Beam steering by liquid crystal elastomer fibres.

The problem of utilizing a laser beam as an information vehicle and dividing it into different channels is an open problem in the telecommunication field. The switching of a signal into different ports has been demonstrated, to date, by employing complex devices and mechanisms such as the electro optic effect, microelectromechanical system (MEMS) mirrors, or liquid crystal-based spatial light modulators (SLMs). We present here a simple device, namely a mirror held by a liquid crystal elastomer (LCE) fibre, as an optically and remotely driven beam steerer. In fact, a considered signal (laser beam) can be addressed in every in-plane direction by controlling the fibre and mirror rotation, i.e., the deflected probe beam angle. Such movement is possible due to the preparation of LCE fibres able to rotate and contract under a selective light stimulus. By adjusting the irradiation stimulus power, elastic fibres are able to rotate with a specific angle, performing more than one complete revolution around their axis. The described movement is perfectly reversible as soon as the stimulus is removed.

Quality improvement of medical records in a teaching hospital.

INTRODUCTION: The aim of this study was to evaluate the quality of the MR compilation in some Operative Units of the "Azienda Ospedaliera Universitaria--II Università di Napoli" (AOU- SUN)-Italy, before and after an intervention of quality improvement, underlining the potential differences in the behaviour of different specialists (physicians vs. surgeons). METHODS: Two random samples of 660 MRs were reviewed. A four-step program was developed: (1) first assessment of the MR; (2) implementation of the MR quality, sending a letter with the purpose of the study, the results obtained in the first step from that ward, the guidelines to correctly fill out the MR; (3) follow-up step four months later; (4) comparison of the data before and after the distribution of the guidelines using indicators of completeness of all sections of MR, clarity of handwriting and presence and clarity of signature. RESULTS: The main concerns were related to the signature of the duty physician (present in 2.0% and legible in only 15.4%), the presence of the letter of discharge (18.0%) and the clarity of the days of hospital stay (32.0%). After the intervention the improvement of the quality of compilation was modest and regarded mainly medical rather than surgical wards. DISCUSSION AND CONCLUSIONS: The improvement was not satisfying since from a medical and a legal point of view the indicators should reach 100% of clarity and completeness. A further study is being carried out to improve the involvement of health care professional, so that such requirements will be perceived as a common goal, not as mere bureaucratic initiatives.

[Quality of medical records in Naples (Italy) 2nd University School of Medicine]. / Qualità di compilazione delle cartelle cliniche nell'Azienda Ospedaliera Universitaria di Napoli.

To evaluate and improve the quality of medical-record keeping, in clinics and surgery departments. The evaluation involved 66 Operative Units (O.U.) of the "2nd University Hospital" in Naples (Italy). 10 medical records for each O.U. were randomly selected, for a total of 660. The quality was evaluated in all sections of medical records using the criteria of completeness, clarity and traceability of the data. The most critical issues are: unclear handwriting in almost all sections, in the whole scarse presence of a discharge letter (17.0%) in surgery (1.4%), almost total absence of the physicians signature in the clinical diary (2.3%). The completeness of medical records (presence of patient's history, physical examination, informed consent) is significantly higher in the surgery departments. The medical records are significantly righter in the clinic departments. In general, a poor quality of medical-record keeping was detected. This indicates the need to improve the quality by involving the staff in the importance of correct compilation.

[In vivo dosimetry and radiographic confirmation in radiotherapy of Hodgkin's lymphoma]. / Dosimetria in vivo e verifica radiografica nella radioterapia del linfoma di Hodgkin.

In September 1991 a protocol for quality control of large shaped irradiation fields was started in our department. In vivo dosimetry with semiconductor detectors was used to measure the absorbed dose and patient positioning was checked with portal films weekly. First, we set a computed dosimetric system yielding dosimetric values in real time and allowing their easy storage. Then, we calibrated the diodes and determined the correction factors for each of them outside standard conditions. Entrance dose, exit dose and midline dose were measured in 62 patients undergoing supradiaphragmatic radiation therapy for Hodgkin's lymphoma. The exist dose was measured weekly to assess treatment repeatability. High agreement was observed between measured and calculated doses; repeatability was also high, since only 6% of exit dose measurements exceeded 5% of the first determination. In 33 patients portal films were obtained in the first treatment session, and thereafter weekly, to assess mispositioning relative to simulation (reproducibility) and from one session to another (repeatability). A small systematic error was detected in both longitudinal (x = -3 mm; SD = 3.7 mm) and transverse (x = -2 mm; SD = 3.4 mm) directions. Statistically significant errors (> 6 mm) were observed in 14% of patients. Reproducibility was excellent. The protocol reported on in this paper not only helps avoid systematic dosimetric and/or positioning errors in the patients, but also helps identify the main causes of uncertainty and thus remove them.