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Enhancing Employee Well-being through Flexible Work Arrangements

Topic is Enhancing Employee Well-being through Flexible Work Arrangements 

Locate the “Prospectus Template” on the DC Network and download either the quantitative or qualitative template depending on your selected methodology. This assignment requires the inclusion of at least two scholarly research sources related to this topic and at least one in-text citation from each source. Based on the methodology of your potential dissertation topic, select the appropriate prospectus template: “Quantitative Prospectus PPT” or “Qualitative Prospectus PPT.” Revise/complete the following template slides to describe and defend your potential study. Your choices must be defended with relevant current research. Proposed Dissertation Topic Title My Topic is Enhancing Employee Well-being through Flexible Work Arrangements Alignment Table (fill in from corresponding slides below). Note: The purpose statement box is not required for this assignment. Literature Review: Background to the Problem Literature Review: Problem Space Literature Review: Theoretical Foundations Literature Review: Review of Literature Problem Statement Variables (if quantitative) or Phenomenon (if qualitative) Research Questions (and Hypotheses if quantitative) Methodology Justification. Note: Include a rationale for not choosing the other methodology. Design. Note: Complete the entire table per the slide requirements. Feasibility.

1.     Proposed Dissertation Topic Title Must be 12 words or less 2.     Alignment Table (fill in from corresponding slides below). Note: The purpose statement box is not required for this assignment. 3.     Literature Review: Background to the Problem 2-3 paragraphs written GCU style: no citation in the first sentence (topic sentence), supporting citations and no citation at end of the paragraph. This is to be about the history of the issue. For your final Proposal, this section will be the history of the research on the issue. 4.     Literature Review: Problem Space Your 5 empirical articles from 2020-23 and each written following this formula: Citation, “conducted a (method/design) study with (# participants) to investigate (what) and found (what). The recommendation for further research was (what?). 5.     Literature Review: Theoretical Foundations: graphic of the theory you are using with an arrow to the parts you are choosing. (If quant—this theory comes from the instruments and you are using the entire theory). Author of the theory and citation 6.     Literature Review: Review of Literature: list only the topics—you do not need to start to populate the topics yet. But if you have started—go ahead and include. NOTE: these topics must align with either your variables (quant) or theory (qual) 7.     Problem Statement: Align with the method you are using 8.     Variables (if quantitative) or Phenomenon (if qualitative) Use the feedback from previous assignments 9.     Research Questions (and Hypotheses if quantitative) 10.   Methodology Justification. Two cited definitions for EACH method; summary for each method “this method is most appropriate when…”; AND 1-3 studies on your topic that are recommending further research using your method. 11.   Design. Qual: all five designs; Quant: all six designs. TWO cited definitions for each with a summary: “This design is most appropriate when… 12.   Feasibility:  Follow the prompts that are listed in the notes section of the PPT

My draft from previous assignment Enhancing Employee Well-being through Flexible Work Arrangements       

Introduction    

Business-related pressure, burnout, and the battle to balance serious and fun activities have become huge difficulties in current working environments. Associations have gone to adaptable work plans, like working from home and strategic scheduling, to resolve these issues (Weideman & Hofmeyr, 2020). In any case, the effectiveness of adaptable work game plans in further developing representative prosperity remains unsure.

The Existence of the Problem and the Need for Additional Research

Ongoing investigations have featured the pervasiveness of business-related pressure, burnout, and diminished balance between serious and fun activities among workers, stressing the need to resolve these issues. Organizations have recognized the significance of offering work flexibility to mitigate the difficulties posed by today’s workplace requirements (Ab Wahab and Tatoglu, E. (2020). Adaptable work courses of action, like working from home, strategic scheduling, packed work-filled weeks, and occupation sharing, offer representatives more prominent command over their plans for getting work done and areas, taking into account further developed work-life reconciliation.

However, regardless of the rising adoption of adaptable work courses of action, the viability of these practices in further developing representative prosperity stays uncertain. While certain investigations have announced positive results, such as decreased pressure and expanded work fulfillment, others have found blended results or adverse consequences on representative prosperity (Weideman & Hofmeyr, 2020). These irregularities feature the requirement for additional examination to comprehend the effect of adaptable work plans on representative prosperity and recognize best practices for execution. 

Furthermore, the research questions probe into the mechanisms and contextual factors surrounding this phenomenon. For instance, “How do flexible work arrangements affect work-life balance and stress levels amongst employees?” and “Are there generational or demographic transformations in the insight of flexible work arrangements on employee well-being?” investigate into the fundamental processes and possible variations in the impact of flexible work arrangements. The questions help uncover the nuances and complications associated with the phenomenon, auxiliary addressing the problem statement (Mache et al., 2020). The research questions are designed to systematically investigate the problem statement’s concerns concerning the impact of flexible work arrangements on employee well-being, cracking light on the phenomenon’s numerous facets and causative to a more inclusive understanding of this important workplace issue.

How might the answers to the research questions inform the problem space?

