A forward planned treatment planning technique for non small cell lung cancer stereotactic ablative body radiotherapy. Based on a Systematic Review of Literature.

Purpose & Method: A systematic literature review of six computerised databases was undertaken in order to review and summarise a forward planned lung Stereotactic Ablative Body Radiotherapy (SABR) treatment planning (TP) technique as a starting point for clinical implementation in the author's department based on current empirical research. The data was abstracted and content analysed to synthesize the findings based upon a SIGN quality checklist tool. Findings: A Four Dimensional Computer Tomography (4DCT) scan should be performed upon which the Internal Target Volume (ITV) and Organs at Risk (OAR) are drawn [1, 2]. A Set-up margin (SM) of 5mm is applied to account for inter-fraction motion. The field arrangement consists of a combination of 7 to 13 coplanar and non-coplanar beams all evenly spaced. Beam modifiers are used to assist in the homogeneity of the beam, although a 20% planning target volume (PTV) dose homogeneity is acceptable. The recommended fractionations by the UK SABR consortium are 54 Gy in 3#s (standard), 55–60 Gy in 5#s (conservative) and the 50-60 Gy in 8-10#s (very conservative). Conformity indices (CI) for both the target volume (TV) and OAR will be used to assess the planned distribution.) [3] Conclusion: An overview of a clinically acceptable forward planned lung SABR TP technique based on current literature as a starting point, with a view to inverse planning with support from the UK SABR Consortium mentoring scheme. [1, 2

Self-care in primary care: findings from a longitudinal comparison study.

To examine the effects of self-care training workshops for primary healthcare workers on frequently attending patients

The self-care for people initiative: the outcome evaluation.

To determine the effects of a community-based training programme in self-care on the lay population

STABILIZATION POLICIES AND AGRICULTURAL IMPACTS IN DEVELOPING COUNTRIES: THE CASE OF BOLIVIA

This research examines the success of stabilization policies to control hyperinflation in Bolivia. Money demand functions for the hyperinflation and stabilization periods were econometrically estimated and statistically tested. We conclude that the demand for money in Bolivia changed after stabilization policies were implemented, indicating that the new government's objectives were met. Stabilization policies resulted in real economic growth for Bolivia's economy, including its agricultural sector, where agricultural export shares increased tenfold as stabilization policies corrected overvalued exchange rates.Bolivia, Developing countries, Hyperinflation, Money demand, Stabilization policies, Political Economy,

Clean home-delivery in rural Southern Tanzania: barriers, influencers, and facilitators.

The study explored the childbirth-related hygiene and newborn care practices in home-deliveries in Southern Tanzania and barriers to and facilitators of behaviour change. Eleven home-birth narratives and six focus group discussions were conducted with recently-delivering women; two focus group discussions were conducted with birth attendants. The use of clean cloth for delivery was reported as common in the birth narratives; however, respondents did not link its use to newborn's health. Handwashing and wearing of gloves by birth attendants varied and were not discussed in terms of being important for newborn's health, with few women giving reasons for this behaviour. The lack of handwashing and wearing of gloves was most commonly linked to the lack of water, gloves, and awareness. A common practice was the insertion of any family member's hands into the vagina of delivering woman to check labour progress before calling the birth attendant. The use of a new razor blade to cut the cord was near-universal; however, the cord was usually tied with a used thread due to the lack of knowledge and the low availability of clean thread. Applying something to the cord was near-universal and was considered essential for newborn's health. Three hygiene practices were identified as needing improvement: family members inserting a hand into the vagina of delivering woman before calling the birth attendant, the use of unclean thread, and putting substances on the cord. Little is known about families conducting internal checks of women in labour, and more research is needed before this behaviour is targeted in interventions. The use of clean thread as cord-tie appears acceptable and can be addressed, using the same channels and methods that were used for successfully encouraging the use of new razor blade

Poisoning with the recreational drug paramethoxyamphetamine ("death")

