ACR Accreditation for Utah Valley Hospital’s Radiation Oncology Center

Becoming an accredited clinic through the American College of Radiology (ACR) and their Radiation Oncology Practice Accreditation (ROPA) program will provide third-party evaluation of patient care to ensure the best treatment possible for patients. Talk of getting ACR accreditation has occurred in the past for Utah Valley Hospital/American Fork Hospital, but at the time it was seen as something that did not provide sufficient value vs. the cost. The recent One Intermountain restructuring is intended to unify all of the Intermountain Healthcare radiation oncology centers in Utah so the Radiation Oncology Director has set the goal that all Intermountain radiation oncology programs will be accredited. Intermountain Medical Center (IMC) and Dixie Regional Medical Center (DRMC) are currently ACR accredited and can be used as model programs. I started with an in-depth examination of our department’s workflow, documentation, and policies in order to determine where improvements to meet ACR accreditation standards could be made. I followed this up by working on implementing some of these improvements throughout the clinic and made sure they become routine and a standard in the department. An analysis of Dixie Regional Medical Center and Intermountain Medical Center’s ACR documents was performed to provide a baseline of an accredited-ACR program. Finally, a comprehensive checklist of everything that will need to be changed or implemented was presented in order to provide guidance for the future

Vacancies, disorder-induced smearing of the electronic structure, and its implications for the superconductivity of anti-perovskite MgC0.93_{0.93}Ni2.85_{2.85}

The anti-perovskite superconductor MgC$_{0.93}$Ni$_{2.85}$ was studied using high-resolution x-ray Compton scattering combined with electronic structure calculations. Compton scattering measurements were used to determine experimentally a Fermi surface that showed good agreement with that of our supercell calculations, establishing the presence of the predicted hole and electron Fermi surface sheets. Our calculations indicate that the Fermi surface is smeared by the disorder due to the presence of vacancies on the C and Ni sites, but does not drastically change shape. The 20\% reduction in the Fermi level density-of-states would lead to a significant ($\sim 70\%$) suppression of the superconducting $T_c$ for pair-forming electron-phonon coupling. However, we ascribe the observed much smaller $T_c$ reduction at our composition (compared to the stoichiometric compound) to the suppression of pair-breaking spin fluctuations.Comment: 11 pages, 3 figure

Interpretative perspectives on the acceptance of an optional information system

Understanding the factors that contribute to the acceptance and use of information systems is a central concern in the field of information systems. Especially in cases where users are relatively free to use an information system (a so called optional information system) it is important for implementers to understand which factors determine acceptance in order to develop an effective design and implementation plan. In order to identify factors that determine acceptance, this report describes and analyses the implementation of a therapy expert system for general practitioners (GPs) in the Netherlands. The Netherlands Ministry of Health decided to implement this system with the objective to promote cost effectiveness, consistency and quality of therapies and drug prescriptions of general practitioners. This paper uses an interpretive perspective to analyze the limited acceptance of the system. While the promotion campaign focused on the system, GPs based their decision on wider contextual factors. The case demonstrates pitfalls, which come up during the implementation of such a system, and shows which factors may play a role in the decision of possible users to accept or reject such an optional information system. Different issues arise from this case. One is that users seem to differ from non-users and that perceptions about the system itself but also about non-system features affect the decision to accept. The paper uses the evidence of the case by suggesting to extend the technology acceptance model (TAM) with relevant contextual factors. It concludes by outlining its implications for implementers of optional information systems in general.

The Political Economy of Globalization – Revisiting Stephen Hymer 50 Years On

We discuss issues pertaining to the political economy of “globalization”, in the context of the seminal contribution by Stephen Hymer. While Hymer’s contribution to the theory of the multinational enterprise (MNE) and foreign direct investment (FDI) is widely recognized, his contribution to the political economy of what he called “multinational corporate capital” has received less attention. In this paper we revisit some of the issues he raised, notably uneven development, global governance and central planning in the context of post-Hymer scholarly thinking and the shifting global landscape. In so doing we also speculate on the challenges and future of globalization.Stephen Hymer, International Political Economy, Institutions, Globalization,Sustainability

Iowa Health Focus, July-August, 2010

Monthly newsletter for the Iowa Department of Public Healt

Out of equilibrium: understanding cosmological evolution to lower-entropy states

Despite the importance of the Second Law of Thermodynamics, it is not absolute. Statistical mechanics implies that, given sufficient time, systems near equilibrium will spontaneously fluctuate into lower-entropy states, locally reversing the thermodynamic arrow of time. We study the time development of such fluctuations, especially the very large fluctuations relevant to cosmology. Under fairly general assumptions, the most likely history of a fluctuation out of equilibrium is simply the CPT conjugate of the most likely way a system relaxes back to equilibrium. We use this idea to elucidate the spacetime structure of various fluctuations in (stable and metastable) de Sitter space and thermal anti-de Sitter space.Comment: 27 pages, 11 figure