The answers to the research questions may considerably inform the problem space by offering an all-inclusive understanding of the link between flexible work arrangements and employee well-being. Perceptions gained from the research may direct organizations in tailoring their policies and practices to enhance well-being, which is particularly crucial in the context of evolving workplace dynamics. Knowledge of the most operative types of flexible work arrangements may help organizations make informed decisions on which options to offer, leading to advanced employee satisfaction and retaining. Understanding how flexible work arrangements impact work-life balance and stress levels can inform beleaguered interventions to alleviate stress and improve work-life coordination (Mache et al., 2020). Likewise, identifying generational or demographic differences in employees’ discernments can help organizations implement inclusive and impartial policies. The research findings may directly shape the problem space by offering actionable information for organizations to augment their approach to flexible work arrangements, eventually fostering a healthier and more fruitful workforce.

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Theoretical foundation that will ground the study

The study on is grounded in the Job-Demands-Resources (JD-R) Model, which hypothesizes that employees’ well-being is affected by job demands and job resources. Flexible work arrangements, including teleworking, flexible hours, and compacted workweeks, can be viewed as valuable job resources that enable employees gain greater autonomy and control over their work. According to the JD-R Model, these arrangements can alleviate the negative effects of job demands, like high workload and job-related stress, finally leading to improved employee well-being (Ray and Pana, 2021). By investigating how flexible work arrangements affect employees’ perceptions of job demands, resources, and their general well-being, the study seeks to contribute to the existing body of research on work-related well-being and offer insights into how establishments can successfully utilize flexible work arrangements to augment the health and satisfaction of their workforce.

Key concepts/Constructs of the study

The theoretical foundation and conceptual framework for the study on “Enhancing Employee Well-being through Flexible Work Arrangements” comprise several essential concepts and constructs. The first one is Flexible Work Arrangements (FWAs). The core of the study, FWAs encompass various methods such as telecommuting, flextime, and compressed workweeks, allowing employees to have more control over their work schedules and locations. The second one is Employee Well-being. This multifaceted construct represents the overall health and satisfaction of employees, encompassing physical, emotional, and psychological dimensions, including job satisfaction, work-life balance, and stress levels.

This is followed by Job-Demands-Resources (JD-R) Model. In this case, a theoretical framework that introduces the concepts of job demands and job resources to explain their effects on employee well-being, with FWAs acting as potential resources to mitigate job demands. The other one is Self-Determination Theory (SDT). This puts a lot of emphasis on intrinsic motivation, SDT inspects how autonomy, competence, and relatedness can influence employee well-being and how FWAs might contribute to fulfilling these needs. The other one is Social Exchange Theory.  This is a concept that explores the reciprocal dynamics in social relationships, suggesting that employees may respond positively to organizations offering supportive work arrangements like FWAs through increased commitment and well-being. The last one is Positive Psychology. Rooted in positive emotions, engagement, and meaning, positive psychology principles are applied to understand how FWAs may contribute to enhanced employee happiness and satisfaction.

Generational and Demographic Differences: Acknowledging the influence of factors such as age, gender, and demographics on employee perceptions and experiences of FWAs, this aspect adds depth to the analysis, allowing for a nuanced understanding of the impact of FWAs on diverse employee groups. The key concepts and constructs cooperatively form the underpinning of the study, guiding the investigation into how FWAs affect employee well-being and the fundamental mechanisms inside the affiliation.

Explain how the theories or conceptual frameworks guide the research topic identified from the problem space

The selected theories and conceptual frameworks play a very significant role in guiding the research topic acknowledged from the problem space. For instance, in this study, the Job-Demands-Resources (JD-R) Model directs the examination by helping identify the specific job demands and resources related to flexible work arrangements (FWAs) and how the elements affect employee well-being. Self-Determination Theory (SDT) offers insight into the mental aspects of motivation and autonomy, helping elucidate why and how FWAs might impact employees’ well-being. Social Exchange Theory directs the exploration of the mutuality between employees and organizations when it comes to FWAs, shedding light on the possible benefits and costs involved. Positive Psychology philosophies give a lens through which to inspect the positive emotional and engagement aspects of well-being associated with FWAs. The frameworks cooperatively inform the research’s structure, theories, and understanding, ensuring a comprehensive understanding of the topic within the problem space.Top of Form

Defend why the theoretical foundation or conceptual framework was selected over other alternatives.

The chosen theoretical foundation and conceptual framework were chosen over other alternatives because they offer a holistic perspective and a well-established basis for comprehending the complex relationship between flexible work arrangements (FWAs) and employee well-being. The Job-Demands-Resources (JD-R) Model, Self-Determination Theory (SDT), Social Exchange Theory, and Positive Psychology principles cooperatively offer a comprehensive framework that considers psychological, social, and organizational aspects of the topic. The frameworks are widely recognized and expansively studied, making them well-suited for guiding research in this field and ensuring the robustness and reliability of the study’s findings.

Relationships between the components

The components of the selected theoretical foundation and conceptual framework are inter-linked in a way that improves our comprehension of the research phenomenon. The Job-Demands-Resources (JD-R) Model identifies job demands and resources related to flexible work arrangements (FWAs), explicating their effects on employee well-being. Self-Determination Theory (SDT) helps expound the psychological areas of motivation and self-sufficiency, skimpy why and how FWAs influence well-being. Social Exchange Theory guides the examination of the reciprocal dynamics between employees and organizations in the context of FWAs. Positive Psychology philosophies offer insights into the positive emotions and engagement linked with well-being through FWAs. Together, the constituents offer a comprehensive and nuanced understanding of how FWAs affect employee well-being, considering psychological, social, and organizational magnitudes.

