Knowledge of family planning methods in Bangladesh, 1969-1979: trends and implications.

PubMed

Amin, R; Mariam, A G

1986-12-01

The changes in levels of knowledge about different contraceptive methods in Bangladesh between 1969-79 were assessed. 2 surveys provided the data: the 1969 National Impact Survey (NIS) of family planning and the 1979 Contraceptive Prevalence Survey (CPS) from Bangladesh. Both surveys were nationally representative and retrospective, containing detailed questions of pregnancy histories, socioeconomic background, family planning knowledge and attitude, and contraceptive practices. The sampling frames for both surveys consisted of all households in Bangladesh from which national probability samples of married women between the ages of 10-50 were selected and stratified by urban-rural residence. Unprompted data were analyzed. Apparently, the National Family Planning Program (NFPP) was successful in communicating general knowledge of family planning among the masses in Bangladesh. In terms of absolute level, the increase in general knowledge of family planning was from 46.3% in 1969 to 82.8% in 1979. With the exception of the oral contraceptive (OC), absolute increase in knowledge of specific family planning methods or a variety of methods was far less than that of general knowledge of family planning. Knowledge of condoms, female sterilization, and male sterilization increased between 1969-79, yet in terms of absolute levels these increases were far less than those of either general knowledge of family planning or knowledge of OCs. The percentages of couples reporting knowledge of the IUD, vaginal methods, rhythm, injection, or induced abortion either decreased or slightly increased between 1969-79. Nearly 40% of couples had knowledge of only 1 method; fewer couples knew of 2 or more methods. There were relative increases in the knowledge of OCs and female sterilization, an 8-fold increase in knowledge of the OC and a 6-fold increase in knowledge of female sterilization between 1969-79. Respondents from the urban areas or those who attended schools were more likely to know about different contraceptive methods. Despite government orders stipulating that each household be visited every month by a family planning worker, face-to-face contact with family planning extension workers continued to be very low. In view of poor field worker performance, the government has made various modifications in the NFPP operation aimed at strengthening information and service delivery programs, yet recent evidence shows their continuing ineffectiveness. The low levels of knowledge about different family planning methods and low level of contact between family planning workers and family planning target couples show that the NFPP, by failing to inform married couples of wider choice of methods, missed many potential new acceptors of family planning methods.

Integrated technique of planning the capital repair of residential buildings and objects of transport infrastructure

NASA Astrophysics Data System (ADS)

Dement'eva, Marina

2017-10-01

The paper presents the results of a comparative analysis of two fundamentally different methods for planning capital repairs of objects of transport infrastructure and residential development. The first method was based on perspective long-term plans. Normative service life were the basis for planning the periodicity of repairs. The second method was based on the performance of repairs in fact of the onset of the malfunction. Problems of financing repair work, of the uneven aging of constructs and engineering systems, different wear mechanism in different conditions of exploitation, absence of methods of planning repairs of administrative and production buildings (depots, stations, etc.) justify the need to optimize methods of planning the repair and the relevance of this paper. The aim of the study was to develop the main provisions of an integrated technique for planning the capital repair of buildings of any functional purpose, which combines the advantages of each of the discussed planning methods. For this purpose, the consequences of technical and economic risk were analyzed of the buildings, including stations, depots, transport transfer hubs, administrative buildings, etc when choosing different planning methods. One of the significant results of the study is the possibility of justifying the optimal period of capital repairs on the basis of the proposed technical and economic criteria. The adjustment of the planned repair schedule is carried out taking into account the reliability and cost-effectiveness of the exploitation process.

A procedural method for express bus-fringe parking transit planning.

DOT National Transportation Integrated Search

1976-01-01

The report illustrates a procedural method for planning express bus-fringe parking transit services - a method built upon the findings from previous research, including disaggregate travel choice models and planning guidelines. The methodology addres...

Plan averaging for multicriteria navigation of sliding window IMRT and VMAT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Craft, David, E-mail: dcraft@partners.org; Papp, Dávid; Unkelbach, Jan

2014-02-15

Purpose: To describe a method for combining sliding window plans [intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT)] for use in treatment plan averaging, which is needed for Pareto surface navigation based multicriteria treatment planning. Methods: The authors show that by taking an appropriately defined average of leaf trajectories of sliding window plans, the authors obtain a sliding window plan whose fluence map is the exact average of the fluence maps corresponding to the initial plans. In the case of static-beam IMRT, this also implies that the dose distribution of the averaged plan is the exact dosimetricmore » average of the initial plans. In VMAT delivery, the dose distribution of the averaged plan is a close approximation of the dosimetric average of the initial plans. Results: The authors demonstrate the method on three Pareto optimal VMAT plans created for a demanding paraspinal case, where the tumor surrounds the spinal cord. The results show that the leaf averaged plans yield dose distributions that approximate the dosimetric averages of the precomputed Pareto optimal plans well. Conclusions: The proposed method enables the navigation of deliverable Pareto optimal plans directly, i.e., interactive multicriteria exploration of deliverable sliding window IMRT and VMAT plans, eliminating the need for a sequencing step after navigation and hence the dose degradation that is caused by such a sequencing step.« less

30 CFR 250.1503 - What are my general responsibilities for training?

Code of Federal Regulations, 2010 CFR

2010-07-01

... plan that specifies the type, method(s), length, frequency, and content of the training for your employees. Your training plan must specify the method(s) of verifying employee understanding and performance. This plan must include at least the following information: (1) Procedures for training employees in...

26 CFR 1.401(a)(4)-0 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Composition-of-work-force method. (3) Minimum-benefit method. (4) Grandfather rules for plans in existence on... allocation rates. (3) Safe harbor testing method for cash balance plans. (d) Safe-harbor testing method for...-crediting period. (e) Family aggregation rules. [Reserved] (f) Governmental plans. [Reserved] (g) Corrective...

SU-E-T-213: Comparison of Treatment Efficiency of Gamma Knife SRS Plans for Brain Metastases with Different Planning Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feng, Y; Huang, Z; Lo, S

2015-06-15

Purpose: To improve Gamma Knife SRS treatment efficiency for brain metastases and compare the differences of treatment time and radiobiological effects between two different planning methods of automatic filling and manual placement of shots with inverse planning. Methods: T1-weighted MRI images with gadolinium contrast from five patients with a single brain metastatic-lesion were used in this retrospective study. Among them, two were from primary breast cancer, two from primary melanoma cancer and one from primary prostate cancer. For each patient, two plans were generated in Leksell GammaPlan10.1.1 for radiosurgical treatment with a Leksell GammaKnife Perfexion machine: one with automatic filling,more » automatic sector configuration and inverse optimization (Method1); and the other with manual placement of shots, manual setup of collimator sizes, manual setup of sector blocking and inverse optimization (Method2). Dosimetric quality of the plans was evaluated with parameters of Coverage, Selectivity, Gradient-Index and DVH. Beam-on Time, Number-of-Shots and Tumor Control Probability(TCP) were compared for the two plans while keeping their dosimetric quality very similar. Relative reduction of Beam-on Time and Number-of-Shots were calculated as the ratios among the two plans and used for quantitative analysis. Results: With very similar dosimetric and radiobiological plan quality, plans created with Method 2 had significantly reduced treatment time. Relative reduction of Beam-on Time ranged from 20% to 51 % (median:29%,p=0.001), and reduction of Number-of-Shots ranged from 5% to 67% (median:40%,p=0.0002), respectively. Time of plan creation for Method1 and Method2 was similar, approximately 20 minutes, excluding the time for tumor delineation. TCP calculated for the tumors from differential DVHs did not show significant difference between the two plans (p=0.35). Conclusion: The method of manual setup combined with inverse optimization in LGP for treatment of brain metastatic lesions with the Perfexion can achieve significantly higher time efficiency without degrading treatment quality.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

MacFarlane, Michael; Battista, Jerry; Chen, Jeff

Purpose: To develop a radiotherapy dose tracking and plan evaluation technique using cone-beam computed tomography (CBCT) images. Methods: We developed a patient-specific method of calibrating CBCT image sets for dose calculation. The planning CT was first registered with the CBCT using deformable image registration (DIR). A scatter plot was generated between the CT numbers of the planning CT and CBCT for each slice. The CBCT calibration curve was obtained by least-square fitting of the data, and applied to each CBCT slice. The calibrated CBCT was then merged with original planning CT to extend the small field of view of CBCT.more » Finally, the treatment plan was copied to the merged CT for dose tracking and plan evaluation. The proposed patient-specific calibration method was also compared to two methods proposed in literature. To evaluate the accuracy of each technique, 15 head-and-neck patients requiring plan adaptation were arbitrarily selected from our institution. The original plan was calculated on each method’s data set, including a second planning CT acquired within 48 hours of the CBCT (serving as gold standard). Clinically relevant dose metrics and 3D gamma analysis of dose distributions were compared between the different techniques. Results: Compared to the gold standard of using planning CTs, the patient-specific CBCT calibration method was shown to provide promising results with gamma pass rates above 95% and average dose metric agreement within 2.5%. Conclusions: The patient-specific CBCT calibration method could potentially be used for on-line dose tracking and plan evaluation, without requiring a re-planning CT session.« less

29 CFR 4206.7 - Amount of credit in plans using the direct attribution method.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TO A PARTIAL WITHDRAWAL § 4206.7 Amount of credit in plans using the direct attribution method. In a plan that uses the direct attribution allocation method described in section 4211(c)(4) of ERISA, the... 29 Labor 9 2010-07-01 2010-07-01 false Amount of credit in plans using the direct attribution...

A human-machine cooperation route planning method based on improved A* algorithm

NASA Astrophysics Data System (ADS)

Zhang, Zhengsheng; Cai, Chao

2011-12-01

To avoid the limitation of common route planning method to blindly pursue higher Machine Intelligence and autoimmunization, this paper presents a human-machine cooperation route planning method. The proposed method includes a new A* path searing strategy based on dynamic heuristic searching and a human cooperated decision strategy to prune searching area. It can overcome the shortage of A* algorithm to fall into a local long term searching. Experiments showed that this method can quickly plan a feasible route to meet the macro-policy thinking.

Reasons for using traditional methods and role of nurses in family planning.

PubMed

Yurdakul, Mine; Vural, Gülsen

2002-05-01

The withdrawal method and other traditional methods of contraception are still used in Turkey. Ninety-eight percent of women in Turkey know about modern family planning methods and where to find contraceptives. In fact, only one in every three women uses an effective method. The aim of this descriptive and experimental study was to investigate reasons for using traditional methods and the role of nurses in family planning. The women included in the sample were visited in their homes by nurses and educated for family planning in four sessions. Overall, 53.3% of women were using an effective method. However, 54.3% of women living in the Sirintepe district and 41.6% of women living in the Yenikent district were still using the traditional methods they used before. After the education sessions, the most widely used method was found to be intrauterine device (22.8%) in Sirintepe and condom (25%) in Yenikent. There was a significant difference in family planning methods between these two districts (p < 0.001).

Systematizing the production of environmental plans: an Australian example

NASA Astrophysics Data System (ADS)

Davis, J. Richard

1985-09-01

Environmental planning legislation in New South Wales now requires local government authorities to draw up statutory plans that take into account, among other concerns, both the biophysical and the social environmental issues within their jurisdictions. The SIRO-PLAN method of plan production provides a systematic mechanism for fulfilling this requirement. This article describes the application of the method by planning researchers over 18 months to the production of a Local Environmental Plan for a rural local government in New South Wales. The policy formulation, the purposive data collection, and the deliberate adjustment of plans in order to recognize interest group requirements were all found to be valuable features of the method, while the translation of the ultimately chosen land-use plan into the explicit regulatory controls available to the local government authority was found to require further refinement. The capacity of SIRO-PLAN to quantify the resolution of competing environmental concerns in the final plan, although of value to planning researchers, proved too arcane for traditionally trained planners.

TRANSMISSION NETWORK PLANNING METHOD FOR COMPARATIVE STUDIES (JOURNAL VERSION)

EPA Science Inventory

An automated transmission network planning method for comparative studies is presented. This method employs logical steps that may closely parallel those taken in practice by the planning engineers. Use is made of a sensitivity matrix to simulate the engineers' experience in sele...

Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

PubMed Central

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

2013-01-01

Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

An Exploration of Strategic Planning Perspectives and Processes within Community Colleges Identified as Being Distinctive in Their Strategic Planning Practices

ERIC Educational Resources Information Center

Augustyniak, Lisa J.

2015-01-01

Community college leaders face unprecedented change, and some have begun reexamining their institutional strategic planning processes. Yet, studies in higher education strategic planning spend little time examining how community colleges formulate their strategic plans. This mixed-method qualitative study used an expert sampling method to identify…

29 CFR 4211.31 - Allocation of unfunded vested benefits following the merger of plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) through (d) of this section, when two or more multiemployer plans merge, the merged plan shall adopt one... allocation methods prescribed in §§ 4211.32 through 4211.35, and the method adopted shall apply to all employer withdrawals occurring after the initial plan year. Alternatively, a merged plan may adopt its own...

The scenario-based generalization of radiation therapy margins.

PubMed

Fredriksson, Albin; Bokrantz, Rasmus

2016-03-07

We give a scenario-based treatment plan optimization formulation that is equivalent to planning with geometric margins if the scenario doses are calculated using the static dose cloud approximation. If the scenario doses are instead calculated more accurately, then our formulation provides a novel robust planning method that overcomes many of the difficulties associated with previous scenario-based robust planning methods. In particular, our method protects only against uncertainties that can occur in practice, it gives a sharp dose fall-off outside high dose regions, and it avoids underdosage of the target in 'easy' scenarios. The method shares the benefits of the previous scenario-based robust planning methods over geometric margins for applications where the static dose cloud approximation is inaccurate, such as irradiation with few fields and irradiation with ion beams. These properties are demonstrated on a suite of phantom cases planned for treatment with scanned proton beams subject to systematic setup uncertainty.

Women's attitudes towards mechanisms of action of family planning methods: survey in primary health centres in Pamplona, Spain.

PubMed

de Irala, Jokin; Lopez del Burgo, Cristina; Lopez de Fez, Carmen M; Arredondo, Jorge; Mikolajczyk, Rafael T; Stanford, Joseph B

2007-06-27

Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.

Model Checking Artificial Intelligence Based Planners: Even the Best Laid Plans Must Be Verified

NASA Technical Reports Server (NTRS)

Smith, Margaret H.; Holzmann, Gerard J.; Cucullu, Gordon C., III; Smith, Benjamin D.

2005-01-01

Automated planning systems (APS) are gaining acceptance for use on NASA missions as evidenced by APS flown On missions such as Orbiter and Deep Space 1 both of which were commanded by onboard planning systems. The planning system takes high level goals and expands them onboard into a detailed of action fiat the spacecraft executes. The system must be verified to ensure that the automatically generated plans achieve the goals as expected and do not generate actions that would harm the spacecraft or mission. These systems are typically tested using empirical methods. Formal methods, such as model checking, offer exhaustive or measurable test coverage which leads to much greater confidence in correctness. This paper describes a formal method based on the SPIN model checker. This method guarantees that possible plans meet certain desirable properties. We express the input model in Promela, the language of SPIN and express the properties of desirable plans formally.

Path Planning for Robot based on Chaotic Artificial Potential Field Method

NASA Astrophysics Data System (ADS)

Zhang, Cheng

2018-03-01

Robot path planning in unknown environments is one of the hot research topics in the field of robot control. Aiming at the shortcomings of traditional artificial potential field methods, we propose a new path planning for Robot based on chaotic artificial potential field method. The path planning adopts the potential function as the objective function and introduces the robot direction of movement as the control variables, which combines the improved artificial potential field method with chaotic optimization algorithm. Simulations have been carried out and the results demonstrate that the superior practicality and high efficiency of the proposed method.

Use of family planning methods in Kassala, Eastern Sudan

PubMed Central

2011-01-01

Background Investigating use and determinants of family planning methods may be instructive in the design of interventions to improve reproductive health services. Findings Across sectional community-based study was conducted during the period February-April 2010 to investigate the use of family planning in Kassala, eastern Sudan. Structured questionnaires were used to gather socio-demographic data and use of family planning. The mean ± SD of the age and parity of 613 enrolled women was 31.1 ± 7 years and 3.4 ± 1.9, respectively. Only 44.0% of these women had previously or currently used one or more of the family planning methods. Combined pills (46.7%) and progesterone injection (17.8%) were the predominant method used by the investigated women. While age, residence were not associated with the use of family planning, parity (> five), couple education (≥ secondary level) were significantly associated with the use of family planning. Husband objection and religious beliefs were the main reasons of non-use of family planning. Conclusion Education, encouragement of health education programs and involvement of the religious persons might promote family planning in eastern Sudan. PMID:21356106

TH-CD-209-01: A Greedy Reassignment Algorithm for the PBS Minimum Monitor Unit Constraint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, Y; Kooy, H; Craft, D

2016-06-15

Purpose: To investigate a Greedy Reassignment algorithm in order to mitigate the effects of low weight spots in proton pencil beam scanning (PBS) treatment plans. Methods: To convert a plan from the treatment planning system’s (TPS) to a deliverable plan, post processing methods can be used to adjust the spot maps to meets the minimum MU constraint. Existing methods include: deleting low weight spots (Cut method), or rounding spots with weight above/below half the limit up/down to the limit/zero (Round method). An alternative method called Greedy Reassignment was developed in this work in which the lowest weight spot in themore » field was removed and its weight reassigned equally among its nearest neighbors. The process was repeated with the next lowest weight spot until all spots in the field were above the MU constraint. The algorithm performance was evaluated using plans collected from 190 patients (496 fields) treated at our facility. The evaluation criteria were the γ-index pass rate comparing the pre-processed and post-processed dose distributions. A planning metric was further developed to predict the impact of post-processing on treatment plans for various treatment planning, machine, and dose tolerance parameters. Results: For fields with a gamma pass rate of 90±1%, the metric has a standard deviation equal to 18% of the centroid value. This showed that the metric and γ-index pass rate are correlated for the Greedy Reassignment algorithm. Using a 3rd order polynomial fit to the data, the Greedy Reassignment method had 1.8 times better metric at 90% pass rate compared to other post-processing methods. Conclusion: We showed that the Greedy Reassignment method yields deliverable plans that are closest to the optimized-without-MU-constraint plan from the TPS. The metric developed in this work could help design the minimum MU threshold with the goal of keeping the γ-index pass rate above an acceptable value.« less

Accessibility of long-term family planning methods: a comparison study between Output Based Approach (OBA) clients verses non-OBA clients in the voucher supported facilities in Kenya.

PubMed

Oyugi, Boniface; Kioko, Urbanus; Kaboro, Stephen Mbugua; Gikonyo, Shadrack; Okumu, Clarice; Ogola-Munene, Sarah; Kalsi, Shaminder; Thiani, Simon; Korir, Julius; Odundo, Paul; Baltazaar, Billy; Ranji, Moses; Muraguri, Nicholas; Nzioka, Charles

2017-03-27

The study seeks to evaluate the difference in access of long-term family planning (LTFP) methods among the output based approach (OBA) and non-OBA clients within the OBA facility. The study utilises a quasi experimental design. A two tailed unpaired t-test with unequal variance is used to test for the significance variation in the mean access. The difference in difference (DiD) estimates of program effect on long term family planning methods is done to estimate the causal effect by exploiting the group level difference on two or more dimensions. The study also uses a linear regression model to evaluate the predictors of choice of long-term family planning methods. Data was analysed using SPSS version 17. All the methods (Bilateral tubal ligation-BTL, Vasectomy, intrauterine contraceptive device -IUCD, Implants, and Total or combined long-term family planning methods -LTFP) showed a statistical significant difference in the mean utilization between OBA versus non-OBA clients. The difference in difference estimates reveal that the difference in access between OBA and non OBA clients can significantly be attributed to the implementation of the OBA program for intrauterine contraceptive device (p = 0.002), Implants (p = 0.004), and total or combined long-term family planning methods (p = 0.001). The county of residence is a significant determinant of access to all long-term family planning methods except vasectomy and the year of registration is a significant determinant of access especially for implants and total or combined long-term family planning methods. The management level and facility type does not play a role in determining the type of long-term family planning method preferred; however, non-governmental organisations (NGOs) as management level influences the choice of all methods (Bilateral tubal ligation, intrauterine contraceptive device, Implants, and combined methods) except vasectomy. The adjusted R 2 value, representing the percentage of the variance explained by various models, is larger than 18% for implants and total or combined long-term family planning. The study showed that the voucher services in Kenya has been effective in providing long-term family planning services and improving access of care provided to women of reproductive age. Therefore, voucher scheme can be used as a tool for bridging the gap of unmet needs of family planning in Kenya and could potentially be more effective if rolled out to other counties.

Guidelines for Analysis of Socio-Cultural Factors in Health. Volume 4: Socio-Cultural Factors in Health Planning. International Health Planning Methods Series.

ERIC Educational Resources Information Center

Fraser, Renee White

Intended to assist Agency for International Development (AID) officers, advisors, and health officials in incorporating health planning into national plans for economic development, this fourth of ten manuals in the International Health Planning Methods Series deals with sociocultural, psychological, and behavioral factors that affect the planning…

Contemporary computerized methods for logging planning

Treesearch

Chris B. LeDoux

1988-01-01

Contemporary harvest planning graphic software is highlighted with practical applications. Planning results from a production study of the Clearwater Cable Yarder are summarized. Application of the planning methods to evaluation of proposed silvicultural treatments is included. Results show that 3-dimensional graphic analysis of proposed harvesting or silvicultural...

Automated replication of cone beam CT-guided treatments in the Pinnacle(3) treatment planning system for adaptive radiotherapy.

PubMed

Hargrave, Catriona; Mason, Nicole; Guidi, Robyn; Miller, Julie-Anne; Becker, Jillian; Moores, Matthew; Mengersen, Kerrie; Poulsen, Michael; Harden, Fiona

2016-03-01

Time-consuming manual methods have been required to register cone-beam computed tomography (CBCT) images with plans in the Pinnacle(3) treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker (FM) placement during CBCT acquisition or the image mid-point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT-plan registration method utilising the Digital Imaging and Communications in Medicine (DICOM) Structure Set (RS) and Spatial Registration (RE) files created during online image-guided radiotherapy (IGRT). CBCTs of a phantom were acquired with FMs and predetermined setup errors using various online IGRT workflows. The CBCTs, DICOM RS and RE files were imported into Pinnacle(3) plans of the phantom and the resulting automated CBCT-plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCTs and plans for six bladder patients. The automated CBCT-plan registration method was successfully applied to thirty-four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCTs acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty-eight patient CBCTs. The automated CBCT-plan registrations were instantaneous, replicating delivered treatments in Pinnacle(3) with errors of ±0.5 mm. These errors were comparable to mid-point-dependant manual registrations but superior to FM-dependant manual registrations. The automated CBCT-plan registration method quickly and reliably replicates delivered treatments in Pinnacle(3) for adaptive radiotherapy.

Determinants of contraceptives use amongst youth: an exploratory study with family planning service providers in Karachi Pakistan.

PubMed

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul

2013-01-05

In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

Comparison of treatment plans: a retrospective study by the method of radiobiological evaluation

NASA Astrophysics Data System (ADS)

Puzhakkal, Niyas; Kallikuzhiyil Kochunny, Abdullah; Manthala Padannayil, Noufal; Singh, Navin; Elavan Chalil, Jumanath; Kulangarakath Umer, Jamshad

2016-09-01

There are many situations in radiotherapy where multiple treatment plans need to be compared for selection of an optimal plan. In this study we performed the radiobiological method of plan evaluation to verify the treatment plan comparison procedure of our clinical practice. We estimated and correlated various radiobiological dose indices with physical dose metrics for a total of 30 patients representing typical cases of head and neck, prostate and brain tumors. Three sets of plans along with a clinically approved plan (final plan) treated by either Intensity Modulated Radiation Therapy (IMRT) or Rapid Arc (RA) techniques were considered. The study yielded improved target coverage for final plans, however, no appreciable differences in doses and the complication probabilities of organs at risk were noticed. Even though all four plans showed adequate dose distributions, from dosimetric point of view, the final plan had more acceptable dose distribution. The estimated biological outcome and dose volume histogram data showed least differences between plans for IMRT when compared to RA. Our retrospective study based on 120 plans, validated the radiobiological method of plan evaluation. The tumor cure or normal tissue complication probabilities were found to be correlated with the corresponding physical dose indices.

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study

PubMed Central

2014-01-01

Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887

Onboard autonomous mission re-planning for multi-satellite system

NASA Astrophysics Data System (ADS)

Zheng, Zixuan; Guo, Jian; Gill, Eberhard

2018-04-01

This paper presents an onboard autonomous mission re-planning system for Multi-Satellites System (MSS) to perform onboard re-planing in disruptive situations. The proposed re-planning system can deal with different potential emergency situations. This paper uses Multi-Objective Hybrid Dynamic Mutation Genetic Algorithm (MO-HDM GA) combined with re-planning techniques as the core algorithm. The Cyclically Re-planning Method (CRM) and the Near Real-time Re-planning Method (NRRM) are developed to meet different mission requirements. Simulations results show that both methods can provide feasible re-planning sequences under unforeseen situations. The comparisons illustrate that using the CRM is average 20% faster than the NRRM on computation time. However, by using the NRRM more raw data can be observed and transmitted than using the CRM within the same period. The usability of this onboard re-planning system is not limited to multi-satellite system. Other mission planning and re-planning problems related to autonomous multiple vehicles with similar demands are also applicable.

Production Planning and Simulation for Reverse Supply Chain

NASA Astrophysics Data System (ADS)

Murayama, Takeshi; Yoda, Mitsunobu; Eguchi, Toru; Oba, Fuminori

This paper describes a production planning method for a reverse supply chain, in which a disassembly company takes reusable components from returned used products and supplies the reusable components for a product manufacturer. This method addresses the issue that the timings and quantities of returned products and reusable components obtained from them are unknown. This method first predicts the quantities of returned products and reusable components at each time period by using reliability models. Using the prediction result, the method performs production planning based on Material Requirements Planning (MRP). This method enables us to plan at each time period: the quantity of the products to be disassembled; the quantity of the reusable components to be used; and the quantity of the new components to be produced. The flow of the components and products through a forward and reverse supply chain is simulated to show the effectiveness of the method.

Association between women's autonomy and family planning outcome in couples residing in Isfahan

PubMed Central

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-01-01

Background: One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. Materials and Methods: This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. Results: The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Conclusions: Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples’ family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration. PMID:25400671

Methods and apparatus for integrating, organizing, and accessing flight planning and other data on multifunction cockpit displays

NASA Technical Reports Server (NTRS)

Gibbs, Michael J. (Inventor); Adams, Michael B. (Inventor); Chase, Karl L. (Inventor); Van Omen, Debi (Inventor); Lewis, Daniel E. (Inventor); McCrobie, Daniel E. (Inventor)

2003-01-01

A method and system for displaying a flight plan such that an entire flight plan is viewable through the use of scrolling devices is disclosed. The flight plan display may also include a method and system for collapsing and expanding a flight plan display, have provisions for the conspicuous marking of changes to a flight plan, the use of tabs to switch between various displays of data, and access to a navigation database that allows a user to view information about various navigational aids. The database may also the access to the information about the navigational aids to be prioritized based on proximity to the current position of the aircraft.

Simultaneous integrated vs. sequential boost in VMAT radiotherapy of high-grade gliomas.

PubMed

Farzin, Mostafa; Molls, Michael; Astner, Sabrina; Rondak, Ina-Christine; Oechsner, Markus

2015-12-01

In 20 patients with high-grade gliomas, we compared two methods of planning for volumetric-modulated arc therapy (VMAT): simultaneous integrated boost (SIB) vs. sequential boost (SEB). The investigation focused on the analysis of dose distributions in the target volumes and the organs at risk (OARs). After contouring the target volumes [planning target volumes (PTVs) and boost volumes (BVs)] and OARs, SIB planning and SEB planning were performed. The SEB method consisted of two plans: in the first plan the PTV received 50 Gy in 25 fractions with a 2-Gy dose per fraction. In the second plan the BV received 10 Gy in 5 fractions with a dose per fraction of 2 Gy. The doses of both plans were summed up to show the total doses delivered. In the SIB method the PTV received 54 Gy in 30 fractions with a dose per fraction of 1.8 Gy, while the BV received 60 Gy in the same fraction number but with a dose per fraction of 2 Gy. All of the OARs showed higher doses (Dmax and Dmean) in the SEB method when compared with the SIB technique. The differences between the two methods were statistically significant in almost all of the OARs. Analysing the total doses of the target volumes we found dose distributions with similar homogeneities and comparable total doses. Our analysis shows that the SIB method offers advantages over the SEB method in terms of sparing OARs.

Long-acting family planning method switching among revisit clients of public health facilities in Dire Dawa, Ethiopia.

PubMed

Atnafe, Meselu; Assefa, Nega; Alemayehu, Tadesse

2016-01-01

"Contraceptive switching" from one method to another is a common phenomenon. Switching from a more effective long-acting method to a less effective method exposes women for unplanned pregnancy. The aim of this study was to assess the level and factors associated with long-acting family planning method switching to other methods. A facility-based cross-sectional study was conducted from January to March 2013 on 634 women attending public health facilities in Dire Dawa City Administration, Ethiopia. Participants of the study were revisit clients of family planning service and were interviewed as they appear in the clinics. Data were analyzed using crude and adjusted logistic regression, and results were reported using OR and corresponding 95 % CI. Long-acting family planning method switching among revisit clients was 40.4 %; switching from implant was 29.8 % and from IUCD, it was 10.6 %. The main reasons for methods switching were side effects of the methods such as bleeding, weight loss, and feeling of arm numbness. The tendency of switching was less among married women (AOR = 2.41, 95 % CI: 1.01, 5.74), women who had 2-4 and 5 and more children (AOR 3.00, 95 % CI: 1.59, 5.67) and (AOR 2.07, 95 % CI: 1.17, 3.66), respectively. It was also less among women who want to stop birth (AOR 5.11, 95 % CI: 1.15, 24.8), among those who mentioned health care providers as source of information for family planning (AOR 1.88, 95 % CI: 1.18, 3.01), and among women whose husbands were aware of their use of the methods (AOR 3.05, 95 % CI: 1.88, 4.94). Method switching from long-acting contraceptives to less effective methods is high. Method switching was significant among unmarried women, who had one child, plan to postpone fertility, and whose husbands were not aware of their wive's use of the method. In the provision of family planning service, the health care providers should give adequate information about each method and risks of method switching. Appropriate family planning Information Education and Communication (IEC) and Behavioral Change Communication (BCC) strategies should be emphasized.

Land management planning: a method of evaluating alternatives

Treesearch

Andres Weintraub; Richard Adams; Linda Yellin

1982-01-01

A method is described for developing and evaluating alternatives in land management planning. A structured set of 15 steps provides a framework for such an evaluation. when multiple objectives and uncertainty must be considered in the planning process. The method is consistent with other processes used in organizational evaluation, and allows for the interaction of...

29 CFR 4281.16 - Benefit valuation methods-plans closing out.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., as determined under this subpart. (b) Valuation rule. The present value of nonforfeitable benefits... 4281(b) of ERISA, the plan sponsor shall value the plan's benefits in accordance with paragraph (b) of... 29 Labor 9 2010-07-01 2010-07-01 false Benefit valuation methods-plans closing out. 4281.16...

Temporal and Resource Reasoning for Planning, Scheduling and Execution in Autonomous Agents

NASA Technical Reports Server (NTRS)

Muscettola, Nicola; Hunsberger, Luke; Tsamardinos, Ioannis

2005-01-01

This viewgraph slide tutorial reviews methods for planning and scheduling events. The presentation reviews several methods and uses several examples of scheduling events for the successful and timely completion of the overall plan. Using constraint based models the presentation reviews planning with time, time representations in problem solving and resource reasoning.

29 CFR 4211.12 - Modifications to the presumptive, modified presumptive and rolling-5 methods.

Code of Federal Regulations, 2014 CFR

2014-07-01

... presumptive method (including a plan that primarily covers employees in the building and construction industry... the building and construction industry, the plan year designated by a plan amendment pursuant to... after the designated plan year are reduced by the value of all outstanding claims for withdrawal...

29 CFR 4211.12 - Modifications to the presumptive, modified presumptive and rolling-5 methods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... presumptive method (including a plan that primarily covers employees in the building and construction industry... the building and construction industry, the plan year designated by a plan amendment pursuant to... after the designated plan year are reduced by the value of all outstanding claims for withdrawal...

29 CFR 4211.12 - Modifications to the presumptive, modified presumptive and rolling-5 methods.

Code of Federal Regulations, 2011 CFR

2011-07-01

... presumptive method (including a plan that primarily covers employees in the building and construction industry... the building and construction industry, the plan year designated by a plan amendment pursuant to... after the designated plan year are reduced by the value of all outstanding claims for withdrawal...

29 CFR 2520.104-4 - Alternative method of compliance for certain successor pension plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... pension plans. 2520.104-4 Section 2520.104-4 Labor Regulations Relating to Labor (Continued) EMPLOYEE... certain successor pension plans. (a) General. Under the authority of section 110 of the Act, this section sets forth an alternative method of compliance for certain successor pension plans in which some...

Preoperative Planning in Orthopaedic Surgery. Current Practice and Evolving Applications.

PubMed

Atesok, Kivanc; Galos, David; Jazrawi, Laith M; Egol, Kenneth A

2015-12-01

Preoperative planning is an essential prerequisite for the success of orthopaedic procedures. Traditionally, the exercise has involved the written down, step by step "blueprint" of the surgical procedure. Preoperative planning of the technical aspects of the orthopaedic procedure has been performed on hardcopy radiographs using various methods such as copying the radiographic image on tracing papers to practice the planned interventions. This method has become less practical due to variability in radiographic magnification and increasing implementation of digital imaging systems. Advances in technology along with recognition of the importance of surgical safety protocols resulted in widespread changes in orthopaedic preoperative planning approaches. Nowadays, perioperative "briefings" have gained particular importance and novel planning methods have started to integrate into orthopaedic practice. These methods include using software that enables surgeons to perform preoperative planning on digital radiographs and to construct 3D digital models or prototypes of various orthopaedic pathologies from a patient's CT scans to practice preoperatively. Evidence-to-date suggests that preoperative planning and briefings are effective means of favorably influencing the outcomes of orthopaedic procedures.

Association between women's autonomy and family planning outcome in couples residing in Isfahan.

PubMed

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-09-01

One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples' family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration.

Diabetes Diet, Eating, & Physical Activity

MedlinePlus

... for pregnancy if you have diabetes. Meal plan methods Two common ways to help you plan how ... about the method that’s best for you. Plate method The plate method helps you control your portion ...

26 CFR 1.412(c)(1)-3 - Applying the minimum funding requirements to restored plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) In general—(1) Restoration method. The restoration method is a funding method that adapts the... spread gain method that maintains an unfunded liability. A plan may adopt any cost method that satisfies...

Implementation of a dose gradient method into optimization of dose distribution in prostate cancer 3D-CRT plans

PubMed Central

Giżyńska, Marta K.; Kukołowicz, Paweł F.; Kordowski, Paweł

2014-01-01

Aim The aim of this work is to present a method of beam weight and wedge angle optimization for patients with prostate cancer. Background 3D-CRT is usually realized with forward planning based on a trial and error method. Several authors have published a few methods of beam weight optimization applicable to the 3D-CRT. Still, none on these methods is in common use. Materials and methods Optimization is based on the assumption that the best plan is achieved if dose gradient at ICRU point is equal to zero. Our optimization algorithm requires beam quality index, depth of maximum dose, profiles of wedged fields and maximum dose to femoral heads. The method was tested for 10 patients with prostate cancer, treated with the 3-field technique. Optimized plans were compared with plans prepared by 12 experienced planners. Dose standard deviation in target volume, and minimum and maximum doses were analyzed. Results The quality of plans obtained with the proposed optimization algorithms was comparable to that prepared by experienced planners. Mean difference in target dose standard deviation was 0.1% in favor of the plans prepared by planners for optimization of beam weights and wedge angles. Introducing a correction factor for patient body outline for dose gradient at ICRU point improved dose distribution homogeneity. On average, a 0.1% lower standard deviation was achieved with the optimization algorithm. No significant difference in mean dose–volume histogram for the rectum was observed. Conclusions Optimization shortens very much time planning. The average planning time was 5 min and less than a minute for forward and computer optimization, respectively. PMID:25337411

Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vandewouw, Marlee M., E-mail: marleev@mie.utoronto

Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, aremore » used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.« less

The method of planning the energy consumption for electricity market

NASA Astrophysics Data System (ADS)

Russkov, O. V.; Saradgishvili, S. E.

2017-10-01

The limitations of existing forecast models are defined. The offered method is based on game theory, probabilities theory and forecasting the energy prices relations. New method is the basis for planning the uneven energy consumption of industrial enterprise. Ecological side of the offered method is disclosed. The program module performed the algorithm of the method is described. Positive method tests at the industrial enterprise are shown. The offered method allows optimizing the difference between planned and factual consumption of energy every hour of a day. The conclusion about applicability of the method for addressing economic and ecological challenges is made.

Study on the methods of rational analysis about the area of the Planning of Sea Usage of Regional Construction

NASA Astrophysics Data System (ADS)

Ya-Juan, Li; Tian-Yu, Mao; Mingjing-Tian

2018-03-01

The Planning of Sea Usage of Regional Construction is a new area, and the rational analysis about the area of which is one of its difficulties. Based on “Urban land classification and land use planning and construction standards”, the land use control index method study the rationality of the sea usage area of the whole region, by accumulating for specific land use indicators for each land type within the planning area. This paper, takeing the project named “caofeidian integrated service area” for example, make a little study on the land use control index method used by the sea usage demonstration of the planning of sea usage of regional construction. The study will be good for improving the technical methods of rational analysis about the area of the planning of sea usage of regional construction.

Perceptions of rural women about contraceptive usage in district Khushab, Punjab.

PubMed

Tabassum, Aqeela; Manj, Yasir Nawaz; Gunjial, Tahira Rehman; Nazir, Salma

2016-12-01

To identify the perceptions of rural women about modern contraceptive methods and to ascertain the psycho-social and economic attitude of women about family planning methods. This cross-sectional study was conducted at the University of Sargodha, Sargodha, Pakistan, from December 2014 to March 2015, and comprised married women. The sample was selected using multistage sampling technique through Fitzgibbon table. They were interviewed regarding use of family planning methods. . SPSS 16 was used for data analysis. Of the 500 women, 358(71.6%) were never-users and 142(28.4%) were past-users of family planning methods. Moreover, 52(14.5%) of never-users did not know about a single modern contraceptive method. Of the past-users, 43(30.3%) knew about 1-3 methods and 99(69.7%) about 4 or more methods. Furthermore, 153(30.6%) respondents graded condoms as good, 261(55.2%) agreed that family planning helped in improving one's standard of living to a great extent while 453(90.6%) indicated that family planning methods were not expensive. Besides, 366(71.2%) respondents believed that using contraceptive method caused infertility. Dissatisfaction with methods, method failure, bad experiences with side effects, privacy concerns and different myths associated to the methods were strongly related to the non-usage of modern contraceptive methods.

SU-F-T-359: Incorporating Dose Volume Histogram Prediction Into Auto-Planning for Volumetric-Modulated Arc Therapy in Rectal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, K; Chen, X; Wang, J

Purpose: To incorporate dose volume histogram (DVH) prediction into Auto-Planning for volumetric-modulated arc therapy (VMAT) treatment planning and investigate the benefit of this new technique for rectal cancer. Methods: Ninety clinically accepted VMAT plans for patients with rectal cancer were selected and trained in the RapidPlan for DVH prediction. Both internal and external validations were performed before implementing the prediction model. A new VMAT planning method (hybrid-VMAT) was created with combining the DVH prediction and Auto-Planning. For each new patient, the DVH will be predicted and individual DVH constrains will be obtained and were exported as the original optimization parametersmore » to the Auto-Planning (Pinnacle3 treatment planning system, v9.10) for planning. A total of 20 rectal cancer patients previously treated with manual VMAT (manual-VMAT) plans were replanned using this new method. Dosimetric comparisons were performed between manual VMAT and new method plans. Results: Hybrid-VMAT shows similar PTV coverage to manual-VMAT in D2%, D98% and HI (p>0.05) and superior coverage in CI (p=0.000). For the bladder, the means of V40 and mean dose are 36.0% and 35.6Gy for hybrid-VMAT and 42% and 38.0Gy for the manual-VMAT. For the left (right) femur, the means of V30 and mean dose are 10.6% (11.6%) and 17.9Gy (19.2Gy) for the hybrid-VMAT and 25.6% (24.1%) and 27.3Gy (26.2Gy) for the manual-VMAT. The hybrid-VMAT has significantly improved the organs at risk sparing. Conclusion: The integration of DVH prediction and Auto-Planning significantly improve the VMAT plan quality in the rectal cancer radiotherapy. Our results show the benefit of the new method and will be further investigated in other tumor sites.« less

SU-F-T-198: Dosimetric Comparison of Carbon and Proton Radiotherapy for Recurrent Nasopharynx Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheng, Y; Zhao, J; Wang, W

2016-06-15

Purpose: Various radiotherapy planning methods for locally recurrent nasopharynx carcinoma (R-NPC) have been proposed. The purpose of this study was to compare carbon and proton therapy for the treatment of R-NPC in terms of dose coverage for target volume and sparing for organs at risk (OARs). Methods: Six patients who were suffering from R-NPC and treated using carbon therapy were selected for this study. Treatment plans with a total dose of 57.5Gy (RBE) in 23 fractions were made using SIEMENS Syngo V11. An intensity-modulated radiotherapy optimization method was chosen for carbon plans (IMCT) while for proton plans both intensity-modulated radiotherapymore » (IMPT) and single beam optimization (proton-SBO) methods were chosen. Dose distributions, dose volume parameters, and selected dosimetric indices for target volumes and OARs were compared for all treatment plans. Results: All plans provided comparable PTV coverage. The volume covered by 95% of the prescribed dose was comparable for all three plans. The average values were 96.11%, 96.24% and 96.11% for IMCT, IMPT, and proton-SBO respectively. A significant reduction of the 80% and 50% dose volumes were observed for the IMCT plans compared to the IMPT and proton-SBO plans. Critical organs lateral to the target such as brain stem and spinal cord were better spared by IMPT than by proton-SBO, while IMCT spared those organs best. For organs in the beam path, such as parotid glands, the mean dose results were similar for all three plans. Conclusion: Carbon plans yielded better dose conformity than proton plans. They provided similar or better target coverage while significantly lowering the dose for normal tissues. Dose sparing for critical organs in IMPT plans was better than proton-SBO, however, IMPT is known to be more sensitive to range uncertainties. For proton plans it is essential to find a balance between the two optimization methods.« less

26 CFR 1.412(c)(1)-3 - Applying the minimum funding requirements to restored plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Applying the minimum funding requirements to..., Stock Bonus Plans, Etc. § 1.412(c)(1)-3 Applying the minimum funding requirements to restored plans. (a) In general—(1) Restoration method. The restoration method is a funding method that adapts the...

76 FR 23809 - Science Advisory Board Staff Office Notification of a Public Meeting of the Clean Air Scientific...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

...: Scope and Methods Plan for Welfare Risk and Exposure Assessment (April 2011 Draft). DATES: The CASAC... Ambient Air Quality Standards: Scope and Methods Plan for Health Risk and Exposure Assessment (April 2011), and Ozone National Ambient Air Quality Standards: Scope and Methods Plan for Welfare Risk and Exposure...

RANGE RAM: a long-term planning method for managing grazing lands

Treesearch

Henricus C. Jansen

1976-01-01

Range RAM (Resource Allocation Method) is a computerized planning method designed to assist range managers in developing and selecting alternatives in spatial and temporal allocation of resources. The technique is applicable at the frest or district management levels, or their equivalents. Range RAM can help formulate plans that maximize the production of range outputs...

Educating the Public About Health: A Planning Guide. Health Planning Methods and Technology Series.

ERIC Educational Resources Information Center

Sullivan, Daniel

A comprehensive overview of major issues involved in educating the public about health, with emphasis on methods and approaches designed to foster community participation in health planning, is presented in this guide. It is intended to provide ideas for those engaged in health education program development with ideas for use in planning,…

29 CFR 2520.104-27 - Alternative method of compliance for certain unfunded dues financed pension plans maintained by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... financed pension plans maintained by employee organizations. 2520.104-27 Section 2520.104-27 Labor... Alternative method of compliance for certain unfunded dues financed pension plans maintained by employee organizations. (a) Scope. Under the authority of section 110 of the Act, a pension benefit plan that meets the...

29 CFR 2520.104-23 - Alternative method of compliance for pension plans for certain selected employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Alternative method of compliance for pension plans for... pension plans for certain selected employees. (a) Purpose and scope. (1) This section contains an... Employee Retirement Income Security Act of 1974 for unfunded or insured pension plans maintained by an...

Alternatives to Re-Planning: Methods for Plan Re-Evaluation at Runtime

NASA Technical Reports Server (NTRS)

Benazera, Emmanuel

2005-01-01

Current planning algorithms have difficulty handling the complexity that is due to an increase in domain uncertainty, and especially in the case of multi-dimensional continuous spaces. Therefore, they produce plans that do not take into account numerous situations that can occur at runtime, such as faults or other changes in the planning domain itself. Thus there is a gap between the plan generation and the reality experienced at runtime. Here we present two methods that allow the plan conditionals to be revised w.r.t. uncertainty on the system as estimated at runtime.

A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning

NASA Astrophysics Data System (ADS)

Guthier, C.; Aschenbrenner, K. P.; Buergy, D.; Ehmann, M.; Wenz, F.; Hesser, J. W.

2015-03-01

This work discusses a novel strategy for inverse planning in low dose rate brachytherapy. It applies the idea of compressed sensing to the problem of inverse treatment planning and a new solver for this formulation is developed. An inverse planning algorithm was developed incorporating brachytherapy dose calculation methods as recommended by AAPM TG-43. For optimization of the functional a new variant of a matching pursuit type solver is presented. The results are compared with current state-of-the-art inverse treatment planning algorithms by means of real prostate cancer patient data. The novel strategy outperforms the best state-of-the-art methods in speed, while achieving comparable quality. It is able to find solutions with comparable values for the objective function and it achieves these results within a few microseconds, being up to 542 times faster than competing state-of-the-art strategies, allowing real-time treatment planning. The sparse solution of inverse brachytherapy planning achieved with methods from compressed sensing is a new paradigm for optimization in medical physics. Through the sparsity of required needles and seeds identified by this method, the cost of intervention may be reduced.

A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning.

PubMed

Guthier, C; Aschenbrenner, K P; Buergy, D; Ehmann, M; Wenz, F; Hesser, J W

2015-03-21

This work discusses a novel strategy for inverse planning in low dose rate brachytherapy. It applies the idea of compressed sensing to the problem of inverse treatment planning and a new solver for this formulation is developed. An inverse planning algorithm was developed incorporating brachytherapy dose calculation methods as recommended by AAPM TG-43. For optimization of the functional a new variant of a matching pursuit type solver is presented. The results are compared with current state-of-the-art inverse treatment planning algorithms by means of real prostate cancer patient data. The novel strategy outperforms the best state-of-the-art methods in speed, while achieving comparable quality. It is able to find solutions with comparable values for the objective function and it achieves these results within a few microseconds, being up to 542 times faster than competing state-of-the-art strategies, allowing real-time treatment planning. The sparse solution of inverse brachytherapy planning achieved with methods from compressed sensing is a new paradigm for optimization in medical physics. Through the sparsity of required needles and seeds identified by this method, the cost of intervention may be reduced.

A Method on Dynamic Path Planning for Robotic Manipulator Autonomous Obstacle Avoidance Based on an Improved RRT Algorithm.

PubMed

Wei, Kun; Ren, Bingyin

2018-02-13

In a future intelligent factory, a robotic manipulator must work efficiently and safely in a Human-Robot collaborative and dynamic unstructured environment. Autonomous path planning is the most important issue which must be resolved first in the process of improving robotic manipulator intelligence. Among the path-planning methods, the Rapidly Exploring Random Tree (RRT) algorithm based on random sampling has been widely applied in dynamic path planning for a high-dimensional robotic manipulator, especially in a complex environment because of its probability completeness, perfect expansion, and fast exploring speed over other planning methods. However, the existing RRT algorithm has a limitation in path planning for a robotic manipulator in a dynamic unstructured environment. Therefore, an autonomous obstacle avoidance dynamic path-planning method for a robotic manipulator based on an improved RRT algorithm, called Smoothly RRT (S-RRT), is proposed. This method that targets a directional node extends and can increase the sampling speed and efficiency of RRT dramatically. A path optimization strategy based on the maximum curvature constraint is presented to generate a smooth and curved continuous executable path for a robotic manipulator. Finally, the correctness, effectiveness, and practicability of the proposed method are demonstrated and validated via a MATLAB static simulation and a Robot Operating System (ROS) dynamic simulation environment as well as a real autonomous obstacle avoidance experiment in a dynamic unstructured environment for a robotic manipulator. The proposed method not only provides great practical engineering significance for a robotic manipulator's obstacle avoidance in an intelligent factory, but also theoretical reference value for other type of robots' path planning.

Evolutionistic or revolutionary paths? A PACS maturity model for strategic situational planning.

PubMed

van de Wetering, Rogier; Batenburg, Ronald; Lederman, Reeva

2010-07-01

While many hospitals are re-evaluating their current Picture Archiving and Communication System (PACS), few have a mature strategy for PACS deployment. Furthermore, strategies for implementation, strategic and situational planning methods for the evolution of PACS maturity are scarce in the scientific literature. Consequently, in this paper we propose a strategic planning method for PACS deployment. This method builds upon a PACS maturity model (PMM), based on the elaboration of the strategic alignment concept and the maturity growth path concept previously developed in the PACS domain. First, we review the literature on strategic planning for information systems and information technology and PACS maturity. Secondly, the PMM is extended by applying four different strategic perspectives of the Strategic Alignment Framework whereupon two types of growth paths (evolutionistic and revolutionary) are applied that focus on a roadmap for PMM. This roadmap builds a path to get from one level of maturity and evolve to the next. An extended method for PACS strategic planning is developed. This method defines eight distinctive strategies for PACS strategic situational planning that allow decision-makers in hospitals to decide which approach best suits their hospitals' current situation and future ambition and what in principle is needed to evolve through the different maturity levels. The proposed method allows hospitals to strategically plan for PACS maturation. It is situational in that the required investments and activities depend on the alignment between the hospital strategy and the selected growth path. The inclusion of both strategic alignment and maturity growth path concepts make the planning method rigorous, and provide a framework for further empirical research and clinical practice.

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana

PubMed Central

2017-01-01

Introduction Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women’s reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. Methods A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Results Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception. PMID:28759624

26 CFR 1.412(c)(1)-3T - Applying the minimum funding requirements to restored plans (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... (temporary). (a) In general—(1) Restoration method. The restoration method is a funding method that adapts... spread gain method that maintains an unfunded liability. A plan may adopt any cost method that satisfies...

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.

PubMed

Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses

2014-08-13

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Three-dimensional Cross-Platform Planning for Complex Spinal Procedures: A New Method Adaptive to Different Navigation Systems.

PubMed

Kosterhon, Michael; Gutenberg, Angelika; Kantelhardt, Sven R; Conrad, Jens; Nimer Amr, Amr; Gawehn, Joachim; Giese, Alf

2017-08-01

A feasibility study. To develop a method based on the DICOM standard which transfers complex 3-dimensional (3D) trajectories and objects from external planning software to any navigation system for planning and intraoperative guidance of complex spinal procedures. There have been many reports about navigation systems with embedded planning solutions but only few on how to transfer planning data generated in external software. Patients computerized tomography and/or magnetic resonance volume data sets of the affected spinal segments were imported to Amira software, reconstructed to 3D images and fused with magnetic resonance data for soft-tissue visualization, resulting in a virtual patient model. Objects needed for surgical plans or surgical procedures such as trajectories, implants or surgical instruments were either digitally constructed or computerized tomography scanned and virtually positioned within the 3D model as required. As crucial step of this method these objects were fused with the patient's original diagnostic image data, resulting in a single DICOM sequence, containing all preplanned information necessary for the operation. By this step it was possible to import complex surgical plans into any navigation system. We applied this method not only to intraoperatively adjustable implants and objects under experimental settings, but also planned and successfully performed surgical procedures, such as the percutaneous lateral approach to the lumbar spine following preplanned trajectories and a thoracic tumor resection including intervertebral body replacement using an optical navigation system. To demonstrate the versatility and compatibility of the method with an entirely different navigation system, virtually preplanned lumbar transpedicular screw placement was performed with a robotic guidance system. The presented method not only allows virtual planning of complex surgical procedures, but to export objects and surgical plans to any navigation or guidance system able to read DICOM data sets, expanding the possibilities of embedded planning software.

Acoustic window planning for ultrasound acquisition.

