An investigation of digital skills of therapeutic radiographers/radiation therapists: A european survey of proficiency level and future educational needs.

INTRODUCTION: This study aims to assess the proficiency level of digital skills, the factors influencing that level and the training needs of Therapeutic Radiographers/Radiation Therapists (TR/RTTs), due to the differences in technology availability and accessibility, variations in the regulation and education of TR/RTTs in European countries, and the lack of a digital skills framework. METHODS: An online survey was distributed to TR/RTTs working in Europe to capture their self-assessment of proficiency levels of digital skills when performing their clinical role. Information was also gathered regarding training, work experience and level of information and communication technology (ICT) skills. Quantitative measures were analysed using descriptive statistics and correlation between variables, and qualitative responses using thematic analysis. RESULTS: 101 respondents from 13 European countries completed the survey. Digital skills in treatment planning followed by management and research were the least developed skills, while the most developed were transversal digital skills followed by digital skills in treatment delivery. The Radiotherapy areas of practice where TR/RTT has experience (e.g. Planning Image, Treatment Planning, Treatment), as well as the level of generic ICT skills (communication, content creation and problem-solving), was related to the level of proficiency of TR/RTT digital skills. Greater scope of practice and level of generic ICT were associated with a higher level of TR/RTT digital skills. Thematic analysis allowed the identification of new sub-themes to be included in the training of TR/RTTs. CONCLUSION: Education and training of TR/RTTs should be improved and adapted to the current needs of digitalisation to avoid differences in digital proficiency levels. IMPLICATIONS FOR PRACTICE: Aligning TR/RTTs' digital skill sets with emerging digitalisation will improve current practice and ensure the best care to all RT patients.

Digital skills of therapeutic radiographers/radiation therapists - Document analysis for a European educational curriculum.

INTRODUCTION: It is estimated that around 50% of cancer patients require Radiotherapy (RT) at some point during their treatment, hence Therapeutic Radiographers/Radiation Therapists (TR/RTTs) have a key role to play in patient management. It is essential for TR/RTTs to keep abreast with new technologies and continuously develop the digital skills necessary for safe RT practice. The RT profession and education is not regulated at European Union level, which leads to heterogeneity in the skills developed and practised among countries. This study aimed to explore the white and grey literature to collate data on the relevant digital skills required for TR/RTTs practice. METHODS: An exhaustive systematic search was conducted to identify literature discussing digital skills of TR/RTTs; relevant grey literature was also identified. A thematic analysis was performed to identify and organise these skills into themes and sub-themes. RESULTS: 195 digital skills were identified, organised in 35 sub-themes and grouped into six main themes: (i) Transversal Digital Skills, (ii) RT Planning Image, (iii) RT Treatment Planning, (iv) RT Treatment Administration, (v) Quality, Safety and Risk Management, and (vi) Management, Education and Research. CONCLUSION: This list can be used as a reference to close current gaps in knowledge or skills of TR/RTTs while anticipating future needs regarding the rapid development of new technologies (such as Artificial Intelligence or Big Data). IMPLICATIONS FOR PRACTICE: It is imperative to align education with current and future RT practice to ensure that all RT patients receive the best care. Filling the gaps in TR/RTTs skill sets will improve current practice and provide TR/RTTs with the support needed to develop more advanced skills.

Comparison of flax (Linum usitatissimum) and Salba-chia (Salvia hispanica L.) seeds on postprandial glycemia and satiety in healthy individuals: a randomized, controlled, crossover study.

BACKGROUND/OBJECTIVES: Flax and Salba-chia seeds have risen in popularity owing to their favorable nutrient composition, including a high fiber content. Despite having comparable nutritional profiles, preliminary observations suggest differences in gelling properties, an attribute that may alter the kinetics of food digestion. Thus, we compared the effect of two seeds on postprandial glycemia and satiety scores. SUBJECTS/METHODS: Fifteen healthy participants (M/F: 5/10; age: 23.9±3 years; BMI: 22.2±0.8 kg/m2) were randomized to receive a 50 g glucose challenge, alone or supplemented with either 25 g ground Salba-chia or 31.5 g flax, on three separate occasions. Blood glucose samples and satiety ratings were collected at fasting and over 2-h postprandially. In addition, in vitro viscosity of the beverages was assessed utilizing standard rheological methodology. RESULTS: Both Salba-chia and flax reduced blood glucose area under the curve over 120 min by 82.5±19.7 mmol/l (P<0.001) and 60.0±19.7 mmol/l (P=0.014), respectively, relative to a glucose control. Salba-chia reduced peak glucose (-0.64±0.24 mmol/l; P=0.030) and increased time to peak (11.3±3.8 min; P=0.015) compared with flax. Salba-chia significantly reduced the mean ratings of desire to eat (-7±2 mm; P=0.005), prospective consumption (-7±2 mm; P=0.010) and overall appetite score (-6±2 mm; P=0.012), when compared with flax. The viscosity of Salba-chia, flax and control was 49.9, 2.5, and 0.002 Pa·s, respectively. CONCLUSIONS: Despite the similarities in nutritional composition, Salba-chia appears to have the ability to convert glucose into a slow-release carbohydrate and affect satiety to a greater extent than flax, possibly due to the higher fiber viscosity. Incorporation of either flax or Salba-chia into the diet may be beneficial, although use of Salba-chia may confer additional benefit.

