Is the bladder filling protocol for prostate cancer patients undergoing radiotherapy fit for purpose? (Abstract only)

Introduction: Conventional radiotherapy has been planned with a full bladder based on the rationale that it will move the small bowel out of the treatment field and result in greater sparing of the bladder itself[1]. Our department has moved from a ‘comfortably full’ bladder to a strict drinking protocol of emptying the bladder, drinking three cups of water and waiting 30 minutes prior to treatment for our prostate cancer patients. A service evaluation was carried out to determine if this change in practice results in a more consistent bladder volume from CT panning to treatment. Method and Materials: Based on 233 prostate patients treated per year a sample size of 146 was determined to result in a 95% confidence level with a 5% margin of error[2]. The last 73 patients on the comfortably full protocol and the first 73 patients on the new bladder protocol were compared. Their bladder volume from CT and on their CBCT fraction one was outlined by one observer to ascertain the difference in bladder volume and assess consistency. Results: The bladder filling protocol does not result in a statistically significant difference in bladder volume from CT to CBCT fraction one compared to comfortably full; the results prove that there is statistically no benefit from moving from comfortably full to the strict drinking protocol in terms of consistency of bladder volume achieved. Conclusion and Discussion: In the UK there are currently no official guidelines on what is the optimal volume of bladder for prostate cancer patients[3]. To attend a busy regional cancer centre patients may have had to travel a long distance. This coupled with any unintended delays can result in patients having to empty or be taken of the treatment couch, therefore a strict drinking protocol may not be feasible .The results of this well powered study that there is no statistically significant difference in consistency gained from employing a strict drinking protocol compared to maintaining a comfortably full bladder

The Letters of Charlotte Browning Page

Charlotte Page was not eminent in state or national life and politics, but for that very reason her papers are an important primary source. The focus of history traditionally centers on prominent people in society: monarchs, presidents, and statesmen. Recently some historians have shifted their interest to obscure individuals: the peasant, the housewife, and the factory-worker. We can gain an intimate view of history by considering Charlotte Page, an ordinary schoolmistress whose collected letters span five decades, from 1878 to 1941. Charlotte\u27s letters provide excellent written records from which to see her as an individual and to study the society in which she lived

A Transition Program: Students\u27 Experiences and Perspectives

The intent of this study was to investigate student perceptions of participation in a transition program the summer before their ninth grade year. Studies have shown that students who have an unsuccessful transition from middle school to high school are more likely to fail ninth grade, which may ultimately lead to dropping out of high school. However, the implementation of a transition program may help ease this transition and provide the student with the tools necessary to acclimate to the changes of the high school and be successful. A purposive sample was comprised of eight students who participated in the transition program. Four of the students were male and four were female, with one gender representative from each grade level 9-12. The students were chosen to best represent the population of participants as a whole. The students chosen ranged in academic levels from average to gifted and two of the students were special education students. The students were interviewed using open-ended questions allowing them to expound upon their thoughts and ideas. Students were asked the same questions regarding their perceptions on their participation in the program and their social interactions, academic, discipline, and attendance in high school. The interviews were also used to determine strengths and weaknesses of the program. The results suggest that the students in this study felt that the program provided them with the tools to manage the layout of the new building reducing the likelihood of getting lost the first day of school. The students identified meeting the teachers prior to the start of school and making new friends or social relationships as benefits of the program. However, the students did not feel that their participation in the program had an impact on improving their academic achievement, reducing their discipline problems, or increasing their attendance. This was identified as a specific weakness of the program, but the students in this study did not have issues in these areas prior to participation

Choose IR Own Adventure: Re-examining the Purpose and Mission of our Institutional Repository

For years, libraries have been involved in the development and management of campus institutional repositories (IRs). The purpose of these IRs varies but it is often to provide a platform for collecting and making freely available the scholarly output of the university or college. Depending on the breadth of materials and campus constituencies represented in the IR, library staff often spend many hours managing this resource. Given the proliferation of online platforms for sharing scholarly works, is this time worth the effort, or can it be diverted into new and possibly more relevant projects? The Library system at the University of Vermont began supporting the University’s IR in 2007, and is currently licensing BePress from Elsevier as the platform. Library staff have recently begun to reevaluate the viability of continuing to support the IR in its current form. In order to determine the future of the library’s involvement in the IR, a working group of librarians has been systematically reexamining the purpose and mission of UVM’s IR, the platform on which to house it, the type of content to include, and the staffing model needed to sustain it. This group hopes to align the mission and management structure of institutional repository services with the library’s strategic plan and the university’s strategic vision. We will share the process by which we engaged in this work, and the changes we plan to recommend as a result

Age-Based Differences in Care Setting Transitions over the Last Year of Life

Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years) and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N = 19, 397). Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons). Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy

The Iowa Homemaker vol.37, no.4

Poem, Bernice Burns, page 4 Symbols – Language of the Soul, Ann Baur, page 4 Search for Creative Living, Esther S. (Warner) Dendel, page 7 Family and Career – I Cater to Both, Donna Schneider, page 8 Uberraschend – Six and a Half Years!, Faye Kochheizer, page 11 Caution, Students at Large, Ann Walters, page 1

‘It’s all about context’: Building school capacity to implement a whole-school approach to bullying

Student bullying behaviours are a significant social issue in schools worldwide. Whilst school staff have access to quality bullying prevention interventions, schools can face significant challenges implementing the whole-school approach required to address the complexity of these behaviours. This study aimed to understand how schools’ capacity to implement whole-school bullying prevention interventions could be strengthened to promote sustainability and improve student outcomes. Qualitative methods were used to observe schools over time to gain insight into their implementation capacity to improve student social and emotional wellbeing and prevent and ameliorate harm from bullying. A four-year longitudinal, multi-site case study intensively followed eight schools’ implementation of Friendly Schools, an Australian evidenced-based whole-school bullying prevention intervention. Regular in-depth interviews with school leaders and implementation teams over four years led to the refinement of a staged-implementation process and capacity building tools and revealed four common drivers of implementation quality: (1) strong, committed leadership; (2) organisational structures, processes and resources; (3) staff competencies and commitment; and (4) translating evidence into local school policy and practice. This paper considers the strengths of qualitative data in understanding how and why bullying prevention interventions work as well as actions schools can take to enhance their implementation and sustainability of complex social interventions

Chemical Plants Remain Vulnerable to Terrorists: A Call to Action

U.S. chemical plants currently have potentially catastrophic vulnerabilities as terrorist targets. The possible consequences of these vulnerabilities echo from the tragedies of the Bhopal incident in 1984 to the terrorist attacks on 11 September 2001 and, most recently, Hurricanes Katrina and Rita. Findings from a 2004 nationwide participatory research study of 125 local union leaders at sites with very large volumes of highly hazardous chemicals suggest that voluntary efforts to achieve chemical plant security are not succeeding. Study respondents reported that companies had only infrequently taken actions that are most effective in preventing or in preparing to respond to a terrorist threat. In addition, companies reportedly often failed to involve key stakeholders, including workers, local unions, and the surrounding communities, in these efforts. The environmental health community thus has an opportunity to play a key role in advocating for and supporting improvements in prevention of and preparation for terrorist attacks. Policy-level recommendations to redress chemical site vulnerabilities and the related ongoing threats to the nation’s security are as follows: a) specify detailed requirements for chemical site assessment and security; b) mandate audit inspections supported by significant penalties for cases of noncompliance; c) require progress toward achieving inherently safer processes, including the minimizing of storage of highly hazardous chemicals; d) examine and require additional effective actions in prevention, emergency preparedness, and response and remediation; e) mandate and fund the upgrading of emergency communication systems; and f) involve workers and community members in plan creation and equip and prepare them to prevent and respond effectively to an incident

Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group

BACKGROUND: To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience. METHODS: This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3). RESULTS: At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088). CONCLUSIONS: The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers

Expanding the horizon of research into the pathogenesis of the white matter diseases: Proceedings of the 2021 Annual Workshop of the Albert Research Institute for White Matter and Cognition

White matter pathologies are critically involved in the etiology of vascular cognitive impairment–dementia (VCID), Alzheimer’s disease (AD), and Alzheimer’s disease and related diseases (ADRD), and therefore need to be considered a treatable target (Roseborough A, Hachinski V, Whitehead S. White matter degeneration - a treatable target? Roseborough et al. JAMA Neurol [Internet]. 2020 Apr 27;77(7):793–4, [1]. To help address this often-missed area of research, several workshops have been sponsored by the Leo and Anne Albert Charitable Trust since 2015, resulting in the incorporation of “The Albert Research Institute for White Matter and Cognition” in 2020. The first annual “Institute” meeting was held virtually on March 3–4, 2021. The Institute provides a forum and workspace for communication and support of the advancement of white matter science and research to better understand the evolution and prevention of dementia. It serves as a platform for young investigator development, to introduce new data and debate biology mechanisms and new ideas, and to encourage and support new research collaborations and directions to clarify how white matter changes, with other genetic and health risk factors, contribute to cognitive impairment. Similar to previous Albert Trust–sponsored workshops (Barone et al. in J Transl Med 14:1–14, [2]; Sorond et al. in GeroScience 42:81–96, [3]), established expert investigators were identified and invited to present. Opportunities to attend and present were also extended by invitation to talented research fellows and younger scientists. Also, updates on institute-funded research collaborations were provided and discussed. The summary that follows is a synopsis of topics and discussion covered in the workshop