PubMed

Göbl, Rüdiger; Virga, Salvatore; Rackerseder, Julia; Frisch, Benjamin; Navab, Nassir; Hennersperger, Christoph

2017-06-01

Autonomous robotic ultrasound has recently gained considerable interest, especially for collaborative applications. Existing methods for acquisition trajectory planning are solely based on geometrical considerations, such as the pose of the transducer with respect to the patient surface. This work aims at establishing acoustic window planning to enable autonomous ultrasound acquisitions of anatomies with restricted acoustic windows, such as the liver or the heart. We propose a fully automatic approach for the planning of acquisition trajectories, which only requires information about the target region as well as existing tomographic imaging data, such as X-ray computed tomography. The framework integrates both geometrical and physics-based constraints to estimate the best ultrasound acquisition trajectories with respect to the available acoustic windows. We evaluate the developed method using virtual planning scenarios based on real patient data as well as for real robotic ultrasound acquisitions on a tissue-mimicking phantom. The proposed method yields superior image quality in comparison with a naive planning approach, while maintaining the necessary coverage of the target. We demonstrate that by taking image formation properties into account acquisition planning methods can outperform naive plannings. Furthermore, we show the need for such planning techniques, since naive approaches are not sufficient as they do not take the expected image quality into account.

26 CFR 1.412(c)(1)-3T - Applying the minimum funding requirements to restored plans (temporary).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Applying the minimum funding requirements to...-Sharing, Stock Bonus Plans, Etc. § 1.412(c)(1)-3T Applying the minimum funding requirements to restored plans (temporary). (a) In general—(1) Restoration method. The restoration method is a funding method...

[Scenario analysis--a method for long-term planning].

PubMed

Stavem, K

2000-01-10

Scenarios are known from the film industry, as detailed descriptions of films. This has given name to scenario analysis, a method for long term planning using descriptions of composite future pictures. This article is an introduction to the scenario method. Scenarios describe plausible, not necessarily probable, developments. They focus on problems and questions that decision makers must be aware of and prepare to deal with, and the consequences of alternative decisions. Scenarios are used in corporate and governmental planning, and they can be useful and complementary to traditional planning and extrapolation of past experience. The method is particularly useful in a rapidly changing world with shifting external conditions.

Interrogating the Lesson Plan in a Pre-Service Methods Course: Evidence from a University in Kenya

ERIC Educational Resources Information Center

Simwa, Kefa L.; Modiba, Maropeng

2015-01-01

The paper reports on research that examined how the content of a History methods course, taught in a university in Kenya, influenced student teachers' lesson planning and pedagogical skills. A lecture on a lesson plan, micro-teaching lesson plan documents and presentations were examined to determine student teachers' preparedness for teaching the…

26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

Code of Federal Regulations, 2013 CFR

2013-04-01

... valuation method must take into account fair market value by making use of the— (i) Fair market value... market value (under paragraph (c) of this section). (4) Defined benefit plans. (i) To satisfy the... changes in the fair market value of plan assets. The funding of plan benefits and the charges and credits...

26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

Code of Federal Regulations, 2012 CFR

2012-04-01

... valuation method must take into account fair market value by making use of the— (i) Fair market value... market value (under paragraph (c) of this section). (4) Defined benefit plans. (i) To satisfy the... changes in the fair market value of plan assets. The funding of plan benefits and the charges and credits...

26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

Code of Federal Regulations, 2011 CFR

2011-04-01

... valuation method must take into account fair market value by making use of the— (i) Fair market value... market value (under paragraph (c) of this section). (4) Defined benefit plans. (i) To satisfy the... changes in the fair market value of plan assets. The funding of plan benefits and the charges and credits...

76 FR 23755 - Release of Draft Risk and Exposure Assessments and Final Integrated Review Plan for the National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... titled, ``Ozone National Ambient Air Quality Standards: Scope and Methods Plan for Health Risk and... Standards: Scope and Methods Plan for Welfare Risk and Exposure Assessment'' (REA Plan for the secondary... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 50 and 58 [EPA-HQ-OAR-2008-0699; FRL-9300-4] RIN 2060...

Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

PubMed Central

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-01-01

ABSTRACT Background: The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Methods: Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. Results: In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Conclusions: Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. PMID:28031299

Fast and fuzzy multi-objective radiotherapy treatment plan generation for head and neck cancer patients with the lexicographic reference point method (LRPM)

NASA Astrophysics Data System (ADS)

van Haveren, Rens; Ogryczak, Włodzimierz; Verduijn, Gerda M.; Keijzer, Marleen; Heijmen, Ben J. M.; Breedveld, Sebastiaan

2017-06-01

Previously, we have proposed Erasmus-iCycle, an algorithm for fully automated IMRT plan generation based on prioritised (lexicographic) multi-objective optimisation with the 2-phase ɛ-constraint (2pɛc) method. For each patient, the output of Erasmus-iCycle is a clinically favourable, Pareto optimal plan. The 2pɛc method uses a list of objective functions that are consecutively optimised, following a strict, user-defined prioritisation. The novel lexicographic reference point method (LRPM) is capable of solving multi-objective problems in a single optimisation, using a fuzzy prioritisation of the objectives. Trade-offs are made globally, aiming for large favourable gains for lower prioritised objectives at the cost of only slight degradations for higher prioritised objectives, or vice versa. In this study, the LRPM is validated for 15 head and neck cancer patients receiving bilateral neck irradiation. The generated plans using the LRPM are compared with the plans resulting from the 2pɛc method. Both methods were capable of automatically generating clinically relevant treatment plans for all patients. For some patients, the LRPM allowed large favourable gains in some treatment plan objectives at the cost of only small degradations for the others. Moreover, because of the applied single optimisation instead of multiple optimisations, the LRPM reduced the average computation time from 209.2 to 9.5 min, a speed-up factor of 22 relative to the 2pɛc method.

Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo

PubMed Central

Ho, Lara S; Wheeler, Erin

2018-01-01

Unmet need for family planning in the conflict-affected area of eastern Democratic Republic of the Congo (DRC) has been reported to be as high as 38%, and women in such conflict settings are often the most at risk for maternal mortality. The International Rescue Committee implements the Family Planning and Post-Abortion Care in Emergencies program in 3 provinces of eastern DRC to provide women and couples access to family planning, including long-acting reversible contraceptives (LARCs). This article presents routine program data from June 2011 through December 2013 from 2 health zones as well as results from a qualitative assessment of family planning clients and of male and female non-users, conducted in 2013. It then describes how these findings were used to make program adjustments to improve access to family planning services and client informed choice and assesses the effects of the program design changes on family planning uptake and method mix using routine program data from January 2014 through December 2016. Between 2011 and 2013, 8,985 clients adopted family planning, with an average 14 clients adopting a method per facility, per month. The method mix remained stable during this period, with implants dominating at 48%. Barriers to uptake identified from the qualitative research were both supply- and demand-related, including misconceptions about certain modern contraceptive methods on the part of providers, users, and other community members. The program implemented several program changes based on the assessment findings, including clinical coaching and supportive supervision to improve provider skills and attitudes, introduction of immediate postpartum insertion of the intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS), and behavior change communication campaigns to raise awareness about family planning. After these program changes, the mean number of clients adopting modern family planning per facility, per month increased from 14 to 37 and the percentage of family planning adopters choosing LARCs increased from 50% to 66%. While implants continued to be the most dominant method, reaching 60% of the method mix in 2016, the percentage of clients adopting IUDs increased each year, from 3% in 2014 to 13% in 2016. In total, 39,399 clients started family planning methods during the post-program design change period (2014–2016). Our experience in eastern DRC demonstrates that women and their partners affected by conflict want family planning, and that it is feasible to deliver the full range of modern contraceptive methods when programs are adapted and sensitive to the local context. PMID:29602870

Effectiveness of Family Planning Methods

MedlinePlus

... women in a year Effectiveness of Family Planning Methods Implant Reversible Intrauterine Device (IUD) Permanent Male Sterilization ... 0.5 % Diaphragm 12 % How to make your method most effective After procedure, little or nothing to ...

Wilderness fire management planning guide

Treesearch

William C. Fischer

1984-01-01

Outlines a procedure for fire management planning for parks; wilderness areas; and other wild, natural, or essentially undeveloped areas. Discusses background and philosophy of wilderness fire management, planning concepts, planning elements, and planning methods.

The Search Conference as a Method in Planning Community Health Promotion Actions

PubMed Central

Magnus, Eva; Knudtsen, Margunn Skjei; Wist, Guri; Weiss, Daniel; Lillefjell, Monica

2016-01-01

Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives. Significance for public health This article describe and discuss how the Search conference can be used as a method when working with knowledge based health promotion actions in local communities. The article describe the sequences of the conference and shows how this have been adapted when planning and prioritizing health promotion actions in three Norwegian municipalities. The significance of the article is that it shows how central elements in the planning of health promotion actions, as participation and involvements as well as evidence was a fundamental thinking in how the conference were accomplished. The article continue discussing how the method function as both a top-down and a bottom-up strategy, and in what way working evidence based can be in conflict with a bottom-up strategy. The experiences described can be used as guidance planning knowledge based health promotion actions in communities. PMID:27747199

Automated construction of an intraoperative high-dose-rate treatment plan library for the Varian brachytherapy treatment planning system.

PubMed

Deufel, Christopher L; Furutani, Keith M; Dahl, Robert A; Haddock, Michael G

2016-01-01

The ability to create treatment plans for intraoperative high-dose-rate (IOHDR) brachytherapy is limited by lack of imaging and time constraints. An automated method for creation of a library of high-dose-rate brachytherapy plans that can be used with standard planar applicators in the intraoperative setting is highly desirable. Nonnegative least squares algebraic methods were used to identify dwell time values for flat, rectangular planar applicators. The planar applicators ranged in length and width from 2 cm to 25 cm. Plans were optimized to deliver an absorbed dose of 10 Gy to three different depths from the patient surface: 0 cm, 0.5 cm, and 1.0 cm. Software was written to calculate the optimized dwell times and insert dwell times and positions into a .XML plan template that can be imported into the Varian brachytherapy treatment planning system. The user may import the .XML template into the treatment planning system in the intraoperative setting to match the patient applicator size and prescribed treatment depth. A total of 1587 library plans were created for IOHDR brachytherapy. Median plan generation time was approximately 1 minute per plan. Plan dose was typically 100% ± 1% (mean, standard deviation) of the prescribed dose over the entire length and width of the applicator. Plan uniformity was best for prescription depths of 0 cm and 0.5 cm from the patient surface. An IOHDR plan library may be created using automated methods. Thousands of plan templates may be optimized and prepared in a few hours to accommodate different applicator sizes and treatment depths and reduce treatment planning time. The automated method also enforces dwell time symmetry for symmetrical applicator geometries, which simplifies quality assurance. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Probabilistic objective functions for margin-less IMRT planning

NASA Astrophysics Data System (ADS)

Bohoslavsky, Román; Witte, Marnix G.; Janssen, Tomas M.; van Herk, Marcel

2013-06-01

We present a method to implement probabilistic treatment planning of intensity-modulated radiation therapy using custom software plugins in a commercial treatment planning system. Our method avoids the definition of safety-margins by directly including the effect of geometrical uncertainties during optimization when objective functions are evaluated. Because the shape of the resulting dose distribution implicitly defines the robustness of the plan, the optimizer has much more flexibility than with a margin-based approach. We expect that this added flexibility helps to automatically strike a better balance between target coverage and dose reduction for surrounding healthy tissue, especially for cases where the planning target volume overlaps organs at risk. Prostate cancer treatment planning was chosen to develop our method, including a novel technique to include rotational uncertainties. Based on population statistics, translations and rotations are simulated independently following a marker-based IGRT correction strategy. The effects of random and systematic errors are incorporated by first blurring and then shifting the dose distribution with respect to the clinical target volume. For simplicity and efficiency, dose-shift invariance and a rigid-body approximation are assumed. Three prostate cases were replanned using our probabilistic objective functions. To compare clinical and probabilistic plans, an evaluation tool was used that explicitly incorporates geometric uncertainties using Monte-Carlo methods. The new plans achieved similar or better dose distributions than the original clinical plans in terms of expected target coverage and rectum wall sparing. Plan optimization times were only about a factor of two higher than in the original clinical system. In conclusion, we have developed a practical planning tool that enables margin-less probability-based treatment planning with acceptable planning times, achieving the first system that is feasible for clinical implementation.

Robust path planning for flexible needle insertion using Markov decision processes.

PubMed

Tan, Xiaoyu; Yu, Pengqian; Lim, Kah-Bin; Chui, Chee-Kong

2018-05-11

Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue-needle interactions. This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue-needle interaction. Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue-needle interactions. Future work will involve experiment with biological tissue in vivo. The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

50 CFR 216.275 - Requirements for monitoring and reporting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Navy shall complete an Integrated Comprehensive Monitoring Plan (ICMP) in 2009. This planning and adaptive management tool shall include: (1) A method for prioritizing monitoring projects that clearly... potentially modify subsequent monitoring and mitigation. (4) An adaptive management plan. (5) A method for...

A novel artificial intelligence method for weekly dietary menu planning.

PubMed

Gaál, B; Vassányi, I; Kozmann, G

2005-01-01

Menu planning is an important part of personalized lifestyle counseling. The paper describes the results of an automated menu generator (MenuGene) of the web-based lifestyle counseling system Cordelia that provides personalized advice to prevent cardiovascular diseases. The menu generator uses genetic algorithms to prepare weekly menus for web users. The objectives are derived from personal medical data collected via forms in Cordelia, combined with general nutritional guidelines. The weekly menu is modeled as a multilevel structure. Results show that the genetic algorithm-based method succeeds in planning dietary menus that satisfy strict numerical constraints on every nutritional level (meal, daily basis, weekly basis). The rule-based assessment proved capable of manipulating the mean occurrence of the nutritional components thus providing a method for adjusting the variety and harmony of the menu plans. By splitting the problem into well determined sub-problems, weekly menu plans that satisfy nutritional constraints and have well assorted components can be generated with the same method that is for daily and meal plan generation.

Alternative sample sizes for verification dose experiments and dose audits

NASA Astrophysics Data System (ADS)

Taylor, W. A.; Hansen, J. M.

1999-01-01

ISO 11137 (1995), "Sterilization of Health Care Products—Requirements for Validation and Routine Control—Radiation Sterilization", provides sampling plans for performing initial verification dose experiments and quarterly dose audits. Alternative sampling plans are presented which provide equivalent protection. These sampling plans can significantly reduce the cost of testing. These alternative sampling plans have been included in a draft ISO Technical Report (type 2). This paper examines the rational behind the proposed alternative sampling plans. The protection provided by the current verification and audit sampling plans is first examined. Then methods for identifying equivalent plans are highlighted. Finally, methods for comparing the cost associated with the different plans are provided. This paper includes additional guidance for selecting between the original and alternative sampling plans not included in the technical report.

Nurse manager succession planning: synthesis of the evidence.

PubMed

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.

Strategic Planning for Independent Schools.

ERIC Educational Resources Information Center

Stone, Susan C.

This manual is intended to serve independent schools beginning strategic planning methods. Chapter 1, "The Case for Strategic Planning," suggests replacing the term "long range planning" with the term "strategic planning," which emphasizes change. The strategic planning and policy development process begins with…

26 CFR 1.412(c)(1)-3T - Applying the minimum funding requirements to restored plans (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... that adapts the underlying funding method of section 412 in the case of certain plans that are or have... accrued liability or to a spread gain method that maintains an unfunded liability. A plan may adopt any...

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana.

PubMed

Staveteig, Sarah

2017-01-01

Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women's reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception.

Family planning among Nigerian postsecondary female students.

PubMed

Oyeka, I C

1986-01-01

This study examines the level of knowledge, attitude, and practice of family planning among postsecondary female students in an urban area of Anambra State, Nigeria. Although only a few of the women sampled expressed knowledge of modern contraceptive methods, the majority had favorable attitudes toward family planning. Among those who had knowledge of family planning, those who had attended a coeducational secondary school were more familiar with modern contraceptive methods, and those who had attended an all-girls' secondary school were more familiar with the rhythm method. Of the 23.3 percent who had ever practiced family planning, almost half had used rhythm; only a very small minority had ever used the pill. Among those who had ever used contraception and who had a positive attitude toward family planning, the greatest proportion was made up of older, married Protestant women.

SU-F-T-356: DosimetricComparison of VMAT Vs Step and Shoot IMRT Plans for Stage III Lung CancerPatients with Mediastinal Involvement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pearson, D; Bogue, J

Purpose: For Stage III lung cancers that entail treatment of some or all of the mediastinum, anterior-posterior focused Step and Shoot IMRT (SS-IMRT) and VMAT plans have been clinically used to deliver the prescribed dose while working to minimize lung dose and avoid other critical structures. A comparison between the two planning methods was completed to see which treatment method is superior and minimizes dose to healthy lung tissue. Methods: Ten patients who were recently treated with SS-IMRT or VMAT plans for Stage III lung cancer with mediastinal involvement were selected. All patients received a simulation CT for treatment planning,more » as well as a 4D CT and PET/CT fusion for target delineation. Plans were prescribed 6250 cGy in 25 fractions and normalized such that 100% of the prescription dose covered 95% of the PTV. Clinically approved SS-IMRT or VMAT plans were then copied and planned using the alternative modality with identical optimization criteria. SS-IMRT plans utilized seven to nine beams distributed around the patient while the VMAT plans consisted of two full 360 degree arcs. Plans were compared for the lung volume receiving 20 Gy (V20). Results: Both SS-IMRT and VMAT can be used to achieve clinical treatment plans for patients with Stage III Lung cancer with targets encompassing the mediastinum. VMAT plans produced an average V20 of 23.0+/−8.3% and SS-IMRT produced an average of 24.2+/−10.0%. Conclusion: Results indicate that either method can achieve comparable dose distributions, however, VMAT can allow the optimizer to distribute dose over paths of minimal lung tissue and reduce the V20. Therefore, creating a VMAT with constraints identical to an SS-IMRT plan could help to reduce the V20 in clinical treatment plans.« less

SU-F-T-352: Development of a Knowledge Based Automatic Lung IMRT Planning Algorithm with Non-Coplanar Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, W; Wu, Q; Yuan, L

Purpose: To improve the robustness of a knowledge based automatic lung IMRT planning method and to further validate the reliability of this algorithm by utilizing for the planning of clinical cases with non-coplanar beams. Methods: A lung IMRT planning method which automatically determines both plan optimization objectives and beam configurations with non-coplanar beams has been reported previously. A beam efficiency index map is constructed to guide beam angle selection in this algorithm. This index takes into account both the dose contributions from individual beams and the combined effect of multiple beams which is represented by a beam separation score. Wemore » studied the effect of this beam separation score on plan quality and determined the optimal weight for this score.14 clinical plans were re-planned with the knowledge-based algorithm. Significant dosimetric metrics for the PTV and OARs in the automatic plans are compared with those in the clinical plans by the two-sample t-test. In addition, a composite dosimetric quality index was defined to obtain the relationship between the plan quality and the beam separation score. Results: On average, we observed more than 15% reduction on conformity index and homogeneity index for PTV and V{sub 40}, V{sub 60} for heart while an 8% and 3% increase on V{sub 5}, V{sub 20} for lungs, respectively. The variation curve of the composite index as a function of angle spread score shows that 0.6 is the best value for the weight of the beam separation score. Conclusion: Optimal value for beam angle spread score in automatic lung IMRT planning is obtained. With this value, model can result in statistically the “best” achievable plans. This method can potentially improve the quality and planning efficiency for IMRT plans with no-coplanar angles.« less

Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.

PubMed

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-12-23

The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. © Corroon et al.

Application of scenario analysis and multiagent technique in land-use planning: a case study on Sanjiang wetlands.

PubMed

Yu, Huan; Ni, Shi-Jun; Kong, Bo; He, Zheng-Wei; Zhang, Cheng-Jiang; Zhang, Shu-Qing; Pan, Xin; Xia, Chao-Xu; Li, Xuan-Qiong

2013-01-01

Land-use planning has triggered debates on social and environmental values, in which two key questions will be faced: one is how to see different planning simulation results instantaneously and apply the results back to interactively assist planning work; the other is how to ensure that the planning simulation result is scientific and accurate. To answer these questions, the objective of this paper is to analyze whether and how a bridge can be built between qualitative and quantitative approaches for land-use planning work and to find out a way to overcome the gap that exists between the ability to construct computer simulation models to aid integrated land-use plan making and the demand for them by planning professionals. The study presented a theoretical framework of land-use planning based on scenario analysis (SA) method and multiagent system (MAS) simulation integration and selected freshwater wetlands in the Sanjiang Plain of China as a case study area. Study results showed that MAS simulation technique emphasizing quantitative process effectively compensated for the SA method emphasizing qualitative process, which realized the organic combination of qualitative and quantitative land-use planning work, and then provided a new idea and method for the land-use planning and sustainable managements of land resources.

Application of Scenario Analysis and Multiagent Technique in Land-Use Planning: A Case Study on Sanjiang Wetlands

PubMed Central

Ni, Shi-Jun; He, Zheng-Wei; Zhang, Cheng-Jiang; Zhang, Shu-Qing; Pan, Xin; Xia, Chao-Xu; Li, Xuan-Qiong

2013-01-01

Land-use planning has triggered debates on social and environmental values, in which two key questions will be faced: one is how to see different planning simulation results instantaneously and apply the results back to interactively assist planning work; the other is how to ensure that the planning simulation result is scientific and accurate. To answer these questions, the objective of this paper is to analyze whether and how a bridge can be built between qualitative and quantitative approaches for land-use planning work and to find out a way to overcome the gap that exists between the ability to construct computer simulation models to aid integrated land-use plan making and the demand for them by planning professionals. The study presented a theoretical framework of land-use planning based on scenario analysis (SA) method and multiagent system (MAS) simulation integration and selected freshwater wetlands in the Sanjiang Plain of China as a case study area. Study results showed that MAS simulation technique emphasizing quantitative process effectively compensated for the SA method emphasizing qualitative process, which realized the organic combination of qualitative and quantitative land-use planning work, and then provided a new idea and method for the land-use planning and sustainable managements of land resources. PMID:23818816

WE-H-BRC-06: A Unified Machine-Learning Based Probabilistic Model for Automated Anomaly Detection in the Treatment Plan Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, X; Liu, S; Kalet, A

Purpose: The purpose of this work was to investigate the ability of a machine-learning based probabilistic approach to detect radiotherapy treatment plan anomalies given initial disease classes information. Methods In total we obtained 1112 unique treatment plans with five plan parameters and disease information from a Mosaiq treatment management system database for use in the study. The plan parameters include prescription dose, fractions, fields, modality and techniques. The disease information includes disease site, and T, M and N disease stages. A Bayesian network method was employed to model the probabilistic relationships between tumor disease information, plan parameters and an anomalymore » flag. A Bayesian learning method with Dirichlet prior was useed to learn the joint probabilities between dependent variables in error-free plan data and data with artificially induced anomalies. In the study, we randomly sampled data with anomaly in a specified anomaly space.We tested the approach with three groups of plan anomalies – improper concurrence of values of all five plan parameters and values of any two out of five parameters, and all single plan parameter value anomalies. Totally, 16 types of plan anomalies were covered by the study. For each type, we trained an individual Bayesian network. Results: We found that the true positive rate (recall) and positive predictive value (precision) to detect concurrence anomalies of five plan parameters in new patient cases were 94.45±0.26% and 93.76±0.39% respectively. To detect other 15 types of plan anomalies, the average recall and precision were 93.61±2.57% and 93.78±3.54% respectively. The computation time to detect the plan anomaly of each type in a new plan is ∼0.08 seconds. Conclusion: The proposed method for treatment plan anomaly detection was found effective in the initial tests. The results suggest that this type of models could be applied to develop plan anomaly detection tools to assist manual and automated plan checks. The senior author received research grants from ViewRay Inc. and Varian Medical System.« less

TU-AB-BRB-02: Stochastic Programming Methods for Handling Uncertainty and Motion in IMRT Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Unkelbach, J.

The accepted clinical method to accommodate targeting uncertainties inherent in fractionated external beam radiation therapy is to utilize GTV-to-CTV and CTV-to-PTV margins during the planning process to design a PTV-conformal static dose distribution on the planning image set. Ideally, margins are selected to ensure a high (e.g. >95%) target coverage probability (CP) in spite of inherent inter- and intra-fractional positional variations, tissue motions, and initial contouring uncertainties. Robust optimization techniques, also known as probabilistic treatment planning techniques, explicitly incorporate the dosimetric consequences of targeting uncertainties by including CP evaluation into the planning optimization process along with coverage-based planning objectives. Themore » treatment planner no longer needs to use PTV and/or PRV margins; instead robust optimization utilizes probability distributions of the underlying uncertainties in conjunction with CP-evaluation for the underlying CTVs and OARs to design an optimal treated volume. This symposium will describe CP-evaluation methods as well as various robust planning techniques including use of probability-weighted dose distributions, probability-weighted objective functions, and coverage optimized planning. Methods to compute and display the effect of uncertainties on dose distributions will be presented. The use of robust planning to accommodate inter-fractional setup uncertainties, organ deformation, and contouring uncertainties will be examined as will its use to accommodate intra-fractional organ motion. Clinical examples will be used to inter-compare robust and margin-based planning, highlighting advantages of robust-plans in terms of target and normal tissue coverage. Robust-planning limitations as uncertainties approach zero and as the number of treatment fractions becomes small will be presented, as well as the factors limiting clinical implementation of robust planning. Learning Objectives: To understand robust-planning as a clinical alternative to using margin-based planning. To understand conceptual differences between uncertainty and predictable motion. To understand fundamental limitations of the PTV concept that probabilistic planning can overcome. To understand the major contributing factors to target and normal tissue coverage probability. To understand the similarities and differences of various robust planning techniques To understand the benefits and limitations of robust planning techniques.« less

Technical Note: Improving the VMERGE treatment planning algorithm for rotational radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gaddy, Melissa R., E-mail: mrgaddy@ncsu.edu; Papp,

2016-07-15

Purpose: The authors revisit the VMERGE treatment planning algorithm by Craft et al. [“Multicriteria VMAT optimization,” Med. Phys. 39, 686–696 (2012)] for arc therapy planning and propose two changes to the method that are aimed at improving the achieved trade-off between treatment time and plan quality at little additional planning time cost, while retaining other desirable properties of the original algorithm. Methods: The original VMERGE algorithm first computes an “ideal,” high quality but also highly time consuming treatment plan that irradiates the patient from all possible angles in a fine angular grid with a highly modulated beam and then makesmore » this plan deliverable within practical treatment time by an iterative fluence map merging and sequencing algorithm. We propose two changes to this method. First, we regularize the ideal plan obtained in the first step by adding an explicit constraint on treatment time. Second, we propose a different merging criterion that comprises of identifying and merging adjacent maps whose merging results in the least degradation of radiation dose. Results: The effect of both suggested modifications is evaluated individually and jointly on clinical prostate and paraspinal cases. Details of the two cases are reported. Conclusions: In the authors’ computational study they found that both proposed modifications, especially the regularization, yield noticeably improved treatment plans for the same treatment times than what can be obtained using the original VMERGE method. The resulting plans match the quality of 20-beam step-and-shoot IMRT plans with a delivery time of approximately 2 min.« less

Motion planning for autonomous vehicle based on radial basis function neural network in unstructured environment.

PubMed

Chen, Jiajia; Zhao, Pan; Liang, Huawei; Mei, Tao

2014-09-18

The autonomous vehicle is an automated system equipped with features like environment perception, decision-making, motion planning, and control and execution technology. Navigating in an unstructured and complex environment is a huge challenge for autonomous vehicles, due to the irregular shape of road, the requirement of real-time planning, and the nonholonomic constraints of vehicle. This paper presents a motion planning method, based on the Radial Basis Function (RBF) neural network, to guide the autonomous vehicle in unstructured environments. The proposed algorithm extracts the drivable region from the perception grid map based on the global path, which is available in the road network. The sample points are randomly selected in the drivable region, and a gradient descent method is used to train the RBF network. The parameters of the motion-planning algorithm are verified through the simulation and experiment. It is observed that the proposed approach produces a flexible, smooth, and safe path that can fit any road shape. The method is implemented on autonomous vehicle and verified against many outdoor scenes; furthermore, a comparison of proposed method with the existing well-known Rapidly-exploring Random Tree (RRT) method is presented. The experimental results show that the proposed method is highly effective in planning the vehicle path and offers better motion quality.

Motion Planning for Autonomous Vehicle Based on Radial Basis Function Neural Network in Unstructured Environment

PubMed Central

Chen, Jiajia; Zhao, Pan; Liang, Huawei; Mei, Tao

2014-01-01

The autonomous vehicle is an automated system equipped with features like environment perception, decision-making, motion planning, and control and execution technology. Navigating in an unstructured and complex environment is a huge challenge for autonomous vehicles, due to the irregular shape of road, the requirement of real-time planning, and the nonholonomic constraints of vehicle. This paper presents a motion planning method, based on the Radial Basis Function (RBF) neural network, to guide the autonomous vehicle in unstructured environments. The proposed algorithm extracts the drivable region from the perception grid map based on the global path, which is available in the road network. The sample points are randomly selected in the drivable region, and a gradient descent method is used to train the RBF network. The parameters of the motion-planning algorithm are verified through the simulation and experiment. It is observed that the proposed approach produces a flexible, smooth, and safe path that can fit any road shape. The method is implemented on autonomous vehicle and verified against many outdoor scenes; furthermore, a comparison of proposed method with the existing well-known Rapidly-exploring Random Tree (RRT) method is presented. The experimental results show that the proposed method is highly effective in planning the vehicle path and offers better motion quality. PMID:25237902

26 CFR 1.412(c)(1)-2 - Shortfall method.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Shortfall method. 1.412(c)(1)-2 Section 1.412(c... (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.412(c)(1)-2 Shortfall method. (a) In general—(1) Shortfall method. The shortfall method is a funding method that adapts a plan's...

Balancing Plan-Driven and Agile Methods in Software Engineering Project Courses

NASA Astrophysics Data System (ADS)

Boehm, Barry; Port, Dan; Winsor Brown, A.

2002-09-01

For the past 6 years, we have been teaching a two-semester software engineering project course. The students organize into 5-person teams and develop largely web-based electronic services projects for real USC campus clients. We have been using and evolving a method called Model- Based (System) Architecting and Software Engineering (MBASE) for use in both the course and in industrial applications. The MBASE Guidelines include a lot of documents. We teach risk-driven documentation: if it is risky to document something, and not risky to leave it out (e.g., GUI screen placements), leave it out. Even so, students tend to associate more documentation with higher grades, although our grading eventually discourages this. We are always on the lookout for ways to have students learn best practices without having to produce excessive documentation. Thus, we were very interested in analyzing the various emerging agile methods. We found that agile methods and milestone plan-driven methods are part of a “how much planning is enough?” spectrum. Both agile and plan-driven methods have home grounds of project characteristics where they clearly work best, and where the other will have difficulties. Hybrid agile/plan-driven approaches are feasible, and necessary for projects having a mix of agile and plan-driven home ground characteristics. Information technology trends are going more toward the agile methods' home ground characteristics of emergent requirements and rapid change, although there is a concurrent increase in concern with dependability. As a result, we are currently experimenting with risk-driven combinations of MBASE and agile methods, such as integrating requirements, test plans, peer reviews, and pair programming into “agile quality management.”

Applying Mixed Methods Techniques in Strategic Planning

ERIC Educational Resources Information Center

Voorhees, Richard A.

2008-01-01

In its most basic form, strategic planning is a process of anticipating change, identifying new opportunities, and executing strategy. The use of mixed methods, blending quantitative and qualitative analytical techniques and data, in the process of assembling a strategic plan can help to ensure a successful outcome. In this article, the author…

A Comparison of Traditional Worksheet and Linear Programming Methods for Teaching Manure Application Planning.

ERIC Educational Resources Information Center

Schmitt, M. A.; And Others

1994-01-01

Compares traditional manure application planning techniques calculated to meet agronomic nutrient needs on a field-by-field basis with plans developed using computer-assisted linear programming optimization methods. Linear programming provided the most economical and environmentally sound manure application strategy. (Contains 15 references.) (MDH)

48 CFR 217.7405 - Plans and reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Plans and reports. 217.7405 Section 217.7405 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Undefinitized Contract Actions 217.7405 Plans and reports. (a)...

48 CFR 217.7405 - Plans and reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Plans and reports. 217.7405 Section 217.7405 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Undefinitized Contract Actions 217.7405 Plans and reports. (a)...

An adequacy-constrained integrated planning method for effective accommodation of DG and electric vehicles in smart distribution systems

NASA Astrophysics Data System (ADS)

Tan, Zhukui; Xie, Baiming; Zhao, Yuanliang; Dou, Jinyue; Yan, Tong; Liu, Bin; Zeng, Ming

2018-06-01

This paper presents a new integrated planning framework for effective accommodating electric vehicles in smart distribution systems (SDS). The proposed method incorporates various investment options available for the utility collectively, including distributed generation (DG), capacitors and network reinforcement. Using a back-propagation algorithm combined with cost-benefit analysis, the optimal network upgrade plan, allocation and sizing of the selected components are determined, with the purpose of minimizing the total system capital and operating costs of DG and EV accommodation. Furthermore, a new iterative reliability test method is proposed. It can check the optimization results by subsequently simulating the reliability level of the planning scheme, and modify the generation reserve margin to guarantee acceptable adequacy levels for each year of the planning horizon. Numerical results based on a 32-bus distribution system verify the effectiveness of the proposed method.

Online survey software as a data collection tool for medical education: A case study on lesson plan assessment.

PubMed

Kimiafar, Khalil; Sarbaz, Masoumeh; Sheikhtaheri, Abbas

2016-01-01

Background: There are no general strategies or tools to evaluate daily lesson plans; however, assessments conducted using traditional methods usually include course plans. This study aimed to evaluate the strengths and weaknesses of online survey software in collecting data on education in medical fields and the application of such softwares to evaluate students' views and modification of lesson plans. Methods: After investigating the available online survey software, esurveypro was selected for assessing daily lesson plans. After using the software for one semester, a questionnaire was prepared to assess the advantages and disadvantages of this method and students' views in a cross-sectional study. Results: The majority of the students (51.7%) rated the evaluation of classes per session (lesson plans) using the online survey as useful or very useful. About 51% (n=36) of the students considered this method effective in improving the management of each session, 67.1% (n=47) considered it effective in improving the management of sessions for the next semester, and 51.4% (n=36) said it had a high impact on improving the educational content of subsequent sessions. Finally, 61.4% (n=43) students expressed high and very high levels of satisfaction with using an online survey at each session. Conclusion: The use of online surveys may be appropriate to improve lesson plans and educational planning at different levels. This method can be used for other evaluations and for assessing people's opinions at different levels of an educational system.

Scheduling of House Development Projects with CPM and PERT Method for Time Efficiency (Case Study: House Type 36)

NASA Astrophysics Data System (ADS)

Kholil, Muhammad; Nurul Alfa, Bonitasari; Hariadi, Madjumsyah

2018-04-01

Network planning is one of the management techniques used to plan and control the implementation of a project, which shows the relationship between activities. The objective of this research is to arrange network planning on house construction project on CV. XYZ and to know the role of network planning in increasing the efficiency of time so that can be obtained the optimal project completion period. This research uses descriptive method, where the data collected by direct observation to the company, interview, and literature study. The result of this research is optimal time planning in project work. Based on the results of the research, it can be concluded that the use of the both methods in scheduling of house construction project gives very significant effect on the completion time of the project. The company’s CPM (Critical Path Method) method can complete the project with 131 days, PERT (Program Evaluation Review and Technique) Method takes 136 days. Based on PERT calculation obtained Z = -0.66 or 0,2546 (from normal distribution table), and also obtained the value of probability or probability is 74,54%. This means that the possibility of house construction project activities can be completed on time is high enough. While without using both methods the project completion time takes 173 days. So using the CPM method, the company can save time up to 42 days and has time efficiency by using network planning.

Diabetes Diet: Create Your Healthy-Eating Plan

MedlinePlus

... methods works for you: The plate method. The American Diabetes Association offers a simple seven-step method of meal ... complications. Diabetes meal plans and a healthy diet. American Diabetes Association. http://www.diabetes.org/food-and-fitness/food/ ...

SU-E-T-287: Robustness Study of Passive-Scattering Proton Therapy in Lung: Is Range and Setup Uncertainty Calculation On the Initial CT Enough to Predict the Plan Robustness?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, X; Dormer, J; Kenton, O

Purpose: Plan robustness of the passive-scattering proton therapy treatment of lung tumors has been studied previously using combined uncertainties of 3.5% in CT number and 3 mm geometric shifts. In this study, we investigate whether this method is sufficient to predict proton plan robustness by comparing to plans performed on weekly verification CT scans. Methods: Ten lung cancer patients treated with passive-scattering proton therapy were randomly selected. All plans were prescribed 6660cGy in 37 fractions. Each initial plan was calculated using +/− 3.5% range and +/− 0.3cm setup uncertainty in x, y and z directions in Eclipse TPS(Method-A). Throughout themore » treatment course, patients received weekly verification CT scans to assess the daily treatment variation(Method-B). After contours and imaging registrations are verified by the physician, the initial plan with the same beamline and compensator was mapped into the verification CT. Dose volume histograms (DVH) were evaluated for robustness study. Results: Differences are observed between method A and B in terms of iCTV coverage and lung dose. Method-A shows all the iCTV D95 are within +/− 1% difference, while 20% of cases fall outside +/−1% range in Method-B. In the worst case scenario(WCS), the iCTV D95 is reduced by 2.5%. All lung V5 and V20 are within +/−5% in Method-A while 15% of V5 and 10% of V20 fall outside of +/−5% in Method-B. In the WCS, Lung V5 increased by 15% and V20 increased by 9%. Method A and B show good agreement with regard to cord maximum and Esophagus mean dose. Conclusion: This study suggests that using range and setup uncertainty calculation (+/−3.5% and +/−3mm) may not be sufficient to predict the WCS. In the absence of regular verification scans, expanding the conventional uncertainty parameters(e.g., to +/−3.5% and +/−4mm) may be needed to better reflect plan actual robustness.« less

TH-EF-BRB-05: 4pi Non-Coplanar IMRT Beam Angle Selection by Convex Optimization with Group Sparsity Penalty

DOE Office of Scientific and Technical Information (OSTI.GOV)

O’Connor, D; Nguyen, D; Voronenko, Y

Purpose: Integrated beam orientation and fluence map optimization is expected to be the foundation of robust automated planning but existing heuristic methods do not promise global optimality. We aim to develop a new method for beam angle selection in 4π non-coplanar IMRT systems based on solving (globally) a single convex optimization problem, and to demonstrate the effectiveness of the method by comparison with a state of the art column generation method for 4π beam angle selection. Methods: The beam angle selection problem is formulated as a large scale convex fluence map optimization problem with an additional group sparsity term thatmore » encourages most candidate beams to be inactive. The optimization problem is solved using an accelerated first-order method, the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). The beam angle selection and fluence map optimization algorithm is used to create non-coplanar 4π treatment plans for several cases (including head and neck, lung, and prostate cases) and the resulting treatment plans are compared with 4π treatment plans created using the column generation algorithm. Results: In our experiments the treatment plans created using the group sparsity method meet or exceed the dosimetric quality of plans created using the column generation algorithm, which was shown superior to clinical plans. Moreover, the group sparsity approach converges in about 3 minutes in these cases, as compared with runtimes of a few hours for the column generation method. Conclusion: This work demonstrates the first non-greedy approach to non-coplanar beam angle selection, based on convex optimization, for 4π IMRT systems. The method given here improves both treatment plan quality and runtime as compared with a state of the art column generation algorithm. When the group sparsity term is set to zero, we obtain an excellent method for fluence map optimization, useful when beam angles have already been selected. NIH R43CA183390, NIH R01CA188300, Varian Medical Systems; Part of this research took place while D. O’Connor was a summer intern at RefleXion Medical.« less

TU-AB-BRB-00: New Methods to Ensure Target Coverage

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2015-06-15

The accepted clinical method to accommodate targeting uncertainties inherent in fractionated external beam radiation therapy is to utilize GTV-to-CTV and CTV-to-PTV margins during the planning process to design a PTV-conformal static dose distribution on the planning image set. Ideally, margins are selected to ensure a high (e.g. >95%) target coverage probability (CP) in spite of inherent inter- and intra-fractional positional variations, tissue motions, and initial contouring uncertainties. Robust optimization techniques, also known as probabilistic treatment planning techniques, explicitly incorporate the dosimetric consequences of targeting uncertainties by including CP evaluation into the planning optimization process along with coverage-based planning objectives. Themore » treatment planner no longer needs to use PTV and/or PRV margins; instead robust optimization utilizes probability distributions of the underlying uncertainties in conjunction with CP-evaluation for the underlying CTVs and OARs to design an optimal treated volume. This symposium will describe CP-evaluation methods as well as various robust planning techniques including use of probability-weighted dose distributions, probability-weighted objective functions, and coverage optimized planning. Methods to compute and display the effect of uncertainties on dose distributions will be presented. The use of robust planning to accommodate inter-fractional setup uncertainties, organ deformation, and contouring uncertainties will be examined as will its use to accommodate intra-fractional organ motion. Clinical examples will be used to inter-compare robust and margin-based planning, highlighting advantages of robust-plans in terms of target and normal tissue coverage. Robust-planning limitations as uncertainties approach zero and as the number of treatment fractions becomes small will be presented, as well as the factors limiting clinical implementation of robust planning. Learning Objectives: To understand robust-planning as a clinical alternative to using margin-based planning. To understand conceptual differences between uncertainty and predictable motion. To understand fundamental limitations of the PTV concept that probabilistic planning can overcome. To understand the major contributing factors to target and normal tissue coverage probability. To understand the similarities and differences of various robust planning techniques To understand the benefits and limitations of robust planning techniques.« less

Optimization of the scheme for natural ecology planning of urban rivers based on ANP (analytic network process) model.

PubMed

Zhang, Yichuan; Wang, Jiangping

2015-07-01

Rivers serve as a highly valued component in ecosystem and urban infrastructures. River planning should follow basic principles of maintaining or reconstructing the natural landscape and ecological functions of rivers. Optimization of planning scheme is a prerequisite for successful construction of urban rivers. Therefore, relevant studies on optimization of scheme for natural ecology planning of rivers is crucial. In the present study, four planning schemes for Zhaodingpal River in Xinxiang City, Henan Province were included as the objects for optimization. Fourteen factors that influenced the natural ecology planning of urban rivers were selected from five aspects so as to establish the ANP model. The data processing was done using Super Decisions software. The results showed that important degree of scheme 3 was highest. A scientific, reasonable and accurate evaluation of schemes could be made by ANP method on natural ecology planning of urban rivers. This method could be used to provide references for sustainable development and construction of urban rivers. ANP method is also suitable for optimization of schemes for urban green space planning and design.

Improved Virtual Planning for Bimaxillary Orthognathic Surgery.

PubMed

Hatamleh, Muhanad; Turner, Catherine; Bhamrah, Gurprit; Mack, Gavin; Osher, Jonas

2016-09-01

Conventional model surgery planning for bimaxillary orthognathic surgery can be laborious, time-consuming and may contain potential errors; hence three-dimensional (3D) virtual orthognathic planning has been proven to be an efficient, reliable, and cost-effective alternative. In this report, the 3D planning is described for a patient presenting with a Class III incisor relationship on a Skeletal III base with pan facial asymmetry complicated by reverse overjet and anterior open bite. A combined scan data of direct cone beam computer tomography and indirect dental scan were used in the planning. Additionally, a new method of establishing optimum intercuspation by scanning dental casts in final occlusion and positioning it to the composite-scans model was shown. Furthermore, conventional model surgery planning was carried out following in-house protocol. Intermediate and final intermaxillary splints were produced following the conventional method and 3D printing. Three-dimensional planning showed great accuracy and treatment outcome and reduced laboratory time in comparison with the conventional method. Establishing the final dental occlusion on casts and integrating it in final 3D planning enabled us to achieve the best possible intercuspation.

Planungsmodelle und Planungsmethoden. Anhaltspunkte zur Strukturierung und Gestaltung von Planungsprozessen

NASA Astrophysics Data System (ADS)

Diller, Christian; Karic, Sarah; Oberding, Sarah

2017-06-01

The topic of this article ist the question, in which phases oft he political planning process planners apply their methodological set of tools. That for the results of a research-project are presented, which were gained by an examination of planning-cases in learned journals. Firstly it is argued, which model oft he planning-process is most suitable to reflect the regarded cases and how it is positioned to models oft he political process. Thereafter it is analyzed, which types of planning methods are applied in the several stages oft he planning process. The central findings: Although complex, many planning processes can be thouroughly pictured by a linear modell with predominantly simple feedback loops. Even in times of he communicative turn, concerning their set of tools, planners should pay attention to apply not only communicative methods but as well the classical analytical-rational methods. They are helpful especially for the understanding of the political process before and after the actual planning phase.

Rotational-path decomposition based recursive planning for spacecraft attitude reorientation

NASA Astrophysics Data System (ADS)

Xu, Rui; Wang, Hui; Xu, Wenming; Cui, Pingyuan; Zhu, Shengying

2018-02-01

The spacecraft reorientation is a common task in many space missions. With multiple pointing constraints, it is greatly difficult to solve the constrained spacecraft reorientation planning problem. To deal with this problem, an efficient rotational-path decomposition based recursive planning (RDRP) method is proposed in this paper. The uniform pointing-constraint-ignored attitude rotation planning process is designed to solve all rotations without considering pointing constraints. Then the whole path is checked node by node. If any pointing constraint is violated, the nearest critical increment approach will be used to generate feasible alternative nodes in the process of rotational-path decomposition. As the planning path of each subdivision may still violate pointing constraints, multiple decomposition is needed and the reorientation planning is designed as a recursive manner. Simulation results demonstrate the effectiveness of the proposed method. The proposed method has been successfully applied in two SPARK microsatellites to solve onboard constrained attitude reorientation planning problem, which were developed by the Shanghai Engineering Center for Microsatellites and launched on 22 December 2016.

SU-E-T-628: A Cloud Computing Based Multi-Objective Optimization Method for Inverse Treatment Planning.

PubMed

Na, Y; Suh, T; Xing, L

2012-06-01

Multi-objective (MO) plan optimization entails generation of an enormous number of IMRT or VMAT plans constituting the Pareto surface, which presents a computationally challenging task. The purpose of this work is to overcome the hurdle by developing an efficient MO method using emerging cloud computing platform. As a backbone of cloud computing for optimizing inverse treatment planning, Amazon Elastic Compute Cloud with a master node (17.1 GB memory, 2 virtual cores, 420 GB instance storage, 64-bit platform) is used. The master node is able to scale seamlessly a number of working group instances, called workers, based on the user-defined setting account for MO functions in clinical setting. Each worker solved the objective function with an efficient sparse decomposition method. The workers are automatically terminated if there are finished tasks. The optimized plans are archived to the master node to generate the Pareto solution set. Three clinical cases have been planned using the developed MO IMRT and VMAT planning tools to demonstrate the advantages of the proposed method. The target dose coverage and critical structure sparing of plans are comparable obtained using the cloud computing platform are identical to that obtained using desktop PC (Intel Xeon® CPU 2.33GHz, 8GB memory). It is found that the MO planning speeds up the processing of obtaining the Pareto set substantially for both types of plans. The speedup scales approximately linearly with the number of nodes used for computing. With the use of N nodes, the computational time is reduced by the fitting model, 0.2+2.3/N, with r̂2>0.99, on average of the cases making real-time MO planning possible. A cloud computing infrastructure is developed for MO optimization. The algorithm substantially improves the speed of inverse plan optimization. The platform is valuable for both MO planning and future off- or on-line adaptive re-planning. © 2012 American Association of Physicists in Medicine.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qu, H; Yu, N; Qi, P

Purpose: In commercial secondary dose calculation system, an average effective depth is used to calculate the Monitor Units for an arc beam from the volumetric modulated arc (VMAT) plans. Typically, an arithmetic mean of the effective depths (AMED) of a VMAT arc beam is used, which may result in large MU discrepancy from that of the primary treatment planning system. This study is to demonstrate the use of a dose weighted mean effective depth (DWED) can improve accuracy of MU calculation for the secondary MU verification. Methods: In-house scripts were written in the primary treatment planning system (TPS) to firstmore » convert a VMAT arc beam to a series of static step & shoot beams (every 4 degree). The computed dose and effective depth of each static beam were then used to obtain the dose weighted mean effective depth (DWED) for the VMAT beam. The DWED was used for the secondary MU calculation for VMAT plans. Six lung SBRT VMAT plans, eight head and neck VMAT plans and ten prostate VMAT plans that had > 5% MU deviations (failed MU verification) using the AMED method were recalculated with the DWED. For comparison, same number VMAT plans that had < 5% MU deviations (passed MU verification) using AMED method were also reevaluated with the dose weighted mean effective depth method. Results: For MU verification passed plans, the mean and standard deviation of MU differences between the TPS and the secondary calculation program were 2.2%±1.5% for the AMED and 2.1%±1.7% for the DMED method. For the failed plans, the mean and standard deviation of MU differences of TPS to the secondary calculation program were 9.9%±4.7% and 4.7%±2.6, respectively. Conclusion: The dose weighted mean effective depth improved MU calculation accuracy which can be used for the pre-treatment MU verification of VMAT plans.« less

Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.

PubMed

Salcedo, Jennifer; Moniaga, Natalie; Harken, Tabetha

2015-08-01

The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned. We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center. Methods of planned and established postpartum contraceptive methods were recorded, as well as demographic information and documented reasons for failure to initiate planned intrauterine contraception. A total of 110 women planned postpartum IUD placement. Of these women, 84 (76%) presented for at least one postpartum appointment. Only 22.6% (95% confidence interval 13.7-31.5) of those presenting for postpartum follow-up underwent IUD placement within 8 weeks of delivery. Women planning postpartum IUD insertion were just as likely as women with no planned postpartum contraceptive method to fail to establish contraception within 8 weeks (P = 0.55). Failure to establish planned postpartum intrauterine contraception occurs frequently, even in a setting with a high rate of postpartum follow-up.

Group versus individual family planning counseling in Ghana: a randomized, noninferiority trial.

PubMed

Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J

2013-08-01

Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana. Copyright © 2013 Elsevier Inc. All rights reserved.

Power Distribution System Planning with GIS Consideration

NASA Astrophysics Data System (ADS)

Wattanasophon, Sirichai; Eua-Arporn, Bundhit

This paper proposes a method for solving radial distribution system planning problems taking into account geographical information. The proposed method can automatically determine appropriate location and size of a substation, routing of feeders, and sizes of conductors while satisfying all constraints, i.e. technical constraints (voltage drop and thermal limit) and geographical constraints (obstacle, existing infrastructure, and high-cost passages). Sequential quadratic programming (SQP) and minimum path algorithm (MPA) are applied to solve the planning problem based on net price value (NPV) consideration. In addition this method integrates planner's experience and optimization process to achieve an appropriate practical solution. The proposed method has been tested with an actual distribution system, from which the results indicate that it can provide satisfactory plans.

A needs analysis method for land-use planning of illegal dumping sites: a case study in Aomori-Iwate, Japan.

PubMed

Ishii, Kazuei; Furuichi, Toru; Nagao, Yukari

2013-02-01

Land use at contaminated sites, following remediation, is often needed for regional redevelopment. However, there exist few methods of developing economically and socially feasible land-use plans based on regional needs because of the wide variety of land-use requirements. This study proposes a new needs analysis method for the conceptual land-use planning of contaminated sites and illustrates this method with a case study of an illegal dumping site for hazardous waste. In this method, planning factors consisting of the land-use attributes and related facilities are extracted from the potential needs of the residents through a preliminary questionnaire. Using the extracted attributes of land use and the related facilities, land-use cases are designed for selection-based conjoint analysis. A second questionnaire for respondents to the first one who indicated an interest in participating in the second questionnaire is conducted for the conjoint analysis to determine the utility function and marginal cost of each attribute in order to prioritize the planning factors to develop a quantitative and economically and socially feasible land-use plan. Based on the results, site-specific land-use alternatives are developed and evaluated by the utility function obtained from the conjoint analysis. In this case study of an illegal dumping site for hazardous waste, the uses preferred as part of a conceptual land-use plan following remediation of the site were (1) agricultural land and a biogas plant designed to recover energy from biomass or (2) a park with a welfare facility and an athletic field. Our needs analysis method with conjoint analysis is applicable to the development of conceptual land-use planning for similar sites following remediation, particularly when added value is considered. Copyright © 2012 Elsevier Ltd. All rights reserved.