Problem Framing: Size and Scope of the Problem

The issue undermining the study involves analyzing the effect of adaptable work game plans on representative prosperity. Work-related stress, burnout, and poor work-life balance between serious and fun activities have huge ramifications for the two people and associations. Representatives encountering these difficulties are bound to experience the ill effects of diminished work fulfillment, decreased efficiency, and expanded turnover rates (Weideman & Hofmeyr, 2020). In addition, the negative effects can impact overall organizational outcomes like employee engagement, organizational commitment, and performance beyond the individual level.

The size and extent of the issue are significant, taking into account the rising pervasiveness of adaptable work game plans and the rising interest in work-life joining. With the fast development of remote work because of mechanical progressions and the COVID-19 pandemic, associations need to comprehend how various kinds of adaptable work game plans impact representative prosperity. This understanding is imperative for associations to foster successful methodologies that advance representative prosperity, keep up with efficiency, and encourage a positive workplace (Ray & Pana-Cryan, 2021). 

Variables Derived from the Problem Space

In this quantitative study, two key factors have been identified: flexible work arrangements and employee well-being. Employees can choose from flexible work options that give them more control over their work schedules and locations (Rozlan & Subramaniam, 2020). These choices incorporate working from home, which permits representatives to work remotely; strategic scheduling, which empowers representatives to have adaptable beginning and end times; compacted work-filled weeks, which include working longer hours on fewer days; furthermore, work sharing, where at least two representatives share the obligations of a solitary position. These various kinds of adaptable work courses of action are fundamental to looking at their effect on representative prosperity.

The concept of employee well-being is multifaceted and includes a variety of aspects of an individual’s overall well-being. Regarding this review, representative prosperity incorporates aspects, for example, actual well-being, mental prosperity, balance between serious and fun activities, work fulfillment, and personal satisfaction. These aspects mirror the comprehensive idea of prosperity and catch the key regions impacted by business-related pressure, burnout, and diminished balance between serious and fun activities (Ray & Pana-Cryan, 2021).

The issue space upholds these factors by featuring the difficulties representatives face in balancing fun and serious activities and the likely advantages of adaptable work game plans in tending to those difficulties. The pervasiveness of business-related pressure and burnout and the adverse consequence of balancing fun and serious activities highlight the need to examine the connection between adaptable work plans and representative prosperity. By looking at these factors, the review expects to give experiences into how various sorts of adaptable work courses of action can impact different elements of representative prosperity.

Concise and Focused Problem Statement

“The issue of work-related stress, burnout, and reduced work-life balance between fun and serious activities has become progressively prevalent, requiring the investigation of the effect of adaptable work game plans on representative prosperity. This quantitative review intends to explore the connection between various kinds of adaptable work plans and different components of representative prosperity, giving experimental proof and commonsense suggestions for associations to improve representative prosperity and advance supportable workplaces.”

By acknowledging the problem’s statement and the need to comprehend the impact of flexible work arrangements on employee well-being, this problem statement effectively addresses the problem space. It expresses the review’s goal: to examine the connection between adaptable work courses of action and representative prosperity across numerous aspects (Ray & Pana-Cryan, 2021). The articulation of the issue also underlines the meaning of the concentrate by featuring its capability to give exact proof and functional suggestions for associations looking to develop representative prosperity further and establish reasonable workplaces.

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Discuss its effect on adolescent behavior and overall well-being

Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission: 

Describe the contemporary issue and explain what external stressors are associated with this issue. 

Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian. 

Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.  

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.   

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.  Within text citation and references please paraphrase to avoid plagiarism 

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How the Fed uses money, and what happens when there is money but it is not being spent

Overview

In this Case Assignment, we will be answering questions about types of money, how the Fed uses money, and what happens when there is money but it is not being spent. This is a multi-part assignment, so make sure that you have addressed each question or topic. The best way to approach this assignment is to prepare your responses in outline form following the order of each question/topic. This will help you keep track of your responses.

Review this brief introductory video which provides a high level overview of the Fed and how it influences the money market.

Case Assignment

Submit a 4- to 5-page paper that addresses the following questions. Be sure to use references within the paper to support your answers.

Are credit cards or debit cards money? Explain your answer.

“When the Fed makes an open market purchase of government securities, the quantity of money will eventually decrease by a fraction of the initial change in the monetary base.” Is the previous statement correct or incorrect? Explain your answer.

Monetary policy is action taken by the Fed to influence the level of real GDP. Suppose the Fed wants to increase the money supply. What three tools could the Fed use to achieve this goal? Be specific in your answer and discuss the implications of this policy.

Assignment Expectations

Use concepts from the modular background readings as well as any good quality resources you can find. Cite all sources within the text and provide a reference list at the end of the paper.

Length: 4–5 pages double-spaced and typed in 12-point Times New Roman font.

The following items will be assessed in particular:

Your ability to understand an application of monetary policy.

