Pippen, John; Chu, Quyen; Chew, Helen; Clark, William Benton; Hanley, Amy E; Sloan, Jeff; Gradishar, William J

2014-04-10

To evaluate satisfaction with work-life balance (WLB) and career plans of US oncologists. The American Society of Clinical Oncology conducted a survey of US oncologists evaluating satisfaction with WLB and career plans between October 2012 and March 2013. The sample included equal numbers of men and women from all career stages. Of 2,998 oncologists contacted, 1,490 (49.7%) returned surveys. From 1,117 oncologists (37.3% of overall sample) completing full-length surveys, we evaluated satisfaction with WLB and career plans among the 1,058 who were not yet retired. The proportion of oncologists satisfied with WLB (n = 345; 33.4%) ranked lower than that reported for all other medical specialties in a recent national study. Regarding career plans, 270 oncologists (26.5%) reported a moderate or higher likelihood of reducing their clinical work hours in the next 12 months, 351 (34.3%) indicated a moderate or higher likelihood of leaving their current position within 24 months, and 273 (28.5%) planned to retire before 65 years of age. Multivariable analyses found women oncologists (odds ratio [OR], 0.458; P hour, 0.977; P work hours and leave current position on multivariable analysis. Satisfaction with WLB among US oncologists seems lower than for other medical specialties. Dissatisfaction with WLB shows a strong relationship with plans to reduce hours and leave current practice. Given the pending US oncologist shortage, additional studies exploring interactions among WLB, burnout, and career satisfaction and their impact on career and retirement plans are warranted.

Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption.

Science.gov (United States)

van Osch, Liesbeth; Beenackers, Mariëlle; Reubsaet, Astrid; Lechner, Lilian; Candel, Math; de Vries, Hein

2009-10-13

Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572) and one on high-caloric snack consumption (N = 585) in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health risk behaviors. Future interventions in dietary modification may

Project W-314 acceptance test report HNF-4643 for HNF-4642 241-AN-A valve pit manifold valves and position indication for project W-314

International Nuclear Information System (INIS)

HAMMERS, J.S.

1999-01-01

The purpose of the test was to verify that the AN Tank Farm Manifold Valves can be manually manipulated to the required operating position and that the electrical and visual indications accurately reflect that position. Physical locking devices were also verified to function. The Acceptance Test Procedure HNF-4642, 241-AN-A Valve Pit Manifold Valves and Position Indication was conducted between 23 June and 10 August 1999 at the 200E AN Tank Farm. The test has no open test exceptions. The test was conducted prior to final engineering ''as built'' activities being completed, this had an impact on the procedure and test results, ECN 653752 was written to correct the mismatch between the procedure and actual field conditions. P and ID H-14-100941 was changed via ECN-W-314-4C-120. All components, identified in the procedure, were not found to be labeled and identified as written in the procedure, temporary tags were used for operational identification. A retest of valve ANA-WT-V 318 was required because it was removed from its installed position and modified after testing was completed

Health Plan Performance Measurement within Medicare Subvention.

Science.gov (United States)

1998-06-01

the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

Treatment Planning for Ion Beam Therapy

Science.gov (United States)

Jäkel, Oliver

The special aspects of treatment planning for ion beams are outlined in this chapter, starting with positioning and immobilization of the patient, describing imaging and segmentation, definition of treatment parameters, dose calculation and optimization, and, finally, plan assessment, verification, and quality assurance.

Ethnic inequalities in doctor-patient communication regarding personal care plans: the mediating effects of positive mental wellbeing.

Science.gov (United States)

Umeh, Kanayo F

2017-04-06

There is limited understanding of ethnic inequalities in doctor-patient communication regarding personal care plans (PCPs). This study investigated the mediating effects of positive mental wellbeing on differences in PCP-related doctor-patient communication amongst South Asian and Caucasian UK residents. Data from 10,980 respondents to the 2013 Health Survey for England was analysed using bootstrapping methods. Constructs from the WEMWBS (Warwick and Edinburgh Mental Wellbeing Scale) (Stewart-Brown, S., and K. Janmohamed. 2008. Warwick, UK) were assessed as mediators of relations between ethnicity and several doctor-patient communication variables, including PCP-related interactions; (a) had a PCP-related discussion about a long-term condition with a doctor/nurse, and (b) had this conversation within the past year, (c) agreed to a PCP with a health professional; and (d) talked to a doctor in the past 2 weeks. Bootstrapped mediation analysis (Hayes, A. F. 2013. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-based Approach. New York, NY: The Guilford Press) showed that three positive mind-sets mediated associations between ethnicity and doctor-patient contact, including PCP-related communication. Being able to make up one's mind (ab = -0.05; BC a CI [-0.14, 0.01]) mediated the effect of ethnicity on agreeing to a PCP, while having energy to spare (ab = 0.07; BC a CI [-0.04, 0.12]), and feeling good about oneself (ab = 0.03; BC a CI [0.01, 0.07]), mediated ethnic effects on talking to a doctor during the past fortnight. The mediating effect of reported energy persisted after controlling for medical history, perceived health, and other covariates. Ethnic disparities in doctor-patient interaction, including PCP-related communication, are partly explained by positive mental wellbeing. Gauging positive psychological moods in patients, particularly self-worth, self-perceived vigour and decisiveness, are relevant to

Overweight and weight dissatisfaction related to socio-economic position, integration and dietary indicators among south Asian immigrants in Oslo.

Science.gov (United States)

Råberg, Marte; Kumar, Bernadette; Holmboe-Ottesen, Gerd; Wandel, Margareta

2010-05-01

To investigate how socio-economic position, demographic factors, degree of integration and dietary indicators are related to BMI/waist:hip ratio (WHR) and to weight dissatisfaction and slimming among South Asians in Oslo, Norway. Cross-sectional study consisting of a health check including anthropometric measures and two self-administered questionnaires. Oslo, Norway. Pakistanis and Sri Lankans (n 629), aged 30-60 years, residing in Oslo. BMI was positively associated with female gender (P = 0.004) and Pakistani origin (P integration (measured by a composite index, independent of duration of residence; P = 0.017). One-third of those with normal weight and most of those obese were dissatisfied with their weight. Among these, about 40 % had attempted to slim during the past year. Dissatisfaction with weight was positively associated with education in women (P = 0.006) and with integration in men (P = 0.026), and inversely associated with physical activity (P = 0.044) in men. Women who had made slimming attempts had breakfast and other meals less frequently than others (P < 0.05). Weight dissatisfaction exists among South Asian immigrants. More research is needed regarding bodily dissatisfaction and the relationship between perception of weight and weight-change attempts among immigrants in Norway, in order to prevent and treat both obesity and eating disorders.

Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

Science.gov (United States)

Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

2014-04-01

We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

Integration of on-line imaging, plan adaptation and radiation delivery: proof of concept using digital tomosynthesis

International Nuclear Information System (INIS)

Mestrovic, Ante; Otto, Karl; Nichol, Alan; Clark, Brenda G

2009-01-01

The main objective of this manuscript is to propose a new approach to on-line adaptive radiation therapy (ART) in which daily image acquisition, plan adaptation and radiation delivery are integrated together and performed concurrently. A method is described in which on-line ART is performed based on intra-fractional digital tomosynthesis (DTS) images. Intra-fractional DTS images were reconstructed as the gantry rotated between treatment positions. An edge detection algorithm was used to automatically segment the DTS images as the gantry arrived at each treatment position. At each treatment position, radiation was delivered based on the treatment plan re-optimized for the most recent DTS image contours. To investigate the feasibility of this method, a model representing a typical prostate, bladder and rectum was used. To simulate prostate deformations, three clinically relevant, non-rigid deformations (small, medium and large) were modeled by systematically deforming the original anatomy. Using our approach to on-line ART, the original treatment plan was successfully adapted to arrive at a clinically acceptable plan for all three non-rigid deformations. In conclusion, we have proposed a new approach to on-line ART in which plan adaptation is performed based on intra-fractional DTS images. The study findings indicate that this approach can be used to re-optimize the original treatment plan to account for non-rigid anatomical deformations. The advantages of this approach are 1) image acquisition and radiation delivery are integrated in a single gantry rotation around the patient, reducing the treatment time, and 2) intra-fractional DTS images can be used to detect and correct for patient motion prior to the delivery of each beam (intra-fractional patient motion).

Research on the Evaluation System for Rural Public Safety Planning

Institute of Scientific and Technical Information of China (English)

Ming; SUN; Jianxin; YAN

2014-01-01

The indicator evaluation system is introduced to the study of rural public safety planning in this article.By researching the current rural public safety planning and environmental carrying capacity,we select some carrying capacity indicators influencing the rural public safety,such as land,population,ecological environment,water resources,infrastructure,economy and society,to establish the environmental carrying capacity indicator system.We standardize the indicators,use gray correlation analysis method to determine the weight of indicators,and make DEA evaluation of the indicator system,to obtain the evaluation results as the basis for decision making in rural safety planning,and provide scientific and quantified technical support for rural public safety planning.

Smart patient, smart community: improving client participation in family planning consultations through a community education and mass-media program in Indonesia.

Science.gov (United States)

Kim, Young Mi; Bazant, Eva; Storey, J Douglas

In health care consultations, patients often receive insufficient information from providers and communicate little with providers about their needs or concerns. This study evaluated a combined community education and mass media intervention to improve clients' participation in family planning consultations. A household survey was conducted with 1,200 women in three sub-districts (two intervention and one control) of West Java province in Indonesia. A comparison of post-campaign findings among family planning clients suggests that the intervention as a whole had a positive effect on client participation, specifically the number of clients who prepared questions to ask the service provider prior to a family planning visit in the past year. Multivariate analyses showed that the "Smart Card" intervention and elements of the "Sahabat" (Friend) mass media campaign were positively associated with clients' preparation of questions and question asking behavior during family planning consultations, indicating that a combined community education and mass-media approach can improve client communication with providers and improve the quality of family planning counseling.

MDOT implementation plan for GPS technology in planning, design, and construction delivery

Science.gov (United States)

2010-09-13

Global Positioning System (GPS) technology offers advantages to transportation agencies in the planning, design and construction stages of project delivery. This research study will develop a guide for Mississippi Department of Transportation (MDOT) ...

Demand for family planning among HIV positive women on ART: the case of South Gondar and North Wollo Zones Amhara region.

Science.gov (United States)

Abeje, Gedefaw; Motbaynor, Achenef

2016-01-25

Although family planning for human immune deficiency virus positive women has numerous advantages, evidences in different parts of the world showed the existence of persistent unmet need. There were few studies done in Ethiopia on level of unmet need for family planning among women in reproductive age on antiretroviral therapy (ART). This study was therefore done to determine the level of demand and unmet need for family planning among women on ART in South Gondar and North Wollo Zones, Amhara region. Institution based cross-sectional study design was used. Data was collected from June 15 to 25, 2013 in South Gondar and North Wollo Zones. Study participants were recruited from six health centers and two hospitals. The study participants were proportionally allocated to the health institutions. Multistage sampling technique was used to recruit study participants. Trained nurses interviewed the respondents using pretested structured Amharic questionnaire. Data was entered, cleaned and analyzed using Statistical Package for Social Science version 16. Ratios and proportions were computed to determine demand and unmet need for family planning. A total of 530 women in reproductive age on ART were interviewed in this study. Two hundred ninety-three women were married. Fourteen (2.6%) women were pregnant at the time of interview. Five of these pregnancies were not planned. In this study, 242 (45.7%) women reported that they were using contraceptives. Most women (74.4%) were using injectable (depo). Among those who were not using contraceptives, 84 (29.2%) reported that they will use in the future. Fifty-two (61.9%) of them said that they will use injectables (depo). In this study, the total demand for family planning among women on ART was 86.7%. From this, 62.1% and 24.6% was met and unmet need respectively. This study revealed that the level of demand and met need for modern contraceptives among reproductive age women on antiretroviral therapy in South Gondar and North

Nurse manager succession planning: synthesis of the evidence.

Science.gov (United States)

Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

2013-10-01

The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

International Nuclear Information System (INIS)

Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q.

2015-01-01

. Results: Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system’s ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. Conclusions: The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

Energy Technology Data Exchange (ETDEWEB)

Li, Taoran, E-mail: taoran.li.duke@gmail.com; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q. [Department of Radiation Oncology, Duke University Medical Center Durham, North Carolina 27710 (United States)

2015-01-15

. Results: Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system’s ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. Conclusions: The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.

Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation.

Science.gov (United States)

Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q

2015-01-01

found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system's ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.

Transition Planning for Foster Youth

Science.gov (United States)

Geenen, Sarah J.; Powers, Laurie E.

2006-01-01

The study evaluated the IEPs/Individualized Transition Plans of 45 students who were in special education and foster care, and compared them to the plans of 45 students who were in special education only. Results indicate that the transition plans of foster youth with disabilities were poor in quality, both in absolute terms and in comparison to…

Proposal of performance indicators/model for Operational Readiness Verification (ORV) at restart after a planned shutdown

International Nuclear Information System (INIS)

Hollnagel, Erik; Nygren, Magnus

2005-12-01

The objectives of the study reported here were to propose a model that can be used in the analysis of possible future ORV-related events and to outline a set of performance indicators that can be used by the inspectorate to assess a utility's level of readiness if an ORV-event should take place. Together the two objectives serve to improve the inspectorate's ability to ensure that the utilities maintain an adequate capability to respond. The background for the current study is the nine ORV events that occurred in Sweden between 1995- 1998, as well as the findings of a previous study of safety during outage and restart of nuclear power plants project. This study found that the three levels or types of tests that occur in ORV were used according to need rather than according to a predefined arrangement or procedure, and that tasks were adapted relative to the different types of embedding and the degree of correspondence between nominal and actual ORV. The organisation's coping with the complexity of ORV was discussed by the relation between expectations and surprises, how planning was used as control, attention to details, and the practices of shift changes. It is a truism that accidents are analysed and interpreted relative to a commonly accepted understanding of their nature. This understanding is, however, relative rather than absolute, and has changed significantly during the last decade. In the 1990s, accidents were analysed step by step, and explanations and recommendations therefore emphasised specific rather than generic solutions. The present study illustrates this by going through the responses to the nine ORV events. Following that, the nine events are analysed anew using a contemporary understanding of accidents (a systemic model), which emphasises that incidents more often arise from context induced performance variability than from failures of people. The alternative interpretation provided by a systemic model is illustrated by a detailed analysis of

Waypoint planning with Dubins Curves using Genetic Algorithms

DEFF Research Database (Denmark)

Hansen, Karl Damkjær; La Cour-Harbo, Anders

2016-01-01

Mission planning for aircraft is often done as waypoint planning. A sequence of waypoints describing the three-dimensional positions that the aircraft must visit. A common approach is to plan the sequence of the waypoints such that the Euclidean distance between them is minimized. When the high...

The Palliative Treatment Plan as a Bone of Contention between Attending Physicians and Nurses

Directory of Open Access Journals (Sweden)

Wolfgang Lederer

2015-10-01

Full Text Available Acute vital crisis in end-of-life situations may result in hospitalization and intensive care without recognizable benefit in many cases. Advance directives regarding indications for resuscitation, hospitalization, and symptomatic treatment help ensure that acute complications can be managed quickly and satisfactorily in the patient’s customary surroundings. A plan was designed and implemented in Austrian nursing homes to provide emergency physicians with rapidly obtainable information on the patient’s current situation, and whether resuscitation attempts and hospitalization are advised or not. This palliative treatment plan is arranged by a physician together with caregivers, close relatives, and the patient or his court-appointed health care guardian or holder of power of attorney. Four years after implementation of the plan, a user satisfaction survey was carried out. The majority of participating nurses, emergency physicians and family doctors judged application and design of the palliative treatment plan positively. However, the low response rate of family doctors indicates nonconformity. In particular, the delegation of symptomatic treatment to nurses proved to be controversial. There is still a need to provide up-to-date information and training for health professionals in order for them to understand advance directives as extended autonomy for patients who have lost their ability to make their own decisions.

Family Planning and Preconception Health Among Men in Their Mid-30s: Developing Indicators and Describing Need.

Science.gov (United States)

Casey, Frances E; Sonenstein, Freya L; Astone, Nan M; Pleck, Joseph H; Dariotis, Jacinda K; Marcell, Arik V

2016-01-01

The Centers for Disease Control and Prevention and Healthy People 2020 call for improvements in meeting men's reproductive health needs but little is known about the proportion of men in need. This study describes men aged 35 to 39 in need of family planning and preconception care, demographic correlates of these needs, and contraception use among men in need of family planning. Using data from Wave 4 (2008-2010) of the National Survey of Adolescent Males, men were classified in need of family planning and preconception care if they reported sex with a female in the last year and believed that they and their partner were fecund; the former included men who were neither intentionally pregnant nor intending future children and the latter included men intending future children. Men were classified as being in need of both if they reported multiple sex partners in the past year. About 40% of men aged 35 to 39 were in need of family planning and about 33% in need of preconception care with 12% in need of both. Current partner's age, current union type, and sexually transmitted infection health risk differentiated men in need of family planning and preconception care (all ps family planning reported none of the time current partner hormonal use (55%) or condom use (52%) during the past year. This study identified that many men in their mid-30s are in need of family planning or preconception care. © The Author(s) 2014.