SU-G-TeP1-05: Development and Clinical Introduction of Automated Radiotherapy Treatment Planning for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winkel, D; Bol, GH; Asselen, B van

Purpose: To develop an automated radiotherapy treatment planning and optimization workflow for prostate cancer in order to generate clinical treatment plans. Methods: A fully automated radiotherapy treatment planning and optimization workflow was developed based on the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). To evaluate our method, a retrospective planning study (n=100) was performed on patients treated for prostate cancer with 5 field intensity modulated radiotherapy, receiving a dose of 35×2Gy to the prostate and vesicles and a simultaneous integrated boost of 35×0.2Gy to the prostate only. A comparison was made between the dosimetric values of the automatically andmore » manually generated plans. Operator time to generate a plan and plan efficiency was measured. Results: A comparison of the dosimetric values show that automatically generated plans yield more beneficial dosimetric values. In automatic plans reductions of 43% in the V72Gy of the rectum and 13% in the V72Gy of the bladder are observed when compared to the manually generated plans. Smaller variance in dosimetric values is seen, i.e. the intra- and interplanner variability is decreased. For 97% of the automatically generated plans and 86% of the clinical plans all criteria for target coverage and organs at risk constraints are met. The amount of plan segments and monitor units is reduced by 13% and 9% respectively. Automated planning requires less than one minute of operator time compared to over an hour for manual planning. Conclusion: The automatically generated plans are highly suitable for clinical use. The plans have less variance and a large gain in time efficiency has been achieved. Currently, a pilot study is performed, comparing the preference of the clinician and clinical physicist for the automatic versus manual plan. Future work will include expanding our automated treatment planning method to other tumor sites and develop other automated radiotherapy workflows.« less

Multi-agent planning and scheduling, execution monitoring and incremental rescheduling: Application to motorway traffic

NASA Technical Reports Server (NTRS)

Mourou, Pascal; Fade, Bernard

1992-01-01

This article describes a planning method applicable to agents with great perception and decision-making capabilities and the ability to communicate with other agents. Each agent has a task to fulfill allowing for the actions of other agents in its vicinity. Certain simultaneous actions may cause conflicts because they require the same resource. The agent plans each of its actions and simultaneously transmits these to its neighbors. In a similar way, it receives plans from the other agents and must take account of these plans. The planning method allows us to build a distributed scheduling system. Here, these agents are robot vehicles on a highway communicating by radio. In this environment, conflicts between agents concern the allocation of space in time and are connected with the inertia of the vehicles. Each vehicle made a temporal, spatial, and situated reasoning in order to drive without collision. The flexibility and reactivity of the method presented here allows the agent to generate its plan based on assumptions concerning the other agents and then check these assumptions progressively as plans are received from the other agents. A multi-agent execution monitoring of these plans can be done, using data generated during planning and the multi-agent decision-making algorithm described here. A selective backtrack allows us to perform incremental rescheduling.

The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

2016-01-01

Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

A Set of Planning Tools for School Leaders & Teams: Differentiated Planning.

ERIC Educational Resources Information Center

Miles, Bruce H.

This presentation outline with overheads demonstrates differentiated planning, a system with four separate planning methods designed to reduce confusion and increase staff commitment to planning efforts. Differentiated planning involves: (1) prioritization (used for single question issues, multiple question issues, and as a follow-up to the…

Three-dimensional virtual planning in orthognathic surgery enhances the accuracy of soft tissue prediction.

PubMed

Van Hemelen, Geert; Van Genechten, Maarten; Renier, Lieven; Desmedt, Maria; Verbruggen, Elric; Nadjmi, Nasser

2015-07-01

Throughout the history of computing, shortening the gap between the physical and digital world behind the screen has always been strived for. Recent advances in three-dimensional (3D) virtual surgery programs have reduced this gap significantly. Although 3D assisted surgery is now widely available for orthognathic surgery, one might still argue whether a 3D virtual planning approach is a better alternative to a conventional two-dimensional (2D) planning technique. The purpose of this study was to compare the accuracy of a traditional 2D technique and a 3D computer-aided prediction method. A double blind randomised prospective study was performed to compare the prediction accuracy of a traditional 2D planning technique versus a 3D computer-aided planning approach. The accuracy of the hard and soft tissue profile predictions using both planning methods was investigated. There was a statistically significant difference between 2D and 3D soft tissue planning (p < 0.05). The statistically significant difference found between 2D and 3D planning and the actual soft tissue outcome was not confirmed by a statistically significant difference between methods. The 3D planning approach provides more accurate soft tissue planning. However, the 2D orthognathic planning is comparable to 3D planning when it comes to hard tissue planning. This study provides relevant results for choosing between 3D and 2D planning in clinical practice. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

PubMed Central

Spindler, Esther; Bitar, Nisreen; Solo, Julie; Menstell, Elizabeth; Shattuck, Dominick

2017-01-01

Health practitioners, researchers, and donors are stumped about Jordan's stalled fertility rate, which has stagnated between 3.7 and 3.5 children per woman from 2002 to 2012, above the national replacement level of 2.1. This stall paralleled United States Agency for International Development (USAID) funding investments in family planning in Jordan, triggering an assessment of USAID family planning programming in Jordan. This article describes the methods, results, and implications of the programmatic assessment. Methods included an extensive desk review of USAID programs in Jordan and 69 interviews with reproductive health stakeholders. We explored reasons for fertility stagnation in Jordan's total fertility rate (TFR) and assessed the effects of USAID programming on family planning outcomes over the same time period. The assessment results suggest that the increased use of less effective methods, in particular withdrawal and condoms, are contributing to Jordan's TFR stall. Jordan's limited method mix, combined with strong sociocultural determinants around reproduction and fertility desires, have contributed to low contraceptive effectiveness in Jordan. Over the same time period, USAID contributions toward increasing family planning access and use, largely focused on service delivery programs, were extensive. Examples of effective initiatives, among others, include task shifting of IUD insertion services to midwives due to a shortage of female physicians. However, key challenges to improved use of family planning services include limited government investments in family planning programs, influential service provider behaviors and biases that limit informed counseling and choice, pervasive strong social norms of family size and fertility, and limited availability of different contraceptive methods. In contexts where sociocultural norms and a limited method mix are the dominant barriers toward improved family planning use, increased national government investments toward synchronized service delivery and social and behavior change activities may be needed to catalyze national-level improvements in family planning outcomes. PMID:29284697

SU-G-BRC-02: A Novel Multi-Criteria Optimization Approach to Generate Deliverable Intensity-Modulated Radiation Therapy (IMRT) Treatment Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirlik, G; D’Souza, W; Zhang, H

2016-06-15

Purpose: To present a novel multi-criteria optimization (MCO) solution approach that generates treatment plans with deliverable apertures using column generation. Methods: We demonstrate our method with 10 locally advanced head-and-neck cancer cases retrospectively. In our MCO formulation, we defined an objective function for each structure in the treatment volume. This resulted in 9 objective functions, including 3 distinct objectives for primary target volume, high-risk and low-risk target volumes, 5 objectives for each of the organs-at-risk (OARs) (two parotid glands, spinal cord, brain stem and oral cavity), and one for the non-target non-OAR normal tissue. Conditional value-at-risk (CVaR) constraints were utilizedmore » to ensure at least certain fraction of the target volumes receiving the prescription doses. To directly generate deliverable plans, column generation algorithm was embedded within our MCO approach for aperture shape generation. Final dose distributions for all plans were generated using a Monte Carlo kernel-superposition dose calculation. We compared the MCO plans with the clinical plans, which were created by clinicians. Results: At least 95% target coverage was achieved by both MCO plans and clinical plans. However, the average conformity indices of clinical plans and the MCO plans were 1.95 and 1.35, respectively (31% reduction, p<0.01). Compared to the conventional clinical plan, the proposed MCO method achieved average reductions in left parotid mean dose of 5% (p=0.06), right parotid mean dose of 18% (p<0.01), oral cavity mean dose of 21% (p=0.03), spinal cord maximum dose of 20% (p<0.01), brain stem maximum dose of 61% (p<0.01), and normal tissue maximum dose of 5% (p<0.01), respectively. Conclusion: We demonstrated that the proposed MCO method was able to obtain deliverable IMRT treatment plans while achieving significant improvements in dosimetric plan quality.« less

Men and family planning in Portugal.

PubMed

Vicente, A

1993-10-01

Although family planning services in Portugal are open to everybody, male and female, and they are free of charge, it is mostly women who are using the services, since family planning services have integrated maternal health care. Between 1978 and 1981, the Commission for the Portuguese Commission for Equality and Women's Rights implemented a family planning information, education, and communication project under technical and financial aid by the United Nations Population Fund. During a training course for a group of 12 women, which took place in the small town Vialonga near Lisbon in 1992, all women said that their husbands did not play any role in family planning. The choice of the method was their sole responsibility. In 1988, data were gathered by the General Direction of Primary Health Care from the local health services. 17.6% of women used the pill, and 28% practiced coitus interruptus. Condom use amounted to 5.7%. Other methods were the IUD (7.3%), natural methods (3.6%), spermicides (2.6%), the diaphragm (0.3%), and sterilization (female 3.6%; male 0.3%). In 1992, the Commission published a study on family planning, involving 638 men and 882 women, which concluded that the responsibility for family planning was no longer exclusively with women and that young, single people were in favor of family planning information sessions. The Portuguese Constitution states that the state shall promote a wider knowledge of family planning methods and responsible parenthood. The Health Secretary of State ordered the integration of family planning into the National Health Service in 1976. A 1984 law, Sex Education and Family Planning, and a 1985 Government Order constitute the legal framework for the practice of family planning. The Commission for Equality and Women's Rights has been implementing information, education, and communication activities since 1976. One of the members of the Consultative Council is the Association for Family Planning, which has also been disseminating information, training, and counselling since it was founded in 1967.

On-line Adaptive Radiation Treatment of Prostate Cancer

DTIC Science & Technology

2009-01-01

12]. For intensity modulated radiation therapy (IMRT) plans , the beamlet weight can be re-optimized on a daily basis to mini- mize the dose to the OAR...Thongphiew D, Wang Z, Mathayomchan B, Chankong V, Yoo S, et al. On-line re-optimization of prostate IMRT plans for adaptive radiation therapy . Phys Med Biol...time. The treatment planning method for VMAT however is not mature. We are developing a robust VMAT treatment planning method which incorporates

Development of Financial Plans for Regional Transportation Plans - Methods, Data and Issues

DOT National Transportation Integrated Search

1997-01-01

This paper focuses on the portion of the Financial Plan for the Regional Transportation Plan (RTP) dealing with the road system in Southeast Michigan Council of Governments (SEMCOG) metropolitan planning region under the jurisdiction of county road a...

SU-E-T-279: Realization of Three-Dimensional Conformal Dose Planning in Prostate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Z; Jiang, S; Yang, Z

2014-06-01

Purpose: Successful clinical treatment in prostate brachytherapy is largely dependent on the effectiveness of pre-surgery dose planning. Conventional dose planning method could hardly arrive at a satisfy result. In this abstract, a three-dimensional conformal localized dose planning method is put forward to ensure the accuracy and effectiveness of pre-implantation dose planning. Methods: Using Monte Carlo method, the pre-calculated 3-D dose map for single source is obtained. As for multiple seeds dose distribution, the maps are combined linearly to acquire the 3-D distribution. The 3-D dose distribution is exhibited in the form of isodose surface together with reconstructed 3-D organs groupmore » real-timely. Then it is possible to observe the dose exposure to target volume and normal tissues intuitively, thus achieving maximum dose irradiation to treatment target and minimum healthy tissues damage. In addition, the exfoliation display of different isodose surfaces can be realized applying multi-values contour extraction algorithm based on voxels. The needles could be displayed in the system by tracking the position of the implanted seeds in real time to conduct block research in optimizing insertion trajectory. Results: This study extends dose planning from two-dimensional to three-dimensional, realizing the three-dimensional conformal irradiation, which could eliminate the limitations of 2-D images and two-dimensional dose planning. A software platform is developed using VC++ and Visualization Toolkit (VTK) to perform dose planning. The 3-D model reconstruction time is within three seconds (on a Intel Core i5 PC). Block research could be conducted to avoid inaccurate insertion into sensitive organs or internal obstructions. Experiments on eight prostate cancer cases prove that this study could make the dose planning results more reasonable. Conclusion: The three-dimensional conformal dose planning method could improve the rationality of dose planning by safely reducing the large target margin and avoiding dose dead zones for prostate cancer treatment. 1) National Natural Science Foundation of People's Republic of China (No. 51175373); 2) New Century Educational Talents Plan of Chinese Education Ministry (NCET-10-0625); 3) Scientific and Technological Major Project, Tianjin (No. 12ZCDZSY10600)« less

Online survey software as a data collection tool for medical education: A case study on lesson plan assessment

PubMed Central

Kimiafar, Khalil; Sarbaz, Masoumeh; Sheikhtaheri, Abbas

2016-01-01

Background: There are no general strategies or tools to evaluate daily lesson plans; however, assessments conducted using traditional methods usually include course plans. This study aimed to evaluate the strengths and weaknesses of online survey software in collecting data on education in medical fields and the application of such softwares to evaluate students' views and modification of lesson plans. Methods: After investigating the available online survey software, esurveypro was selected for assessing daily lesson plans. After using the software for one semester, a questionnaire was prepared to assess the advantages and disadvantages of this method and students’ views in a cross-sectional study. Results: The majority of the students (51.7%) rated the evaluation of classes per session (lesson plans) using the online survey as useful or very useful. About 51% (n=36) of the students considered this method effective in improving the management of each session, 67.1% (n=47) considered it effective in improving the management of sessions for the next semester, and 51.4% (n=36) said it had a high impact on improving the educational content of subsequent sessions. Finally, 61.4% (n=43) students expressed high and very high levels of satisfaction with using an online survey at each session. Conclusion: The use of online surveys may be appropriate to improve lesson plans and educational planning at different levels. This method can be used for other evaluations and for assessing people’s opinions at different levels of an educational system. PMID:28491839

Optimal helicopter trajectory planning for terrain following flight

NASA Technical Reports Server (NTRS)

Menon, P. K. A.

1990-01-01

Helicopters operating in high threat areas have to fly close to the earth surface to minimize the risk of being detected by the adversaries. Techniques are presented for low altitude helicopter trajectory planning. These methods are based on optimal control theory and appear to be implementable onboard in realtime. Second order necessary conditions are obtained to provide a criterion for finding the optimal trajectory when more than one extremal passes through a given point. A second trajectory planning method incorporating a quadratic performance index is also discussed. Trajectory planning problem is formulated as a differential game. The objective is to synthesize optimal trajectories in the presence of an actively maneuvering adversary. Numerical methods for obtaining solutions to these problems are outlined. As an alternative to numerical method, feedback linearizing transformations are combined with the linear quadratic game results to synthesize explicit nonlinear feedback strategies for helicopter pursuit-evasion. Some of the trajectories generated from this research are evaluated on a six-degree-of-freedom helicopter simulation incorporating an advanced autopilot. The optimal trajectory planning methods presented are also useful for autonomous land vehicle guidance.

Utility of learning plans in general practice vocational training: a mixed-methods national study of registrar, supervisor, and educator perspectives.

PubMed

Garth, Belinda; Kirby, Catherine; Silberberg, Peter; Brown, James

2016-08-19

Learning plans are a compulsory component of the training and assessment requirements of general practice (GP) registrars in Australia. There is a small but growing number of studies reporting that learning plans are not well accepted or utilised in general practice training. There is a lack of research examining this apparent contradiction. The aim of this study was to examine use and perceived utility of formal learning plans in GP vocational training. This mixed-method Australian national research project utilised online learning plan usage data from 208 GP registrars and semi-structured focus groups and telephone interviews with 35 GP registrars, 12 recently fellowed GPs, 16 supervisors and 17 medical educators across three Regional Training Providers (RTPs). Qualitative data were analysed thematically using template analysis. Learning plans were used mostly as a log of activities rather than as a planning tool. Most learning needs were entered and ticked off as complete on the same day. Learning plans were perceived as having little value for registrars in their journey to becoming a competent GP, and as a bureaucratic hurdle serving as a distraction rather than an aid to learning. The process of learning planning was valued more so than the documentation of learning planning. This study provides creditable evidence that mandated learning plans are broadly considered by users to be a bureaucratic impediment with little value as a learning tool. It is more important to support registrars in planning their learning than to enforce documentation of this process in a learning plan. If learning planning is to be an assessed competence, methods of assessment other than the submission of a formal learning plan should be explored.

30 CFR 48.3 - Training plans; time of submission; where filed; information required; time for approval; method...

Code of Federal Regulations, 2013 CFR

2013-07-01

... will be given for each course. (5) A description of the teaching methods and the course materials which...; information required; time for approval; method for disapproval; commencement of training; approval of....3 Training plans; time of submission; where filed; information required; time for approval; method...

30 CFR 48.3 - Training plans; time of submission; where filed; information required; time for approval; method...

Code of Federal Regulations, 2011 CFR

2011-07-01

... will be given for each course. (5) A description of the teaching methods and the course materials which...; information required; time for approval; method for disapproval; commencement of training; approval of....3 Training plans; time of submission; where filed; information required; time for approval; method...

30 CFR 48.3 - Training plans; time of submission; where filed; information required; time for approval; method...

Code of Federal Regulations, 2012 CFR

2012-07-01

... will be given for each course. (5) A description of the teaching methods and the course materials which...; information required; time for approval; method for disapproval; commencement of training; approval of....3 Training plans; time of submission; where filed; information required; time for approval; method...

30 CFR 48.3 - Training plans; time of submission; where filed; information required; time for approval; method...

Code of Federal Regulations, 2010 CFR

2010-07-01

... will be given for each course. (5) A description of the teaching methods and the course materials which...; information required; time for approval; method for disapproval; commencement of training; approval of....3 Training plans; time of submission; where filed; information required; time for approval; method...

30 CFR 48.3 - Training plans; time of submission; where filed; information required; time for approval; method...

Code of Federal Regulations, 2014 CFR

2014-07-01

... will be given for each course. (5) A description of the teaching methods and the course materials which...; information required; time for approval; method for disapproval; commencement of training; approval of....3 Training plans; time of submission; where filed; information required; time for approval; method...

Perceived Risks Associated with Contraceptive Method Use among Men and Women in Ibadan and Kaduna, Nigeria.

PubMed

Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana E; Saad, Abdulmumin

2015-12-01

Research shows that side effects are often the most common reason for contraceptive non-use in Nigeria; however, research to date has not explored the underlying factors that influence risk and benefit perceptions associated with specific contraceptive methods in Nigeria. A qualitative study design using focus group discussions was used to explore social attitudes and beliefs about family planning methods in Ibadan and Kaduna, Nigeria. A total of 26 focus group discussions were held in 2010 with men and women of reproductive age, disaggregated by city, sex, age, marital status, neighborhood socioeconomic status, and--for women only--family planning experience. A discussion guide was used that included specific questions about the perceived risks and benefits associated with the use of six different family planning methods. A thematic content analytic approach guided the analysis. Participants identified a spectrum of risks encompassing perceived threats to health (both real and fictitious) and social concerns, as well as benefits associated with each method. By exploring Nigerian perspectives on the risks and benefits associated with specific family planning methods, programs aiming to increase contraceptive use in Nigeria can be better equipped to highlight recognized benefits, address specific concerns, and work to dispel misperceptions associated with each family planning method.

Method and system for entering data within a flight plan entry field

NASA Technical Reports Server (NTRS)

Gibbs, Michael J. (Inventor); Van Omen, Debi (Inventor); Adams, Michael B. (Inventor); Chase, Karl L. (Inventor); Lewis, Daniel E. (Inventor); McCrobie, Daniel E. (Inventor)

2005-01-01

The present invention provides systems, apparatus and methods for entering data into a flight plan entry field which facilitates the display and editing of aircraft flight-plan data. In one embodiment, the present invention provides a method for entering multiple waypoint and procedure identifiers at once within a single a flight plan entry field. In another embodiment, the present invention provides for the partial entry of any waypoint or procedure identifiers, and thereafter relating the identifiers with an aircraft's flight management system to anticipate the complete text entry for display. In yet another embodiment, the present invention discloses a method to automatically provide the aircraft operator with selectable prioritized arrival and approach routing identifiers by a single manual selection. In another embodiment, the present invention is a method for providing the aircraft operator with selectable alternate patterns to a new runway.

Automatic repositioning of jaw segments for three-dimensional virtual treatment planning of orthognathic surgery.

PubMed

Santos, Rodrigo Mologni Gonçalves Dos; De Martino, José Mario; Passeri, Luis Augusto; Attux, Romis Ribeiro de Faissol; Haiter Neto, Francisco

2017-09-01

To develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. The method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered. Cone-beam computed tomographic images acquired from four preoperative patients with skeletal malocclusion were used for evaluating the method. Dentofacial problems of the four patients were rectified, including skeletal malocclusion, facial asymmetry, and jaw discrepancies. The results show that the method is potentially able to be used in routine clinical practice as support for treatment-planning decisions in orthognathic surgery. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Documenting Preservice Teacher Growth through Critical Assessment of Online Lesson Plans

ERIC Educational Resources Information Center

Cude, Michelle D.; Haraway, Dana L.

2017-01-01

This research explores the question of how students in a social studies methods course improve skills in analyzing and critiquing pre-existing lesson plans. It utilizes a pre-post authentic assessment tool to measure student growth in key skills of lesson plan critique over the course of one semester's methods instruction. The results support the…

Benefits of Using Planned Comparisons Rather Than Post Hoc Tests: A Brief Review with Examples.

ERIC Educational Resources Information Center

DuRapau, Theresa M.

The rationale behind analysis of variance (including analysis of covariance and multiple analyses of variance and covariance) methods is reviewed, and unplanned and planned methods of evaluating differences between means are briefly described. Two advantages of using planned or a priori tests over unplanned or post hoc tests are presented. In…

RELAP-7 Software Verification and Validation Plan: Requirements Traceability Matrix (RTM) Part 1 – Physics and numerical methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choi, Yong Joon; Yoo, Jun Soo; Smith, Curtis Lee

2015-09-01

This INL plan comprehensively describes the Requirements Traceability Matrix (RTM) on main physics and numerical method of the RELAP-7. The plan also describes the testing-based software verification and validation (SV&V) process—a set of specially designed software models used to test RELAP-7.

Planning for Schools of Choice: Achieving Equity and Excellence. Book II--Planning Guide.

ERIC Educational Resources Information Center

Clinchy, Evans; Kolb, Frances Arick, Ed.

Designed to aid school personnel considering school choice as a possible desegregation method, this booklet explains the principles of controlled choice, presents an overall plan and flow chart, and reviews the types of organizations that might be developed. Controlled choice is a desegregation method that is voluntary, empowers parents and school…

Methodology for Planning Technical Education: With a Case Study of Polytechnics in Bangladesh.

ERIC Educational Resources Information Center

Ritzen, Jozef M.; Balderston, Judith B.

A product of research first begun by one of the authors in Bangladesh, this book develops a comprehensive set of methods for planning technical education. Wherever possible, the authors draw on existing tools, fitting them to the specific context of technical education. When faced with planning problems for which existing methods are ill suited…

Method and apparatus for planning motions of robot manipulators

DOEpatents

Chen, Pang C.; Hwang, Yong K.

1996-01-01

Method and apparatus for automatically planning motions of robot manipulators. The invention rapidly finds a collision-free path in a cluttered robot environment, if one exists, from any starting configuration of the robot manipulator to any ending configuration. The time to solution of a motion planning problem is not uniform, but proportional to the complexity of the problem.

42 CFR 59.5 - What requirements must be met by a family planning project?

Code of Federal Regulations, 2010 CFR

2010-10-01

...). If an organization offers only a single method of family planning, it may participate as part of a... status. (5) Not provide abortion as a method of family planning. A project must: (i) Offer pregnant women...) about which the pregnant woman indicates she does not wish to receive such information and counseling...

Planning for the Aging: A Manual of Practical Methods.

ERIC Educational Resources Information Center

Cotton, Frank E., Jr.

This manual is divided into three major parts. Part One explores the role and process of planning delivery services to the aging, including leadership. Part Two offers several methods for carrying out each of seven steps delineated in the planning process, and describes their application to the delivery of services for the aging. Part Three…

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

Using gEUD based plan analysis method to evaluate proton vs. photon plans for lung cancer radiation therapy.

PubMed

Xiao, Zhiyan; Zou, Wei J; Chen, Ting; Yue, Ning J; Jabbour, Salma K; Parikh, Rahul; Zhang, Miao

2018-03-01

The goal of this study was to exam the efficacy of current DVH based clinical guidelines draw from photon experience for lung cancer radiation therapy on proton therapy. Comparison proton plans and IMRT plans were generated for 10 lung patients treated in our proton facility. A gEUD based plan evaluation method was developed for plan evaluation. This evaluation method used normal lung gEUD(a) curve in which the model parameter "a" was sampled from the literature reported value. For all patients, the proton plans delivered lower normal lung V 5 Gy with similar V 20 Gy and similar target coverage. Based on current clinical guidelines, proton plans were ranked superior to IMRT plans for all 10 patients. However, the proton and IMRT normal lung gEUD(a) curves crossed for 8 patients within the tested range of "a", which means there was a possibility that proton plan would be worse than IMRT plan for lung sparing. A concept of deficiency index (DI) was introduced to quantify the probability of proton plans doing worse than IMRT plans. By applying threshold on DI, four patients' proton plan was ranked inferior to the IMRT plan. Meanwhile if a threshold to the location of curve crossing was applied, 6 patients' proton plan was ranked inferior to the IMRT plan. The contradictory ranking results between the current clinical guidelines and the gEUD(a) curve analysis demonstrated there is potential pitfalls by applying photon experience directly to the proton world. A comprehensive plan evaluation based on radio-biological models should be carried out to decide if a lung patient would really be benefit from proton therapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Quality assessment for VMAT prostate radiotherapy planning based on data envelopment analysis

NASA Astrophysics Data System (ADS)

Lin, Kuan-Min; Simpson, John; Sasso, Giuseppe; Raith, Andrea; Ehrgott, Matthias

2013-08-01

The majority of commercial radiotherapy treatment planning systems requires planners to iteratively adjust the plan parameters in order to find a satisfactory plan. This iterative trial-and-error nature of radiotherapy treatment planning results in an inefficient planning process and in order to reduce such inefficiency, plans can be accepted without achieving the best attainable quality. We propose a quality assessment method based on data envelopment analysis (DEA) to address this inefficiency. This method compares a plan of interest to a set of past delivered plans and searches for evidence of potential further improvement. With the assistance of DEA, planners will be able to make informed decisions on whether further planning is required and ensure that a plan is only accepted when the plan quality is close to the best attainable one. We apply the DEA method to 37 prostate plans using two assessment parameters: rectal generalized equivalent uniform dose (gEUD) as the input and D95 (the minimum dose that is received by 95% volume of a structure) of the planning target volume (PTV) as the output. The percentage volume of rectum overlapping PTV is used to account for anatomical variations between patients and is included in the model as a non-discretionary output variable. Five plans that are considered of lesser quality by DEA are re-optimized with the goal to further improve rectal sparing. After re-optimization, all five plans improve in rectal gEUD without clinically considerable deterioration of the PTV D95 value. For the five re-optimized plans, the rectal gEUD is reduced by an average of 1.84 Gray (Gy) with only an average reduction of 0.07 Gy in PTV D95. The results demonstrate that DEA can correctly identify plans with potential improvements in terms of the chosen input and outputs.

Preparation for an online asynchronous university doctoral course. Lessons learned.

PubMed

Milstead, J A; Nelson, R

1998-01-01

This article addresses the development of the initial course in the first completely online doctoral program in nursing. Synchronous and asynchronous methods of distance education were assessed. Planning focused at the university, school, and course levels. University planning involved the technical infrastructure, registration, student services, and library services. School planning examined administrative commitment and faculty commitment and willingness. Course planning focused on marketing, precourse information, time frame, modular design, planned interaction, and professor availability and support. Implementation issues centered on getting students connected, learning the software, changing instructional methods, and managing chats. Traditional methods of evaluating student learning and course evaluation were supplemented with the development of qualitative and quantitative tools to gather data for making administrative decisions. The Dean and faculty agreed that the internet was an effective method of delivering content in the initial Health Policy course. The Dean and faculty agreed to continue the PhD program online for one cohort and continue to evaluate student progress and faculty and student satisfaction.

Looking to the future: Framing the implementation of interprofessional education and practice with scenario planning.

PubMed

Forman, Dawn; Nicol, Pam; Nicol, Paul

2015-01-01

Adapting to interprofessional education and practice requires a change of perspective for many health professionals. We aimed to explore the potential of scenario planning to bridge the understanding gap and framing strategic planning for interprofessional education (IPE) and practice (IPP), as well as to implement innovative techniques and technology for large-group scenario planning. A full-day scenario planning workshop incorporating innovative methodology was designed and offered to participants. The 71 participants included academics from nine universities, as well as service providers, government, students and consumer organisations. The outcomes were evaluated by statistical and thematic analysis of a mixed method survey questionnaire. The scenario planning method resulted in a positive response as a means of collaboratively exploring current knowledge and broadening entrenched attitudes. It was perceived to be an effective instrument for framing strategy for the implementation of IPE/IPP, with 81 percent of respondents to a post-workshop survey indicating they would consider using scenario planning in their own organisations. The scenario planning method can be used by tertiary academic institutions as a strategy in developing, implementing and embedding IPE, and for the enculturation of IPP in practice settings.

Factors determining family planning in Catalonia. Sources of inequity

PubMed Central

2012-01-01

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 use family planning methods (36.68%, 38.59% and 70.51%, respectively). Conclusions The use of family planning methods is positively related to a higher level of education and having children over 14. Factors such as sex, age, income and self-perceived health do not appear to influence their use. Furthermore, being a native of this country, the European Union or Central/South America represents a greater likelihood of use than being African or Asian. Although no general differences in use were found between sexes, the difference found in the case of Asian women stands out, with a higher likelihood of use. PMID:22818829

Coordinating robot motion, sensing, and control in plans. LDRD project final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xavier, P.G.; Brown, R.G.; Watterberg, P.A.

1997-08-01

The goal of this project was to develop a framework for robotic planning and execution that provides a continuum of adaptability with respect to model incompleteness, model error, and sensing error. For example, dividing robot motion into gross-motion planning, fine-motion planning, and sensor-augmented control had yielded productive research and solutions to individual problems. Unfortunately, these techniques could only be combined by hand with ad hoc methods and were restricted to systems where all kinematics are completely modeled in planning. The original intent was to develop methods for understanding and autonomously synthesizing plans that coordinate motion, sensing, and control. The projectmore » considered this problem from several perspectives. Results included (1) theoretical methods to combine and extend gross-motion and fine-motion planning; (2) preliminary work in flexible-object manipulation and an implementable algorithm for planning shortest paths through obstacles for the free-end of an anchored cable; (3) development and implementation of a fast swept-body distance algorithm; and (4) integration of Sandia`s C-Space Toolkit geometry engine and SANDROS motion planer and improvements, which yielded a system practical for everyday motion planning, with path-segment planning at interactive speeds. Results (3) and (4) have either led to follow-on work or are being used in current projects, and they believe that (2) will eventually be also.« less

[The family planning program in Rwanda: assessment of ten years (1981-1991) and prospects].

PubMed

Munyakazi, A

1990-12-01

Rwanda's official family planning policy dates back to 1981 and creation of the National Office of Population (ONAPO). Among its other function, ONAPO monitors proper use of family planning methods and studies the integration of family planning services into public health. Pilot family planning programs began in the prefectures of Butare, Kigali, and Ruhengeri and were extended to the other 7 around 1985. The development of family planning services in Rwanda is based on their integration into existing services, especially those devoted to maternal-child health. In 1989, 277 of the 350 health centers of all kinds in Rwanda and 12 secondary posts offered family planning services. The rate of integration was 79.4%. 185 of the 277 health services with family planning services were in the public sector. As of December 1989, the rate of integration in different prefectures varied from a high of 95.5% in Kibungo to a low of 64.9% in Gisenyi. Integration is particularly weak in health facilities administered by the Catholic Church. The 2 strategies to confront this situation are continuing dialogue with Catholic Church officials and creation of secondary family planning posts to improve accessibility to family planning for populations served by Church health services. The number of new and continuing family planning users increased from 1178 and 1368 respectively in 1982 to 66,950 and 104,604 through September 1990. There is wide variation from 1 prefecture to another in recruitment of new acceptors and in the number of acceptors per health facility. Recruitment of new acceptors is greatest in Ruhengeri, followed by Kigali and Byumba. As of September 1990, 28,943 women used pills, 2037 used IUDs, 66,515 used injectables, 3051 used barrier methods, 2888 used auto-observation methods, 343 used implants, and 588 were sterilized. The overall rate of contraceptive prevalence increased from .9% in 1983 to 6.2% in 1989 and 10% in 1990. The strategy for promoting family planning has included training of personnel, improvement of supervision, regular supply of contraceptive equipment and supplies to health supervision, regular supply of contraceptive equipment and supplies to health centers, diversification of available methods, and addition of secondary family planning posts to improve accessibility. Obstacles still affecting Rwanda's family planning program include the pronatalist cultural orientation, which is being confronted by a vigorous IEC program. The reluctance of Catholic-affiliated health services to offer modern family planning methods, the shortage of trained family planning workers, contraceptive supply problems, and geographic inaccessibility of family planning services are other serious problems. To confront these problems, ONAPO plans to begin social marketing program, create more secondary health planning posts, promote integration of family planning services into the vaccination program, strengthen efforts to motivate postpartum women, and undertake a community distribution program for condoms and spermicides.

Family planning use among urban poor women from six cities of Uttar Pradesh, India.

PubMed

Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K

2012-08-01

Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 05: A novel respiratory motion simulation program for VMAT treatment plans: a phantom validation study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hubley, Emily; Pierce, Greg; Ploquin, Nicolas

Purpose: To develop and validate a computational method to simulate craniocaudal respiratory motion in a VMAT treatment plan. Methods: Three 4DCTs of the QUASAR respiratory motion phantom were acquired with a 2cm water-density spherical tumour embedded in cedar to simulate lung. The phantom was oscillating sinusoidally with an amplitude of 2cm and periods of 3, 4, and 5 seconds. An ITV was contoured and 5mm PTV margin was added. High and a low modulation factor VMAT plans were created for each scan. An in-house program was developed to simulate respiratory motion in the treatment plans by shifting the MLC leafmore » positions relative to the phantom. Each plan was delivered to the phantom and the dose was measured using Gafchromic film. The measured and calculated plans were compared using an absolute dose gamma analysis (3%/3mm). Results: The average gamma pass rate for the low modulation plan and high modulation plans were 91.1% and 51.4% respectively. The difference between the high and low modulation plans gamma pass rates is likely related to the different sampling frequency of the respiratory curve and the higher MLC leaf speeds in the high modulation plan. A high modulation plan has a slower gantry speed and therefore samples the breathing cycle at a coarser frequency leading to inaccuracies between the measured and planned doses. Conclusion: A simple program, including a novel method for increasing sampling frequency beyond the control point frequency, has been developed to simulate respiratory motion in VMAT plans by shifting the MLC leaf positions.« less

Production Planning and Planting Pattern Scheduling Information System for Horticulture

NASA Astrophysics Data System (ADS)

Vitadiar, Tanhella Zein; Farikhin; Surarso, Bayu

2018-02-01

This paper present the production of planning and planting pattern scheduling faced by horticulture farmer using two methods. Fuzzy time series method use to predict demand on based on sales amount, while linear programming is used to assist horticulture farmers in making production planning decisions and determining the schedule of cropping patterns in accordance with demand predictions of the fuzzy time series method, variable use in this paper is size of areas, production advantage, amount of seeds and age of the plants. This research result production planning and planting patterns scheduling information system with the output is recommendations planting schedule, harvest schedule and the number of seeds will be plant.

Interdisciplinary Care Planning and the Written Care Plan in Nursing Homes: A Critical Review

ERIC Educational Resources Information Center

Dellefield, Mary Ellen

2006-01-01

Purpose: This article is a critical review of the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes. Design and Methods: We reviewed educational and empirical literature. Results: Interdisciplinary care planning and the written care plan are…

40 CFR 62.14580 - What is a waste management plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 9 2014-07-01 2014-07-01 false What is a waste management plan? 62... Construction On or Before November 30, 1999 Waste Management Plan § 62.14580 What is a waste management plan? A waste management plan is a written plan that identifies both the feasibility and the methods used to...

40 CFR 60.2055 - What is a waste management plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 7 2013-07-01 2013-07-01 false What is a waste management plan? 60... Industrial Solid Waste Incineration Units Waste Management Plan § 60.2055 What is a waste management plan? A waste management plan is a written plan that identifies both the feasibility and the methods used to...

40 CFR 62.14580 - What is a waste management plan?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 9 2012-07-01 2012-07-01 false What is a waste management plan? 62... Construction On or Before November 30, 1999 Waste Management Plan § 62.14580 What is a waste management plan? A waste management plan is a written plan that identifies both the feasibility and the methods used to...

40 CFR 60.2055 - What is a waste management plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 7 2014-07-01 2014-07-01 false What is a waste management plan? 60... Industrial Solid Waste Incineration Units Waste Management Plan § 60.2055 What is a waste management plan? A waste management plan is a written plan that identifies both the feasibility and the methods used to...

40 CFR 62.14580 - What is a waste management plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 9 2013-07-01 2013-07-01 false What is a waste management plan? 62... Construction On or Before November 30, 1999 Waste Management Plan § 62.14580 What is a waste management plan? A waste management plan is a written plan that identifies both the feasibility and the methods used to...

29 CFR 4207.7 - Liability for subsequent complete withdrawals and related adjustments for allocating unfunded...

Code of Federal Regulations, 2010 CFR

2010-07-01

... uses either the “presumptive” or the “direct attribution” method (section 4211(b) or (c)(4), respectively) for allocating unfunded vested benefits, the plan shall modify those allocation methods as... using “presumptive” method. In a plan using the “presumptive” allocation method under section 4211(b) of...

IAEA Sampling Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geist, William H.

2017-09-15

The objectives for this presentation are to describe the method that the IAEA uses to determine a sampling plan for nuclear material measurements; describe the terms detection probability and significant quantity; list the three nuclear materials measurement types; describe the sampling method applied to an item facility; and describe multiple method sampling.

Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harding, R., E-mail: ruth.harding2@wales.nhs.uk; Trnková, P.; Lomax, A. J.

Purpose: Base of skull meningioma can be treated with both intensity modulated radiation therapy (IMRT) and spot scanned proton therapy (PT). One of the main benefits of PT is better sparing of organs at risk, but due to the physical and dosimetric characteristics of protons, spot scanned PT can be more sensitive to the uncertainties encountered in the treatment process compared with photon treatment. Therefore, robustness analysis should be part of a comprehensive comparison between these two treatment methods in order to quantify and understand the sensitivity of the treatment techniques to uncertainties. The aim of this work was tomore » benchmark a spot scanning treatment planning system for planning of base of skull meningioma and to compare the created plans and analyze their robustness to setup errors against the IMRT technique. Methods: Plans were produced for three base of skull meningioma cases: IMRT planned with a commercial TPS [Monaco (Elekta AB, Sweden)]; single field uniform dose (SFUD) spot scanning PT produced with an in-house TPS (PSI-plan); and SFUD spot scanning PT plan created with a commercial TPS [XiO (Elekta AB, Sweden)]. A tool for evaluating robustness to random setup errors was created and, for each plan, both a dosimetric evaluation and a robustness analysis to setup errors were performed. Results: It was possible to create clinically acceptable treatment plans for spot scanning proton therapy of meningioma with a commercially available TPS. However, since each treatment planning system uses different methods, this comparison showed different dosimetric results as well as different sensitivities to setup uncertainties. The results confirmed the necessity of an analysis tool for assessing plan robustness to provide a fair comparison of photon and proton plans. Conclusions: Robustness analysis is a critical part of plan evaluation when comparing IMRT plans with spot scanned proton therapy plans.« less

Intentions to use contraceptives in Pakistan: implications for behavior change campaigns

PubMed Central

2010-01-01

Background Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan. Methods In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods. Results Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization. The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods. Conclusions These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan. PMID:20673374

How "the best" companies use MRP (materiel requirements planning) and just-in-time for successful manufacturing.

PubMed

Spencer, M S

1994-08-01

A study of production planning and control methods used in six leading companies found that a blending strategy is more effective than reliance on a single system. The blending of just-in-time and materiel requirements planning and other approaches allowed companies to select methods that best fit the unique characteristics of their production environments.

Sulfur Oxides Risk and Exposure Assessment Planning ...

EPA Pesticide Factsheets

In conducting risk/exposure assessments for the Sulfur Oxides NAAQS review, EPA will first develop a draft Scope and Methods Plan which will describe the proposed scope of the quantitative and qualitative analyses to be performed and the tools/methods that may be employed Provide opportunity for CASAC feedback on EPA's plans for the risk and exposure assessment for the Sulfur Oxides NAAQS review

Coupling the biophysical and social dimensions of wildfire risk to improve wildfire mitigation planning

Treesearch

Alan A. Ager; Jeffrey D. Kline; A. Paige Fisher

2015-01-01

We describe recent advances in biophysical and social aspects of risk and their potential combined contribution to improve mitigation planning on fire-prone landscapes. The methods and tools provide an improved method for defining the spatial extent of wildfire risk to communities compared to current planning processes. They also propose an expanded role for social...

Utilizing Strategic and Operational Methods for Whole-Community Disaster Planning.

PubMed

Franks, Stevee; Seaton, Ellen

2017-12-01

Analysis of response and recovery efforts to disasters over the past 2 decades has identified a consistent gap that plagues the nation in regard to persons with access and functional needs. This gap can be highlighted by Hurricane Katrina, where the majority of those killed were a part of the access and functional needs population. After a disaster, many individuals with access and functional needs require assistance recovering but often have difficulty accessing services and resources. These difficulties are due to a combination of issues, such as health problems and the disruption of community support services. We sought to help bridge this gap by focusing on strategic and operational methods used while planning for the whole community. This article highlights the many partnerships that must be fostered for successful whole-community planning. These partnerships include, but are not limited to, local government departments, health agencies, nonprofit and nongovernmental organizations, and other volunteer organizations. We showcase these methods by using a developmental Post-Disaster Canvassing Plan to highlight planning methods that may aid jurisdictions across the United States in disaster planning for the whole community. (Disaster Med Public Health Preparedness. 2017;11:741-746).

SU-E-J-122: The CBCT Dose Calculation Using a Patient Specific CBCT Number to Mass Density Conversion Curve Based On a Novel Image Registration and Organ Mapping Method in Head-And-Neck Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, J; Lasio, G; Chen, S

2015-06-15

Purpose: To develop a CBCT HU correction method using a patient specific HU to mass density conversion curve based on a novel image registration and organ mapping method for head-and-neck radiation therapy. Methods: There are three steps to generate a patient specific CBCT HU to mass density conversion curve. First, we developed a novel robust image registration method based on sparseness analysis to register the planning CT (PCT) and the CBCT. Second, a novel organ mapping method was developed to transfer the organs at risk (OAR) contours from the PCT to the CBCT and corresponding mean HU values of eachmore » OAR were measured in both the PCT and CBCT volumes. Third, a set of PCT and CBCT HU to mass density conversion curves were created based on the mean HU values of OARs and the corresponding mass density of the OAR in the PCT. Then, we compared our proposed conversion curve with the traditional Catphan phantom based CBCT HU to mass density calibration curve. Both curves were input into the treatment planning system (TPS) for dose calculation. Last, the PTV and OAR doses, DVH and dose distributions of CBCT plans are compared to the original treatment plan. Results: One head-and-neck cases which contained a pair of PCT and CBCT was used. The dose differences between the PCT and CBCT plans using the proposed method are −1.33% for the mean PTV, 0.06% for PTV D95%, and −0.56% for the left neck. The dose differences between plans of PCT and CBCT corrected using the CATPhan based method are −4.39% for mean PTV, 4.07% for PTV D95%, and −2.01% for the left neck. Conclusion: The proposed CBCT HU correction method achieves better agreement with the original treatment plan compared to the traditional CATPhan based calibration method.« less

Excess Benefit Plans and Other Nonqualified Deferred Compensation Palns Under ERISA

ERIC Educational Resources Information Center

Vogel, Mark A.

1977-01-01

The benefits of and restrictions imposed on qualified pension and profit-sharing plans are discussed in terms of Excess Benefit Plans (EPB), a type of deferred compensation plan. EPBs and unfunded deferred compensation plans offer flexible methods of providing additional benefits for executives and key employees. (LBH)

Care planning for aggression management in a specialist secure mental health service: An audit of user involvement.

PubMed

Hallett, Nutmeg; Huber, Jörg W; Sixsmith, Judith; Dickens, Geoffrey L

2016-12-01

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation. © 2016 Australian College of Mental Health Nurses Inc.

Two-phase Computerized Planning of Cryosurgery Using Bubble-packing and Force-field Analogy

PubMed Central

Tanaka, Daigo; Shimada, Kenji; Rabin, Yoed

2007-01-01

Background: Cryosurgery is the destruction of undesired tissues by freezing, as in prostate cryosurgery, for example. Minimally-invasive cryosurgery is currently performed by means of an array of cryoprobes, each in the shape of a long hypodermic needle. The optimal arrangement of the cryoprobes, which is known to have a dramatic effect on the quality of the cryoprocedure, remains an art held by the cryosurgeon, based on the cryosurgeon's experience and “rules of thumb.” An automated computerized technique for cryosurgery planning is the subject matter of the current report, in an effort to improve the quality of cryosurgery. Method of Approach: A two-phase optimization method is proposed for this purpose, based on two previous and independent developments by this research team. Phase I is based on a bubble-packing method, previously used as an efficient method for finite elements meshing. Phase II is based on a force-field analogy method, which has proven to be robust at the expense of a typically long runtime. Results: As a proof-of-concept, results are demonstrated on a 2D case of a prostate cross-section. The major contribution of this study is to affirm that in many instances cryosurgery planning can be performed without extremely expensive simulations of bioheat transfer, achieved in Phase I. Conclusions: This new method of planning has proven to reduce planning runtime from hours to minutes, making automated planning practical in a clinical time frame. PMID:16532617

Impact of the 1985 Space World Administrative Radio Conference on frequency/orbit planning and use

NASA Technical Reports Server (NTRS)

Miller, E. F.

1986-01-01

The 1985 World Administrative Radio Conference (WARC-ORB-85) was held to determine which space radio services should be planned and which planning methods should be used. The second session of this Conference (WARC-ORB-88) will meet to develop the required plans. This paper presents the results of WARC-ORB-85, assesses the impact of those decisions, and identifies the intersessional work to be conducted by administrations and the CCIR (Consultative Committee on International Radio). The major decisions of WARC-ORB-85 were: (1) the restriction of additional planning to the fixed satellite service at identified frequencies; and (2) the selection of a planning method consisting of two parts (a) an allotment plan, and (b) improved procedures. The paper also discusses WARC-ORB-85 decisions relative to the Region 2 broadcast satellite service plans at 12 GHz, feederlink planning for Regions 1 and 3 broadcast satellites at 12 GHz, and sound broadcast satellite service.

29 CFR 4050.3 - Method of distribution for missing participants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Method of distribution for missing participants. 4050.3... TERMINATIONS MISSING PARTICIPANTS § 4050.3 Method of distribution for missing participants. The plan administrator of a terminating plan must distribute benefits for each missing participant by— (a) Purchasing...

29 CFR 4050.3 - Method of distribution for missing participants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Method of distribution for missing participants. 4050.3... TERMINATIONS MISSING PARTICIPANTS § 4050.3 Method of distribution for missing participants. The plan administrator of a terminating plan must distribute benefits for each missing participant by— (a) Purchasing...

29 CFR 4050.3 - Method of distribution for missing participants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Method of distribution for missing participants. 4050.3... TERMINATIONS MISSING PARTICIPANTS § 4050.3 Method of distribution for missing participants. The plan administrator of a terminating plan must distribute benefits for each missing participant by— (a) Purchasing...

29 CFR 4050.3 - Method of distribution for missing participants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Method of distribution for missing participants. 4050.3... TERMINATIONS MISSING PARTICIPANTS § 4050.3 Method of distribution for missing participants. The plan administrator of a terminating plan must distribute benefits for each missing participant by— (a) Purchasing...

29 CFR 4050.3 - Method of distribution for missing participants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false Method of distribution for missing participants. 4050.3... TERMINATIONS MISSING PARTICIPANTS § 4050.3 Method of distribution for missing participants. The plan administrator of a terminating plan must distribute benefits for each missing participant by— (a) Purchasing...

Factors determining family planning in Catalonia. Sources of inequity.

PubMed

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 70.51%, respectively). The use of family planning methods is positively related to a higher level of education and having children over 14. Factors such as sex, age, income and self-perceived health do not appear to influence their use. Furthermore, being a native of this country, the European Union or Central/South America represents a greater likelihood of use than being African or Asian. Although no general differences in use were found between sexes, the difference found in the case of Asian women stands out, with a higher likelihood of use.

A mission planning concept and mission planning system for future manned space missions

NASA Technical Reports Server (NTRS)

Wickler, Martin

1994-01-01

The international character of future manned space missions will compel the involvement of several international space agencies in mission planning tasks. Additionally, the community of users requires a higher degree of freedom for experiment planning. Both of these problems can be solved by a decentralized mission planning concept using the so-called 'envelope method,' by which resources are allocated to users by distributing resource profiles ('envelopes') which define resource availabilities at specified times. The users are essentially free to plan their activities independently of each other, provided that they stay within their envelopes. The new developments were aimed at refining the existing vague envelope concept into a practical method for decentralized planning. Selected critical functions were exercised by planning an example, founded on experience acquired by the MSCC during the Spacelab missions D-1 and D-2. The main activity regarding future mission planning tasks was to improve the existing MSCC mission planning system, using new techniques. An electronic interface was developed to collect all formalized user inputs more effectively, along with an 'envelope generator' for generation and manipulation of the resource envelopes. The existing scheduler and its data base were successfully replaced by an artificial intelligence scheduler. This scheduler is not only capable of handling resource envelopes, but also uses a new technology based on neuronal networks. Therefore, it is very well suited to solve the future scheduling problems more efficiently. This prototype mission planning system was used to gain new practical experience with decentralized mission planning, using the envelope method. In future steps, software tools will be optimized, and all data management planning activities will be embedded into the scheduler.

Planning for retirement from medicine: a mixed-methods study

PubMed Central

Pannor Silver, Michelle; Easty, Laura K.

2017-01-01

Background: Evidence suggests there are important personal and social consequences associated with inadequate retirement planning for physicians. We evaluated whether academic physicians felt satisfied with their retirement planning, and identified obstacles to retirement planning and a set of factors to facilitate retirement planning. Methods: We applied a sequential mixed-methods research design to explore and examine factors that facilitate academic physician retirement planning using data collected from multiple sources (including 7 focus groups, an internet-based survey and 23 in-depth interviews). We examined survey results regarding retirement planning satisfaction and preferences for complete versus gradual retirement. We used thematic analysis to examine verbatim transcripts and notes from the focus groups and interviews. Results: Survey data (response rate 51%) indicated that 10% of respondents were very satisfied with their retirement planning and 89.5% would prefer to retire gradually rather than stop work completely. Key barriers to retirement planning that emerged included poor personal financial management, rigid institutional structures and professional norms. Facilitators included financial planning resources for physicians at multiple career stages, opportunities and resources for later-career transitions and later-career mentorship support for intergenerational collaboration, and recognition of retirees. Interpretation: Key findings highlight perceived barriers to retirement planning at various career stages in addition to factors that can enhance physicians' retirement planning, including creating gradual and flexible retirement options, supporting ongoing discussions about financial planning and later career transitions, and fostering a culture that continues to honour and involve retirees. Medical institutions could foster innovative models for later-career transitions from medicine in ways that address physicians' needs at various career stages, support gradual transitions from practice and recognize the value of experienced, capable later-career physicians and retirees. PMID:28401128

Planning 4D intensity-modulated arc therapy for tumor tracking with a multileaf collimator

NASA Astrophysics Data System (ADS)

Niu, Ying; Betzel, Gregory T.; Yang, Xiaocheng; Gui, Minzhi; Parke, William C.; Yi, Byongyong; Yu, Cedric X.

2017-02-01

This study introduces a practical four-dimensional (4D) planning scheme of IMAT using 4D computed tomography (4D CT) for planning tumor tracking with dynamic multileaf beam collimation. We assume that patients can breathe regularly, i.e. the same way as during 4D CT with an unchanged period and amplitude, and that the start of 4D-IMAT delivery can be synchronized with a designated respiratory phase. Each control point of the IMAT-delivery process can be associated with an image set of 4D CT at a specified respiratory phase. Target is contoured at each respiratory phase without a motion-induced margin. A 3D-IMAT plan is first optimized on a reference-phase image set of 4D CT. Then, based on the projections of the planning target volume in the beam’s eye view at different respiratory phases, a 4D-IMAT plan is generated by transforming the segments of the optimized 3D plan by using a direct aperture deformation method. Compensation for both translational and deformable tumor motion is accomplished, and the smooth delivery of the transformed plan is ensured by forcing connectivity between adjacent angles (control points). It is envisioned that the resultant plans can be delivered accurately using the dose rate regulated tracking method which handles breathing irregularities (Yi et al 2008 Med. Phys. 35 3955-62).This planning process is straightforward and only adds a small step to current clinical 3D planning practice. Our 4D planning scheme was tested on three cases to evaluate dosimetric benefits. The created 4D-IMAT plans showed similar dose distributions as compared with the 3D-IMAT plans on a single static phase, indicating that our method is capable of eliminating the dosimetric effects of breathing induced target motion. Compared to the 3D-IMAT plans with large treatment margins encompassing respiratory motion, our 4D-IMAT plans reduced radiation doses to surrounding normal organs and tissues.

