An evaluation of the supply and demand of radiation oncology medical physicists in the United States.

Background: This dissertation is a mixed methods evaluation of the radiation oncology medical physics workforce in the United States. Radiation oncology medical physicists serve a vital role in the safe treatment of patients with radiation therapy. While cancer incidence continues to rise, the pathways to board certification in radiation oncology medical physics continue to narrow causing a potential shortage of radiation oncology physicists in the United States. While there is no lack of data about the medical physics community it has scarcely been used to evaluate the current state of the workforce. In order to ensure patient safety, appropriate physics to patient staffing ratios are important and cannot be sustained without an adequate supply of qualified physicists entering the profession annually. Purpose: The purpose of this dissertation is to determine the current supply of medical physicists, develop a model to predict the future supply and demand, and evaluate the current job market based on the perceptions of recent graduates. The primary question to be addressed is that based on current data and development of a new supply and demand model, will there be enough Radiation Oncology Physicists to keep up with the supply and demand through 2030? Secondary questions include: Do the perceptions of recent Masters and PhD graduates of medical physics support the new model findings of the residency shortage? Are graduates of residency programs in high demand because of the now single pathway into the field? Methods: Quantitative methods include standard distributive methods; minimum, maximum, quartiles, mean and medians of data ranges. Qualitative methods include a five-point Likert psychometric scale and open-ended question surveys with radiation oncology medical physics graduate students, residents, and recent retirees. Mixed methods procedures include the use of Stella modeling software used for supply and demand analysis. The anonymized list of potential survey respondents was supplied and coded by the American Association of Physicists in Medicine. Subjects with personal emails for follow up responses obtained institutional Review Board approval due to potential self-identifying information. Results: Based on modeling results approximately 250 residency positions for radiation oncology medical physicists are needed. This is a growth by almost 100 positions needed urgently to meet the rising demand. Perceptions of recent graduates and residents support the modeling results that limited residency positions are leading to a surplus of graduates with no pathway to board eligibility and thus creating a limitation on the workforce making it difficult to meet the rising demand. Conclusions: While the medical physics profession is a rewarding career, there are immediate and urgent risks to the future of the medical physics workforce. The lack of residencies will lead to a deficit of almost fifteen percent by 2030 if nothing changes. There is an urgent need for a widespread evaluation of the medical physics education pathways to ensure a proper workforce moving forward while meeting the ethical obligation to students to have a pathway to certification in the profession

How Play Therapists Integrate Knowledge of Attachment Theory Into Clinical Practice: A Grounded Theory

The quality of the dynamics within individuals’ early relationships with their caregivers can impact the overall mental health, functioning, and quality of future relationships for those individuals (Aguilar, Sroufe, Egeland, & Carlson, 2000; Bowlby, 1988; Carlson, 1998; Cassidy & Shaver, 2008; Deklyen & Greenberg, 2008; Johnson & Whiffen, 2003; Levy & Orlans, 1998; Ogawa et al., 1997; Renken et al., 1989; Warren, Huston, Egeland, & Sroufe, 1997). Attachment Theory describes the nature, characteristics, and dynamics of the relationship between a child and caregiver, and delineates how an internal concept of self and self and others is created via those relationships (Bowlby, 1988; Brisch, 2011; Levy & Orlans, 1998; Solomon & George, 1999). Assessing for and addressing attachment issues early in life, and helping to establish a secure base for a child, can serve as a preventative measure for thwarting a variety of interpersonal and self-concept issues (Bowlby, 1988; Martin, 2005; Morisset et al., 1990; Rutter, 1987). Several play therapy interventions for addressing attachment issues exist, yet no framework existed to describe how theoretical knowledge of Attachment Theory may be integrated into clinical practice from initial contact through termination. The purpose of this research was to generate a framework that explored and described how play therapists integrated knowledge of Attachment Theory within their treatment planning. The constructed framework may be used by educators, play therapists and families to conceptualize the play therapy process from an attachment-based perspective

Characterization of Stream Turbidity in the Catskills, New York: Insights into Environmental Controls

