A feasibility study of auricular therapy and self-administered acupressure for insomnia following cancer treatment

Introduction: Many cancer patients experience sleeping difficulties which can persist several years after the completion of cancer treatment. Previous research suggests that acupuncture, and variants of acupuncture (acupressure, auricular therapy) may be effective treatment options for sleep disturbance. However, current evidence is limited for cancer patients. Methods: Feasibility study with 3 arms. Seven cancer patients with insomnia randomised to receive either auricular therapy (attaching semen vaccariae seeds to ear acupoints) (n = 4), self-acupressure (n= 1) or no treatment (n= 2). Participants assigned to receive auricular therapy or self-acupressure stimulated the acupoints each night an hour before retiring to bed. The duration of participant involvement was 5 weeks. Subjective sleep quality was measured at baseline and post-treatment using the Pittsburgh sleep quality index (PSQI). The impact of treatment on concerns of importance to the participants themselves was measured using the measure yourself concerns and wellbeing (MYCaW). Each participant also completed a treatment log book. Results: All participants completed their treatment. All auricular therapy and self-acupressure participants recorded clinically significant improvements in global PSQI scores. In the auricular therapy arm mean global PSQI reduced from 12.5 at baseline to 8 following completion of treatment. In the self-acupressure arm PSQI reduced from 15 to 11. While in the no treatment arm the mean PSQI score was 14.5 at both baseline and follow up. Conclusions: Despite the limited sample size, both auricular therapy and self-acupressure may represent potentially effective treatments for cancer patients with insomnia. The positive findings suggest further research is warranted into both treatment modalities.School of Nursin

Advanced practice in radiotherapy across Europe: stakeholders’ perceptions of implementation and evolution

Introduction Adapting radiotherapy services with workforce innovation using skills-mix or task-shifting optimises resources, supporting current and future demands. Advanced practitioners (APs) work at a different level of practice (beyond initial registration) across four pillars: clinical practice, leadership and management, education, and research. There is limited cross-country research on the advanced therapeutic radiographers/radiation therapists (TR/RTTs), particularly in Europe. This study aimed to investigate European radiotherapy stakeholders’ perceptions regarding current and future advanced practice (AP). Methods From June to September 2022, one-to-one online semi-structured interviews were conducted in English, and audio and video were recorded. Full verbatim audio files were independently transcribed and checked by interviewer and interviewees. Braun and Clarke's seven steps guided the thematic analysis (using NVivo). Results Thirty-three interviewees working or studying in 16 European countries represented practitioners (n=14), managers (n=6), educators (n=4), professional bodies (n=4), students (n=3), and regulators (n=2). Four overarching themes emerged: “AP drivers and outcomes”, “AP challenges vs enablers”, “Current vs future AP”, “Becoming and being advanced practitioner”. Participants identified research as the neglected AP pillar due to a lack of protected time, limited staff skills, no research culture, no funding, workload, and clinical priorities. Interviewees highlighted the importance of consistency in job titles, harmonisation of education models and curricula, definition of AP requirements, and support for all AP pillars through job plans and workforce planning. Conclusion Neither the profession nor education of TR/RTTs are harmonised across Europe, which is highly reflected in advanced-level practice. Advanced TR/RTTs should work across all pillars, including research, and these should be embedded in master's programmes, including leadership. Implications for practice This study highlights a policy gap in the education and practice of APs in radiotherapy

Gravitation and inertia; a rearrangement of vacuum in gravity

We address the gravitation and inertia in the framework of 'general gauge principle', which accounts for 'gravitation gauge group' generated by hidden local internal symmetry implemented on the flat space. We connect this group to nonlinear realization of the Lie group of 'distortion' of local internal properties of six-dimensional flat space, which is assumed as a toy model underlying four-dimensional Minkowski space. The agreement between proposed gravitational theory and available observational verifications is satisfactory. We construct relativistic field theory of inertia and derive the relativistic law of inertia. This theory furnishes justification for introduction of the Principle of Equivalence. We address the rearrangement of vacuum state in gravity resulting from these ideas.Comment: 17 pages, no figures, revtex4, Accepted for publication in Astrophys. Space Sc

Digital skills of therapeutic radiographers/radiation therapists – Document analysis for a European educational curriculum

It is estimated that around 50% of cancer patients require Radiotherapy (RT) at some point during their treatment, hence Therapeutic Radiographers/Radiation Therapists (TR/RTTs) have a key role to play in patient management. It is essential for TR/RTTs to keep abreast with new technologies and continuously develop the digital skills necessary for safe RT practice. The RT profession and education is not regulated at European Union level, which leads to heterogeneity in the skills developed and practised among countries. This study aimed to explore the white and grey literature to collate data on the relevant digital skills required for TR/RTTs practice.info:eu-repo/semantics/publishedVersio

Maternal and child reflective functioning in the context of child sexual abuse: pathways to depression and externalising difficulties

