Evaluation of Varian's SmartAdapt for clinical use in radiation therapy for patients with thoracic lesions.

Introduction: Deformable image registration (DIR) is a required tool in any adaptive radiotherapy program to help account for anatomical changes that occur during a multifraction treatment. SmartAdapt is a DIR tool from Varian incorporated within the eclipse treatment planning system, that can be used for contour propagation and transfer of PET, MRI, or computed tomography (CT) data. The purpose of this work is to evaluate the registration and contour propagation accuracy of SmartAdapt for thoracic CT studies using the guidelines from AAPM TG 132.

Dosimetric comparison of two treatment planning systems for spine SBRT.

Two commonly used treatment planning systems (TPS) are compared for the planning of spine stereotactic body radiotherapy (SBRT). The main purpose is to highlight relative advantages and disadvantages of each system and propose a methodologic approach for comparisons. Twenty clinical plans were inversely planned with step-and-shoot intensity-modulated radiotherapy (IMRT) each using 9 to 11 beams, referred to as IMRT_P.

Complex care for kids Ontario: protocol for a mixed-methods randomised controlled trial of a population-level care coordination initiative for children with medical complexity.

Introduction: Technological and medical advances have led to a growing population of children with medical complexity (CMC) defined by substantial medical needs, healthcare utilisation and morbidity. These children are at a high risk of missed, fragmented and/or inappropriate care, and families bear extraordinary financial burden and stress. While small in number (<1% of children), this group uses ~1/3 of all child healthcare resources, and need coordinated care to optimise their health.

Blood Pressure Management in Adults With Type 2 Diabetes: Insights From the Diabetes Mellitus Status in Canada (DM-SCAN) Survey.

Objectives: Optimal treatment of blood pressure (BP) and other cardiovascular risk factors, including hyperglycemia, is integral to diabetes management. There are limited data from the primary care setting concerning the contemporary and comprehensive management of type 2 diabetes and other cardiovascular risk factors in relation to guideline-recommended BP target achievement.

Methods: The Diabetes Mellitus Status in Canada (DM-SCAN) survey included 5172 ambulatory patients with type 2 diabetes.

Increased uptake of guideline-recommended oral antiplatelet therapy: insights from the Canadian acute coronary syndrome reflective.

Current guideline-based recommendations for oral dual-antiplatelet therapy in an acute coronary syndrome (ACS) include the use of newer adenosine diphosphate receptor inhibitor (ADPri) regimens and agents. The Canadian ACS Reflective Program is a multicenter observational quality-enhancement project that compared the use of ADPri therapy in 2 phases (November 2011-March 2013 and April 2013-November 2013) and also compared ADPri use with previous national data from the Canadian Global Registry of Acute Coronary Events (2000-2008). Of 3099 patients with ACS, 30.

Final results from PRIME: randomized phase III study of panitumumab with FOLFOX4 for first-line treatment of metastatic colorectal cancer.

Background: The Panitumumab Randomized trial In combination with chemotherapy for Metastatic colorectal cancer to determine Efficacy (PRIME) demonstrated that panitumumab-FOLFOX4 significantly improved progression-free survival (PFS) versus FOLFOX4 as first-line treatment of wild-type (WT) KRAS metastatic colorectal cancer (mCRC), the primary end point of the study.

Patients And Methods: Patients were randomized 1:1 to panitumumab 6.0 mg/kg every 2 weeks + FOLFOX4 (arm 1) or FOLFOX4 (arm 2).

The premature infant pain profile-revised (PIPP-R): initial validation and feasibility.

Objectives: To describe revisions to the Premature Infant Pain Profile (PIPP) and initial construct validation and feasibility of the Premature Infant Pain Profile-Revised (PIPP-R).

Methods: The PIPP was revised to enhance validity and feasibility. To validate the PIPP-R, data from 2 randomized cross-over studies were utilized to: (1) calculate and compare PIPP and PIPP-R scores in extremely low gestational age infants undergoing a painful and nonpainful event (N=52; dataset #1) and (2) calculate and compare PIPP and PIPP-R scores in assessing the effectiveness of (a) sucrose, (b) non-nutritive sucking (NNS)+sucrose, and (c) facilitated tucking+NNS+sucrose during heel lance (N = 85; dataset #2).

A Practice-based Taxonomy for Radiation Treatment Errors.

Purpose: An absence of a common language for incident classification limits knowledge sharing within and between organizations in the radiotherapy community. This challenge provided the motivation to develop a clinically relevant taxonomy for radiotherapy errors.

Materials And Methods: This was a multicenter, prospective study that consisted of three phases: (1) an initial version of the taxonomy was developed based on the World Health Organization Conceptual Framework for the International Classification for Patient Safety and taxonomy models from radiotherapy and other industries; (2) the taxonomy was evaluated using actual incident data from a single practitioner and revised; and (3) face validity testing of the taxonomy was performed by two additional practitioners from different radiotherapy centers using simulated incident cases.