Changes in contraceptive use and method mix in Pakistan: 1990-91 to 2006-07.

PubMed

Carton, Thomas W; Agha, Sohail

2012-03-01

To determine (a) whether the influence of the determinants of family planning use in Pakistan changed between 1990-91 and 2006-07, and (b) if these changes were associated with changes in the method mix. Data from the Pakistan Demographic and Health Surveys (PDHS) of 1990-91 and 2006-07 were used in the analyses. Data on 5184 married, non-pregnant, fecund women in 1990-91 and 8041 married, non-pregnant, fecund women in 2006-07 were used. Logistic regression analysis was used to identify factors associated with the use of any contraceptive method and whether the influence of these factors changed between the survey years. Changes in the method mix were examined. The effects of urban/rural residence, wealth and education on contraceptive use changed between 1990-91 and 2006-07. Differentials in contraceptive use by residence, wealth and education declined and were accompanied by changes in the method mix. In rural areas and among less-educated women, the contribution of traditional methods to the method mix increased. Among the poorest women, the method mix shifted towards traditional methods and condoms. Less-educated, rural, Pakistani women increased the use of family planning at a faster rate than more-educated, urban, women by adopting the use of traditional family planning methods. Poor women also increased family planning use more quickly than non-poor women, by adopting condoms and traditional methods. The more rapid increase in the demand for family planning among poorer, less-educated, rural women is a positive trend. In order to convert this demand into the use of longer-term modern methods, however, access to high quality services must be improved in rural and low-income urban areas.

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

PubMed

Hernandez, Julie H; Muanda, Mbadu; Garcia, Mélissa; Matawa, Grace

2017-09-01

Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.

Fast approximate delivery of fluence maps for IMRT and VMAT

NASA Astrophysics Data System (ADS)

Balvert, Marleen; Craft, David

2017-02-01

In this article we provide a method to generate the trade-off between delivery time and fluence map matching quality for dynamically delivered fluence maps. At the heart of our method lies a mathematical programming model that, for a given duration of delivery, optimizes leaf trajectories and dose rates such that the desired fluence map is reproduced as well as possible. We begin with the single fluence map case and then generalize the model and the solution technique to the delivery of sequential fluence maps. The resulting large-scale, non-convex optimization problem was solved using a heuristic approach. We test our method using a prostate case and a head and neck case, and present the resulting trade-off curves. Analysis of the leaf trajectories reveals that short time plans have larger leaf openings in general than longer delivery time plans. Our method allows one to explore the continuum of possibilities between coarse, large segment plans characteristic of direct aperture approaches and narrow field plans produced by sliding window approaches. Exposing this trade-off will allow for an informed choice between plan quality and solution time. Further research is required to speed up the optimization process to make this method clinically implementable.

A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

NASA Astrophysics Data System (ADS)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

2018-01-01

The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

Two-phase computerized planning of cryosurgery using bubble-packing and force-field analogy.

PubMed

Tanaka, Daigo; Shimada, Kenji; Rabin, Yoed

2006-02-01

Cryosurgery is the destruction of undesired tissues by freezing, as in prostate cryosurgery, for example. Minimally invasive cryosurgery is currently performed by means of an array of cryoprobes, each in the shape of a long hypodermic needle. The optimal arrangement of the cryoprobes, which is known to have a dramatic effect on the quality of the cryoprocedure, remains an art held by the cryosurgeon, based on the cryosurgeon's experience and "rules of thumb." An automated computerized technique for cryosurgery planning is the subject matter of the current paper, in an effort to improve the quality of cryosurgery. A two-phase optimization method is proposed for this purpose, based on two previous and independent developments by this research team. Phase I is based on a bubble-packing method, previously used as an efficient method for finite element meshing. Phase II is based on a force-field analogy method, which has proven to be robust at the expense of a typically long runtime. As a proof-of-concept, results are demonstrated on a two-dimensional case of a prostate cross section. The major contribution of this study is to affirm that in many instances cryosurgery planning can be performed without extremely expensive simulations of bioheat transfer, achieved in Phase I. This new method of planning has proven to reduce planning runtime from hours to minutes, making automated planning practical in a clinical time frame.

Planning for Downtown Circulation Systems. Volume 2. Analysis Techniques.

DOT National Transportation Integrated Search

1983-10-01

This volume contains the analysis and refinement stages of downtown circulator planning. Included are sections on methods for estimating patronage, costs, revenues, and impacts, and a section on methods for performing micro-level analyses.

Planning a DSN support section technical library

NASA Technical Reports Server (NTRS)

Bailey, T.; Chatburn, C. C.

1980-01-01

The planning procedure being used to establish a technical library for the Deep Space Network support section is described. The inventory and survey methods employed are described and the preliminary results of these methods are discussed.

Location and Size Planning of Distributed Photovoltaic Generation in Distribution network System Based on K-means Clustering Analysis

NASA Astrophysics Data System (ADS)

Lu, Siqi; Wang, Xiaorong; Wu, Junyong

2018-01-01

The paper presents a method to generate the planning scenarios, which is based on K-means clustering analysis algorithm driven by data, for the location and size planning of distributed photovoltaic (PV) units in the network. Taken the power losses of the network, the installation and maintenance costs of distributed PV, the profit of distributed PV and the voltage offset as objectives and the locations and sizes of distributed PV as decision variables, Pareto optimal front is obtained through the self-adaptive genetic algorithm (GA) and solutions are ranked by a method called technique for order preference by similarity to an ideal solution (TOPSIS). Finally, select the planning schemes at the top of the ranking list based on different planning emphasis after the analysis in detail. The proposed method is applied to a 10-kV distribution network in Gansu Province, China and the results are discussed.

26 CFR 1.401(a)(26)-7 - Testing methods.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Testing methods. 1.401(a)(26)-7 Section 1.401(a... (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.401(a)(26)-7 Testing methods... the rules in § 1.401(a)(26)-5. (b) Simplified testing method. A plan is treated as satisfying the...

Overview of U.S. EPA Office of Research and Development’s planned research on analysis and monitoring in fresh and coastal/estuarine environments

EPA Science Inventory

This research plan has several objectives: 1) develop new or refine existing chemical, instrument and biological methods for the detection of cyanobacteria and their toxins; test such methods in field studies in both HAB and non HAB environments; 2) determine the method(s) that c...

SU-E-T-492: Implementing a Method for Brain Irradiation in Rats Utilizing a Commercially Available Radiosurgery Irradiator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cates, J; Drzymala, R

2014-06-01

Purpose: The purpose of the study was to implement a method for accurate rat brain irradiation using the Gamma Knife Perfexion unit. The system needed to be repeatable, efficient, and dosimetrically and spatially accurate. Methods: A platform (“rat holder”) was made such that it is attachable to the Leskell Gamma Knife G Frame. The rat holder utilizes two ear bars contacting bony anatomy and a front tooth bar to secure the rat. The rat holder fits inside of the Leskell localizer box, which utilizes fiducial markers to register with the GammaPlan planning system. This method allows for accurate, repeatable setup.Amore » cylindrical phantom was made so that film can be placed axially in the phantom. We then acquired CT image sets of the rat holder and localizer box with both a rat and the phantom. Three treatment plans were created: a plan on the rat CT dataset, a phantom plan with the same prescription dose as the rat plan, and a phantom plan with the same delivery time as the rat plan. Results: Film analysis from the phantom showed that our setup is spatially accurate and repeatable. It is also dosimetrically accurate, with an difference between predicted and measured dose of 2.9%. Film analysis with prescription dose equal between rat and phantom plans showed a difference of 3.8%, showing that our phantom is a good representation of the rat for dosimetry purposes, allowing for +/- 3mm diameter variation. Film analysis with treatment time equal showed an error of 2.6%, which means we can deliver a prescription dose within 3% accuracy. Conclusion: Our method for irradiation of rat brain has been shown to be repeatable, efficient, and accurate, both dosimetrically and spatially. We can treat a large number of rats efficiently while delivering prescription doses within 3% at millimeter level accuracy.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gopishankar, N; Agarwal, Priyanka; Bisht, Raj Kishor

Purpose: To evaluate forward and inverse planning methods for acoustic neuroma cases treated in Gamma Knife Perfexion. Methods: Five patients with acoustic neuroma tumour abutting brainstem were planned twice in LGP TPS (Version 10.1) using TMR10 algorithm. First plan was entirely based on forward planning (FP) in which each shot was chosen manually. Second plan was generated using inverse planning (IP) for which planning parameters like coverage, selectivity, gradient index (GI) and beam-on time threshold were set. Number of shots in IP was automatically selected by objective function using iterative process. In both planning methods MRI MPRAGE sequence images weremore » used for tumour localization and planning. A planning dose of 12Gy at 50% isodose level was chosen. Results and Discussion: Number of shots used in FP was greater than IP and beam-on time in FP was in average 1.4 times more than IP. One advantage of FP was that the brainstem volume subjected to 6Gy dose (25% isodose) was less in FP than IP. Our results showed use of more number of shots as in FP results in GI less than or equal to 2.55 which is close to its lower limit. Dose homogeneity index (DHI) analysis of FP and IP showed average values of 0.59 and 0.67 respectively. General trend in GK for planning in acoustic neuroma cases is to use small collimator shots to avoid dose to adjacent critical structures. More number of shots and prolonged treatment time causes inconvenience to the patients. Similarly overuse of automatic shot shaping as in IP results in increased scatter dose. A compromise is required in shot selection for these cases. Conclusion: IP method could be used in acoustic neuroma cases to decrease treatment time provided the source sector openings near brainstem are shielded or adjusted appropriately to reduce brainstem dose.« less

The weight of Thai infants exclusively breast-fed and formula-fed from birth to four months.

PubMed

Chavalittamrong, B; Jirapinyo, P

1987-05-01

The 18-month Industry-Based Family Planning Project, which involved 30 industrial establishments located in Metro Manila (Philippines), combined a heavy interpersonal component, through a network of trained in-plant volunteers (IPVs), with an intensive in-plant information campaign. The latter made use of seminars, audiovisual presentations, posters, brochures, leaflets, photo exhibits, and contests. Training of the project staff -- 5 project officers and a project coordinator -- included providing them with the knowledge, attitudes, and skills necessary to carry out their tasks. Tasks were: to transfer to the IPVs knowledge of the concept of responsible parenthood and the various family planning methods, skills in motivating other workers, and responding to rumors and misconceptions about family planning methods; to act as resource persons on responsible parenthood and family planning methods in the industry setting; and to provide the technical support to the IPVs on responsible parenthood. The campaign plan centered on strategies which would help achieve the project objective, i.e., to increase the demand for and the availability of family planning information and services using nongovernment and government organizations. Basically, the plan addressed 2 segments of the industrial sector: the workers as the primary audience and the company managers as the secondary target. According to the program's pro-choice policy, a wide range of approved family planning services were made available to interested employees either by accredited company clinics or outside family planning service centers. Services by outside family planning service clinics were delivered via referrals or, in some instances, at the company's "doorstep." The end-of-project evaluation and the analysis of data gathered from reports and records maintained by the companies and by the Population Center Foundation (PCF) indicate that, after 18 months of operation, the project was able to substantially achieve its objective. It increased the demand for family planning information and services among workers in 30 industrial establishments located in Metro Manila. The more frequently mentioned sources of information on responsible parenthood and family planning were project-related personnel. Additionally, the different family planning methods became more widely known in the companies.

Simulating Mission Command for Planning and Analysis

DTIC Science & Technology

2015-06-01

mission plan. 14. SUBJECT TERMS Mission Planning, CPM , PERT, Simulation, DES, Simkit, Triangle Distribution, Critical Path 15. NUMBER OF...Battalion Task Force CO Company CPM Critical Path Method DES Discrete Event Simulation FA BAT Field Artillery Battalion FEL Future Event List FIST...management tools that can be utilized to find the critical path in military projects. These are the Critical Path Method ( CPM ) and the Program Evaluation and

Osm-Oriented Method of Multimodal Route Planning

NASA Astrophysics Data System (ADS)

Li, X.; Wu, Q.; Chen, L.; Xiong, W.; Jing, N.

2015-07-01

With the increasing pervasiveness of basic facilitate of transportation and information, the need of multimodal route planning is becoming more essential in the fields of communication and transportation, urban planning, logistics management, etc. This article mainly described an OSM-oriented method of multimodal route planning. Firstly, it introduced how to extract the information we need from OSM data and build proper network model and storage model; then it analysed the accustomed cost standard adopted by most travellers; finally, we used shortest path algorithm to calculate the best route with multiple traffic means.

Terrain classification in navigation of an autonomous mobile robot

NASA Astrophysics Data System (ADS)

Dodds, David R.

1991-03-01

In this paper we describe a method of path planning that integrates terrain classification (by means of fractals) the certainty grid method of spatial representation Kehtarnavaz Griswold collision-zones Dubois Prade fuzzy temporal and spatial knowledge and non-point sized qualitative navigational planning. An initially planned (" end-to-end" ) path is piece-wise modified to accommodate known and inferred moving obstacles and includes attention to time-varying multiple subgoals which may influence a section of path at a time after the robot has begun traversing that planned path.

Strategic Petroleum Reserve Plan. Distribution Plan for the Strategic Petroleum Reserve. Amendment No. 3. Energy Action DOE No. 5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

Purpose of this Strategic Petroleum Reserve (SPR) Plan Amendment is to provide a Distribution Plan, setting forth the method of drawdown and distribution of the Reserve. Chapter VII of the SPR Plan contained a Distribution Plan which identified and discussed the major objectives, criteria and other factors that will be considered in developing the detailed plan. This Amendment replaces Chapter VII of the SPR Plan in its entirety.

Comparing extinction risk and economic cost in wildlife conservation planning

Treesearch

Robert G. Haight

1995-01-01

Planning regulations pursuant to the National Forest Management Act of 1976 require the USDA Forest Service to produce cost-effective, multiple-use forest plans that ensure the viability of native wildlife populations within the planning area. In accordance with these regulations, this paper presents a method for determining cost-effective conservation plans for...

Patient-specific calibration of cone-beam computed tomography data sets for radiotherapy dose calculations and treatment plan assessment.

PubMed

MacFarlane, Michael; Wong, Daniel; Hoover, Douglas A; Wong, Eugene; Johnson, Carol; Battista, Jerry J; Chen, Jeff Z

2018-03-01

In this work, we propose a new method of calibrating cone beam computed tomography (CBCT) data sets for radiotherapy dose calculation and plan assessment. The motivation for this patient-specific calibration (PSC) method is to develop an efficient, robust, and accurate CBCT calibration process that is less susceptible to deformable image registration (DIR) errors. Instead of mapping the CT numbers voxel-by-voxel with traditional DIR calibration methods, the PSC methods generates correlation plots between deformably registered planning CT and CBCT voxel values, for each image slice. A linear calibration curve specific to each slice is then obtained by least-squares fitting, and applied to the CBCT slice's voxel values. This allows each CBCT slice to be corrected using DIR without altering the patient geometry through regional DIR errors. A retrospective study was performed on 15 head-and-neck cancer patients, each having routine CBCTs and a middle-of-treatment re-planning CT (reCT). The original treatment plan was re-calculated on the patient's reCT image set (serving as the gold standard) as well as the image sets produced by voxel-to-voxel DIR, density-overriding, and the new PSC calibration methods. Dose accuracy of each calibration method was compared to the reference reCT data set using common dose-volume metrics and 3D gamma analysis. A phantom study was also performed to assess the accuracy of the DIR and PSC CBCT calibration methods compared with planning CT. Compared with the gold standard using reCT, the average dose metric differences were ≤ 1.1% for all three methods (PSC: -0.3%; DIR: -0.7%; density-override: -1.1%). The average gamma pass rates with thresholds 3%, 3 mm were also similar among the three techniques (PSC: 95.0%; DIR: 96.1%; density-override: 94.4%). An automated patient-specific calibration method was developed which yielded strong dosimetric agreement with the results obtained using a re-planning CT for head-and-neck patients. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Religious leaders gain ground in the Jordanian family-planning movement.

PubMed

Underwood, Carol; Kamhawi, Sarah; Nofal, Ahmad

2013-11-01

To assess the effect of a training program designed to enhance the role of Muslim religious leaders (RLs) in promoting family welfare, including reproductive health generally and family planning more specifically. A panel study design was utilized; 136 and 115 RLs completed the self-administered questionnaires at baseline (pre-training) and endline (6 months post-training), respectively. Scales were generated to assess RLs' knowledge of the number of family-planning methods deemed to be acceptable according to Islamic teachings (9 methods, Cronbach α=0.85), attitudes toward family planning (7 statements, Cronbach α=0.67), and preaching and/or counseling on family-planning topics (7 topics, Cronbach α=0.85). Linear regressions controlling for sex, age, and educational attainment showed that, on average, RLs cited more methods deemed acceptable according to Islamic teachings (β=1.381; P<0.001), expressed more positive attitudes toward family planning (β=0.514; P<0.05), and preached and/or counseled on family-planning topics more frequently at endline compared with baseline (β=0.965; P<0.01). Culturally appropriate training for RLs can lead to a deeper understanding of, and appreciation for, reproductive health and family planning, with the effects manifesting as increased preaching and/or counseling about these important topics. © 2013.

A fixed-jaw method to protect critical organs during intensity-modulated radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Jiayun; Chen, Xinyuan; Huang, Manni, E-mail: dai_jianrong@163.com

2014-01-01

Intensity-modulated radiotherapy (IMRT) plays an important role in cancer radiotherapy. For some patients being treated with IMRT, the extremely low tolerances of critical organs (such as lens, ovaries, and testicles) cannot be met during treatment planning. The aim of this article is to introduce a new planning method to overcome that problem. In current planning practice, jaw positions are automatically set to cover all target volumes by the planning system (e.g., Pinnacle{sup 3} system). Because of such settings, critical organs may be fully blocked by the multileaf collimator (MLC), but they still sit in the field that is shaped bymore » collimator jaws. These critical organs receive doses from the transmission and leakage of MLC leaves. We manually fixed jaw positions to block them to further reduce such doses. This method has been used for different treatment sites in our clinic, and it was thoroughly evaluated in patients with radical hysterectomy plus ovarian transposition after surgery. For each patient, 2 treatment plans were designed with the same optimization parameters: the original plan with automatically chosen jaw positions (called O-plan) and the plan with fixed-jaw positions (named F-plan). In the F-plan, the jaws were manually fixed to block the ovaries. For target coverage, the mean conformity index (CI) of the F-plan (1.28 ± 0.02) was remarkably lower than that of the O-plan (1.53 ± 0.09) (p < 0.05). The F-plan and the O-plan performed similarly in target dose homogeneity. Meanwhile, for the critical organ sparing, the mean dose of both ovaries were much lower in the F-plan than that in the O-plan (p < 0.05). The V{sub 20}, V{sub 30}, and V{sub 40} of bladder were also lower in the F-plan (93.57 ± 1.98, 73.99 ± 5.76, and 42.33 ± 3.7, respectively) than those in the O-plan (97.98 ± 1.11, 85.07 ± 4.04, and 49.71 ± 3.63, respectively) (p < 0.05). The maximum dose to the spinal cord planning organ at risk (OAR) volume (PRV) in the O-plan (3940.24 ± 102.8) was higher than that in the F-plan (3628.18 ± 131.45) with significant differences (p < 0.01). For other OARs, there were no significant differences in doses between these 2 plans except that the high-dose regions of the rectum were higher for V{sub 40} in the O-plan than that in the F-plan (p < 0.01). But the monitor units (MUs) in the F-plan were 1.4 times as much as that in the O-plan. Thus the treatment time could be longer by using the F-plan. As it results in more MUs in spite of better plan quality, it is recommended to be used only in situations in which clinical requirements to critical organs cannot be met with the regular method.« less

Development of Methods of Evaluating Abilities to Make Plans in New Group Work

NASA Astrophysics Data System (ADS)

Kiriyama, Satoshi

The ability to evaluate something vague which is, for example, originality can be regarded as one of important elements which constitute the ability to make plans. The author has made use of cooperative activities in which every member undertakes each stage of a plan-do-check-cycle in order to develop training methods and evaluating methods of evaluating ability. The members of a CHECK team evaluated activities of a PLAN team and a DO team. The author tried to grasp the abilities of the members of a CHECK team by analyzing results of the evaluation. In addition, the author have made some teachers evaluate a sample in order to study the accuracy of criteria and extracted some challenges.

Resource Constrained Planning of Multiple Projects with Separable Activities

NASA Astrophysics Data System (ADS)

Fujii, Susumu; Morita, Hiroshi; Kanawa, Takuya

In this study we consider a resource constrained planning problem of multiple projects with separable activities. This problem provides a plan to process the activities considering a resource availability with time window. We propose a solution algorithm based on the branch and bound method to obtain the optimal solution minimizing the completion time of all projects. We develop three methods for improvement of computational efficiency, that is, to obtain initial solution with minimum slack time rule, to estimate lower bound considering both time and resource constraints and to introduce an equivalence relation for bounding operation. The effectiveness of the proposed methods is demonstrated by numerical examples. Especially as the number of planning projects increases, the average computational time and the number of searched nodes are reduced.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gorissen, BL; Giantsoudi, D; Unkelbach, J

Purpose: Cell survival experiments suggest that the relative biological effectiveness (RBE) of proton beams depends on linear energy transfer (LET), leading to higher RBE near the end of range. With intensity-modulated proton therapy (IMPT), multiple treatment plans that differ in the dose contribution per field may yield a similar physical dose distribution, but the RBE-weighted dose distribution may be disparate. RBE models currently do not have the required predictive power to be included in an optimization model due to the variations in experimental data. We propose an LET-based planning method that guides IMPT optimization models towards plans with reduced RBE-weightedmore » dose in surrounding organs at risk (OARs) compared to inverse planning based on physical dose alone. Methods: Optimization models for physical dose are extended with a term for dose times LET (doseLET). Monte Carlo code is used to generate the physical dose and doseLET distribution of each individual pencil beam. The method is demonstrated for an atypical meningioma patient where the target volume abuts the brainstem and partially overlaps with the optic nerve. Results: A reference plan optimized based on physical dose alone yields high doseLET values in parts of the brainstem and optic nerve. Minimizing doseLET in these critical structures as an additional planning goal reduces the risk of high RBE-weighted dose. The resulting treatment plan avoids the distal fall-off of the Bragg peaks for shaping the dose distribution in front of critical stuctures. The maximum dose in the OARs evaluated with RBE models from literature is reduced by 8–14\\% with our method compared to conventional planning. Conclusion: LET-based inverse planning for IMPT offers the ability to reduce the RBE-weighted dose in OARs without sacrificing target dose. This project was in part supported by NCI - U19 CA 21239.« less

SU-E-T-502: Initial Results of a Comparison of Treatment Plans Produced From Automated Prioritized Planning Method and a Commercial Treatment Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tiwari, P; Chen, Y; Hong, L

2015-06-15

Purpose We developed an automated treatment planning system based on a hierarchical goal programming approach. To demonstrate the feasibility of our method, we report the comparison of prostate treatment plans produced from the automated treatment planning system with those produced by a commercial treatment planning system. Methods In our approach, we prioritized the goals of the optimization, and solved one goal at a time. The purpose of prioritization is to ensure that higher priority dose-volume planning goals are not sacrificed to improve lower priority goals. The algorithm has four steps. The first step optimizes dose to the target structures, whilemore » sparing key sensitive organs from radiation. In the second step, the algorithm finds the best beamlet weight to reduce toxicity risks to normal tissue while holding the objective function achieved in the first step as a constraint, with a small amount of allowed slip. Likewise, the third and fourth steps introduce lower priority normal tissue goals and beam smoothing. We compared with prostate treatment plans from Memorial Sloan Kettering Cancer Center developed using Eclipse, with a prescription dose of 72 Gy. A combination of liear, quadratic, and gEUD objective functions were used with a modified open source solver code (IPOPT). Results Initial plan results on 3 different cases show that the automated planning system is capable of competing or improving on expert-driven eclipse plans. Compared to the Eclipse planning system, the automated system produced up to 26% less mean dose to rectum and 24% less mean dose to bladder while having the same D95 (after matching) to the target. Conclusion We have demonstrated that Pareto optimal treatment plans can be generated automatically without a trial-and-error process. The solver finds an optimal plan for the given patient, as opposed to database-driven approaches that set parameters based on geometry and population modeling.« less

76 FR 77431 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... (DG) DG-4014, ``Decommissioning Planning During Operations.'' This guide describes a method that the.... The draft regulatory guide entitled, ``Decommissioning Planning During Operations,'' is temporarily..., 40, 50, 70, and 72 RIN 3150-AI55 [NRC-2011-0286; NRC-2008-0030] Decommissioning Planning During...

78 FR 663 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...] Decommissioning Planning During Operations AGENCY: Nuclear Regulatory Commission. ACTION: Regulatory guide..., ``Decommissioning Planning During Operations.'' The guide describes a method that the NRC staff considers acceptable for use by holders of licenses in complying with the NRC's Decommissioning Planning Rule (DPR) (76 FR...

77 FR 41107 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

..., 40, 50, 70, and 72 [NRC-2011-0162] Decommissioning Planning During Operations AGENCY: Nuclear... (DG) 4014, ``Decommissioning Planning During Operations.'' This guide describes a method that the NRC staff considers acceptable for use in complying with the NRC's Decommissioning Planning Rule. The NRC...

29 CFR 547.1 - Essential requirements for qualifications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... in accordance with a definite formula specified in the plan, which formula may be based on one or... formula or method of calculation specified in the plan, which formula or method of calculation is based on...

Poster — Thur Eve — 69: Computational Study of DVH-guided Cancer Treatment Planning Optimization Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghomi, Pooyan Shirvani; Zinchenko, Yuriy

2014-08-15

Purpose: To compare methods to incorporate the Dose Volume Histogram (DVH) curves into the treatment planning optimization. Method: The performance of three methods, namely, the conventional Mixed Integer Programming (MIP) model, a convex moment-based constrained optimization approach, and an unconstrained convex moment-based penalty approach, is compared using anonymized data of a prostate cancer patient. Three plans we generated using the corresponding optimization models. Four Organs at Risk (OARs) and one Tumor were involved in the treatment planning. The OARs and Tumor were discretized into total of 50,221 voxels. The number of beamlets was 943. We used commercially available optimization softwaremore » Gurobi and Matlab to solve the models. Plan comparison was done by recording the model runtime followed by visual inspection of the resulting dose volume histograms. Conclusion: We demonstrate the effectiveness of the moment-based approaches to replicate the set of prescribed DVH curves. The unconstrained convex moment-based penalty approach is concluded to have the greatest potential to reduce the computational effort and holds a promise of substantial computational speed up.« less

48 CFR 1515.305-70 - Scoring plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 1515.305-70 Scoring plans. When... solicitation, e.g., other numeric, adjectival, color rating systems, etc. Scoring Plan Value Descriptive...

Cryosurgery Planning Using Bubble Packing in 3D

PubMed Central

Tanaka, Daigo; Shimada, Kenji; Rossi, Michael R.; Rabin, Yoed

2008-01-01

As part of an ongoing project to develop automated tools for cryosurgery planning, the current study focuses on the development of a 3D bubble packing method. A proof-of-concept for the new method is demonstrated on five prostate models, reconstructed from ultrasound images. The new method is a modification of an established method in 2D. Ellipsoidal bubbles are packed in the volume of the prostate in the current study; such bubbles can be viewed as a first-order approximation of a frozen region around a single cryoprobe. When all cryoprobes are inserted to the same depth, optimum planning was found to occur at about 60% of the length of the prostate (measured from its apex), which leads to cooling of approximately 75% of the prostate volume below a specific temperature threshold of −22°C. Bubble packing has the potential to dramatically reduce the run time for automated planning. PMID:17963095

Cryosurgery planning using bubble packing in 3D.

PubMed

Tanaka, Daigo; Shimada, Kenji; Rossi, Michael R; Rabin, Yoed

2008-04-01

As part of an ongoing project to develop automated tools for cryosurgery planning, the current study focuses on the development of a 3D bubble packing method. A proof-of-concept for the new method is demonstrated on five prostate models, reconstructed from ultrasound images. The new method is a modification of an established method in 2D. Ellipsoidal bubbles are packed in the volume of the prostate in the current study; such bubbles can be viewed as a first-order approximation of a frozen region around a single cryoprobe. When all cryoprobes are inserted to the same depth, optimum planning was found to occur at about 60% of the length of the prostate (measured from its apex), which leads to cooling of approximately 75% of the prostate volume below a specific temperature threshold of - 22 degrees C. Bubble packing has the potential to dramatically reduce the run time for automated planning.

Application of modified dynamic conformal arc (MDCA) technique on liver stereotactic body radiation therapy (SBRT) planning following RTOG 0438 guideline

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shi, Chengyu, E-mail: shicy1974@yahoo.com; Chen, Yong; Fang, Deborah

2015-04-01

Liver stereotactic body radiation therapy (SBRT) is a feasible treatment method for the nonoperable, patient with early-stage liver cancer. Treatment planning for the SBRT is very important and has to consider the simulation accuracy, planning time, treatment efficiency effects etc. The modified dynamic conformal arc (MDCA) technique is a 3-dimensional conformal arc planning method, which has been proposed for liver SBRT planning at our center. In this study, we compared the MDCA technique with the RapidArc technique in terms of planning target volume (PTV) coverage and sparing of organs at risk (OARs). The results show that the MDCA technique hasmore » comparable plan quality to RapidArc considering PTV coverage, hot spots, heterogeneity index, and effective liver volume. For the 5 PTVs studied among 4 patients, the MDCA plan, when compared with the RapidArc plan, showed 9% more hot spots, more heterogeneity effect, more sparing of OARs, and lower liver effective volume. The monitor unit (MU) number for the MDCA plan is much lower than for the RapidArc plans. The MDCA plan has the advantages of less planning time, no-collision treatment, and a lower MU number.« less

Capacity planning for the future.

PubMed

Johnson, A M

1997-01-01

Managed care is changing the way health care organizations plan for their futures. Traditional planning takes into account history and geography, while the new approach factors in the impact of managed care of future utilization. The new approach also incorporates strategic planning into an organization's broader strategic plan and budgeting process. The result is a more comprehensive planning method that is critical for health care organization's success.

An Empirical Assessment of Administration and Planning Activity and Their Impact on the Realization of Sustainability-Related Initiatives and Programs in Higher Education

ERIC Educational Resources Information Center

Semeraro, Elizabeth; Boyd, Neil M.

2017-01-01

Purpose: Administrators in higher-education settings routinely create planning documents that help steer the organization in mission-centric ways. In the area of sustainability planning, strategic plans, sustainability plans and climate action plans are the most common methods used. The purpose of this study is to evaluate if specific forms of…

The Danish Organic Action Plan 2020: assessment method and baseline status of organic procurement in public kitchens.

PubMed

Sørensen, Nina N; Lassen, Anne D; Løje, Hanne; Tetens, Inge

2015-09-01

With political support from the Danish Organic Action Plan 2020, organic public procurement in Denmark is expected to increase. In order to evaluate changes in organic food procurement in Danish public kitchens, reliable methods are needed. The present study aimed to compare organic food procurement measurements by two methods and to collect and discuss baseline organic food procurement measurements from public kitchens participating in the Danish Organic Action Plan 2020. Comparison study measuring organic food procurement by applying two different methods, one based on the use of procurement invoices (the Organic Cuisine Label method) and the other on self-reported procurement (the Dogme method). Baseline organic food procurement status was based on organic food procurement measurements and background information from public kitchens. Public kitchens participating in the six organic food conversion projects funded by the Danish Organic Action Plan 2020 during 2012 and 2013. Twenty-six public kitchens (comparison study) and 345 public kitchens (baseline organic food procurement status). A high significant correlation coefficient was found between the two organic food procurement measurement methods (r=0·83, P<0·001) with measurements relevant for the baseline status. Mean baseline organic food procurement was found to be 24 % when including measurements from both methods. The results indicate that organic food procurement measurements by both methods were valid for the baseline status report of the Danish Organic Action Plan 2020. Baseline results in Danish public kitchens suggest there is room for more organic as well as sustainable public procurement in Denmark.

TU-AB-BRB-01: Coverage Evaluation and Probabilistic Treatment Planning as a Margin Alternative

DOE Office of Scientific and Technical Information (OSTI.GOV)

Siebers, J.

The accepted clinical method to accommodate targeting uncertainties inherent in fractionated external beam radiation therapy is to utilize GTV-to-CTV and CTV-to-PTV margins during the planning process to design a PTV-conformal static dose distribution on the planning image set. Ideally, margins are selected to ensure a high (e.g. >95%) target coverage probability (CP) in spite of inherent inter- and intra-fractional positional variations, tissue motions, and initial contouring uncertainties. Robust optimization techniques, also known as probabilistic treatment planning techniques, explicitly incorporate the dosimetric consequences of targeting uncertainties by including CP evaluation into the planning optimization process along with coverage-based planning objectives. Themore » treatment planner no longer needs to use PTV and/or PRV margins; instead robust optimization utilizes probability distributions of the underlying uncertainties in conjunction with CP-evaluation for the underlying CTVs and OARs to design an optimal treated volume. This symposium will describe CP-evaluation methods as well as various robust planning techniques including use of probability-weighted dose distributions, probability-weighted objective functions, and coverage optimized planning. Methods to compute and display the effect of uncertainties on dose distributions will be presented. The use of robust planning to accommodate inter-fractional setup uncertainties, organ deformation, and contouring uncertainties will be examined as will its use to accommodate intra-fractional organ motion. Clinical examples will be used to inter-compare robust and margin-based planning, highlighting advantages of robust-plans in terms of target and normal tissue coverage. Robust-planning limitations as uncertainties approach zero and as the number of treatment fractions becomes small will be presented, as well as the factors limiting clinical implementation of robust planning. Learning Objectives: To understand robust-planning as a clinical alternative to using margin-based planning. To understand conceptual differences between uncertainty and predictable motion. To understand fundamental limitations of the PTV concept that probabilistic planning can overcome. To understand the major contributing factors to target and normal tissue coverage probability. To understand the similarities and differences of various robust planning techniques To understand the benefits and limitations of robust planning techniques.« less

TU-AB-BRB-03: Coverage-Based Treatment Planning to Accommodate Organ Deformable Motions and Contouring Uncertainties for Prostate Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, H.

The accepted clinical method to accommodate targeting uncertainties inherent in fractionated external beam radiation therapy is to utilize GTV-to-CTV and CTV-to-PTV margins during the planning process to design a PTV-conformal static dose distribution on the planning image set. Ideally, margins are selected to ensure a high (e.g. >95%) target coverage probability (CP) in spite of inherent inter- and intra-fractional positional variations, tissue motions, and initial contouring uncertainties. Robust optimization techniques, also known as probabilistic treatment planning techniques, explicitly incorporate the dosimetric consequences of targeting uncertainties by including CP evaluation into the planning optimization process along with coverage-based planning objectives. Themore » treatment planner no longer needs to use PTV and/or PRV margins; instead robust optimization utilizes probability distributions of the underlying uncertainties in conjunction with CP-evaluation for the underlying CTVs and OARs to design an optimal treated volume. This symposium will describe CP-evaluation methods as well as various robust planning techniques including use of probability-weighted dose distributions, probability-weighted objective functions, and coverage optimized planning. Methods to compute and display the effect of uncertainties on dose distributions will be presented. The use of robust planning to accommodate inter-fractional setup uncertainties, organ deformation, and contouring uncertainties will be examined as will its use to accommodate intra-fractional organ motion. Clinical examples will be used to inter-compare robust and margin-based planning, highlighting advantages of robust-plans in terms of target and normal tissue coverage. Robust-planning limitations as uncertainties approach zero and as the number of treatment fractions becomes small will be presented, as well as the factors limiting clinical implementation of robust planning. Learning Objectives: To understand robust-planning as a clinical alternative to using margin-based planning. To understand conceptual differences between uncertainty and predictable motion. To understand fundamental limitations of the PTV concept that probabilistic planning can overcome. To understand the major contributing factors to target and normal tissue coverage probability. To understand the similarities and differences of various robust planning techniques To understand the benefits and limitations of robust planning techniques.« less

A feasibility study using TomoDirect for craniospinal irradiation

PubMed Central

Molloy, Janelle A.; Gleason, John F.; Feddock, Jonathan M.

2013-01-01

The feasibility of delivering craniospinal irradiation (CSI) with TomoDirect is investigated. A method is proposed to generate TomoDirect plans using standard three‐dimensional (3D) beam arrangements on Tomotherapy with junctioning of these fields to minimize hot or cold spots at the cranial/spinal junction. These plans are evaluated and compared to a helical Tomotherapy and a three‐dimensional conformal therapy (3D CRT) plan delivered on a conventional linear accelerator (linac) for CSI. The comparison shows that a TomoDirect plan with an overlap between the cranial and spinal fields might be preferable over Tomotherapy plans because of decreased low dose to large volumes of normal tissues outside of the planning target volume (PTV). Although the TomoDirect plans were not dosimetrically superior to a 3D CRT linac plan, the patient can be easily treated in the supine position, which is often more comfortable and efficient from an anesthesia standpoint. TomoDirect plans also have only one setup position which obviates the need for matching of fields and feathering of junctions, two issues encountered with conventional 3D CRT plans. TomoDirect plans can be delivered with comparable treatment times to conventional 3D plans and in shorter times than a Tomotherapy plan. In this paper, a method is proposed for creating TomoDirect craniospinal plans, and the dosimetric consequences for choosing different planning parameters are discussed. PACS number: 87.55.D‐ PMID:24036863

Preventing Pregnancy in Kenya Through Distribution and Use of the CycleBeads Mobile Application.

PubMed

Shelus, Victoria; Ashcroft, Nicki; Burgess, Sarah; Giuffrida, Monica; Jennings, Victoria

2017-09-01

Given the proportion of Kenyan women not using hormonal contraceptives, the country appears to have a substantial need for a modern, natural family planning option. The CycleBeads® mobile phone application (app), a digital platform for the Standard Days Method® of family planning, could help address this issue. After the CycleBeads app was promoted in Kenya in May-June 2015, a three-month pilot study was conducted to collect quantitative and qualitative data from 185 female app users. Chi-square testing, binary logistic regression and thematic content analysis were used to assess whether the app brought new users to family planning, to understand users' experiences and to assess how user experiences vary by distribution channel. Participants learned about the app through nongovernmental organizations (17%), via digital media (33%) or from family or friends (50%). Most used the app to track their periods (54%) or prevent pregnancy (37%); a few used it to plan a pregnancy (7%) or for other reasons (2%). The main reason for choosing the Standard Days Method was fear of side effects from hormonal methods (64%). The majority of women found the app and method easy to use (53%). Among those preventing pregnancy, 42% had never before used a method. By midline, all participants knew when fertile days occurred, and most (97%) knew the method's cycle-length requirements. Women reported high rates of condom use (88%), abstinence (68%) and withdrawal (46%) on fertile days. Offering the CycleBeads app to support women in use of the Standard Days Method may expand family planning options, reduce unmet need and make family planning more widely available.

Proposing water balance method for water availability estimation in Indonesian regional spatial planning

NASA Astrophysics Data System (ADS)

Juniati, A. T.; Sutjiningsih, D.; Soeryantono, H.; Kusratmoko, E.

2018-01-01

The water availability (WA) of a region is one of important consideration in both the formulation of spatial plans and the evaluation of the effectiveness of actual land use in providing sustainable water resources. Information on land-water needs vis-a-vis their availability in a region determines the state of the surplus or deficit to inform effective land use utilization. How to calculate water availability have been described in the Guideline in Determining the Carrying Capacity of the Environment in Regional Spatial Planning. However, the method of determining the supply and demand of water on these guidelines is debatable since the determination of WA in this guideline used a rational method. The rational method is developed the basis for storm drain design practice and it is essentially a peak discharge method peak discharge calculation method. This paper review the literature in methods of water availability estimation which is described descriptively, and present arguments to claim that water balance method is a more fundamental and appropriate tool in water availability estimation. A better water availability estimation method would serve to improve the practice in preparing formulations of Regional Spatial Plan (RSP) as well as evaluating land use capacity in providing sustainable water resources.

40 CFR 230.94 - Planning and documentation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management; and...

40 CFR 230.94 - Planning and documentation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management; and...

40 CFR 230.94 - Planning and documentation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management; and...

40 CFR 230.94 - Planning and documentation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management; and...

Inspection Methods in Programming.

DTIC Science & Technology

1981-06-01

Counting is a a specialization of Iterative-generation in which the generating function is Oneplus ) Waters’ second category of plan building method...is Oneplus and the initial input is 1. 0 I 180 CHAPTER NINE -ta a acio f igr9-.IeaieGnrtoPln 7 -7 STEADY STATE PLANS 181 TemporalPlan counting...specializalion iterative-generation roles .action(afu nction) ,tail(counting) conslraints .action.op = oneplus A .action.input = 1 The lItcrative-application

Financial Planning for Information Technology: Conventional Approaches Need Not Apply.

ERIC Educational Resources Information Center

Falduto, Ellen F.

1999-01-01

Rapid advances in information technology have rendered conventional approaches to planning and budgeting useless, and no single method is universally appropriate. The most successful planning efforts are consistent with the institution's overall plan, and may combine conventional, opportunistic, and entrepreneurial approaches. Chief financial…

Some factors affecting acceptance of family planning in Manus.

PubMed

Avue, B; Freeman, P

1991-12-01

This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

Place-based planning: innovations and applications from four western forests.

Treesearch

Jennifer O. Farnum; Linda E. Kruger

2008-01-01

Place-based planning is an emergent method of public lands planning that aims to redefine the scale at which planning occurs, using place meanings and place values to guide planning processes. Despite the approach's growing popularity, there exist few published accounts of place-based approaches. To provide practitioners and researchers with such examples, the...

Scenario Planning: A Phenomenological Examination of Influence on Organizational Learning and Decision-Making in a K-12 Public Education System

ERIC Educational Resources Information Center

Deklotz, Patricia F.

2013-01-01

Organizations commonly engage in long range planning to direct decisions. Scenario planning, one method of private sector planning, is recognized as useful when organizations are facing uncertainty. Scenario planning engages the organization in a process that produces plausible stories, called scenarios, describing the organization in several…

77 FR 74508 - Notice of Availability of the Draft Resource Management Plan Amendment, Draft Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... Statement for the Ring of Fire Resource Management Plan--Haines Planning Area, Alaska AGENCY: Bureau of Land.../Draft Environmental Impact Statement (EIS) for the Ring of Fire RMP for the Haines Planning Area and by... Fire RMP-- Haines Planning Area Amendment by any of the following methods: Email: [email protected

The Nature and Use of Individualized Learning Plans as a Promising Career Intervention Strategy

ERIC Educational Resources Information Center

Solberg, V. Scott; Phelps, L. Allen; Haakenson, Kristin A.; Durham, Julie F.; Timmons, Joe

2012-01-01

Individualized learning plans (ILPs) are being implemented in high schools throughout the United States as strategic planning tools that help students align course plans with career aspirations and often include the development of postsecondary plans. Initial indications are that ILPs may be an important method for helping students achieve both…

NASA plan for international crustal dynamics studies

NASA Technical Reports Server (NTRS)

1979-01-01

The international activities being planned as part of the NASA geodynamics program are described. Methods of studying the Earth's crustal movements and deformation characteristics are discussed. The significance of the eventual formalations of earthquake predictions methods is also discussed.

Alignment focus of daily image guidance for concurrent treatment of prostate and pelvic lymph nodes.

PubMed

Ferjani, Samah; Huang, Guangshun; Shang, Qingyang; Stephans, Kevin L; Zhong, Yahua; Qi, Peng; Tendulkar, Rahul D; Xia, Ping

2013-10-01

To determine the dosimetric impact of daily imaging alignment focus on the prostate soft tissue versus the pelvic bones for the concurrent treatment of the prostate and pelvic lymph nodes (PLN) and to assess whether multileaf collimator (MLC) tracking or adaptive planning (ART) is necessary with the current clinical planning margins of 8 mm/6 mm posterior to the prostate and 5 mm to the PLN. A total of 124 kilovoltage cone-beam computed tomography (kV-CBCT) images from 6 patients were studied. For each KV-CBCT, 4 plans were retrospectively created using an isocenter shifting method with 2 different alignment focuses (prostate, PLN), an MLC shifting method, and the ART method. The selected dosimetric endpoints were compared among these plans. For the isoshift contour, isoshift bone, MLC shift, and ART plans, D99 of the prostate was ≥97% of the prescription dose in 97.6%, 73.4%, 98.4%, and 96.8% of 124 fractions, respectively. Accordingly, D99 of the PLN was ≥97% of the prescription dose in 98.4%, 98.4%, 98.4%, and 100% of 124 fractions, respectively. For the rectum, D5 exceeded 105% of the planned D5 (and D5 of ART plans) in 11% (4%), 10% (2%), and 13% (5%) of 124 fractions, respectively. For the bladder, D5 exceeded 105% of the planned D5 (and D5 of ART) plans in 0% (2%), 0% (2%), and 0% (1%) of 124 fractions, respectively. For concurrent treatment of the prostate and PLN, with a planning margin to the prostate of 8 mm/6 mm posterior and a planning margin of 5 mm to the PLN, aligning to the prostate soft tissue can achieve adequate dose coverage to the both target volumes; aligning to the pelvic bone would result in underdosing to the prostate in one-third of fractions. With these planning margins, MLC tracking and ART methods have no dosimetric advantages. Copyright © 2013 Elsevier Inc. All rights reserved.

An efficient inverse radiotherapy planning method for VMAT using quadratic programming optimization.

PubMed

Hoegele, W; Loeschel, R; Merkle, N; Zygmanski, P

2012-01-01

The purpose of this study is to investigate the feasibility of an inverse planning optimization approach for the Volumetric Modulated Arc Therapy (VMAT) based on quadratic programming and the projection method. The performance of this method is evaluated against a reference commercial planning system (eclipse(TM) for rapidarc(TM)) for clinically relevant cases. The inverse problem is posed in terms of a linear combination of basis functions representing arclet dose contributions and their respective linear coefficients as degrees of freedom. MLC motion is decomposed into basic motion patterns in an intuitive manner leading to a system of equations with a relatively small number of equations and unknowns. These equations are solved using quadratic programming under certain limiting physical conditions for the solution, such as the avoidance of negative dose during optimization and Monitor Unit reduction. The modeling by the projection method assures a unique treatment plan with beneficial properties, such as the explicit relation between organ weightings and the final dose distribution. Clinical cases studied include prostate and spine treatments. The optimized plans are evaluated by comparing isodose lines, DVH profiles for target and normal organs, and Monitor Units to those obtained by the clinical treatment planning system eclipse(TM). The resulting dose distributions for a prostate (with rectum and bladder as organs at risk), and for a spine case (with kidneys, liver, lung and heart as organs at risk) are presented. Overall, the results indicate that similar plan qualities for quadratic programming (QP) and rapidarc(TM) could be achieved at significantly more efficient computational and planning effort using QP. Additionally, results for the quasimodo phantom [Bohsung et al., "IMRT treatment planning: A comparative inter-system and inter-centre planning exercise of the estro quasimodo group," Radiother. Oncol. 76(3), 354-361 (2005)] are presented as an example for an extreme concave case. Quadratic programming is an alternative approach for inverse planning which generates clinically satisfying plans in comparison to the clinical system and constitutes an efficient optimization process characterized by uniqueness and reproducibility of the solution.

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

PubMed Central

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 planning and thus reduce the rapid population growth and poverty. PMID:27099401

Evaluation of dosimetric effect caused by slowing with multi-leaf collimator (MLC) leaves for volumetric modulated arc therapy (VMAT)

PubMed Central

Wang, Iris Z.; Kumaraswamy, Lalith K.; Podgorsak, Matthew B.

2016-01-01

Background This study is to report 1) the sensitivity of intensity modulated radiation therapy (IMRT) QA method for clinical volumetric modulated arc therapy (VMAT) plans with multi-leaf collimator (MLC) leaf errors that will not trigger MLC interlock during beam delivery; 2) the effect of non-beam-hold MLC leaf errors on the quality of VMAT plan dose delivery. Materials and methods. Eleven VMAT plans were selected and modified using an in-house developed software. For each control point of a VMAT arc, MLC leaves with the highest speed (1.87-1.95 cm/s) were set to move at the maximal allowable speed (2.3 cm/s), which resulted in a leaf position difference of less than 2 mm. The modified plans were considered as ‘standard’ plans, and the original plans were treated as the ‘slowing MLC’ plans for simulating ‘standard’ plans with leaves moving at relatively lower speed. The measurement of each ‘slowing MLC’ plan using MapCHECK®2 was compared with calculated planar dose of the ‘standard’ plan with respect to absolute dose Van Dyk distance-to-agreement (DTA) comparisons using 3%/3 mm and 2%/2 mm criteria. Results All ‘slowing MLC’ plans passed the 90% pass rate threshold using 3%/3 mm criteria while one brain and three anal VMAT cases were below 90% with 2%/2 mm criteria. For ten out of eleven cases, DVH comparisons between ‘standard’ and ‘slowing MLC’ plans demonstrated minimal dosimetric changes in targets and organs-at-risk. Conclusions For highly modulated VMAT plans, pass rate threshold (90%) using 3%/3mm criteria is not sensitive in detecting MLC leaf errors that will not trigger the MLC leaf interlock. However, the consequential effects of non-beam hold MLC errors on target and OAR doses are negligible, which supports the reliability of current patient-specific IMRT quality assurance (QA) method for VMAT plans. PMID:27069458

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

PubMed

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.

Impact of tumour motion compensation and delineation methods on FDG PET-based dose painting plan quality for NSCLC radiation therapy.

PubMed

Thomas, Hannah Mary; Kinahan, Paul E; Samuel, James Jebaseelan E; Bowen, Stephen R

2018-02-01

To quantitatively estimate the impact of different methods for both boost volume delineation and respiratory motion compensation of [18F] FDG PET/CT images on the fidelity of planned non-uniform 'dose painting' plans to the prescribed boost dose distribution. Six locally advanced non-small cell lung cancer (NSCLC) patients were retrospectively reviewed. To assess the impact of respiratory motion, time-averaged (3D AVG), respiratory phase-gated (4D GATED) and motion-encompassing (4D MIP) PET images were used. The boost volumes were defined using manual contour (MANUAL), fixed threshold (FIXED) and gradient search algorithm (GRADIENT). The dose painting prescription of 60 Gy base dose to the planning target volume and an integral dose of 14 Gy (total 74 Gy) was discretized into seven treatment planning substructures and linearly redistributed according to the relative SUV at every voxel in the boost volume. Fifty-four dose painting plan combinations were generated and conformity was evaluated using quality index VQ0.95-1.05, which represents the sum of planned dose voxels within 5% deviation from the prescribed dose. Trends in plan quality and magnitude of achievable dose escalation were recorded. Different segmentation techniques produced statistically significant variations in maximum planned dose (P < 0.02), as well as plan quality between segmentation methods for 4D GATED and 4D MIP PET images (P < 0.05). No statistically significant differences in plan quality and maximum dose were observed between motion-compensated PET-based plans (P > 0.75). Low variability in plan quality was observed for FIXED threshold plans, while MANUAL and GRADIENT plans achieved higher dose with lower plan quality indices. The dose painting plans were more sensitive to segmentation of boost volumes than PET motion compensation in this study sample. Careful consideration of boost target delineation and motion compensation strategies should guide the design of NSCLC dose painting trials. © 2017 The Royal Australian and New Zealand College of Radiologists.

Quantitative Evaluation Method of Each Generation Margin for Power System Planning

NASA Astrophysics Data System (ADS)

Su, Su; Tanaka, Kazuyuki

As the power system deregulation advances, the competition among the power companies becomes heated, and they seek more efficient system planning using existing facilities. Therefore, an efficient system planning method has been expected. This paper proposes a quantitative evaluation method for the (N-1) generation margin considering the overload and the voltage stability restriction. Concerning the generation margin related with the overload, a fast solution method without the recalculation of the (N-1) Y-matrix is proposed. Referred to the voltage stability, this paper proposes an efficient method to search the stability limit. The IEEE30 model system which is composed of 6 generators and 14 load nodes is employed to validate the proposed method. According to the results, the proposed method can reduce the computational cost for the generation margin related with the overload under the (N-1) condition, and specify the value quantitatively.