Preliminary Results on Setup Precision of Prone-Lateral Patient Positioning for Whole Breast Irradiation

International Nuclear Information System (INIS)

Veldeman, Liv; Speleers, Bruno; Bakker, Marlies; Jacobs, Filip; Coghe, Marc; De Gersem, Werner; Impens, Aline; Nechelput, Sarah; De Wagter, Carlos

2010-01-01

Purpose: The aim of this study was to develop a rapid and reproducible technique for prone positioning and to compare dose-volume indices in prone and supine positions. Methods and Materials: Eighteen patients underwent computed tomography imaging for radiotherapy planning in prone and supine position. Experience was gained in the first eight patients, which lead to modifications of the Horizon prone breast board (Civco Medical Solutions, Orange City, Iowa, USA) and the patient setup technique. A unilateral breast holder (U-BH) was developed (Van de Velde, Schellebelle, Belgium) to retract the contralateral breast away from the treated breast. The technique was then applied to an additional 10 patients. The setup precision was evaluated using daily cone-beam CT. Results: Modifications to the breast board were made to secure a prone-lateral rather then a pure prone position. We evolved from a classical setup using laser marks on the patients' body to a direct breast setup using marks on the breast only. The setup precision of the direct positioning procedure with the modified breast board and the U-BH is comparable to supine setup data in the literature. Dose-volume indices for heart and lung show significantly better results for prone than for supine position, and dose homogeneity within the treated breast did not differ according to the treatment position. Conclusions: The setup precision of our prone-lateral positioning technique is comparable to supine data in literature. Our data show the advantage of prone radiotherapy to spare the lung and heart. Further research is necessary to reduce the duration of prone setup.

Development of safety performance indicators for HANARO

International Nuclear Information System (INIS)

Wu, Jong-Sup; Jung, Hoan-Sung; Ahn, Guk-Hoon; Lee, Kye-Hong; Lim, In-Cheol

2007-01-01

The nuclear facilities need an extensive basis for ensuring their safety. An operating organization should conduct its operation and utilization important to the safety in accordance with approved procedures and regulations. The general aims of a management system for nuclear facilities are to improve the safety performance through a planning, control and supervision of safety related activities and to foster a strong safety culture. The effectiveness of a management system can be monitored and measured to confirm the ability of its processes to achieve the intended safety performance by an assessment of the operational performance. The Operational Safety Performance Indicators, also known as SPI, help an organization define and measure a progress with regard to safety activity goals. The elements of a SPI are quantifiable measurements that reflect the critical success factors of an organizational safety. Since 1995, efforts have been directed towards the elaboration of a framework for the establishment of an operational safety performance indicator program in nuclear power plants (NPP). IAEA-TECDOC-1141, 'Operational safety performance indicators for NPP' attempted to provide a frame work for an identification of performance indicators which have a relationship to the desired safety attributes, and therefore, to a safe plant operation. Three key attributes of a smooth operation, an operation with a low risk, and an operation with a positive safety attitude, were recommended, which are associated with a safe operation. Because these attributes cannot be directly measured, an indicator structure is expanded further until a level of easily quantifiable or directly measurable indicators is identified. The intention of this approach is to use quantitative information provided by the specific indicators and to analyze performance trends relative to established goals. The safety activities in HANARO have been continuously conducted to enhance its safe operation. HANARO

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

Science.gov (United States)

Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

2016-01-01

Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

Science.gov (United States)

Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

EEG signatures of arm isometric exertions in preparation, planning and execution.

Science.gov (United States)

Nasseroleslami, Bahman; Lakany, Heba; Conway, Bernard A

2014-04-15

The electroencephalographic (EEG) activity patterns in humans during motor behaviour provide insight into normal motor control processes and for diagnostic and rehabilitation applications. While the patterns preceding brisk voluntary movements, and especially movement execution, are well described, there are few EEG studies that address the cortical activation patterns seen in isometric exertions and their planning. In this paper, we report on time and time-frequency EEG signatures in experiments in normal subjects (n=8), using multichannel EEG during motor preparation, planning and execution of directional centre-out arm isometric exertions performed at the wrist in the horizontal plane, in response to instruction-delay visual cues. Our observations suggest that isometric force exertions are accompanied by transient and sustained event-related potentials (ERP) and event-related (de-)synchronisations (ERD/ERS), comparable to those of a movement task. Furthermore, the ERPs and ERD/ERS are also observed during preparation and planning of the isometric task. Comparison of ear-lobe-referenced and surface Laplacian ERPs indicates the contribution of superficial sources in supplementary and pre-motor (FC(z)), parietal (CP(z)) and primary motor cortical areas (C₁ and FC₁) to ERPs (primarily negative peaks in frontal and positive peaks in parietal areas), but contribution of deep sources to sustained time-domain potentials (negativity in planning and positivity in execution). Transient and sustained ERD patterns in μ and β frequency bands of ear-lobe-referenced and surface Laplacian EEG indicate the contribution of both superficial and deep sources to ERD/ERS. As no physical displacement happens during the task, we can infer that the underlying mechanisms of motor-related ERPs and ERD/ERS patterns do not only depend on change in limb coordinate or muscle-length-dependent ascending sensory information and are primary generated by motor preparation, direction

Strategic Planning for New Presidents: Developing an Entrance Plan

Science.gov (United States)

Garza Mitchell, Regina L.; Maldonado, Cesar

2015-01-01

Community colleges are greatly impacted by turbulent external forces while also experiencing turnover in the topmost leadership positions. New presidents must learn how to lead an institution while also planning for purposeful change that will allow the college to thrive. In this article, the authors propose a method for new presidents to develop…

Succession Planning and Financial Performance: Does Competition Matter?

Science.gov (United States)

Patidar, Nitish; Gupta, Shivani; Azbik, Ginger; Weech-Maldonado, Robert

2016-01-01

Succession planning has been defined as the process by which one or more successors are identified for key positions, development activities are planned for identified successors, or both. Limited research exists pertaining to the relationship between hospital succession planning and financial performance, particularly in the context of market competition. We used the resource-based view framework to analyze the differential effect of succession planning on hospitals' financial performance based on market competition. According to RBV, organizations can achieve higher performance by using their superior resources and capabilities. We used a panel design consisting of a national sample of hospitals in the United States for 2006-2010. We analyzed data using multivariate linear regression with facility random effects and year and state fixed effects. The sample included 22,717 hospital-year observations; more than one half of the hospitals (55.4%) had a succession planning program. The study found a positive relationship between the presence of succession planning and financial performance (β = 1.41, p planning programs on the basis of competition in their market.

The Student Plan

DEFF Research Database (Denmark)

Krejsler, John B.

2009-01-01

that must reconcile the challenges of student diversity, differentiated teaching, the documentation of achievement and so forth. Social technologies reduce complexity by coding procedures, thus signalling what is expected in terms of learning activities, and by coding subject positions, thereby guiding...... teachers and students in terms of the roles they may position themselves in. Some of the most prevalent social technologies adopted by schools today include project work, logbooks, social contracts, interactive testing, and student and personal action plans....

Can slide positivity rates predict malaria transmission?

Directory of Open Access Journals (Sweden)

Bi Yan

2012-04-01

Full Text Available Abstract Background Malaria is a significant threat to population health in the border areas of Yunnan Province, China. How to accurately measure malaria transmission is an important issue. This study aimed to examine the role of slide positivity rates (SPR in malaria transmission in Mengla County, Yunnan Province, China. Methods Data on annual malaria cases, SPR and socio-economic factors for the period of 1993 to 2008 were obtained from the Center for Disease Control and Prevention (CDC and the Bureau of Statistics, Mengla, China. Multiple linear regression models were conducted to evaluate the relationship between socio-ecologic factors and malaria incidence. Results The results show that SPR was significantly positively associated with the malaria incidence rates. The SPR (β = 1.244, p = 0.000 alone and combination (SPR, β = 1.326, p  Conclusion SPR is a strong predictor of malaria transmission, and can be used to improve the planning and implementation of malaria elimination programmes in Mengla and other similar locations. SPR might also be a useful indicator of malaria early warning systems in China.

Face-down positioning versus non-supine positioning in macular hole surgery

DEFF Research Database (Denmark)

Alberti, Mark; Dornonville de la Cour, Morten

2015-01-01

AIM: To evaluate the full thickness macular hole (FTMH) closure rate in patients positioning non-supine (NSP) compared with patients positioning face-down (FDP). METHODS: We retrospectively reviewed two FTMH case series-postoperative positioning was FDP and NSP, respectively. All eyes were...... group fully complied with the recommended positioning protocol. CONCLUSIONS: Results from consistent FTMH repair indicate similar anatomical success rates in FDP and NSP groups, suggesting that FDP is unnecessary. Objective monitoring of positioning would be beneficial in future FTMH studies to be able...

Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

Science.gov (United States)

Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

2006-01-01

Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

Decennial development plan of the GRTgaz's transmission network 2012-2021

International Nuclear Information System (INIS)

2012-09-01

The GRTgaz network is the longest high pressure natural gas transmission network in Europe, and one of the best interconnected. It comprises a main network and a regional network. After an indication of some key figures of the GRTgaz network (duct length, transported volume, exchanged power, clients, turnover, investments), this report proposes a synthetic overview of the decennial development plan framework, of European and French energy policies, of the French geographical position in relationship with Europe, and of the energetic objectives of the decennial plan. In its other parts, this report reviews the gas transmission demand and supply, analyses the evolution of the gas market in Europe and in France (consumption and supplies, issue of secure supply), describes the development of the GRTgaz transmission network (developments in the northern and southern areas, merger of North and South market areas, connection of Corsica), presents the provisional timetable for the planned works (projects put into service within 3 years or after 2014, provisional development of capacities during the 2012-2021 period)

A comparative assessment of the long term electricity expansion plans in Mexico by using the position vector of minimum regret analysis

International Nuclear Information System (INIS)

Martindelcampo, C.; Gonzalezbello, C. R.

2012-01-01

A comparative assessment of alternative expansion plans for the Mexican electricity generating system was made by applying the Position Vector of Minimum Regret Analysis (PVMRA) as a decision analysis tool. Four expansion plans were ranked according to the following decision criteria: The cost which calculates the cumulated cost of electricity generation during the time period studied. The external cost which brings into play the costs associated with the impact on health and the environment. The risk which takes into account the economic impact associated with incremental fuel prices from the baseline scenario to the high scenario. The diversity which evaluates the generation park diversity in terms of the Shannon-Weaner Index. The foreign-capital fraction in investment using foreign inputs. The carbon-free fraction which evaluates electricity generation that contributes to climate change policies. The cost of severe-accidents which is the sum of full chain damage costs and external costs of severe accidents with at least 10 injured. Optimizations were made by internalizing the external cost into the objective function of the WASP-IV model, the cost of externalise of the operation and maintenance cost, and these expansions were compared with those that did not. Special attention was paid to studying the convenience of including nuclear power in the electricity generation mix. Furthermore, better electricity expansion plans, with lower internal and external costs, were also found when the optimization had included externalise

“THE NET MONETARY STATEMENT” AND “THE NET NON-MONETARY STATEMENT” – ASSESSMENT INDICATORS FOR THE FINANCIAL POSITION OF THE ENTITY

Directory of Open Access Journals (Sweden)

SORIN-CONSTANTIN DEACONU

2012-10-01

Full Text Available This paper examines two indicators, namely the net monetary statement and the net non-monetary statement. To determine and analyze them, we started with the classification of assets (monetary and non-monetary and liabilities (monetary and nonmonetary. The actual values of these elements were established on the basis of information supplied by the balance sheet, followed by the calculus of the net monetary statement and of the net non-monetary statement. These indicators provide relevant and reliable information to the users of financial statements and, in the future, they should be taken into account because they bring additional information about the financial position of the entity.

TU-D-201-06: HDR Plan Prechecks Using Eclipse Scripting API

Energy Technology Data Exchange (ETDEWEB)

Palaniswaamy, G; Morrow, A; Kim, S; Rangaraj, D [Baylor Scott & White Health, Temple, TX (United States)

2016-06-15

Purpose: Automate brachytherapy treatment plan quality check using Eclipse v13.6 scripting API based on pre-configured rules to minimize human error and maximize efficiency. Methods: The HDR Precheck system is developed based on a rules-driven approach using Eclipse scripting API. This system checks for critical plan parameters like channel length, first source position, source step size and channel mapping. The planned treatment time is verified independently based on analytical methods. For interstitial or SAVI APBI treatment plans, a Patterson-Parker system calculation is performed to verify the planned treatment time. For endobronchial treatments, an analytical formula from TG-59 is used. Acceptable tolerances were defined based on clinical experiences in our department. The system was designed to show PASS/FAIL status levels. Additional information, if necessary, is indicated appropriately in a separate comments field in the user interface. Results: The HDR Precheck system has been developed and tested to verify the treatment plan parameters that are routinely checked by the clinical physicist. The report also serves as a reminder or checklist for the planner to perform any additional critical checks such as applicator digitization or scenarios where the channel mapping was intentionally changed. It is expected to reduce the current manual plan check time from 15 minutes to <1 minute. Conclusion: Automating brachytherapy plan prechecks significantly reduces treatment plan precheck time and reduces human errors. When fully developed, this system will be able to perform TG-43 based second check of the treatment planning system’s dose calculation using random points in the target and critical structures. A histogram will be generated along with tabulated mean and standard deviation values for each structure. A knowledge database will also be developed for Brachyvision plans which will then be used for knowledge-based plan quality checks to further reduce

Societal health and urban sustainability indicators

Energy Technology Data Exchange (ETDEWEB)

Petrich, C.H.; Tonn, B.E.

1996-08-27

Without the social will, no city can successfully Undertake the planning and programs necessary for meaningful progress toward sustainability. Social will derives from wellsprings of vital societal health. This paper presents an approach to helping cities in APEC member economies initiate a program for developing indicators of sustainability. Representative indicators of social capital and other aspects of civic engagement, as proxies for societal health, are presented.

Robust Path Planning for Space Exploration Rovers

Data.gov (United States)

National Aeronautics and Space Administration — Motion planning considers the problem of moving a system from a starting position to a desired goal position. This problem has been shown to be a computationally...

An investigation into the relevance of action planning, theory of planned behaviour concepts, and automaticity for fruit intake action control.

Science.gov (United States)

de Bruijn, Gert-Jan; Wiedemann, Amelie; Rhodes, Ryan E

2014-09-01

In the action control framework, intention-behaviour discordance is studied around public health guidelines. Although this framework has been applied to physical activity behaviours, it has only seen very limited attention regarding fruit intake. The purpose of this study was therefore to investigate distributions and predictors of fruit intake intention-behaviour discordance. Prospective correlational design. Data were obtained from undergraduate students (n = 413) using validated questionnaires. Variables from the theory of planned behaviour, automaticity, and action planning were assessed at baseline, and fruit intake was assessed 2 weeks later. Data were analysed using discriminant function analyses and analyses of variance. The proportion of unsuccessful intenders ranged from 39.2% to 80.8%. There was a larger proportion of fruit intake intenders amongst those who reported strong automatic fruit intake. Action control was predicted by fruit intake automaticity and affective attitudes, but the strongest predictor was perceived behavioural control. No action planning items were related to fruit intake action control. There is considerable asymmetry in the intention-fruit intake relationship. An application of the action control framework may stimulate debate on the applicability of intention-based models at the public health level. What is already known on this subject? Intention is theorized to be a key construct in fruit intake. Studies in the physical activity domain indicate that nearly half of the people with positive intentions fail to subsequently act. What does this study add? The proportion of unsuccessful intenders ranged from 39.2% to 80.8%. Holding positive intentions is not sufficient to consume fruit at suggested public health guidelines. Perceived behavioural control is the most important predictor of fruit intake action control. © 2013 The British Psychological Society.

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, Gary M.; Fowble, Barbara L.; Hanlon, Alexandra L.; Myint, Maung A.; Hoffman, John P.; Sigurdson, Elin R.; Eisenberg, Burton L.; Goldstein, Lori J.; Fein, Douglas A.

