Predicting the likelihood of QA failure using treatment plan accuracy metrics

This study used automated data processing techniques to calculate a set of novel treatment plan accuracy metrics, and investigate their usefulness as predictors of quality assurance (QA) success and failure. 151 beams from 23 prostate and cranial IMRT treatment plans were used in this study. These plans had been evaluated before treatment using measurements with a diode array system. The TADA software suite was adapted to allow automatic batch calculation of several proposed plan accuracy metrics, including mean field area, small-aperture, off-axis and closed-leaf factors. All of these results were compared the gamma pass rates from the QA measurements and correlations were investigated. The mean field area factor provided a threshold field size (5 cm2, equivalent to a 2.2 x 2.2 cm2 square field), below which all beams failed the QA tests. The small aperture score provided a useful predictor of plan failure, when averaged over all beams, despite being weakly correlated with gamma pass rates for individual beams. By contrast, the closed leaf and off-axis factors provided information about the geometric arrangement of the beam segments but were not useful for distinguishing between plans that passed and failed QA. This study has provided some simple tests for plan accuracy, which may help minimise time spent on QA assessments of treatments that are unlikely to pass.

Primary schools and the delivery of relationships and sexuality education : the experience of Queensland teachers

Primary school provides an appropriate opportunity for children to commence comprehensive relationships and sexuality education (RSE), yet many primary school teachers avoid teaching this subject area. In the absence of teacher confidence and competence, schools have often relied on health promotion professionals, external agencies and/or one-off issue related presentations rather than cohesive, systematic and meaningful health education. This study examines the implementation of a ten-lesson pilot RSE unit of work and accompanying assessment task in two primary schools in South-East Queensland, Australia. Drawing predominantly from qualitative data, this research explores the experiences of primary school teachers as they engage with RSE curriculum resources and content delivery. The results show that the provision of a high quality RSE curriculum resource grounded in contemporary educational principles and practices enables teachers to feel more confident to deliver RSE and minimises potential barriers such as parental objections and fear of mishandling sensitive content.

The Language : Rationale and Fundamentals

The Business Process Management domain has evolved at a dramatic pace over the past two decades and the notion of the business process has become a ubiquitous part of the modern business enterprise. Most organizations now view their operations in terms of business processes and manage these business processes in the same way as other corporate assets. In recent years, an increasingly broad range of generic technology has become available for automating business processes. This is part of a growing trend in the software engineering field throughout the past 40 years, where aspects of functionality that are potentially reusable on a widespread basis have coalesced into generic software components. Figure 2.1 illustrates this trend and shows how software systems have evolved from the monolithic applications of the 1960s developed in their entirety often by a single development team to today’s offerings that are based on the integration of a range of generic technologies with only a small component of the application actually being developed from scratch. In the 1990s, generic functionality for the automation of business processes first became commercially available in the form of workflow technology and subsequently evolved in the broader field of business process management systems (BPMS). This technology alleviated the necessity to develop process support within applications from scratch and provided a variety of off-the-shelf options on which these requirements could be based. The demand for this technology was significant and it is estimated that by 2000 there were well over 200 distinct workflow offerings in the market, each with a distinct conceptual foundation. Anticipating the difficulties that would be experienced by organizations seeking to utilize and integrate distinct workflow offerings, the Workflow Management Coalition (WfMC), an industry group formed to advance technology in this area, proposed a standard reference model for workflow technology with an express desire to seek a common platform for achieving workflow interoperation.

Lumbar epidural steroids are not cost effective in sciatica

Background Lumbar Epidural Steroids Injections (ESI’s) have previously been shown to provide some degree of pain relief in sciatica. Number Needed To Treat (NNT) to achieve 50% pain relief has been estimated at 7 from the results of randomised controlled trials. Pain relief is temporary. They remain one of the most commonly provided procedures in the UK. It is unknown whether this pain relief represents good value for money. Methods 228 patients were randomised into a multi-centre Double Blind Randomised Controlled Trial. Subjects received up to 3 ESI’s or intra-spinous saline depending on response and fall off with the first injection. All other treatments were permitted. All received a review of analgesia, education and physical therapy. Quality of life was assessed using the SF36 at 6 points and compared using independent sample t-tests. Follow up was up to 1 yr. Missing data was imputed using last observation carried forward (LOCF). QALY’s (Quality of Life Years) were derived from preference based heath values (summary health utility score). SF-6D health state classification was derived from SF-36 raw score data. Standard gambles (SG) were calculated using Model 10. SG scores were calculated on trial results. LOCF was not used for this. Instead average SG were derived for a subset of patients with observations for all visits up to week 12. Incremental QALY’s were derived as the difference in the area between the SG curve for the active group and placebo group. Results SF36 domains showed a significant improvement in pain at week 3 but this was not sustained (mean 54 Active vs 61 Placebo P<0.05). Other domains did not show any significant gains compared with placebo. For derivation of SG the number in the sample in each period differed. In week 12, average SG scores for active and placebo converged. In other words, the health gain for the active group as measured by SG was achieved by the placebo group by week 12. The incremental QALY gained for a patient under the trial protocol compared with the standard care package was 0.0059350. This is equivalent to an additional 2.2 days of full health. The cost per QALY gained to the provider from a patient management strategy administering one epidural as suggested by results was £25 745.68. This result was derived assuming that the gain in QALY data calculated for patients under the trial protocol would approximate that under a patient management strategy based on the trial results (one ESI). This is above the threshold suggested by some as a cost effective treatment. Conclusions The transient benefit in pain relief afforded by ESI’s does not appear to be cost-effective. Further work is needed to develop more cost-effective conservative treatments for sciatica.

