First multicentre experience of SABR for lymph node and liver oligometastatic disease on the unity MR-Linac

The treatment of oligometastatic disease using MR guidance is an evolving field. Since August 2018 patients are treated on a 1.5 Tesla MR-Linac (MRL). We present current workflows and practice standards from seven institutions for the initial patients treated for lymph node and liver metastases

Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008.

BACKGROUND: Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008. METHODS: The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred. RESULTS: The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994-2008, whilst in women it was 2.8% between 1994-2000 and 6.7% between 2005-2008 (p < 0.05 for all periods).Stroke mortality declined between 1990-1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994-2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods). CONCLUSIONS: A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control

Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

Extent: 10p.BACKGROUND: Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. METHODS: We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4) were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. RESULTS: The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. CONCLUSION: Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation) were consistently identified as opportunities for improvement across services.Alice R. Rumbold, Ross S. Bailie, Damin Si, Michelle C. Dowden, Catherine M. Kennedy, Rhonda J. Cox, Lynette O’Donoghue, Helen E. Liddle, Ru K. Kwedza, Sandra C. Thompson, Hugh P. Burke, Alex D. H. Brown, Tarun Weeramanthri and Christine M. Connor

Images from a Visual Buildings Record (level 1) and Evaluation at 15 Foss Islands Road, York 2024

This collection comprises images from a visual buildings record and evaluation at 15 Foss Islands Road, York undertaken by On-Site Archaeology in June and July 2024

Images from an Archaeological Evaluation and Open Area Excavation at James Street/Brinkworth Terrace, York 2022

This collection comprises images from an archaeological evaluation and open area excavation at land off James Street/Brinkworth Terrace, York undertaken by On-Site Archaeology between August and November 2022. The earliest land use identified during the site investigation was ditch digging activity of a probable late 1st to early 2nd centuries AD Roman date. Other finds included pits and evidence of an earth-fasted post holed structure

Images from an Archaeological Watching Brief at Becketwell, Public Square, Derby, January - June 2023

This digital archive comprises of images from an archaeological watching brief at Becketwell, Public Square, Derby. The archaeological work was undertaken by On-Site Archaeology, between January and June 2023.The area considered comprises the proposed new public square, located between Becket Well Lane / Colyear Street and Victoria Street

Images from an Archaeological Evaluation and Open Area Excavation at Becketwell Site, St Peters Quarter, Derby 2021-2022

This digital archive comprises images from an archaeological evaluation and excavation at Becketwell Site,Derby.The work was undertaken by On-Site Archaeology Ltd and the initial evaluation was undertaken between February to April 2021, followed by further fieldwork in March and September 2022

Images from Archaeological Investigations at Dishforth Road, Boroughbridge, North Yorkshire, 2017-21

This collection comprises images from archaeological investigations at Dishforth Road, Boroughbridge, North Yorkshire, undertaken by On-Site Archaeology between 2017 and 2021. The evaluation was required as part of Condition 24 of the grant of outline planning permission. A total of five evaluation trenches were excavated in this phase, each measuring 50m by 2m at the modern ground surface. The eastern area of the site, where geophysical survey and trial trenching indicated a concentration of archaeology was excavated as Area A. The expansion of the area previously investigated by trench 5 during the second phase of evaluation was recorded as Area B. The second phase of works was undertaken outside the main development site along the line of a proposed surface water outfall pipe (Areas C and D). The field where the pipe trench was proposed lay partially within the registered battlefield site of the Battle of Boroughbridge. The earliest phase of activity largely comprised an enclosed Iron Age settlement. Only Iron Age, hand-made pottery, was recovered from the internal features of the principal enclosure indicating abandonment or disuse of the internal area after the Iron Age period. Activity during the Roman period appears to be represented by the shallower redefinition and extension of the existing principal enclosure and the creation of additional land division