1998-01-01

Introduction: Indications for postmastectomy radiation include primary tumor size ≥5 cm and/or ≥4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with close or positive margins who otherwise would be considered low risk (tumor size 50 (p = 0.04). There was no correlation with chest wall failure and number of positive nodes, ER status, lymphovascular invasion, location of primary, grade, family history, or type of tumor close to the margin. Of 5 chest wall failures, 4 were in patients who had received adjuvant systemic chemotherapy ± tamoxifen. Chest wall failures occurred in 1 patient with a positive deep margin, 3 patients with margins within 2 mm, and 1 patient with a margin of 5 mm. The estimated cumulative incidence probability of chest wall recurrence at 8 years by margin proximity was 24% ≤ 2 mm vs. 7% 2.1-6 mm (p = 0.36), and by clinical size 24% for T2 tumors vs. 7% for T1 (p = 0.98). Conclusions: A close or positive margin is uncommon (≤5%) after mastectomy in patients with tumor size <5 cm and 0-3 positive axillary nodes but, when present, it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy and, therefore, should be considered for postmastectomy radiation

The French path after the Grenelle Environment: result indicators. Report for the Conference on the Environment of the September 14 and 15 2012

International Nuclear Information System (INIS)

Wahl, Thierry; Mordant, Guillaume; Poupard, Christophe

2012-09-01

Before presenting a set of 29 indicators, the background of their selection, their definition, the methodology used to assess them, graphs illustrating their evolution, this document highlights the fact that these indicators do not have all the same capacity to express the situation of the environment, reports comments made by some partners about these indicators, discusses the various evolutions noticed for these different indicators, and outlines how these evolutions reveal contrasted results and France's position with respect to other countries in Europe and in the world. The indicators are related to buildings, urban planning, transports, energy and climate, sea and biodiversity, water, agriculture, risks and health, wastes and materials, public bodies, and eco-activities

A cone beam CT-guided online plan modification technique to correct interfractional anatomic changes for prostate cancer IMRT treatment

International Nuclear Information System (INIS)

Fu Weihua; Yang Yong; Yue, Ning J; Heron, Dwight E; Huq, M Saiful

2009-01-01

The purpose of this work is to develop an online plan modification technique to compensate for the interfractional anatomic changes for prostate cancer intensity-modulated radiation therapy (IMRT) treatment based on daily cone beam CT (CBCT) images. In this proposed technique, pre-treatment CBCT images are acquired after the patient is set up on the treatment couch using an in-room laser with the guidance of the setup skin marks. Instead of moving the couch to rigidly align the target or re-planning using the CBCT images, we modify the original IMRT plan to account for the interfractional target motion and deformation based on the daily CBCT image feedback. The multileaf collimator (MLC) leaf positions for each subfield are automatically adjusted in the proposed algorithm based on the position and shape changes of target projection in the beam's eye view (BEV). Three typical prostate cases were adopted to evaluate the proposed technique, and the results were compared with those obtained with bony-structure-based rigid translation correction, prostate-based correction and CBCT-based re-planning strategies. The study revealed that the proposed modification technique is superior to the bony-structure-based and prostate-based correction techniques, especially when interfractional target deformation exists. Its dosimetric performance is closer to that of the re-planned strategy, but with much higher efficiency, indicating that the introduced online CBCT-guided plan modification technique may be an efficient and practical method to compensate for the interfractional target position and shape changes for prostate IMRT.

Consumer experiences in a consumer-driven health plan.

Science.gov (United States)

Christianson, Jon B; Parente, Stephen T; Feldman, Roger

2004-08-01

To assess the experience of enrollees in a consumer-driven health plan (CDHP). Survey of University of Minnesota employees regarding their 2002 health benefits. Comparison of regression-adjusted mean values for CDHP and other plan enrollees: customer service, plan paperwork, overall satisfaction, and plan switching. For CDHP enrollees only, use of plan features, willingness to recommend the plan to others, and reports of particularly negative or positive experiences. There were significant differences in experiences of CDHP enrollees versus enrollees in other plans with customer service and paperwork, but similar levels of satisfaction (on a 10-point scale) with health plans. Eight percent of CDHP enrollees left their plan after one year, compared to 5 percent of enrollees leaving other plans. A minority of CDHP enrollees used online plan features, but enrollees generally were satisfied with the amount and quality of the information provided by the CDHP. Almost half reported a particularly positive experience, compared to a quarter reporting a particularly negative experience. Thirty percent said they would recommend the plan to others, while an additional 57 percent said they would recommend it depending on the situation. Much more work is needed to determine how consumer experience varies with the number and type of plan options available, the design of the CDHP, and the length of time in the CDHP. Research also is needed on the factors that affect consumer decisions to leave CDHPs.

Collaborative Strategic Planning: Myth or Reality?

Science.gov (United States)

Mbugua, Flora; Rarieya, Jane F. A.

2014-01-01

The concept and practice of strategic planning, while entrenched in educational institutions in the West, is just catching on in Kenya. While literature emphasizes the importance of collaborative strategic planning, it does not indicate the challenges presented by collaboratively engaging in strategic planning. This article reports on findings of…

Improvement of Internal Audit Planning Method through Application of Risk Card by the Indices of Value-Based Management System of Joint-Stock Company

OpenAIRE

Oleksandr Smetanko

2014-01-01

The Article deals with issues of improving methods of planning and carrying out internal audit in conditions of risk-oriented approach to audit according to the indices of value-based management system - VBM (Value Based Management) using the risk card (risk matrix). A risk card (risk matrix) method has been disclosed taking into account risk level of each of the key factors influencing joint-stock company value rates. Recommendations have been given and abstract of working document has been ...

Positioning the Co-op Program for Maximum Marketing Effectiveness.

Science.gov (United States)

Harris, Ronald R.

1983-01-01

Examines the concept of positioning, which is the way that individuals perceive and are made aware of a program and believe in its benefit to them and its application to cooperative education programs. Includes a five-step plan for assessing the position of cooperative programs and six ways to implement a positioning strategy. (JOW)

Surgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography.

Science.gov (United States)

Kim, Seong-Hun; Choi, Yong-Suk; Hwang, Eui-Hwan; Chung, Kyu-Rhim; Kook, Yoon-Ah; Nelson, Gerald

2007-04-01

This article illustrates a new surgical guide system that uses cone-beam computed tomography (CBCT) images to replicate dental models; surgical guides for the proper positioning of orthodontic mini-implants were fabricated on the replicas, and the guides were used for precise placement. The indications, efficacy, and possible complications of this method are discussed. Patients who were planning to have orthodontic mini-implant treatment were recruited for this study. A CBCT system (PSR 9000N, Asahi Roentgen, Kyoto, Japan) was used to acquire virtual slices of the posterior maxilla that were 0.1 to 0.15 mm thick. Color 3-dimensional rapid prototyping was used to differentiate teeth, alveolus, and maxillary sinus wall. A surgical guide for the mini-implant was fabricated on the replica model. Proper positioning for mini-implants on the posterior maxilla was determined by viewing the CBCT images. The surgical guide was placed on the clinical site, and it allowed precise pilot drilling and accurate placement of the mini-implant. CBCT imaging allows remarkably lower radiation doses and thinner acquisition slices compared with medical computed tomography. Virtually reproduced replica models enable precise planning for mini-implant positions in anatomically complex sites.

Family planning costs and benefits.

Science.gov (United States)

1989-01-01

Government sponsored family planning programs have had major success in declining birth rates in Barbados, China, Cuba, Hong Kong, Indonesia, Korea, Mexico, Singapore, Sri Lanka, Taiwan, and Thailand. Non- government programs have had similar success in Brazil and Colombia. These programs have been estimated as preventing over 100 million births in China and 80 million in India. Research indicates that family planning programs can produce a 30-50% drop in fertility. Family planning information and some contraceptives can be best distributed through community organizations. Research also indicates male opposition has been a major factor in wider acceptance of family planning. Surveys indicate that 50% of the woman who want no additional children are not using any birth control. Many governments do not have the resource and money to implement programs. In the developing countries if those who were able to prevent the unwanted births had birth control, the population increases in those countries would have been 1.3% versus 2.2%. In earlier family planning programs foreign assistance paid over 80% of the cost, and national governments 20%; today this is reversed. The World Bank estimates that for major improvements in population growth and women's health, $7 billion will be needed yearly by the year 2000. The countries that have had the similar goals in development of human resources, social services, health, and education. They have attended to the status of women, female employment, and maternal and child health. Estimates are that 1.3 billion couples and individuals will need family planning services by the year 2000, and this will be a formidable task. This key elements of successful family planning programs are community participation, decentralization, and training.

Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

Science.gov (United States)

Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

2016-09-01

Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

Advanced Education and Technology Business Plan, 2007-10

Science.gov (United States)

Alberta Enterprise and Advanced Education, 2007

2007-01-01

The Government of Alberta Strategic Business Plan addresses significant opportunities and challenges facing Alberta over the next three years and positions Alberta to make the most of its economic, social and natural advantages. It is a plan to strategically manage growth and plan for a sustainable and secure future. Advanced Education and…

Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

International Nuclear Information System (INIS)

Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

2007-01-01

Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

Treatment planning for radiotherapy with very high-energy electron beams and comparison of VHEE and VMAT plans

International Nuclear Information System (INIS)

Bazalova-Carter, Magdalena; Qu, Bradley; Palma, Bianey; Jensen, Christopher; Maxim, Peter G.; Loo, Billy W.; Hårdemark, Björn; Hynning, Elin

2015-01-01

plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI 100 = 1.09 and CI 50 = 4.07) were better than VMAT conformity indices (CI 100 = 1.30 and CI 50 = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI 100 and CI 50 conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI 100 and CI 50 conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans

High dose-rate brachytherapy source localization: positional resolution using a diamond detector

International Nuclear Information System (INIS)

Nakano, T; Suchowerska, N; Bilek, M M; McKenzie, D R; Ng, N; Kron, T

2003-01-01

A potential real-time source position verification process for high dose-rate (HDR) brachytherapy treatment is described. This process is intended to provide immediate confirmation that a treatment is proceeding according to plan, so that corrective action can be taken if necessary. We show that three dosimeters are in principle sufficient and demonstrate the feasibility of the process using a diamond detector and an Ir-192 source. An error analysis including all identified sources of error shows that this detector is capable of locating the distance to the source to within 2 mm for distances up to 12 cm. This positional accuracy is less than the diameter of typical HDR catheters indicating that a diamond detector can be used to accurately determine the distance to the source. The uncertainty in the distance is found to increase with distance

Tourism Planning and Tourismphobia: An Analysis of the Strategic Tourism Plan of Barcelona 2010-2015

Directory of Open Access Journals (Sweden)

Marco Martins

2018-05-01

Full Text Available The exponential growth of tourism has brought new challenges to destinations; how to plan themselves to avoid overtourism and this new form of intolerance, the so-called tourismphobia. In order to address the negative impacts of tourism and enhance the positive ones Barcelona has developed and implemented a strategic tourism plan. This paper seeks to understand how Barcelona addressed the tourismphobia problematic through planning: how it was done and which results were achieved in the end. This research reveals a clear gap between the planner’s intention and the plan’s implementation.

Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

Directory of Open Access Journals (Sweden)

Candel Math

2009-10-01

Full Text Available Abstract Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572 and one on high-caloric snack consumption (N = 585 in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health

Computed tomography in therapy planning: Abdominal region

International Nuclear Information System (INIS)

Munzenrider, J.E.

1983-01-01

The radiotherapy community is continuing to appreciate the significant contribution CBT can make to planning abdominal radiotherapy and is also beginning to appreciate the pitfalls and limitations of the technique. Specific attention should continue to focus on patient registration with the scanner and simulator radiographs, patient position during scanning and treatment, and effects of involuntary patient motion, especially breathing, on organ and tumor localization. Effects of patient positional changes and of involuntary motion during treatment on treatment planning and execution should be quantitated, as should effects of inhomogeneities, especially gut air, on abdominal dose distribution. Radiotherapy planned with CBT data can impact significantly on morbidity and mortality associated with abdominal malignancies. Faster scanners (with a scanning time of 9 sec or less) should be employed where possible to obtain maximum diagnostic information. Multiplanar reconstruction and true three-dimensional treatment planning can enhance significantly the value of CBT in treatment planning. Radiotherapists, radiodiagnosticians, radiation physicists, and oncologists must be continue to meet the challenge of realizing the true potential of CBT for the benefit of the cancer patients entrusted to their care

Examination of CT-AEC when the positioning changes after planning of CT scanning

International Nuclear Information System (INIS)

Esaki, Tooru; Yamazaki, Shoichi

2009-01-01

CT-automatic exposure control (AEC) controls tube current collecting information of the subject from positioning shooting. Because of this, we consider that CT-AEC does not get to operate properly if the body position of the test subject changes after the positioning shooting. However, we often experience in body positions of test subjects after the positioning shooting. In cases like this, we measured by using a phantom again to see how they affect the tube current value and standard deviation (SD) value comparing them to the normal scan where a body position does not change. As a result of the measurement, there was an impact on CT-AEC that optimization of tube current becomes insufficient if the body position of a test subject changes. As the image quality is deteriorated and radiation exposure increases because of this, taking positioning shooting again is required on the part of users and it's desirable on the part of manufacturers to develop CT-AEC that can be controlled with high accuracy. (author)

SU-F-T-303: Quantification of MLC Positioning Accuracy in VMAT Delivery of Head and Neck Cancer Treatment

Energy Technology Data Exchange (ETDEWEB)

Li, X; Yang, F [University Of Miami, Miami, FL (United States)

2016-06-15

Purpose: Knowing MLC leaf positioning error over the course of treatment would be valuable for treatment planning, QA design, and patient safety. The objective of the current study was to quantify the MLC positioning accuracy for VMAT delivery of head and neck treatment plans. Methods: A total of 837 MLC log files were collected from 14 head and neck cancer patients undergoing full arc VMAT treatment on one Varian Trilogy machine. The actual and planned leaf gaps were extracted from the retrieved MLC log files. For a given patient, the leaf gap error percentage (LGEP), defined as the ratio of the actual leaf gap over the planned, was evaluated for each leaf pair at all the gantry angles recorded over the course of the treatment. Statistics describing the distribution of the largest LGEP (LLGEP) of the 60 leaf pairs including the maximum, minimum, mean, Kurtosis, and skewness were evaluated. Results: For the 14 studied patients, their PTV located at tonsil, base of tongue, larynx, supraglottis, nasal cavity, and thyroid gland with volume ranging from 72.0 cm{sup 3} to 602.0 cm{sup 3}. The identified LLGEP differed between patients. It ranged from 183.9% to 457.7% with a mean of 368.6%. For the majority of the patients, the LLGEP distributions peaked at non-zero positions and showed no obvious dependence on gantry rotations. Kurtosis and skewness, with minimum/maximum of 66.6/217.9 and 6.5/12.6, respectively, suggested relatively more peaked while right-skewed leaf error distribution pattern. Conclusion: The results indicate pattern of MLC leaf gap error differs between patients of lesion located at similar anatomic site. Understanding the systemic mechanisms underlying these observed error patterns necessitates examining more patient-specific plan parameters in a large patient cohort setting.

The Effects of Pre-Task Planning and On-line Planning on Fluency, Complexity, and Accuracy in L2 Monologic Oral Production.

Science.gov (United States)

Yuan, Fangyuan; Ellis, Rod

2003-01-01

Investigated the effects of both pre-task and on-line planning on second language (L2) oral production. Results show that pre-task planning enhances grammatical complexity while on-line planning positively influences accuracy and grammatical complexity. Pre-task planners also produced more fluent and lexically varied language than the on-line…

Dose exposure work planning using DMU kinematics tools

International Nuclear Information System (INIS)

Rosli Darmawan

2010-01-01

The study on the possibility of using DMU Kinematics module in CAE tools for dose exposure work planning was carried out. A case scenario was created using 3D CAD software and transferred to DMU Kinematics module in CAE software. A work plan was created using DMU Kinematics tools and animated to simulate a real time scenario. Data on the phantom position against the radioactive source was collected by activating positioning sensors in the module. The data was used to estimate dose rate exposure for the phantom. The results can be used to plan the safest and optimum procedures in carrying out the radiation related task. (author)

Urban planning and habitat III: indications of a necessary reform for Mexico

OpenAIRE

Juan Jose Gutierrez Chaparro

2018-01-01

Initiatives are being promoted to implement the New Urban Agenda in several cities around the world. This occurs about a year after the New Agenda was adopted in Habitat III. Accelerated urbanization and the aspiration to achieve a sustainable development are the common axes that coincide with Mexico, although our cities continue to grow well beyond any forecasting strategy. The Urban Development Plans in our country follow the same precepts as their predecessors, whose bases correspond to th...

Plan of Time Management of Satellite Positioning System using Quasi-zenith Satellite

Science.gov (United States)

Takahashi, Yasuhiro; Fujieda, Miho; Amagai, Jun; Yokota, Shoichiro; Kimura, Kazuhiro; Ito, Hiroyuki; Hama, Shin'ichi; Morikawa, Takao; Kawano, Isao; Kogure, Satoshi

The Quasi-Zenith satellites System (QZSS) is developed as an integrated satellite service system of communication, broadcasting and positioning for mobile users in specified regions of Japan from high elevation angle. Purposes of the satellite positioning system using Quasi-Zenith satellite (QZS) are to complement and augment the GPS. The national institutes concerned have been developing the positioning system using QZS since 2003 and will carry out experiments and researches in three years after the launch. In this system, National Institute of Information and Communications Technology (NICT) is mainly in charge of timing system for the satellite positioning system using QZS, such as onboard hydrogen maser atomic clock and precise time management system of the QZSS. We started to develop the engineering model of the time management system for the QZSS. The time management system for the QZSS will be used to compare time differences between QZS and earth station as well as to compare between three onboard atomic clocks. This paper introduces time management of satellite positioning system using the QZSS.