Some in-text references to the modular background material. APA formatting is recommended. Use this site from the Purdue Owl if you need help with APA: https://tinyurl.com/3rnc5vt.

The essay should address each element of the assignment. Remember to support your answers with solid references, including the Case readings

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current article related to a patient’s rights being violated by a health care provider

Instructions

Negligence

Review a current article related to a patient’s rights being violated by a health care provider. The article can be taken from a wide variety of journals, magazines, and newspapers, such as Hospitals, National Law Journal, Business Week, Newsweek, Time, and The New York Times. You can also choose an article from the CSU Online Library.

  • Provide a summary of the article.
  • Discuss the facts of the case.
  • Indicate whether the violation was an example of negligence or an intentional tort. Explain your reasoning.
  • Discuss the outcome, and state if you agree or not and why or why not.
  • Explain the responsibility of health care providers to protect their patients from harm.
  • State three lessons to be learned from the case.

Use subheadings for each of the sections to be discussed.Your review of the article must be at least two pages in length and use at least three sources, including the article being reviewed. One source must come from the CSU Online Library. Adhere to APA Style when constructing this review, including in-text citations and references for all sources that are used. Please note that no abstract is needed.

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How can we use classList methods to change the CSS being displayed?

For this project, you will be writing most of your code in js/app.js

Rubric Tip: All the points mentioned below will help you to satisfy the criteria for the project rubric. Please make sure to re-review the rubric for detailed project requirements prior to submission.
Start by linking your app.js.
Build out your HTML and at least 4 content sections. The rest of your functionality relies on these sections.
Take a quick look at all the HTML elements in index.html. Note the values for their id, class, and data attributes.
Think about how you can create, say, an unordered list (i.e., bulleted list) in HTML from this structure, and where you be placing that list.
Think about how you’ll test whether a section is in the viewport.
What actions are you performing that will cause interactivity with the DOM?
Build the navigation menu.
Add functionality to distinguish the section in view.
How can we use classList methods to change the CSS being displayed? What about removing that CSS?
Add the functionality to scroll to sections
Add an active state to your navigation items when a section is in the viewport.
Detect the element location relative to the viewport using .getBoundingClientRect() built-in function.
Set CSS class active state when the element is in the viewport

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State the name of the article you found and that is being evaluated and who the author(s) is/are

By far, the type of writing that we encounter, both in secular and academic settings, fall in the category of being “informational/Observatory”. The intent of research writing is different – research writing is usually centered around advancing understanding of a topical problem/issue, and for a “community”. Research writings, therefore, leverage the work of prior research or it opens a discussion around a current topic. In either case, such writings follow a streamlined format that is familiar to researchers. This format, typically, contain components such as: Title, Abstract, Introduction, Method, Results, Future Works, etc. (see example research paper under this week’s Learning Materials section). The purpose of your assignment this week is for you to examine components of a research article and to identify guidelines for conducting critical analyses of published works. The knowledge gain here should be applied when completing your Week 14 research writing assignment.  As you complete any writing assignment it is a good idea to proof read your work or use the University Writing Center to help with APA formatting; both will assist in minimizing grammatical errors and improve conducting research. 

Your Assignment:

Find a research article – Mobile technology preferred; but any technology topic is acceptable. A research effort is usually placed in the context of a “business problem” that can be understood in terms of carefully designed research questions; this allows for maximum research, understanding, and participation around resolving the problem.

Write a four – six (4-6) page paper that evaluates the research article that you found – your paper should be: typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. See hand-outs provided on graduate and APA style research papers. 

Evaluation criteria – notice what specific research components (Title, Abstract, Method, etc.) are found in the article

  • State the name of the article you found and that is being evaluated and who the author(s) is/are.
  • What is this article about – talk about its context (what is the topic; its purpose, and significance to what/whom)?
  • What components of a research format is included in this article?
  • How does this format contribute to the purpose of the writing?
  • Do the author(s) use this format in a way that furthers research – what other component(s), if any, might be helpful to that purpose?
  • What makes research writing different than ordinary information/observation writing?
  • Identify and explain major components of a research paper format.
  • Why use peer-reviewed journals in research?
  • Why are keywords used in the Abstract and during the Literature Review process?
  • Why use/apply APA basic citation style in these writing assignments?
  • Why is academic integrity important (see syllabus)?

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A merger-related current best practice or trend that is being successfully employed by HR departments

Overview

Company mergers are very busy and challenging times for corporate leadership. The role that HR plays during a merger is often complex and far reaching. In this assignment, you write an executive brief that considers aspects of how an HR department might prioritize and operate to support the union of two companies. 

Preparation

How to Brief an Executive

There is no single correct way to brief an executive or other stakeholder. The final deliverable is your choice, but effective briefs have common elements; they should be clear, concise, relevant, well-structured, and provide decision-making information. Here are a couple of resources you may use to get started:

Scenario

Imagine that Anchor Hospital, a 250-bed medical center, is merging with the similar-sized Saint Mary’s Hospital to better serve the needs of their metropolitan community. An administrative board has been formed to guide all aspects of the merger. They have asked all departments to submit an executive brief that states their roles, intended model of operations, and initial steps to build interdepartmental relationships. 