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

PubMed Central

Steinfeld, Rachel L.; Newmann, Sara J.; Onono, Maricianah; Cohen, Craig R.; Bukusi, Elizabeth A.; Grossman, Daniel

2013-01-01

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. PMID:23738057

SU-E-T-175: Clinical Evaluations of Monte Carlo-Based Inverse Treatment Plan Optimization for Intensity Modulated Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chi, Y; Li, Y; Tian, Z

2015-06-15

Purpose: Pencil-beam or superposition-convolution type dose calculation algorithms are routinely used in inverse plan optimization for intensity modulated radiation therapy (IMRT). However, due to their limited accuracy in some challenging cases, e.g. lung, the resulting dose may lose its optimality after being recomputed using an accurate algorithm, e.g. Monte Carlo (MC). It is the objective of this study to evaluate the feasibility and advantages of a new method to include MC in the treatment planning process. Methods: We developed a scheme to iteratively perform MC-based beamlet dose calculations and plan optimization. In the MC stage, a GPU-based dose engine wasmore » used and the particle number sampled from a beamlet was proportional to its optimized fluence from the previous step. We tested this scheme in four lung cancer IMRT cases. For each case, the original plan dose, plan dose re-computed by MC, and dose optimized by our scheme were obtained. Clinically relevant dosimetric quantities in these three plans were compared. Results: Although the original plan achieved a satisfactory PDV dose coverage, after re-computing doses using MC method, it was found that the PTV D95% were reduced by 4.60%–6.67%. After re-optimizing these cases with our scheme, the PTV coverage was improved to the same level as in the original plan, while the critical OAR coverages were maintained to clinically acceptable levels. Regarding the computation time, it took on average 144 sec per case using only one GPU card, including both MC-based beamlet dose calculation and treatment plan optimization. Conclusion: The achieved dosimetric gains and high computational efficiency indicate the feasibility and advantages of the proposed MC-based IMRT optimization method. Comprehensive validations in more patient cases are in progress.« less

Methods for Aquifer Thermal Energy Storage planning; The hidden side of cities.

NASA Astrophysics Data System (ADS)

Jaxa-Rozen, M.; Bloemendal, M.; Theo, O.

2017-12-01

Aquifer Thermal Energy Storage (ATES) systems reduce energy use and greenhouse gas emissions in urban areas, by supplying heating and cooling to buildings with a heat pump combined with seasonal heat storage in aquifers. The climactic and geohydrological conditions required for this technology can be found in many temperate regions around the world; In The Netherlands there are currently approximately 2,200 active systems. Despite this modest adoption level, many urban areas in the Netherlands already struggle to accommodate the subsurface claims needed to further develop ATES under current planning regulations. To identify best practices for ATES planning and maximize the technology's future potential, this work first reviews a set of 24 ATES-plans which were used for the spatial layout of ATES in various urban areas in The Netherlands and the method used to make those plans. This analysis revealed that three crucial elements are found to be missing in current ATES planning: i) a consistent assessment framework which can be used to compare the performance of different planning strategies; ii) a systematic adjustment of ATES design parameters to suit local conditions; iii) the identification and use of aquifer allocation thresholds to guide the choice of a planning strategy. All three steps are elaborated and added to the method. For the latter, these thresholds are identified by exploratory numerical modelling, using a coupled agent-based/geohydrological (MODFLOW) simulation to explore a broad range of scenarios for ATES design and layout parameters. The results give insight in how technical ATES-well design choices affect optimal use of subsurface space and in the trade-of between individual efficiency and overall emission reductions. The improved ATES-planning method now fosters planning and design rules ensuring optimal and sustainable use of subsurface space, i.e. maximizing energy saving by accommodating as much ATES systems as possible while maintaining individual well efficiency.

SU-E-T-644: Evaluation of Angular Dependence Correction for 2D Array Detector Using for Quality Assurance of Volumetric Modulated Arc Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karthikeyan, N; Ganesh, K M; Vikraman, S

2014-06-15

Purpose: To evaluate the angular dependence correction for Matrix Evolution 2D array detector in quality assurance of volumetric modulated arc therapy(VMAT). Methods: Total ten patients comprising of different sites were planned for VMAT and taken for the study. Each plan was exposed on Matrix Evolution 2D array detector with Omnipro IMRT software based on the following three different methods using 6MV photon beams from Elekta Synergy linear accelerator. First method, VMAT plan was delivered on Matrix Evolution detector as it gantry mounted with dedicated holder with build-up of 2.3cm. Second, the VMAT plan was delivered with the static gantry anglemore » on to the table mounted setup. Third, the VMAT plan was delivered with actual gantry angle on Matrix Evolution detector fixed in Multicube phantom with gantry angle sensor and angular dependence correction were applied to quantify the plan quality. For all these methods, the corresponding QA plans were generated in TPS and the dose verification was done for both point and 2D fluence analysis with pass criteria of 3% dose difference and 3mm distance to agreement. Results: The measured point dose variation for the first method was observed as 1.58±0.6% of mean and SD with TPS calculated. For second and third method, the mean and standard deviation(SD) was observed as 1.67±0.7% and 1.85±0.8% respectively. The 2D fluence analysis of measured and TPS calculated has the mean and SD of 97.9±1.1%, 97.88±1.2% and 97.55±1.3% for first, second and third methods respectively. The calculated two-tailed Pvalue for point dose and 2D fluence analysis shows the insignificance with values of 0.9316 and 0.9015 respectively, among the different methods of QA. Conclusion: The qualitative evaluation of angular dependence correction for Matrix Evolution 2D array detector shows its competency in accuracy of quality assurance measurement of composite dose distribution of volumetric modulated arc therapy.« less

Improving the Knowledge and Attitude on 'Standard Days Method' of Family Planning Through a Promotional Program Among Indian Postgraduate Students.

PubMed

Menachery, Philby Babu; Noronha, Judith Angelitta; Fernanades, Sweety

2017-08-01

The 'Standard Days Method' is a fertility awareness-based method of family planning that identifies day 8 through day 19 of the menstrual cycle as fertile days during which a woman is likely to conceive with unprotected intercourse. The study was aimed to determine the effectiveness of a promotional program on the 'Standard Days Method' in terms of improving the knowledge scores and attitude scores. A pre-experimental one-group pretest-posttest research design was adopted. The samples included 365 female postgraduate students from selected colleges of Udupi Taluk, Karnataka. The data was collected using self-administered questionnaires. The plan for the promotional program was also established. The findings of the study were analyzed using the descriptive and inferential statistics. The mean pretest and posttest knowledge scores were computed, and it was found that there was an increase in the mean knowledge score from 8.96 ± 3.84 to 32.64 ± 5.59, respectively. It was observed that the promotional program on 'Standard Days Method' was effective in improving the knowledge ( p  < 0.001) and attitude ( p  < 0.001) of the postgraduate students. The promotional program on Standard Days Method of family planning was effective in improving the knowledge and attitude of the postgraduate female students. This will enable the women to adopt this method and plan their pregnancies naturally and reduce the side effects of using oral contraceptives.

SU-E-T-07: 4DCT Robust Optimization for Esophageal Cancer Using Intensity Modulated Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liao, L; Department of Industrial Engineering, University of Houston, Houston, TX; Yu, J

2015-06-15

Purpose: To develop a 4DCT robust optimization method to reduce the dosimetric impact from respiratory motion in intensity modulated proton therapy (IMPT) for esophageal cancer. Methods: Four esophageal cancer patients were selected for this study. The different phases of CT from a set of 4DCT were incorporated into the worst-case dose distribution robust optimization algorithm. 4DCT robust treatment plans were designed and compared with the conventional non-robust plans. Result doses were calculated on the average and maximum inhale/exhale phases of 4DCT. Dose volume histogram (DVH) band graphic and ΔD95%, ΔD98%, ΔD5%, ΔD2% of CTV between different phases were used tomore » evaluate the robustness of the plans. Results: Compare to the IMPT plans optimized using conventional methods, the 4DCT robust IMPT plans can achieve the same quality in nominal cases, while yield a better robustness to breathing motion. The mean ΔD95%, ΔD98%, ΔD5% and ΔD2% of CTV are 6%, 3.2%, 0.9% and 1% for the robustly optimized plans vs. 16.2%, 11.8%, 1.6% and 3.3% from the conventional non-robust plans. Conclusion: A 4DCT robust optimization method was proposed for esophageal cancer using IMPT. We demonstrate that the 4DCT robust optimization can mitigate the dose deviation caused by the diaphragm motion.« less

Timber RAM. . .a long-range planning method for commercial timber lands under multiple-use management

Treesearch

Daniel I. Navon

1971-01-01

Timber RAM (Resource Allocation Method) is a long-range planning method for commercial timber lands under multiple-use management. Timber RAM can produce cutting and reforestation schedules and related harvest and economic reports. Each schedule optimizes an index of performance, subject to periodic constraints on revenues, costs, and, harvest levels. Periodic...

Role of land use planning in noise control

Treesearch

Stephanie J. Caswell; Karl Jakus

1977-01-01

A method for controlling outdoor noise through land use planning is presented. The method utilizes a computer model that broadly assesses the likely noise environments of a community on the basis of generalized land use and highway noise production and transmission conditions. The method is designed to enable town planners and other community decision-makers to...

7 CFR 1751.100 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... developed methods of telecommunications. Modernization Plan (State Telecommunications Modernization Plan). A... legislature, or a numeric majority of the RUS Borrowers within the State. When this part refers to the PUC as... circuit, it is not the major method of transmission as in radiotelephone. ...

Standard road plans [English version].

DOT National Transportation Integrated Search

2011-01-01

The Standard Road Plans contained within this manual have been developed : to show standardized design features, construction methods and approved : materials to be used in design plans for Interstate, Primary, and Secondary : road construction in th...

Performance planning for rural planning organizations - final report.

DOT National Transportation Integrated Search

2017-02-01

Recent federal rules place increased emphasis on performance-based management of the multimodal : transportation system and require the use of performance based methods in state, metropolitan, and : non-metropolitan transportation planning and progra...

Standard road plans : metric [version].

DOT National Transportation Integrated Search

2011-01-01

The Standard Road Plans contained within this manual have been developed : to show standardized design features, construction methods and approved : materials to be used in design plans for Interstate, Primary, and Secondary : road construction in th...

An Analysis of Categorical and Quantitative Methods for Planning Under Uncertainty

PubMed Central

Langlotz, Curtis P.; Shortliffe, Edward H.

1988-01-01

Decision theory and logical reasoning are both methods for representing and solving medical decision problems. We analyze the usefulness of these two approaches to medical therapy planning by establishing a simple correspondence between decision theory and non-monotonic logic, a formalization of categorical logical reasoning. The analysis indicates that categorical approaches to planning can be viewed as comprising two decision-theoretic concepts: probabilities (degrees of belief in planning hypotheses) and utilities (degrees of desirability of planning outcomes). We present and discuss examples of the following lessons from this decision-theoretic view of categorical (nonmonotonic) reasoning: (1) Decision theory and artificial intelligence techniques are intended to solve different components of the planning problem. (2) When considered in the context of planning under uncertainty, nonmonotonic logics do not retain the domain-independent characteristics of classical logical reasoning for planning under certainty. (3) Because certain nonmonotonic programming paradigms (e.g., frame-based inheritance, rule-based planning, protocol-based reminders) are inherently problem-specific, they may be inappropriate to employ in the solution of certain types of planning problems. We discuss how these conclusions affect several current medical informatics research issues, including the construction of “very large” medical knowledge bases.

Towards automatic planning for manufacturing generative processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

CALTON,TERRI L.

2000-05-24

Generative process planning describes methods process engineers use to modify manufacturing/process plans after designs are complete. A completed design may be the result from the introduction of a new product based on an old design, an assembly upgrade, or modified product designs used for a family of similar products. An engineer designs an assembly and then creates plans capturing manufacturing processes, including assembly sequences, component joining methods, part costs, labor costs, etc. When new products originate as a result of an upgrade, component geometry may change, and/or additional components and subassemblies may be added to or are omitted from themore » original design. As a result process engineers are forced to create new plans. This is further complicated by the fact that the process engineer is forced to manually generate these plans for each product upgrade. To generate new assembly plans for product upgrades, engineers must manually re-specify the manufacturing plan selection criteria and re-run the planners. To remedy this problem, special-purpose assembly planning algorithms have been developed to automatically recognize design modifications and automatically apply previously defined manufacturing plan selection criteria and constraints.« less

Enterprise Architecture Planning in developing A planning Information System: a Case Study of Semarang State University

NASA Astrophysics Data System (ADS)

Budiman, Kholiq; Prahasto, Toni; Kusumawardhani, Amie

2018-02-01

This research has applied an integrated design and development of planning information system, which is been designed using Enterprise Architecture Planning. Frequent discrepancy between planning and realization of the budget that has been made, resulted in ineffective planning, is one of the reason for doing this research. The design using EAP aims to keep development aligned and in line with the strategic direction of the organization. In the practice, EAP is carried out in several stages of the planning initiation, identification and definition of business functions, proceeded with architectural design and EA implementation plan that has been built. In addition to the design of the Enterprise Architecture, this research carried out the implementation, and was tested by several methods of black box and white box. Black box testing method is used to test the fundamental aspects of the software, tested by two kinds of testing, first is using User Acceptance Testing and the second is using software functionality testing. White box testing method is used to test the effectiveness of the code in the software, tested using unit testing. Tests conducted using white box and black box on the integrated planning information system, is declared successful. Success in the software testing can not be ascertained if the software built has not shown any distinction from prior circumstance to the development of this integrated planning information system. For ensuring the success of this system implementation, the authors test consistency between the planning of data and the realization of prior-use of the information system, until after-use information system. This consistency test is done by reducing the time data of the planning and realization time. From the tabulated data, the planning information system that has been built reduces the difference between the planning time and the realization time, in which indicates that the planning information system can motivate the planner unit in realizing the budget that has been designed. It also proves that the value chain of the information planning system has brought implications for budget realization.

Assessing climate impacts of planning policies-An estimation for the urban region of Leipzig (Germany)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwarz, Nina, E-mail: nina.schwarz@ufz.de; Bauer, Annette, E-mail: annette.bauer@ufz.de; Haase, Dagmar, E-mail: dagmar.haase@ufz.d

2011-03-15

Local climate regulation by urban green areas is an important urban ecosystem service, as it reduces the extent of the urban heat island and therefore enhances quality of life. Local and regional planning policies can control land use changes in an urban region, which in turn alter local climate regulation. Thus, this paper describes a method for estimating the impacts of current land uses as well as local and regional planning policies on local climate regulation, using evapotranspiration and land surface emissivity as indicators. This method can be used by practitioners to evaluate their policies. An application of this methodmore » is demonstrated for the case study Leipzig (Germany). Results for six selected planning policies in Leipzig indicate their distinct impacts on climate regulation and especially the role of their spatial extent. The proposed method was found to easily produce a qualitative assessment of impacts of planning policies on climate regulation.« less

New method for estimation of fluence complexity in IMRT fields and correlation with gamma analysis

NASA Astrophysics Data System (ADS)

Hanušová, T.; Vondráček, V.; Badraoui-Čuprová, K.; Horáková, I.; Koniarová, I.

2015-01-01

A new method for estimation of fluence complexity in Intensity Modulated Radiation Therapy (IMRT) fields is proposed. Unlike other previously published works, it is based on portal images calculated by the Portal Dose Calculation algorithm in Eclipse (version 8.6, Varian Medical Systems) in the plane of the EPID aS500 detector (Varian Medical Systems). Fluence complexity is given by the number and the amplitudes of dose gradients in these matrices. Our method is validated using a set of clinical plans where fluence has been smoothed manually so that each plan has a different level of complexity. Fluence complexity calculated with our tool is in accordance with the different levels of smoothing as well as results of gamma analysis, when calculated and measured dose matrices are compared. Thus, it is possible to estimate plan complexity before carrying out the measurement. If appropriate thresholds are determined which would distinguish between acceptably and overly modulated plans, this might save time in the re-planning and re-measuring process.

Using mean duration and variation of procedure times to plan a list of surgical operations to fit into the scheduled list time.

PubMed

Pandit, Jaideep J; Tavare, Aniket

2011-07-01

It is important that a surgical list is planned to utilise as much of the scheduled time as possible while not over-running, because this can lead to cancellation of operations. We wished to assess whether, theoretically, the known duration of individual operations could be used quantitatively to predict the likely duration of the operating list. In a university hospital setting, we first assessed the extent to which the current ad-hoc method of operating list planning was able to match the scheduled operating list times for 153 consecutive historical lists. Using receiver operating curve analysis, we assessed the ability of an alternative method to predict operating list duration for the same operating lists. This method uses a simple formula: the sum of individual operation times and a pooled standard deviation of these times. We used the operating list duration estimated from this formula to generate a probability that the operating list would finish within its scheduled time. Finally, we applied the simple formula prospectively to 150 operating lists, 'shadowing' the current ad-hoc method, to confirm the predictive ability of the formula. The ad-hoc method was very poor at planning: 50% of historical operating lists were under-booked and 37% over-booked. In contrast, the simple formula predicted the correct outcome (under-run or over-run) for 76% of these operating lists. The calculated probability that a planned series of operations will over-run or under-run was found useful in developing an algorithm to adjust the planned cases optimally. In the prospective series, 65% of operating lists were over-booked and 10% were under-booked. The formula predicted the correct outcome for 84% of operating lists. A simple quantitative method of estimating operating list duration for a series of operations leads to an algorithm (readily created on an Excel spreadsheet, http://links.lww.com/EJA/A19) that can potentially improve operating list planning.

SU-E-T-154: Establishment and Implement of 3D Image Guided Brachytherapy Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, S; Zhao, S; Chen, Y

2014-06-01

Purpose: Cannot observe the dose intuitionally is a limitation of the existing 2D pre-implantation dose planning. Meanwhile, a navigation module is essential to improve the accuracy and efficiency of the implantation. Hence a 3D Image Guided Brachytherapy Planning System conducting dose planning and intra-operative navigation based on 3D multi-organs reconstruction is developed. Methods: Multi-organs including the tumor are reconstructed in one sweep of all the segmented images using the multiorgans reconstruction method. The reconstructed organs group establishs a three-dimensional visualized operative environment. The 3D dose maps of the three-dimentional conformal localized dose planning are calculated with Monte Carlo method whilemore » the corresponding isodose lines and isodose surfaces are displayed in a stereo view. The real-time intra-operative navigation is based on an electromagnetic tracking system (ETS) and the fusion between MRI and ultrasound images. Applying Least Square Method, the coordinate registration between 3D models and patient is realized by the ETS which is calibrated by a laser tracker. The system is validated by working on eight patients with prostate cancer. The navigation has passed the precision measurement in the laboratory. Results: The traditional marching cubes (MC) method reconstructs one organ at one time and assembles them together. Compared to MC, presented multi-organs reconstruction method has superiorities in reserving the integrality and connectivity of reconstructed organs. The 3D conformal localized dose planning, realizing the 'exfoliation display' of different isodose surfaces, helps make sure the dose distribution has encompassed the nidus and avoid the injury of healthy tissues. During the navigation, surgeons could observe the coordinate of instruments real-timely employing the ETS. After the calibration, accuracy error of the needle position is less than 2.5mm according to the experiments. Conclusion: The speed and quality of 3D reconstruction, the efficiency in dose planning and accuracy in navigation all can be improved simultaneously.« less

Range optimization for mono- and bi-energetic proton modulated arc therapy with pencil beam scanning

NASA Astrophysics Data System (ADS)

Sanchez-Parcerisa, Daniel; Kirk, Maura; Fager, Marcus; Burgdorf, Brendan; Stowe, Malorie; Solberg, Tim; Carabe, Alejandro

2016-11-01

The development of rotational proton therapy plans based on a pencil-beam-scanning (PBS) system has been limited, among several other factors, by the energy-switching time between layers, a system-dependent parameter that ranges between a fraction of a second and several seconds. We are investigating mono- and bi-energetic rotational proton modulated arc therapy (PMAT) solutions that would not be affected by long energy switching times. In this context, a systematic selection of the optimal proton energy for each arc is vital. We present a treatment planning comparison of four different range selection methods, analyzing the dosimetric outcomes of the resulting treatment plans created with the ranges obtained. Given the patient geometry and arc definition (gantry and couch trajectories, snout elevation) our in-house treatment planning system (TPS) FoCa was used to find the maximum, medial and minimum water-equivalent thicknesses (WETs) of the target viewed from all possible field orientations. Optimal ranges were subsequently determined using four methods: (1) by dividing the max/min WET interval into equal steps, (2) by taking the average target midpoints from each field, (3) by taking the average WET of all voxels from all field orientations, and (4) by minimizing the fraction of the target which cannot be reached from any of the available angles. After the range (for mono-energetic plans) or ranges (for bi-energetic plans) were selected, the commercial clinical TPS in use in our institution (Varian Eclipse™) was used to produce the PMAT plans using multifield optimization. Linear energy transfer (LET) distributions of all plans were also calculated using FoCa and compared among the different methods. Mono- and bi-energetic PMAT plans, composed of a single 180° arc, were created for two patient geometries: a C-shaped target located in the mediastinal area of a thoracic tissue-equivalent phantom and a small brain tumor located directly above the brainstem. All plans were optimized using the same procedure to (1) achieve target coverage, (2) reduce dose to OAR and (3) limit dose hot spots in the target. Final outcomes were compared in terms of the resulting dose and LET distributions. Data shows little significant differences among the four studied methods, with superior results obtained with mono-energetic plans. A streamlined systematic method has been implemented in an in-house TPS to find the optimal range to maximize target coverage with rotational mono- or bi-energetic PBS rotational plans by minimizing the fraction of the target that cannot be reached by any direction.

ENVIRONMENTAL METHODS TESTING SITE PROJECT: DATA MANAGEMENT PROCEDURES PLAN

EPA Science Inventory

The Environmental Methods Testing Site (EMTS) Data Management Procedures Plan identifies the computer hardware and software resources used in the EMTS project. It identifies the major software packages that are available for use by principal investigators for the analysis of data...

SU-E-T-43: A Methodology for Quality Control of IMPT Treatment Plan Based On VMAT Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, S; Tianjin Medical University Cancer Institute and Hospital; Yang, Y

Purpose: IMPT plan design is highly dependent on planner’s experiences. VMAT plan design is relatively mature and can even be automated. The quality of IMPT plan designed by in-experienced planner could be inferior to that of VMAT plan designed by experienced planner or automatic planning software. Here we introduce a method for designing IMPT plan based on VMAT plan to ensure the IMPT plan be superior to IMRT/VMAT plan for majority clinical scenario. Methods: To design a new IMPT plan, a VMAT plan is first generated either by experienced planner or by in-house developed automatic planning system. An in-house developedmore » tool is used to generate the dose volume constrains for the IMPT plan as plan template to Eclipse TPS. The beam angles for IMPT plan are selected based on the preferred angles in the VMAT plan. IMPT plan is designed by importing the plan objectives generated from VMAT plan. Majority thoracic IMPT plans are designed using this plan approach in our center. In this work, a thoracic IMPT plan under RTOG 1308 protocol is selected to demonstrate the effectiveness and efficiency of this approach. The dosimetric indices of IMPT are compared with VMAT plan. Results: The PTV D95, lung V20, MLD, mean heart dose, esophagus D1, cord D1 are 70Gy, 31%, 17.8Gy, 25.5Gy, 73Gy, 45Gy for IMPT plan and 65.3Gy, 34%, 21.6Gy, 35Gy, 74Gy, 48Gy for VMAT plan. For majority cases, the high dose region of the normal tissue which is in proximity of PTV is comparable between IMPT and VMAT plan. The low dose region of the IMPT plan is significantly better than VMAT plan. Conclusion: Using the knowledge gained in VMAT plan design can help efficiently and effectively design high quality IMPT plan. The quality of IMPT plan can be controlled to ensure the superiority of IMPT plan compared to VMAT/IMRT plan.« less

Generalizable Skills in Individualized Vocational Program Planning for Special Needs Students.

ERIC Educational Resources Information Center

Stodden, Robert A.; Boone, Rosalie

1986-01-01

The authors address planning issues and suggest methods of interagency cooperation, integration of generalizable skills in individualized educational planning/programming, developing goals and objectives, and using student assessment and evaluation information. (CT)

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

Planning for a Distributed Disruption: Innovative Practices for Incorporating Distributed Solar into Utility Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mills, Andrew D.; Barbose, Galen L.; Seel, Joachim

The rapid growth of distributed solar photovoltaics (DPV) has critical implications for U.S. utility planning processes. This report informs utility planning through a comparative analysis of roughly 30 recent utility integrated resource plans or other generation planning studies, transmission planning studies, and distribution system plans. It reveals a spectrum of approaches to incorporating DPV across nine key planning areas, and it identifies areas where even the best current practices might be enhanced. (1) Forecasting DPV deployment: Because it explicitly captures several predictive factors, customer-adoption modeling is the most comprehensive forecasting approach. It could be combined with other forecasting methods tomore » generate a range of potential futures. (2) Ensuring robustness of decisions to uncertain DPV quantities: using a capacity-expansion model to develop least-cost plans for various scenarios accounts for changes in net load and the generation portfolio; an innovative variation of this approach combines multiple per-scenario plans with trigger events, which indicate when conditions have changed sufficiently from the expected to trigger modifications in resource-acquisition strategy. (3) Characterizing DPV as a resource option: Today's most comprehensive plans account for all of DPV's monetary costs and benefits. An enhanced approach would address non-monetary and societal impacts as well. (4) Incorporating the non-dispatchability of DPV into planning: Rather than having a distinct innovative practice, innovation in this area is represented by evolving methods for capturing this important aspect of DPV. (5) Accounting for DPV's location-specific factors: The innovative propensity-to-adopt method employs several factors to predict future DPV locations. Another emerging utility innovation is locating DPV strategically to enhance its benefits. (6) Estimating DPV's impact on transmission and distribution investments: Innovative practices are being implemented to evaluate system needs, hosting capacities, and system investments needed to accommodate DPV deployment. (7) Estimating avoided losses associated with DPV: A time-differentiated marginal loss rate provides the most comprehensive estimate of avoided losses due to DPV, but no studies appear to use it. (8) Considering changes in DPV's value with higher solar penetration: Innovative methods for addressing the value changes at high solar penetrations are lacking among the studies we evaluate. (9) Integrating DPV in planning across generation, transmission, and distribution: A few states and regions have started to develop more comprehensive processes that link planning forums, but there are still many issues to address.« less

Planning for a Distributed Disruption: Innovative Practices for Incorporating Distributed Solar into Utility Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mill, Andrew; Barbose, Galen; Seel, Joachim

The rapid growth of distributed solar photovoltaics (DPV) has critical implications for U.S. utility planning processes. This report informs utility planning through a comparative analysis of roughly 30 recent utility integrated resource plans or other generation planning studies, transmission planning studies, and distribution system plans. It reveals a spectrum of approaches to incorporating DPV across nine key planning areas, and it identifies areas where even the best current practices might be enhanced. 1) Forecasting DPV deployment: Because it explicitly captures several predictive factors, customer-adoption modeling is the most comprehensive forecasting approach. It could be combined with other forecasting methods tomore » generate a range of potential futures. 2) Ensuring robustness of decisions to uncertain DPV quantities: using a capacity-expansion model to develop least-cost plans for various scenarios accounts for changes in net load and the generation portfolio; an innovative variation of this approach combines multiple per-scenario plans with trigger events, which indicate when conditions have changed sufficiently from the expected to trigger modifications in resource-acquisition strategy. 3) Characterizing DPV as a resource option: Today’s most comprehensive plans account for all of DPV’s monetary costs and benefits. An enhanced approach would address non-monetary and societal impacts as well. 4) Incorporating the non-dispatchability of DPV into planning: Rather than having a distinct innovative practice, innovation in this area is represented by evolving methods for capturing this important aspect of DPV. 5) Accounting for DPV’s location-specific factors: The innovative propensity-to-adopt method employs several factors to predict future DPV locations. Another emerging utility innovation is locating DPV strategically to enhance its benefits. 6) Estimating DPV’s impact on transmission and distribution investments: Innovative practices are being implemented to evaluate system needs, hosting capacities, and system investments needed to accommodate DPV deployment. 7) Estimating avoided losses associated with DPV: A time-differentiated marginal loss rate provides the most comprehensive estimate of avoided losses due to DPV, but no studies appear to use it. 8) Considering changes in DPV’s value with higher solar penetration: Innovative methods for addressing the value changes at high solar penetrations are lacking among the studies we evaluate. 9) Integrating DPV in planning across generation, transmission, and distribution: A few states and regions have started to develop more comprehensive processes that link planning forums, but there are still many issues to address.« less

Speech planning happens before speech execution: online reaction time methods in the study of apraxia of speech.

PubMed

Maas, Edwin; Mailend, Marja-Liisa

2012-10-01

The purpose of this article is to present an argument for the use of online reaction time (RT) methods to the study of apraxia of speech (AOS) and to review the existing small literature in this area and the contributions it has made to our fundamental understanding of speech planning (deficits) in AOS. Following a brief description of limitations of offline perceptual methods, we provide a narrative review of various types of RT paradigms from the (speech) motor programming and psycholinguistic literatures and their (thus far limited) application with AOS. On the basis of the review of the literature, we conclude that with careful consideration of potential challenges and caveats, RT approaches hold great promise to advance our understanding of AOS, in particular with respect to the speech planning processes that generate the speech signal before initiation. A deeper understanding of the nature and time course of speech planning and its disruptions in AOS may enhance diagnosis and treatment for AOS. Only a handful of published studies on apraxia of speech have used reaction time methods. However, these studies have provided deeper insight into speech planning impairments in AOS based on a variety of experimental paradigms.

The NASA competitive placement plan for positions GS-15 and below (including trades and labor positions)

NASA Technical Reports Server (NTRS)

1993-01-01

This plan provides the framework for selection based on merit from among the best qualified candidates available. Selections will be made without regard to political, religious, or labor organization affiliation or nonaffiliation, marital status, race, color, sex, national origin, nondisqualifying disability, or age. This plan does not guarantee promotion but rather ensures that all qualified available candidates receive fair and equitable consideration for positions filled under these competitive procedures. Announcing a vacancy under this plan is only one method of locating applicants for a position and can be used in conjunction with other methods. Subject to applicable law and regulation, selection of an individual to fill a position is the decision of management, as is the decision as to the method(s) to be used in identifying candidates. This plan is applicable to all NASA Installations. It covers all positions in the competitive service at (and below) the GS/GM-15 level (including all trades and labor positions), except positions in the Office of the Inspector General. The requirements herein are not intended to, nor should they be construed to limit in any way, the independent personnel authority of the Inspector General under the Inspector General Act, as Amended.

Tactical resource allocation and elective patient admission planning in care processes.

PubMed

Hulshof, Peter J H; Boucherie, Richard J; Hans, Erwin W; Hurink, Johann L

2013-06-01

Tactical planning of resources in hospitals concerns elective patient admission planning and the intermediate term allocation of resource capacities. Its main objectives are to achieve equitable access for patients, to meet production targets/to serve the strategically agreed number of patients, and to use resources efficiently. This paper proposes a method to develop a tactical resource allocation and elective patient admission plan. These tactical plans allocate available resources to various care processes and determine the selection of patients to be served that are at a particular stage of their care process. Our method is developed in a Mixed Integer Linear Programming (MILP) framework and copes with multiple resources, multiple time periods and multiple patient groups with various uncertain treatment paths through the hospital, thereby integrating decision making for a chain of hospital resources. Computational results indicate that our method leads to a more equitable distribution of resources and provides control of patient access times, the number of patients served and the fraction of allocated resource capacity. Our approach is generic, as the base MILP and the solution approach allow for including various extensions to both the objective criteria and the constraints. Consequently, the proposed method is applicable in various settings of tactical hospital management.

ON THE BENEFITS AND RISKS OF PROTON THERAPY IN PEDIATRIC CRANIOPHARYNGIOMA

PubMed Central

Beltran, Chris; Roca, Monica; Merchant, Thomas E.

2013-01-01

Purpose Craniopharyngioma is a pediatric brain tumor whose volume is prone to change during radiation therapy. We compared photon- and proton-based irradiation methods to determine the effect of tumor volume change on target coverage and normal tissue irradiation in these patients. Methods and Materials For this retrospective study, we acquired imaging and treatment-planning data from 14 children with craniopharyngioma (mean age, 5.1 years) irradiated with photons (54 Gy) and monitored by weekly magnetic resonance imaging (MRI) examinations during radiation therapy. Photon intensity-modulated radiation therapy (IMRT), double-scatter proton (DSP) therapy, and intensity-modulated proton therapy (IMPT) plans were created for each patient based on his or her pre-irradiation MRI. Target volumes were contoured on each weekly MRI scan for adaptive modeling. The measured differences in conformity index (CI) and normal tissue doses, including functional sub-volumes of the brain, were compared across the planning methods, as was target coverage based on changes in target volumes during treatment. Results CI and normal tissue dose values of IMPT plans were significantly better than those of the IMRT and DSP plans (p < 0.01). Although IMRT plans had a higher CI and lower optic nerve doses (p < 0.01) than did DSP plans, DSP plans had lower cochlear, optic chiasm, brain, and scanned body doses (p < 0.01). The mean planning target volume (PTV) at baseline was 54.8 cm3, and the mean increase in PTV was 11.3% over the course of treatment. The dose to 95% of the PTV was correlated with a change in the PTV; the R2 values for all models, 0.73 (IMRT), 0.38 (DSP), and 0.62 (IMPT), were significant (p < 0.01). Conclusions Compared with photon IMRT, proton therapy has the potential to significantly reduce whole-brain and -body irradiation in pediatric patients with craniopharyngioma. IMPT is the most conformal method and spares the most normal tissue; however, it is highly sensitive to target volume changes, whereas the DSP method is not. PMID:21570209

A Varian DynaLog file-based procedure for patient dose-volume histogram-based IMRT QA.

PubMed

Calvo-Ortega, Juan F; Teke, Tony; Moragues, Sandra; Pozo, Miquel; Casals-Farran, Joan

2014-03-06

In the present study, we describe a method based on the analysis of the dynamic MLC log files (DynaLog) generated by the controller of a Varian linear accelerator in order to perform patient-specific IMRT QA. The DynaLog files of a Varian Millennium MLC, recorded during an IMRT treatment, can be processed using a MATLAB-based code in order to generate the actual fluence for each beam and so recalculate the actual patient dose distribution using the Eclipse treatment planning system. The accuracy of the DynaLog-based dose reconstruction procedure was assessed by introducing ten intended errors to perturb the fluence of the beams of a reference plan such that ten subsequent erroneous plans were generated. In-phantom measurements with an ionization chamber (ion chamber) and planar dose measurements using an EPID system were performed to investigate the correlation between the measured dose changes and the expected ones detected by the reconstructed plans for the ten intended erroneous cases. Moreover, the method was applied to 20 cases of clinical plans for different locations (prostate, lung, breast, and head and neck). A dose-volume histogram (DVH) metric was used to evaluate the impact of the delivery errors in terms of dose to the patient. The ionometric measurements revealed a significant positive correlation (R² = 0.9993) between the variations of the dose induced in the erroneous plans with respect to the reference plan and the corresponding changes indicated by the DynaLog-based reconstructed plans. The EPID measurements showed that the accuracy of the DynaLog-based method to reconstruct the beam fluence was comparable with the dosimetric resolution of the portal dosimetry used in this work (3%/3 mm). The DynaLog-based reconstruction method described in this study is a suitable tool to perform a patient-specific IMRT QA. This method allows us to perform patient-specific IMRT QA by evaluating the result based on the DVH metric of the planning CT image (patient DVH-based IMRT QA).

SU-F-T-293: Experimental Comparisons of Ionization Chambers with Different Volumes for CyberKnife Delivery Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakayama, M; Kobe University Graduate School of Medicine, Kobe, Hyogo; Munetomo, Y

2016-06-15

Purpose: To evaluate the practicality use of ionization chambers with different volumes for delivery quality assurance of CyberKnife plans, Methods: Dosimetric measurements with a spherical solid water phantom and three ionization chambers with volumes of 0.13, 0.04, and 0.01 cm3 (IBA CC13, CC04, and CC01, respectively) were performed for various CyberKnife clinical treatment plans including both isocentric and nonisocentric delivery. For each chamber, the ion recombination correction factors Ks were calculated using the Jaffe plot method and twovoltage method at a 10-cm depth for a 60-mm collimator field in a water phantom. The polarity correction factors Kpol were determined formore » 5–60-mm collimator fields in same experimental setup. The measured doses were compared to the doses for the detectors calculated using a treatment planning system. Results: The differences in the Ks between the Jaffe plot method and two-voltage method were −0.12, −0.02, and 0.89% for CC13, CC04, and CC01, respectively. The changes in Kpol for the different field sizes were 0.2, 0.3, and 0.8% for CC13, CC04, and CC01, respectively. The measured doses for CC04 and CC01 were within 3% of the calculated doses for the clinical treatment plans with isocentric delivery with collimator fields greater than 12.5 mm. Those for CC13 had differences of over 3% for the plans with isocentric delivery with collimator fields less than 15 mm. The differences for the isocentric plans were similar to those for the single beam plans. The measured doses for each chamber were within 3% of the calculated doses for the non-isocentric plans except for that with a PTV volume less than 1.0 cm{sup 3}. Conclusion: Although there are some limitations, the ionization chamber with a smaller volume is a better detector for verification of the CyberKnife plans owing to the high spatial resolution.« less

The effects of method of presenting health plan information on HMO enrollment by Medicaid beneficiaries.

PubMed Central

Andrews, R M; Curbow, B A; Owen, E; Burke, A

1989-01-01

Marketing strategies are critical for enhancing HMO enrollments among Medicaid beneficiaries when they are provided a choice of health plans. This study examined one component of marketing HMOs--the method of communicating the HMO's attributes. The purpose of the analysis was to determine if characteristics of Medicaid beneficiaries who enroll in HMOs vary by method of communicating information about health plan options. Data were analyzed from the marketing component of California's Prepaid Health Research, Evaluation, and Demonstration (PHRED) project. Five communication methods are examined in the article: brochure, film, county eligibility worker presentation, state representative presentation, and HMO representative presentation. The analysis reveals that each communication method is most effective with a different type of beneficiary. No single consumer characteristic is related to HMO enrollment across all five methods, although lack of a private physician and dissatisfaction with a current provider are associated with choice in four methods. Film is the best method for attracting persons who have an ongoing relationship with a provider. PMID:2668236

Four-dimensional dose distributions of step-and-shoot IMRT delivered with real-time tumor tracking for patients with irregular breathing: Constant dose rate vs dose rate regulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang Xiaocheng; Han-Oh, Sarah; Gui Minzhi

2012-09-15

Purpose: Dose-rate-regulated tracking (DRRT) is a tumor tracking strategy that programs the MLC to track the tumor under regular breathing and adapts to breathing irregularities during delivery using dose rate regulation. Constant-dose-rate tracking (CDRT) is a strategy that dynamically repositions the beam to account for intrafractional 3D target motion according to real-time information of target location obtained from an independent position monitoring system. The purpose of this study is to illustrate the differences in the effectiveness and delivery accuracy between these two tracking methods in the presence of breathing irregularities. Methods: Step-and-shoot IMRT plans optimized at a reference phase weremore » extended to remaining phases to generate 10-phased 4D-IMRT plans using segment aperture morphing (SAM) algorithm, where both tumor displacement and deformation were considered. A SAM-based 4D plan has been demonstrated to provide better plan quality than plans not considering target deformation. However, delivering such a plan requires preprogramming of the MLC aperture sequence. Deliveries of the 4D plans using DRRT and CDRT tracking approaches were simulated assuming the breathing period is either shorter or longer than the planning day, for 4 IMRT cases: two lung and two pancreatic cases with maximum GTV centroid motion greater than 1 cm were selected. In DRRT, dose rate was regulated to speed up or slow down delivery as needed such that each planned segment is delivered at the planned breathing phase. In CDRT, MLC is separately controlled to follow the tumor motion, but dose rate was kept constant. In addition to breathing period change, effect of breathing amplitude variation on target and critical tissue dose distribution is also evaluated. Results: Delivery of preprogrammed 4D plans by the CDRT method resulted in an average of 5% increase in target dose and noticeable increase in organs at risk (OAR) dose when patient breathing is either 10% faster or slower than the planning day. In contrast, DRRT method showed less than 1% reduction in target dose and no noticeable change in OAR dose under the same breathing period irregularities. When {+-}20% variation of target motion amplitude was present as breathing irregularity, the two delivery methods show compatible plan quality if the dose distribution of CDRT delivery is renormalized. Conclusions: Delivery of 4D-IMRT treatment plans, stemmed from 3D step-and-shoot IMRT and preprogrammed using SAM algorithm, is simulated for two dynamic MLC-based real-time tumor tracking strategies: with and without dose-rate regulation. Comparison of cumulative dose distribution indicates that the preprogrammed 4D plan is more accurately and efficiently conformed using the DRRT strategy, as it compensates the interplay between patient breathing irregularity and tracking delivery without compromising the segment-weight modulation.« less

An Interactive Scheduling Method for Railway Rolling Stock Allocation

NASA Astrophysics Data System (ADS)

Otsuki, Tomoshi; Nakajima, Masayoshi; Fuse, Toru; Shimizu, Tadashi; Aisu, Hideyuki; Yasumoto, Takanori; Kaneko, Kenichi; Yokoyama, Nobuyuki

Experts working for railway schedule planners still have to devote considerable time and effort for creating rolling stock allocation plans. In this paper, we propose a semiautomatic planning method for creating these plans. Our scheduler is able to interactively deal with flexible constraint-expression inputs and to output easy-to-understand failure messages. Owing to these useful features, the scheduler can provide results that are comparable to those obtained by experts and are obtained faster than before.

A Marketing Study of the Impatient Pharmacy Branch Dwight David Eisenhower Army Medical Center

DTIC Science & Technology

1984-06-01

Tucker, "Introducing Marketing as a Planning and Management Tool," Hospital and Health Services Administration (Winter 1977):37-45. 1 0 Philip Kotler ...34 Hospital Financial Management (September 1980):12-18. 1 2 Kotler , Marketing for Nonprofit Organizations. 1 3 MacStravic, Marketing Health Care. 1 4...industries as a basic method of planning and management . Yet incorporation of marketing methods into the planning and management of health care

Patient Selection and Activity Planning Guide for Selective Internal Radiotherapy With Yttrium-90 Resin Microspheres

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lau, Wan-Yee, E-mail: josephlau@surgery.cuhk.edu.hk; Kennedy, Andrew S.; Department of Biomedical Engineering, North Carolina State University, Raleigh, NC

Purpose: Selective internal radiotherapy (SIRT) with yttrium-90 ({sup 90}Y) resin microspheres can improve the clinical outcomes for selected patients with inoperable liver cancer. This technique involves intra-arterial delivery of {beta}-emitting microspheres into hepatocellular carcinomas or liver metastases while sparing uninvolved structures. Its unique mode of action, including both {sup 90}Y brachytherapy and embolization of neoplastic microvasculature, necessitates activity planning methods specific to SIRT. Methods and Materials: A panel of clinicians experienced in {sup 90}Y resin microsphere SIRT was convened to integrate clinical experience with the published data to propose an activity planning pathway for radioembolization. Results: Accurate planning is essentialmore » to minimize potentially fatal sequelae such as radiation-induced liver disease while delivering tumoricidal {sup 90}Y activity. Planning methods have included empiric dosing according to degree of tumor involvement, empiric dosing adjusted for the body surface area, and partition model calculations using Medical Internal Radiation Dose principles. It has been recommended that at least two of these methods be compared when calculating the microsphere activity for each patient. Conclusions: Many factors inform {sup 90}Y resin microsphere SIRT activity planning, including the therapeutic intent, tissue and vasculature imaging, tumor and uninvolved liver characteristics, previous therapies, and localization of the microsphere infusion. The influence of each of these factors has been discussed.« less

Patient geometry-driven information retrieval for IMRT treatment plan quality control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu Binbin; Ricchetti, Francesco; Sanguineti, Giuseppe

Purpose: Intensity modulated radiation therapy (IMRT) treatment plan quality depends on the planner's level of experience and the amount of time the planner invests in developing the plan. Planners often unwittingly accept plans when further sparing of the organs at risk (OARs) is possible. The authors propose a method of IMRT treatment plan quality control that helps planners to evaluate the doses of the OARs upon completion of a new plan. Methods: It is achieved by comparing the geometric configurations of the OARs and targets of a new patient with those of prior patients, whose plans are maintained in amore » database. They introduce the concept of a shape relationship descriptor and, specifically, the overlap volume histogram (OVH) to describe the spatial configuration of an OAR with respect to a target. The OVH provides a way to infer the likely DVHs of the OARs by comparing the relative spatial configurations between patients. A database of prior patients is built to serve as an external reference. At the conclusion of a new plan, planners search through the database and identify related patients by comparing the OAR-target geometric relationships of the new patient with those of prior patients. The treatment plans of these related patients are retrieved from the database and guide planners in determining whether lower doses delivered to the OARs in the new plan are feasible. Results: Preliminary evaluation is promising. In this evaluation, they applied the analysis to the parotid DVHs of 32 prior head-and-neck patients, whose plans are maintained in a database. Each parotid was queried against the other 63 parotids to determine whether a lower dose was possible. The 17 parotids that promised the greatest reduction in D{sub 50} (DVH dose at 50% volume) were flagged. These 17 parotids came from 13 patients. The method also indicated that the doses of the other nine parotids of the 13 patients could not be reduced, so they were included in the replanning process as controls. Replanning with an effort to reduce D{sub 50} was conducted on these 26 parotids. After replanning, the average reductions for D{sub 50} of the 17 flagged parotids and nine unflagged parotids were 6.6 and 1.9 Gy, respectively. These results demonstrate that the quality control method has accurately identified not only the parotids that require dose reductions but also those for which dose reductions are marginal. Originally, 11 of out the 17 flagged parotids did not meet the Radiation Therapy Oncology Group sparing goal of V(30 Gy)<50%. Replanning reduced them to three. Additionally, PTV coverage and OAR sparing of the original plans were compared to those of the replans by using pairwise Wilcoxon p test. The statistical comparisons show that replanning compromised neither PTV coverage nor OAR sparing. Conclusions: This method provides an effective quality control mechanism for evaluating the DVHs of the OARs. Adoption of such a method will advance the quality of current IMRT planning, providing better treatment plan consistency.« less

WE-AB-209-05: Development of an Ultra-Fast High Quality Whole Breast Radiotherapy Treatment Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheng, Y; Li, T; Yoo, S

2016-06-15

Purpose: To enable near-real-time (<20sec) and interactive planning without compromising quality for whole breast RT treatment planning using tangential fields. Methods: Whole breast RT plans from 20 patients treated with single energy (SE, 6MV, 10 patients) or mixed energy (ME, 6/15MV, 10 patients) were randomly selected for model training. Additional 20 cases were used as validation cohort. The planning process for a new case consists of three fully automated steps:1. Energy Selection. A classification model automatically selects energy level. To build the energy selection model, principle component analysis (PCA) was applied to the digital reconstructed radiographs (DRRs) of training casesmore » to extract anatomy-energy relationship.2. Fluence Estimation. Once energy is selected, a random forest (RF) model generates the initial fluence. This model summarizes the relationship between patient anatomy’s shape based features and the output fluence. 3. Fluence Fine-tuning. This step balances the overall dose contribution throughout the whole breast tissue by automatically selecting reference points and applying centrality correction. Fine-tuning works at beamlet-level until the dose distribution meets clinical objectives. Prior to finalization, physicians can also make patient-specific trade-offs between target coverage and high-dose volumes.The proposed method was validated by comparing auto-plans with manually generated clinical-plans using Wilcoxon Signed-Rank test. Results: In 19/20 cases the model suggested the same energy combination as clinical-plans. The target volume coverage V100% was 78.1±4.7% for auto-plans, and 79.3±4.8% for clinical-plans (p=0.12). Volumes receiving 105% Rx were 69.2±78.0cc for auto-plans compared to 83.9±87.2cc for clinical-plans (p=0.13). The mean V10Gy, V20Gy of the ipsilateral lung was 24.4±6.7%, 18.6±6.0% for auto plans and 24.6±6.7%, 18.9±6.1% for clinical-plans (p=0.04, <0.001). Total computational time for auto-plans was < 20s. Conclusion: We developed an automated method that generates breast radiotherapy plans with accurate energy selection, similar target volume coverage, reduced hotspot volumes, and significant reduction in planning time, allowing for near-real-time planning.« less

Planning and Assessing To Improve Campus-Community Engagement.

ERIC Educational Resources Information Center

Bringle, Robert G.; Hatcher, Julie; Hamilton, Sharon; Young, Peter

2001-01-01

Presents two methods for assessing the scholarship of engagement at the institutional level: (1) Comprehensive Assessment of the Scholarship of Engagement (CASE), a systematic method that compiles information about service learning and community engagement, identifies campus strengths, and prioritizes planning areas; and (2) an institutional…

A model and solving algorithm of combination planning for weapon equipment based on Epoch-era analysis method

NASA Astrophysics Data System (ADS)

Wang, Meng; Zhang, Huaiqiang; Zhang, Kan

2017-10-01

Focused on the circumstance that the equipment using demand in the short term and the development demand in the long term should be made overall plans and took into consideration in the weapons portfolio planning and the practical problem of the fuzziness in the definition of equipment capacity demand. The expression of demand is assumed to be an interval number or a discrete number. With the analysis method of epoch-era, a long planning cycle is broke into several short planning cycles with different demand value. The multi-stage stochastic programming model is built aimed at maximize long-term planning cycle demand under the constraint of budget, equipment development time and short planning cycle demand. The scenario tree is used to discretize the interval value of the demand, and genetic algorithm is designed to solve the problem. At last, a case is studied to demonstrate the feasibility and effectiveness of the proposed mode.

Men's knowledge and spousal communication about modern family planning methods in Ethiopia.

PubMed

Berhane, Adugnaw; Biadgilign, Sibhatu; Amberbir, Alemayehu; Morankar, Sudhakar; Berhane, Alemayehu; Deribe, Kebede

2011-12-01

This study attempted to determine knowledge, approval and communication about family planning methods among married men in Ethiopia. A cross-sectional study was conducted among a representative sample of 738 married males in Amhara Region. All 738 (100%) of the respondents had heard of family planning. About 558 (75.6%) mentioned the importance of using contraceptives for birth spacing and 457 (61.9%) to limit birth. Four hundred and forty-five (60.3%) of participants had ever discussed family planning with their wives. Thirty-three (33.0%) of the respondents reported that they were the sole decision makers in their families. About 597 (80.9%) approved the use of contraceptives. However, some participants did not discuss and approve family planning with their partner. This recalled an intensive effort has been taken by the concerned body to reach the country's targeted family planning coverage by involving men in reproductive health endeavor to enhance the discussion and agreement about family planning usage.

Improved approach for electric vehicle rapid charging station placement and sizing using Google maps and binary lightning search algorithm

PubMed Central

Shareef, Hussain; Mohamed, Azah

2017-01-01

The electric vehicle (EV) is considered a premium solution to global warming and various types of pollution. Nonetheless, a key concern is the recharging of EV batteries. Therefore, this study proposes a novel approach that considers the costs of transportation loss, buildup, and substation energy loss and that incorporates harmonic power loss into optimal rapid charging station (RCS) planning. A novel optimization technique, called binary lightning search algorithm (BLSA), is proposed to solve the optimization problem. BLSA is also applied to a conventional RCS planning method. A comprehensive analysis is conducted to assess the performance of the two RCS planning methods by using the IEEE 34-bus test system as the power grid. The comparative studies show that the proposed BLSA is better than other optimization techniques. The daily total cost in RCS planning of the proposed method, including harmonic power loss, decreases by 10% compared with that of the conventional method. PMID:29220396

Improved approach for electric vehicle rapid charging station placement and sizing using Google maps and binary lightning search algorithm.

PubMed

Islam, Md Mainul; Shareef, Hussain; Mohamed, Azah

2017-01-01

The electric vehicle (EV) is considered a premium solution to global warming and various types of pollution. Nonetheless, a key concern is the recharging of EV batteries. Therefore, this study proposes a novel approach that considers the costs of transportation loss, buildup, and substation energy loss and that incorporates harmonic power loss into optimal rapid charging station (RCS) planning. A novel optimization technique, called binary lightning search algorithm (BLSA), is proposed to solve the optimization problem. BLSA is also applied to a conventional RCS planning method. A comprehensive analysis is conducted to assess the performance of the two RCS planning methods by using the IEEE 34-bus test system as the power grid. The comparative studies show that the proposed BLSA is better than other optimization techniques. The daily total cost in RCS planning of the proposed method, including harmonic power loss, decreases by 10% compared with that of the conventional method.

Discussion on teaching reform of environmental planning and management

NASA Astrophysics Data System (ADS)

Zhang, Qiugen; Chen, Suhua; Xie, Yu; Wei, Li'an; Ding, Yuan

2018-05-01

The curriculum of environmental planning and management is an environmental engineering major curriculum established by the teaching steering committee of environmental science and engineering of Education Ministry, which is the core curriculum of Chinese engineering education professional certification. It plays an important role in cultivating environmental planning and environmental management ability of environmental engineering major. The selection and optimization of the course teaching content of environmental planning and management were discussed which including curriculum teaching content updating and optimizing and teaching resource system construction. The comprehensive application of teaching method was discussed which including teaching method synthesis and teaching method. The final combination of the assessment method was also discussed which including the formative assessment normal grades and the final result of the course examination. Through the curriculum comprehensive teaching reform, students' knowledge had been broadened, the subject status and autonomy of learning had been enhanced, students' learning interest had been motivated, the ability of students' finding, analyzing and solving problems had been improved. Students' innovative ability and positive spirit had been well cultivated.