Assessing the Financial Condition of Provider-Sponsored Health Plans.

Science.gov (United States)

McCue, Michael J

2015-06-01

The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

Forward versus inverse planning in oropharyngeal cancer: A comparative study using physical and biological indices

Directory of Open Access Journals (Sweden)

T Sundaram

2013-01-01

Full Text Available Context: Possible benefits of inverse planning. Aims: To analyze possible benefits of inverse planning intensity modulated radiation therapy (IMRT over field-in-field 3D conformal radiation therapy (FIF-3DCRT and to evaluate the differences if any, between low (6 Million Volts and high energy (15 Million Volts IMRT plans. Materials and Methods: Ten patients with squamous cell carcinoma of oropharynx, previously treated with 6 MV step and shoot IMRT were studied. V 100 , V 33 , V 66 , mean dose and normal tissue complication probabilities (NTCP were evaluated for parotid glands. Maximum dose and NTCP were the parameters for spinal cord. Statistical Analysis Used: A two-tailed t-test was applied to analyze statistical significance between the different techniques. Results: For combined parotid gland, a reduction of 4.374 Gy, 9.343 Gy and 7.883 Gy were achieved for D 100 , D 66 and D 33 , respectively in 6 MV-IMRT when compared with FIF-3DCRT. Spinal cord sparing was better in 6 MV-IMRT (40.963 ± 2.650, with an average reduction of maximum spinal cord dose by 7.355 Gy from that using the FIF-3DCRT technique. The uncomplicated tumor control probabilities values were higher in IMRT plans thus leading to a possibility of dose escalation. Conclusions: Though low-energy IMRT is the preferred choice for treatment of oropharyngeal cancers, FIF-3DCRT must be given due consideration as a second choice for its well established advantages over traditional conventioan technique.

Monitor of spatial plans. Feasibility study

International Nuclear Information System (INIS)

Bollen, M.J.S.; Ritsema van Eck, J.; Farjon, J.M.J.

2008-01-01

The national government needs assessments of consequences of building projects in relation to spatial policy objectives such as the prevention of urban sprawl or the development of landscape qualities. Normally the effects of spatial policies appear after several years. Spatial plans can possibly indicate these effects earlier. To allow policies to be adapted to unwanted developments, the assessments should be available in the early planning stages of these building projects. The Dutch Minister of VROM has asked the Netherlands Environmental Assessment Agency to investigate the feasibility of a monitoring system based on building plans. As building projects take a long period from conception until realization, a monitoring system for these projects should include all plans for the next ten to fifteen years with an indication of the chance that these plans are realized. The existing databases in the Netherlands provide sufficient information to assess consequences of plans for those objectives that are directly related to the urbanization pattern. However, an improvement of these databases is necessary, amongst other things by coordination of these databases [nl

Nursing Personnel Planning for Rural Hospitals in Burdwan District, West Bengal, India, Using Workload Indicators of Staffing Needs

Science.gov (United States)

Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil

2014-01-01

ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

Vocal effort modulates the motor planning of short speech structures

Science.gov (United States)

Taitz, Alan; Shalom, Diego E.; Trevisan, Marcos A.

2018-05-01

Speech requires programming the sequence of vocal gestures that produce the sounds of words. Here we explored the timing of this program by asking our participants to pronounce, as quickly as possible, a sequence of consonant-consonant-vowel (CCV) structures appearing on screen. We measured the delay between visual presentation and voice onset. In the case of plosive consonants, produced by sharp and well defined movements of the vocal tract, we found that delays are positively correlated with the duration of the transition between consonants. We then used a battery of statistical tests and mathematical vocal models to show that delays reflect the motor planning of CCVs and transitions are proxy indicators of the vocal effort needed to produce them. These results support that the effort required to produce the sequence of movements of a vocal gesture modulates the onset of the motor plan.

Mallinckrodt's position on SLR production

International Nuclear Information System (INIS)

Lee, T.L.

1985-01-01

The potential of the short-lived radionuclides used in nuclear medicine applications and Mallinckrodt's position are discussed. An update of Mallinckrodt's activities and future plans are also given. The keen interest of Mallinckrodt, Inc., in the application and development of short-lived radionuclides for medical use is stressed, as well as envisioned innovations

Study Protocol--Alcohol Management Plans (AMPs) in remote indigenous communities in Queensland: their impacts on injury, violence, health and social indicators and their cost-effectiveness.

Science.gov (United States)

Clough, Alan R; Fitts, Michelle S; Robertson, Jan A; Shakeshaft, Anthony; Miller, Adrian; Doran, Christopher M; Muller, Reinhold; Ypinazar, Valmae; Martin, David; McDermott, Robyn; Sanson-Fisher, Rob; Towle, Simon; Margolis, Stephen A; West, Caryn

2014-01-09

In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland's AMPs. The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland's Indigenous communities affected by alcohol management plans. This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the

The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

NARCIS (Netherlands)

Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

2010-01-01

OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California,

The Effect of Manpower Planning and Development in Lagos State (Nigeria Civil Service Performance

Directory of Open Access Journals (Sweden)

Chinyeaka J. Igbokwe-Ibeto

2015-12-01

Full Text Available The study examined effects of manpower planning and development in Lagos state civil service performance. Lagos state civil service is the greatest asset of the state in its quest for socio-economic development. The primary question that was explored is whether the nature of manpower planning and development curriculum in Lagos state civil service has effect on the service performance and the attainment of state objective. The study relied on primary and secondary data, and multiple stage sampling technique was used to select the sample population. The data collected was presented in frequency bar chart and simple percentage. Pearson’s Product Moment Correlation Coefficient (PPMC statistical tool was used to test the hypotheses. Findings of the study show that the nature of manpower planning and development curriculum has a positive effect on the Lagos state civil performance. It also reveals that the manpower planning and development has a positive effect on the attainment of Lagos state objective. To achieve better performance in the service, it should among others, improve on the current manpower planning strategy and continue to update its manpower development curriculum in line with the global best practices. Given the pivotal role that technology plays in the 21st century, the service should avail itself the windows of opportunities that information technology provides in its drive to enhance employees’ skills, knowledge and abilities that will invariably improve the service performance. Yet, the service should imbibe the prescripts of New PublicManagement theory (NPM, and that goals and targets should be defined and measurable as indicators of organizational performance.

How Do High School Seniors See Their Future? Parental and Peer Influences on Their Personal and Professional Plans

Directory of Open Access Journals (Sweden)

Iovu Mihai-Bogdan

2014-07-01

Full Text Available Statement of problem: Future orientation is a multidimensional and multistage phenomenon. Studies have indicated that how adolescents anticipate and plan for their future is greatly influenced by the particular context in which they are placed, but most of the research in this area has been conducted with adolescents from western cultures. Aim: This study examined the personal (getting married, moving with the partner, having a child and professional (having a job, starting a business future planning of adolescents in contemporary Romania and its relation with adolescents’ background and with parents and friends support. Method: We administered a questionnaire measuring their future orientation and support from parents and friends to 3524 high school seniors from Romania. Results: Adolescents’ personal future planning varies across different life domains. Females were more likely to plan moving with the partner and getting married, while males were more likely to plan a career option. Family had an effect on professional plans, but the effect is negative, while friends were positive associated with all the future planning

OCCUPATIONAL EDUCATION--PLANNING AND PROGRAMMING. VOLUME TWO.

Science.gov (United States)

KOTZ, ARNOLD

ADDITIONAL POSITION PAPERS BASED ON INFORMATION GATHERED IN THE RECONNAISSANCE SURVEYS OF PLANNING AND PROGRAMING IN OCCUPATIONAL EDUCATION, REPORTED IN VOLUME ONE (VT 005 041), ARE PRESENTED. PART IV, CONCERNED WITH PROGRAM STRUCTURE AND BUDGETING AND THEIR RELATION TO THE PLANNING PROCESS, INCLUDES THE PAPERS--(1) "CURRENT POLICIES AND…

Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

Science.gov (United States)

Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

2014-01-01

The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

Leadership and effective succession planning in health-system pharmacy departments.

Science.gov (United States)

Ellinger, Lara Kathryn; Trapskin, Philip J; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-04-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution's strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department's strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments.

Improving in organization of in-site planning for NPP

International Nuclear Information System (INIS)

Gitel'man, L.D.; Khanin, V.V.; Trunov, V.M.; Khanin, R.V.

1986-01-01

The organization of NPP section activity planning is considered. With regard to the structure of in-site plans by time and content, their distribution in organization control structure, order of plan development, stimulation, accounting and estimation of plan fulfillment, plan indices for each shop and plan-assignment form are developed

A municipal guide to least cost utility planning

International Nuclear Information System (INIS)

1992-03-01

The recent track record of ''traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process

A municipal guide to least cost utility planning

Energy Technology Data Exchange (ETDEWEB)

1992-03-01

The recent track record of ``traditional`` electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states` least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

A municipal guide to least cost utility planning

Energy Technology Data Exchange (ETDEWEB)

1992-03-01

The recent track record of traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

Multiage Assessment: One School's Plan.

Science.gov (United States)

Arnold, Sue Beth; Kidwell, Barbara; Rossman, David

1998-01-01

Describes one elementary school's multiage assessment plan. Describes how standards were developed, and describes the assessment plan's guiding element: the progress report arranged as a continuum of objectives that serve as a goal indicator and a reporting mechanism. Discusses how objectives are assessed, record keeping and documentation, and the…

Consumer Behaviour Towards Organic Food in Porto Alegre: an application of the Theory of Planned Behaviour

OpenAIRE

Hoppe, Alexia; Vieira, Luciana Marques; Barcellos, Marcia Dutra de

2013-01-01

The aim of this study was to investigate consumers' decision-making process, attitudes and values towards organic food throughout the employment of the Theory of Planned Behaviour, adapting the methodology from a European project. 450 consumers were interviewed at supermarkets and farmers' markets in Porto Alegre, Brazil. Results indicate a high penetration level and very positive attitude towards organic products. Organics are believed to be healthier, tastier, more natural and environmental...

Orofacial manifestations of histoplasmosis in HIV-positive patients: a case report.

Science.gov (United States)

Gomes Ferreira, O; Vieira Fernandes, A; Sebastião Borges, A; Simão Ferreira, M; Mota Loyola, A

2001-01-01

Amongst the main opportunistic diseases that affect the HIV-positive patient, histoplasmosis is found. This systemic mycosis caused by the fungus Histoplasma capsulatum has the capacity to disseminate from the lung to the skin and oral mucosa. Oral lesions of histoplasmosis can be found with ulcerated or nodular aspect, being always very painful and infiltrating the mucosa. When they are present in the mouth, they strongly indicate the presence of some kind of immunosuppression. This study shows the disease's evolution in an HIV-positive patient, who presented several ulcerated lesions in the oral cavity and facial skin. The symptomatology and clinical aspects of the lesions were not specific for the disease, and due to this, the diagnosis was obtained by cytological smear and oral biopsy. The results of the exams defined the disseminated picture of the infection. The treatment plan involved the use of amphotericin B for the lesions' remission, and, following this, itraconazole was administered in the maintenance phase.

Explicit optimization of plan quality measures in intensity-modulated radiation therapy treatment planning.

Science.gov (United States)

Engberg, Lovisa; Forsgren, Anders; Eriksson, Kjell; Hårdemark, Björn

2017-06-01

To formulate convex planning objectives of treatment plan multicriteria optimization with explicit relationships to the dose-volume histogram (DVH) statistics used in plan quality evaluation. Conventional planning objectives are designed to minimize the violation of DVH statistics thresholds using penalty functions. Although successful in guiding the DVH curve towards these thresholds, conventional planning objectives offer limited control of the individual points on the DVH curve (doses-at-volume) used to evaluate plan quality. In this study, we abandon the usual penalty-function framework and propose planning objectives that more closely relate to DVH statistics. The proposed planning objectives are based on mean-tail-dose, resulting in convex optimization. We also demonstrate how to adapt a standard optimization method to the proposed formulation in order to obtain a substantial reduction in computational cost. We investigated the potential of the proposed planning objectives as tools for optimizing DVH statistics through juxtaposition with the conventional planning objectives on two patient cases. Sets of treatment plans with differently balanced planning objectives were generated using either the proposed or the conventional approach. Dominance in the sense of better distributed doses-at-volume was observed in plans optimized within the proposed framework. The initial computational study indicates that the DVH statistics are better optimized and more efficiently balanced using the proposed planning objectives than using the conventional approach. © 2017 American Association of Physicists in Medicine.

Factor 4 planning

International Nuclear Information System (INIS)

Bariol-Mathais, Brigitte; Lavoillotte, Philippine; Gall-Sorrentino, Florence; Malez, Marianne; Sanna, Daniela; Marsauche, Maud; Marquet, Sarah; Debergue, Sophie; Aminu, Olufunmi; Bernard, Helene; Marchand, Jean-Michel; Blin, Frederic; Grange, Jerome; Caillierez, Sophie; Muller, Dania; Clement, Bob; Desire, Jean-Charles; Metais, Benedicte; Lannuzel, Philippe; Pezet-Kuhn, Murielle; Pons, Anne; Rivoire-Meley, Benedicte; Tissot, Heloise

2015-07-01

Factor 4 is the goal of cutting our greenhouse gas emissions by 75% by 2050. Achieving this objective will necessitate radical changes in our practices, in particular concerning transport and housing; the measures currently implemented, such as positive-energy buildings, low-impact mobility and eco-neighbourhoods, will not be enough to meet this goal. These measures must be conceived in the framework of broad territorial planning that integrates environmental and energy objectives far upstream. To this end, the French Environment and Energy Management Agency (ADEME) and the French network of Urban Planning Agencies (FNAU), pursuing their missions in their respective areas of competence, have joined forces to make infrastructure and land use planning an integral part of the environmental and energy transition process. In 2013, the two organisations signed a partnership agreement and compiled an inventory of practices that are relevant to Factor 4 planning. This work was led by Epures, Saint-etienne urban planning agency, along with FNAU, drawing upon the expertise of a dozen urban planning agencies in precursor territories. This inventory describes the stakes, resources and strengths for each territory, which have led to cross-sectoral territorial planning exercises with ambitious environmental and energy objectives; the importance of evaluation in attaining these goals is emphasised. Current experience, questions and available methodological tools are summarised in this document, to encourage territories and help them design their planning policies along a trajectory to achieve Factor 4 goals. The compilation also aims to be a contribution to the COP21 climate conference

Rulison Monitoring Plan

Energy Technology Data Exchange (ETDEWEB)

None

2010-07-01

The Project Rulison Monitoring Plan has been developed as part of the U.S. Department of Energy (DOE) Office of Legacy Management's mission to protect human health and the environment. The purpose of the plan is to monitor fluids from gas wells for radionuclides that would indicate contamination is migrating from the Rulison detonation zone to producing gas wells, allowing action to be taken before the contamination could pose a risk. The Monitoring Plan (1) lists the contaminants present and identifies those that have the greatest potential to migrate from the detonation zone (radionuclide source term), (2) identifies locations that monitor the most likely transport pathways, (3) identifies which fluids will be sampled (gas and liquid) and why, (4) establishes the frequency of sampling, and (5) specifies the most practical analyses and where the analysis results will be reported. The plan does not affect the long-term hydrologic sampling conducted by DOE since 1972, which will continue for the purpose of sampling shallow groundwater and surface water near the site. The Monitoring Plan was developed in anticipation of gas wells being drilled progressively nearer the Rulison site. DOE sampled 10 gas wells in 1997 and 2005 at distances ranging from 2.7 to 7.6 miles from the site to establish background concentrations for radionuclides. In a separate effort, gas industry operators and the Colorado Oil and Gas Conservation Commission (COGCC) developed an industry sampling and analysis plan that was implemented in 2007. The industry plan requires the sampling of gas wells within 3 miles of the site, with increased requirements for wells within 1 mile of the site. The DOE plan emphasizes the sampling of wells near the site (Figure 1), specifically those with a bottom-hole location of 1 mile or less from the detonation, depending on the direction relative to the natural fracture trend of the producing formation. Studies indicate that even the most mobile

Basic plans on measures of mine site at the Ningyo-Toge Environmental Engineering Center

International Nuclear Information System (INIS)

2002-04-01

At the Ningyo-Toge and its peripheries, there are some mine relating facilities and apparatuses finishing their actions such as wasted stones and slags accumulation sites, and so on formed by results of searching and mining works of uranium mine carried out from beginning of 1950s by the Nuclear Fuels Corporation and the Power Reactor and Nuclear Fuel Development Corporation, both of which are predecessors of the Japan Nuclear Cycle Development Institute (JNC). These facilities are, at present, adequately maintained and managed by the Ningyo-Toge Environmental Engineering Center, but as resource development of uranium was positioned to a disposal business on JNC, JNC has investigated on optimal measuring methods and testing plans to evaluate their safety under cooperation with other works of JNC, to summarize a draft of the basic plans on measures of mine site'. Here were described two drafts of the 'Basic plans on measures of mine site' summarized on concepts and indications of whole of measures of mine relating facilities sites and of the 'Proof test plan' summarized on testing plans containing concrete measures to obtain basic data and knowledge required for progressing the measures and a proof test. (G.K.)

