Introduction
This research assessed the preparedness of new graduate radiation therapists (NGRTs) for the clinical practice of planning.
Methods
A senior planner from each department and NGRTs who ...completed their degree in 2020 were surveyed after approximately 6 months of practice. Both were asked about NGRTs preparedness for practice and for feedback on the Bachelor of Radiation Therapy (BRT) planning curriculum. NGRTs were asked about body sites planned, how many plans they completed and planning techniques they had used. Senior planners were asked about their expectations of NGRTs in planning.
Results
New graduate radiation therapists frequently planned using three‐dimensional conformal radiation therapy (3DCRT) or virtual simulation (VSim). Commonly planned body sites were those with palliative intent, radical breast and sites more frequently planned using 3DCRT. The departmental sign‐off process sometimes prevented them from generating VMAT plans. They suggested more VMAT teaching could be included in the BRT. Senior planners expected NGRTs to be able to plan using 3DCRT and VMAT/IMRT. They suggested more clinical workflow teaching in the BRT planning curriculum. The majority of NGRTs and senior planners felt the BRT prepared the NGRTs for clinical practice.
Conclusion
The undergraduate degree is preparing NGRTs for clinical practice in planning. 3DCRT and VSim planning techniques remain a core role of NGRTs and a large proportion of clinical workload. NGRTs utilised their VMAT/IMRT planning skills less often during their initial period of practice, despite being expected to possess these skills. This is a challenge for the undergraduate curriculum and New Zealand departments as the clinical use of VMAT/IMRT continues to increase.
This study surveyed senior planners and a cohort of new graduate radiation therapists (NGRTs) in New Zealand (NZ) to assess NGRTs preparedness for the clinical practice of planning. The study found that the undergraduate Bachelor of Radiation Therapy degree is preparing NGRTs for clinical practice in planning. However, the challenge for curriculum design, is to maintain simple virtual simulation and three‐dimensional conformal radiation therapy planning content, which remains a core role of NGRTs, but also include more complex volumetric modulated arc therapy/intensity‐modulated radiation therapy techniques which are being used increasingly in NZ clinical departments.
Rock hind (Epinephelus adscensionis) and spotted moray (Gymnothorax moringa) are ubiquitous mesopredators that co-occur in the nearshore waters of Ascension Island in the South Atlantic Ocean, where ...they have significant cultural and subsistence value, but management of their non-commercial take is limited. This isolated volcanic system is home to high biomass and low species diversity, which poses two key questions: How can two mesopredators that perform similar ecological roles coexist? And if these two species are so ecologically similar, can they be managed using the same approach? Here, we combined acoustic telemetry, stomach content analysis, and stable isotope analysis to (i) explore space use and diet choices within and between these two species and (ii) to assess appropriate species-specific management options. Although rock hind had high residency and small calculated home ranges (0.0001-0.3114 km
), spotted moray exhibited shorter periods of residency (<3 months) before exiting the array. Vertical space use differed significantly across the 20-month tracking period, with individual differences in vertical space observed for both species. A hierarchical generalized additive model using 12-h averaged depth data identified that rock hind occurred lower in the water column than spotted moray, with both species occupying moderately deeper depths at night versus day (+1.6% relative depth). Spotted moray depth was also significantly predicted by lunar illumination. Aggregating samples by species and tissue type, Bayesian ecological niche modeling identified a 53.14%-54.15% and 78.02%-97.08% probability of niche overlap from fin clip and white muscle, respectively, whereas limited stomach content data indicated a preference for piscivorous prey. Variability in niche breadth between years suggests these species may exploit a range of prey items over time. These findings indicate that although these two species perform a similar ecological role by feeding on prey occupying the same trophic levels, subtle differences in movement behaviors between them suggest a one-rule-fits-all management approach is not likely the most effective option.
A Virtual Revolution Chadwick, Kate
Imaging & Therapy Practice,
09/2014
Trade Publication Article
High-fidelity simulation can enhance critical thinking and clinical judgement skills by the creation of artificial yet true to life scenarios, stimulating critical thinking at a high level and ...emphasise problem solving by integrating knowledge acquired in the classroom into clinical practice11. VERT is now embedded into the BSc programme as part of an innovative approach to skills acquisition through the use of dedicated problem-based learning weeks, where students return from clinical placement in order to focus on certain key elements of practical training.
VERT in education Chadwick, Kate
Imaging & Therapy Practice,
08/2014
Trade Publication Article
Current staff shortages in radiotherapy departments limits the amount of time which can be spent training student radiographers and trainee APs therefore a virtual learning environment (VLE) called ...VERT (virtual environment for radiotherapy training) was developed by the University of Hull and the Princess Royal Hospital, Hull and introduced firstly into higher education settings, and subsequently into radiotherapy clinical environments to ease the burden on qualified staff members4'7. Alternatively a treatment couch and lasers aligned in a designated room would allow the students to practice treatment set ups to 'tattoo' on a dummy patient (the students were offered the opportunity to practice manoeuvring each other on the diagnostic x-ray room couch in the University's skills suite, but were reluctant to do so out of embarrassment).The advantage of this would be the ability to physically manoeuvre a 'patient' which some students struggle to master, particularly under the time constraints of a busy, working linear accelerator.