The caveat in Queensland : getting it off!

This article critically analyses the provisions by which a caveat against dealings may be cleared from a land title in Queensland, namely ss 126, 127 and 128 of the Land Title Act 1994(Qld). It includes a comparison of the current provisions with the pre-existing law and provides a comprehensive guide as to the circumstances in which, and the manner by which, the current provisions may be utilised to clear caveats from land titles in Queensland.

Standing surface waves in a dust-contaminated large-area planar plasma source

The effect of charged particulates or dusts on surface wave produced microwave discharges is studied. The frequencies of the standing electromagnetic eigenmodes of large-area flat plasmas are calculated. The dusts absorb a significant amount of the plasma electrons and can lead to a modification of the electromagnetic field structure in the discharge by shifting the originally excited operating mode out of resonance. For certain given proportions of dusts, mode conversion is found to be possible. The power loss in the discharge is also increased because of dust-specific dissipations, leading to a decrease of the operating mode quality factor.

A model of a large-area planar plasma producer based on surface wave propagation in a plasma-metal structure with a dielectric sheath

A theoretical model of a large-area planar plasma producer based on surface wave (SW) propagation in a plasma-metal structure with a dielectric sheath is presented. The SW which produces and sustains the microwave gas discharge in the planar structure propagates along an external magnetic field and possesses an eigenfrequency within the range between electron cyclotron and electron plasma frequencies. The spatial distributions of the produced plasma density, electromagnetic fields, energy flow density, phase velocity and reverse skin depth of the SW are obtained analytically and numerically.

Parameters and equilibrium profiles for large-area surface-wave sustained plasmas

The equilibrium profiles of the plasma parameters of large-area if discharges in a finite-length metal-shielded dielectric cylinder are computed using a two-dimensional fluid code. The rf power is coupled to the plasma through edge-localized surface waves traveling in the azimuthal direction along the plasma edge. It is shown that self-consistent accounting for axial plasma diffusion and radial nonuniformity of the electron temperature can explain the frequently reported deviations of experimentally measured radial density profiles from that of the conventional linear diffusion models. The simulation results are in a good agreement with existing experimental data obtained from surface-wave sustained large-diameter plasmas. © 2002 The American Physical Society.

Low-temperature growth of large area, vertically aligned carbon nanotubes for field emission applications

Large area, highly uniform vertically aligned carbon nanotips (VACNTP) and other nanostructures have been grown on silicon (100) substrates with Ni catalyst in the low-temperature, low-frequency, high-density inductively coupled plasmas (ICP) of methane-hydrogen-argon gas mixtures. The control strategies for the morphology, crystalline structure and chemical states of the resulting nanostructures by varying the growth conditions are proposed. XRD and Roman analyses confirm that the nanotips are well graphitized, which is favorable for the field emission applications.

Examining the role of within functional area resource–capability complementarity in achieving customer and product-based performance outcomes

Adopting both the resource-based view and dynamic capability theory this study advances the contention that firms must possess both resources and capabilities at a superior level to achieve superior customer and product performance. To examine this contention this study investigates the individual effect of the complementarity between marketing resources and capability and complementarity between innovation resources and capability on customer and product performance respectively. The results of a survey of 171 B2B manufacturing firms show a significant main effect for complementarity between marketing resources–capability and complementarity between innovation resources–capability on customer and product performance. The findings also show that complementarity marketing resources–capability has a stronger positive relationship with customer performance than with product performance, while complementarity between innovation resources–capability has a stronger positive relationship with product performance than with customer performance.