A comparison of plan-based and abstract MDP reward shaping

NASA Astrophysics Data System (ADS)

Efthymiadis, Kyriakos; Kudenko, Daniel

2014-01-01

Reward shaping has been shown to significantly improve an agent's performance in reinforcement learning. As attention is shifting away from tabula-rasa approaches many different reward shaping methods have been developed. In this paper, we compare two different methods for reward shaping; plan-based, in which an agent is provided with a plan and extra rewards are given according to the steps of the plan the agent satisfies, and reward shaping via abstract Markov decision process (MDPs), in which an abstract high-level MDP of the environment is solved and the resulting value function is used to shape the agent. The comparison is conducted in terms of total reward, convergence speed and scaling up to more complex environments. Empirical results demonstrate the need to correctly select and set up reward shaping methods according to the needs of the environment the agents are acting in. This leads to the more interesting question, is there a reward shaping method which is universally better than all other approaches regardless of the environment dynamics?

SPIDERplan: A tool to support decision-making in radiation therapy treatment plan assessment.

PubMed

Ventura, Tiago; Lopes, Maria do Carmo; Ferreira, Brigida Costa; Khouri, Leila

2016-01-01

In this work, a graphical method for radiotherapy treatment plan assessment and comparison, named SPIDERplan, is proposed. It aims to support plan approval allowing independent and consistent comparisons of different treatment techniques, algorithms or treatment planning systems. Optimized plans from modern radiotherapy are not easy to evaluate and compare because of their inherent multicriterial nature. The clinical decision on the best treatment plan is mostly based on subjective options. SPIDERplan combines a graphical analysis with a scoring index. Customized radar plots based on the categorization of structures into groups and on the determination of individual structures scores are generated. To each group and structure, an angular amplitude is assigned expressing the clinical importance defined by the radiation oncologist. Completing the graphical evaluation, a global plan score, based on the structures score and their clinical weights, is determined. After a necessary clinical validation of the group weights, SPIDERplan efficacy, to compare and rank different plans, was tested through a planning exercise where plans had been generated for a nasal cavity case using different treatment planning systems. SPIDERplan method was applied to the dose metrics achieved by the nasal cavity test plans. The generated diagrams and scores successfully ranked the plans according to the prescribed dose objectives and constraints and the radiation oncologist priorities, after a necessary clinical validation process. SPIDERplan enables a fast and consistent evaluation of plan quality considering all targets and organs at risk.

The challenge of recreation planning: methodology and factors to consider

Treesearch

Ronald B. Uleck

1971-01-01

The proposed methodology of planning is a description, explanation, and justification of the methods or techniques that a planner should use in preparing outdoor recreation development plans. The sequence of steps required is described

Standard road plans index sheets [English version].

DOT National Transportation Integrated Search

2011-01-01

The Standard Road Plans contained within this manual have been developed to show standardized design features, construction methods and approved materials to be used in design plans for Interstate, Primary, and Secondary road construction in the Stat...

Standard road plans index sheets [metric version].

DOT National Transportation Integrated Search

2011-01-01

The Standard Road Plans contained within this manual have been developed to show standardized design features, construction methods and approved materials to be used in design plans for Interstate, Primary, and Secondary road construction in the Stat...

Planning for Downtown Circulation Systems. Volume 1. Planning Concepts.

DOT National Transportation Integrated Search

1983-10-01

This document brings together the state-of-the-art in planning concepts, methods and data for use by those cities proposing or considering comprehensive or innovative downtown circulation systems, particularly Downtown People Mover systems. DPM syste...

Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran

PubMed Central

Salarvand, Shahin; Azizimalekabadi, Maryam; Jebeli, Azadeh Akbari; Nazer, Mohamadreza

2017-01-01

Introduction The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses’ challenges in implementing healthcare reform in Iran. Methods A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Results Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people’s misconceptions and solutions. Conclusions The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for. PMID:28607646

Function-Based Intervention Plans: What and How to Teach

ERIC Educational Resources Information Center

Liaupsin, Carl J.; Cooper, Justin T.

2017-01-01

Most function-based intervention plans (FBIP) discuss what to teach, but often fail to address effective methods for teaching the skills addressed in the plan. This article discusses the various parts of the FBIP plan that may require teaching and provides potential instructional approaches for teaching the components of the FBIP to students and…

Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education

PubMed Central

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-01-01

Background: Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. Methods: In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Results: Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. Conclusion: lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization. PMID:25168998

[How to expand and improve the coverage of family planning services: a Latin American viewpoint].

PubMed

Trias, M

1992-12-01

It is probably not possible to implant a family planning program that will have a reasonable demographic impact in areas lacking awareness of the disadvantages of overly high fertility. Rural-urban migration, increasing educational levels, women's labor force participation, and declining infant mortality are all factors that have been found to correlate with demand for family planning services. It has been recognized since the Bucharest World Population Conference in 1974 that development and family planning are both required for the fertility transition to begin. Where these conditions exist, a family planning program appropriate to the needs, limitations, preferences, and expectations of the target population has an excellent chance of success. Expanded and improved coverage results from tailoring programs to the specific groups served. Most programs are directed toward women. It has been found most effective to provide services for men in separate sessions. It is also useful to distinguish between services for adolescents, who require more information and fewer services, for mature women who require more services than information, and for premenopausal women whose needs for information and services are both declining. Contraceptive preferences vary with social class, but family planning programs in developing countries should concentrate on the lower middle and lower classes which comprise 80% of the population. Rural areas and marginal urban areas require special attention. In order to provide services that will attract all potential users, the maximum possible variety of methods should be available. A family planning program offering a variety of methods throughout the country and financially accessible to the population should be successful. Family planning programs, whether public or private, require adequate financial resources and the support or at least tolerance of the government. Knowledge of contraception is now almost universal. A major challenge of family planning programs is to prompt women who say they want to limit their reproduction but who do not practice family planning to adopt a method. Program leadership and interpersonal relations with clients should be competent. The experience of PROFAMILIA in Colombia suggests that charging fees for all services offered by the family planning program is a positive feature allowing the client to avoid feeling like a charity recipient and the program to account for materials and services more easily. Goals and objective indicators stimulate performance and allow progress to be assessed. It is recommended that client education focus on a synthesis of information concerning available methods and provision of somewhat greater detail on the method chosen. Integration of services is usually an enemy of family planning because, despite theoretical advantages, it usually means neglect of family planning in favor of curative care.

Contraceptives: choice for the millions?

PubMed

Dhall, A

1994-06-01

India adds each year the population of Sub-Saharan Africa to the earth. User based factors determining the type of contraceptive that is used most often in a country are sociocultural practices including religion, literacy, women's status and their role in decision making, men's status, misconceptions, and convenience of use. Service related factors include knowledge and skill of the provider, attitude of the provider, accessibility of family planning services, cost of the contraceptives, and quality of services. The government, nongovernmental organizations, and the pharmaceutical firms tend to be the contraceptive researchers and suppliers. The mass media are used to disseminate information on contraceptives. They often relay sensational reports about a contraceptive method that results in its reduced use. Temporary or spacing family planning methods include natural family planning methods, condoms, IUDs, oral contraceptives, implants, and injectables, spermicides and vaginal barriers. The natural family planning methods are sexual abstinence, especially in the postpartum period; rhythm or calendar method; and coitus interruptus. The most cost-effective method is also the most popular method--sexual sterilization. Even though female sterilization is more difficult to perform than vasectomy, it is more common than vasectomy. Contraception should become a people's movement rather than be forced upon the people. People should insist on good quality, affordable contraceptive services as their basic right.

IFRP studies child-spacing trends in subSaharan Africa.

PubMed

1981-10-01

The IFRP (International Fertility Research Program) conducted in late 1980 a study of the changing patterns of breast feeding, postpartum abstinence, and use of modern contraceptive methods among women of reproductive age in Lagos, Nigeria, the largest city in tropical Africa. There is concern among family planning experts that the traditional child-spacing practices are breaking down in subSaharan Africa without being replaced sufficiently with modern fertility control methods. The household survey showed a total fertility rate of 6.56. Compared to the mean cumulative fertility of 6.19 for women aged 45-49, it appears that fertility is actually increasing in Lagos. There were low levels of awareness and practice of modern family planning methods reported by these women. Less than 1/4 were using a method of family planning currently. Of these, 7% were using a modern method (mostly pills), 3% were using a conventional method (condoms), and 14% were using only a traditional method. Many of these women did not consider either breast feeding or sexual abstinence as means of contraception. Breast feeding was practiced by 85% of the women during the 1st 2 months, with rates falling off sharply after that. Child spacing rather than fertility limitation was the motivation of most of the women practicing family planning.

Planning in the Continuous Operations Environment of the International Space Station

NASA Technical Reports Server (NTRS)

Maxwell, Theresa; Hagopian, Jeff

1996-01-01

The continuous operation planning approach developed for the operations planning of the International Space Station (ISS) is reported on. The approach was designed to be a robust and cost-effective method. It separates ISS planning into two planning functions: long-range planning for a fixed length planning horizon which continually moves forward as ISS operations progress, and short-range planning which takes a small segment of the long-range plan and develops a detailed operations schedule. The continuous approach is compared with the incremental approach, the short and long-range planning functions are described, and the benefits and challenges of implementing a continuous operations planning approach for the ISS are summarized.

"Civil unrest does not stop ovulation": women's prenatal and family planning services in a 1960s Detroit neighborhood clinic.

PubMed

DeGuzman, Pamela B; Schminkey, Donna L; Koyen, Emily A

2014-01-01

In 1965, Nancy Milio established a prenatal and family planning clinic in Detroit, Michigan, to address health disparities and limited access to care among low-income, African American, urban women. Women's health disparities persist today nationally and internationally. Using historical methods, this research analyzes how Milio provided women's health services in the context of the social and political environment. Milio empowered neighborhood women to direct, plan, and participate in the care they received. Successful methods to address disparities in access to family and planning and prenatal care should include empowered participation from the women these programs are intending to serve.

Normal tissue complication probability modelling of tissue fibrosis following breast radiotherapy

NASA Astrophysics Data System (ADS)

Alexander, M. A. R.; Brooks, W. A.; Blake, S. W.

2007-04-01

Cosmetic late effects of radiotherapy such as tissue fibrosis are increasingly regarded as being of importance. It is generally considered that the complication probability of a radiotherapy plan is dependent on the dose uniformity, and can be reduced by using better compensation to remove dose hotspots. This work aimed to model the effects of improved dose homogeneity on complication probability. The Lyman and relative seriality NTCP models were fitted to clinical fibrosis data for the breast collated from the literature. Breast outlines were obtained from a commercially available Rando phantom using the Osiris system. Multislice breast treatment plans were produced using a variety of compensation methods. Dose-volume histograms (DVHs) obtained for each treatment plan were reduced to simple numerical parameters using the equivalent uniform dose and effective volume DVH reduction methods. These parameters were input into the models to obtain complication probability predictions. The fitted model parameters were consistent with a parallel tissue architecture. Conventional clinical plans generally showed reducing complication probabilities with increasing compensation sophistication. Extremely homogenous plans representing idealized IMRT treatments showed increased complication probabilities compared to conventional planning methods, as a result of increased dose to areas receiving sub-prescription doses using conventional techniques.

Particle swarm optimizer for weighting factor selection in intensity-modulated radiation therapy optimization algorithms.

PubMed

Yang, Jie; Zhang, Pengcheng; Zhang, Liyuan; Shu, Huazhong; Li, Baosheng; Gui, Zhiguo

2017-01-01

In inverse treatment planning of intensity-modulated radiation therapy (IMRT), the objective function is typically the sum of the weighted sub-scores, where the weights indicate the importance of the sub-scores. To obtain a high-quality treatment plan, the planner manually adjusts the objective weights using a trial-and-error procedure until an acceptable plan is reached. In this work, a new particle swarm optimization (PSO) method which can adjust the weighting factors automatically was investigated to overcome the requirement of manual adjustment, thereby reducing the workload of the human planner and contributing to the development of a fully automated planning process. The proposed optimization method consists of three steps. (i) First, a swarm of weighting factors (i.e., particles) is initialized randomly in the search space, where each particle corresponds to a global objective function. (ii) Then, a plan optimization solver is employed to obtain the optimal solution for each particle, and the values of the evaluation functions used to determine the particle's location and the population global location for the PSO are calculated based on these results. (iii) Next, the weighting factors are updated based on the particle's location and the population global location. Step (ii) is performed alternately with step (iii) until the termination condition is reached. In this method, the evaluation function is a combination of several key points on the dose volume histograms. Furthermore, a perturbation strategy - the crossover and mutation operator hybrid approach - is employed to enhance the population diversity, and two arguments are applied to the evaluation function to improve the flexibility of the algorithm. In this study, the proposed method was used to develop IMRT treatment plans involving five unequally spaced 6MV photon beams for 10 prostate cancer cases. The proposed optimization algorithm yielded high-quality plans for all of the cases, without human planner intervention. A comparison of the results with the optimized solution obtained using a similar optimization model but with human planner intervention revealed that the proposed algorithm produced optimized plans superior to that developed using the manual plan. The proposed algorithm can generate admissible solutions within reasonable computational times and can be used to develop fully automated IMRT treatment planning methods, thus reducing human planners' workloads during iterative processes. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT

NASA Astrophysics Data System (ADS)

Aghdasi, Nava; Li, Yangming; Berens, Angelique; Moe, Kris S.; Bly, Randall A.; Hannaford, Blake

2015-03-01

Minimally invasive neuroendoscopic surgery provides an alternative to open craniotomy for many skull base lesions. These techniques provides a great benefit to the patient through shorter ICU stays, decreased post-operative pain and quicker return to baseline function. However, density of critical neurovascular structures at the skull base makes planning for these procedures highly complex. Furthermore, additional surgical portals are often used to improve visualization and instrument access, which adds to the complexity of pre-operative planning. Surgical approach planning is currently limited and typically involves review of 2D axial, coronal, and sagittal CT and MRI images. In addition, skull base surgeons manually change the visualization effect to review all possible approaches to the target lesion and achieve an optimal surgical plan. This cumbersome process relies heavily on surgeon experience and it does not allow for 3D visualization. In this paper, we describe a rapid pre-operative planning system for skull base surgery using the following two novel concepts: importance-based highlight and mobile portal. With this innovation, critical areas in the 3D CT model are highlighted based on segmentation results. Mobile portals allow surgeons to review multiple potential entry portals in real-time with improved visualization of critical structures located inside the pathway. To achieve this we used the following methods: (1) novel bone-only atlases were manually generated, (2) orbits and the center of the skull serve as features to quickly pre-align the patient's scan with the atlas, (3) deformable registration technique was used for fine alignment, (4) surgical importance was assigned to each voxel according to a surgical dictionary, and (5) pre-defined transfer function was applied to the processed data to highlight important structures. The proposed idea was fully implemented as independent planning software and additional data are used for verification and validation. The experimental results show: (1) the proposed methods provided greatly improved planning efficiency while optimal surgical plans were successfully achieved, (2) the proposed methods successfully highlighted important structures and facilitated planning, (3) the proposed methods require shorter processing time than classical segmentation algorithms, and (4) these methods can be used to improve surgical safety for surgical robots.

Use of plan quality degradation to evaluate tradeoffs in delivery efficiency and clinical plan metrics arising from IMRT optimizer and sequencer compromises

PubMed Central

Wilkie, Joel R.; Matuszak, Martha M.; Feng, Mary; Moran, Jean M.; Fraass, Benedick A.

2013-01-01

Purpose: Plan degradation resulting from compromises made to enhance delivery efficiency is an important consideration for intensity modulated radiation therapy (IMRT) treatment plans. IMRT optimization and/or multileaf collimator (MLC) sequencing schemes can be modified to generate more efficient treatment delivery, but the effect those modifications have on plan quality is often difficult to quantify. In this work, the authors present a method for quantitative assessment of overall plan quality degradation due to tradeoffs between delivery efficiency and treatment plan quality, illustrated using comparisons between plans developed allowing different numbers of intensity levels in IMRT optimization and/or MLC sequencing for static segmental MLC IMRT plans. Methods: A plan quality degradation method to evaluate delivery efficiency and plan quality tradeoffs was developed and used to assess planning for 14 prostate and 12 head and neck patients treated with static IMRT. Plan quality was evaluated using a physician's predetermined “quality degradation” factors for relevant clinical plan metrics associated with the plan optimization strategy. Delivery efficiency and plan quality were assessed for a range of optimization and sequencing limitations. The “optimal” (baseline) plan for each case was derived using a clinical cost function with an unlimited number of intensity levels. These plans were sequenced with a clinical MLC leaf sequencer which uses >100 segments, assuring delivered intensities to be within 1% of the optimized intensity pattern. Each patient's optimal plan was also sequenced limiting the number of intensity levels (20, 10, and 5), and then separately optimized with these same numbers of intensity levels. Delivery time was measured for all plans, and direct evaluation of the tradeoffs between delivery time and plan degradation was performed. Results: When considering tradeoffs, the optimal number of intensity levels depends on the treatment site and on the stage in the process at which the levels are limited. The cost of improved delivery efficiency, in terms of plan quality degradation, increased as the number of intensity levels in the sequencer or optimizer decreased. The degradation was more substantial for the head and neck cases relative to the prostate cases, particularly when fewer than 20 intensity levels were used. Plan quality degradation was less severe when the number of intensity levels was limited in the optimizer rather than the sequencer. Conclusions: Analysis of plan quality degradation allows for a quantitative assessment of the compromises in clinical plan quality as delivery efficiency is improved, in order to determine the optimal delivery settings. The technique is based on physician-determined quality degradation factors and can be extended to other clinical situations where investigation of various tradeoffs is warranted. PMID:23822412

Development of Consensus Treatment Plans for Juvenile Localized Scleroderma

PubMed Central

Li, Suzanne C.; Torok, Kathryn S.; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T.; Rabinovich, C. Egla; Laxer, Ronald M.; Higgins, Gloria C.; Ferguson, Polly J.; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M.; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A.; Ilowite, Norman T.; Fuhlbrigge, Robert C

2013-01-01

Objective To develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile localized scleroderma (jLS). Background jLS is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies have been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment of have made it difficult to compare approaches and identify optimal therapy. Methods A core group of pediatric rheumatologists, dermatologists and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for jLS using consensus methods/nominal group techniques. Recommendations were validated in two face-to-face conferences with a larger group of practitioners with expertise in jLS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the U.S and Canada. Results Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (67% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with jLS. Conclusions Using consensus methodology, we have developed standardized treatment plans and assessment methods for jLS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of jLS. PMID:22505322

SU-F-T-504: Non-Divergent Planning Method for Craniospinal Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sperling, N; Bogue, J; Parsai, E

2016-06-15

Purpose: Traditional Craniospinal Irradiation (CSI) planning techniques require careful field placement to allow optimal divergence and field overlap at depth, and measurement of skin gap. The result of this is a necessary field overlap resulting in dose heterogeneity in the spinal canal. A novel, nondivergent field matching method has been developed to allow simple treatment planning and delivery without the need to measure skin gap. Methods: The CSI patient was simulated in the prone, and a plan was developed. Bilateral cranial fields were designed with couch and collimator rotation to eliminate divergence with the upper spine field and minimize anteriormore » divergence into the lenses. Spinal posterior-to-anterior fields were designed with the couch rotated to 90 degrees to allow gantry rotation to eliminate divergence at the match line, and the collimator rotated to 90 degrees to allow appropriate field blocking with the MLCs. A match line for the two spinal fields was placed and the gantry rotated to equal angles in opposite directions about the match line. Jaw positions were then defined to allow 1mm overlap at the match line to avoid cold spots. A traditional CSI plan was generated using diverging spinal fields, and a comparison between the two techniques was generated. Results: The non-divergent treatment plan was able to deliver a highly uniform dose to the spinal cord with a cold spot of only 95% and maximum point dose of 115.8%, as compared to traditional plan cold spots of 87% and hot spots of 132% of the prescription dose. Conclusion: A non-divergent method for planning CSI patients has been developed and clinically implemented. Planning requires some geometric manipulation in order to achieve an adequate dose distribution, however, it can help to manage cold spots and simplify the shifts needed between spinal fields.« less

Yielding impressive results. The Egyptian experience in family planning communication campaign has been an exemplary model for many developing countries.

PubMed

Wafai, M

1994-09-01

In Egypt the current use of family planning methods nearly doubled from 1980 to 1992. The toughest obstacles to the promotion of family planning are the deeply rooted pronatalism, the high rate of illiteracy, and low use of print media. The early efforts of the 1960s through the 1970s helped raise people's awareness of the problem, but traditional attitudes to family planning persisted. The Information, Education and Communication (IEC) Center established in 1979 in the State Information Service (SIS) of the Ministry of Information spearheaded the IEC efforts for family planning throughout the country. The Egyptian Contraceptives Prevalence Survey conducted in 1984 showed that the current use of family planning methods had increased 6.1% from the 1980 level, and that 56% of married women wished to stop having children, but were afraid of side effects of contraceptive use. The SIS/IEC Center launched a creative mass media campaign using TV spots and dramas. It also pioneered community-based public communication activities on population and family planning by organizing population communication forums. The local communication work is implemented by each of the 60 regional offices of SIS. Other government agencies, such as Health Insurance Organization, also launched IEC campaigns promoting their own services. Non-governmental organizations (NGOs) such as the Family of the Future and the Clinical Service Improvement Project also engaged in social marketing of contraceptives. The use of family planning methods mounted between 1980 and 1992 from 24% to nearly 48%, and the method of choice shifted from the pill to the IUD. The country's crude birth rate declined steadily from 40 per 1000 population in 1985 down to 29/1000 in 1992. The six major factors for success included an innovative communication program, religious support, political commitment, an improved service delivery system, involvement of NGOs, and the economic influence. The Egyptian experience in family planning IEC has been an exemplary model for many developing countries.

SU-E-T-626: Accuracy of Dose Calculation Algorithms in MultiPlan Treatment Planning System in Presence of Heterogeneities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moignier, C; Huet, C; Barraux, V

Purpose: Advanced stereotactic radiotherapy (SRT) treatments require accurate dose calculation for treatment planning especially for treatment sites involving heterogeneous patient anatomy. The purpose of this study was to evaluate the accuracy of dose calculation algorithms, Raytracing and Monte Carlo (MC), implemented in the MultiPlan treatment planning system (TPS) in presence of heterogeneities. Methods: First, the LINAC of a CyberKnife radiotherapy facility was modeled with the PENELOPE MC code. A protocol for the measurement of dose distributions with EBT3 films was established and validated thanks to comparison between experimental dose distributions and calculated dose distributions obtained with MultiPlan Raytracing and MCmore » algorithms as well as with the PENELOPE MC model for treatments planned with the homogenous Easycube phantom. Finally, bones and lungs inserts were used to set up a heterogeneous Easycube phantom. Treatment plans with the 10, 7.5 or the 5 mm field sizes were generated in Multiplan TPS with different tumor localizations (in the lung and at the lung/bone/soft tissue interface). Experimental dose distributions were compared to the PENELOPE MC and Multiplan calculations using the gamma index method. Results: Regarding the experiment in the homogenous phantom, 100% of the points passed for the 3%/3mm tolerance criteria. These criteria include the global error of the method (CT-scan resolution, EBT3 dosimetry, LINAC positionning …), and were used afterwards to estimate the accuracy of the MultiPlan algorithms in heterogeneous media. Comparison of the dose distributions obtained in the heterogeneous phantom is in progress. Conclusion: This work has led to the development of numerical and experimental dosimetric tools for small beam dosimetry. Raytracing and MC algorithms implemented in MultiPlan TPS were evaluated in heterogeneous media.« less

SU-F-T-499: Anatomic Features for Selection of Electronic Tissue Compensation Radiotherapy in Early-Stage Breast Cancer Patients After Breast-Conserving Surgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Song, Y; Gan, L; Chen, X

Purpose: To explore the correlations between anatomic features and dose-volumetric parameters in 3DCRT and eComp whole breast irradiation and identify the feasibility of anatomic parameters to predict the planning method selection. Methods: We compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and electronic tissue compensation (eComp) for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing dose to lung, heart, and skin. Statistical analyses were performed betweenmore » critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS). Results: Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. To keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. Conclusion: The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost. This study was supported by National Natural Science Foundation of China (NO. 31420103915) and Chongqing Health and Family Planning Commission Project (2015MSXM012).« less

SU-F-T-264: VMAT QA with 2D Radiation Measuring Equipment Attached to Gantry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fung, A

2016-06-15

Purpose: To introduce a method of VMAT QA by 2D measuring device. The 2D device is attached to the gantry throughout measurement duration. This eliminates error caused by the angular dependence of the radiation detectors. Methods: A 2D radiation measuring device was attached to the gantry of linear accelerator. The center of the detector plane was at the isocenter. For each patient plan, two verification plans were created for QA purpose. One was like an ordinary VMAT plan, to be used for radiation delivery. The other is a plan with gantry angle fixed at zero, so the dose distribution asmore » seen by the rotating 2D device. Points above 10% dose threshold were analyzed. Data is in tolerance if it fits within the 3 mm or 3% dose gamma criteria. For each patient, the plan was passed when 95% of all the points in the 2D matrix fit the gamma criteria. The following statistics were calculated: number of patient plans passed, percentage of all points passed, average percentage difference of all points. Results: VMAT QA was performed for patients during one year in our department, and the results were analyzed. All irradiation was with 6 MV photon beam. Each plan has calculated and measured doses compared. After collecting one year’s result, with 81 patient plans analyzed, all (100%) of the plans passed the gamma criteria. Of the points analyzed from all plans, 98.8% of all points passed. Conclusion: This method of attaching a 2D measuring device on the linac gantry proves to be an accurate way for VMAT QA. It is simple to use and low cost, and it eliminates the problem of directional dependence.« less

Safe teleradiology: information assurance as project planning methodology

NASA Astrophysics Data System (ADS)

Collmann, Jeff R.; Alaoui, Adil; Nguyen, Dan; Lindisch, David

2003-05-01

This project demonstrates use of OCTAVE, an information security risk assessment method, as an approach to the safe design and planning of a teleradiology system. By adopting this approach to project planning, we intended to provide evidence that including information security as an intrinsic component of project planning improves information assurance and that using information assurance as a planning tool produces and improves the general system management plan. Several considerations justify this approach to planning a safe teleradiology system. First, because OCTAVE was designed as a method for retrospectively assessing and proposing enhancements for the security of existing information management systems, it should function well as a guide to prospectively designing and deploying a secure information system such as teleradiology. Second, because OCTAVE provides assessment and planning tools for use primarily by interdisciplinary teams from user organizations, not consultants, it should enhance the ability of such teams at the local level to plan safe information systems. Third, from the perspective of sociological theory, OCTAVE explicitly attempts to enhance organizational conditions identified as necessary to safely manage complex technologies. Approaching information system design from the perspective of information security risk management proactively integrates health information assurance into a project"s core. This contrasts with typical approaches that perceive "security" as a secondary attribute to be "added" after designing the system and with approaches that identify information assurance only with security devices and user training. The perspective of health information assurance embraces so many dimensions of a computerized health information system"s design that one may successfully deploy a method for retrospectively assessing information security risk as a prospective planning tool. From a sociological perspective, this approach enhances the general conditions as well as establishes specific policies and procedures for reliable performance of health information assurance.

Computational path planner for product assembly in complex environments

NASA Astrophysics Data System (ADS)

Shang, Wei; Liu, Jianhua; Ning, Ruxin; Liu, Mi

2013-03-01

Assembly path planning is a crucial problem in assembly related design and manufacturing processes. Sampling based motion planning algorithms are used for computational assembly path planning. However, the performance of such algorithms may degrade much in environments with complex product structure, narrow passages or other challenging scenarios. A computational path planner for automatic assembly path planning in complex 3D environments is presented. The global planning process is divided into three phases based on the environment and specific algorithms are proposed and utilized in each phase to solve the challenging issues. A novel ray test based stochastic collision detection method is proposed to evaluate the intersection between two polyhedral objects. This method avoids fake collisions in conventional methods and degrades the geometric constraint when a part has to be removed with surface contact with other parts. A refined history based rapidly-exploring random tree (RRT) algorithm which bias the growth of the tree based on its planning history is proposed and employed in the planning phase where the path is simple but the space is highly constrained. A novel adaptive RRT algorithm is developed for the path planning problem with challenging scenarios and uncertain environment. With extending values assigned on each tree node and extending schemes applied, the tree can adapts its growth to explore complex environments more efficiently. Experiments on the key algorithms are carried out and comparisons are made between the conventional path planning algorithms and the presented ones. The comparing results show that based on the proposed algorithms, the path planner can compute assembly path in challenging complex environments more efficiently and with higher success. This research provides the references to the study of computational assembly path planning under complex environments.

Evaluation of a commercial automatic treatment planning system for prostate cancers.

PubMed

Nawa, Kanabu; Haga, Akihiro; Nomoto, Akihiro; Sarmiento, Raniel A; Shiraishi, Kenshiro; Yamashita, Hideomi; Nakagawa, Keiichi

2017-01-01

Recent developments in Radiation Oncology treatment planning have led to the development of software packages that facilitate automated intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) planning. Such solutions include site-specific modules, plan library methods, and algorithm-based methods. In this study, the plan quality for prostate cancer generated by the Auto-Planning module of the Pinnacle 3 radiation therapy treatment planning system (v9.10, Fitchburg, WI) is retrospectively evaluated. The Auto-Planning module of Pinnacle 3 uses a progressive optimization algorithm. Twenty-three prostate cancer cases, which had previously been planned and treated without lymph node irradiation, were replanned using the Auto-Planning module. Dose distributions were statistically compared with those of manual planning by the paired t-test at 5% significance level. Auto-Planning was performed without any manual intervention. Planning target volume (PTV) dose and dose to rectum were comparable between Auto-Planning and manual planning. The former, however, significantly reduced the dose to the bladder and femurs. Regression analysis was performed to examine the correlation between volume overlap between bladder and PTV divided by the total bladder volume and resultant V70. The findings showed that manual planning typically exhibits a logistic way for dose constraint, whereas Auto-Planning shows a more linear tendency. By calculating the Akaike information criterion (AIC) to validate the statistical model, a reduction of interoperator variation in Auto-Planning was shown. We showed that, for prostate cancer, the Auto-Planning module provided plans that are better than or comparable with those of manual planning. By comparing our results with those previously reported for head and neck cancer treatment, we recommend the homogeneous plan quality generated by the Auto-Planning module, which exhibits less dependence on anatomic complexity. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

SU-F-T-192: Study of Robustness Analysis Method of Multiple Field Optimized IMPT Plans for Head & Neck Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Y; Wang, X; Li, H

Purpose: Proton therapy is more sensitive to uncertainties than photon treatments due to protons’ finite range depending on the tissue density. Worst case scenario (WCS) method originally proposed by Lomax has been adopted in our institute for robustness analysis of IMPT plans. This work demonstrates that WCS method is sufficient enough to take into account of the uncertainties which could be encountered during daily clinical treatment. Methods: A fast and approximate dose calculation method is developed to calculate the dose for the IMPT plan under different setup and range uncertainties. Effects of two factors, inversed square factor and range uncertainty,more » are explored. WCS robustness analysis method was evaluated using this fast dose calculation method. The worst-case dose distribution was generated by shifting isocenter by 3 mm along x,y and z directions and modifying stopping power ratios by ±3.5%. 1000 randomly perturbed cases in proton range and x, yz directions were created and the corresponding dose distributions were calculated using this approximated method. DVH and dosimetric indexes of all 1000 perturbed cases were calculated and compared with the result using worst case scenario method. Results: The distributions of dosimetric indexes of 1000 perturbed cases were generated and compared with the results using worst case scenario. For D95 of CTVs, at least 97% of 1000 perturbed cases show higher values than the one of worst case scenario. For D5 of CTVs, at least 98% of perturbed cases have lower values than worst case scenario. Conclusion: By extensively calculating the dose distributions under random uncertainties, WCS method was verified to be reliable in evaluating the robustness level of MFO IMPT plans of H&N patients. The extensively sampling approach using fast approximated method could be used in evaluating the effects of different factors on the robustness level of IMPT plans in the future.« less

Fully automated treatment planning for head and neck radiotherapy using a voxel-based dose prediction and dose mimicking method

NASA Astrophysics Data System (ADS)

McIntosh, Chris; Welch, Mattea; McNiven, Andrea; Jaffray, David A.; Purdie, Thomas G.

2017-08-01

Recent works in automated radiotherapy treatment planning have used machine learning based on historical treatment plans to infer the spatial dose distribution for a novel patient directly from the planning image. We present a probabilistic, atlas-based approach which predicts the dose for novel patients using a set of automatically selected most similar patients (atlases). The output is a spatial dose objective, which specifies the desired dose-per-voxel, and therefore replaces the need to specify and tune dose-volume objectives. Voxel-based dose mimicking optimization then converts the predicted dose distribution to a complete treatment plan with dose calculation using a collapsed cone convolution dose engine. In this study, we investigated automated planning for right-sided oropharaynx head and neck patients treated with IMRT and VMAT. We compare four versions of our dose prediction pipeline using a database of 54 training and 12 independent testing patients by evaluating 14 clinical dose evaluation criteria. Our preliminary results are promising and demonstrate that automated methods can generate comparable dose distributions to clinical. Overall, automated plans achieved an average of 0.6% higher dose for target coverage evaluation criteria, and 2.4% lower dose at the organs at risk criteria levels evaluated compared with clinical. There was no statistically significant difference detected in high-dose conformity between automated and clinical plans as measured by the conformation number. Automated plans achieved nine more unique criteria than clinical across the 12 patients tested and automated plans scored a significantly higher dose at the evaluation limit for two high-risk target coverage criteria and a significantly lower dose in one critical organ maximum dose. The novel dose prediction method with dose mimicking can generate complete treatment plans in 12-13 min without user interaction. It is a promising approach for fully automated treatment planning and can be readily applied to different treatment sites and modalities.

SU-D-BRD-06: Automated Population-Based Planning for Whole Brain Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schreibmann, E; Fox, T; Crocker, I

2014-06-01

Purpose: Treatment planning for whole brain radiation treatment is technically a simple process but in practice it takes valuable clinical time of repetitive and tedious tasks. This report presents a method that automatically segments the relevant target and normal tissues and creates a treatment plan in only a few minutes after patient simulation. Methods: Segmentation is performed automatically through morphological operations on the soft tissue. The treatment plan is generated by searching a database of previous cases for patients with similar anatomy. In this search, each database case is ranked in terms of similarity using a customized metric designed formore » sensitivity by including only geometrical changes that affect the dose distribution. The database case with the best match is automatically modified to replace relevant patient info and isocenter position while maintaining original beam and MLC settings. Results: Fifteen patients were used to validate the method. In each of these cases the anatomy was accurately segmented to mean Dice coefficients of 0.970 ± 0.008 for the brain, 0.846 ± 0.009 for the eyes and 0.672 ± 0.111 for the lens as compared to clinical segmentations. Each case was then subsequently matched against a database of 70 validated treatment plans and the best matching plan (termed auto-planned), was compared retrospectively with the clinical plans in terms of brain coverage and maximum doses to critical structures. Maximum doses were reduced by a maximum of 20.809 Gy for the left eye (mean 3.533), by 13.352 (1.311) for the right eye, and by 27.471 (4.856), 25.218 (6.315) for the left and right lens. Time from simulation to auto-plan was 3-4 minutes. Conclusion: Automated database- based matching is an alternative to classical treatment planning that improves quality while providing a cost—effective solution to planning through modifying previous validated plans to match a current patient's anatomy.« less

Fully automated treatment planning for head and neck radiotherapy using a voxel-based dose prediction and dose mimicking method.

PubMed

McIntosh, Chris; Welch, Mattea; McNiven, Andrea; Jaffray, David A; Purdie, Thomas G

2017-07-06

Recent works in automated radiotherapy treatment planning have used machine learning based on historical treatment plans to infer the spatial dose distribution for a novel patient directly from the planning image. We present a probabilistic, atlas-based approach which predicts the dose for novel patients using a set of automatically selected most similar patients (atlases). The output is a spatial dose objective, which specifies the desired dose-per-voxel, and therefore replaces the need to specify and tune dose-volume objectives. Voxel-based dose mimicking optimization then converts the predicted dose distribution to a complete treatment plan with dose calculation using a collapsed cone convolution dose engine. In this study, we investigated automated planning for right-sided oropharaynx head and neck patients treated with IMRT and VMAT. We compare four versions of our dose prediction pipeline using a database of 54 training and 12 independent testing patients by evaluating 14 clinical dose evaluation criteria. Our preliminary results are promising and demonstrate that automated methods can generate comparable dose distributions to clinical. Overall, automated plans achieved an average of 0.6% higher dose for target coverage evaluation criteria, and 2.4% lower dose at the organs at risk criteria levels evaluated compared with clinical. There was no statistically significant difference detected in high-dose conformity between automated and clinical plans as measured by the conformation number. Automated plans achieved nine more unique criteria than clinical across the 12 patients tested and automated plans scored a significantly higher dose at the evaluation limit for two high-risk target coverage criteria and a significantly lower dose in one critical organ maximum dose. The novel dose prediction method with dose mimicking can generate complete treatment plans in 12-13 min without user interaction. It is a promising approach for fully automated treatment planning and can be readily applied to different treatment sites and modalities.

Multi-criteria evaluation in strategic environmental assessment for waste management plan, a case study: The city of Belgrade

DOE Office of Scientific and Technical Information (OSTI.GOV)

Josimović, Boško, E-mail: bosko@iaus.ac.rs; Marić, Igor; Milijić, Saša

2015-02-15

Highlights: • The paper deals with the specific method of multi-criteria evaluation applied in drafting the SEA for the Belgrade WMP. • MCE of the planning solutions, assessed according to 37 objectives of the SEA and four sets of criteria, was presented in the matrix form. • The results are presented in the form of graphs so as to be easily comprehensible to all the participants in the decision-making process. • The results represent concrete contribution proven in practice. - Abstract: Strategic Environmental Assessment (SEA) is one of the key instruments for implementing sustainable development strategies in planning in general;more » in addition to being used in sectoral planning, it can also be used in other areas such as waste management planning. SEA in waste management planning has become a tool for considering the benefits and consequences of the proposed changes in space, also taking into account the capacity of space to sustain the implementation of the planned activities. In order to envisage both the positive and negative implications of a waste management plan for the elements of sustainable development, an adequate methodological approach to evaluating the potential impacts must be adopted and the evaluation results presented in a simple and clear way, so as to allow planners to make relevant decisions as a precondition for the sustainability of the activities planned in the waste management sector. This paper examines the multi-criteria evaluation method for carrying out an SEA for the Waste Management Plan for the city of Belgrade (BWMP). The method was applied to the evaluation of the impacts of the activities planned in the waste management sector on the basis of the environmental and socioeconomic indicators of sustainability, taking into consideration the intensity, spatial extent, probability and frequency of impact, by means of a specific planning approach and simple and clear presentation of the obtained results.« less

An innovative approach to capability-based emergency operations planning

PubMed Central

Keim, Mark E

2013-01-01

This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology. PMID:28228987

An innovative approach to capability-based emergency operations planning.

PubMed

Keim, Mark E

2013-01-01

This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology.

29 CFR 4281.17 - Asset valuation methods-in general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Asset valuation methods-in general. 4281.17 Section 4281.17 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION, TERMINATION, AND OTHER RULES APPLICABLE TO MULTIEMPLOYER PLANS DUTIES OF PLAN SPONSOR FOLLOWING...

29 CFR 4281.13 - Benefit valuation methods-in general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Benefit valuation methods-in general. 4281.13 Section 4281.13 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION, TERMINATION, AND OTHER RULES APPLICABLE TO MULTIEMPLOYER PLANS DUTIES OF PLAN SPONSOR FOLLOWING...

Robust optimization methods for cardiac sparing in tangential breast IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahmoudzadeh, Houra, E-mail: houra@mie.utoronto.ca; Lee, Jenny; Chan, Timothy C. Y.

Purpose: In left-sided tangential breast intensity modulated radiation therapy (IMRT), the heart may enter the radiation field and receive excessive radiation while the patient is breathing. The patient’s breathing pattern is often irregular and unpredictable. We verify the clinical applicability of a heart-sparing robust optimization approach for breast IMRT. We compare robust optimized plans with clinical plans at free-breathing and clinical plans at deep inspiration breath-hold (DIBH) using active breathing control (ABC). Methods: Eight patients were included in the study with each patient simulated using 4D-CT. The 4D-CT image acquisition generated ten breathing phase datasets. An average scan was constructedmore » using all the phase datasets. Two of the eight patients were also imaged at breath-hold using ABC. The 4D-CT datasets were used to calculate the accumulated dose for robust optimized and clinical plans based on deformable registration. We generated a set of simulated breathing probability mass functions, which represent the fraction of time patients spend in different breathing phases. The robust optimization method was applied to each patient using a set of dose-influence matrices extracted from the 4D-CT data and a model of the breathing motion uncertainty. The goal of the optimization models was to minimize the dose to the heart while ensuring dose constraints on the target were achieved under breathing motion uncertainty. Results: Robust optimized plans were improved or equivalent to the clinical plans in terms of heart sparing for all patients studied. The robust method reduced the accumulated heart dose (D10cc) by up to 801 cGy compared to the clinical method while also improving the coverage of the accumulated whole breast target volume. On average, the robust method reduced the heart dose (D10cc) by 364 cGy and improved the optBreast dose (D99%) by 477 cGy. In addition, the robust method had smaller deviations from the planned dose to the accumulated dose. The deviation of the accumulated dose from the planned dose for the optBreast (D99%) was 12 cGy for robust versus 445 cGy for clinical. The deviation for the heart (D10cc) was 41 cGy for robust and 320 cGy for clinical. Conclusions: The robust optimization approach can reduce heart dose compared to the clinical method at free-breathing and can potentially reduce the need for breath-hold techniques.« less

Least-cost transportation planning in ODOT : feasibility report.

DOT National Transportation Integrated Search

1995-03-01

Least-Cost Planning or Integrated Resource Planning is used in the electric utility industry to broaden the scope of choices to meet service requirements. This typically includes methods to reduce to demands for electricity as well the more tradition...

The California general plan process and sustainable transportation planning

DOT National Transportation Integrated Search

2001-11-01

This study reviewed the current and potential utility of California's General Plan process as a tool for promoting more sustainable local transportation systems The study used multiple methods to investigate this issue, including: 1. An extensive lit...

Including robustness in multi-criteria optimization for intensity-modulated proton therapy

NASA Astrophysics Data System (ADS)

Chen, Wei; Unkelbach, Jan; Trofimov, Alexei; Madden, Thomas; Kooy, Hanne; Bortfeld, Thomas; Craft, David

2012-02-01

We present a method to include robustness in a multi-criteria optimization (MCO) framework for intensity-modulated proton therapy (IMPT). The approach allows one to simultaneously explore the trade-off between different objectives as well as the trade-off between robustness and nominal plan quality. In MCO, a database of plans each emphasizing different treatment planning objectives, is pre-computed to approximate the Pareto surface. An IMPT treatment plan that strikes the best balance between the different objectives can be selected by navigating on the Pareto surface. In our approach, robustness is integrated into MCO by adding robustified objectives and constraints to the MCO problem. Uncertainties (or errors) of the robust problem are modeled by pre-calculated dose-influence matrices for a nominal scenario and a number of pre-defined error scenarios (shifted patient positions, proton beam undershoot and overshoot). Objectives and constraints can be defined for the nominal scenario, thus characterizing nominal plan quality. A robustified objective represents the worst objective function value that can be realized for any of the error scenarios and thus provides a measure of plan robustness. The optimization method is based on a linear projection solver and is capable of handling large problem sizes resulting from a fine dose grid resolution, many scenarios, and a large number of proton pencil beams. A base-of-skull case is used to demonstrate the robust optimization method. It is demonstrated that the robust optimization method reduces the sensitivity of the treatment plan to setup and range errors to a degree that is not achieved by a safety margin approach. A chordoma case is analyzed in more detail to demonstrate the involved trade-offs between target underdose and brainstem sparing as well as robustness and nominal plan quality. The latter illustrates the advantage of MCO in the context of robust planning. For all cases examined, the robust optimization for each Pareto optimal plan takes less than 5 min on a standard computer, making a computationally friendly interface possible to the planner. In conclusion, the uncertainty pertinent to the IMPT procedure can be reduced during treatment planning by optimizing plans that emphasize different treatment objectives, including robustness, and then interactively seeking for a most-preferred one from the solution Pareto surface.

Family Planning in the Context of Latin America's Universal Health Coverage Agenda

PubMed Central

Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

2017-01-01

ABSTRACT Background: Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. Methods: We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method or force them to pay out of pocket. Conclusion: Leveraging UHC-oriented schemes to sustain and further increase family planning progress will require that governments take deliberate steps to (1) target poor and informal sector populations, (2) include family planning in benefits packages, (3) ensure sufficient financing for family planning, and (4) reduce nonfinancial barriers to access. Through these steps, countries can increase financial protection for family planning and better ensure the right to health of poor and marginalized populations. PMID:28765156

SU-E-T-574: Novel Chance-Constrained Optimization in Intensity-Modulated Proton Therapy Planning to Account for Range and Patient Setup Uncertainties

DOE Office of Scientific and Technical Information (OSTI.GOV)

An, Y; Liang, J; Liu, W

2015-06-15

Purpose: We propose to apply a probabilistic framework, namely chanceconstrained optimization, in the intensity-modulated proton therapy (IMPT) planning subject to range and patient setup uncertainties. The purpose is to hedge against the influence of uncertainties and improve robustness of treatment plans. Methods: IMPT plans were generated for a typical prostate patient. Nine dose distributions are computed — the nominal one and one each for ±5mm setup uncertainties along three cardinal axes and for ±3.5% range uncertainty. These nine dose distributions are supplied to the solver CPLEX as chance constraints to explicitly control plan robustness under these representative uncertainty scenarios withmore » certain probability. This probability is determined by the tolerance level. We make the chance-constrained model tractable by converting it to a mixed integer optimization problem. The quality of plans derived from this method is evaluated using dose-volume histogram (DVH) indices such as tumor dose homogeneity (D5% – D95%) and coverage (D95%) and normal tissue sparing like V70 of rectum, V65, and V40 of bladder. We also compare the results from this novel method with the conventional PTV-based method to further demonstrate its effectiveness Results: Our model can yield clinically acceptable plans within 50 seconds. The chance-constrained optimization produces IMPT plans with comparable target coverage, better target dose homogeneity, and better normal tissue sparing compared to the PTV-based optimization [D95% CTV: 67.9 vs 68.7 (Gy), D5% – D95% CTV: 11.9 vs 18 (Gy), V70 rectum: 0.0 % vs 0.33%, V65 bladder: 2.17% vs 9.33%, V40 bladder: 8.83% vs 21.83%]. It also simultaneously makes the plan more robust [Width of DVH band at D50%: 2.0 vs 10.0 (Gy)]. The tolerance level may be varied to control the tradeoff between plan robustness and quality. Conclusion: The chance-constrained optimization generates superior IMPT plan compared to the PTV-based optimization with explicit control of plan robustness. NIH/NCI K25CA168984, Eagles Cancer Research Career Development, The Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, Mayo ASU Seed Grant, and The Kemper Marley Foundation.« less

A Randomized Controlled Trial to Promote Long-Term Contraceptive Use Among HIV-Serodiscordant and Concordant Positive Couples in Zambia

PubMed Central

Vwalika, Bellington; Greenberg, Lauren; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Kilembe, William; Tichacek, Amanda; Allen, Susan

2011-01-01

Abstract Background Countries facing high HIV prevalence often also experience high levels of fertility and low contraceptive use, suggesting high levels of unmet need for contraceptive services. In particular, the unique needs of couples with one or both partners HIV positive are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in the absence of reduction of the risk of HIV and other sexually transmitted infections (STIs). Methods This article presents an examination of contraceptive method uptake among a cohort of HIV serodiscordant and concordant positive study participants in Zambia. Results Baseline contraceptive use was low; however, exposure to a video-based intervention that provided information on contraceptive methods and modeled desirable future planning behaviors dramatically increased the uptake of modern contraceptive methods. Conclusions Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet the needs and concerns of HIV-positive women or those with HIV-positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on dual method use, combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy. PMID:21410332

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

NASA Astrophysics Data System (ADS)

Fortunati, Valerio; Verhaart, René F.; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; van Walsum, Theo

2015-08-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck. Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available. The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used. Using the proposed approach we improved the performance of the approach previously presented for H&N hyperthermia treatment planning, making the method suitable for clinical application.

Medicare Part D Roulette: Potential Implications of Random Assignment and Plan Restrictions

PubMed Central

Patel, Rajul A.; Walberg, Mark P.; Woelfel, Joseph A.; Amaral, Michelle M.; Varu, Paresh

2013-01-01

Background Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown. Objective We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan. Methods Dual-eligible beneficiaries were provided Part D plan assistance during the 2010 annual election period. The Medicare Web site was used to determine benchmark plan costs and prescription utilization restrictions for each of the six California benchmark plans available for random assignment in 2010. A standardized survey was used to record all de-identified beneficiary demographic and plan specific data. For each low-income subsidy-recipient (n = 113), cost, rank, number of non-formulary medications, and prescription utilization restrictions were recorded for each available 2010 California benchmark plan. Formulary matching rates (percent of beneficiary's medications on plan formulary) were calculated for each benchmark plan. Results Auto-assigned beneficiaries had only a 34% chance of being assigned to the lowest cost plan; the remainder faced potentially significant avoidable out-of-pocket costs. Wide variations between benchmark plans were observed for plan cost, formulary coverage, formulary matching rates, and prescription utilization restrictions. Conclusions Beneficiaries had a 66% chance of being assigned to a sub-optimal plan; thereby, they faced significant avoidable out-of-pocket costs. Alternative methods of beneficiary assignment could decrease beneficiary and Medicare costs while also reducing medication non-compliance. PMID:24753963

A method of forest management for the planned introduction of intensive husbandry in virgin forest stands

Treesearch

B. Dolezal

1978-01-01

The method proposed is derived from long experience of intensive management in forest stands of Central Europe and from our proposal for management in virgin Iranian forests of the Caspian Region. The method establishes the need for systematic planning of stand conversion to insure both sustained yield and the harvesting of sufficient timber to sustain economic...

Speech Planning Happens before Speech Execution: Online Reaction Time Methods in the Study of Apraxia of Speech

ERIC Educational Resources Information Center

Maas, Edwin; Mailend, Marja-Liisa

2012-01-01

Purpose: The purpose of this article is to present an argument for the use of online reaction time (RT) methods to the study of apraxia of speech (AOS) and to review the existing small literature in this area and the contributions it has made to our fundamental understanding of speech planning (deficits) in AOS. Method: Following a brief…

Waste Analysis Plan and Waste Characterization Survey, Barksdale AFB, Louisiana

DTIC Science & Technology

1991-03-01

review to assess if analysis is needed, any analyses that are to be provided by generators, and methods to be used to meet specific waste analysis ...sampling method , sampling frequency, parameters of analysis , SW 846 test methods , Department of Transportation (DOT) shipping name and hazard class...S.e.iceA w/Atchs 2. HQ SAC/DEV Ltr, 28 Sep 90 19 119 APPENDIX B Waste Analysis Plan Rationale 21 APPENDIX B 1. SAMPLING METHOD RATIONALE: Composite Liquid

Accuracy assessment of surgical planning and three-dimensional-printed patient-specific guides for orthopaedic osteotomies.

PubMed

Sys, Gwen; Eykens, Hannelore; Lenaerts, Gerlinde; Shumelinsky, Felix; Robbrecht, Cedric; Poffyn, Bart

2017-06-01

This study analyses the accuracy of three-dimensional pre-operative planning and patient-specific guides for orthopaedic osteotomies. To this end, patient-specific guides were compared to the classical freehand method in an experimental setup with saw bones in two phases. In the first phase, the effect of guide design and oscillating versus reciprocating saws was analysed. The difference between target and performed cuts was quantified by the average distance deviation and average angular deviations in the sagittal and coronal planes for the different osteotomies. The results indicated that for one model osteotomy, the use of guides resulted in a more accurate cut when compared to the freehand technique. Reciprocating saws and slot guides improved accuracy in all planes, while oscillating saws and open guides lead to larger deviations from the planned cut. In the second phase, the accuracy of transfer of the planning to the surgical field with slot guides and a reciprocating saw was assessed and compared to the classical planning and freehand cutting method. The pre-operative plan was transferred with high accuracy. Three-dimensional-printed patient-specific guides improve the accuracy of osteotomies and bony resections in an experimental setup compared to conventional freehand methods. The improved accuracy is related to (1) a detailed and qualitative pre-operative plan and (2) an accurate transfer of the planning to the operation room with patient-specific guides by an accurate guidance of the surgical tools to perform the desired cuts.