Effect of position of blades in the treatment of IMRT

International Nuclear Information System (INIS)

Perez Azorin, J. F.; Ramos Garcia, L. I.; Ortiz de Zarate Vivanco, R.; Trueba Garayo, I.; Cacicedo, J.; Hoyo, O. del

2013-01-01

This paper presents a method of calculation of the positions of each blade measures during treatment for all segments and the subsequent reconstruction of these positions in the planning system on the patient's physical and anatomical data. (Author)

Effects of Positioning Uncertainty and Breathing on Dose Delivery and Radiation Pneumonitis Prediction in Breast Cancer

International Nuclear Information System (INIS)

Mavroidis, Panayiotis; Axelsson, Sofie; Hyoedynmaa, Simo; Rajala, Juha; Pitkaenen, Maunu A.; Lind, Bengt K.; Brahme, Anders

2002-01-01

complication probabilities than the original plans. This means that the true expected complications are often underestimated in clinical practice. The lung density variation during breathing is calculated from the maximal change in average density during tidal breathing. The change in density in the lung due to breathing is shown to have almost no influence on the dose distribution in the lung. The proposed treatment-plan adjustments taking positioning uncertainty and breathing effects into account indicate significant deviations in the dose delivery and the predicted lung complications

Decision support in hierarchical planning systems: The case of procurement planning in oil refining industries

DEFF Research Database (Denmark)

Kallestrup, Kasper Bislev; Lynge, Lasse Hadberg; Akkerman, Renzo

2014-01-01

In this paper, we discuss the development of decision support systems for hierarchically structured planning approaches, such as commercially available advanced planning systems. We develop a framework to show how such a decision support system can be designed with the existing organization in mind...... and from the perspective of the organizational aspects involved. To exemplify and develop our framework, we use a case study of crude oil procurement planning in the refining industry. The results of the case study indicate an improved organizational embedding of the DSS, leading to significant savings...... in terms of planning efforts and procurement costs. In general, our framework aims to support the continuous improvement of advanced planning systems, increasing planning quality in complex supply chain settings....

Planned Organizational Change in Higher Education: Dashboard Indicators and Stakeholder Sensemaking--A Case Study

Science.gov (United States)

Smulowitz, Stacy

2014-01-01

This dissertation examined the introduction and implementation of an organizational Dashboard as a planned organizational change within four educational support service departments and the senior leadership group within a large, Northeastern university. General systems theory provides a theoretical framework for conceptualizing planned…

Computerized radiation treatment planning

International Nuclear Information System (INIS)

Laarse, R. van der.

1981-01-01

Following a general introduction, a chain consisting of three computer programs which has been developed for treatment planning of external beam radiotherapy without manual intervention is described. New score functions used for determination of optimal incidence directions are presented and the calculation of the position of the isocentre for each optimum combination of incidence directions is explained. A description of how a set of applicators, covering fields with dimensions of 4 to 20 cm, for the 6 to 20 MeV electron beams of a MEL SL75-20 linear accelerator was developed, is given. A computer program for three dimensional electron beam treatment planning is presented. A microprocessor based treatment planning system for the Selectron remote controlled afterloading system for intracavitary radiotherapy is described. The main differences in treatment planning procedures for external beam therapy with neutrons instead of photons is discussed. A microprocessor based densitometer for plotting isodensity lines in film dosimetry is described. A computer program for dose planning of brachytherapy is presented. Finally a general discussion about the different aspects of computerized treatment planning as presented in this thesis is given. (Auth.)

Settlement Networks in Polish Spatial Development Regional Plans

Science.gov (United States)

Sołtys, Jacek

2017-10-01

In 1999, ten years after the great political changes in Poland, 16 self-governed regions (in Polish: voivodeship) were created. According to Polish law, voivodeship spatial development plans, or regional plans in short, determine basic elements of the settlement network. No detailed regulations indicate the specific elements of the settlement network or what features of these elements should be determined. For this reason, centres as elements of the settlement network are variously named in different regions and take the form of various models. The purposes of the research described in this article are: (1) recognition and systematization of settlement network models determined in regional plans; and (2) assessment of the readability of determination in planning and its usefulness in the practice of regional policy. Six models of settlement networks in regional plans have been identified and classified into types and sub-types. Names of specific levels of centres indicate that they were classified according to two criteria: (1) level of services, which concerns only 5 voivodships; and (2) importance in development, which concerns the 11 other voivodships. The hierarchical model referring to the importance of development is less understandable than the one related to services. In the text of most plans, centres of services and centres of development are treated independently from their names. In some plans the functional types of towns and cities are indicated. In some voivodships, specifications in the plan text are too general and seem to be rather useless in the practice of regional policy. The author suggests that regional plans should determine two kinds of centres: hierarchical service centres and non-hierarchical centres of development. These centres should be further distinguished according to: (1) their role in the activation of surroundings; (2) their level of development and the necessity of action for their development; and (3) the types of actions

Improving and Maintaining Physical Activity and Anthropometric Indices in females from Tehran: Application of the Theory of Planned Behavior

Directory of Open Access Journals (Sweden)

Zeynab Gholamnia-shirvani

2016-03-01

Full Text Available Background and Objectives: The amount of physical activity as an essential determinant of healthy lifestyle in females is less than is required. Theory-driven health education interventions, particularly Theory of Planned Behavior (TPB, are effective in promoting and sustaining physical activity. This research evaluated the TPB-based educational intervention on exercise behavior and anthropometric indices in females residing in organizational houses in Tehran. Materials and Methods: A randomized controlled trial was performed on 130 females residing in institutional houses in Tehran (2014. Participants were randomly chosen with multi-stage cluster sampling. The instructional sessions were carried out applying modified methods of the TPB structure (instrumental and affective attitudes, subjective norms, perceived behavioral control, intention and behavior. The TPB constructs, physical activity level and intensity, Body Mass Index (BMI and Waist Hip Ratio (WHR were analyzed using the SPSS 16software in baseline, three and six months post-education. Results: Conducting the educational program led to a rise and maintained the mean of the TPB constructs and mean rank of the physical activity level and intensity, three and six months post-intervention in the case group (P0.05 Conclusions: Implementing the TPB-directed instructional sessions resulted in ameliorating and sustaining exercise behavior and anthropometric indices in females.

Indicators and Performance Measures for Transportation, Environment and Sustainability in North America

DEFF Research Database (Denmark)

Gudmundsson, H.

A study trip to USA and Canada was undertaken in October 2000 with support from the German Marshall Fund. The purpose of the trip was to learn about performance planning and performance indicators in the area of transportation and environment. The report describe findings from the trip in the fol......A study trip to USA and Canada was undertaken in October 2000 with support from the German Marshall Fund. The purpose of the trip was to learn about performance planning and performance indicators in the area of transportation and environment. The report describe findings from the trip...... in the following areas: how performance planning for transportation and environment is conducted in the US and Canada at federal, state and municipal level, to what extent performance planning serve as an instrument to integrate environmental and sustainability goals in transportation policy which specific...... indicators are used to measure the environmental sustainability of transportation systems and policies in the two North American countries....

Radiation indicator options for environmental policy

CERN Document Server

Pruppers, M J M

2002-01-01

It has proven impossible to create an indicator capable of showing the state of the art in a single figure so as to determine the progress made in the 'radiation component' of environmental policy from the trends indicated. This is the conclusion following an investigation requested by the Ministry of Housing, Spatial Planning and the Environment in the framework of the environmental theme 'dispersion of radioactive substances and ionising radiation' to develop a radiation indicator comparable to the indicators for proprietary substances and pesticides. The most important reasons for failing to develop this indicator lie in the absence of both suitable policy targets and data for the calculations necessary for the indicator. Substituting policy targets with reference emissions, reference concentrations and reference doses would make it possible to define indicators for radiation protection. Here, environmental pressure indicators are proposed for nuclear installations and the process industry. The environment...

Positive autoantibodies to ZnT8 indicate elevated risk for additional autoimmune conditions in patients with Addison's disease.

Science.gov (United States)

Fichna, Marta; Rogowicz-Frontczak, Anita; Żurawek, Magdalena; Fichna, Piotr; Gryczyńska, Maria; Zozulińska-Ziółkiewicz, Dorota; Ruchała, Marek

2016-07-01

Autoimmune Addison's disease (AAD) associates with exceptional susceptibility to develop other autoimmune conditions, including type 1 diabetes (T1D), marked by positive serum autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and insulinoma-associated protein 2 (IA-2A). Zinc transporter 8 (ZnT8) is a new T1D autoantigen, encoded by the SLC30A8 gene. Its polymorphic variant rs13266634C/T seems associated with the occurrence of serum ZnT8 antibodies (ZnT8A). This study was designed to determine the prevalence of serum ZnT8A and their clinical implication in 140 AAD patients. Other beta cell and thyroid-specific autoantibodies were also investigated, and ZnT8A results were confronted with the rs13266634 genotype. ZnT8A were detectable in 8.5 %, GADA in 20.7 %, IA-2A in 5.7 %, IAA in 1.6 % and various anti-thyroid antibodies in 7.1-67.8 % individuals. Type 1 diabetes was found in 10 % AAD patients. ZnT8A were positive in 57.1 % of T1D patients and 3.4 % non-diabetic AAD. Analysis of ZnT8A enabled to identify autoimmunity in two (14.3 %) T1D individuals previously classified as autoantibody-negative. ZnT8A-positive patients revealed significantly higher number of autoimmune conditions (p < 0.001), increased prevalence of T1D (p < 0.001) and other beta cell-specific autoantibodies. Carriers of the rs13266634 T-allele displayed increased frequency (p = 0.006) and higher titres of ZnT8A (p = 0.002). Our study demonstrates high incidence of ZnT8A in AAD patients. ZnT8A are associated with coexisting T1D and predictive of T1D in non-diabetic subjects. Moreover, positive ZnT8A in AAD indicate elevated risk for additional autoimmune conditions. Autoantibodies to beta cell antigens, comprising ZnT8, could be included in routine screening panels in AAD.

Local matching indicators for concave transport costs

OpenAIRE

Delon , Julie; Salomon , Julien; Sobolevskii , A.

2010-01-01

International audience; In this note, we introduce a class of indicators that enable to compute efficiently optimal transport plans associated to arbitrary distributions of $N$ demands and $N$ supplies in $\\mathbf{R}$ in the case where the cost function is concave. The computational cost of these indicators is small and independent of $N$. A hierarchical use of them enables to obtain an efficient algorithm.

Using Model to Plan of Strategic Objectives

OpenAIRE

Terezie Bartusková; Jitka Baňařová; Zuzana Kusněřová

2012-01-01

Importance of strategic planning is unquestionable. However, the practical implementation of a strategic plan faces too many obstacles. The aim of the article is explained the importance of strategic planning and to find how companies in Moravian-Silesian Region deal with strategic planning, and to introduce the model, which helps to set strategic goals in financial indicators area. This model should be part of the whole process of strategic planning and can be use to predict the future value...

Daily CT planning during boost irradiation of prostate cancer. Feasibility and time requirements

International Nuclear Information System (INIS)

Geinitz, H.; Zimmermann, F.B.; Kuzmany, A.; Kneschaurek, P.

2000-01-01

Background: In the irradiation of prostate cancer internal organ movement leads to uncertainties in the daily localization of the clinical target volume. Therefore more or less large safety margins are added when designing the treatment portals. With daily CT planning internal organ movement can be compensated to some extent, safety margins can be reduced and irradiated normal tissue can be spared. The feasibility of daily CT-based 3D treatment planning is studied in a patient with localized prostate carcinoma using a new patient positioning system. Methods: Daily CT planning was applied during boost irradiation of a patient with prostate cancer: After patient immobilization the pelvis was scanned in 3 mm CT slices. Planning was done with the BrainSCAN planning system for stereotactic body irradiation. The prostate was contoured in all slices and the safety margins of the micromultileafs were automatically set to the distance chosen by the physician (0.8 cm). Patient positioning was done with the BrainLAB ExacTrac positioning system on the basis of skin attached stereotactic body markers. Before each treatment verification images of the isocenter were taken. Results: The total time requirement for planning and irradiation was about 1 hour 15 minutes. Patient positioning on the treatment couch took about 10 minutes. The accuracy of the positioning system was good (75% of the deviations were smaller than 3 mm). The shift of the single markers from CT scan to CT scan was more extensive than those of the center of all 7 markers combined (47% of the deviations were smaller than 3 mm). The location of the markers seems to influence the magnitude of their dislocation. Conclusion: Daily CT planning is feasible but time consuming. The new patient positioning system ExacTrac is an interesting tool especially for daily CT planning since conventional simulation can be omitted. (orig.) [de

Comparative Study of the Characteristics of Family Planning Service ...

African Journals Online (AJOL)

In logistics regression analysis family planning was significantly lower in the illiterate. Positive husband\\'s attitude had the strongest association (0R 9.3, 95% CI 4.6,18.7) with family planning, in addition to programs that create demand for smaller well-spread children, IEC and family planning services should target men and ...

Prospects offered by the departmental plans inspection; Les perspectives offertes par la revision des plans departementaux

Energy Technology Data Exchange (ETDEWEB)

Thauvin, Ph.

2000-07-01

In the framework of the departmental plans inspection, a detailed document is presented on the domestic and industrial wastes management. These plans forecast an increase of the recycling facing the incineration, a mastership of the costs, a better application of the regulations and a campaign of public information. The indicators of control and the main points of these plans are discussed, supported by tables and definitions. (A.L.B.)

Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

International Nuclear Information System (INIS)

Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

2013-01-01

Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

The Use of Industrial Robot Arms for High Precision Patient Positioning

International Nuclear Information System (INIS)

Katuin, J.E.; Schreuder, A.N.; Starks, W.M.; Doskow, J.

2003-01-01

The Indiana University Cyclotron Facility (IUCF) is in the process of designing and building the Midwest Proton Radiation Institute (MPRI) [1]. The design process includes the development of several patient treatment systems. This paper discusses the use of two such systems that provide for the high precision positioning of a patient. They are the Patient Positioner System and the X-ray system. The Patient Positioner System positions an immobilized patient on a support device to a treatment position based on a prescribed Treatment Plan. The X-ray system uses an industrial robot arm to position a Digital Radiography Panel to acquire an X-ray image to verify the location of the prescribed treatment volume in a patient by comparing the acquired images with reference images obtained from the patient's Treatment plan

Material requirements planning using uncertain data

OpenAIRE

Ramonas, Martynas

2007-01-01

Last decennials in many companies information like strategical reservoir bursted into preponderant positions. Strategical information systems which withstand competition hold information place like this and help to survive for companies. First integrated IS which upstarted to computerize the planning of companies activities, are material recourse planning systems (MRP). It helps for company to solve the serious problems. Strategical information systems change the aims, processes of business, ...

From action planning and plan enactment to fruit consumption: moderated mediation effects.

Science.gov (United States)

Kasten, Stefanie; van Osch, Liesbeth; Eggers, Sander Matthijs; de Vries, Hein

2017-10-23

Sufficient fruit consumption is beneficial for a healthy live. While many Dutch adults intent to eat the recommended amount of fruit, only 5-10% of the population actually adheres to the recommendation. One mechanism that can help to narrow this gap between intention and actual fruit consumption is action planning. However, action planning is only assumed to be effective if plans are enacted. This study assessed which action plans are made and enacted, and further aimed to investigate two main hypotheses: 1. the effect of action planning (at T1) on fruit consumption (at T2) is mediated by plan enactment (at T3); 2. positive intentions (2a), high self-efficacy (2b) and a strong habit to eat fruit (2c) enhance the mediation of plan enactment, whereas a strong habit to eat snacks (2d) hinders the mediation of plan enactment. This study was a self-reported longitudinal online survey study. A total of 428 participants filled in a survey, measuring demographic factors (e.g. gender, age, education level), several socio-cognitive constructs (i.e. attitudes, self-efficacy, habit, action planning, plan enactment), and fruit consumption, at three points in time (baseline, after 1 month, and after 3 months). Mediation and moderated mediation analyses were used to investigate the planning-plan enactment- fruit consumption relationship. Up to 70% of the participants reported to have enacted their T1 action plans at T2. Action planning on fruit consumption was fully mediated by plan enactment (Hypothesis 1). All four proposed moderators (i.e. intention, self-efficacy, habit to consume fruit, and habit to consume snacks) significantly influenced the mediation (Hypotheses 2a-2d). Mediation of plan enactment was only present with high levels of intention, high levels of self-efficacy, strong habits to eat fruit, and weak habits to eat snacks. The study suggests the importance of plan enactment for fruit consumption. Furthermore, it emphasizes the necessity of facilitating factors

New horizons with PET/CT in high-tech radiotherapy planning

International Nuclear Information System (INIS)

Hadjieva, T.

