Self-commissioning in design refers to the practice of setting goals and objectives for oneself rather than having a brief or from company. In self-commission, creator has more control over creative process can focus on his own visions. Creative intuition, as ability trust inspiration ideas that arise spontaneously, is not dependent traditional methods. The combination both, self-commissioning ...

Linacs equipped with flattening filter-free (FFF) megavoltage photon beams are now commercially available. However, the commissioning of FFF beams poses challenges that are not shared with traditional flattened megavoltage X-ray beams. The planning system must model a beam that is peaked in the center and has an energy spectrum that is softer than the flattened beam. Removing the flattening fil...

This paper summarizes clinical commissioning of the world's first commercial, clinically utilized installation of a compact, image-guided, pencil-beam scanning, intensity-modulated proton therapy system, the IBA Proteus® ONE, at the Willis-Knighton Cancer Center (WKCC) in Shreveport, LA. The Proteus® ONE is a single-room, compact-gantry system employing a cyclotron-generated proton beam with im...

The paper deals with risk analysis and management in the realisation of process plants by engineering and contracting companies. Specifically, a new analytical methodology is developed to manage the typical risks of plant commissioning. Following a detailed study of the commissioning process and its criticalities, Hazop is selected as the most suitable approach in forecasting particular risks o...

AIM This paper aims to explore patient and public representation in a NHS clinical commissioning group and how this is experienced by staff and lay members involved. BACKGROUND Patient and public involvement is believed to foster greater public representativeness in the development and delivery of health care services. However, there is widespread debate about what representation is or what i...

OBJECTIVES Using the findings of incident investigations to improve patient safety management is well-established and mandatory under Swedish law. This study seeks to identify the mechanisms behind successful implementation of the recommendations of incident investigations. SETTING This study was based in a university hospital in southern Sweden. PARTICIPANTS A sample of 55 incident investi...

OBJECTIVES To assess the compliance of clinical commissioning groups (CCGs) in England with the ENT-UK rhinosinusitis commissioning guide produced in collaboration with the Royal College of Surgeons England and the National Institute of Clinical Excellence. We also aimed to assess the ease of accessibility of data from CCGs. DESIGN Audit of compliance of English CCGs with the ENT-UK rhinosinu...

Commissioning ensures buildings deliver the performance and energy savings promised by their design. Ongoing commissioning aims to fully automate the commissioning process, providing periodic or even continuous monitoring, identification and possibly remedial actions ensuring persistence in intended operation and performance . One of the major research areas inongoing commissioning at the momen...

OBJECTIVES Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commis...