High Dose Rate Brachytherapy Quality Assurance Optimisation using CMRP Dose Magnifying Glass

The purpose of this thesis was to develop a more precise and rigorous technique for performing pre-treatment/daily quality assurance (QA) of high dose rate (HDR) brachytherapy afterloaders, incorporating QA of: dwell position accuracy, dwell time accuracy, transit velocity consistency, relative transit dose, timer linearity and relative Air-Kerma Strength (AKS). A Sharp 5F ProGuide 240 mm catheter was fixed above a 1D monolithic 256-channel epitaxial diode array, the ‘dose magnifying glass’ (DMG256) to track the 192Ir source position within the applicator. The outputted data files from the data acquisition system were analysed to provide positional and temporal localisation of the 192Ir source by tracking the centroid of the detected response. Three dwell positions, each of 5.0 s dwell times, were spaced 13.0 mm apart along the array with the Flexitron HDR afterloader. Measurements were repeated on a weekly basis, for a period of 5 weeks to assess the consistency of the measured parameters over an extended period. Using DMG256 for relative AKS measurements resulted in measured values within 0.6 – 3.0 % of the expected source strength over a 7-week period. The set 10 ms temporal resolution of this device allowed for independent measurements of the transit velocity with an average of (10.88 ± 1.01) cm s−1 for 13.0 mm steps, with it accurately resolving the source movement down to the minimum afterloader step size of 1.0 mm and minimum time-step interval of 10 ms. The dwell position localisation for 1, 2, 5, 10 and 13 mm steps had an accuracy between 0.1 – 0.2 mm (3σ). The DMG allows for clinics to perform rigorous QA of HDR afterloader spatial and temporal accuracy, with greater precision to aid in quantifying and minimising dosimetric errors, all performed within the same time-frame as the current standard methodology using CCTV feed and a stopwatch. Additionally, DMG256 unlocks the ability to perform measurements of relative transit dose, transit velocity and relative AKS, which are not possible using current standard techniques

Sexual experience, relationships, and factors associated with sexual and romantic satisfaction in the first Australian Trans & Gender Diverse Sexual Health Survey

Background: Sexual and romantic satisfaction are important aspects of sexual health and wellbeing, but they have not been thoroughly investigated among transgender and gender diverse (‘trans’) people in Australia. Aims: To address this gap and improve sexual health and wellbeing, we assessed the sexual behavior and relationships of a national sample of trans people in Australia, and factors associated with sexual and romantic satisfaction. Methods: We conducted a national survey of trans people from Australia in October-November 2018. Results: The sample included 1,613 trans participants, of whom 353 (21.9%) were men, 397 (24.6%) were women and 863 (53.5%) were non-binary. Over 70% of the sample had been sexually active in the previous year, and 56.9% were in a relationship, but only 32.4% were satisfied with the sexual aspects and 47.1% with the romantic aspects of their lives. Sexual satisfaction was associated with younger age, being asexual, having more trans friends, more frequent sex, and using illicit drugs in the context of sexual activity. Anxiety or fear about sex was associated with less sexual satisfaction, as was being in an open relationship. Romantic satisfaction was associated with younger age, having non-binary partners, and being in a current relationship (particularly a monogamous one). Recent distress, anxiety, or fear about sex were associated with less romantic satisfaction. Conclusion: Participants reported a broad range of sexual relationships, but low levels of satisfaction with the sexual and romantic aspects of their lives. The findings underscore the importance of supportive partners, access to social support and peer networks of trans people, as well as access to mental health support and sex-positive, trans affirming counseling in sexual health services

Finding a way: long-term care homes to support dementia

An ageing demographic has increased the number of people with dementia. Although dementia is commonly associated with memory loss, other early symptoms include difficulty with wayfinding. Dementia alters visuo-spatial perception and the processes used to interpret the physical environment. The role of the design of the physical environment for people with dementia has gained increased recognition. Despite this, design for dementia is often overlooked, focusing on issues relating to physical impairment. This paper presents the results of a PhD study and aims to examine the role of the design of the physical environment in supporting wayfinding for people with dementia living in long-term care settings in Northern Ireland. Mixed methods combined the observation of wayfinding walks and conversational style interviews to elicit perspectives and experiences of residents with dementia. The findings aim to promote well-being for those with dementia living in long-term care settings

