Thesis (M.D.) -- University of Texas Southwestern Medical Center at Dallas, 2007. / Vita. Bibliography: pp.73-78.

<p>Background: This is a retrospective study of patients treated with stereotactic body radiation therapy (SBRT) with the stereotactic body frame for centrally located lung tumours. The purpose was to investigate the doses to the different structures of the tracheobronchial tree and to relate these doses to the incidence of atelectasis. The goal was to estimate a tolerance dose for the bronchi. Materials: The patient material consisted of 71 patient treated at the Karolinska University Hospital for a total of 102 tumours between November 1993 and March 2004. The patient group consisted of 36 men and 35 women with a mean age at the treatment of 67 years (range 34-87). The group was a mixture of patients with primary lung cancer and pulmonary metastases. Methods: After rereading and reactivating the dose plans for the patients in the treatment planning system (TPS) the different tracheobronchial structures (trachea, right mainstem bronchus, right superior bronchus, right intermedius bronchus, right medius bronchus, right inferior bronchus, left mainstem bronchus, left superior bronchus, left intermedius bronchus, left inferior bronchus) were outlined. The dose distribution in each structure was calculated and a dose-volume histogram (DVH) was created. Patients were allocated to four groups, i.e. patients with right sided tumours (22), left sided tumours (14), mediastinal tumours (23) and bilateral tumours (10). After that the maximum and mean doses to all structures were analysed. An oncologist reviewed the medical records for the patients and especially looked for atelectasis. The doses were related to the incidence of atelectasis.</p><p>Results and Conclusions: For the patient group with right sided tumours it seems like the maximum doses to the bronchi are higher for the patients with atelectasis in comparison with patients without atelectasis. A better correlation between atelectasis and maximum doses rather than mean doses was observed for these patients. At this moment the results are too preliminary, so it is not possible to suggest a tolerance dose for the bronchi. What can be said is that the maximum doses to the bronchi for patients with right sided tumours without atelectasis are below 250 Gy3 expressed in biologically equivalent dose (BED) with α/β=3Gy, while at least one bronchi structure in the atelectasis patients received a maximum dose above 250 Gy3.</p>

<p>Background: Stereotactic body radiation therapy (SBRT) is a relatively new method which has been employed e.g. in the treatment of liver tumours. Little dosimetric data has been published for SBRT in the liver. The aim of this retrospective study was to quantify the dosimetric parameters that influence the toxicity of the healthy liver, and the effect on the tumour, for SBRT to liver tumours in patients treated at Karolinska University Hospital. A comparison was made to relating published studies.</p><p>Patients and Methods: The patient group to be studied were treated at Karolinska University Hospital for liver metastases with SBRT between July 1993 and October 2004. There were 64 patients treated with 71 treatment plans for 81 tumours. Differential dose volume histograms were collected for the clinical target volume (CTV), the planning target volume (PTV) and the liver excluding the CTV, from all dose plans. Since different fractionation schedules were used, the doses were normalised using the linear quadratic model, to be comparable. The doses to the uninvolved liver were evaluated with the mean liver dose, the Lyman-Kutcher-Burman (LKB) effective volume normal tissue complication probability (NTCP) model as well as the critical volume NTCP-model. A comparison was made to the studies of Dawson et al (2002) and Schefter et al (2005). The doses to the CTV were evaluated using the equivalent uniform dose tumour control probability (TCP) model, and related to target size and date of treatment.</p><p>Results: When the mean doses to the uninvolved liver (the liver volume without tumour tissue) were compared to Dawson and Ten Haken’s results (2005), 20 treatments out of 71 were predicted to give a risk of radiation induced liver disease (RILD) higher than 50%. The effective volume calculations predicted that 18 treatments gave a risk of RILD higher than 50%, when compared to the results of Dawson et al (2002). According to the critical volume model and the parameter values of Schefter et al (2005), our data predict that 10 of the treatments gave a risk of liver function failure, to an unspecified risk level. Treatments of large tumours resulted in higher doses to the liver. The doses to the CTV showed that the maximum prescribed dose decreased with increasing CTV.</p><p>Discussion and Conclusions: An evaluation of clinical data is necessary to make a full analysis of the treatments of this study. Such an analysis is planned for the future.</p>

