The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review

© 2018 The College of Radiographers Objectives: To determine women's experiences of brachytherapy for cervical cancer. Key findings: Nineteen studies were included for data extraction/synthesis. Twelve studies focussed on psychological issues, seven on pharmacological aspects of women's experiences. Themes of anxiety, distress, pain, informational needs and non-pharmacological interventions were found. Nine out of ten psychological studies described brachytherapy as a distressing experience causing anxiety and distress for most women. Non-pharmacological interventions were found to be effective and inexpensive adjuncts. Peri and post-operative pharmacological management was variable, but duration of procedure was an important factor. Conclusion: Brachytherapy for gynaecological cancer causes varying levels of pain, anxiety and distress. To improve women's experiences there needs to be better pain management, patient information and the development of non-pharmacological interventions. Future recommendations are to develop clinical support guidelines, audit the quality of services and develop effective interventions to improve women's experiences of brachytherapy for locally advanced cervical cancer

Non-equilibrium microtubule fluctuations in a model cytoskeleton

Biological activity gives rise to non-equilibrium fluctuations in the cytoplasm of cells; however, there are few methods to directly measure these fluctuations. Using a reconstituted actin cytoskeleton, we show that the bending dynamics of embedded microtubules can be used to probe local stress fluctuations. We add myosin motors that drive the network out of equilibrium, resulting in an increased amplitude and modified time-dependence of microtubule bending fluctuations. We show that this behavior results from step-like forces on the order of 10 pN driven by collective motor dynamics

Globalising assessment: an ethnography of literacy assessment, camels and fast food in the Mongolian Gobi

What happens when standardised literacy assessments travel globally? The paper presents an ethnographic account of adult literacy assessment events in rural Mongolia. It examines the dynamics of literacy assessment in terms of the movement and re-contextualisation of test items as they travel globally and are received locally by Mongolian respondents. The analysis of literacy assessment events is informed by Goodwin’s ‘participation framework’ on language as embodied and situated interactive phenomena and by Actor Network Theory. Actor Network Theory (ANT) is applied to examine literacy assessment events as processes of translation shaped by an ‘assemblage’ of human and non-human actors (including the assessment texts)

Are we seeing accretion flows in a 250kpc-sized Ly-alpha halo at z=3?

Using MUSE on the ESO-VLT, we obtained a 4 hour exposure of the z=3.12 radio galaxy MRC0316-257. We detect features down to ~10^-19 erg/s/cm^2/arcsec^2 with the highest surface brightness regions reaching more than a factor of 100 higher. We find Ly-alpha emission out to ~250 kpc in projection from the active galactic nucleus (AGN). The emission shows arc-like morphologies arising at 150-250 kpc from the nucleus in projection with the connected filamentary structures reaching down into the circum-nuclear region. The most distant arc is offset by 700 km/s relative to circum-nuclear HeII 1640 emission, which we assume to be at the systemic velocity. As we probe emission closer to the nucleus, the filamentary emission narrows in projection on the sky, the relative velocity decreases to ~250 km/s, and line full-width at half maximum range from 300-700 km/s. From UV line ratios, the emission on scales of 10s of kpc from the nucleus along a wide angle in the direction of the radio jets is clearly excited by the radio jets and ionizing radiation of the AGN. Assuming ionization equilibrium, the more extended emission outside of the axis of the jet direction would require 100% or more illumination to explain the observed surface brightness. High speed (>300 km/s) shocks into rare gas would provide sufficiently high surface brightness. We discuss the possibility that the arcs of Ly-alpha emission represent accretion shocks and the filamentary emission represent gas flows into the halo, and compare our results with gas accretion simulations.Comment: 4 pages, 2 figures, 1 table, A&A letters accepte

Face-to-face: Social work and evil

The concept of evil continues to feature in public discourses and has been reinvigorated in some academic disciplines and caring professions. This article navigates social workers through the controversy surrounding evil so that they are better equipped to acknowledge, reframe or repudiate attributions of evil in respect of themselves, their service users or the societal contexts impinging upon both. A tour of the landscape of evil brings us face-to-face with moral, administrative, societal and metaphysical evils, although it terminates in an exhortation to cultivate a more metaphorical language. The implications for social work ethics, practice and education are also discussed

Density functional investigations of defect induced mid-gap states in graphane

We have carried out ab initio electronic structure calculations on graphane (hydrogenated graphene) with single and double vacancy defects. Our analysis of the density of states reveal that such vacancies induce the mid gap states and modify the band gap. The induced states are due to the unpaired electrons on carbon atoms. Interestingly the placement and the number of such states is found to be sensitive to the distance between the vacancies. Furthermore we also found that in most of the cases the vacancies induce a local magnetic moment.Comment: 15 page

Delphi study to identify key features of community-based child and adolescent mental health services in the East of England.

OBJECTIVE: To identify priorities for the delivery of community-based Child and Adolescent Mental health Services (CAMHS). DESIGN: (1) Qualitative methods to gather public and professional opinions regarding the key principles and components of effective service delivery. (2) Two-round, two-panel adapted Delphi study. The Delphi method was adapted so professionals received additional feedback about the public panel scores. Descriptive statistics were computed. Items rated 8-10 on a scale of importance by ≥80% of both panels were identified as shared priorities. SETTING: Eastern region of England. PARTICIPANTS: (1) 53 members of the public; 95 professionals from the children's workforce. (2) Two panels. Public panel: round 1,n=23; round 2,n=16. Professional panel: round 1,n=44; round 2,n=33. RESULTS: 51 items met the criterion for between group consensus. Thematic grouping of these items revealed three key findings: the perceived importance of schools in mental health promotion and prevention of mental illness; an emphasis on how specialist mental health services are delivered rather than what is delivered (ie, specific treatments/programmes), and the need to monitor and evaluate service impact against shared outcomes that reflect well-being and function, in addition to the mere absence of mental health symptoms or disorders. CONCLUSIONS: Areas of consensus represent shared priorities for service provision in the East of England. These findings help to operationalise high level plans for service transformation in line with the goals and needs of those using and working in the local system and may be particularly useful for identifying gaps in ongoing transformation efforts. More broadly, the method used here offers a blueprint that could be replicated by other areas to support the ongoing transformation of CAMHS