POSTED training manual

This manual describes POSTED - a training programme for parents, teachers and teaching assistants who are responsible for the daytime postural care needs of children with a physical disability. The training programme is intended to improve understanding and knowledge of postural care and the confidence carers. The training should be facilitated by occupational therapists and/or physiotherapists who have attended a train-the-trainer workshop. It contains background information relating to the development, structure and content of the training programme. The contents of the manual were originally designed for use in research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB‐PG‐ 0110‐21045)

Advances in Clinical Molecular Imaging Instrumentation

In this article, we describe recent developments in the design of both single-photon emission computed tomography (SPECT) and positron emission tomography (PET) instrumentation that have led to the current range of superior performance instruments. The adoption of solid-state technology for either complete detectors [e.g., cadmium zinc telluride (CZT)] or read-out systems that replace photomultiplier tubes [avalanche photodiodes (APD) or silicon photomultipliers (SiPM)] provide the advantage of compact technology, enabling flexible system design. In SPECT, CZT is well suited to multi-radionuclide and kinetic studies. For PET, SiPM technology provides MR compatibility and superior time-of-flight resolution, resulting in improved signal-to-noise ratio. Similar SiPM technology has also been used in the construction of the first SPECT insert for clinical brain SPECT/MRI

Fine Structure in 3C 120 and 3C 84

Seven epochs of very long baseline radio interferometric observations of the Seyfert galaxies 3C 120 and 3C 84, at 3.8-cm wave length using stations at Westford, Massachusetts, Goldstone, California, Green Bank, West Virginia, and Onsala, Sweden, have been analyzed for source structure. An algorithm for reconstructing the brightness distribution of a spatially confined source from fringe amplitude and so called closure phase data has been developed and successfully applied to artificially generated test data and to data on the above mentioned sources. Over the two year time period of observation, 3C 120 was observed to consist of a double source showing apparent super relativistic expansion and separation velocities. The total flux changes comprising one outburst can be attributed to one of these components. 3C 84 showed much slower changes, evidently involving flux density changes in individual stationary components rather than relative motion

A study into the effectiveness of an education programme for parents and teachers

Introduction: Parents and teachers lack knowledge and self-efficacy when providing postural care to physically disabled children. This can act as a barrier to the successful implementation of therapy. An intervention was developed to improve knowledge and confidence in providing postural care. The aim is to determine whether this intervention improves parents’ and teachers’ knowledge and confidence. Participants and Methods: The intervention includes a 2-hour interactive workshop and follow-up home/school visits delivered in three localities across the south-east of England. The UKC-PostCarD scale, which assesses levels of knowledge and confidence in providing postural care, was used to evaluate the intervention. It is completed at baseline and after the intervention is completed. Focus groups with participants will provide insight into elements that were effective/ineffective.Interviews with children will provide their perspective. Interviews with therapists will consider the feasibility and acceptability of delivery. Results: A mixed-design ANOVA 2 (Time: before vs. after) 9 3 (Area:Kent, Sussex, Surrey) will be used to determine whether knowledge and confidence improved following the intervention. Framework analysis will be used for the focus group and interview data. Qualitative findings will be fed into the overall evaluation. Results will be available by September 2013. Conclusion: If shown to improve confidence and knowledge, we will make this education programme available nationally

Improved correction for the tissue fraction effect in lung PET/CT imaging

Recently, there has been an increased interest in imaging different pulmonary disorders using PET techniques. Previous work has shown, for static PET/CT, that air content in the lung influences reconstructed image values and that it is vital to correct for this 'tissue fraction effect' (TFE). In this paper, we extend this work to include the blood component and also investigate the TFE in dynamic imaging. CT imaging and PET kinetic modelling are used to determine fractional air and blood voxel volumes in six patients with idiopathic pulmonary fibrosis. These values are used to illustrate best and worst case scenarios when interpreting images without correcting for the TFE. In addition, the fractional volumes were used to determine correction factors for the SUV and the kinetic parameters. These were then applied to the patient images. The kinetic parameters K1 and Ki along with the static parameter SUV were all found to be affected by the TFE with both air and blood providing a significant contribution to the errors. Without corrections, errors range from 34-80% in the best case and 29-96% in the worst case. In the patient data, without correcting for the TFE, regions of high density (fibrosis) appeared to have a higher uptake than lower density (normal appearing tissue), however this was reversed after air and blood correction. The proposed correction methods are vital for quantitative and relative accuracy. Without these corrections, images may be misinterpreted