Aligning off-balance sheet risk, on-balance sheet risk and audit fees: a PLS path modelling analysis

This study focuses on using the partial least squares (PLS) path modelling technique in archival auditing research by replicating the data and research questions from prior bank audit fee studies. PLS path modelling allows for inter-correlations among audit fee determinants by establishing latent constructs and multiple relationship paths in one simultaneous PLS path model. Endogeneity concerns about auditor choice can also be addressed with PLS path modelling. With a sample of US bank holding companies for the period 2003-2009, we examine the associations among on-balance sheet financial risks, off-balance sheet risks and audit fees, and also address the pervasive client size effect, and the effect of the self-selection of auditors. The results endorse the dominating effect of size on audit fees, both directly and indirectly via its impacts on other audit fee determinants. By simultaneously considering the self-selection of auditors, we still find audit fee premiums on Big N auditors, which is the second important factor on audit fee determination. On-balance-sheet financial risk measures in terms of capital adequacy, loan composition, earnings and asset quality performance have positive impacts on audit fees. After allowing for the positive influence of on-balance sheet financial risks and entity size on off-balance sheet risk, the off-balance sheet risk measure, SECRISK, is still positively associated with bank audit fees, both before and after the onset of the financial crisis. The consistent results from this study compared with prior literature provide supporting evidence and enhance confidence on the application of this new research technique in archival accounting studies.

Aligning off-balance sheet risk, on-balance sheet risk and audit fees: a PLS path modelling analysis

This study focuses on using the partial least squares (PLS) path modelling methodology in archival auditing research by replicating the data and research questions from prior bank audit fee studies. PLS path modelling allows for inter-correlations among audit fee determinants by establishing latent constructs and multiple relationship paths in one simultaneous PLS path model. Endogeneity concerns about auditor choice can also be addressed with PLS path modelling. With a sample of US bank holding companies for the period 2003-2009, we examine the associations among on-balance sheet financial risks, off-balance sheet risks and audit fees, and also address the pervasive client size effect, and the effect of the self-selection of auditors. The results endorse the dominating effect of size on audit fees, both directly and indirectly via its impacts on other audit fee determinants. By simultaneously considering the self-selection of auditors, we still find audit fee premiums on Big N auditors, which is the second important factor on audit fee determination. On-balance-sheet financial risk measures in terms of capital adequacy, loan composition, earnings and asset quality performance have positive impacts on audit fees. After allowing for the positive influence of on-balance sheet financial risks and entity size on off-balance sheet risk, the off-balance sheet risk measure, SECRISK, is still positively associated with bank audit fees, both before and after the onset of the financial crisis. The consistent results from this study compared with prior literature provide supporting evidence and enhance confidence on the application of this new research technique in archival accounting studies.

Finite-SNR diversity-multiplexing trade-off of inter-vehicular cooperative diversity protocols

The finite-signal-to-noise ratio (SNR) diversity-multiplexing trade-off (DMT) of cooperative diversity protocols are investigated in vehicular networks based on cascaded Rayleigh fading. Lower bounds of DMT at finite SNR for orthogonal and non-orthogonal protocols are derived. The results showcase the first look into the achievable DMT trade-off of cooperative diversity in volatile vehicular environments. It is shown that the diversity gains are significantly suboptimal at realistic SNRs.

Book Reviews : "Off Limits: a parent’s guide to keeping kids safe from sexual abuse" and "Smart Parenting for Safer Kids"

Two important books on the topic of child sexual abuse prevention were recently published: Off Limits: A Parent’s Guide to Keeping Kids Safe from Sexual Abuse (Wurtele & Berkower, 2010) and Smart Parenting for Safer Kids (Briggs, 2010). The authors of both books are highly credentialed with long experience researching and writing about child sexual abuse prevention. Sandy Wurtele, PhD, is author of landmark child- and parent-focused sexual abuse prevention programs conducted in the USA over the past 30 years. She has published over 80 journal articles and book chapters on this topic. Her co-author, Feather Berkower, MSW, has been conducting workshops for adults on this topic for 25 years. Freda Briggs, PhD, has over 40 years’ experience in child protection in Australia and has also published numerous scholarly works on the topic. She was the inaugural recipient of the Australian Humanitarian Award in 1998, was Senior Australian of the Year in 2000, and was awarded an Order of Australia in 2005.

Public preferences for biodiversity conservation and climate-change mitigation: A choice experiment using ecosystem services indicators

Potential conflicts exist between biodiversity conservation and climate-change mitigation as trade-offs in multiple-use land management. This study aims to evaluate public preferences for biodiversity conservation and climate-change mitigation policy considering respondents’ uncertainty on their choice. We conducted a choice experiment using land-use scenarios in the rural Kushiro watershed in northern Japan. The results showed that the public strongly wish to avoid the extinction of endangered species in preference to climate-change mitigation in the form of carbon sequestration by increasing the area of managed forest. Knowledge of the site and the respondents’ awareness of the personal benefits associated with supporting and regulating services had a positive effect on their preference for conservation plans. Thus, decision-makers should be careful about how they provide ecological information for informed choices concerning ecosystem services tradeoffs. Suggesting targets with explicit indicators will affect public preferences, as well as the willingness of the public to pay for such measures. Furthermore, the elicited-choice probabilities approach is useful for revealing the distribution of relative preferences for incomplete scenarios, thus verifying the effectiveness of indicators introduced in the experiment.