2009-01-01

Full text:The precise delineation of exposed volumes in the high-tech radiotherapy is a major problem. The malignoma imaging was revolutionized by PET. PET became one of the routine imaging methods in developed countries in Europe and USA. PET with 18-FDG, combined with structural and topographic representation of images by CT, currently provides the most reliable information about the location and spread of tumor. Three dimensional radiotherapy planning is a challenge in today's practice and requires the most accurate visualization of the tumor, with its functional characteristics (proliferation activity, hypoxic cells, apoptosis, neoangiogenesis) and surrounding radiosensitive normal tissue and organs. The collected information about the main indications for radiotherapy planning using PET / CT in head and neck cancers , small cell lung carcinoma and some malignant lymphomas has been discussed. The problem of false positive and false negative findings has been also considered. The protocol for 18-FDG PET / CT conducting according to the agreed consensus of the IAEA expert meeting held in 2006 is presented

Using the theory of planned behavior to explore attitudes and beliefs about dietary supplements among HIV-positive Black women.

Science.gov (United States)

Lino, Stephanie; Marshak, Helen Hopp; Herring, R Patti; Belliard, Juan Carlos; Hilliard, Charles; Campbell, Danielle; Montgomery, Susanne

2014-04-01

This cross-sectional study investigated whether the theory of planned behavior (TPB) constructs: attitudes, subjective norms, and perceived behavioral control were related to intention of dietary supplements use among African-American women living with Human Immunodeficiency Virus and/or Acquired Immune Deficiency Syndrome (HIV/AIDS). A closed-ended questionnaire based on the TPB was utilized to explore the use of dietary supplements among a cohort of 153 HIV-positive African-American women. Overall, 45% of the respondents used dietary supplements to manage/control their HIV. Combined, attitudes, subjective norms and perceived behavioral control were significant predictors of intention toward dietary supplement use (69% of the variance explained, pbehavioral control (β=0.45, pBehavioral intention and proximal TPB constructs (attitudes, subjective norms, and perceived behavioral control), as well as their underlying beliefs about dietary supplements use, were all found to be significantly more positive in users of dietary supplements compared to non-users (pbehavioral control are important predictors in the intention to use dietary supplements for control of HIV among African-American women. Implications from this study suggest that the TPB can be used to better identify and understand salient beliefs that surround intentions to use alternative therapies for management of disease. These beliefs can be used to develop interventions surrounding HIV treatment and care. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Motion Planning of Overhead Crane Based on Suppressing Payload Residual Swing

Directory of Open Access Journals (Sweden)

Liu Hua-sen

2016-01-01

Full Text Available Since the overhead crane system is subject to under actuation system due to that overhead crane and payload are connected by flexibility wire rope. The payload generates residual swing when the overhead crane is accelerating/ decelerating the motions. This may cause trouble for the payload precise positioning and motion planning. Hence, an optimization input shaping control method is presented to reduce the under actuated overhead crane’s payload swing caused via the inertia force. The dynamic model of the overhead crane is proposed according to the physics structure of the crane. The input shaper based on the motion planning of the crane is used as the feed forward input to suppress payload residual swing. Simulation and experiment results indicate that the ZV input shaper and ZVD input shaper can reduce the payload swing of the overhead crane.

Assessing coastal plain risk indices for subsurface phosphorus loss

Science.gov (United States)

Phosphorus (P) Indices are important tools for nutrient management planning in the U.S. whose evaluation often has been deemphasized in favor of research and development. Assessing P Indices in artificially drained agroecosystems is especially important, as subsurface flow is the predominant mode of...

Inverse planning for interstitial gynecologic template brachytherapy: truly anatomy-based planning

International Nuclear Information System (INIS)

Lessard, Etienne; Hsu, I-Chou; Pouliot, Jean

2002-01-01

Purpose: Commercially available optimization schemes generally result in an undesirable dose distribution, because of the particular shapes of tumors extending laterally from the tandem. Dose distribution is therefore manually obtained by adjusting relative dwell time values until an acceptable solution is found. The objective of this work is to present the clinical application of an inverse planning dose optimization tool for the automatic determination of source dwell time values in the treatment of interstitial gynecologic templates. Methods and Materials: In cases where the tumor extends beyond the range of the tandem-ovoid applicator, catheters as well as the tandem are inserted into the paravaginal and parametrial region in an attempt to cover the tumor volume. CT scans of these patients are then used for CT-based dose planning. Dose distribution is obtained manually by varying the relative dwell times until adequate dose coverage is achieved. This manual planning is performed by an experienced physician. In parallel, our in-house inverse planning based on simulated annealing is used to automatically determine which of all possible dwell positions will become active and to calculate the dwell time values needed to fulfill dose constraints applied to the tumor volume and to each organ at risk. To compare the results of these planning methods, dose-volume histograms and isodose distributions were generated for the target and each organ at risk. Results: This procedure has been applied for the dose planning of 12 consecutive interstitial gynecologic templates cases. For all cases, once the anatomy was contoured, the routine of inverse planning based on simulated annealing found the solution to the dose constraints within 1 min of CPU time. In comparison, manual planning took more than 45 min. The inverse planning-generated plans showed improved protection to organs at risk for the same coverage compared to manual planning. Conclusion: This inverse planning tool

Normal position and malposition of the heart

International Nuclear Information System (INIS)

Andresen, J.H.; Eggert Hansen, T.

1980-01-01

The main types of heart positions and the malpositions are described as demonstrated on plain films of the thorax. Special attention is drawn to the situs ambiguous with the poly- or asplenia which may be recognized from hypoarterial or epiarterial position of the main bronchi and their equal lengths and courses. This diagnosis is important because of the frequent accompanying congenital cardiac malformations and in respect to the planning of angiocardiography. (orig.) [de

Animation as a Visual Indicator of Positional Uncertainty in Geographic Information

DEFF Research Database (Denmark)

Kessler, Carsten; Lotstein, Enid

2018-01-01

Effectively communicating the uncertainty that is inherent in any kind of geographic information remains a challenge. This paper investigates the efficacy of animation as a visual variable to represent positional uncertainty in a web mapping context. More specifically, two different kinds...... of animation (a ‘bouncing’ and a ‘rubberband’ effect) have been compared to two static visual variables (symbol size and transparency), as well as different combinations of those variables in an online experiment with 163 participants. The participants’ task was to identify the most and least uncertain point...... visualizations using symbol size and transparency. Somewhat contradictory to those results, the participants showed a clear preference for those static visualizations....

Preparedness and planning for nuclear accidents at national level

International Nuclear Information System (INIS)

Shiukshta, A.

1998-01-01

National plan for the protection of population in the case in nuclear accident at Ignalina NPP is presented. The plan was elaborated and approved in 1995, tested in a number of training and practical operations and positively evaluated by experts. The plan provides for measures of protection, their scope, schedule, executive officers and organizations and procedure of implementation

Performance indicators proposal for the government electric power distribution facilities in the Brazilian electric sector; Proposta de indicadores de desempenho as distribuidoras de energia federalizadas do setor eletrico brasileiro

Energy Technology Data Exchange (ETDEWEB)

Carregaro, Jose Carlos

2003-07-01

In this dissertation a set of indicators is proposed to the Centrais Eletricas Brasileiras S/A - ELETROBRAS, allowing the holding companies to attain the top position in the market, and a global vision of their performance. The methodology applied the definition of the performance indicators and the context, existing studies, and the indicators used by the Brazilian electric sector. It is expected that the proposed set of indicators be used by ELETROBRAS for a better planning and a more objective control of the holding companies performance, as well as an analysis of their administration strong and weak aspects.

SU-E-T-512: Evaluation of Treatment Planning Dose Calculation Accuracy at the Interface of Prosthetic Devices.

Science.gov (United States)

Paulu, D; Alaei, P

2012-06-01

To evaluate the ability of treatment planning algorithm to accurately predict dose delivered at the interface of high density implanted devices. A high density (7.6 g/cc) Cobalt-Chromium-Molybdenum hip prosthesis was molded into an epoxy-based cylindrical leg phantom. The phantom was designed to be separated in half to access the prosthesis and to place the TLDs. Using MVCT to image the apparatus, a simple treatment plan was developed using the Philips Pinnacle treatment planning system. Wires were placed in the molded epoxy to allow for accurate definition of measurement sites (TLD positions) along the surface of the prosthesis. Micro-cube TLDs (1 mm 3 ) were placed at six measurement locations for which the dose had been calculated by the treatment planning system. An Elekta Synergy linear accelerator was used to deliver a 400 cGy plan to the phantom with 6 MV photons in a single fraction. A total of four 10 cm × 21 cm fields were used at 0, 90, 180, and 270 degree gantry rotations. Initial results indicate that the measured dose is 7-17% lower than the dose calculated by the treatment planning system. Further study using high energy beams are also in progress. Initial results indicate that the treatment planning system does predict the dose near a high density prosthetic device within 10-15% but underestimates the dose. The results of this study could help in designing treatment plans which would reduce the uncertainty of the dose delivered in the vicinity of prosthetic hip implants and similar devices. © 2012 American Association of Physicists in Medicine.

Six-Position, Frontal View Photography in Blepharoplasty: A Simple Method.

Science.gov (United States)

Zhang, Cheng; Guo, Xiaoshuang; Han, Xuefeng; Tian, Yi; Jin, Xiaolei

2018-02-26

Photography plays a pivotal role in patient education, photo-documentation, preoperative planning and postsurgical evaluation in plastic surgeries. It has long been serving as a bridge that facilitated communication not only between patients and doctors, but also among plastic surgeons from different countries. Although several basic principles and photographic methods have been proposed, there is no internationally accepted photography that could provide both static and dynamic information in blepharoplasty. In this article, we introduced a novel six-position, frontal view photography for thorough assessment in blepharoplasty. From October 2013 to January 2017, 1068 patients who underwent blepharoplasty were enrolled in our clinical research. All patients received six-position, frontal view photography. Pictures were taken of the patients looking up, looking down, squeezing, smiling, looking ahead and with closed eyes. Conventionally, frontal view photography only contained the last two positions. Then, both novel six-position photographs and conventional two-position photographs were used to appraise postsurgical outcomes. Compared to conventional two-position, frontal view photography, six-position, frontal view photography can provide more detailed, thorough information about the eyes. It is of clinical significance in indicating underlying adhesion of skin/muscle/fat according to individual's features and assessing preoperative and postoperative dynamic changes and aesthetic outcomes. Six-position, frontal view photography is technically uncomplicated while exhibiting static, dynamic and detailed information of the eyes. This innovative method is favorable in eye assessment, especially for revision blepharoplasty. We suggest using six-position, frontal view photography to obtain comprehensive photographs. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer

Integrated Care Planning for Cancer Patients: A Scoping Review

Directory of Open Access Journals (Sweden)

Anum Irfan Khan

2017-11-01

Full Text Available Introduction: There has been a growing emphasis on the use of integrated care plans to deliver cancer care. However little is known about how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact. Methods: Given limited consensus around what constitutes an integrated care plan for cancer patients, a scoping review was conducted to explore the components of integrated care plans and contextual factors that influence design and uptake. Results: Five types of integrated care plans based on the stage of cancer care: surgical, systemic, survivorship, palliative and comprehensive (involving a transition between stages are described in current literature. Breast, esophageal and colorectal cancers were common disease sites. Multi-disciplinary teams, patient needs assessment and transitional planning emerged as key features. Provider buy-in and training alongside informational technology support served as important facilitators for plan uptake. Provider-level measurement was considerably less robust compared to patient and system-level indicators. Conclusions: Similarities in design features, components and facilitators across the various types of integrated care plans indicates opportunities to leverage shared features and enable a management lens that spans the trajectory of a patient’s journey rather than a phase-specific silo approach to care.

Indicators for planning of health services: assessing impacts of social and health care factors on population health.

Science.gov (United States)

Wan, T T; Broida, J H

1983-01-01

Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

3-Dimensional Reproducibility of Natural Head Position

Science.gov (United States)

2012-04-12

the “Six Elements to Orofacial Harmony”. He advocated using his Element II Analysis with natural head orientation for treatment planning, since “it...temporomandibular disorders, neck pain , headache, dentofacial structures, mandibular length, mandibular position, mandibular divergency and overjet (Cuccia, 2009

Evaluating California local land use plan's environmental impact reports

International Nuclear Information System (INIS)

Tang Zhenghong; Bright, Elise; Brody, Samuel

2009-01-01

Local land use planning has profound impacts on environmental quality; however, few empirical studies have been conducted to systematically measure local land use plans' environmental assessment quality and to identify the factors influencing it. This paper analyzes the quality of 40 Environmental Impact Reports (EIRs) of local jurisdictions' land use plans in California. A plan evaluation protocol defined by five core components and sixty-three indicators is developed to measure the quality of local land use plans' EIRs. The descriptive results indicate that the local jurisdictions produce relatively good quality on its EIRs, but there is still much room for improvement. There are large variations in the quality of EIRs across local jurisdictions. The regression results further highlight three major factors that can significantly influence local land use plan's EIR quality: number of planners, plan updating ability, and development pressure

Patient positioning and its influence on dose distribution

International Nuclear Information System (INIS)

Morrissey, J.; Moss, R.; Watkins, P.

2000-01-01

In comparison to conventional radiotherapy, the positioning of a patient for BNCT treatment has some unique aspects. In particular, the neutron beam coming from the core of a nuclear research reactor is fixed and horizontal. In particular, a head fixation mask, which is prepared at the patient referral hospital, is included in the CT images. The mask allows reproducible positioning for use during the treatment. Fiducial markers placed on the mask before imaging, provide reference points. The INEEL treatment planning code used in Petten produces a beam angle, and beam line entrance and exit co-ordinates. These are related to the fiducial marker co-ordinates. A spreadsheet, named COSINE, developed at Petten produces positioning co-ordinates from the data produced by the rtt MC code. These co-ordinates are related to a positioning frame, which allows the marking of the beams on the mask. In order to have reliable treatment data, the influence of small deviations of angle or target point on dose distribution must be known. To demonstrate this, a number of beams have been calculated with the Petten beam, with slight variations and compared with an approved plan. (author)

Planning and evaluation of sustainability in transport

DEFF Research Database (Denmark)

Introduction and general approaches 2. Brief overview ofsome projects related to sustainability 3. Examples from research – Decision analysis and support – Policy Influence of indic ators – National Sustainable Transport Planning 4. Some perspectives......Introduction and general approaches 2. Brief overview ofsome projects related to sustainability 3. Examples from research – Decision analysis and support – Policy Influence of indic ators – National Sustainable Transport Planning 4. Some perspectives...

What is the value of performance indicators for the nuclear industry?

International Nuclear Information System (INIS)

Johann Popp

2006-01-01

WANO is an Association of all Operators of Nuclear Power Plants worldwide. This association is promoting and running for their members 4 programmes which are Operating Experience, Peer Reviews, Professional and Technical Development and Technical Support and Exchange. The Technical Support and Exchange programme comprises Good Practices, Performance Indicators, Operator-to-Operator Exchanges and Technical Support Missions. This paper explains the Performance Indicator programme. WANO is collecting significant NPP nuclear power plant data and is computing indicators according to selected criteria for the only purpose of comparing or benchmarking plant performance of all types and different designs. All effective organisations measure their performance in order to know, how well they are doing and in order to identify opportunities for improvement. Indicators are central to the monitoring and reporting of progress towards sustainable development in all areas. Indicators are mainly derived from statistical data in order to exhibit weaknesses and strengths of programs. There are many hundreds of commercial and technical indicators known. WANO is tracing just ten significant indicators out of the many available, and only for the purpose of comparing plant performance. The first set of three indicators is more related to productivity and exhibit, how well management is planning, staff is maintaining and operators are conducting the plants. The second set of two indicators is related to safety systems, how well they are maintained and how reliable they are. The next set of two is material related and the last two indicators are related to human resources. Indicators are reflecting the current industrial standard and allow the positioning of a plant with regard to the 'state of the art'. They pinpoint to weaknesses and strengths of different designs/fleets

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, G.M.; Fowble, B.L.; Hanlon, A.L.; Myint, M.A.; Hoffman, J.P.; Sigurdson, E.R.; Eisenberg, B.L.; Goldstein, L.J.; Fein, D.A.