The board’s primary concern for HR is how it will manage the merging of the workforces into a single, cohesive, and effective team. They want to understand HR’s primary role, guiding principles, and application of current practice. Specifically, they want your vision for the following:

  • A merger-related current best practice or trend that is being successfully employed by HR departments.
  • HR’s primary role in assimilating the workforces for the two hospitals.
  • The HR management model to be followed.
  • How to foster relationships between HR and department managers.

Instructions

Write a 3–4-page executive brief that address the following merger-related items:

  1. Recommend a relevant HR trend or practice that would be useful to consider as part of this merger. Justify your recommendation.
  2. Analyze HR’s primary role(s) as a strategic corporate partner in merging the workforces of the organizations. 
  3. Recommend an HRM model that would effectively steer the joining of each organization’s employees into a single, cohesive workforce. Justify your recommendation.
  4. Recommend two initial steps that HR should initiate to develop an effective relationship between HR and management. Justify your recommendation.

Additional Requirements

  • Resources: Use four sources to support your writing. Choose sources that are credible, relevant, and appropriate. Cite each source listed on your source page at least one time within your assignment. For help with research, writing, and citation, access the library or review library guides

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Starting around 1972, Computed Tomography is consistently being created phenomenally, eminently with the assistance of software engineering

 Introduction:

Starting around 1972, Computed Tomography is consistently being created phenomenally, eminently with the assistance of software engineering, which has permitted making exceptionally exact diagnostics. CT advancement went through a few phases, from the model of Hounsfield to going through the consecutive and helical modalities. This advancement made CT a vital assessment in radiology (Kanne & Lin, 2018). In any case, this radiological strategy is the most lighting contrasted with different procedures; it can convey a portion of 50-500 times more prominent than a standard radiological assessment. Some patients can have life-altering effects after having a CT scan, but others oppose having the scan done, due to cancer risk. Studies have shown that the scan has a low risk of cancer-causing agents in the body (Pontone, G). To assess the danger to patients from CT checks, a gauge of the dose delivered to the skin and organs of a patient is fundamental. A need in this way exists to decide proper dosimetric amounts, for example, the organ dose and peak skin dose (PSD) (De las Heras).

The Federal Drug Administration (FDA) states that the Peak Skin Dose is the “highest radiation dose accruing actually at a single site on a patient’s skin.” Knowing the appropriate highest dosage is vital so that no harm is caused to the patient. The United States has regulated that the” fluoroscopic system provides a display of the irradiation time, dose rate at the interventional reference point during irradiation, and the cumulative dose for the procedure upon completion of irradiation” (Pontone, G). In preparation for actual patients, technologists and physicists would revert to the manufactured dose estimation which is called the Computed Tomography Dose Index (CTDI). The CTDI is generally utilized for quality control including the radiation output of CT machines. Specifically, the volume CTDI is shown on the control center of all CT machines and is promptly accessible to the administrator. In any case, the CT Dose Index (CTDIvol) was originally designed as an index of dose associated with various CT diagnostic procedures, not as a direct dosimetry method for individual patient dose assessments.

Moreover, CTDIvol is reported in two units: a 16-cm phantom for head exams or 32-cm phantom or body exams. The relationship between the CTDIvol and airiest dose depends on various factors, two of which are the patient size and composition. CTDIvol is displayed on the console of CT scanners, and it gives genuine estimates of the dose being delivered to patients and can serve to approve Monte Carlo recreations (Jones, A. Kyle). Specifically, estimating Peak Skin Dose is ideal since it is a surely known dosimetric amount that directly identifies with radiation-incited skin wounds. Besides, estimation estimates of PSD values, utilizing appropriate phantoms can without much of a stretch be made across all types of CT units and scan protocols accessible in clinics (Tack & Gevenois, 2018). This is significant for comparing doses for a similar CT examination in different facilities, which can change fundamentally. More recently, modifications to the original CTDI concept have attempted to convert it into to patient dosimetry method, but have mixed results in terms of accuracy.

Nonetheless, CTDI-based dosimetry is the current worldwide standard for estimation of patient dose in CT. Therefore, CTDIvol is often used to enable medical physicists to compare the dose output between different CT scanners. Also, since CTDIvol estimates the patient’s radiation exposure from the CT procedure, the exposures are the same regardless of patient size, but the size of the patients is a factor in the overall patient’s absorbed dose (SSDE). The size-specific dose estimate (SSDE) is measured in mGy, and it is a method of estimating CT radiation dose that takes a patient’s size into account.

From a radiation protection point of view, determining the maximum dose delivered to the skin would allow deriving quantities that can be compared with dose reference levels set by national and international standards. The most important outcome from a radiation safety perspective is evaluating if a radiation injury had occurred quickly (NCRP Report 116.) In this research, the peak skin dose delivered to a patient was estimated experimentally by measuring the dose delivered to the surface of the NEMA phantom and 32 cm CTDI phantom using external dosimeters. These dosimeters will provide PSD values for a given protocol and its related CTDIvol. From this, a relationship can be evaluated between both quantities. The aim of this project was to test the hypothesis that the size-specific dose estimate (SSDE) has a sufficiently strong linear relationship with PSD to allow direct calculation of the PSD directly from the SSDE.

