Long-term survival for a cohort of adults with cerebral palsy

The aim of this study was to investigate long-term survival and examine causes of death in adult patients with cerebral palsy (CP). A 1940–1950 birth cohort based on paediatric case referral allows for long-term survival follow-up. Survival is analyzed by birth characteristics and severity of disability from age 20 years (and age 2y for a subset of the data). Survival outcome compared with that expected in the general population based on English life tables. The main cohort consisted of 341 individuals, with 193 males and 148 females. Conditional on surviving to age 20 years, almost 85% of the cohort survived to age 50 years (a comparable estimate for the general population is 96%). Very few deaths were attributed to CP for those people dying over 20 years of age. Females survived better than males. However, females faced a greater increase in risk relative to the general population than did males. We conclude that survival outlook is good though lower than in the general population. The relative risk of death compared with the UK population decreases with age, although it shows some indication of rising again after age 50 years. Many more deaths were caused by diseases of the respiratory system among those dying in their 20s and 30s than would be expected in the general population. Many fewer deaths than expected in this age group are caused by injuries and accidents. For those people who die in their 40s and 50s, an increase in deaths due to diseases of the circulatory system and neoplasms is observed. More deaths than expected in this age group are due to diseases of the nervous system

Student Reflections on Study Abroad: A Collective Case Study Exploring the Experiences of Pre-Service Teachers During an International Student Teaching Program

As classrooms in the United States grow more culturally and linguistically diverse, schools of education are challenged to prepare more culturally responsive, globally minded educators. International student teaching (IST) programs provide a unique opportunity for pre-service teachers to develop cultural competencies in a global context. However, in order for these programs to effectively meet ambitious global and intercultural learning objectives, multiple curricular and programmatic components must be considered, and on-going research exploring individual student experiences must be conducted. The present collective case study explored the experiences of five, pre-service teachers during a semester-long, IST program at Florida International University. A reentry interview took place after participants returned home from their IST placements in Ecuador. Participants were asked to describe their overall experience of the program, and share stories about their teaching experiences, living with host families and engaging with the host community. Reflective assignments completed throughout the semester were also collected and analyzed. These included visual stories, written and video reflections, pre-departure surveys and other cultural learning assignments. Data collected from both the reentry interviews and reflective assignments were explored on an individual case basis and then across cases to collectively analyze emergent themes. Findings revealed both the similarities of student experiences across cases, as well as the nuances that make an experience like international student teaching unique to each participant, particularly diverse students. This supports the experiential/constructivist paradigm which posits that an individual creates their world both individually and with others, and learning occurs through the individual’s transactions with a culture and with others. Further findings illustrated the connection between critical reflection and intercultural and global learning. It is intended that the findings of this study will serve as valuable insights for study abroad stakeholders to develop programming more intentionally, with critical reflection and cultural learning as a design framework. Additional program recommendations include providing ample preparation for both participants and faculty, a structure of support that facilitates intercultural and global learning throughout the study abroad cycle, and curriculum that elevates and leverages student voice

Distribution and incidence of viruses in Irish seed potato crops

peer-reviewedVirus diseases are of key importance in potato production and in particular for the production of disease-free potato seed. However, there is little known about the frequency and distribution of potato virus diseases in Ireland. Despite a large number of samples being tested each year, the data has never been collated either within or across years. Information from all known potato virus testing carried out in the years 2006–2012 by the Department of Agriculture Food and Marine was collated to give an indication of the distribution and incidence of potato virus in Ireland. It was found that there was significant variation between regions, varieties, years and seed classes. A definition of daily weather data suitable for aphid flight was developed, which accounted for a significant proportion of the variation in virus incidence between years. This use of weather data to predict virus risk could be developed to form the basis of an integrated pest management approach for aphid control in Irish potato crops

Reviews

The J.R.R. Tolkien Companion and Guide. Christina Scull and Wayne G. Hammond. Reviewed by David D. Oberhelman. The Lord of the Rings and Philosophy: One Book to Rule Them All. Edited by Gregory Bassham and Eric Bronson. Reviewed by Clark Hutton

Therapeutic radiographers' perceptions of the barriers and enablers to effective smoking cessation support

