Feasibility of Estimating Patient-Specific Dose Verification Results Directly from Linear Accelerator Log Files in Volumetric Modulated Arc Therapy

The feasibility of estimating patient-specific dose verification results directly from linear accelerator (linac) log files has been investigated for prostate cancer patients who undergo volumetric modulated arc therapy (VMAT). Twenty-six patients who underwent VMAT in our facility were consecutively selected. VMAT plans were created using Monaco treatment planning system and were transferred to an Elekta linac. During the beam delivery, dynamic machine parameters such as positions of the multi-leaf collimator and the gantry were recorded in the log files;subsequently, root mean square (rms) values of control errors, speeds and accelerations of the above machine parameters were calculated for each delivery. Dose verification was performed for all the plans using a cylindrical phantom with diodes placed in a spiral array. The gamma index pass rates were evaluated under 3%/3 mm and 2%/2 mm criteria with a dose threshold of 10%. Subsequently, the correlation coefficients between the gamma index pass rates and each of the above rms values were calculated. Under the 2%/2 mm criteria, significant negative correlations were found between the gamma index pass rates and the rms gantry angle errors (r = 0.64, p < 0.001) as well as the pass rates and the rms gantry accelerations (r = 0.68, p < 0.001). On the other hand, the rms values of the other dynamic machine parameters did not significantly correlate with the gamma index pass rates. We suggest that the VMAT quality assurance (QA) results can be directly estimated from the log file thereby providing potential to simplify patient-specific prostate VMAT QA procedure.

病人日志在神经内科护患沟通中的作用

目的:探讨病人在住院期间记录日志的真实体验,研究病人日志在护患沟通中的作用。方法:以质性研究中的现象学方法为指导,采用目的抽样方法,对北京市某一"三甲"医院的研究对象进行录音半结构式个人深入访谈。样本包括 3 组人群:①记录病房日志大于 5 天的住院病人;②在某一病房工作大于半年的主管护士;③在某一病房工作大于半年的主治医生。访谈的内容全部录音,并使用原始笔记补充、分析研究和资料的收集同时进行,直至最后研究报告的完成。结果:病人日志在临床运用中可促进病人心理和情绪的稳定,能为护患沟通提供一种交流方式,并减少护患纠纷。结论:将病人日志与面对面的沟通有机结合,并加强对病人的随访可提高医疗护理质量。

患者日志在精神科护患沟通中的应用效果

目的：研究患者目志在护患沟通中的作用。方法：选取2011年4—11月新入院的精神科患者476例，随机分为实验组和对照组各238例.两组患者人院期间均给予精神科常规护理，实验组除常规护理外通过访谈，以患者自愿为原则，发放患者日志本；由患者用日志的方式记录住院期间内心的真实感受；由责任护士每日阅读和回复，与护士长共同就存在的问题进行回复和沟通处理。观察两组患者住院满意度。结果：患者日志记录的内容能及时帮助护士了解患者的主观体验和病房存在的管理问题，为护患沟通提供有效的交流方式,实验组满意度多项指标明显高于对照组。结论：将患者日志与面对面的沟通有机结合，一方面可通过日。志及时掌握病情的动态变化，预警意外发生，有助于护理工作的顺利开展，提高护理质量；另一方面能及时改进病房存在的问题，融洽护患关系,提升患者满意度。