Elevated turbidity poses a threat to water quality, which is especially problematic in unfiltered water supply systems such as New York City\u27s (NYC). The Catskills Region of New York, which supplies NYC with the majority of its drinking water, is especially prone to chronically elevated turbidity due to the erosion of glacial till in Catskill streams. Here, we characterize turbidity and streamflow in the Catskills to understand the drivers of turbidity in this region. To accomplish this, we examined over a decade\u27s worth of observed turbidity and streamflow data (2010-2022, n = 88,255) at 20 United States Geological Survey (USGS) monitoring sites. We investigated the seasonal and temporal trends in turbidity and streamflow, as well as the potential underlying causes for extreme turbidity events. Our results indicate that turbidity peaks during January through April across sites, which suggests that earlier timings of spring snow melt may contribute to elevated turbidity during these months. The turbidity baseline conditions also differ across sites, along with several sites frequently exceeding the Environmental Protection Agency (EPA) turbidity regulatory limit of 5 NTU, suggesting that certain areas of the Catskill Watershed are more susceptible to higher turbidity. Examination of extreme floods in the Catskills, such as a severe flood in December 2020 that affected the entire region, reveals that there is a characteristic process that can explain turbidity dynamics after severe flooding in this region. The December 2020 flood elevated turbidity above baseline conditions for approximately three months at several Catskill sites. There was an intermediate flood in March 2021 that could flush the easily erodible sediment that had been deposited in the channels as a result of the first flood event. However, this intermediate flood did not produce enough energy to overwhelm the system and keep turbidity above baseline conditions. Overall, our analysis proposes potential mechanisms to explain elevated turbidity events throughout the watershed and highlights the extent of the turbidity problem in the Catskills, which has important implications for water resources management of this water supply system

Security in Key Agreement: Two-Party Certificateless Schemes

The main goal of cryptography is to enable secure communication over a public channel; often a secret shared among the communicating parties is used to achieve this. The process by which these parties agree on such a shared secret is called key agreement. In this thesis, we focus on two-party key agreement protocols in the public-key setting and study the various methods used to establish and validate public keys. We pay particular attention to certificateless key agreement schemes and attempt to formalize a relevant notion of security. To that end, we give a possible extension of the existing extended Canetti-Krawzcyk security model applicable to the certificateless setting. We observe that none of the certificateless protocols we have seen in the literature are secure in this model; it is an open question whether such schemes exist. We analyze several published certificateless key agreement protocols, demonstrating the existence of key compromise impersonation attacks and even a man-in-the-middle attack in one case, contrary to the claims of the authors. We also briefly describe weaknesses exhibited by these protocols in the context of our suggested security model

The Iowa Homemaker vol.7, no.4

Table of Contents The Home Library by Charles H. Brown, page 1 Fashion Forecast for Fall and Winter by Miss Marie Stephens, page 2 The Place of The Child by Lydia Swanson, page 3 Home Economics Research at Iowa State by Dorothy McDaniel and Melba Nisewanger, page 4 Cooking Utensils of Today by Zula Dowler, page 5 Girls’ 4-H Page by Frances Jones, page 6 Home Economics Training in Choice of Life Mate by Marcia Turner, page 8 Community Laundry of the Des Moines Roadside Settlement House by Margaret Davidson, page 10 Who’s There and Where by Cleo Fitzsimmons, page 12 Iowa State Home Economics Association Page, page 9 Preparation for Nutrition Research by Melba Nisewanger, page 10 Who’s There and Where by Cleo Fitzsimmons, page 1

Projections from the Dorsomedial Division of the Bed Nucleus of the Stria Terminalis to Hypothalamic Nuclei in the Mouse

Acknowledgments: All the authors contributed to perform the experiments. SC designed the experiments, analyzed the data and wrote the paper. MB, JAG, DB and PYR edited the manuscript. This work was supported by the Region Franche-Comté, France (PYR), by The Francis Crick Institute (DB), by the Swiss National Science Foundation (PZ00P3_167934/1) and the Novartis Foundation for medical-biological research (19B145) (SC) The data that support the findings of this study are available from the corresponding author upon reasonable request.Peer reviewedPublisher PD