Abstract This qualitative interview study was designed to understand how early literacy experiences continue to influence individuals as they become adult readers. The study utilized a case study methodology that allowed detailed descriptions of participants’ recollections of early literacy experiences and descriptions of the participants’ current reading habits. The researcher, working from a constructivist paradigm, worked to find evidence to explore what features of early reading experiences might compel an individual to turn to reading again and again, or to choose to abstain from reading. The following research questions guided this study: “What specific memories do adult readers recall about early reading experiences?” “What is the nature of the influence of early reading experiences on lifelong reading habits as reported by adults?” and “What is the nature of the influence of lifelong reading habits on social and professional life as reported by adults?” Seven participants shared their earliest memories of literacy experiences, as rooted in family and school contexts, along with explanations of the uses of reading in their adult lives. The researcher employed a typological analysis to determine how participants’ memories of early literacy experiences impacted their adult reading habits. The many facets of early reading experiences that influenced the participants’ reading habits could be categorized as positive, neutral, or negative. Most individuals experienced a combination of positive and negative literacy experiences, and the nature of these experiences influenced the participants’ adult reading habits in particular ways. The results of the analysis supported prior research in the field about the influence of teachers and the importance of early literacy instruction, and highlighted in particular, the emotional impact of successes or perceived failure in learning to read.

Background: This is a retrospective study of patients treated with stereotactic body radiation therapy (SBRT) with the stereotactic body frame for centrally located lung tumours. The purpose was to investigate the doses to the different structures of the tracheobronchial tree and to relate these doses to the incidence of atelectasis. The goal was to estimate a tolerance dose for the bronchi. Materials: The patient material consisted of 71 patient treated at the Karolinska University Hospital for a total of 102 tumours between November 1993 and March 2004. The patient group consisted of 36 men and 35 women with a mean age at the treatment of 67 years (range 34-87). The group was a mixture of patients with primary lung cancer and pulmonary metastases. Methods: After rereading and reactivating the dose plans for the patients in the treatment planning system (TPS) the different tracheobronchial structures (trachea, right mainstem bronchus, right superior bronchus, right intermedius bronchus, right medius bronchus, right inferior bronchus, left mainstem bronchus, left superior bronchus, left intermedius bronchus, left inferior bronchus) were outlined. The dose distribution in each structure was calculated and a dose-volume histogram (DVH) was created. Patients were allocated to four groups, i.e. patients with right sided tumours (22), left sided tumours (14), mediastinal tumours (23) and bilateral tumours (10). After that the maximum and mean doses to all structures were analysed. An oncologist reviewed the medical records for the patients and especially looked for atelectasis. The doses were related to the incidence of atelectasis. Results and Conclusions: For the patient group with right sided tumours it seems like the maximum doses to the bronchi are higher for the patients with atelectasis in comparison with patients without atelectasis. A better correlation between atelectasis and maximum doses rather than mean doses was observed for these patients. At this moment the results are too preliminary, so it is not possible to suggest a tolerance dose for the bronchi. What can be said is that the maximum doses to the bronchi for patients with right sided tumours without atelectasis are below 250 Gy3 expressed in biologically equivalent dose (BED) with α/β=3Gy, while at least one bronchi structure in the atelectasis patients received a maximum dose above 250 Gy3.

Background: Stereotactic body radiation therapy (SBRT) is a relatively new method which has been employed e.g. in the treatment of liver tumours. Little dosimetric data has been published for SBRT in the liver. The aim of this retrospective study was to quantify the dosimetric parameters that influence the toxicity of the healthy liver, and the effect on the tumour, for SBRT to liver tumours in patients treated at Karolinska University Hospital. A comparison was made to relating published studies. Patients and Methods: The patient group to be studied were treated at Karolinska University Hospital for liver metastases with SBRT between July 1993 and October 2004. There were 64 patients treated with 71 treatment plans for 81 tumours. Differential dose volume histograms were collected for the clinical target volume (CTV), the planning target volume (PTV) and the liver excluding the CTV, from all dose plans. Since different fractionation schedules were used, the doses were normalised using the linear quadratic model, to be comparable. The doses to the uninvolved liver were evaluated with the mean liver dose, the Lyman-Kutcher-Burman (LKB) effective volume normal tissue complication probability (NTCP) model as well as the critical volume NTCP-model. A comparison was made to the studies of Dawson et al (2002) and Schefter et al (2005). The doses to the CTV were evaluated using the equivalent uniform dose tumour control probability (TCP) model, and related to target size and date of treatment. Results: When the mean doses to the uninvolved liver (the liver volume without tumour tissue) were compared to Dawson and Ten Haken’s results (2005), 20 treatments out of 71 were predicted to give a risk of radiation induced liver disease (RILD) higher than 50%. The effective volume calculations predicted that 18 treatments gave a risk of RILD higher than 50%, when compared to the results of Dawson et al (2002). According to the critical volume model and the parameter values of Schefter et al (2005), our data predict that 10 of the treatments gave a risk of liver function failure, to an unspecified risk level. Treatments of large tumours resulted in higher doses to the liver. The doses to the CTV showed that the maximum prescribed dose decreased with increasing CTV. Discussion and Conclusions: An evaluation of clinical data is necessary to make a full analysis of the treatments of this study. Such an analysis is planned for the future.

