The Impact of Colleague Peer Review on the Radiotherapy Treatment Planning Process in the Radical Treatment of Lung Cancer

AIMS: Modern radiotherapy uses techniques to reliably identify tumour and reduce target volume margins. However, this can potentially lead to an increased risk of geographic miss. One source of error is the accuracy of target volume delineation (TVD). Colleague peer review (CPR) of all curative-intent lung cancer plans has been mandatory in our institution since May 2013. At least two clinical oncologists review plans, checking treatment paradigm, TVD, prescription dose tumour and critical organ tolerances. We report the impact of CPR in our institution.

MATERIALS AND METHODS: Radiotherapy treatment plans of all patients receiving radical radiotherapy were presented at weekly CPR meetings after their target volumes were reviewed and signed off by the treating consultant. All cases and any resultant change to TVD (including organs at risk) or treatment intent were recorded in our prospective CPR database. The impact of CPR over a 13 month period from May 2013 to June 2014 is reported.

RESULTS: One hundred and twenty-two patients (63% non-small cell lung carcinoma, 17% small cell lung carcinoma and 20% 'clinical diagnosis') were analysed. On average, 3.2 cases were discussed per meeting (range 1-8). CPR resulted in a change in treatment paradigm in 3% (one patient proceeded to induction chemotherapy, two patients had high-dose palliative radiotherapy). Twenty-one (17%) had a change in TVD and one (1%) patient had a change in dose prescription. In total, 6% of patients had plan adjustment after review of dose volume histogram.

CONCLUSION: The introduction of CPR in our centre has resulted in a change in a component of the treatment plan for 27% of patients receiving curative-intent lung radiotherapy. We recommend CPR as a mandatory quality assurance step in the planning process of all radical lung plans.

ANNUAL ACCOUNTABILITY REPORT FISCAL YEAR 2009-2010

Coastal Carolina University reports to the Office of State Budget its annual accountability report that includes a discussion and analysis, major accomplishments, strategic planning and performance measurement.

HIV Voluntary Testing among Portuguese Women Attending Family Planning Clinics: Implications for HIV Prevention Education and Testing

Objectives: The aim of this article is to analyze the factors associated with HIV testing among 767 sexually active women. Methods: Participants were administered several self-report questionnaires that assessed behavioral and psychosocial measures. Results: Overall, 59.8% of the participants reported ever having tested for HIV. Results show that higher levels of education, being pregnant or having been pregnant, concern about AIDS, AIDS knowledge, self-efficacy in condom negotiation and perception of no risk in partner significantly predicted the likelihood of testing among women. Attending the mass was negatively associated with HIV testing. Conclusions: These findings provide information that can be used in the development of a focused gender sensitive HIV prevention program to increase HIV testing.

A Transportation Safety Planning Tool for the City of Ames, August 2011

The historically-reactive approach to identifying safety problems and mitigating them involves selecting black spots or hot spots by ranking locations based on crash frequency and severity. The approach focuses mainly on the corridor level without taking the exposure rate (vehicle miles traveled) and socio-demographics information of the study area, which are very important in the transportation planning process, into consideration. A larger study analysis unit at the Transportation Analysis Zone (TAZ) level or the network planning level should be used to address the needs of development of the community in the future and incorporate safety into the long-range transportation planning process. In this study, existing planning tools (such as the PLANSAFE models presented in NCHRP Report 546) were evaluated for forecasting safety in small and medium-sized communities, particularly as related to changes in socio-demographics characteristics, traffic demand, road network, and countermeasures. The research also evaluated the applicability of the Empirical Bayes (EB) method to network-level analysis. In addition, application of the United States Road Assessment Program (usRAP) protocols at the local urban road network level was investigated. This research evaluated the applicability of these three methods for the City of Ames, Iowa. The outcome of this research is a systematic process and framework for considering road safety issues explicitly in the small and medium-sized community transportation planning process and for quantifying the safety impacts of new developments and policy programs. More specifically, quantitative safety may be incorporated into the planning process, through effective visualization and increased awareness of safety issues (usRAP), the identification of high-risk locations with potential for improvement, (usRAP maps and EB), countermeasures for high-risk locations (EB before and after study and PLANSAFE), and socio-economic and demographic induced changes at the planning-level (PLANSAFE).

Juvenile Justice System Planning Data Iowa’s Juvenile Justice Advisory Council Three Year Comprehensive Plan with Additional Juvenile Justice System Information, November 2015

This report provides key juvenile justice system planning data, most of which are taken from Iowa’s 2015 Juvenile Justice and Delinquency Prevention Act Three Year Plan. The data and related descriptions serve as an overview of decision making for major juvenile justice system processing points, and also assist state and local officials with policy and practice. Included in the report are school discipline data and data related to juvenile in the adult criminal justice system.

The effectiveness of a computer program on career planning for university students

This study investigated the effectiveness of a computer program, PERSONAL CAREER DIRECTIONS (PC DIRECTIONS) (Anderson, Welborn, & Wright, 1983) on career planning and exploration for twenty-four Brock University students (18 women and 6 men) who requested career planning assistance at the Career/Placement Services of the Counselling Centre. A one-group pretest/posttest design was used in the study_ Progress in career planning and exploration was measured by Career Planning (CP) and Career Exploration (CE) scales of the Career Development Inventory (College and University Form) (Super, Thompson, Lindeman, Jordaan, & Myers, 1981). A paired samples 2-tailed t test for Career Development Attitudes (CDA) , the combined CP and CE scales, revealed the posttest scores were significantly higher than the pretest scores, t(23) = 3.74, 2 < .001. Student progress was also assessed by self-report lists of job titles which reflected positive changes after students used PC DIRECTIONS. In response to several questions, students' attitudes were more positive than negative toward the program. Implications are that PC DIRECTIONS is an effective component in promoting career planning for university students. Further studies may reveal that different types of students may benefit from different interventions in the career planning process.

Effectiveness of personal planning for residents re-entering the community during the facility initiative in Ontario

This paper reports on the relocation of people with intellectual disabilities (ID) from large-scale provincially run institutions that took place in Ontario as part of the Facility Initiative. Three case studies were examined in order to report on this process as experienced by those who lived and worked through it. Specifically, the planning process conducted by the Ministry of Community and Social Services (MCSS) to assist each person with hislher transition to community living was examined using the current standard of practice in person- centered planning approaches. Effectiveness was evaluated as the ability to apply a person-centered approach across settings and people, as well as what factors facilitated or hindered its application. Results show that, in general, the personal plans do not appear to reflect the pre-transition experience of the person. Also, the transitional planning process did not appear person-centered nor facilitate further person-centered planning in the community.

Adaptive project planning and management based on best practices - COBRA system

Planning a project with proper considerations of all necessary factors and managing a project to ensure its successful implementation will face a lot of challenges. Initial stage in planning a project for bidding a project is costly, time consuming and usually with poor accuracy on cost and effort predictions. On the other hand, detailed information for previous projects may be buried in piles of archived documents which can be increasingly difficult to learn from the previous experiences. Project portfolio has been brought into this field aiming to improve the information sharing and management among different projects. However, the amount of information that could be shared is still limited to generic information. This paper, we report a recently developed software system COBRA to automatically generate a project plan with effort estimation of time and cost based on data collected from previous completed projects. To maximise the data sharing and management among different projects, we proposed a method of using product based planning from PRINCE2 methodology. (Automated Project Information Sharing and Management System -�COBRA) Keywords: project management, product based planning, best practice, PRINCE2