BACKGROUND: Sexual abuse is a well-recognised risk factor for child psychopathology. Little is known regarding whether child and maternal mentalization can be considered a potential resource or protective factor in this context, respectively, mediating or moderating the relationship between sexual abuse and psychopathology. OBJECTIVE: The aims of this study were (1) to explore the relationships between child and maternal mentalizing, measured as reflective functioning (RF), and child depressive symptoms and externalising difficulties; and (2) to examine whether child mentalizing mediates the relationship between child sexual abuse (CSA) and psychopathology. METHOD: A total of 168 children aged 7-12 years and their mothers participated in the study. The sample included 74 dyads where children had experienced sexual abuse. The Child Attachment Interview was rated by using the Child Reflective Functioning Scale to assess children's mentalization, and the Child Depression Inventory was used to assess depressive symptoms. Mothers completed the Parent Development Interview to assess maternal RF and the Child Behavior Checklist to assess their child's externalising difficulties. A model involving direct and indirect paths from CSA, child and maternal RF to child psychopathology was examined using Mplus software. RESULTS: Child mentalization partially mediated the relationships between CSA and depressive symptoms, as well as the relationship between CSA and externalising difficulties. Maternal mentalization was an independent predictor of child externalising difficulties, with higher maternal RF associated with less externalising difficulties. DISCUSSION: The findings indicate that by ages 7-12, child mentalization is an important inner resource associated with lower depression and externalising. In addition, this study provides new evidence of the importance of the parent's mentalizing stance for the development of self-regulation and externalising difficulties in both abused and non-abused children. The clinical implications are discussed

An investigation of digital skills of therapeutic radiographers/radiation therapists: A european survey of proficiency level and future educational needs

This study aims to assess the proficiency level of digital skills, the factors influencing that level and the training needs of Therapeutic Radiographers/Radiation Therapists (TR/RTTs), due to the differences in technology availability and accessibility, variations in the regulation and education of TR/RTTs in European countries, and the lack of a digital skills framework. An online survey was distributed to TR/RTTs working in Europe to capture their self assessment of proficiency levels of digital skills when performing their clinical role. Information was also gathered regarding training, work experience and level of information and communication tech nology (ICT) skills. Quantitative measures were analysed using descriptive statistics and correlation between variables, and qualitative responses using thematic analysis. 101 respondents from 13 European countries completed the survey. Digital skills in treatment planning followed by management and research were the least developed skills, while the most developed were transversal digital skills followed by digital skills in treatment delivery. The Radio therapy areas of practice where TR/RTT has experience (e.g. Planning Image, Treatment Planning, Treatment), as well as the level of generic ICT skills (communication, content creation and problem solving), was related to the level of proficiency of TR/RTT digital skills. Greater scope of practice and level of generic ICT were associated with a higher level of TR/RTT digital skills. Thematic analysis allowed the identification of new sub-themes to be included in the training of TR/RTTs. Education and training of TR/RTTs should be improved and adapted to the current needs of digitalisation to avoid differences in digital proficiency levels. Implications for practice: Aligning TR/RTTs’ digital skill sets with emerging digitalisation will improve current practice and ensure the best care to all RT patients.info:eu-repo/semantics/publishedVersio

Identity and integration of Russian speakers in the Baltic states: a framework for analysis

Following a review of current scholarship on identity and integration patterns of Russian speakers in the Baltic states, this article proposes an analytical framework to help understand current trends. Rogers Brubaker's widely employed triadic nexus is expanded to demonstrate why a form of Russian-speaking identity has been emerging, but has failed to become fully consolidated, and why significant integration has occurred structurally but not identificationally. By enumerating the subfields of political, economic, and cultural ‘stances’ and ‘representations’ the model helps to understand the complicated integration processes of minority groups that possess complex relationships with ‘external homelands’, ‘nationalizing states’ and ‘international organizations’. Ultimately, it is argued that socio-economic factors largely reduce the capacity for a consolidated identity; political factors have a moderate tendency to reduce this capacity, whereas cultural factors generally increase the potential for a consolidated group identity

Force-velocity relation and density profiles for biased diffusion in an adsorbed monolayer

In this paper, which completes our earlier short publication [Phys. Rev. Lett. 84, 511 (2000)], we study dynamics of a hard-core tracer particle (TP) performing a biased random walk in an adsorbed monolayer, composed of mobile hard-core particles undergoing continuous exchanges with a vapor phase. In terms of an approximate approach, based on the decoupling of the third-order correlation functions, we obtain the density profiles of the monolayer particles around the TP and derive the force-velocity relation, determining the TP terminal velocity, V_{tr}, as the function of the magnitude of external bias and other system's parameters. Asymptotic forms of the monolayer particles density profiles at large separations from the TP, and behavior of V_{tr} in the limit of small external bias are found explicitly.Comment: Latex, 31 pages, 3 figure