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.Objective: To describe the clinical features of paramethoxyamphetamine (PMA; "death") poisoning and to compare these with those of people with self-reported "ecstasy" poisoning. Design: Retrospective casenote review. Participants and setting: 22 patients who presented to the Emergency Department of the Royal Adelaide Hospital (RAH), a major metropolitan teaching hospital, between 1 January 1996 and 31 December 1998 with PMA poisoning identified through urine drug screens; and 61 patients with self-reported ecstasy poisoning between 1 September 1997 and 31 December 1998 found through the hospital databases. Results: Patients with PMA poisoning presented with tachycardia (64%), hyperthermia (temperature > 37.5ºC; 36%), coma (41%), seizures (32%), arrhythmias (23%), and QRS intervals 100 ms (50%) with greater frequency and often greater severity than those with self-reported ecstasy poisoning. Two patients with PMA poisoning presented with severe hypoglycaemia (blood glucose level, 7.5 mmol/L). Conclusions: At our hospital, PMA poisonings accounted for most of the severe reactions among people who believed they had taken ecstasy. Hypoglycaemia and hyperkalaemia may be specific to PMA poisoning. PMA toxicity should be suspected with severe or atypical reactions to "ecstasy", and confirmed by chromatographic urine drug screens.Liang Han Ling, Colin Marchant, Nicholas A. Buckley, Michael Prior and Rod J. Irvin

Planning a Family:priorities and concerns in rural Tanzanmia

A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use was 16%. Current use was influenced by rising parity, educational level, age of last born child, breastfeeding status, a\ud preference for longer than the mean birth interval (32 months), not being related to the household head, and living in a house with a tin roof. Three principal concerns amongst women were outlined from the findings. First, that there is a large unmet need for family planning services in the area particularly among teenagers for whom it is associated with induced abortion. Second, that family planning is being used predominantly for spacing but fears\ud associated with it often curtail effective use. Third, that service provision is perceived to be lacking in two main areas — regularity of supply, and addressing rumours and fears associated with family planning. Reproductive health interventions in the area should ultimately be more\ud widespread and, in particular, abortion is highlighted as an urgent issue for further research.\ud The potential for a fast and positive impact is high, given the simplicity of the perceived needs of\ud women from this study. (Afr J Reprod Health 2004; 8[2]:111-123)\u

Plasma REST: a novel candidate biomarker of Alzheimer's disease is modified by psychological intervention in an at-risk population.

The repressor element 1-silencing transcription (REST) factor is a key regulator of the aging brain's stress response. It is reduced in conditions of stress and Alzheimer's disease (AD), which suggests that increasing REST may be neuroprotective. REST can be measured peripherally in blood plasma. Our study aimed to (1) examine plasma REST levels in relation to clinical and biological markers of neurodegeneration and (2) alter plasma REST levels through a stress-reduction intervention-mindfulness training. In study 1, REST levels were compared across the following four well-characterized groups: healthy elderly (n=65), mild cognitive impairment who remained stable (stable MCI, n=36), MCI who later converted to dementia (converter MCI, n=29) and AD (n=65) from the AddNeuroMed cohort. REST levels declined with increasing severity of risk and impairment (healthy elderly>stable MCI>converter MCI>AD, F=6.35, P<0.001). REST levels were also positively associated with magnetic resonance imaging-based hippocampal and entorhinal atrophy and other putative blood-based biomarkers of AD (Ps<0.05). In study 2, REST was measured in 81 older adults with psychiatric risk factors for AD before and after a mindfulness-based stress reduction intervention or an education-based placebo intervention. Mindfulness-based training caused an increase in REST compared with the placebo intervention (F=8.57, P=0.006), and increased REST was associated with a reduction in psychiatric symptoms associated with stress and AD risk (Ps<0.02). Our data confirm plasma REST associations with clinical severity and neurodegeneration, and originally, that REST is modifiable by a psychological intervention with clinical benefit

New Candidate Interstellar Particle in Stardust IS Aerogel Collector: Analysis by STXM and Ptychography

The Stardust Interstellar Preliminary Examination (ISPE) reported in 2014 the discovery of 7 probable contemporary interstellar (IS) particles captured in Stardust IS Collector aerogel and foils. The ISPE reports represented work done over 6 years by more than 60 scientists and >30,000 volunteers, which emphasizes the challenge identifying and analyzing Stardust IS samples was far beyond the primary Stardust cometary collection. We present a new potentially interstellar particle resulting from a continuation of analyses of the IS aerogel collection