1997-01-01

Purpose: Indications for postmastectomy radiation include primary tumor size > 5 cm and ≥ 4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with this pathologic feature who otherwise would be considered low risk (tumor size 25% at 8 years: Age ≤ 50 years was 28% vs. 0% for age > 50 (p=0.08). There was no correlation with chest wall failure and number of nodes, ER status, lymphovascular invasion, location of primary, grade, family history or type of tumor close to the margin. All four chest wall failures were in patients who had received adjuvant systemic chemotherapy ± Tamoxifen. Chest wall failures occurred in patients with margins within 1-2 mm in three patients and 5 mm in one patient. The cumulative chest wall recurrence at 8 years by margin proximity was 24% ≤ 2mm vs. 7% 2.1-6 mm (p=0.44), and by clinical size 24% for T2 tumors vs. 7% for T1 (p=0.55). Conclusions: A close or positive margin is uncommon (< 5%) after mastectomy in patients with tumor size < 5 cm and 0-3 positive axillary nodes, but when present it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤ 5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy, and therefore we recommend they be considered for postmastectomy radiation. This high risk of local failure was not observed in patients over age 50, suggesting this subgroup may not require adjuvant chest wall irradiation

Positive and negative emotional eating have different associations with overeating and binge eating: Construction and validation of the Positive-Negative Emotional Eating Scale.

Science.gov (United States)

Sultson, Hedvig; Kukk, Katrin; Akkermann, Kirsti

2017-09-01

Research on emotional eating mostly focuses on negative emotions. Much less is known about how positive emotions relate to overeating and binge eating (BE). The aim of the current study was to construct a scale for positive and negative emotional eating and to assess its predictive validity. In study 1, the Positive-Negative Emotional Eating Scale (PNEES) was constructed and tested on 531 women, who also completed Eating Disorders Assessment Scale (EDAS). Results showed that a two-factor model constituting Positive emotional eating (PNEES-P) and Negative emotional eating (PNEES-N) fit the data well. PNEES-N also showed good convergent validity in assessing binge eating, correlating highly with EDAS subscale Binge eating. Further, a path analysis showed that after controlling for the mediating effect of PNEES-N, PNEES-P continued to significantly predict binge eating. In study 2 (N = 60), experience sampling method was used to assess overeating and BE in the natural environment. Palmtop computers were given to participants for a three-day study period that prompted them with questions regarding emotional experience, overeating, and BE. Results indicated that PNEES-P significantly predicted overeating, whereas PNEES-N predicted overeating and BE episodes only in a subsample of women who had experienced at least one overeating or BE episode. Thus, positive and negative emotional eating might have different relations with overeating and BE, with the latter being more characteristic of the severity/frequency of overeating and BE. New assessment tools that in addition to negative emotional eating also address positive emotional eating could be of potential help in planning intervention. Further, the tendency to overeat in response to positive emotions could be integrated into current models of eating disorders, especially when addressing relapse prevention. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Positioning diagnosis of benign positional paroxysmal vertigo by VNG].

Science.gov (United States)

Wang, Na; Chen, Taisheng; Lin, Peng; Song, Wei; Dong, Hong

2009-07-01

To analyze the value of positioning diagnosis of VNG (Videonystagmograph) in patients with benign paroxysmal positional vertigo (BPPV). One hundred and twenty-six patients with BPPV were enrolled in this retrospective study. Their positional nystagmus recorded by VNG in Dix-Hallpike and roll tests were analyzed to summarize the characteristics of nystagmus on nystagmography of various BPPV. Of 126 patients with BPPV diagnosed in our center, the posterior semicircular canals (PSC) were involved in 98 patients (77.8%), whereas the horizontal semicircular canal (HSC) and anterior semicircular canal (ASC) were involved in 17 (13.5%) and 5 (3.9%), respectively. Six patients (4.8%) confirmed combined-BPPV had HSC-BPPV and ipsilateral PSC-BPPV. Twenty-eight patients with PSC-BPPV had reversal phase on nystagmography. The nystagmus of patients with P/ASC-canalithiasis showed upward/downward on the vertical phase of nystagmography and orientated the opposite side on horizontal phase in the head hanging position, and the nystagmus reversed when returned to sit. Nystagmus on horizontal phase could be provoked when the head turned to both sides of the roll tests in patients with HSC-BPPV. If the nystagmus and the head-turning shared the same direction, then HSC-canalithiasis was confirmed, and the direction of the head-turning which provoked the stronger nystagmus indicates the lesion side. If the nystagmus and the head-turning had the opposite direction, then HSC-cupulolithiasis was confirmed, and the direction of the head-turning which provoked the weaker nystagmus indicates the lesion side. Positional nystagmus can be recorded objectively using VNG, According to which positioning the semicircular canal involved would be easier and more accurate. The recording conserved also could be helpful for clinical diagnosis and repositioning of BPPV.

Development of customized positioning guides using computer-aided design and manufacturing technology for orthognathic surgery.

Science.gov (United States)

Lin, Hsiu-Hsia; Chang, Hsin-Wen; Lo, Lun-Jou

2015-12-01

The purpose of this study was to devise a method for producing customized positioning guides for translating virtual plans to actual orthognathic surgery, and evaluation of the feasibility and validity of the devised method. Patients requiring two-jaw orthognathic surgery were enrolled and consented before operation. Two types of positioning guides were designed and fabricated using computer-aided design and manufacturing technology: One of the guides was used for the LeFort I osteotomy, and the other guide was used for positioning the maxillomandibular complex. The guides were fixed to the medial side of maxilla. For validation, the simulation images and postoperative cone beam computed tomography images were superimposed using surface registration to quantify the difference between the images. The data were presented in root-mean-square difference (RMSD) values. Both sets of guides were experienced to provide ideal fit and maximal contact to the maxillary surface to facilitate their accurate management in clinical applications. The validation results indicated that RMSD values between the images ranged from 0.18 to 0.33 mm in the maxilla and from 0.99 to 1.56 mm in the mandible. The patients were followed up for 6 months or more, and all of them were satisfied with the results. The proposed customized positioning guides are practical and reliable for translation of virtual plans to actual surgery. Furthermore, these guides improved the efficiency and outcome of surgery. This approach is uncomplicated in design, cost-effective in fabrication, and particularly convenient to use.

Predicting Physical Activity Outcomes During Episodes of Academic Goal Conflict: The Differential Role of Action Planning and Coping Planning.

Science.gov (United States)

Carraro, Natasha; Gaudreau, Patrick

2015-09-01

The moderating role of academic goal conflict in the relations between action planning (AP) and coping planning (CP) with physical activity was tested using samples of university students concurrently pursuing an academic and a physical activity goal. In Study 1 (N = 317), AP was found to positively relate to physical activity goal progress at low, but not at high, levels of goal conflict. CP trended toward being positively related to goal progress at high, but not at low levels of goal conflict. Study 2 (N = 97), using a 1-week daily diary design and measures of self-reported physical activity behavior and goal progress, showed that daily AP positively related to daily physical activity outcomes on days when students experienced lower, but not higher, levels of goal conflict relative to their average. Conversely, CP positively related to daily physical activity outcomes on days when students experienced higher, but not lower, levels of goal conflict. © 2015 by the Society for Personality and Social Psychology, Inc.

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques.

Science.gov (United States)

Hampp, Emily L; Chughtai, Morad; Scholl, Laura Y; Sodhi, Nipun; Bhowmik-Stoker, Manoshi; Jacofsky, David J; Mont, Michael A

2018-05-01

This study determined if robotic-arm assisted total knee arthroplasty (RATKA) allows for more accurate and precise bone cuts and component position to plan compared with manual total knee arthroplasty (MTKA). Specifically, we assessed the following: (1) final bone cuts, (2) final component position, and (3) a potential learning curve for RATKA. On six cadaver specimens (12 knees), a MTKA and RATKA were performed on the left and right knees, respectively. Bone-cut and final-component positioning errors relative to preoperative plans were compared. Median errors and standard deviations (SDs) in the sagittal, coronal, and axial planes were compared. Median values of the absolute deviation from plan defined the accuracy to plan. SDs described the precision to plan. RATKA bone cuts were as or more accurate to plan based on nominal median values in 11 out of 12 measurements. RATKA bone cuts were more precise to plan in 8 out of 12 measurements ( p  ≤ 0.05). RATKA final component positions were as or more accurate to plan based on median values in five out of five measurements. RATKA final component positions were more precise to plan in four out of five measurements ( p  ≤ 0.05). Stacked error results from all cuts and implant positions for each specimen in procedural order showed that RATKA error was less than MTKA error. Although this study analyzed a small number of cadaver specimens, there were clear differences that separated these two groups. When compared with MTKA, RATKA demonstrated more accurate and precise bone cuts and implant positioning to plan. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Establishment of a solar utilisation plan

International Nuclear Information System (INIS)

Gernhardt, D.; Mohr, M.; Unger, H.

1992-01-01

One of the main bases of the project ''Analysis of Possibilities of Solar Power Supply in Nordrhein-Westfalen and its Development until 2020'' is the achievement of a solar surface utilization plan. The duty of this plan is to indicate usefull areas for solar application in Nordrhein-Westfalen. This report shows the task of the solar surface utilization plan and explains attributes to describe surfaces for solar applications. (orig.) [de

Does elimination of planned postoperative radiation to the primary bed in p16-positive, transorally-resected oropharyngeal carcinoma associate with poorer outcomes?

Science.gov (United States)

Sinha, Parul; Pipkorn, Patrik; Thorstad, Wade L; Gay, Hiram A; Haughey, Bruce H

2016-10-01

The purpose of our study is to compare oncologic and functional outcomes of p16-positive oropharyngeal squamous cell carcinoma (OPSCC) patients, in the presence and absence of planned radiation to the primary bed following transoral surgery (TOS), stratified by T-classification. Retrospective cohort study of 261, T1-T4, consecutively TOS-treated OPSCC patients. At a median follow-up of 61months, local recurrence (LR) occurred in 6 (2.3%)patients (3 each in T1-T2 and T3-T4 groups), of which 5 had tumors in the tongue base and one in the tonsil. Of patients not receiving planned primary bed radiation, LR occurred in 3% of T1-T2s versus 17% of T3-T4s. In patients with T1-T2 tumors, Absolute Risk Reduction of LR with primary bed radiation was 3.26% (95% CI: -0.37%, 7%); Number Needed to Treat to prevent one LR was 31 (95% CI: 14.5, 271). Absolute Risk Increase for gastrostomy-tube with primary bed radiation was 34.4% (95% CI: 24%, 45%); Number Needed to Harm was 3 (95% CI: 2.2, 4.2), i.e., for every three patients with T1-T2 tumors receiving primary bed radiation, one had a gastrostomy-tube. Elimination of primary bed radiation in margin-negative resected, T1-T2 p16-positive OPSCC was not associated with significant compromise of local control, and correlated with superior swallowing preservation, assessed using gastrostomy rate as a surrogate. Lack of primary bed radiation in T3-T4 tumors associated with significantly increased LR rates. Copyright © 2016 Elsevier Ltd. All rights reserved.

Strategic planning in hospitals in two Australian states: an exploratory study of its practice using planning documentation.

Science.gov (United States)

Jayasuriya, R; Sim, A B

1998-01-01

Hospitals are under pressure to respond to new challenges and competition. Many hospitals have used strategic planning to respond to these environmental changes. This exploratory study examines the extent of strategic planning in hospitals in two Australian States, New South Wales and Victoria, using a sample survey. Based on planning documentation, the study indicated that 47% of the hospitals surveyed did not have a strategic or business plan. A significant difference was found in the comprehensiveness of the plans between the two States. Plans from Victorian hospitals had more documented evidence of external/internal analysis, competitor orientation and customer orientation compared with plans from New South Wales hospitals. The paper discusses the limitations of the study and directions for future research.

Dose deviations caused by positional inaccuracy of multileaf collimator in intensity modulated radiotherapy

International Nuclear Information System (INIS)

Wang, H.C.; Chui, C.S.; Tsai, H.Y.; Chen, C.H.; Tsai, L.F.

2008-01-01

Introduction: Multileaf collimator (MLC) is currently a widely used system in the delivery of intensity modulated radiotherapy (IMRT). The accuracy of the multileaf position plays an important role in the final outcome of the radiation treatment. According to ICRU recommendation, a dose inaccuracy over than 5% of prescribed dose affects treatment results. In order to quantify the influence of leaf positional errors on dose distribution, we set different MLC positional inaccuracy from 0 to 6 mm for step-and-shoot IMRT in clinical cases. Two-dimensional dose distributions of radiotherapy plans with different leaf displacements generated with a commercial treatment planning system. And verification films were used to measure two-dimensional dose distributions. Then a computerized dose comparison system will be introduced to analyze the dose deviations. Materials/methods: We assumed MLC positional inaccuracy from 0 to 6 mm for step-and-shoot IMRT in clinical cases by simulating the different leaf displacements with a commercial treatment planning system. Then we transferred the treatment plans with different leaf offset that may be happened in clinical situation to linear accelerator. Verification films (Kodat EDR2) were well positioned within solid water phantoms to be irradiated by the simulated plans. The films were scanned to display two-dimensional dose distributions. Finally, we compared with the dose distributions with MLC positional inaccuracy by a two-dimensional dose comparison software to analyze the deviations in Gamma indexes and normalized agreement test (NAT) values. Results: In general, the data show that larger leaf positional error induces larger dose error. More fields used for treatment generate lesser errors. Besides, leaf position relative to a field influences the degree of dose error. A leaf lying close to the border of a field leads to a more significant dose deviation than a leaf in the center. Algorithms for intensity modulation also affect

Do children perceive postural constraints when estimating reach or action planning?

Science.gov (United States)

Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

2009-03-01

Estimation of whether an object is reachable from a specific body position constitutes an important aspect in effective motor planning. Researchers who estimate reachability by way of motor imagery with adults consistently report the tendency to overestimate, with some evidence of a postural effect (postural stability hypothesis). This idea suggests that perceived reaching limits depend on an individual's perceived postural constraints. Based on previous work with adults, the authors expected a significant postural effect with the Reach 2 condition, as evidenced by reduced overestimation. Furthermore, the authors hypothesized that the postural effect would be greater in younger children. They then tested these propositions among children aged 7, 9, and 11 years by asking them to estimate reach while seated (Reach 1) and in the more demanding posture of standing on 1 foot and leaning forward (Reach 2). Results indicated no age or condition difference, therefore providing no support for a postural effect. When the authors compared these data to a published report of adults, a developmental difference emerged. That is, adults recognize the perceived postural constraint of the standing position resulting in under- rather than overestimation, as displayed in the seated condition. Although preliminary, these observations suggest that estimates of reach (action planning) continue to be refined between late childhood and young adulthood.

Indications of a positive feedback between coastal development and beach nourishment

Science.gov (United States)

Armstrong, Scott B.; Lazarus, Eli D.; Limber, Patrick W.; Goldstein, Evan B.; Thorpe, Curtis; Ballinger, Rhoda C.

2016-12-01

Beach nourishment, a method for mitigating coastal storm damage or chronic erosion by deliberately replacing sand on an eroded beach, has been the leading form of coastal protection in the United States for four decades. However, investment in hazard protection can have the unintended consequence of encouraging development in places especially vulnerable to damage. In a comprehensive, parcel-scale analysis of all shorefront single-family homes in the state of Florida, we find that houses in nourishing zones are significantly larger and more numerous than in non-nourishing zones. The predominance of larger homes in nourishing zones suggests a positive feedback between nourishment and development that is compounding coastal risk in zones already characterized by high vulnerability.

Sexual Minority Stress, Coping, and Physical Health Indicators.

Science.gov (United States)

Flenar, Delphia J; Tucker, Carolyn M; Williams, Jaime L

2017-12-01

Sexual minorities experience higher rates of several physical health problems compared to their heterosexual counterparts. The present study uses Meyer's Minority Stress Model (Psychological Bulletin, 129(5): 674-697, 2003) to examine physical health indicators among 250 adults who identified as sexual minorities. Study hypotheses include that sexual minority stress is predictive of two physical health indicators (i.e., engagement in a health-promoting lifestyle and number of physical health problems) and that planning (i.e., problem-focused) and social support coping will partially mediate the relationship between sexual minority stress and each physical health indicator. Results showed that as level of sexual minority stress increased, engagement in a health-promoting lifestyle decreased and the number of physical health problems increased. Planning and social support coping did not mediate these relationships; however, as levels of coping increased, engagement in a health-promoting lifestyle increased. These findings have implications for researchers and healthcare professionals in their efforts to promote the physical health of sexual minorities.

Enterprise resource planning: An assessment for readiness to change

Directory of Open Access Journals (Sweden)

Ali Ashraf Nazari

2014-01-01

Full Text Available This paper presents an empirical investigation for the implementation of enterprise resource planning among 58 production units in province of Ilam, Iran. The proposed study of this paper considers the readiness in terms of six factors including human resources, financial resources, infrastructures, quality control, and information systems and communication technology. Using structural equation modeling, the study examines six hypotheses and the implementation is accomplished on LISREL software package. Cronbach alpha has been calculated as 0.91, which is well above the minimum desirable level. The results of the survey have indicated that all six mentioned factors influence positively on ERP implementation and for a successful implementation of ERP, it is suggested to consider these factors, seriously.