WITHDRAWN: A Descriptive Review Article for Pump Initiation in a Pediatric Diabetes Centre.

The Publisher regrets that this article is an accidental duplication of an article that has already been published, DOI of original article:10.1016/j.pedn.

Antibiotic prescribing practices for catheter urine culture results.

Background: The literature suggests that positive results of catheter urine cultures frequently lead to unnecessary antimicrobial prescribing, which therefore represents an important target for stewardship.

Objective: To assess the appropriateness of antibiotic prescribing in response to the results of urine cultures from patients with indwelling urinary catheters.

Methods: This retrospective study was conducted at a tertiary care centre and involved adults with indwelling urinary catheters from whom urine specimens were obtained for culture.

The gift of true presence: a nursing story where theory and practice meet.

Nursing theories have long existed to guide nursing practice but, in reality, can be challenging to achieve. In this paper the application of Parse's theory on Human Becoming is seen through a nurse's experience with an oncology patient and her family. Her reflection highlights how the concepts and paradoxes of the theory can meet practice.

Poster - Thur Eve - 54: A software solution for ongoing DVH quality assurance in radiation therapy.

Purpose: A program has been developed in MATLAB for use in quality assurance of treatment planning of radiation therapy. It analyzes patient DVH files and compiles dose volume data for review, trending, comparison and analysis.

Material And Methods: Patient DVH files are exported from the Eclipse treatment planning system and saved according to treatment sites and date.

Poster - Thur Eve - 74: A set of tests designed for electron dose calculation algorithm verification during a treatment planning system upgrade.

A set of tests were designed to verify an electron algorithm effectively and quickly during a treatment planning system upgrade. Based on TG-53 report's suggestion and the assumption that the algorithm is well commissioned before the upgrade, the tests spot-check the output factors, depth doses, off-axis doses and treatment field sizes. The field sizes of 4×4, 6×6, 10×10, 15×15, 20×20 and 25×25 are to be tested.

Poster - Thur Eve - 76: A quality control to achieve planning consistency in arc radiotherapy of the prostate.

Purpose: To report a quality control program in prostate radiation therapy at our center that includes semi-automated planning process to generate high quality plans and in-house software to track plan quality in the subsequent clinical application.

Material And Methods: Arc planning in Eclipse v10.0 was preformed for both intact prostate and post-prostatectomy treatments.

Poster - Thur Eve - 09: Novel radiation safety challenges of a brachytherapy redevelopment at the Credit Valley Hospital.

Carlo Fidani Peel Regional Cancer Center at the Credit Valley Site of the Credit Valley Hospital and Trillium Health Center is currently undergoing a redevelopment to build a brachytherapy suite and associated areas with a projected start date of April 2013. The new brachytherapy suite will be located in the PRCC, and is a redevelopment of office area into clinical space. The workload for the full brachytherapy program is expected to be 20 patients per week, in cervix, prostate, skin, lung and other sites.

Sci-Thur AM: Planning - 11: The impact of distributed calculation framework settings on plan calculation time.

Some treatment planning system can divide a treatment plan calculation into multiple threads and allow both local and network computing resources to perform the calculation concurrently, which significantly reduces the calculation time for a calculation-demanding planning such as Volumetric Modulated Arc Therapy (VMAT) or electron Monte Carlo (eMC). This study tested in Eclipse (Varian, V10.0.

Real numbers tell real stories in health services management.

In the words of one hospital manager, "hospital data is currently indigestible and alien to the average user." Drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a Clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. This article identifies lessons for hospital board governance, media relations, employee communications, and citizen and patient engagement that are applicable across the healthcare industry in many countries.

The short adjustable suture.

Objective: To describe a new, adjustable suture technique for strabismus surgery that is safe and effective and allows for adjustment during the postoperative week only when required.

Design: Retrospective review.

Participants: A total of 304 patients, of which 149 were male and 155 female, with an age range from 4 to 89 years and a median age of 42 years.

Laparoscopic surgery for endometrial cancer: a review.

Uterine cancer is the fourth most common cancer in Canadian women, with an estimated 4200 new cases and 790 disease-related deaths in 2008. We investigated the domains that are important for further implementation of minimally invasive surgery for the management of endometrial cancer by performing a literature review to assess the available data on overall and disease-free survival in laparoscopic versus open surgery. We also investigated the influence of patient- related factors, surgical factors, quality of life, and cost implications.

From boardroom to bedside: how to define and measure hospital quality.

Following the release of its strategic plan, in which patient safety and quality were highlighted as key directions, St. Joseph's Healthcare Hamilton recognized the importance of engaging its board of trustees to achieve these goals. Following a collaborative retreat with senior management, medical staff leadership and professional practice leaders, the board enhanced its governance oversight on quality.

Perhaps I am one of the lucky ones.

I recently participated in the Ontario Hospital Association (OHA) webinar on quality and safety, in which I was asked to address the topic of engaging physicians in performance measurement, quality and safety. I am not a physician, but much of my work in healthcare has involved working with clinical leaders in these areas. At St.