POSTED - general questionnaire

This questionnaire is concerned with carers experiences of daytime postural care. This questionnaire may be completed by anyone with experience of providing postural care to a child with a physical disability in a school and/or home environment. This includes parents, teachers and teaching assistants. It is likely that information, training and support needs vary considerably from one person to the next – due to the needs of the child, the type of equipment used, or the environment in which postural care is provided. This questionnaire was developed to enable parents, teachers, and teaching assistants to highlight specific aspects of postural care that they find challenging in order that information, training and support may be appropriately targeted. The questionnaire was originally designed for use in research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB‐PG‐ 0110‐21045). When using/referring to this questionnaire please acknowledge authorship as appropriate. Details of the development of the questionnaire can be found in the following publication. Hotham, S., Hutton, E. & Hamilton‐West, K. E. (2015) Development of a reliable, valid measure to assess parents' and teachers' understanding of postural care for children with physical disabilities: the (UKC‐PostCarD) questionnaire. Child: Care, Health and Development, 41, 1172– 1178

Local magnitudes and apparent variations in seismicity rates in Southern California

Redetermination of local magnitudes for moderate earthquakes recorded by the Southern California Seismographic Network (SCSN) from 1932 to 1990 has shown that the magnitudes have not been consistently determined over that time period. The amplitudes of ground velocities recorded on Wood-Anderson instruments were systematically overestimated prior to 1944 compared to present reading procedures, leading to a significant overestimation of local magnitudes. In addition, the change from human to computerized estimation of event magnitude from a suite of amplitudes in 1975 led to slightly lower event magnitudes for the time after 1975 compared to the time before. These changes contribute to an apparently higher rate of seismicity in the 1930s and 1940s than later in the catalog, which had been interpreted as a decrease in seismicity rate after the 1952 Kern County (M_w 7.5) earthquake. Wood-Anderson amplitudes have been reread and consistent magnitudes recalculated using uniform procedures for all earthquakes with a catalog magnitude of 4.5 and greater within the SCSN from 1932 to 1943 and those with a catalog magnitude of 4.8 and greater from 1944 to 1990 so as to create a complete list of all earthquakes with a modern local magnitude of 5.0 or greater. Using these new magnitudes, we find that the rate of M_L 5.0 and greater earthquakes in southern California over this 59-year period to be Poissonian, with no changes in rate significant above the 90% level. From this rate, in any 30-year period, the Poissonian probability of a M ≧ 6 earthquake is 99.7%, the probability of an M ≧ 7 earthquake is 65%, and the probability of an M ≧ 8 event is 18%

Aftershocks and Preearthquake Seismicity

Although primary surface faulting was mapped for nearly 30 km, aftershocks extended in a complex pattern more than 100 km along the trend of the Imperial fault. A first-motion focal mechanism for the main shock is consistent with right-lateral motion on a vertical fault striking N. 42° W., in agreement with the strike of the Imperial fault within the limits of resolution. There is evidence that conjugate faulting on a buried complementary northeast-trending structure occurred at the north limit of displacement on the Imperial fault near Brawley, Calif. This faulting was apparently initiated at the time of a magnitude 5.8 aftershock 8 hours after the main shock. A line of epicenters extending along the trend of the San Andreas fault nearly 100 km into the eastern Imperial Valley was noted during the aftershock sequence, in an area recognized as notably aseismic during the preceding 5 years. The main shock was preceded by a 3-month period of significantly reduced seismicity affecting the central Imperial Valley. Although three small events near the incipient epicenter during this interval may be deemed foreshocks, no distinct foreshocks immediately before the main shock were observed

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