Tuomey Healthcare System

We all encounter various forms of stress every single day. Stress can be caused by family issues, relationships, children and especially work. With the ever-growing demands that are placed on Healthcare Security professionals today, career burnout associated with stress is becoming more and more common. In this article, the author discusses some signs and symptoms, as well as giving some stress reduction exercises that may be able to help your officers reduce their stress.

Purpose: To explore the feasibility of measuring and analyzing beam profiles for diagnostic x-ray beams with a 2D ion chamber array. Method and Materials: Diagnostic x-ray beam profiles were measured using PTW seven29 ionization chamber array at 100 SSD with 0.5 cm buildup. Acuity simulator (Varian Medical Systems Inc.) was used for generating diagnostic x-rays. Fluoroscopy mode was used throughout the study. Blades were used to shape the fields while the wires were set completely out of those filed. For 115 kVp beam energy, field size 10×10 was used and for 75 kVp beam energy, field size 20×20 was used. For 10×10 field size, the operating parameters were: 80 mA, 15 ms. Approximately 60 seconds measurement time was used to improve signal-to-noise ratio and for 20×20 field size: 50 mA, 5 ms with 30 seconds measurement time. Beam flatness and symmetry were analyzed using MultiCheck and VeriSoft software (PTW Inc.) Results: The flatness (Percentage Dose Difference) for 10×10 field is 6.0%, and for 20×20 field is 4.0%. The symmetry (Maximum Dose Ratio) for 10×10 is 1.05, and for 20×20 is 1.03. Conclusion: Diagnostic x-ray beam profiles were measured with PTW seven29 2D ion chamber array. The device came with a calibration certificate for 60Co. and was designed for dose measurements in radiation therapy. It could be used in relative dose mode to provide a straightforward way for verifying beam flatness and symmetry for diagnostic x-ray beams. The data obtained could be added to form the basis for a periodic QA program for such units. Further study is needed to investigate the relative advantages and limitations of this method.

Purpose: To derive a nomogram for prostate seed implant. Method and Materials: Adopting the isotropic point source model from TG43, the integral dose delivered by a single source is , where g(r) is the radial dose function, given as (1). Let N be the number of sources implanted, the total integral dose will be NE. Defining F is the fraction factor for energy absorbed by the prostate, and then energy absorbed inside the prostate will be NEF. Assuming the prostate is spherical and radioactivity is uniformly distributed, fraction factor F with energy 30 keV ('s average energy) has been calculated by Monte Carlo technique (2). The integral dose inside the prostate will be the volume of the prostate (V) times the mean dose (Dmean). The mean dose in the uniformly distributed sphere is calculated using numerical integration (3) to be 1.76 times of prescribed dose (D). By equating , the nomogram is obtained. Results: The nomogram (total activity =0.1128DV0.6727) is used to compare with clinical data provided by IsoRay (Richland, WA). The agreement is within 10% for monotherapy cases and within 12% for boost cases with regular gland sizes (25 to 60 cc). With gland sizes range from 30 to 60 cc, the agreement improves to 7% for monotherapy cases. Conclusion: Assuming radioactivity is uniformly distributed inside the spherical prostate, we have derived a nomogram for seeds used in prostate implant. Compared with clinical data, our nomogram shows good agreement for regular size glands. The agreement is improved in monotherapy for large size glands (30 to 60 cc).