SU-E-T-97: An Analysis of Knowledge Based Planning for Stereotactic Body Radiation Therapy of the Spine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foy, J; Marsh, R; Owen, D

2015-06-15

Purpose: Creating high quality SBRT treatment plans for the spine is often tedious and time consuming. In addition, the quality of treatment plans can vary greatly between treatment facilities due to inconsistencies in planning methods. This study investigates the performance of knowledge-based planning (KBP) for spine SBRT. Methods: Treatment plans were created for 28 spine SBRT patients. Each case was planned to meet strict dose objectives and guidelines. After physician and physicist approval, the plans were added to a custom model in a KBP system (RapidPlan, Varian Eclipse v13.5). The model was then trained to be able to predict estimatedmore » DVHs and provide starting objective functions for future patients based on both generated and manual objectives. To validate the model, ten additional spine SBRT cases were planned manually as well as using the model objectives. Plans were compared based on planning time and quality (ability to meet the plan objectives, including dose metrics and conformity). Results: The average dose to the spinal cord and the cord PRV differed between the validation and control plans by <0.25% demonstrating iso-toxicity. Six out of 10 validation plans met all dose objectives without the need for modifications, and overall, target dose coverage was increased by about 4.8%. If the validation plans did not meet the dose requirements initially, only 1–2 iterations of modifying the planning parameters were required before an acceptable plan was achieved. While manually created plans usually required 30 minutes to 3 hours to create, KBP can be used to create similar quality plans in 15–20 minutes. Conclusion: KBP for spinal tumors has shown to greatly decrease the amount of time required to achieve high quality treatment plans with minimal human intervention and could feasibly be used to standardize plan quality between institutions. Supported by Varian Medical Systems.« less

Nurse manager succession planning: a concept analysis.

PubMed

Titzer, Jennifer L; Shirey, Maria R

2013-01-01

The current nursing leadership pipeline is inadequate and demands strategic succession planning methods. This article provides concept clarification regarding nurse manager succession planning. Attributes common to succession planning include organizational commitment and resource allocation, proactive and visionary leadership approach, and a mentoring and coaching environment. Strategic planning, current and future leadership analysis, high-potential identification, and leadership development are succession planning antecedents. Consequences of succession planning are improved leadership and organizational culture continuity, and increased leadership bench strength. Health care has failed to strategically plan for future leadership. Developing a strong nursing leadership pipeline requires deliberate and strategic succession planning. © 2013 Wiley Periodicals, Inc.

Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy.

PubMed

Wu, Vincent W C; Kwong, Dora L W; Sham, Jonathan S T

2004-05-01

Dose conformity to the planning target volume is an important criterion in radiotherapy treatment planning, for which the conformity index is a useful assessment tool. The purpose of this study is to compare the differences in CI for the treatment planning of four cancers including the nasopharynx, oesophagus, lung and prostate. Seventy patients with cancers of nasopharynx (30), oesophagus (15), lung (15) and prostate (10) were recruited. Each of these patients was planned with three sets of treatment plans using the FOCUS treatment planning system: the forward and inverse 3DCRT plans and the IMRT plan. The CI was generated for each treatment plan. The mean CI from each cancer patient group was calculated and compared with the other three cancer groups. The mean value of CI was also compared among the three planning methods. The oesophageal and lung cancers demonstrated relatively higher overall mean CI values (0.64 and 0.62, respectively), whereas that of the nasopharynx and prostate were lower (0.54 and 0.50, respectively). With regards to the planning method groups, the IMRT plans produced the highest overall mean CI (0.62), while those for the forward and inverse 3DCRT were similar (0.57 and 0.55, respectively). For the four selected cancers, oesophageal and lung cancers were easier to conform than the nasopharyngeal and prostate cancers. The IMRT plans were more effective in achieving better dose conformity than that of the 3DCRT.

Social Work Discharge Planning in Acute Care Hospitals in Israel: Clients' Evaluation of the Discharge Planning Process and Adequacy

ERIC Educational Resources Information Center

Soskolne, Varda; Kaplan, Giora; Ben-Shahar, Ilana; Stanger, Varda; Auslander, Gail. K.

2010-01-01

Objective: To examine the associations of patients' characteristics, hospitalization factors, and the patients' or family assessment of the discharge planning process, with their evaluation of adequacy of the discharge plan. Method: A prospective study. Social workers from 11 acute care hospitals in Israel provided data on 1426 discharged…

Harvesting to get a Eucalyptus coppice crop

Treesearch

Thomas F. Geary

1983-01-01

Coppicing of eucalypts saves replanting after harvesting, but plan for coppice before planting seedlings. Select a species that coppices in the planned season of harvest; plan spacing and harvesting methods so that harvesting will not damage stumps; plan coppice management. Best coppice is produced by spring harvest with chain saws, low stumps, no bark or root damage,...

Shaping the College Curriculum: Academic Plans in Action.

ERIC Educational Resources Information Center

Stark, Joan S.; Lattuca, Lisa R.

This book proposes a broad view of the college curriculum, suggesting that it be defined as an "academic plan." The plan included decisions about what, why, and how students learn; ways to determine whether students have learned what they are supposed to learn; and methods of using this information to improve the plan. Taking both a macro and a…

A Framework to Support S&T Planning for Royal Australian Navy Capability Acquisition

DTIC Science & Technology

2012-03-01

for guiding policy and assisting with strategic planning innovation processes. At the commencement of a Foresight Planning exercise the...for many Australian Defence Force (ADF) capability projects . Specifically, the methodology could prove beneficial in the development of science and...27 6.4 Selecting Appropriate Foresight Planning Methods ....................................... 28 7. SCIENCE AND

Selected Bibliographies for Pharmaceutical Supply Systems. Volume 5: Pharmaceutical Supply Systems Bibliographies. International Health Planning Reference Series.

ERIC Educational Resources Information Center

Schaumann, Leif

Intended as a companion piece to volume 7 in the Method Series, Pharmaceutical Supply System Planning (CE 024 234), this fifth of six volumes in the International Health Planning Reference Series is a combined literature review and annotated bibliography dealing with alternative methodologies for planning and analyzing pharmaceutical supply…

Rotorcraft noise

NASA Technical Reports Server (NTRS)

Huston, R. J. (Compiler)

1982-01-01

The establishment of a realistic plan for NASA and the U.S. helicopter industry to develop a design-for-noise methodology, including plans for the identification and development of promising noise reduction technology was discussed. Topics included: noise reduction techniques, scaling laws, empirical noise prediction, psychoacoustics, and methods of developing and validing noise prediction methods.

Apprehensions and Expectations of the Adoption of Systematically Planned, Outcome-Oriented Practice

ERIC Educational Resources Information Center

Savaya, Riki; Altschuler, Dorit; Melamed, Sharon

2013-01-01

Objectives: The study examined social workers' apprehensions and expectations of the impending adoption of systematically planned, empirically based, outcome-oriented practice (SEOP). Method: Employing a mixed methods longitudinal design, the study used concept mapping to identify and map workers' apprehensions and expectations and a self-reported…

A Multi-Objective Method to Align Human Resource Allocation with University Strategy

ERIC Educational Resources Information Center

Bouillard, Philippe

2016-01-01

Universities are currently under considerable pressure to reach their stakeholders' expectations. Management tools that use strategic plans, key performance indicators and quality assurance methods are increasingly deployed. This paper aims to demonstrate how resource allocation can be aligned with institutional strategic plans with a very simple…

SU-F-T-337: Accounting for Patient Motion During Volumetric Modulated Ac Therapy (VMAT) Planning for Post Mastectomy Chest Wall Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hernandez, M; Fontenot, J; Heins, D

2016-06-15

Purpose: To evaluate two dose optimization strategies for maintaining target volume coverage of inversely-planned post mastectomy radiotherapy (PMRT) plans during patient motion. Methods: Five patients previously treated with VMAT for PMRT at our clinical were randomly selected for this study. For each patient, two plan optimization strategies were compared. Plan 1 was optimized to a volume that included the physician’s planning target volume (PTV) plus an expansion up to 0.3 cm from the bolus surface. Plan 2 was optimized to the PTV plus an expansion up to 0.3 cm from the patient surface (i.e., not extending into the bolus). VMATmore » plans were optimized to deliver 95% of the prescription to 95% of the PTV while sparing organs at risk based on clinical dose limits. PTV coverage was then evaluated following the simulation of patient shifts by 1.0 cm in the anterior and posterior directions using the treatment planning system. Results: Posterior patient shifts produced a difference in D95% of around 11% in both planning approaches from the non-shifted dose distributions. Coverage of the medial and lateral borders of the evaluation volume was reduced in both the posteriorly shifted plans (Plan 1 and Plan 2). Anterior patient shifts affected Plan 2 more than Plan 1 with a difference in D95% of 1% for Plan 1 versus 6% for Plan 2 from the non-shifted dose distributions. The least variation in PTV dose homogeneity for both shifts was obtained with Plan 1. However, all posteriorly shifted plans failed to deliver 95% of the prescription to 95% of the PTV. Whereas, only a few anteriorly shifted plans failed this criteria. Conclusion: The results of this study suggest both planning volume methods are sensitive to patient motion, but that a PTV extended into a bolus volume is slightly more robust for anterior patient shifts.« less

Climate change streamflow scenarios designed for critical period water resources planning studies

NASA Astrophysics Data System (ADS)

Hamlet, A. F.; Snover, A. K.; Lettenmaier, D. P.

2003-04-01

Long-range water planning in the United States is usually conducted by individual water management agencies using a critical period planning exercise based on a particular period of the observed streamflow record and a suite of internally-developed simulation tools representing the water system. In the context of planning for climate change, such an approach is flawed in that it assumes that the future climate will be like the historic record. Although more sophisticated planning methods will probably be required as time goes on, a short term strategy for incorporating climate uncertainty into long-range water planning as soon as possible is to create alternate inputs to existing planning methods that account for climate uncertainty as it affects both supply and demand. We describe a straight-forward technique for constructing streamflow scenarios based on the historic record that include the broad-based effects of changed regional climate simulated by several global climate models (GCMs). The streamflow scenarios are based on hydrologic simulations driven by historic climate data perturbed according to regional climate signals from four GCMs using the simple "delta" method. Further data processing then removes systematic hydrologic model bias using a quantile-based bias correction scheme, and lastly, the effects of random errors in the raw hydrologic simulations are removed. These techniques produce streamflow scenarios that are consistent in time and space with the historic streamflow record while incorporating fundamental changes in temperature and precipitation from the GCM scenarios. Planning model simulations based on these climate change streamflow scenarios can therefore be compared directly to planning model simulations based on the historic record of streamflows to help planners understand the potential impacts of climate uncertainty. The methods are currently being tested and refined in two large-scale planning exercises currently being conducted in the Pacific Northwest (PNW) region of the US, and the resulting streamflow scenarios will be made freely available on the internet for a large number of sites in the PNW to help defray the costs of including climate change information in other studies.

SU-E-T-614: Plan Averaging for Multi-Criteria Navigation of Step-And-Shoot IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guo, M; Gao, H; Craft, D

2015-06-15

Purpose: Step-and-shoot IMRT is fundamentally discrete in nature, while multi-criteria optimization (MCO) is fundamentally continuous: the MCO planning consists of continuous sliding across the Pareto surface (the set of plans which represent the tradeoffs between organ-at-risk doses and target doses). In order to achieve close to real-time dose display during this sliding, it is desired that averaged plans share many of the same apertures as the pre-computed plans, since dose computation for apertures generated on-the-fly would be expensive. We propose a method to ensure that neighboring plans on a Pareto surface share many apertures. Methods: Our baseline step-and-shoot sequencing methodmore » is that of K. Engel (a method which minimizes the number of segments while guaranteeing the minimum number of monitor units), which we customize to sequence a set of Pareto optimal plans simultaneously. We also add an error tolerance to study the relationship between the number of shared apertures, the total number of apertures needed, and the quality of the fluence map re-creation. Results: We run tests for a 2D Pareto surface trading off rectum and bladder dose versus target coverage for a clinical prostate case. We find that if we enforce exact fluence map recreation, we are not able to achieve much sharing of apertures across plans. The total number of apertures for all seven beams and 4 plans without sharing is 217. With sharing and a 2% error tolerance, this number is reduced to 158 (73%). Conclusion: With the proposed method, total number of apertures can be decreased by 42% (averaging) with no increment of total MU, when an error tolerance of 5% is allowed. With this large amount of sharing, dose computations for averaged plans which occur during Pareto navigation will be much faster, leading to a real-time what-you-see-is-what-you-get Pareto navigation experience. Minghao Guo and Hao Gao were partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000) and the Shanghai Pujiang Talent Program (#14PJ1404500)« less

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study

PubMed Central

Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

2015-01-01

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses. PMID:29546129

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

PubMed

Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

2015-01-01

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses.

A Methodical Development of Measures of Effectiveness for a Condition-Based Maintenance Management System

DTIC Science & Technology

2014-06-01

21 C . CMMS USE IN THE LCS PROGRAM ......................................................22 D. CBM+ MAINTENANCE MANAGEMENT SYSTEM...45 b. Plan Maintenance Budgeting .................................................45 c . Plan Maintenance Logistics... Maintenance Planning ...................................46 b. Communicate Maintenance Budget .......................................46 c . Communicate

Moving granular-bed filter development program, Option III: Development of moving granular-bed filter technology for multi-contaminant control. Task 14: Test plan; Topical report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haas, J.C.; Olivo, C.A.; Wilson, K.B.

1994-04-01

An experimental test plan has been prepared for DOE/METC review and approval to develop a filter media suitable for multi-contaminant control in granular-bed filter (GBF) applications. The plan includes identification, development, and demonstration of methods for enhanced media morphology, chemical reactivity, and mechanical strength. The test plan includes media preparation methods, physical and chemical characterization methods for fresh and reacted media, media evaluation criteria, details of test and analytical equipment, and test matrix of the proposed media testing. A filter media composed of agglomerated limestone and clay was determined to be the best candidate for multi-contaminate control in GBF operation.more » The combined limestone/clay agglomerate has the potential to remove sulfur and alkali species, in addition to particulate, and possibly halogens and trace heavy metals from coal process streams.« less

Comparison of forward- and back-projection in vivo EPID dosimetry for VMAT treatment of the prostate

NASA Astrophysics Data System (ADS)

Bedford, James L.; Hanson, Ian M.; Hansen, Vibeke N.

2018-01-01

In the forward-projection method of portal dosimetry for volumetric modulated arc therapy (VMAT), the integrated signal at the electronic portal imaging device (EPID) is predicted at the time of treatment planning, against which the measured integrated image is compared. In the back-projection method, the measured signal at each gantry angle is back-projected through the patient CT scan to give a measure of total dose to the patient. This study aims to investigate the practical agreement between the two types of EPID dosimetry for prostate radiotherapy. The AutoBeam treatment planning system produced VMAT plans together with corresponding predicted portal images, and a total of 46 sets of gantry-resolved portal images were acquired in 13 patients using an iViewGT portal imager. For the forward-projection method, each acquisition of gantry-resolved images was combined into a single integrated image and compared with the predicted image. For the back-projection method, iViewDose was used to calculate the dose distribution in the patient for comparison with the planned dose. A gamma index for 3% and 3 mm was used for both methods. The results were investigated by delivering the same plans to a phantom and repeating some of the deliveries with deliberately introduced errors. The strongest agreement between forward- and back-projection methods is seen in the isocentric intensity/dose difference, with moderate agreement in the mean gamma. The strongest correlation is observed within a given patient, with less correlation between patients, the latter representing the accuracy of prediction of the two methods. The error study shows that each of the two methods has its own distinct sensitivity to errors, but that overall the response is similar. The forward- and back-projection EPID dosimetry methods show moderate agreement in this series of prostate VMAT patients, indicating that both methods can contribute to the verification of dose delivered to the patient.

Final Report for X-ray Diffraction Sample Preparation Method Development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ely, T. M.; Meznarich, H. K.; Valero, T.

WRPS-1500790, “X-ray Diffraction Saltcake Sample Preparation Method Development Plan/Procedure,” was originally prepared with the intent of improving the specimen preparation methodology used to generate saltcake specimens suitable for XRD-based solid phase characterization. At the time that this test plan document was originally developed, packed powder in cavity supports with collodion binder was the established XRD specimen preparation method. An alternate specimen preparation method less vulnerable, if not completely invulnerable to preferred orientation effects, was desired as a replacement for the method.

A three-dimensional visualization preoperative treatment planning system for microwave ablation in liver cancer: a simulated experimental study.

PubMed

Liu, Fangyi; Cheng, Zhigang; Han, Zhiyu; Yu, Xiaoling; Yu, Mingan; Liang, Ping

2017-06-01

To evaluate the application value of three-dimensional (3D) visualization preoperative treatment planning system (VPTPS) for microwave ablation (MWA) in liver cancer. The study was a simulated experimental study using the CT imaging data of patients in DICOM format in a model. Three students (who learn to interventional ultrasound for less than 1 year) and three experts (who have more than 5 years of experience in ablation techniques) in MWA performed the preoperative planning for 39 lesions (mean diameter 3.75 ± 1.73 cm) of 32 patients using two-dimensional (2D) image planning method and 3D VPTPS, respectively. The number of planning insertions, planning ablation rate, and damage rate to surrounding structures were compared between2D image planning group and 3D VPTPS group. There were fewer planning insertions, lower ablation rate and higher damage rate to surrounding structures in 2D image planning group than 3D VPTPS group for both students and experts. When using the 2D ultrasound planning method, students could carry out fewer planning insertions and had a lower ablation rate than the experts (p < 0.001). However, there was no significant difference in planning insertions, the ablation rate, and the incidence of damage to the surrounding structures between students and experts using 3D VPTPS. 3DVPTPS enables inexperienced physicians to have similar preoperative planning results to experts, and enhances students' preoperative planning capacity, which may improve the therapeutic efficacy and reduce the complication of MWA.

Incentives to promote family planning

PubMed Central

Heil, Sarah H.; Gaalema, Diann E.; Herrmann, Evan S.

2012-01-01

Objective Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Method Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Results Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Conclusion Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. PMID:22743293

Opportunities and challenges of resident specialists’ attendance plan guidelines (health-care transformation plan) in Isfahan university hospitals in 2015

PubMed Central

Moradi, Reza; Karimi, Saeid; Yarmohammadian, Mohammad Hossein; Kiaei, Mohammad Zakaria; Mazaheri, Elaheh

2018-01-01

BACKGROUND: Given new reforms in Iran's health-care system and due to the need for gathering evidence regarding the implementation of this plan, this study aimed to investigate opportunities and challenges created by resident specialist attendance plan guidelines in university hospitals. MATERIALS AND METHODS: This study used the qualitative method. Semi-structured interviews were used for data gathering. The study population included all experts of Isfahan University of Medical Science. Sampling was carried out using purposeful sampling method and continued until data saturation was reached. In total, 16 experts were interviewed. Criteria such as “reliability of information,” “trustworthiness,” and “verifiability of the information” were considered. Interviewees were assured that their names would keep hidden and that all information is confidential. Subject analysis method was used for data analysis. RESULTS: The findings of this study based on subject analysis led to extracting three themes in regards of challenges in the implementation of resident (specialist or fellowship) plan in hospitals including structural, management, and resource challenges and one theme in the area of opportunities which were improved quality and timely provision of services. CONCLUSION: The findings showed that despite the strengths of this guideline, there are some fundamental challenges in various areas and need better attention by national level policymakers. These results help health-care policymakers to evaluate the problem with a better attitude and improve the necessary plans for implementation of these guidelines. PMID:29619390

Comparing Planning Hydrologic Ensembles associated with Paleoclimate, Projected Climate, and blended Climate Information Sets

NASA Astrophysics Data System (ADS)

Brekke, L. D.; Prairie, J.; Pruitt, T.; Rajagopalan, B.; Woodhouse, C.

2008-12-01

Water resources adaptation planning under climate change involves making assumptions about probabilistic water supply conditions, which are linked to a given climate context (e.g., instrument records, paleoclimate indicators, projected climate data, or blend of these). Methods have been demonstrated to associate water supply assumptions with any of these climate information types. Additionally, demonstrations have been offered that represent these information types in a scenario-rich (ensemble) planning framework, either via ensembles (e.g., survey of many climate projections) or stochastic modeling (e.g., based on instrument records or paleoclimate indicators). If the planning goal involves using a hydrologic ensemble that jointly reflects paleoclimate (e.g., lower- frequency variations) and projected climate information (e.g., monthly to annual trends), methods are required to guide how these information types might be translated into water supply assumptions. However, even if such a method exists, there is lack of understanding on how such a hydrologic ensemble might differ from ensembles developed relative to paleoclimate or projected climate information alone. This research explores two questions: (1) how might paleoclimate and projected climate information be blended into an planning hydrologic ensemble, and (2) how does a planning hydrologic ensemble differ when associated with the individual climate information types (i.e. instrumental records, paleoclimate, projected climate, or blend of the latter two). Case study basins include the Gunnison River Basin in Colorado and the Missouri River Basin above Toston in Montana. Presentation will highlight ensemble development methods by information type, and comparison of ensemble results.

A study of acceptors and non-acceptors of family planning methods among three tribal communities.

PubMed

Mutharayappa, R

1995-03-01

Primary data were collected from 399 currently married women of the Marati, Malekudiya, and Koraga tribes in the Dakshina Kannada district of Karnataka State in this study of the implementation of family planning programs in tribal areas. The Marati, Malekudiya, and Koraga tribes are three different endogamous tribal populations living in similar ecological conditions. Higher levels of literacy and a high rate of acceptance of family planning methods, however, have been observed among these tribes compared to the rest of the tribal population in the state. 46.4% of currently married women aged 15-49 years in the tribes were acceptors of family planning methods, having a mean 3.7 children. The majority of acceptors opted for tubectomy and vasectomy. The adoption of spacing methods is less common among tribal people. Most acceptors received their operations through government health facilities. They were motivated mainly by female health workers and received both cash and other incentives to accept family planning. The main reason for non-acceptance of family planning among non-acceptors was the desire to conceive and bear more children. The data indicate that most of the tribal households are nuclear families with household size more or less similar to that of the general population. They have a higher literacy rate than the rest of the tribal population in the state, with literacy levels between males and females and between the three tribes being quite different; the school enrollment ratio is relatively higher for both boys and girls.

Choosing your health insurance package: a method for measuring the public's preferences for changes in the national health insurance plan.

PubMed

Victoor, Aafke; Hansen, Johan; van den Akker-van Marle, M Elske; van den Berg, Bernard; van den Hout, Wilbert B; de Jong, Judith D

2014-08-01

With rising healthcare expenditure and limited budgets available, countries are having to make choices about the content of health insurance plans. The views of the general population can help determine such priorities. In this article, we investigate whether preferences of the general population regarding the content of health insurance plans could be measured with the help of a stated preference method: the Basket Method (BM). In this method, people use an online tool to include or exclude healthcare interventions from their hypothetical insurance package; this then affects their monthly premium. The study was conducted in the Netherlands. In total, 1007 members of two panels managed by the NIVEL filled out an online questionnaire that included the BM. The suitability of the BM was tested with the help of five criteria, e.g. the BM's ability to distinguish between healthcare interventions. Our results suggest that the BM is suitable for measuring preferences of the general population regarding the content of the health insurance plan, as it performs well on most criteria. Policy makers can use these preferences when deciding the content of the health insurance plan. Its contents will then be more aligned to the population's needs and preferences. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A randomized controlled trial to promote long-term contraceptive use among HIV-serodiscordant and concordant positive couples in Zambia.

PubMed

Stephenson, Rob; Vwalika, Bellington; Greenberg, Lauren; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Kilembe, William; Tichacek, Amanda; Allen, Susan

2011-04-01

Countries facing high HIV prevalence often also experience high levels of fertility and low contraceptive use, suggesting high levels of unmet need for contraceptive services. In particular, the unique needs of couples with one or both partners HIV positive are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in the absence of reduction of the risk of HIV and other sexually transmitted infections (STIs). This article presents an examination of contraceptive method uptake among a cohort of HIV serodiscordant and concordant positive study participants in Zambia. Baseline contraceptive use was low; however, exposure to a video-based intervention that provided information on contraceptive methods and modeled desirable future planning behaviors dramatically increased the uptake of modern contraceptive methods. Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet the needs and concerns of HIV-positive women or those with HIV-positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on dual method use, combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy.

SU-G-TeP4-02: A Method for Evaluating the Direct Impact of Failed IMRT QAs On Patient Dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geneser, S; Butkus, M

Purpose: We developed a method to calculate patient doses corresponding to IMRT QA measurements in order to determine and assess the actual dose delivered for plans with failed (or borderline) IMRT QA. This work demonstrates the feasibility of automatically computing delivered patient dose from portal dosimetry measurements in the Varian TPS system, which would provide a valuable and clinically viable IMRT QA tool for physicists and physicians. Methods: IMRT QA fluences were measured using portal dosimetry, processed using in-house matlab software, and imported back into Eclipse to calculate dose on the planning CT. To validate the proposed workflow, the Eclipsemore » calculated portal dose for a 5-field sliding window prostate boost plan was processed as described above. The resulting dose was compared to the planned dose and found to be within 0.5 Gy. Two IMRT QA results for the prostate boost plan (one that failed and one that passed) were processed and the resulting patient doses were evaluated. Results: The max dose difference between IMRT QA #1 and the original planned and approved dose is 4.5 Gy, while the difference between the planned and IMRT QA #2 dose is 4.0 Gy. The inferior portion of the PTV is slightly underdosed in both plans, and the superior portion is slightly overdosed. The patient dose resulting from IMRT QA #1 and #2 differs by only 0.5 Gy. With this new information, it may be argued that the evaluated plan alteration to obtain passing gamma analysis produced clinically irrelevant differences. Conclusion: Evaluation of the delivered QA dose on the planning CT provides valuable information about the clinical relevance of failed or borderline IMRT QAs. This particular workflow demonstrates the feasibility of pushing the measured IMRT QA portal dosimetry results directly back onto the patient planning CT within the Varian system.« less

Library Bulletin [International Planned Parenthood Federation].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Resources located in the International Planned Parenthood Federation (IPPF) Headquarters Library are inventoried in this library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration; (2) contraceptive methods; (3) family planning (general); (4) United Nations,…

Request for Correction 15003 - Information Quality Act request for Correction of the TSCA Work Plan

EPA Pesticide Factsheets

This RFC concerns the Information Quality Act request for correction of the TSCA Work Plan for Chemical Assessments: 20154 Update and the TSCA Work Plan Chemicals: Methods Document (February 2012) regarding assessment of phthalic anhydride

MO-FG-BRA-04: A Novel Time Weighted Density Correction for Stereotactic Lung Radiotherapy: A Phantom Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohatt, D; Malhotra, H

Purpose: Conventional treatment plans for lung radiotherapy are created using either the free breathing (FB) scheme which represents the tumor at an arbitrary breathing phase of the patient’s respiratory cycle, or the average computed tomography (ACT) intensity projection over 10-binned phases. Neither method is entirely accurate because of the absence of time dependence of tumor movement. In the present “Hybrid” method, the HU of tumor in 3D space is determined by relative weighting of the HU of the tumor and lung in proportion to the time they spend at that location during the entire breathing cycle. Methods: A Quasar respiratorymore » motion phantom was employed to simulate lung tumor movement. Utilizing 4DCT image scans, volumetric modulated arc therapy (VMAT) plans were generated for three treatment planning scenarios which included conventional FB and ACT schemes, along with a third alternative Hybrid approach. Our internal target volume (ITV) hybrid structure was created using Boolean operation in Eclipse (ver. 11) treatment planning system, where independent sub-regions created by the gross tumor volume (GTV) overlap from the 10 motion phases were each assigned a time weighted CT value. The dose-volume-histograms (DVH) for each scheme were compared and analyzed. Results: Using our hybrid technique, we have demonstrated a reduction of 1.9% – 3.4% in total monitor units with respect to conventional treatment planning strategies, along with a 6 fold improvement in high dose spillage over the FB plan. The higher density ACT and Hybrid schemes also produced a slight enhancement in target conformity and reduction in low dose spillage. Conclusion: All treatment plans created in this study exceeded RTOG protocol criteria. Our results determine the free breathing approach yields an inaccurate account of the target treatment density. A significant decrease in unnecessary lung irradiation can be achieved by implementing Hybrid HU method with ACT method second best.« less

Public Law No. 101-167 of 21 November 1989, Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1990.

PubMed

1989-01-01

Among other things, this US Act makes appropriations for foreign operations, export financing, and related programs. With respect to these appropriations, it does the following: 1) prohibits funding for coercive abortion or forced sterilization as part of bilateral development and population planning assistance; 2) prohibits the use of funds appropriated under the Act to lobby for abortion; and 3) prohibits the use of development assistance funds to pay for abortions or involuntary sterilizations as a method of family planning or to motivate or coerce any persons to practice abortions or undergo sterilization, or any biomedical research concerning abortions or involuntary sterilization as a method of family planning. The Act also reaffirms the congressional commitment to population planning, development assistance, and the need for informed voluntary family planning.

Assembly planning based on subassembly extraction

NASA Technical Reports Server (NTRS)

Lee, Sukhan; Shin, Yeong Gil

1990-01-01

A method is presented for the automatic determination of assembly partial orders from a liaison graph representation of an assembly through the extraction of preferred subassemblies. In particular, the authors show how to select a set of tentative subassemblies by decomposing a liaison graph into a set of subgraphs based on feasibility and difficulty of disassembly, how to evaluate each of the tentative subassemblies in terms of assembly cost using the subassembly selection indices, and how to construct a hierarchical partial order graph (HPOG) as an assembly plan. The method provides an approach to assembly planning by identifying spatial parallelism in assembly as a means of constructing temporal relationships among assembly operations and solves the problem of finding a cost-effective assembly plan in a flexible environment. A case study of the assembly planning of a mechanical assembly is presented.

Final Work Plan: Targeted Investigation at York, Nebraska

DOE Office of Scientific and Technical Information (OSTI.GOV)

LaFreniere, Lorraine M.

The targeted investigation at York will be implemented in phases, so that data collected and interpretations developed at each stage of the program can be evaluated to guide subsequent phases most effectively. Section 2 of this Work Plan presents a brief overview of the York site, its geologic and hydrologic setting, and the previous CCC/USDA investigations. Section 3, outlines the proposed technical program for the targeted investigation, and Section 4 describes the investigative methods to be employed. A community relations plan is in Section 5, and Section 6 includes health and safety information. In addition to this site-specific Work Plan,more » the Master Work Plan (Argonne 2002) developed by Argonne for CCC/USDA investigations in Nebraska should be consulted for complete details of the methods and procedures to be used at York.« less

Core competency model for the family planning public health nurse.

PubMed

Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

2014-01-01

A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation

PubMed Central

Lonic, Daniel; Pai, Betty Chien-Jung; Yamaguchi, Kazuaki; Chortrakarnkij, Peerasak; Lin, Hsiu-Hsia; Lo, Lun-Jou

2016-01-01

Background Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method. Patients and Methods This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years). All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment. Results 83.3% of 2D plans were modified, mostly concerning yaw (63.3%) and midline (36.7%) adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation. Conclusion Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D planning. PMID:27002726

SU-E-J-43: Deformed Planning CT as An Electron Density Substitute for Cone-Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mishra, K; Godley, A

2014-06-01

Purpose: To confirm that deforming the planning CT to the daily Cone-Beam CTs (CBCT) can provide suitable electron density for adaptive planning. We quantify the dosimetric difference between plans calculated on deformed planning CTs (DPCT) and daily CT-on-rails images (CTOR). CTOR is used as a test of the method as CTOR already contains accurate electron density to compare against. Methods: Five prostate only IMRT patients, each with five CTOR images, were selected and re-planned on Panther (Prowess Inc.) with a uniform 5 mm PTV expansion, prescribed 78 Gy. The planning CT was deformed to match each CTOR using ABAS (Elektamore » Inc.). Contours were drawn on the CTOR, and copied to the DPCT. The original treatment plan was copied to both the CTOR and DPCT, keeping the center of the prostate as the isocenter. The plans were then calculated using the collapsed cone heterogeneous dose engine of Prowess and typical DVH planning parameters used to compare them. Results: Each DPCT was visually compared to its CTOR with no differences observed. The agreement of the copied CTOR contours with the DPCT anatomy further demonstrated the deformation accuracy. The plans calculated using CTOR and DPCT were compared. Over the 25 plan pairs, the average difference between them for prostate D100, D98 and D95 were 0.5%, 0.2%, and 0.2%; PTV D98, D95 and mean dose: 0.3%, 0.2% and 0.3%; bladder V70, V60 and mean dose: 1.1%, 0.7%, and 0.2%; and rectum mean dose: 0.3%. (D100 is the dose covering 100% of the target; V70 is the volume of the organ receiving 70 Gy). Conclusion: We observe negligible difference between the dose calculated on the DPCT and the CTOR, implying that deformed planning CTs are a suitable substitute for electron density. The method can now be applied to CBCTs. Research version of Panther provided by Prowess Inc. Research version of ABAS provided by Elekta Inc.« less

Head-target tracking control of well drilling

NASA Astrophysics Data System (ADS)

Agzamov, Z. V.

2018-05-01

The method of directional drilling trajectory control for oil and gas wells using predictive models is considered in the paper. The developed method does not apply optimization and therefore there is no need for the high-performance computing. Nevertheless, it allows following the well-plan with high precision taking into account process input saturation. Controller output is calculated both from the present target reference point of the well-plan and from well trajectory prediction with using the analytical model. This method allows following a well-plan not only on angular, but also on the Cartesian coordinates. Simulation of the control system has confirmed the high precision and operation performance with a wide range of random disturbance action.

[A new contraceptive method: breast feeding].

PubMed

Townsend, S

1993-08-01

Even though women have known for centuries that breast feeding has a contraceptive effect, family planning agents have only recently promoted it. Family planning specialists at a meeting in Bellagio, Italy, on breast feeding developed directives referred to as the Lactational Amenorrhea Method (LAM). Adherence to these directives assure effective protection against pregnancy until resumption of menstruation, expansion of infant feeding to foods other than breast milk, or until 6 months postpartum. Nipple stimulation during suckling is sufficient to suppress ovulation. Frequent suckling or more intense suckling maintains the contraceptive effect, so the directives insist that mothers exclusively or almost exclusively breast feed their infants. LAM provides 98% effective protection against pregnancy for 6 months if women observe it as directed. After 6 months, they should use another family planning method. Scientists are trying to see whether they can make the directives more simple. They will discuss this possibility at their next international meeting in 1993 or 1994. Research indicates that the most crucial rule is amenorrhea and use of this rule will make LAM more easy to learn and use, thereby increasing its use. It is difficult to motivate hospital and family planning clinic staff to promote LAM. Information and education are needed to support LAM. for example, a project in Honduras is using peer counseling to promote LAM. Family Health International is following 1000 women for 1 year postpartum in Pakistan and the Philippines. This study's 6-month LAM efficacy rate was around 95%. Little research has looked at the cost effectiveness of LAM. Optimally, LAM is a temporary contraceptive method which must be followed immediately by another contraceptive method. Indeed, LAM counseling should often pregnancy. LAM supporters do not intend for LAM to be a substitute for family planning, but want LAM to be another method in the contraceptive method mix.

A strategic planning methodology for aircraft redesign

NASA Astrophysics Data System (ADS)

Romli, Fairuz Izzuddin

Due to a progressive market shift to a customer-driven environment, the influence of engineering changes on the product's market success is becoming more prominent. This situation affects many long lead-time product industries including aircraft manufacturing. Derivative development has been the key strategy for many aircraft manufacturers to survive the competitive market and this trend is expected to continue in the future. Within this environment of design adaptation and variation, the main market advantages are often gained by the fastest aircraft manufacturers to develop and produce their range of market offerings without any costly mistakes. This realization creates an emphasis on the efficiency of the redesign process, particularly on the handling of engineering changes. However, most activities involved in the redesign process are supported either inefficiently or not at all by the current design methods and tools, primarily because they have been mostly developed to improve original product development. In view of this, the main goal of this research is to propose an aircraft redesign methodology that will act as a decision-making aid for aircraft designers in the change implementation planning of derivative developments. The proposed method, known as Strategic Planning of Engineering Changes (SPEC), combines the key elements of the product redesign planning and change management processes. Its application is aimed at reducing the redesign risks of derivative aircraft development, improving the detection of possible change effects propagation, increasing the efficiency of the change implementation planning and also reducing the costs and the time delays due to the redesign process. To address these challenges, four research areas have been identified: baseline assessment, change propagation prediction, change impact analysis and change implementation planning. Based on the established requirements for the redesign planning process, several methods and tools that are identified within these research areas have been abstracted and adapted into the proposed SPEC method to meet the research goals. The proposed SPEC method is shown to be promising in improving the overall efficiency of the derivative aircraft planning process through two notional aircraft system redesign case studies that are presented in this study.

Report of the AAPM Task Group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning.

PubMed

Chetty, Indrin J; Curran, Bruce; Cygler, Joanna E; DeMarco, John J; Ezzell, Gary; Faddegon, Bruce A; Kawrakow, Iwan; Keall, Paul J; Liu, Helen; Ma, C M Charlie; Rogers, D W O; Seuntjens, Jan; Sheikh-Bagheri, Daryoush; Siebers, Jeffrey V

2007-12-01

The Monte Carlo (MC) method has been shown through many research studies to calculate accurate dose distributions for clinical radiotherapy, particularly in heterogeneous patient tissues where the effects of electron transport cannot be accurately handled with conventional, deterministic dose algorithms. Despite its proven accuracy and the potential for improved dose distributions to influence treatment outcomes, the long calculation times previously associated with MC simulation rendered this method impractical for routine clinical treatment planning. However, the development of faster codes optimized for radiotherapy calculations and improvements in computer processor technology have substantially reduced calculation times to, in some instances, within minutes on a single processor. These advances have motivated several major treatment planning system vendors to embark upon the path of MC techniques. Several commercial vendors have already released or are currently in the process of releasing MC algorithms for photon and/or electron beam treatment planning. Consequently, the accessibility and use of MC treatment planning algorithms may well become widespread in the radiotherapy community. With MC simulation, dose is computed stochastically using first principles; this method is therefore quite different from conventional dose algorithms. Issues such as statistical uncertainties, the use of variance reduction techniques, the ability to account for geometric details in the accelerator treatment head simulation, and other features, are all unique components of a MC treatment planning algorithm. Successful implementation by the clinical physicist of such a system will require an understanding of the basic principles of MC techniques. The purpose of this report, while providing education and review on the use of MC simulation in radiotherapy planning, is to set out, for both users and developers, the salient issues associated with clinical implementation and experimental verification of MC dose algorithms. As the MC method is an emerging technology, this report is not meant to be prescriptive. Rather, it is intended as a preliminary report to review the tenets of the MC method and to provide the framework upon which to build a comprehensive program for commissioning and routine quality assurance of MC-based treatment planning systems.

A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, Ryan L., E-mail: ryan.smith@wbrc.org.au; Millar, Jeremy L.; Franich, Rick D.

Purpose: Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. Methods: A phantom study was conducted to establish the resolutionmore » and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the {sup 192}Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. Results: The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). Conclusions: We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the source position as each dwell was delivered. This approach using a FPD for imaging and source tracking provides a noninvasive method of acquiring extensive information for verification in HDR prostate brachytherapy.« less

A quality control method for intensity-modulated radiation therapy planning based on generalized equivalent uniform dose.

PubMed

Pang, Haowen; Sun, Xiaoyang; Yang, Bo; Wu, Jingbo

2018-05-01

To ensure good quality intensity-modulated radiation therapy (IMRT) planning, we proposed the use of a quality control method based on generalized equivalent uniform dose (gEUD) that predicts absorbed radiation doses in organs at risk (OAR). We conducted a retrospective analysis of patients who underwent IMRT for the treatment of cervical carcinoma, nasopharyngeal carcinoma (NPC), or non-small cell lung cancer (NSCLC). IMRT plans were randomly divided into data acquisition and data verification groups. OAR in the data acquisition group for cervical carcinoma and NPC were further classified as sub-organs at risk (sOAR). The normalized volume of sOAR and normalized gEUD (a = 1) were analyzed using multiple linear regression to establish a fitting formula. For NSCLC, the normalized intersection volume of the planning target volume (PTV) and lung, the maximum diameter of the PTV (left-right, anterior-posterior, and superior-inferior), and the normalized gEUD (a = 1) were analyzed using multiple linear regression to establish a fitting formula for the lung gEUD (a = 1). The r-squared and P values indicated that the fitting formula was a good fit. In the data verification group, IMRT plans verified the accuracy of the fitting formula, and compared the gEUD (a = 1) for each OAR between the subjective method and the gEUD-based method. In conclusion, the gEUD-based method can be used effectively for quality control and can reduce the influence of subjective factors on IMRT planning optimization. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Statistical Methods in Assembly Quality Management of Multi-Element Products on Automatic Rotor Lines

NASA Astrophysics Data System (ADS)

Pries, V. V.; Proskuriakov, N. E.

2018-04-01

To control the assembly quality of multi-element mass-produced products on automatic rotor lines, control methods with operational feedback are required. However, due to possible failures in the operation of the devices and systems of automatic rotor line, there is always a real probability of getting defective (incomplete) products into the output process stream. Therefore, a continuous sampling control of the products completeness, based on the use of statistical methods, remains an important element in managing the quality of assembly of multi-element mass products on automatic rotor lines. The feature of continuous sampling control of the multi-element products completeness in the assembly process is its breaking sort, which excludes the possibility of returning component parts after sampling control to the process stream and leads to a decrease in the actual productivity of the assembly equipment. Therefore, the use of statistical procedures for continuous sampling control of the multi-element products completeness when assembled on automatic rotor lines requires the use of such sampling plans that ensure a minimum size of control samples. Comparison of the values of the limit of the average output defect level for the continuous sampling plan (CSP) and for the automated continuous sampling plan (ACSP) shows the possibility of providing lower limit values for the average output defects level using the ACSP-1. Also, the average sample size when using the ACSP-1 plan is less than when using the CSP-1 plan. Thus, the application of statistical methods in the assembly quality management of multi-element products on automatic rotor lines, involving the use of proposed plans and methods for continuous selective control, will allow to automating sampling control procedures and the required level of quality of assembled products while minimizing sample size.

SU-D-201-06: Remote Dosmetric Auditing of VMAT Deliveries for Clinical Trials Using EPID

DOE Office of Scientific and Technical Information (OSTI.GOV)

Legge, K; Miri, N; Lehmann, J

2016-06-15

Purpose: To develop a method for remote dosimetric auditing the delivery of VMAT using EPID which allows for simple, inexpensive and time efficient dosimetric credentialing for clinical trials. Methods: Remote centers are provided with CT datasets and planning guidelines to produce VMAT plans for a head and neck and a post-prostatectomy treatment. Plans are transferred in the planning system to two virtual water equivalent phantoms, one flat and one cylindrical. Cine images are acquired during VMAT delivery to the EPID in air with gantry angle recorded in image headers. Centers also deliver provided calibration plans to enable EPID signal tomore » dose conversion, determination of the central axis, and correction of EPID sag prior to analysis. EPID images and planned doses are sent to the central site. EPID cine images are converted to dose in the virtual phantoms using an established backprojection method (King et al., Med.Phys. 2012) with EPID backscatter correction. Individual arcs (with gantry angles collapsed to zero) are evaluated at 10 cm depth in the flat phantom using 2D gamma, and total doses are evaluated in the cylindrical phantom using 3D gamma. Results are reported for criteria of 3%,3mm, 3%,2mm and 2%,2mm for all points greater than 10% of global maximum. Results: The pilot study for Varian centers has commenced, and three centers have been audited for head and neck plans and two for post-prostatectomy plans to date. The mean pass rate for arc-by-arc 2D analysis at 3%,3mm is 99.5% and for 3D analysis is 95.8%. A method for Elekta linacs using an inclinometer for gantry angle information is under development. Conclusion: Preliminary results for this new method are promising. The method takes advantage of EPID equipment available at most centers and clinically established software to provide a feasible, low cost solution to credentialing centers for clinical trials. Funding has been provided from Calvary Mater Newcastle Department of Radiation Oncology, TROG Cancer Research and the University of Newcastle. Kimberley Legge is the recipient of an Australian Postgraduate Award. Narges Miri is a recipient of a University of Newcastle postgraduate scholarship.« less

Male involvement in family planning decision making in sub-Saharan Africa- what the evidence suggests

PubMed Central

Vouking, Marius Zambou; Evina, Christine Danielle; Tadenfok, Carine Nouboudem

2014-01-01

The World Health Organization (WHO) estimated in 2012 that 287,000 maternal deaths occurred in 2010; sub-Saharan Africa (56%) and Southern Asia (29%) accounted for the global burden of maternal deaths. Men are also recognized to be responsible for the large proportion of ill reproductive health suffered by their female partners. Male involvement helps not only in accepting a contraceptive but also in its effective use and continuation. The objectives were to assess men's knowledge, attitude, and practice of modern contraceptive methods; determine the level of spousal communication about family planning decision making; and investigate the correlates of men's opinion about their roles in family planning decision making. We searched the following electronic databases from January 1995 to December 2013: Medline, Embase, CINAHL, LILAS, International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Along with MeSH terms and relevant keywords, we used the Cochrane Highly Sensitive Search Strategy for identifying reports of articles in PubMed. There were no restrictions to language or publication status. Of 137 hits, 7 papers met the inclusion criteria. The concept of family planning was well known to men. In the Nigerian study, almost (99%) men were aware of the existence of modern contraceptives, and most of them were aware of at least two modern methods. Awareness of the condom was highest (98%). In the Malawi study, all of the participants reported that they were not using contraception before the intervention. In Ethiopia, above 90% of male respondents have supported and approved using and choosing family planning methods, but none of them practiced terminal methods. Generally, more male respondents disagreed than agreed that men should make decisions about selected family planning issues in the family. Decision-making dynamics around method choice followed a slightly different pattern. According to female participants, decisions regarding method choice were equally made by women or jointly, with male-dominated decisions falling last. There are many challenges to increase male involvement in family planning services. So far very few interventions addressing these challenges have been evaluated scientifically. Health education campaigns to improve beliefs and attitudes of men are absolutely needed. Additionally, improving accessibility, affordability, availability, accommodation and acceptability of family planning service venues will make them more attractive for male partners. PMID:25922638

Male involvement in family planning decision making in sub-Saharan Africa- what the evidence suggests.

PubMed

Vouking, Marius Zambou; Evina, Christine Danielle; Tadenfok, Carine Nouboudem

2014-01-01

The World Health Organization (WHO) estimated in 2012 that 287,000 maternal deaths occurred in 2010; sub-Saharan Africa (56%) and Southern Asia (29%) accounted for the global burden of maternal deaths. Men are also recognized to be responsible for the large proportion of ill reproductive health suffered by their female partners. Male involvement helps not only in accepting a contraceptive but also in its effective use and continuation. The objectives were to assess men's knowledge, attitude, and practice of modern contraceptive methods; determine the level of spousal communication about family planning decision making; and investigate the correlates of men's opinion about their roles in family planning decision making. We searched the following electronic databases from January 1995 to December 2013: Medline, Embase, CINAHL, LILAS, International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Along with MeSH terms and relevant keywords, we used the Cochrane Highly Sensitive Search Strategy for identifying reports of articles in PubMed. There were no restrictions to language or publication status. Of 137 hits, 7 papers met the inclusion criteria. The concept of family planning was well known to men. In the Nigerian study, almost (99%) men were aware of the existence of modern contraceptives, and most of them were aware of at least two modern methods. Awareness of the condom was highest (98%). In the Malawi study, all of the participants reported that they were not using contraception before the intervention. In Ethiopia, above 90% of male respondents have supported and approved using and choosing family planning methods, but none of them practiced terminal methods. Generally, more male respondents disagreed than agreed that men should make decisions about selected family planning issues in the family. Decision-making dynamics around method choice followed a slightly different pattern. According to female participants, decisions regarding method choice were equally made by women or jointly, with male-dominated decisions falling last. There are many challenges to increase male involvement in family planning services. So far very few interventions addressing these challenges have been evaluated scientifically. Health education campaigns to improve beliefs and attitudes of men are absolutely needed. Additionally, improving accessibility, affordability, availability, accommodation and acceptability of family planning service venues will make them more attractive for male partners.

Development of a Nationally Coordinated Evaluation Plan for the Ghana National Strategy for Key Populations

PubMed Central

Reynolds, Heidi W; Atuahene, Kyeremeh; Sutherland, Elizabeth; Amenyah, Richard; Kwao, Isaiah Doe; Larbi, Emmanuel Tettey

2015-01-01

Objective Just as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations. Methods This was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods. Results An evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship. Conclusion The experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system. PMID:26120495

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

PubMed Central

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

2014-01-01

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi.

PubMed

Ndayizigiye, M; Fawzi, M C Smith; Lively, C Thompson; Ware, N C

2017-03-15

Family planning can reduce deaths, improve health, and facilitate economic development in resource-limited settings. Yet, modern contraceptive methods are often underused. This mixed-methods study, conducted in rural Burundi, sought to explain low uptake of contraceptives by identifying utilization barriers. Results may inform development of family planning interventions in Burundi and elsewhere. We investigated uptake of contraceptives among women of reproductive age in two rural districts of Burundi, using an explanatory sequential, mixed-methods research design. We first assessed availability and utilization rates of modern contraceptives through a facility-based survey in 39 health clinics. Barriers to uptake of contraceptives were then explored through qualitative interviews (N = 10) and focus groups (N = 7). Contraceptives were generally available in the 39 clinics studied, yet uptake of family planning averaged only 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision, and with the number of different types of contraceptives available. Four uptake barriers were identified: (1) lack of providers to administer contraception, (2) lack of fit between available and preferred contraceptive methods, (3) a climate of fear surrounding contraceptive use, and (4) provider refusal to offer family planning services. Where resources are scarce, availability of modern contraceptives alone will likely not ensure uptake. Interventions addressing multiple uptake barriers simultaneously have the greatest chance of success. In rural Burundi, examples are community distribution of contraceptive methods, public information campaigns, improved training for health professionals and community health workers, and strengthening of the health infrastructure.

SU-E-T-546: Use of Implant Volume for Quality Assurance of Low Dose Rate Brachytherapy Treatment Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilkinson, D; Kolar, M

Purpose: To analyze the application of volume implant (V100) data as a method for a global check of low dose rate (LDR) brachytherapy plans. Methods: Treatment plans for 335 consecutive patients undergoing permanent seed implants for prostate cancer and for 113 patients treated with plaque therapy for ocular melanoma were analyzed. Plaques used were 54 COMS (10 to 20 mm, notched and regular) and 59 Eye Physics EP917s with variable loading. Plots of treatment time x implanted activity per unit dose versus v100 ^.667 were made. V100 values were obtained using dose volume histograms calculated by the treatment planning systemsmore » (Variseed 8.02 and Plaque Simulator 5.4). Four different physicists were involved in planning the prostate seed cases; two physicists for the eye plaques. Results: Since the time and dose for the prostate cases did not vary, a plot of implanted activity vs V100 ^.667 was made. A linear fit with no intercept had an r{sup 2} = 0.978; more than 94% of the actual activities fell within 5% of the activities calculated from the linear fit. The greatest deviations were in cases where the implant volumes were large (> 100 cc). Both COMS and EP917 plaque linear fits were good (r{sup 2} = .967 and .957); the largest deviations were seen for large volumes. Conclusions: The method outlined here is effective for checking planning consistency and quality assurance of two types of LDR brachytherapy treatment plans (temporary and permanent). A spreadsheet for the calculations enables a quick check of the plan in situations were time is short (e.g. OR-based prostate planning)« less

Simulations using patient data to evaluate systematic errors that may occur in 4D treatment planning: a proof of concept study.

PubMed

St James, Sara; Seco, Joao; Mishra, Pankaj; Lewis, John H

2013-09-01

The purpose of this work is to present a framework to evaluate the accuracy of four-dimensional treatment planning in external beam radiation therapy using measured patient data and digital phantoms. To accomplish this, 4D digital phantoms of two model patients were created using measured patient lung tumor positions. These phantoms were used to simulate a four-dimensional computed tomography image set, which in turn was used to create a 4D Monte Carlo (4DMC) treatment plan. The 4DMC plan was evaluated by simulating the delivery of the treatment plan over approximately 5 min of tumor motion measured from the same patient on a different day. Unique phantoms accounting for the patient position (tumor position and thorax position) at 2 s intervals were used to represent the model patients on the day of treatment delivery and the delivered dose to the tumor was determined using Monte Carlo simulations. For Patient 1, the tumor was adequately covered with 95.2% of the tumor receiving the prescribed dose. For Patient 2, the tumor was not adequately covered and only 74.3% of the tumor received the prescribed dose. This study presents a framework to evaluate 4D treatment planning methods and demonstrates a potential limitation of 4D treatment planning methods. When systematic errors are present, including when the imaging study used for treatment planning does not represent all potential tumor locations during therapy, the treatment planning methods may not adequately predict the dose to the tumor. This is the first example of a simulation study based on patient tumor trajectories where systematic errors that occur due to an inaccurate estimate of tumor motion are evaluated.