Replacing Military Personnel in Support Positions With Civilian Employees

Science.gov (United States)

2015-12-01

burdened costs , as they are known, would include the per-person share of costs for recruit -processing centers, schools, and training bases and would...sector so that, in principle, those same positions could be filled by civilian employees. To cut costs , DoD could transfer some of those positions to...functions more cost -effectively. DoD competed and outsourced many positions outlined in those plans. However, CBO does not have information showing

Correlation coefficients of three self-perceived orthodontic treatment need indices

Directory of Open Access Journals (Sweden)

Faezeh Eslamipour

2017-01-01

Conclusion: Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning.

Helicopter precision approach capability using the Global Positioning System

Science.gov (United States)

Kaufmann, David N.

1992-01-01

The period between 1 July and 31 December, 1992, was spent developing a research plan as well as a navigation system document and flight test plan to investigate helicopter precision approach capability using the Global Positioning System (GPS). In addition, all hardware and software required for the research was acquired, developed, installed, and verified on both the test aircraft and the ground-based reference station.

Assessment of child psychomotor development in population groups as a positive health indicator.

Science.gov (United States)

Lejarraga, Horacio; Kelmansky, Diana M; Passcucci, María C; Masautis, Alicia; Insua, Iván; Lejarraga, Celina; Nunes, Fernando

2016-02-01

It is necessary to use health indicators describing the conditions of all individuals in a population, not just of those who have a disease or die. To introduce a method to collect population indicators of psychomotor development in children younger than 6 years old and show its results. Data were obtained from a cross-sectional assessment regarding compliance with 13 developmental milestones (selected from the national reference) conducted in 5465 children using five surveys administered by the Matanza-Riachuelo River Basin Authority in areas of this basin where a high proportion of families with unmet basic needs live. For each survey, a logistic regression analysis was used to estimate the median age at attainment of the 13 developmental milestones. A linear regression model between the estimated age at attainment of the 13 milestones was adjusted for each survey based on the corresponding age at attainment of the national reference. Based on this model, three indicators were defined: overall developmental quotient, developmental quotient at 4 years old, and developmental trend. Results from the five surveys ranged between 0.74 and 0.85, 0.88 and 0.81, and -0.15 and -0.26 for the overall developmental quotient, developmental quotient at 4 years old, and developmental trend, respectively. A distinct developmental delay and an increasing trend in delay with age were observed. Indicators are easily interpreted and related to social indicators (unmet basic needs, etc.). Collecting the information necessary to make estimations takes little time and can be applied to population groups, but not on an individual level. Sociedad Argentina de Pediatría.

Service Animals in School. Position Statement

Science.gov (United States)

Garret, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy

2014-01-01

It is the position of the National Association of School Nurses (NASN) that registered school nurses (hereinafter referred to as school nurses) are integral to the team planning process necessary to successfully integrate "service animals" into schools. A request to bring a service animal into the school setting presents questions due to…

Estrella Mountain Plan for Institutional Effectiveness, 1997-1998.

Science.gov (United States)

Estrella Mountain Community Coll., Avondale, AZ.

This plan provides information on the efforts of Arizona's Estrella Mountain Community College (EMCC) to evaluate its effectiveness in achieving organizational mission and purpose. The plan contains the following information: (1) a discussion of EMCC's institutional effectiveness efforts to date, indicating that the college's Plan for…

New model of enterprises resource planning implementation planning process in manufacturing enterprises

Directory of Open Access Journals (Sweden)

Mirjana Misita

2016-05-01

Full Text Available This article presents new model of enterprises resource planning implementation planning process in manufacturing enterprises based on assessment of risk sources. This assessment was performed by applying analytic hierarchy process. Analytic hierarchy process method allows variation of relative importance of specific risk sources dependent on the section from which the risk source originates (organizational environment, technical issues, people issues, adoption process management, and external support. Survey was conducted on 85 manufacturing enterprises involved with an enterprises resource planning solution. Ranking of risk sources assessments returns most frequent risks of enterprises resource planning implementation success in manufacturing enterprises, and representative factors were isolated through factor analysis by risk source origin. Finally, results indicate that there are hidden causes of failed implementation, for example, risk source “top management training and education,” from risk origin “adoption process management.”

Planning developments in British Nuclear Fuels Ltd

Energy Technology Data Exchange (ETDEWEB)

Roper, D A [British Nuclear Fuels Ltd., Risley

1978-10-01

The state of the corporate planning art in British Nuclear Fuels Ltd. was described by N.R.Geary (Long Range Planning, September (1973)) just 2 years after Company formation. This article discusses more recent planning developments over the period to date during which the Company adopted a Divisionalized structure (from October 1974) and has been required to submit an annual Company plan to the Department of Energy (from November 1975). Background information on the origin and nature of the BNFL and its business, and the particular features of the Company which reflect into the nature and method of its planning were given in the 1973 article and only a brief introductory updating of the Company position is included here. Subsequently the features and problems of BNFL's operating and development planning system are described. Finally, messages arising from BNFL's planning experience to date which may be of general application and therefore of value to other practitioners of planning are listed.

78 FR 10104 - Watermelon Research and Promotion Plan; Importer Membership Requirements

Science.gov (United States)

2013-02-13

..., advertising, and promotion designed to strengthen the watermelon's position in the market place and to... Service 7 CFR Part 1210 [Document Number AMS-FV-11-0031] Watermelon Research and Promotion Plan; Importer... rule proposes to amend the Watermelon Research and Promotion Plan (Plan) importer membership...

Factors determining family planning in Catalonia. Sources of inequity

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Saurina Carme

2012-07-01

Full Text Available Abstract Introduction In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010 and in particular Girona province (6.18% in 2000 and 21.55% in 2010. Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain by sex, health status, place of birth and socioeconomic conditions. Methods Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users’ sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. Results The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7% and the pill (28.0% being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood and having children over 14 (35.35% more likelihood. With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to

Factors determining family planning in Catalonia. Sources of inequity.

Science.gov (United States)

Saurina, Carme; Vall-Llosera, Laura; Saez, Marc

2012-07-20

In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010) and in particular Girona province (6.18% in 2000 and 21.55% in 2010). Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain) by sex, health status, place of birth and socioeconomic conditions. Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users' sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use) of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU) and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7%) and the pill (28.0%) being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood) and having children over 14 (35.35% more likelihood). With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to use family planning methods (36.68%, 38.59% and 70

Epidemiological and financial indicators of hypertension in older adults in Mexico: challenges for health planning and management in Latin America.

Science.gov (United States)

Arredondo, Armando; Duarte, Maria Beatriz; Cuadra, Silvia Magali

2017-04-01

This study estimated the epidemiological and financial indicators of hypertension in order to identify challenges in strategic planning and management for health systems in Latin America. This is a longitudinal study with a population base of 187 326 reported cases of older adults with hypertension, diagnosed at public health institutions in Mexico. The cost-evaluation method that was used was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2015-2017, time series analyses and probabilistic models were constructed according to the Box-Jenkins technique. Regarding epidemiological changes for 2015 versus 2017, an increase of 8-12% is expected (p financial requirements. The total amount estimated for hypertension in 2015 (in US dollars) was $1 575 671 330. It included $747 527 259 as direct costs and $829 144 071 as indirect costs. If the risk factors and the different healthcare services for older adults remain as they are currently, the financial consequences of epidemiological changes in older adults will have a major impact on the users' pockets, following in order of importance, on social security providers and on public assistance providers. The challenges and implications of our findings in the context of universal coverage reforms in Latin America reinforce the urgent need to develop more and better strategic planning for the prevention of chronic diseases. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

La asistencia europea a colombia: ¿una contribución virtual a un plan virtual de paz?.

Directory of Open Access Journals (Sweden)

Joaquín Roy.

2001-01-01

Full Text Available This article presents a detailed analysis of current European assistance to Colombia, indicating the differences between European and American perceptions of the causes of the problems that plague the country as reflected in their respective views of Plan Colombia. The European perspective ¡s illustrated by presenting the critical positions taken by various entities regarding Plan Colombia's excessive military focus, including the European Commission, the European Parliament, Spain and other European states. The author examines the contrasting view that stresses a broader range of needs and problems in Colombia to which the European Union's aid should respond, the difficulties met in this approach, and the philosophic basis of the European contribution to Colombia.

Why victimology should stay positive: The ongoing need for positive victimology

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Ronel Natti

2015-01-01

Full Text Available This paper presents the need for positive victimology and its unique contribution to victimology. Victimology presented a shift in attention and awareness in practice, research and theory, by focusing on victims of crime and of abuse of power, and on victims’ rights and victims’ services. Positive victimology indicates a more specified shift in attention and awareness, within the larger shift of victimology. This shift stands in line with positive psychology, positive criminology and the idea of victims’ victimology. It denotes an approach to provide the following, as much as possible: 1. A wide range of social responses to the victims and their victimization that victims can experience as positive, 2. Positive outcomes of healing and recovery for victims, and 3. Positive integration of victims. Within each of those, positive victimology suggests a pragmatic coordinated system that ranges from definitions of negative poles to those of positive ones. When moving towards the positive pole at any given coordinate, a sense of justice is an important factor that might reduce the impact of the harm. Support is also a crucial factor and at the very positive pole, stands human, inter-personal love.

PSSD - Planning System for Sustainable Development

DEFF Research Database (Denmark)

PSSD - Planning System for Sustainable Development - is a part of the Baltic Sea Region's INTERREG II C program. The current report describes some theories, methods and tools developed under the PSSD project. First, the theoretical foundation of the project is described. Secondly, the role...... of indicators in sustainable development is discussed and a Web-based indicator generator is described. Thirdly, we describe a number of methods and tools, which support planning for sustainable development. Finally, some technical interface tools - especially a Web-based interface to the methods and tools...

Regulatory supervision of safety indicators; experience with radiation safety indicators in Dukovany nuclear power plant performance

International Nuclear Information System (INIS)

Urbancik, L.; Kulich, V.

2004-01-01

The State Office for Nuclear Safety uses three sets of indicators describing the following aspects of a favourable nuclear power plant operation: smooth operation in normal circumstances, low risk to the population, and operation with a positive safety attitude. These are three safety-related areas for assessment. Each area has its own set of indicators. Overall operational safety performance indicators were identified for each attribute. From this point, a level of strategic indicators was developed, and finally, a set of specific indicators was set up. While neither the overall indicators nor the strategic indicators are directly measurable, the specific indicators are directly measurable and are targeted during inspection. (author)

St. Lawrence action plan meter

Energy Technology Data Exchange (ETDEWEB)

NONE

1992-12-31

The purpose of this bulletin is to report on the progress achieved under the St. Lawrence Action Plan. Under each of the Action Plan`s five objectives, it outlines environmental management indicators which identify actions taken and shows the results. This report presents the data collected in late August 1992 on the activities carried out by all partners of both governments involved in SLAP. The objectives examined in the bulletin are: to reduce by 90% the liquid toxic waste discharged by the 50 plants targeted for priority action; to prepare remediation plans for contaminated federal sites and restore wetlands; to conserve 5000 additional hectares of habitat and create a marine park; to develop and implement recovery plans for mammals, fish, birds, amphibians, reptiles, and plants; and to determine the state of the St. Lawrence River.

SU-E-T-337: Treatment Planning Study of Craniospinal Irradiation with Spot Scanning Proton Therapy

International Nuclear Information System (INIS)

Tasson, A; Beltran, C; Laack, N; Childs, S; Tryggestad, E; Whitaker, T

2014-01-01

Purpose: To develop a treatment planning technique that achieves optimal robustness against systematic position and range uncertainties, and interfield position errors for craniospinal irradiation (CSI) using spot scanning proton radiotherapy. Methods: Eighteen CSI patients who had previously been treated using photon radiation were used for this study. Eight patients were less than 10 years old. The prescription dose was 23.4Gy in 1.8Gy fractions. Two different field arrangement types were investigated: 1 posterior field per isocenter and 2 posterior oblique fields per isocenter. For each field type, two delivery configurations were used: 5cm bolus attached to the treatment table and a 4.5cm range shifter located inside the nozzle. The target for each plan was the whole brain and thecal sac. For children under the age of 10, all plan types were repeated with an additional dose of 21Gy prescribed to the vertebral bodies. Treatment fields were matched by stepping down the dose in 10% increments over 9cm. Robustness against 3% and 3mm uncertainties, as well as a 3mm inter-field error was analyzed. Dose coverage of the target and critical structure sparing for each plan type will be considered. Ease of planning and treatment delivery was also considered for each plan type. Results: The mean dose volume histograms show that the bolus plan with posterior beams gave the best overall plan, and all proton plans were comparable to or better than the photon plans. The plan type that was the most robust against the imposed uncertainties was also the bolus plan with posterior beams. This is also the plan configuration that is the easiest to deliver and plan. Conclusion: The bolus plan with posterior beams achieved optimal robustness against systematic position and range uncertainties, as well as inter-field position errors

Planning a Stigmatized Nonvisible Illness Disclosure: Applying the Disclosure Decision-Making Model

Science.gov (United States)

Choi, Soe Yoon; Venetis, Maria K.; Greene, Kathryn; Magsamen-Conrad, Kate; Checton, Maria G.; Banerjee, Smita C.

2016-01-01

This study applied the disclosure decision-making model (DD-MM) to explore how individuals plan to disclose nonvisible illness (Study 1), compared to planning to disclose personal information (Study 2). Study 1 showed that perceived stigma from the illness negatively predicted disclosure efficacy; closeness predicted anticipated response (i.e., provision of support) although it did not influence disclosure efficacy; disclosure efficacy led to reduced planning, with planning leading to scheduling. Study 2 demonstrated that when information was considered to be intimate, it negatively influenced disclosure efficacy. Unlike the model with stigma (Study 1), closeness positively predicted both anticipated response and disclosure efficacy. The rest of the hypothesized relationships showed a similar pattern to Study 1: disclosure efficacy reduced planning, which then positively influenced scheduling. Implications of understanding stages of planning for stigmatized information are discussed. PMID:27662447

SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

Energy Technology Data Exchange (ETDEWEB)

Kumar, Syam [Malabar Cancer Centre, Kannur, Kerala (India); Sitha [University of Calicut, Calicut, Kerala (India)

2015-06-15

Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on the 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly.

SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

International Nuclear Information System (INIS)

Kumar, Syam; Sitha

2015-01-01

Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on the 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly

Socioeconomic position and the risk of spontaneous abortion

DEFF Research Database (Denmark)

Norsker, Filippa Nyboe; Espenhain, Laura; rogvi, Sofie

2012-01-01

To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion.......To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion....

Endocrine Society of Australia position statement on male hypogonadism (part 1): assessment and indications for testosterone therapy.

Science.gov (United States)

Yeap, Bu B; Grossmann, Mathis; McLachlan, Robert I; Handelsman, David J; Wittert, Gary A; Conway, Ann J; Stuckey, Bronwyn Ga; Lording, Douglas W; Allan, Carolyn A; Zajac, Jeffrey D; Burger, Henry G

2016-08-15

This article, Part 1 of the Endocrine Society of Australia's position statement on male hypogonadism, focuses on assessment of male hypogonadism, including the indications for testosterone therapy. (Part 2 will deal with treatment and therapeutic considerations.) Key points and recommendations are:Pathological hypogonadism arises due to diseases of the hypothalamus or pituitary gland (hypogonadotropic hypogonadism) or testes (hypergonadotropic hypogonadism). It is a clinical diagnosis with a pathological basis, confirmed by hormone assays.Hormonal assessment is based on measurement of circulating testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) concentrations. Measurement of sex hormone-binding globulin levels can be informative, but use of calculated free testosterone is not recommended for clinical decision making.Testosterone replacement therapy is warranted in men with pathological hypogonadism, regardless of age.Currently, there are limited data from high-quality randomised controlled trials with clinically meaningful outcomes to justify testosterone treatment in older men, usually with chronic disease, who have low circulating testosterone levels but without hypothalamic, pituitary or testicular disease.Obesity, metabolic syndrome and type 2 diabetes are associated with lowering of circulating testosterone level, but without elevation of LH and FSH levels. Whether these are non-specific consequences of non-reproductive disorders or a correctable deficiency state is unknown, but clear evidence for efficacy and safety of testosterone therapy in this setting is lacking.Glucocorticoid and opioid use is associated with possibly reversible reductions in circulating testosterone level, without elevation of LH and FSH levels. Where continuation of glucocorticoid or opioid therapy is necessary, review by an endocrinologist may be warranted.Changes in management as result of the position statement: Men with pathological hypogonadism should

Consumer Intention toward Bringing Your Own Shopping Bags in Taiwan: An Application of Ethics Perspective and Theory of Planned Behavior