Researchers have found considerable evidence that information about school performance affects people's choices about which schools to send their children to and even where to live. In contrast, little attention has been paid to the effects of school performance information on people's political behavior. Yet Hirschman (1970) famously highlighted the importance of taking seriously not only economic forces, but also the role of "political mechanisms", that is, "non-market forces" or "voice", in analyzing people's responses to school performance and the implications of these responses for school outcomes. This dissertation explores the effect of information about student and school performance on people's political attitudes and behavior. I first present findings from an original dataset of school board elections in Florida that indicate that voters fail to punish school board incumbents in response to information signaling poor school performance. There is even evidence that voters sometimes reward incumbents for failure. I next analyze a dataset that links student test scores in England to a subsequent survey, and find that that informational signals about individual student performance can have long&minus;lasting effects on parental behavior. Finally, I analyze the results of a survey experiment administered to a nationally representative sample of Americans, and find that information about the relative performance of local schools depresses average perceptions of local school quality and increases support for school reforms. / Government

This research study explore: (a) beliefs Korean ESL readers have about reading in L1 and L2 prior to the Retrospective Miscue Analysis (RMA) sessions, (b) how their beliefs about reading affect the way they read in L1 and L2 and their evaluation of themselves as readers in L1 and L2 reading, and (c) change of their beliefs about reading and about themselves as readers that result from the use of RMA.

Inledning: Bandy har en låg skadeincidens med cirka 7 skador per 1000 matchtimmar. Den vanligaste skadelokalisationen är ansiktet som står för ca en tredjedel av rapporterade skador. Eftersom antalet studier inom bandy är begränsat, finns anledning till att öka kunskapen om skadepanoramat, för att på sikt kunna arbeta förebyggande för att minska antalet skador. Syfte: Att med en kvantitativ ansats analysera rapporterade skador i elitseriebandy herrar 2007-2012. Metod: Resultatet av samtliga inrapporterade skador mellan 2007-2012 har analyserats. Materialet bestod av det totala antalet individer från lag som rapporterat skador, totalt 378 spelare. Resultat: Totalt rapporterades 97 skador under 2007-2012. Av dessa klassades 36 % (35/97) som allvarliga, det vill säga spelaren bedömdes avstå träning samt match mer än sju dagar. Ansiktsskador stod för 28 % (29/97) av skadorna. Slutsats: Studien visade i att ansiktsskador var den vanligaste skadelokalisationen, och att andelen allvarliga skador i likhet med tidigare studie inom elitbandy var hög. Nyckelord: ansiktsskada, bandy, retrospektiv, skadeprevention / Introduction: A low injury incidence has been reported from elite bandy (approximately 7 injuries/1000 game hours). The most common location was in the face, which represent about 30% of reported injuries. However, the studies are few and more knowledge is needed to support planning of preventive measures. Objective: To investigate injuries in Elite male bandy the years 2007-2012. Method: All reported injuries from participating teams in the Swedish professional 2007-2012 has been analysed. The participants consisted of 378 players followed between one and four seasons. Result: Totally, 97 injuries were reported during 2007-2012. Of those were 36 % (35/97) classified as severe, meaning that the player could not participate in training or games for at least 7 days. Facial injuries represent 29 % (28/97) of total injuries. Conclusion: Present study show similar results as previous report that face injuries is the most common injury in male elite bandy, and that the share of severe injuries is high. Key words: bandy, facial injury, injury prevention, retrospective

The distorted illusion that drinking alcohol in excess and/or using drugs is fun, sexy, and accepted as the ‘thing to do’ has unfortunately become mainstream. The health effects associated with substance use and abuse in Canada have direct implications on health service utilization, especially when emergent services are required. The prevalence of substance related ED visits in Winnipeg have never been reported, so it was not known if the prevalence of such presentations in Winnipeg were consistent with those rates in other developed nations. The overall aim of this study was to explore, using retrospective secondary analysis methodology and being guided by the Circle of Frequency, what the prevalence, patient profiles, and visit characteristics of substance-related ED presentations in Winnipeg from January 1, 2011-December 31, 2013. 14,255 substance-related ED visits were identified during this study time, accounting for 2.1% of the overall ED visits. Following frequency analysis, young-adult, unmarried men were identified as the ones most likely to arrive to the ED in Winnipeg with substance-related care needs arriving during inopportune times (on weekends and during the night when staffing levels and support are less), via ambulance, with acute CTAS scores secondary to substance misuse/intoxication, however not requiring admission. The significance of such presentations to the ED in Winnipeg has direct and indirect clinical implications which impacts clinical nursing practice, education, research, and patient care. Strategies to better identify and treat such care needs in the ED are evident and paramount to ensure best practice is provided, and optimal care is achieved.