SU-F-T-308: Mobius FX Evaluation and Comparison Against a Commercial 4D Detector Array for VMAT Plan QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vazquez Quino, L; Huerta Hernandez, C; Morrow, A

2016-06-15

Purpose: To evaluate the use of MobiusFX as a pre-treatment verification IMRT QA tool and compare it with a commercial 4D detector array for VMAT plan QA. Methods: 15 VMAT plan QA of different treatment sites were delivered and measured by traditional means with the 4D detector array ArcCheck (Sun Nuclear corporation) and at the same time measurement in linac treatment logs (Varian Dynalogs files) were analyzed from the same delivery with MobiusFX software (Mobius Medical Systems). VMAT plan QAs created in Eclipse treatment planning system (Varian) in a TrueBeam linac machine (Varian) were delivered and analyzed with the gammamore » analysis routine from SNPA software (Sun Nuclear corporation). Results: Comparable results in terms of the gamma analysis with 99.06% average gamma passing with 3%,3mm passing rate is observed in the comparison among MobiusFX, ArcCheck measurements, and the Treatment Planning System dose calculated. When going to a stricter criterion (1%,1mm) larger discrepancies are observed in different regions of the measurements with an average gamma of 66.24% between MobiusFX and ArcCheck. Conclusion: This work indicates the potential for using MobiusFX as a routine pre-treatment patient specific IMRT method for quality assurance purposes and its advantages as a phantom-less method which reduce the time for IMRT QA measurement. MobiusFX is capable of produce similar results of those by traditional methods used for patient specific pre-treatment verification VMAT QA. Even the gamma results comparing to the TPS are similar the analysis of both methods show that the errors being identified by each method are found in different regions. Traditional methods like ArcCheck are sensitive to setup errors and dose difference errors coming from the linac output. On the other hand linac log files analysis record different errors in the VMAT QA associated with the MLCs and gantry motion that by traditional methods cannot be detected.« less

Current practice and future prospects for social data in coastal and ocean planning.

PubMed

Le Cornu, Elodie; Kittinger, John N; Koehn, J Zachary; Finkbeiner, Elena M; Crowder, Larry B

2014-08-01

Coastal and ocean planning comprises a broad field of practice. The goals, political processes, and approaches applied to planning initiatives may vary widely. However, all planning processes ultimately require adequate information on both the biophysical and social attributes of a planning region. In coastal and ocean planning practice, there are well-established methods to assess biophysical attributes; however, less is understood about the role and assessment of social data. We conducted the first global assessment of the incorporation of social data in coastal and ocean planning. We drew on a comprehensive review of planning initiatives and a survey of coastal and ocean practitioners. There was significantly more incorporation of social data in multiuse versus conservation-oriented planning. Practitioners engaged a wide range of social data, including governance, economic, and cultural attributes of planning regions and human impacts data. Less attention was given to ecosystem services and social-ecological linkages, both of which could improve coastal and ocean planning practice. Although practitioners recognize the value of social data, little funding is devoted to its collection and incorporation in plans. Increased capacity and sophistication in acquiring critical social and ecological data for planning is necessary to develop plans for more resilient coastal and ocean ecosystems and communities. We suggest that improving social data monitoring, and in particular spatial social data, to complement biophysical data, is necessary for providing holistic information for decision-support tools and other methods. Moving beyond people as impacts to people as beneficiaries, through ecosystem services assessments, holds much potential to better incorporate the tenets of ecosystem-based management into coastal and ocean planning by providing targets for linked biodiversity conservation and human welfare outcomes. © 2014 Society for Conservation Biology.

29 CFR 2520.104-44 - Limited exemption and alternative method of compliance for annual reporting by unfunded plans and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Labor may exempt an employee welfare benefit plan from any or all of the reporting and disclosure requirements of title I. An employee welfare benefit plan which meets the requirements of paragraph (b)(1) of... section. (b) Application. This section applies only to: (1) An employee welfare benefit plan under the...

75 FR 64197 - Additional Rules Regarding Hybrid Retirement Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-19

... defined benefit plan to provide that an employee who has completed at least 3 years of service has a... are the 3 percent method of section 411(b)(1)(A), the 133\\1/3\\ percent rule of section 411(b)(1)(B... plan satisfies the requirements of the 133\\1/3\\ percent rule for a particular plan year if, under the...

An Interpretive Master Plan at the Museum of Fine Arts, Houston

ERIC Educational Resources Information Center

Schneider, Beth B.

2008-01-01

This case study presents the methods the staff at the Museum of Fine Arts, Houston used to develop and implement an interpretive master plan from 1996-2000. The process can be a model for other museums. Looking back a decade after the plan was developed provides insights into the role of interpretive plans as statements of goals, expressions of…

Evaluating the Impact of Action Plans on Trainee Compliance with Learning Objectives

ERIC Educational Resources Information Center

Aumann, Michael J.

2013-01-01

This mixed methods research study evaluated the use of technology-based action plans as a way to help improve compliance with the learning objectives of an online training event. It explored how the action planning strategy impacted subjects in a treatment group and compared them to subjects in a control group who did not get the action plan. The…

Improvement of Experiment Planning as an Important Precondition for the Quality of Educational Research

ERIC Educational Resources Information Center

Rutkiene, Ausra; Tereseviciene, Margarita

2010-01-01

The article presents the stages of the experiment planning that are necessary to ensure the validity and reliability of it. The research data reveal that doctoral students of Educational Research approach the planning of the experiment as the planning of the whole dissertation research; and the experiment as a research method is often confused…

An Economic History of Medicare Part C

PubMed Central

Mcguire, Thomas G; Newhouse, Joseph P; Sinaiko, Anna D

2011-01-01

Context: Twenty-five years ago, private insurance plans were introduced into the Medicare program with the stated dual aims of (1) giving beneficiaries a choice of health insurance plans beyond the fee-for-service Medicare program and (2) transferring to the Medicare program the efficiencies and cost savings achieved by managed care in the private sector. Methods: In this article we review the economic history of Medicare Part C, known today as Medicare Advantage, focusing on the impact of major changes in the program's structure and of plan payment methods on trends in the availability of private plans, plan enrollment, and Medicare spending. Additionally, we compare the experience of Medicare Advantage and of employer-sponsored health insurance with managed care over the same time period. Findings: Beneficiaries' access to private plans has been inconsistent over the program's history, with higher plan payments resulting in greater choice and enrollment and vice versa. But Medicare Advantage generally has cost more than the traditional Medicare program, an overpayment that has increased in recent years. Conclusions: Major changes in Medicare Advantage's payment rules are needed in order to simultaneously encourage the participation of private plans, the provision of high-quality care, and to save Medicare money. PMID:21676024

Primary care managers' perceptions of their capability in providing care planning to patients with complex needs.

PubMed

Larsson, Lena Gunvor; Bäck-Pettersson, Siv; Kylén, Sven; Marklund, Bertil; Carlström, Eric

2017-01-01

The aim of this study was to investigate primary care managers' perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient's care needs and plan care interventions together. Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin's theoretical cooperation model. Data were analysed using a qualitative deductive method. Results reveal that the managers' approach to care planning was dominated by non-cooperation and separation. The managers were permeated by uncertainty about the meaning of the task of care planning as such. They did not seem to be familiar with the national legislation stipulating that every healthcare provider must meet patients' need for care interventions and participate in the care planning. To accomplish care planning, the process needs to cross - and overcome - both professional and organisational boundaries. There is also a need for incentives to develop working methods that promote local cooperation in order to facilitate optimal care for patients with complex needs. Copyright © 2016. Published by Elsevier Ireland Ltd.

Comparison of optimization algorithms in intensity-modulated radiation therapy planning

NASA Astrophysics Data System (ADS)

Kendrick, Rachel

Intensity-modulated radiation therapy is used to better conform the radiation dose to the target, which includes avoiding healthy tissue. Planning programs employ optimization methods to search for the best fluence of each photon beam, and therefore to create the best treatment plan. The Computational Environment for Radiotherapy Research (CERR), a program written in MATLAB, was used to examine some commonly-used algorithms for one 5-beam plan. Algorithms include the genetic algorithm, quadratic programming, pattern search, constrained nonlinear optimization, simulated annealing, the optimization method used in Varian EclipseTM, and some hybrids of these. Quadratic programing, simulated annealing, and a quadratic/simulated annealing hybrid were also separately compared using different prescription doses. The results of each dose-volume histogram as well as the visual dose color wash were used to compare the plans. CERR's built-in quadratic programming provided the best overall plan, but avoidance of the organ-at-risk was rivaled by other programs. Hybrids of quadratic programming with some of these algorithms seems to suggest the possibility of better planning programs, as shown by the improved quadratic/simulated annealing plan when compared to the simulated annealing algorithm alone. Further experimentation will be done to improve cost functions and computational time.

Strategic Planning towards a World-Class University

NASA Astrophysics Data System (ADS)

Usoh, E. J.; Ratu, D.; Manongko, A.; Taroreh, J.; Preston, G.

2018-02-01

Strategic planning with a focus on world-class university status is an option that cannot be avoided by universities today to survive and succeed in competition as a provider of higher education. The objective of this research is to obtain exploratory research results on the strategic plans of universities that are prepared to generate world-class university status. This research utilised exploratory qualitative research method and data was collected by in-depth interviews method. Interview transcripts were analyzed by using thematic content analysis through NVivo software analysis and manual systems. The main finding of interview shows that most interviewees agreed that UNIMA has been engaged in strategic planning. Contribution from faculties and schools are acknowledged and inform the planning process. However, a new model of strategic planning should be adopted by UNIMA due to the shift towards a “corporate university”. The finding results from documents, literature review and interview were the addition of world-class university characteristics and features to current strategic planning of UNIMA and how to upgrade by considering to use the characteristics and features towards world-class university.

TH-CD-209-04: Fuzzy Robust Optimization in Intensity-Modulated Proton Therapy Planning to Account for Range and Patient Setup Uncertainties

DOE Office of Scientific and Technical Information (OSTI.GOV)

An, Y; Bues, M; Schild, S

Purpose: We propose to apply a robust optimization model based on fuzzy-logic constraints in the intensity-modulated proton therapy (IMPT) planning subject to range and patient setup uncertainties. The purpose is to ensure the plan robustness under uncertainty and obtain the best trade-off between tumor dose coverage and organ-at-risk(OAR) sparing. Methods: Two IMPT plans were generated for 3 head-and-neck cancer patients: one used the planning target volume(PTV) method; the other used the fuzzy robust optimization method. In the latter method, nine dose distributions were computed - the nominal one and one each for ±3mm setup uncertainties along three cardinal axes andmore » for ±3.5% range uncertainty. For tumors, these nine dose distributions were explicitly controlled by adding hard constraints with adjustable parameters. For OARs, fuzzy constraints that allow the dose to vary within a certain range were used so that the tumor dose distribution was guaranteed by minimum compromise of that of OARs. We rendered this model tractable by converting the fuzzy constraints to linear constraints. The plan quality was evaluated using dose-volume histogram(DVH) indices such as tumor dose coverage(D95%), homogeneity(D5%-D95%), plan robustness(DVH band at D95%), and OAR sparing like D1% of brain and D1% of brainstem. Results: Our model could yield clinically acceptable plans. The fuzzy-logic robust optimization method produced IMPT plans with comparable target dose coverage and homogeneity compared to the PTV method(unit: Gy[RBE]; average[min, max])(CTV D95%: 59 [52.7, 63.5] vs 53.5[46.4, 60.1], CTV D5% - D95%: 11.1[5.3, 18.6] vs 14.4[9.2, 21.5]). It also generated more robust plans(CTV DVH band at D95%: 3.8[1.2, 5.6] vs 11.5[6.2, 16.7]). The parameters of tumor constraints could be adjusted to control the tradeoff between tumor coverage and OAR sparing. Conclusion: The fuzzy-logic robust optimization generates superior IMPT with minimum compromise of OAR sparing. This research was supported by the National Cancer Institute Career Developmental Award K25CA168984, by the Fraternal Order of Eagles Cancer Research Fund Career Development Award, by The Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, by Mayo Arizona State University Seed Grant, and by The Kemper Marley Foundation. eRA Person ID(s) for the Principal Investigator: 11017970 (Research Supported by National Institutes of Health)« less

Comparison of linear and nonlinear programming approaches for "worst case dose" and "minmax" robust optimization of intensity-modulated proton therapy dose distributions.

PubMed

Zaghian, Maryam; Cao, Wenhua; Liu, Wei; Kardar, Laleh; Randeniya, Sharmalee; Mohan, Radhe; Lim, Gino

2017-03-01

Robust optimization of intensity-modulated proton therapy (IMPT) takes uncertainties into account during spot weight optimization and leads to dose distributions that are resilient to uncertainties. Previous studies demonstrated benefits of linear programming (LP) for IMPT in terms of delivery efficiency by considerably reducing the number of spots required for the same quality of plans. However, a reduction in the number of spots may lead to loss of robustness. The purpose of this study was to evaluate and compare the performance in terms of plan quality and robustness of two robust optimization approaches using LP and nonlinear programming (NLP) models. The so-called "worst case dose" and "minmax" robust optimization approaches and conventional planning target volume (PTV)-based optimization approach were applied to designing IMPT plans for five patients: two with prostate cancer, one with skull-based cancer, and two with head and neck cancer. For each approach, both LP and NLP models were used. Thus, for each case, six sets of IMPT plans were generated and assessed: LP-PTV-based, NLP-PTV-based, LP-worst case dose, NLP-worst case dose, LP-minmax, and NLP-minmax. The four robust optimization methods behaved differently from patient to patient, and no method emerged as superior to the others in terms of nominal plan quality and robustness against uncertainties. The plans generated using LP-based robust optimization were more robust regarding patient setup and range uncertainties than were those generated using NLP-based robust optimization for the prostate cancer patients. However, the robustness of plans generated using NLP-based methods was superior for the skull-based and head and neck cancer patients. Overall, LP-based methods were suitable for the less challenging cancer cases in which all uncertainty scenarios were able to satisfy tight dose constraints, while NLP performed better in more difficult cases in which most uncertainty scenarios were hard to meet tight dose limits. For robust optimization, the worst case dose approach was less sensitive to uncertainties than was the minmax approach for the prostate and skull-based cancer patients, whereas the minmax approach was superior for the head and neck cancer patients. The robustness of the IMPT plans was remarkably better after robust optimization than after PTV-based optimization, and the NLP-PTV-based optimization outperformed the LP-PTV-based optimization regarding robustness of clinical target volume coverage. In addition, plans generated using LP-based methods had notably fewer scanning spots than did those generated using NLP-based methods. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Human Cognitive Processes in Command and Control Planning. 3. Determining Basic Processes Involved in Planning in Time and Space (Cognitieve Processen in Command and Control Planning. 3. Basisprocessen in Planning in Tijd en Ruimte)

DTIC Science & Technology

1991-08-07

spatidle componenten bevat."De studie had twee do6elen: hei ontwikkelen, van een methode voor bet bepalen van . de cognitieve processen, die met...planning samenhangen en bet ontwikkelen van een model voor efficidnte planning voor de taak gebruikt in deze studie. Twee planners gaven verbale en...grafische protocolfen terwijl ze een planning maakten voor de meest effi-cidnte weg voor winkel-robot’s orn goederen op te halen in een winkel. Voor twaalf

Motion Planning of Two Stacker Cranes in a Large-Scale Automated Storage/Retrieval System

NASA Astrophysics Data System (ADS)

Kung, Yiheng; Kobayashi, Yoshimasa; Higashi, Toshimitsu; Ota, Jun

We propose a method for reducing the computational time of motion planning for stacker cranes. Most automated storage/retrieval systems (AS/RSs) are only equipped with one stacker crane. However, this is logistically challenging, and greater work efficiency in warehouses, such as those using two stacker cranes, is required. In this paper, a warehouse with two stacker cranes working simultaneously is proposed. Unlike warehouses with only one crane, trajectory planning in those with two cranes is very difficult. Since there are two cranes working together, a proper trajectory must be considered to avoid collision. However, verifying collisions is complicated and requires a considerable amount of computational time. As transport work in AS/RSs occurs randomly, motion planning cannot be conducted in advance. Planning an appropriate trajectory within a restricted duration would be a difficult task. We thereby address the current problem of motion planning requiring extensive calculation time. As a solution, we propose a “free-step” to simplify the procedure of collision verification and reduce the computational time. On the other hand, we proposed a method to reschedule the order of collision verification in order to find an appropriate trajectory in less time. By the proposed method, we reduce the calculation time to less than 1/300 of that achieved in former research.

Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gladstone, D. J.; Li, S.; Jarvis, L. A.

2011-07-15

Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging,more » the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.« less

34 CFR 364.38 - What methods of evaluation must the State plan include?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What methods of evaluation must the State plan include? 364.38 Section 364.38 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING...

34 CFR 364.38 - What methods of evaluation must the State plan include?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true What methods of evaluation must the State plan include? 364.38 Section 364.38 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING...

Understanding Succession Planning and Management Efforts at Midwestern University: A Mixed Methods Study

ERIC Educational Resources Information Center

Mateso, Peter E. E.

2010-01-01

The purpose of this concurrent triangulation mixed methods study was to understand the status of succession planning and management (SPM) efforts of the subject university as perceived by the fulltime academic and fulltime administrative staff. Four research questions guided this study: (1) how do fulltime academic staff and fulltime…

Two-Method Planned Missing Designs for Longitudinal Research

ERIC Educational Resources Information Center

Garnier-Villarreal, Mauricio; Rhemtulla, Mijke; Little, Todd D.

2014-01-01

We examine longitudinal extensions of the two-method measurement design, which uses planned missingness to optimize cost-efficiency and validity of hard-to-measure constructs. These designs use a combination of two measures: a "gold standard" that is highly valid but expensive to administer, and an inexpensive (e.g., survey-based)…

Application of Network Planning to Teaching Wind-Surfing

ERIC Educational Resources Information Center

Zybko, Przemyslaw; Jaczynowski, Lech

2008-01-01

Study aim: To determine the effects of network planning on teaching untrained subjects windsurfing. Material and methods: Untrained physical education students (n = 390), aged 19-23 years, took part in the study while staying on a summer camp. They were randomly assigned into two groups: experimental (n = 216) and control (n = 174). Two methods of…

Two Methods for Classifying Jobs into Equal Employment Opportunity Categories. Working Paper 83/84-4-21.

ERIC Educational Resources Information Center

Potter, Penny F.; Graham-Moore, Brian E.

Most organizations planning to assess adverse impact or perform a stock analysis for affirmative action planning must correctly classify their jobs into appropriate occupational categories. Two methods of job classification were assessed in a combination archival and field study. Classification results from expert judgment of functional job…

10 CFR 905.11 - What must an IRP include?

Code of Federal Regulations, 2010 CFR

2010-01-01

... forecasting method, including but not limited to the time series, end-use, and econometric methods. The... projected durability of such savings measured over time; and must treat demand and supply resources on a... implement its IRP. (i) The IRP must state the time period that the action plan covers, and the action plan...

10 CFR 905.11 - What must an IRP include?

Code of Federal Regulations, 2011 CFR

2011-01-01

... forecasting method, including but not limited to the time series, end-use, and econometric methods. The... projected durability of such savings measured over time; and must treat demand and supply resources on a... implement its IRP. (i) The IRP must state the time period that the action plan covers, and the action plan...

10 CFR 905.11 - What must an IRP include?

Code of Federal Regulations, 2012 CFR

2012-01-01

... forecasting method, including but not limited to the time series, end-use, and econometric methods. The... projected durability of such savings measured over time; and must treat demand and supply resources on a... implement its IRP. (i) The IRP must state the time period that the action plan covers, and the action plan...

10 CFR 905.11 - What must an IRP include?

Code of Federal Regulations, 2014 CFR

2014-01-01

... forecasting method, including but not limited to the time series, end-use, and econometric methods. The... projected durability of such savings measured over time; and must treat demand and supply resources on a... implement its IRP. (i) The IRP must state the time period that the action plan covers, and the action plan...

10 CFR 905.11 - What must an IRP include?

Code of Federal Regulations, 2013 CFR

2013-01-01

... forecasting method, including but not limited to the time series, end-use, and econometric methods. The... projected durability of such savings measured over time; and must treat demand and supply resources on a... implement its IRP. (i) The IRP must state the time period that the action plan covers, and the action plan...

Evaluating alternative methods for biophysical and cultural ecosystem services hotspot mapping in natural resource planning

USGS Publications Warehouse

Bagstad, Kenneth J.; Semmens, Darius J.; Ancona, Zachary H.; Sherrouse, Ben C.

2017-01-01

Statistical hotspot methods of intermediate conservatism (i.e., Getis-Ord Gi*, α = 0.10 significance) may be most useful for ecosystem service hot/coldspot mapping to inform landscape scale planning. We also found spatially explicit evidence in support of past findings about public attitudes toward wilderness areas.

A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy

PubMed Central

Baltas, Dimos; Karabis, Andreas; Stock, Markus; Dimopoulos, Johannes; Georg, Dietmar; Pötter, Richard; Kirisits, Christian

2011-01-01

Purpose The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna) protocol. Material and methods For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO) and with Inverse Planning Simulated Annealing (IPSA) were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated. Results HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles. This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low. Conclusions HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning. PMID:27853479

Perceptions of family planning among low-income men in Western Kenya.

PubMed

Wambui, T; Ek, A-C; Alehagen, S

2009-09-01

Men have rarely been involved in either receiving or providing information on sexuality, reproductive health or birth spacing. They have also been ignored or excluded in one way or the other from participating in many family planning programmes as family planning is viewed as a woman's affair. To describe the perceptions of family planning among low-income men in Western Kenya. A qualitative study using focus group interviews and content analysis was conducted, with 64 men aged 15-54 years participating actively. Perceptions of family planning were manifold. For example, some perceived it as meaning having the number of children one is able to provide for. Most men knew about traditional and modern methods of birth control, although their knowledge was poor and misconceived. Modern methods were thought to give side effects, discouraging family planning. Low instances of family planning were also because of the fact that culturally, children are considered wealth. A law advocating family size limitation was regarded as necessary for the future. Men's perceptions of family planning are manifold. Their knowledge about contraception is poor and sometimes misconceived. Preferences regarding a child's gender are strong, thus attitudes and cultural beliefs that might hinder family planning have to be considered. A policy on male contraception and contraceptive services is seen as necessary.

Automatic learning-based beam angle selection for thoracic IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amit, Guy; Marshall, Andrea; Purdie, Thomas G., E-mail: tom.purdie@rmp.uhn.ca

Purpose: The treatment of thoracic cancer using external beam radiation requires an optimal selection of the radiation beam directions to ensure effective coverage of the target volume and to avoid unnecessary treatment of normal healthy tissues. Intensity modulated radiation therapy (IMRT) planning is a lengthy process, which requires the planner to iterate between choosing beam angles, specifying dose–volume objectives and executing IMRT optimization. In thorax treatment planning, where there are no class solutions for beam placement, beam angle selection is performed manually, based on the planner’s clinical experience. The purpose of this work is to propose and study a computationallymore » efficient framework that utilizes machine learning to automatically select treatment beam angles. Such a framework may be helpful for reducing the overall planning workload. Methods: The authors introduce an automated beam selection method, based on learning the relationships between beam angles and anatomical features. Using a large set of clinically approved IMRT plans, a random forest regression algorithm is trained to map a multitude of anatomical features into an individual beam score. An optimization scheme is then built to select and adjust the beam angles, considering the learned interbeam dependencies. The validity and quality of the automatically selected beams evaluated using the manually selected beams from the corresponding clinical plans as the ground truth. Results: The analysis included 149 clinically approved thoracic IMRT plans. For a randomly selected test subset of 27 plans, IMRT plans were generated using automatically selected beams and compared to the clinical plans. The comparison of the predicted and the clinical beam angles demonstrated a good average correspondence between the two (angular distance 16.8° ± 10°, correlation 0.75 ± 0.2). The dose distributions of the semiautomatic and clinical plans were equivalent in terms of primary target volume coverage and organ at risk sparing and were superior over plans produced with fixed sets of common beam angles. The great majority of the automatic plans (93%) were approved as clinically acceptable by three radiation therapy specialists. Conclusions: The results demonstrated the feasibility of utilizing a learning-based approach for automatic selection of beam angles in thoracic IMRT planning. The proposed method may assist in reducing the manual planning workload, while sustaining plan quality.« less

Commissioning and initial acceptance tests for a commercial convolution dose calculation algorithm for radiotherapy treatment planning in comparison with Monte Carlo simulation and measurement

PubMed Central

Moradi, Farhad; Mahdavi, Seyed Rabi; Mostaar, Ahmad; Motamedi, Mohsen

2012-01-01

In this study the commissioning of a dose calculation algorithm in a currently used treatment planning system was performed and the calculation accuracy of two available methods in the treatment planning system i.e., collapsed cone convolution (CCC) and equivalent tissue air ratio (ETAR) was verified in tissue heterogeneities. For this purpose an inhomogeneous phantom (IMRT thorax phantom) was used and dose curves obtained by the TPS (treatment planning system) were compared with experimental measurements and Monte Carlo (MCNP code) simulation. Dose measurements were performed by using EDR2 radiographic films within the phantom. Dose difference (DD) between experimental results and two calculation methods was obtained. Results indicate maximum difference of 12% in the lung and 3% in the bone tissue of the phantom between two methods and the CCC algorithm shows more accurate depth dose curves in tissue heterogeneities. Simulation results show the accurate dose estimation by MCNP4C in soft tissue region of the phantom and also better results than ETAR method in bone and lung tissues. PMID:22973081

Library Bulletin [International Planned Parenthood Federation, February 1973].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Resources located in the International Planned Parenthood Federation (IPPF) Headquarters Library are inventoried in this quarterly library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration; (2) contraceptive methods; (3) family planning (general); (4) United…

Library Bulletin [International Planned Parenthood Federation, November 1972].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Resources located in the International Planned Parenthood Federation (IPPF) Headquarters Library are inventoried in this quarterly library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration; (2) contraceptive methods; (3) family planning (general); (4) United…

Library Bulletin [International Planned Parenthood Federation, February 1972].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Resources located in the International Planned Parenthood Federation (IPPF) Headquarters Library are inventoried in this library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration; (2) contraceptive methods; (3) family planning (general); (4) United Nations,…

Library Bulletin [International Planned Parenthood Federation, May 1973].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Resources located in the International Planned Parenthood Federation (IPPF) Headquarters Library are inventoried in this library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration; (2) contraceptive methods; (3) family planning (general); (4) United Nations,…

50 CFR 600.1011 - Reduction methods and other conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., require such title restriction or scrapping of reduction vessels unless the business plan voluntarily... reduction fishery. (e) Reduction vessels disposition. Where a business plan requires the withdrawal from... (b) of this section unless the business plan volunteers to do otherwise; and (3) Any subsidized...

Family Planning: Bosnian, Russian, Spanish, Nuer.

ERIC Educational Resources Information Center

Anoka County Community Health and Environmental Services, Coon Rapids, MN.

This guide provides information in English, Bosnian, Russian, Spanish, and Nuer on family planning. Topics covered include a variety of birth control methods: abstinence, condoms, contraceptive foam, birth control pills, the Depo-Provera shot, the Norplant implant, diaphragms, intrauterine devices, natural family planning, sterilization, and the…

PRE-QAPP AGREEMENT (PQA) AND ANALYTICAL METHOD CHECKLISTS (AMCS): TOOLS FOR PLANNING RESEARCH PROJECTS

EPA Science Inventory

The Land Remediation and Pollution Control Division (LRPCD) QA Manager strives to assist LRPCD researchers in developing functional planning documents for their research projects. As part of the planning process, several pieces of information are needed, including information re...

77 FR 73658 - Federal Acquisition Regulation; Submission for OMB Review; Professional Employee Compensation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

...; Submission for OMB Review; Professional Employee Compensation Plan AGENCIES: Department of Defense (DOD... approved information collection requirement concerning submission of a Professional Employee Compensation..., Professional Employee Compensation Plan by any of the following methods: Regulations.gov : http://www...

48 CFR 1515.305-70 - Scoring plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Scoring plans. 1515.305-70 Section 1515.305-70 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 1515.305-70 Scoring plans. When...

48 CFR 1515.305-70 - Scoring plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Scoring plans. 1515.305-70 Section 1515.305-70 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 1515.305-70 Scoring plans. When...

Applying social science and public health methods to community-based pandemic planning.

PubMed

Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

2010-11-01

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

Women's experiences after Planned Parenthood's exclusion from a family planning program in Texas.

PubMed

Woo, C Junda; Alamgir, Hasanat; Potter, Joseph E

2016-04-01

We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Requiring low-income family planning patients to switch healthcare providers has adverse consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

Women’s experiences after Planned Parenthood’s exclusion from a family planning program in Texas☆

PubMed Central

Woo, C. Junda; Alamgir, Hasanat; Potter, Joseph E.

2016-01-01

Objective We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. Study Design We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006–2010 (NSFG). Results (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Conclusions Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Implications Requiring low-income family planning patients to switch healthcare providers has adverse consequences. PMID:26680757

Three dimensional intensity modulated brachytherapy (IMBT): dosimetry algorithm and inverse treatment planning.

PubMed

Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko

2010-07-01

The feasibility of intensity modulated brachytherapy (IMBT) to improve dose conformity for irregularly shaped targets has been previously investigated by researchers by means of using partially shielded sources. However, partial shielding does not fully explore the potential of IMBT. The goal of this study is to introduce the concept of three dimensional (3D) intensity modulated brachytherapy and solve two fundamental issues regarding the application of 3D IMBT treatment planning: The dose calculation algorithm and the inverse treatment planning method. A 3D IMBT treatment planning system prototype was developed using the MATLAB platform. This system consists of three major components: (1) A comprehensive IMBT source calibration method with dosimetric inputs from Monte Carlo (EGSnrc) simulations; (2) a "modified TG-43" (mTG-43) dose calculation formalism for IMBT dosimetry; and (3) a physical constraint based inverse IMBT treatment planning platform utilizing a simulated annealing optimization algorithm. The model S700 Axxent electronic brachytherapy source developed by Xoft, Inc. (Fremont, CA), was simulated in this application. Ten intracavitary accelerated partial breast irradiation (APBI) cases were studied. For each case, an "isotropic plan" with only optimized source dwell time and a fully optimized IMBT plan were generated and compared to the original plan in various dosimetric aspects, such as the plan quality, planning, and delivery time. The issue of the mechanical complexity of the IMBT applicator is not addressed in this study. IMBT approaches showed superior plan quality compared to the original plans and tht isotropic plans to different extents in all studied cases. An extremely difficult case with a small breast and a small distance to the ribs and skin, the IMBT plan minimized the high dose volume V200 by 16.1% and 4.8%, respectively, compared to the original and the isotropic plans. The conformity index for the target was increased by 0.13 and 0.04, respectively. The maximum dose to the skin was reduced by 56 and 28 cGy, respectively, per fraction. Also, the maximum dose to the ribs was reduced by 104 and 96 cGy, respectively, per fraction. The mean dose to the ipsilateral and contralateral breasts and lungs were also slightly reduced by the IMBT plan. The limitations of IMBT are the longer planning and delivery time. The IMBT plan took around 2 h to optimize, while the isotropic plan optimization could reach the global minimum within 5 min. The delivery time for the IMBT plan is typically four to six times longer than the corresponding isotropic plan. In this study, a dosimetry method for IMBT sources was proposed and an inverse treatment planning system prototype for IMBT was developed. The improvement of plan quality by 3D IMBT was demonstrated using ten APBI case studies. Faster computers and higher output of the source can further reduce plan optimization and delivery time, respectively.

Patient-specific Monte Carlo-based dose-kernel approach for inverse planning in afterloading brachytherapy.

PubMed

D'Amours, Michel; Pouliot, Jean; Dagnault, Anne; Verhaegen, Frank; Beaulieu, Luc

2011-12-01

Brachytherapy planning software relies on the Task Group report 43 dosimetry formalism. This formalism, based on a water approximation, neglects various heterogeneous materials present during treatment. Various studies have suggested that these heterogeneities should be taken into account to improve the treatment quality. The present study sought to demonstrate the feasibility of incorporating Monte Carlo (MC) dosimetry within an inverse planning algorithm to improve the dose conformity and increase the treatment quality. The method was based on precalculated dose kernels in full patient geometries, representing the dose distribution of a brachytherapy source at a single dwell position using MC simulations and the Geant4 toolkit. These dose kernels are used by the inverse planning by simulated annealing tool to produce a fast MC-based plan. A test was performed for an interstitial brachytherapy breast treatment using two different high-dose-rate brachytherapy sources: the microSelectron iridium-192 source and the electronic brachytherapy source Axxent operating at 50 kVp. A research version of the inverse planning by simulated annealing algorithm was combined with MC to provide a method to fully account for the heterogeneities in dose optimization, using the MC method. The effect of the water approximation was found to depend on photon energy, with greater dose attenuation for the lower energies of the Axxent source compared with iridium-192. For the latter, an underdosage of 5.1% for the dose received by 90% of the clinical target volume was found. A new method to optimize afterloading brachytherapy plans that uses MC dosimetric information was developed. Including computed tomography-based information in MC dosimetry in the inverse planning process was shown to take into account the full range of scatter and heterogeneity conditions. This led to significant dose differences compared with the Task Group report 43 approach for the Axxent source. Copyright © 2011 Elsevier Inc. All rights reserved.

Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali

PubMed Central

Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

2017-01-01

Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. Methods and Results: The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Conclusion: Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family planning services, even in settings with low contraceptive prevalence. PMID:28655803

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia.

PubMed

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

2013-10-01

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

Analyses of group sequential clinical trials.

PubMed

Koepcke, W

1989-12-01

In the first part of this article the methodology of group sequential plans is reviewed. After introducing the basic definition of such plans the main properties are shown. At the end of this section three different plans (Pocock, O'Brien-Fleming, Koepcke) are compared. In the second part of the article some unresolved issues and recent developments in the application of group sequential methods to long-term controlled clinical trials are discussed. These include deviation from the assumptions, life table methods, multiple-arm clinical trials, multiple outcome measures, and confidence intervals.

Selecting optimal structure of burners for tubular cylindrical furnaces by the mathematical experiment planning method

NASA Astrophysics Data System (ADS)

Katin, Viktor; Kosygin, Vladimir; Akhtiamov, Midkhat

2017-10-01

This paper substantiates the method of mathematical planning for experimental research in the process of selecting the most efficient types of burning devices for tubular refinery furnaces of vertical-cylindrical design. This paper provides detailed consideration of an experimental plan of a 4×4 Latin square type when studying the impact of three factors with four levels of variance. On the basis of the experimental research we have developed practical recommendations on the employment of optimal burners for two-step fuel combustion.

SU-F-P-46: Comparative Study Between Two Normalization Prescriptions for Accelerated Partial Breast Irradiation: A Dosimetric Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Agarwal, P; Sharma, D; Gandhi, A

2016-06-15

Purpose: To compare the Accelerated Partial Breast Irradiation (APBI) plan with the normalized basal dose points and 5mm box prescription. Methods: Five patients of APBI were planned twice in Oncentra Master planning TPS (Version 4.3) using TG-43 algorithm. The number of catheters for all the patients was 10 to 16 and implant plane 2 to 3. For planning all catheters were reconstructed. Source loading was done as per HR-CTV contoured. The HR-CTV volume range was from 75cc to 182cc. Plans were normalized in two methods. First all plans were normalized on Basal dose points (PlanA) and second all the planmore » were normalized on 5mm box (PlanB). The prescription dose (PD) was 35Gy in 10 fractions. All the plans were completely based on normalization and without optimization. Plan evaluation was based on certain parameters coverage Index (CI), dose homogeneity index (DHI), conformity index (COIN), over dose volume index (OI). Results: The average and median of CI for planA was 0.835 and 0.8154, for planB 0.82 and 0.799 respectively. The median and average of DHI for planA was 0.66 and 0.6062, for planB 0.67 and 0.62 respectively. The range of COIN for planA and planB was from 0.58 to 0.65 respectively. The range of OI was from 0.083 to 0.169 for planA and planB. The treatment time in planA was in average 1.13 times more than planB as V150% of HR-CTV in planA was 4–6% more. The ipsilateral lung was getting 30% of PD which was 0.6% to 3.5%. Conclusion: Treatment Planning should be individualized based on implants characteristics. Planning with prescription to basal dose points should be preferred to 5mm box prescription, in order to achieve better DHI and less treatment time.« less

SU-D-BRB-02: Combining a Commercial Autoplanning Engine with Database Dose Predictions to Further Improve Plan Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robertson, SP; Moore, JA; Hui, X

Purpose: Database dose predictions and a commercial autoplanning engine both improve treatment plan quality in different but complimentary ways. The combination of these planning techniques is hypothesized to further improve plan quality. Methods: Four treatment plans were generated for each of 10 head and neck (HN) and 10 prostate cancer patients, including Plan-A: traditional IMRT optimization using clinically relevant default objectives; Plan-B: traditional IMRT optimization using database dose predictions; Plan-C: autoplanning using default objectives; and Plan-D: autoplanning using database dose predictions. One optimization was used for each planning method. Dose distributions were normalized to 95% of the planning target volumemore » (prostate: 8000 cGy; HN: 7000 cGy). Objectives used in plan optimization and analysis were the larynx (25%, 50%, 90%), left and right parotid glands (50%, 85%), spinal cord (0%, 50%), rectum and bladder (0%, 20%, 50%, 80%), and left and right femoral heads (0%, 70%). Results: All objectives except larynx 25% and 50% resulted in statistically significant differences between plans (Friedman’s χ{sup 2} ≥ 11.2; p ≤ 0.011). Maximum dose to the rectum (Plans A-D: 8328, 8395, 8489, 8537 cGy) and bladder (Plans A-D: 8403, 8448, 8527, 8569 cGy) were significantly increased. All other significant differences reflected a decrease in dose. Plans B-D were significantly different from Plan-A for 3, 17, and 19 objectives, respectively. Plans C-D were also significantly different from Plan-B for 8 and 13 objectives, respectively. In one case (cord 50%), Plan-D provided significantly lower dose than plan C (p = 0.003). Conclusion: Combining database dose predictions with a commercial autoplanning engine resulted in significant plan quality differences for the greatest number of objectives. This translated to plan quality improvements in most cases, although special care may be needed for maximum dose constraints. Further evaluation is warranted in a larger cohort across HN, prostate, and other treatment sites. This work is supported by Philips Radiation Oncology Systems.« less

Dual stage potential field method for robotic path planning

NASA Astrophysics Data System (ADS)

Singh, Pradyumna Kumar; Parida, Pramod Kumar

2018-04-01

Path planning for autonomous mobile robots are the root for all autonomous mobile systems. Various methods are used for optimization of path to be followed by the autonomous mobile robots. Artificial potential field based path planning method is one of the most used methods for the researchers. Various algorithms have been proposed using the potential field approach. But in most of the common problems are encounters while heading towards the goal or target. i.e. local minima problem, zero potential regions problem, complex shaped obstacles problem, target near obstacle problem. In this paper we provide a new algorithm in which two types of potential functions are used one after another. The former one is to use to get the probable points and later one for getting the optimum path. In this algorithm we consider only the static obstacle and goal.

Comparison of the helical tomotherapy against the multileaf collimator-based intensity-modulated radiotherapy and 3D conformal radiation modalities in lung cancer radiotherapy

PubMed Central

Mavroidis, P; Shi, C; Plataniotis, G A; Delichas, M G; Costa Ferreira, B; Rodriguez, S; Lind, B K; Papanikolaou, N

2011-01-01

Objectives The aim of this study was to compare three-dimensional (3D) conformal radiotherapy and the two different forms of IMRT in lung cancer radiotherapy. Methods Cases of four lung cancer patients were investigated by developing a 3D conformal treatment plan, a linac MLC-based step-and-shoot IMRT plan and an HT plan for each case. With the use of the complication-free tumour control probability (P+) index and the uniform dose concept as the common prescription point of the plans, the different treatment plans were compared based on radiobiological measures. Results The applied plan evaluation method shows the MLC-based IMRT and the HT treatment plans are almost equivalent over the clinically useful dose prescription range; however, the 3D conformal plan inferior. At the optimal dose levels, the 3D conformal treatment plans give an average P+ of 48.1% for a effective uniform dose to the internal target volume (ITV) of 62.4 Gy, whereas the corresponding MLC-based IMRT treatment plans are more effective by an average ΔP+ of 27.0% for a Δ effective uniform dose of 16.3 Gy. Similarly, the HT treatment plans are more effective than the 3D-conformal plans by an average ΔP+ of 23.8% for a Δ effective uniform dose of 11.6 Gy. Conclusion A radiobiological treatment plan evaluation can provide a closer association of the delivered treatment with the clinical outcome by taking into account the dose–response relations of the irradiated tumours and normal tissues. The use of P – effective uniform dose diagrams can complement the traditional tools of evaluation to compare and effectively evaluate different treatment plans. PMID:20858664

Multi-criteria evaluation in strategic environmental assessment for waste management plan, a case study: the city of Belgrade.

PubMed

Josimović, Boško; Marić, Igor; Milijić, Saša

2015-02-01

Strategic Environmental Assessment (SEA) is one of the key instruments for implementing sustainable development strategies in planning in general; in addition to being used in sectoral planning, it can also be used in other areas such as waste management planning. SEA in waste management planning has become a tool for considering the benefits and consequences of the proposed changes in space, also taking into account the capacity of space to sustain the implementation of the planned activities. In order to envisage both the positive and negative implications of a waste management plan for the elements of sustainable development, an adequate methodological approach to evaluating the potential impacts must be adopted and the evaluation results presented in a simple and clear way, so as to allow planners to make relevant decisions as a precondition for the sustainability of the activities planned in the waste management sector. This paper examines the multi-criteria evaluation method for carrying out an SEA for the Waste Management Plan for the city of Belgrade (BWMP). The method was applied to the evaluation of the impacts of the activities planned in the waste management sector on the basis of the environmental and socioeconomic indicators of sustainability, taking into consideration the intensity, spatial extent, probability and frequency of impact, by means of a specific planning approach and simple and clear presentation of the obtained results. Copyright © 2014 Elsevier Ltd. All rights reserved.

29 CFR 1926.705 - Requirements for lift-slab construction operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... operations shall be designed and planned by a registered professional engineer who has experience in lift-slab construction. Such plans and designs shall be implemented by the employer and shall include detailed instructions and sketches indicating the prescribed method of erection. These plans and designs...

29 CFR 1926.705 - Requirements for lift-slab construction operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... operations shall be designed and planned by a registered professional engineer who has experience in lift-slab construction. Such plans and designs shall be implemented by the employer and shall include detailed instructions and sketches indicating the prescribed method of erection. These plans and designs...

29 CFR 1926.705 - Requirements for lift-slab construction operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... operations shall be designed and planned by a registered professional engineer who has experience in lift-slab construction. Such plans and designs shall be implemented by the employer and shall include detailed instructions and sketches indicating the prescribed method of erection. These plans and designs...

29 CFR 1926.705 - Requirements for lift-slab construction operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operations shall be designed and planned by a registered professional engineer who has experience in lift-slab construction. Such plans and designs shall be implemented by the employer and shall include detailed instructions and sketches indicating the prescribed method of erection. These plans and designs...

29 CFR 1926.705 - Requirements for lift-slab construction operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... operations shall be designed and planned by a registered professional engineer who has experience in lift-slab construction. Such plans and designs shall be implemented by the employer and shall include detailed instructions and sketches indicating the prescribed method of erection. These plans and designs...

Library Bulletin [International Planned Parenthood Federation, August 1973].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Recent additions to the International Planned Parenthood Federation (IPPF) Headquarters Library are listed in this library bulletin. Entries follow the IPPF classification scheme and are arranged by topics: (1) general office management and administration, (2) contraceptive methods, (3) family planning (general), (4) United Nations, conferences,…

Active transportation monitoring plan : initial evaluation of bicycling and walking baseline & planned traffic counts through 2015.

DOT National Transportation Integrated Search

2011-09-06

Active Transportation in the form of bicycle and pedestrian traffic, is monitored for the Austin-Round Rock-San Marcos, TX region by the Capital Area Metropolitan Planning Organization using a variety of methods: automatic, manual and surveyed. This ...

The Logistics Planning Process of the Far East Air Material Command during the Korean War

DTIC Science & Technology

1988-09-01

Figures . . ........... ........ vii Abstract ........... ........................ viii I. Introduction to the Research ............. 1 Overview ...31 Particular Method . . . ........... 32 II. The National Defense Planning Structure. . . ... 34 Overview ...Air Materiel Command’s Logistics Plans and Policy Making Response to Korean Tasking . . . . ........ 83 Overview

50 CFR 216.175 - Requirements for monitoring and reporting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... complete an Integrated Comprehensive Monitoring Plan (ICMP) in 2009. This planning and adaptive management... subsequent monitoring and mitigation. (4) An adaptive management plan. (5) A method for standardizing data... Report—The Navy shall submit a report annually on October 1 describing the implementation and results...

10 CFR 436.102 - General operations plan format and content.

Code of Federal Regulations, 2011 CFR

2011-01-01

... tasking resulting from development of the Plan; (B) Guidance for the development of emergency conservation... § 436.106(a); (I) Schedules of plan preparation and publication; (J) Communication, implementation, and... evaluate any innovative energy conserving technologies or methods, not included in this part, which the...

Medicare Part D Beneficiaries' Plan Switching Decisions and Information Processing.

PubMed

Han, Jayoung; Urmie, Julie

2017-03-01

Medicare Part D beneficiaries tend not to switch plans despite the government's efforts to engage beneficiaries in the plan switching process. Understanding current and alternative plan features is a necessary step to make informed plan switching decisions. This study explored beneficiaries' plan switching using a mixed-methods approach, with a focus on the concept of information processing. We found large variation in beneficiary comprehension of plan information among both switchers and nonswitchers. Knowledge about alternative plans was especially poor, with only about half of switchers and 2 in 10 nonswitchers being well informed about plans other than their current plan. We also found that helpers had a prominent role in plan decision making-nearly twice as many switchers as nonswitchers worked with helpers for their plan selection. Our study suggests that easier access to helpers as well as helpers' extensive involvement in the decision-making process promote informed plan switching decisions.

Using a Staff Needs Planning System To Increase Organization, To Increase Quality of Client Services, and To Reduce Overtime.

ERIC Educational Resources Information Center

Stang, David

A staff-needs planning system was developed and tested in a Department of Social Services' Family and Children's Services Unit in a medium-sized county where caseworkers used no established strategy or planning method to facilitate accomplishment of all the job requirements. The goal of the study was to implement a planning system based on each…

Late-successional and old-growth forest effectiveness monitoring plan for the Northwest Forest Plan.

Treesearch

Miles Hemstrom; Thomas Spies; Craig Palmer; Ross Kiester; John Teply; Phil McDonald; Ralph. Warbington

1998-01-01

This report presents options for long-term effectiveness monitoring of late-successional and old-growth forests under the Northwest Forest Plan. It describes methods to answer questions about how much late-successional forest exists on Federal land, its pattern, how it’s changing, and if the Forest Plan is providing for its conservation and management. It specifies...

Manufacturing Methods and Technology Program Plan. Update.

DTIC Science & Technology

1981-11-01

INDUSTRIAL BASE ENGINEERING ACTIVITY ROCK ISLAND. ILLINOIS 61299 82 INDEX PAGE I. INTRODUCTION The MMT Program Plan Update ........... 1 Industry Guide...obtained from that Plan, extra copies of which are available upon request from the Industrial Base Engineering Activity. Other sources for this data are...Major Subcommands (SUBMACOM’S). The SUBMACOM’S plan, formulate, budget, and execute individual projects. The Industrial Base Engineering Activity

Selected Bibliographies and State-of-the-Art Review for Environmental Health. Volume 2: Environmental Health References. International Health Planning Reference Series.

ERIC Educational Resources Information Center

Fraser, Renee White; Shani, Hadasa

Intended as a companion piece to volume 2 in the Method Series, Environmental Health Planning (CE 024 230), this second of six volumes in the International Health Planning Reference Series is a combined literature review and annotated bibliography dealing with environmental factors in health planning for developing countries. The review identifies…

SU-E-J-160: 4D Dynamic Arc of Non-Modulated Variable-Dose-Rate Fields for Lung SBRT: A Feasibility Study.

PubMed

Yi, B; Yang, X; Niu, Y; Yu, C

2012-06-01

Conformal SBRT plans for Lung cancer with static gantry angles are ideal candidates for applying motion tracking because of: (1) better dosimetric conformity with reduced target margin and (2) easier and more faithful target tracking without intensity modulation. This work is to demonstrate that by delivering the target tracking during gantry rotation, we can significantly improve delivery efficiency without negatively affecting plan quality. A lung SBRT plan with static beams was created using CT images of the reference breathing phase. It is converted to an arc plan with variable dose rate followed by the conversion to a 4D plan with the segment aperture morphing (SAM) method (Gui 2010) with considerations of both target location and shape changes as depicted by the 4D CT. Gantry angle ranges were determined from the clinical monitor units, with the 22.2 MU/degree, which is chosen to maximize the dose rate. All segments of the dynamic 4D plan were merged into a single arc with variable dose rate. Each segment occupying 1/10 of the breathing period delivers 6.6 MUs at a dose rate of 1000 MU/min. Delivery time was measured and compared to the planned. The dose distributions of the single phase 3D plan and the arc 4D plan showed little difference. The delivered time for the 4D arc plan agreed with the calculated time, and is almost the same as delivering the 3D plan without target tracking. A 12 Gy treatment takes less than 2.5 min. The feasibility of a novel 4D delivery method where a 3D SBRT plan is converted into 4D arc delivery has been demonstrated. In addition to realizing the conventional target tracking benefits, our method further improves delivery efficiency, which is important for maintaining the geometric relationship between the target motion and the breathing surrogate during treatment. This study is supported by NIH_Grant_1R01CA133539-01 A2. © 2012 American Association of Physicists in Medicine.

Improving IMRT delivery efficiency with reweighted L1-minimization for inverse planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Hojin; Becker, Stephen; Lee, Rena

2013-07-15

Purpose: This study presents an improved technique to further simplify the fluence-map in intensity modulated radiation therapy (IMRT) inverse planning, thereby reducing plan complexity and improving delivery efficiency, while maintaining the plan quality.Methods: First-order total-variation (TV) minimization (min.) based on L1-norm has been proposed to reduce the complexity of fluence-map in IMRT by generating sparse fluence-map variations. However, with stronger dose sparing to the critical structures, the inevitable increase in the fluence-map complexity can lead to inefficient dose delivery. Theoretically, L0-min. is the ideal solution for the sparse signal recovery problem, yet practically intractable due to its nonconvexity of themore » objective function. As an alternative, the authors use the iteratively reweighted L1-min. technique to incorporate the benefits of the L0-norm into the tractability of L1-min. The weight multiplied to each element is inversely related to the magnitude of the corresponding element, which is iteratively updated by the reweighting process. The proposed penalizing process combined with TV min. further improves sparsity in the fluence-map variations, hence ultimately enhancing the delivery efficiency. To validate the proposed method, this work compares three treatment plans obtained from quadratic min. (generally used in clinic IMRT), conventional TV min., and our proposed reweighted TV min. techniques, implemented by a large-scale L1-solver (template for first-order conic solver), for five patient clinical data. Criteria such as conformation number (CN), modulation index (MI), and estimated treatment time are employed to assess the relationship between the plan quality and delivery efficiency.Results: The proposed method yields simpler fluence-maps than the quadratic and conventional TV based techniques. To attain a given CN and dose sparing to the critical organs for 5 clinical cases, the proposed method reduces the number of segments by 10-15 and 30-35, relative to TV min. and quadratic min. based plans, while MIs decreases by about 20%-30% and 40%-60% over the plans by two existing techniques, respectively. With such conditions, the total treatment time of the plans obtained from our proposed method can be reduced by 12-30 s and 30-80 s mainly due to greatly shorter multileaf collimator (MLC) traveling time in IMRT step-and-shoot delivery.Conclusions: The reweighted L1-minimization technique provides a promising solution to simplify the fluence-map variations in IMRT inverse planning. It improves the delivery efficiency by reducing the entire segments and treatment time, while maintaining the plan quality in terms of target conformity and critical structure sparing.« less

Simulation-optimization model for production planning in the blood supply chain.

PubMed

Osorio, Andres F; Brailsford, Sally C; Smith, Honora K; Forero-Matiz, Sonia P; Camacho-Rodríguez, Bernardo A

2017-12-01

Production planning in the blood supply chain is a challenging task. Many complex factors such as uncertain supply and demand, blood group proportions, shelf life constraints and different collection and production methods have to be taken into account, and thus advanced methodologies are required for decision making. This paper presents an integrated simulation-optimization model to support both strategic and operational decisions in production planning. Discrete-event simulation is used to represent the flows through the supply chain, incorporating collection, production, storing and distribution. On the other hand, an integer linear optimization model running over a rolling planning horizon is used to support daily decisions, such as the required number of donors, collection methods and production planning. This approach is evaluated using real data from a blood center in Colombia. The results show that, using the proposed model, key indicators such as shortages, outdated units, donors required and cost are improved.

Market-Based Approaches to Managing Science Return from Planetary Missions

NASA Technical Reports Server (NTRS)

Wessen, Randii R.; Porter, David; Hanson, Robin

1996-01-01

A research plan is described for the design and testing of a method for the planning and negotiation of science observations. The research plan is presented in relation to the fact that the current method, which involves a hierarchical process of science working groups, is unsuitable for the planning of the Cassini mission. The research plan involves the market-based approach in which participants are allocated budgets of scheduling points. The points are used to provide an intensity of preference for the observations being scheduled. In this way, the schedulers do not have to limit themselves to solving major conflicts, but try to maximize the number of scheduling points that result in a conflict-free timeline. Incentives are provided for the participants by the fixed budget concerning their tradeoff decisions. A degree of feedback is provided in the process so that the schedulers may rebid based on the current timeline.