An assessment of safety.

Anticipated challenges include the replacement of the original radiation therapy simulator with a computed tomographic simulator, which requires significant adjustments in how HDR brachytherapy methods are performed; the use of new methods and methods, which can result in mistakes because of inadequate teaching, QA or inappropriate methods; the proliferation of devices, applicators and radionuclides utilized for brachytherapy treatment, which prospects to an increased number of possible processes, types of gear and clinical uses, rendering it increasingly difficult to regulate how to assure that all of the variants are used with appropriate process control and quality management; and the potential for increased use of model-based algorithms such as Monte Carlo options for dosage calculations for brachytherapy sources, that may require new procedures for commissioning, new algorithm QA and new patient-specific planning checks.The survey also found that people are having to pay less for health care-related expenses. The share of adults reporting out-of-pocket expenses greater than $500 dropped by 4 %, as the quantity of low-income adults reporting out-of-pocket expenses greater than $3,000 fell 8 %. Low-income adults were much more likely to possess a spot to go when they were ill and were much more likely to visit a doctor for preventive care.