POSIWID and determinism in design for behaviour change

Copyright @ 2012 Social Services Research GroupWhen designing to influence behaviour for social or environmental benefit, does designers' intent matter? Or are the effects on behaviour more important, regardless of the intent involved? This brief paper explores -- in the context of design for behaviour change -- some treatments of design, intentionality, purpose and responsibility from a variety of fields, including Stafford Beer's "The purpose of a system is what it does" and Maurice Broady's perspective on determinism. The paper attempts to extract useful implications for designers working on behaviour-related problems, in terms of analytical or reflective questions to ask during the design process

The Function of Bachelardian Epistemology in the Post-colonial Project of Mohammed ‘Abed al-Jabri

This paper explores the function of historical epistemology in the thought of Gaston Bachelard (1884–1962) and Mohammed ‘Abed al-Jabri (1935–2010). Attributing thought with a particular function challenges our tendency to explain the development of thought in other socio-historical contexts in terms of mere conceptual influence. Available English-language literature on al-Jabri commonly references Bachelard’s concept of epistemological rupture as a source of inspiration. Though the reference is astute, this term remains poorly understood and has long been overshadowed by Thomas Kuhn’s notion of ‘paradigm shift’. The broader function of Bachelard’s thought as a renegotiation of time, place, subject, and reason in the natural sciences has been largely neglected in historiographies of the philosophy of science outside of France. This paper emphasizes the level of insight and ingenuity with which al-Jabri employs the function of Bachelard’s epistemology by re-interpreting it within the framework of his own socio-historical context. Far from reducing al-Jabri’s thought to a mere programmatic reproduction of French thought, I suggest that al-Jabri was among the most astute interpreters of this long-misunderstood theorist

Repeated infusions of donor-derived cytokine-induced killer cells in patients relapsing after allogeneic stem cell transplantation: a phase I study

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Hypolithic Microbial Community of Quartz Pavement in the High-Altitude Tundra of Central Tibet

The hypolithic microbial community associated with quartz pavement at a high-altitude tundra location in central Tibet is described. A small-scale ecological survey indicated that 36% of quartz rocks were colonized. Community profiling using terminal restriction fragment length polymorphism revealed no significant difference in community structure among a number of colonized rocks. Real-time quantitative PCR and phylogenetic analysis of environmental phylotypes obtained from clone libraries were used to elucidate community structure across all domains. The hypolithon was dominated by cyanobacterial phylotypes (73%) with relatively low frequencies of other bacterial phylotypes, largely represented by the chloroflexi, actinobacteria, and bacteriodetes. Unidentified crenarchaeal phylotypes accounted for 4% of recoverable phylotypes, while algae, fungi, and mosses were indicated by a small fraction of recoverable phylotypes

Quality of Life and Socioeconomic Indicators Associated with Survival of Myeloid Leukemias in Canada

Understanding how patient‐reported quality of life (QoL) and socioeconomic status (SES) relate to survival of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) may improve prognostic information sharing. This study explores associations among QoL, SES, and survival through administration of the Euro‐QoL 5‐Dimension, 3‐level and Functional Assessment of Cancer Therapy‐Leukemia and financial impact questionnaires to 138 adult participants with newly diagnosed AML or MDS in a longitudinal, pan‐Canadian study. Cox regression and lasso variable selection models were used to explore associations among QoL, SES, and established predictors of survival. Secondary outcomes were changes in QoL, performance of the QoL instruments, and lost income. We found that higher QoL and SES were positively associated with survival. The Lasso model selected the visual analog scale of the EQ‐5D‐3L as the most important predictor among all other variables (P = .03; 92% selection). Patients with AML report improved QoL after treatment, despite higher mean out‐of‐pocket expenditures compared with MDS (up to $599 CDN/month for AML vs$239 for MDS; P = .05), greater loss of productivity‐related income (reaching id="mce_marker"786/month for AML vs $709 for MDS; P < .05), and greater caregiver effects (65% vs 35% caregiver productivity losses for AML vs MDS; P < .05). Our results suggest that including patient‐reported QoL and socioeconomic indicators can improve the accuracy of survival models