A simple conceptual model of surface specific humidity change (Δq) over land is described, based on the effect of increased moisture advection from the oceans in response to sea surface temperature ...(SST) warming. In this model, future q over land is determined by scaling the present-day pattern of land q by the fractional increase in the oceanic moisture source. Simple model estimates agree well with climate model projections of future Δq (mean spatial correlation coefficient 0.87), so Δq over both land and ocean can be viewed primarily as a thermodynamic process controlled by SST warming. Precipitation change (ΔP) is also affected by Dq, and the new simple model can be included in a decomposition of tropical precipitation change, where it provides increased physical understanding of the processes that drive ΔP over land. Confidence in the thermodynamic part of extreme precipitation change over land is increased by this improved understanding, and this should scale approximately with Clausius–Clapeyron oceanic q increases under SST warming. Residuals of actual climate model Δq from simple model estimates are often associated with regions of large circulation change, and can be thought of as the “dynamical” part of specific humidity change. The simple model is used to explore intermodel uncertainty in Δq, and there are substantial contributions to uncertainty from both the thermodynamic (simple model) and dynamical (residual) terms. The largest cause of intermodel uncertainty within the thermodynamic term is uncertainty in the magnitude of global mean SST warming.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The potential for soils to produce nitrous oxide (N2O) is impacted by past moisture conditions; however, the extent of this impact is not fully understood. We conducted the first review of this, ...using two literature searches and a meta‐analysis. We found 36 studies out of a possible 735 that described experiments where soil moisture conditions had been controlled, such that the impact of antecedent moisture levels could be separated from contemporary moisture levels and attributed to N2O emissions. Of those studies, 14 (130 data points) used the appropriate experimental design and presented suitable data that could be standardized for the meta‐analysis. We found that the degree to which the soil was rewetted and the water filled pore space (WFPS) the soil was brought to were significant explanatory variables (p = < 0.0001). The larger the difference between the dry and wet states of the soil and the higher the WFPS of the soil after rewetting, the larger the hot moment, with an exponential increase once the soil is anaerobic. Substrate availability and fertiliser quantity and type were also important controls on the amount of N2O emitted during the hot moment (p = < 0.0001). However, controls with a constant WFPS can have the same anaerobicity and substrate concentrations, yet much lower emissions, so we suggest that it is the bioavailability of and how the substrates are utilized by the microbial community, and thus how they are primed by the drought, that is the main causal mechanism. Unfortunately, there is still a large uncertainty regarding how microbial population structure, relative gene abundances and gene expression profiles change according to antecedent dry/wet cycles. We suggest several areas of improvement for future studies and the development of drought‐impact curves. These would show the relationship between N2O emissions and the length of drought (we found no studies that have investigated this) and N2O emissions and the severity of drought (e.g. the difference between 20% and 40% WFPS).
Highlights
We investigated the main causal mechanisms of N2O hot moments after soil is rewetted.
This is the first meta‐analysis and synthesis of the literature regarding N2O hot moments.
The more anaerobic the soil and the more C and N substrates, the larger the hot moment.
We provide recommendations for future studies and outline key gaps in the research.
Grain boundary formation during coarsening of nanoporous gold (NPG) is investigated wherein a nanocrystalline structure can form by particles detaching and reattaching to the structure. MicroLaue and ...electron backscatter diffraction measurements demonstrate that an in-grain orientation spread develops as NPG is coarsened. The volume fraction of the NPG sample is near the limit of bicontinuity, at which simulations predict that a bicontinuous structure begins to fragment into independent particles during coarsening. Phase-field simulations of coarsening using a computationally generated structure with a volume fraction near the limit of bicontinuity are used to model particle detachment rates. This model is tested by using the measured NPG structure as an initial condition in the phase-field simulations. We predict that up to ∼5% of the NPG structure detaches as a dealloyed Formula: see text sample is annealed at 300 °C for 420 min. The quantity of volume detached is found to be highly dependent on the volume fraction and volume fraction homogeneity of the nanostructure. As the void phase in the experiments cannot support independent particles, they must fall and reattach to the structure, a process that results in the formation of new grain boundaries. This particle reattachment process, along with other classic processes, leads to the formation of grain boundaries during coarsening in nanoporous metals. The formation of grain boundaries can impact a variety of applications, including mechanical strengthening; thus, the consideration and understanding of particle detachment phenomena are essential when studying nanoporous metals.
These evidence-based guidelines are an updated version of those published in 2006. They have been produced after a literature review of the treatment and prophylaxis of methicillin-resistant ...Staphylococcus aureus (MRSA). The guidelines aim to complement those recently published for the antibiotic treatment of common and emerging community-onset MRSA infections in the UK. The guidelines have reviewed and updated, where appropriate, previous recommendations, taking into account any changes in the UK epidemiology of MRSA, ongoing national surveillance data and the value of new antistaphylococcal agents licensed for use in UK practice. Emerging therapies that have not been licensed for UK use are not reviewed, but their future potential role has been mentioned where deemed appropriate. Recommendations are given for the treatment of common infections caused by MRSA, elimination of MRSA from carriage sites and prophylaxis of surgical site infection.
Understanding observed changes to the global water cycle is key to predicting future climate changes and their impacts. While many datasets document crucial variables such as precipitation, ocean ...salinity, runoff, and humidity, most are uncertain for determining long-term changes. In situ networks provide long time series over land, but are sparse in many regions, particularly the tropics. Satellite and reanalysis datasets provide global coverage, but their long-term stability is lacking. However, comparisons of changes among related variables can give insights into the robustness of observed changes. For example, ocean salinity, interpreted with an understanding of ocean processes, can help cross-validate precipitation. Observational evidence for human influences on the water cycle is emerging, but uncertainties resulting from internal variability and observational errors are too large to determine whether the observed and simulated changes are consistent. Improvements to the in situ and satellite observing networks that monitor the changing water cycle are required, yet continued data coverage is threatened by funding reductions. Uncertainty both in the role of anthropogenic aerosols and because of the large climate variability presently limits confidence in attribution of observed changes.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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