Materials and Methods:

The measurements were performed with a Siemens 64 slices, Biograph mCT. A comparison was made between the CTDIvol value displayed on the CT console and the measured CTDIvol value using the AAPM protocol. For every examined scanner, the CTDIvol was obtained from scans in an axial mode for head scans and helical mode of the routine pelvis, cervical spine, abdomen, and thoracic scans using the scan parameters as shown in Table 1. The corresponding CTDIvol displayed on the console was recorded as shown in Table 1.

Peak Skin Dose was estimated by using Nanodots dosimeters (International Specialty Products, Inc., Wayne, NJ, USA) which have optically stimulated luminescence (OSL) technology which is a single point radiation monitoring dosimeter. It is a useful tool in measuring the patient dose, and it is an ideal solution in multiple settings, including diagnostic radiology, nuclear medicine, interventional procedures and radiation oncology (LANDAUER).

Nanodots dosimeters also have minimal angular or energy dependencies with appropriate calibration which can be used to measure skin dose at a point of interest. Moreover, LANDAUER provides a set of calibration dosimeters exposed at a beam quality of 80 kVp on a PMMA phantom at normal incidence for conventional (non-mammography) diagnostic radiology applications. For radiation oncology applications, LANDAUER provides a set of screened, unexposed calibration dosimeters that can be irradiated using a radiation therapy beam quality. Another way for calibration is to request a dosimeter set exposed to a 662 keV beam quality (Cs-137).

The Nanodot dosimeters were placed on three different locations (Anterior-Posterior, Lateral (LAT) and Posterior-Anterior) as shown in figure 1, and the dose to the skin was measured at these locations.

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Diagram, schematic  Description automatically generated

3

CT TABLE

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Figure1: The phantoms in the middle of the CT scan and 1 is the AP location, 2 is the LAT location and 3 is the PA location.

Experimental set-up and procedure:

The CTDIvol displayed by the scanner was validated to the true CTDIvol following the ACR testing guidelines. A correction factor was used to correct the inaccuracies in the displayed value. This correction was applied to the DLP displayed by the scanner.

Peak skin dose and its relation were measured by the 2 phantoms, and the phantoms were aligned at the isocenter of the scanner and a single axial CT scan was made. After placing the Nanodot dosimeters on the AP, LAT and PA locations, the phantoms were scanned over the scan length for a fixed value of the tube current. The measurement was repeated several times using various scanning techniques (with varying energy, current) as shown in table 1. Size conversion factors used were based on the dimension of the phantom being scanned. These K-factors with the CTDIvol produced the size-specific dose estimates (SSDEs), and since the CT dose index was provided at the CT scanner too, the size-specific dose estimate for the phantoms was calculated. Also testing if the correlation between the size-specific dose estimate and the measurement of the peak skin dose match was done, and since such a relationship exists, finding that factor was achieved.

Results:

After measuring the Peak Skin Dose and Size Specific Dose Estimates (SSDE), a comparison was done. The SSDE was calculated using the corresponding k-factor based on the AP and lateral dimension from TG204 and the CTDIvol value which was displayed on the console (SSDE = CTDIvol x K factor).

The conversion factor based on the use of the 32 cm diameter NEMA phantom for CTDIvol was 1.35 for the AP and PA locations, and the conversion factor for the Lat location was 1.55. Also, the AAPM Report 204 stated that the conversion factor based on the use of the 16-cm diameter ACR phantom was 0.89 for the three locations.

Figure 1: The graph illustrates the relationship between Peak Skin Dose in AP location and the Size Specific Dose Estimates in AP location in 32 cm NEMA phantom and 16 cm ACR phantom.

The figure above illustrates the measured PSD in AP location against the SSDE in AP location with using 2 different phantoms (32-cm NEMA phantom and 16-cm ACR phantom). For both phantoms, there was linear relationship between the size specific dose estimates and the peak skin dose. In this study an R-squared value was used to value the data in the graphs and to tell how accurate the line is. In this study, the R-squared value was 0.21 which indicate that 21% of the variance of the dependent variable being studied is explained by the variance of the independent variable. Therefore, the relationship between the PSD in AP location and the SSDE in AP location has a weak correlation.

Figure 2: The graph demonstrates the relationship between Peak Skin Dose in PA location and the Size Specific Dose Estimates in PA location in 32 cm NEMA phantom and 16 cm ACR phantom.

The second figure demonstrates the measured PSD in PA location against the SSDE in PA location. For both phantoms, there was linear relationship between the size specific dose estimates and the peak skin dose. In this graph, the R-squared value was 0.66. Therefore, the relationship between the PSD in PA location and the SSDE has a moderate positive relationship, so a correlation might occur.

Figure 3: The graph illustrates the relationship between Peak Skin Dose in Lateral location and the Size Specific Dose Estimates in Lateral location in 32 cm NEMA phantom and 20 cm ACR phantom.

The third figure illustrates the measured PSD in the lateral location against the SSDE in Lateral location. For both phantoms, there was linear relationship between the size specific dose estimates and the peak skin dose. In this graph the R-squared value was 0.61 which indicated that there was a moderate positive relationship between the PSD in lateral location and the SSDE in lateral location.

