Establishment Of Workflow Research Articles

Treatment of pediatric patients and young adults with particle therapy at the Heidelberg Ion Therapy Center (HIT): establishment of workflow and initial clinical data

BackgroundTo report on establishment of workflow and clinical results of particle therapy at the Heidelberg Ion Therapy Center.Materials and methodsWe treated 36 pediatric patients (aged 21 or younger) with particle therapy at HIT. Median age was 12 years (range 2-21 years), five patients (14%) were younger than 5 years of age. Indications included pilocytic astrocytoma, parameningeal and orbital rhabdomyosarcoma, skull base and cervical chordoma, osteosarcoma and adenoid-cystic carcinoma (ACC), as well as one patient with an angiofibroma of the nasopharynx. For the treatment of small children, an anesthesia unit at HIT was established in cooperation with the Department of Anesthesiology.ResultsTreatment concepts depended on tumor type, staging, age of the patient, as well as availability of specific study protocols. In all patients, particle radiotherapy was well tolerated and no interruptions due to toxicity had to be undertaken. During follow-up, only mild toxicites were observed. Only one patient died of tumor progression: Carbon ion radiotherapy was performed as an individual treatment approach in a child with a skull base recurrence of the previously irradiated rhabdomyosarcoma. Besides this patient, tumor recurrence was observed in two additional patients.ConclusionClinical protocols have been generated to evaluate the real potential of particle therapy, also with respect to carbon ions in distinct pediatric patient populations. The strong cooperation between the pediatric department and the department of radiation oncology enable an interdisciplinary treatment and stream-lined workflow and acceptance of the treatment for the patients and their parents.

Mission impossible? The future of “paperless” library operations

PurposeThe purpose of this paper is to discuss the current state of the “paperless office” and explore how likely it is that libraries will be administered by librarians in paperless offices in the near future.Design/methodology/approachThis paper surveys the literature on forecasts for the paperless office to determine whether library operations and offices could be as paperless as some of their collections might be in the near future.FindingsThe paperless office was once seen as inevitable, but is looking less far less likely given how we access and organize documents, how we read and understand information, and how we analyze what we read online and in print. Nonetheless, certain routine library operations would lend themselves almost immediately to paperless storage and retrieval processes and systems.Research limitations/implicationsMore research is required on records management systems in libraries with a view to establishing largely paperless operations in the future. Implications for future research involve the establishment of processes and the testing of systems which would most easily lend themselves to standard library operations.Practical implicationsRecent research on reading and cognitive function indicates that there are certain practical implications involved in doing away with paper entirely. Nonetheless, certain routine library functions could be made paperless operations once practical considerations such as the choice of systems, establishment of work flow, policies and processes have been realized.Originality/valueThe paper makes the case for more research and exploration of the viability of paperless or near‐paperless library operations.