Introduction: Tobacco smoking during and post radiotherapy is associated with increased treatment toxicity and increased cancer related mortality. Routine delivery of smoking cessation advice is inconsistent in practice. This study identifies the key barriers and facilitators to the provision of effective smoking cessation conversations in radiotherapy practice. Methods: A baseline questionnaire (n ¼ 43) was used to identify current practice, barriers and facilitators to smoking cessation in radiotherapy and to inform a topic guide for follow up focus groups (n ¼ 5). Ethical approval was obtained through the 4 NHS trusts and the Health Research Authority. Focus group transcription was coded by two researchers. Results: Therapeutic Radiographers initiate health behaviour conversations with patients; there are a number of factors that facilitate the likelihood of a health behaviour conversation; indication that a patient smokes anatomical site and presence of acute effects. Key barriers to smoking cessation provision include; lack of training, limited knowledge, limitations as a result of poor clinical infrastructure, local culture and perceptions that patients do not prioritise smoking cessation during treatment. Conclusion: Therapeutic Radiographers have the motivation to provide smoking cessation advice, however they require further training to develop knowledge and skills in relation to benefits of smoking cessation and cessation strategies. Therapeutic Radiographers also expect that patients will respond negatively to smoking cessation advice, and that this might be damaging to the therapeutic relationship. Departmental culture and trust infrastructure can also significantly inhibit the provision of smoking cessation in radiotherapy practice and further support to implement NICE guidance is required

Shielding requirements of a SPECT insert for installation in a PET/MRI system

The objective of this work is to evaluate the shielding requirements of a SPECT insert for installation in the Siemens Biograph mMR in order to perform simultaneous SPECT/MR imaging of the human brain. We intend to use the radionuclides 99mTc, 123I and 111In. The main photopeaks of these radionuclides have the following energies: 140.5, 159.0, 171.3 and 245.4 keV. There is also about ∼3% of emission probability of high energy gamma photons for 123I in the range of 248-784 keV. The main constraints to the design of the gamma shielding are the presence of high energy photons, the weight, the MR compatibility and the PET LSO crystals intrinsic activity. We used GATE to simulate a SPECT acquisition, defining an MRI system with LSO crystals, a partial SPECT ring and a NEMA phantom. We also defined a lead (Pb) base plate (BP) to simulate the support system and three Pb shielding volumes with variable thickness: front and end (FE), back (B), and lateral (L) shield. These volumes reduce interference from out-of-field activity, LSO intrinsic activity and edge effects, respectively. We performed 4 sets of simulations, with variable FE, variable B, variable L and variable BP thickness, respectively, with a NEMA phantom filled with 185 MBq of 123I or 111In. For all simulations, we compared the different energy spectra and count-distribution plots. Results show that a Pb shielding configuration with a thickness of 6 mm-F, 2 mm-E, 3 mm-B, and 5 mm-L is appropriate for the insert. For 123I there is still a high contribution from high energy photons, as the amount of shielding is limited by weight, however this contribution is likely to be overestimated in the simulations as compared to practice. The effect of the LSO intrinsic activity is negligible at the energies of interest

A novel approach to image reconstruction and calibration for a multi-slit-slat SPECT system

In the context of the development of a simultaneous SPECT/MRI system, we have previously proposed a multi-minislit-slat (MSS) collimator, with multiple sections of short slits in order to improve the angular sampling. The data can be reconstructed using a 3D reconstruction algorithm that models the collimator geometry. One drawback, however, is that the projection data obtained with this collimator are difficult to interpret visually. Also, calibration can be problematic, as each mini-slit only covers part of the object FoV. We have therefore developed an algorithm for transforming the MSS projection data into the traditional sinogram format. These sinograms consist of multiple thin tilted lines with gaps in between due to the lack of detector rotation in this system. The data can be reconstructed using standard parallel-beam algorithms, taking into account the fact that there are data missing. We have shown with simulations and measurements that the algorithm can transform complex data, consisting of multiple rough broken line segments, into simple sine-curves. This algorithm can be useful for interpreting the acquired MSS data, reconstructing images, and calibrating the system