In all the plots, linear relationship between the PSD and SSDE was found, and the linear fitting equation was calculated by Excel. (SSDE = 3.4827 x (PSD) + 5.522), this was the fitting equation for the AP location graph (1st graph). However, since there was a weak correlation between the PSD and SSDE in the AP location, calculating the SSDE will not be accurate.

(SSDE = 6.7198 x (PSD) + 2.1234) and (SSDE = 8.2489 x (PSD) + 2.3624), Those two linear fitting equations were for the PA location graph (2nd graph) and lateral location graph (3rd graph) respectively. Both equations have a moderate positive relationship. Therefore, predicting the value of SSDE or PSD will be possible but not 100% accurate. With using these data and fitting equations, a physicist can estimate the PSD, but with some limitations. The physicist would be within 30% the true dose estimates and a large error would be there as well. The regression was almost 65% in both locations, so roughly 65% of the data points will fall close to the linear line.

Other trend line equations such as exponential, logarithmic, polynomial and power were tested to evaluate the measured PSD and SSDE, but the linear fitting equation was the only one that the line fitted with the data.

Discussion:

The anterior Peak Skin Dose was different in the AP and LAT locations comparison with the lateral location which is because the thickness of the phantom. Considering that examination is performed in the lateral location of the body which has the highest x-ray attenuation, thus requiring higher beam energy to penetrate. With increasing the patient average diameter, the peak skin dose was higher. According to the data that was measured, the measured PSD was higher in all the lateral location than the AP and PA locations. The bigger the phantom (more tissue to penetrate), the more dose was required to attenuate and reached the dosimeter.

In the is study the AP and lateral dimensions of the phantom were used to measure the SSDE which is a factor that is used to estimate the absorbed dose. This could’ve been an error in measuring the peak skin dose since the SSDE was not measured at that time. Also, there was a linear relationship between the PSD and the SSDE because the Size Specific Dose Estimates dictate the patient’s dose and this could be one of the reasons that the linear relationship occurred. Also, there could be better modifications to the K-factors in order to dictate the patient’s more accurately.

When calculating how much radiation dose a patient is actually receiving, it’s best to consider their actual size. CTDIvol and DLP are common methods to estimate a patient’s radiation dose from a CT procedure. The dose is the same regardless of patient size, but the size of the patients is a factor in the overall patient’s absorbed dose. Therefore, SSDE measured in mGy, would allow the physicists to use the patient’s size as a factor in order to estimate the radiation dose. In the other hand the PSD is the maximum absorbed dose in mGy to the most heavily exposed region of the skin in specific location. In this study, the measured values of the PSD and SSDE had a linear relationship in most projections (C-spine, thoracic and pelvis). The higher the PSD was, the higher the SSDE which was due to the measured CTDIvol which displayed in the console (the higher the CTDIvol was, the higher SSDE was calculated).

There is different between the CTDIvol that was shown on the console and the actual CTDIvol. The CTDIvol or its derivative the DLP, as seen on consoles and outputted, do not represent the actual absorbed or effective dose for the patient. They should be taken as an index of radiation output by the system for comparison purposes. In this study, it is not possible to compare the true CTDIvol to the displayed because the phantoms that were used were not CTDI phantoms, so it is not possible to place a CTDI probe.

However, nowadays many modifications to original CTDI concept have attempted to make it more accurate patient dosimetry method, with mixed results. Body CTDIvol reported by the CT scanner, or measured on a CT scanner, is a dose index that results from air kerma measurements at two locations, to a very cylinder of plastic phantom with a density of 1.19 g/cm3 (Morgan, M. 2021).

According to the measured data, some scan projections such as abdomen had high PSD and high SSDE due to the high measured CTDIvol and DLP caused out wire and low regression. Taking out the abdomen PSD and SSDE from the graphs make the regression higher (more positive) which means correlation could exist. Therefore, some projections such as an abdomen and head might make the data points and graphs not clear and hard to be read.

When graphing the measured PSD and SSDE in each phantom separately, a higher regression (more positive correlation) was found (close to 90%) in all the three locations. This means that the closer the patient to become cylindrical, the better relationship between PSD and SSDE will be and more accurate doses will be measured. It fails at very large effective circumferences with perfectly cylindrical patients.

Conclusion:

The results showed there is a moderate positive relationship in both PA and lateral locations, so there might be a correlation between the PSD and SSDE. There is some promises in Posterior and Lateral angles because the higher the PSD was, the higher the SSDE was in most projections. The measured PSD and SSDE showed that a physicist can estimate the PSD within 30% the true dose estimates with a large error due to the moderate positive relationship.

Further studies with more data should be done to prove or decline the hypothesis. In this study, only two phantoms were used (NEMA and ACR phantoms) with 32 cm and 16 cm thicknesses, so other phantoms such as anthropomorphic phantoms and fake human phantoms with different thickness styles could be used to get better data and correlation.

In this study, only 8 measurements were taken in the three different location due to the limitation of the Nanodats. More measurements could have been taken and a better data points would have been measured. With more date testing if the SSDE has a sufficiently strong linear relationship with PSD could be done.

Reference:Jones, A. K., Kisiel, M. E., Rong, X. J., & Tam, A. L. (2021). Validation of a method for estimating peak skin dose from CT‐guided procedures. Journal of applied clinical medical physics.Pontone, G., Scafuri, S., Mancini, M. E., Agalbato, C., Guglielmo, M., Baggiano, A., … & Rossi, A (2021). Role of computed tomography in COVID-19. Journal of cardiovascular computed tomography, 15(1), 27-36.De las Heras, H., Minniti, R., Wilson, S., Mitchell, C., Skopec, M., Brunner, C. C., & Chakrabarti, K. (2013). Experimental estimates of peak skin dose and its relationship to the CT dose index using the CTDI head phantom. Radiation protection dosimetry157(4), 536-542.Tack, D., & Gevenois, P. A. (2018). Radiation dose from adult and pediatric Multidetector computed tomography. Springer Science & Business Media.Coy, D., Kanne & Lin, E. (2018). Body CT the essentials. McGraw-Hill Education / Medical.Moniruzzaman, M., & Hossain, A. (2018). Pediatric and adult body CT examinations: Size-specific effective dose estimates in pediatric and adult body CT examinations for Polymethyl Methacrylate phantom. LAP Lambert Academic Publishing.Zhang, D. et al.Peak skin and eye lens radiation dosefrom brain perfusion CT based on Monte Carlo simula-tion. AJR 198, 412–417 (2012).Zhang, D. et al.Peak skin and eye lens radiation dosefrom brain perfusion CT based on Monte Carlo simula-tion. AJR 198, 412–417 (2012).Zhang, D. et al.Peak skin and eye lens radiation dosefrom brain perfusion CT based on Monte Carlo simula-tion. AJR 198, 412–417 (2012).Zhang, D. et al. Peak skin and eye lens radiation dose from brain perfusion CT based on Monte Carlo simula- tion. AJR 198, 412–417 (2012).McCollough, C. H., Leng, S., Yu, L., Cody, D. D., Boone, J. M. and McNitt-Gray, M. F. CT dose index and patient dose: they are not the same thing. Radiology 259(2), 311 – 316 (2011).Bauhs, J. A., Vrieze, T. J., Primak, A. N., Bruesewitz, M. R. and McCollough, C. H. CT dosimetry: Comparison of measurement techniques and devices. Radiographics 28, 245 – 253 (2008).Beganovic, A., Sefic-Pasic, I., Skopljak-Beganovic, A., Kristic, S., Sunjic, S., Mekic, A., Gazdic-Santic, M., Drljevic, A. and Samek, D. Doses to skin during dynamic perfusion computed tomography of the liver. Radiat. Prot. Dosim. 153(1), 106–111 (2013).Publications. AAPM Publications – AAPM Reports. (n.d.). Retrieved November 19, 2021, from https://www.aapm.org/pubs/reports/.LANDAUER, 50749 Nano-Dot™ Dosimeter Patient Monitoring SolutionsNCRP Report 116, Limitation of Exposure to Ionizing Radiation, National Council on Radiation Protection and Measurements, Bethesda, MD, 1993Center for Devices and Radiological Health. (n.d.). Radiation Dose Quality Assurance: Questions and Answers. U.S. Food and Drug Administration. Retrieved November 19, 2021, from https://www.fda.gov/radiation-emitting-products/initiative-reduce-unnecessary-radiation-exposure-medical-imaging/radiation-dose-quality-assurance-questions-and-answers.NanoDot™. LANDAUER. (n.d.). Retrieved November 19, 2021, from https://www.landauer.com/product/nanodot.ACR–sar–SPR practice parameter for the performance of … (n.d.). Retrieved November 19, 2021, from https://www.acr.org/-/media/ACR/Files/Practice-Parameters/CT-Entero.pdf.Frost, J. (2021). How To Interpret R-squared in Regression Analysis. Retrieved 1 December 2021, from https://statisticsbyjim.com/regression/interpret-r-squared-regression/Morgan, M. (2021). Size specific dose estimate | Radiology Reference Article | Radiopaedia.org. Retrieved 1 December 2021, from https://radiopaedia.org/articles/size-specific-dose-estimate?lang=us1.9E-2 0.55000000000000004 0.59699999999999998 0.96399999999999997 1.08 3.0049999999999999 0.616999999999 99999 2.7160000000000002 13.58 1.83 3.39 8.6199999999999992 13.61 36.979999999999997 3.35 16.3Peak Skin Dose (mGy)Size Specific Dose Estimates (mGy)1.2999999999999999E-2 0.621 0.75 0.95199999999999996 0.98799999999999999 2.7330000000000001 2.7829999999999999 3.6859999999999999 11.74 1.83 3.39 7.45 11.77 31.97 3.35 16.3Peak Skin Dose (mGy)Size Specific Dose Estimates (mGy)3.9E-2 0.4879999 9999999999 0.71199999999999997 1.169 1.2549999999999999 3.2269999999999999 0.59399999999999997 3.0539999999999998 11.74 1.83 3.39 7.45 11.77 31.97 3.35 16.3Peak Skin Dose (mGy)Size Specific Dose Estimates (mGy)12
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