The effect of megavoltage radiation on polymeric materials to be used in biomedical devices.

For a number of biomedical applications, including the development of phantoms for quality control of radiotherapy treatments and dose determination, it is important to study the radiation response of the used materials, in order to distinguish the relevant dose distribution modifications from the artifacts caused by the phantom material when subjected to high dose irradiation. Beside the radiation response, those materials should have certain physical and chemical properties in order to be able to be used for the purposes described above, i.e., mechanical hardness and inelasticity, chemically stability and nonreactive, among others. In this work, a wide range of polymeric materials were irradiated under megavoltage radiation using a radiotherapy linear accelerator. The irradiated materials were imaged using transmission X-ray tomography to determine if some radiation induced electronic density change could result in altered Hounsfield units. Furthermore, Raman Spectroscopy and X-ray Diffraction (XRD) techniques were used before and after irradiation in order to study any structural modification induced by the radiation. In addition, a special phantom simulating a breast treatment with two tangential beams has been fabricated and tested.

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.).

Despite strong correlations linking whole-grain consumption to reductions in heart disease, the physiological mechanisms involved remain ambiguous. We assessed whether Salba (Salvia Hispanica L.) whole grain reduces postprandial glycemia in healthy subjects, as a possible explanation for its cardioprotective effects observed in individuals with diabetes. The study used acute, randomized, double-blind, controlled design in which 11 healthy individuals (6 males and 5 females; body mass index 22.3+/-2.8 kg/m(2)) received 0, 7, 15 or 24 g of Salba baked into white bread. Capillary samples and appetite ratings were collected over 2 h after consumption. A dose-response reduction in postprandial glycemia (P=0.002, r(2)=0.203) was observed with all three doses of Salba, significantly decreasing incremental areas under the curve (iAUCs) and time point-specific blood glucose (P<0.05). Appetite ratings were decreased at 60 min after high, 90 min after high and intermediate and at 120 min after all treatments (P<0.05). Decrease in postprandial glycemia provides a potential explanation for improvements in blood pressure, coagulation and inflammatory markers previously observed after 12-week Salba supplementation in type II diabetes.

Nanocrystalline diamond: In vitro biocompatibility assessment by MG63 and human bone marrow cells cultures.

Nanocrystalline diamond (NCD) has a great potential for prosthetic implants coating. Nevertheless, its biocompatibility still has to be better understood. To do so, we employed several materials characterization techniques (SEM, AFM, micro-Raman spectroscopy) and cell culture assays using MG63 osteoblast-like and human bone marrow cells. Biochemical routines (MTT assays, Lowry's method, ALP activity) supported by SEM and confocal microscopy characterization were carried out. We used silicon nitride (Si3N4) substrates for NCD coatings based on a previous demonstration of the superior adhesion and tribological performance of these NCD coated ceramics. Results demonstrate an improved human osteoblast proliferation and the stimulation of differentiated markers, like ALP activity and matrix mineralization, compared with standard polystyrene tissue culture plates. The nanometric featuring of NCD, associated to its chemical affinity are key points for bone regeneration purposes.

Opening wedge high tibial osteotomy using 3D biomodelling Bonelike macroporous structures: case report.

Two synthetic calcium phosphates in porous wedge shape, Bonelike and a commercial HA/beta-TCP biphasic material, were used as an alternative to bone autografts and allografts in the treatment of medial compartment osteoarthritis of varus knees. The structure of Bonelike has a 3D architecture that is computer controlled, and a composition that mimics the mineral composition of natural bone. The HA/beta-TCP biphasic material used as a control material in this study was prepared using conventional foaming based methods. No signs of inflammatory reactions were observed post-operatively for both materials. After 4 months signs of fusion at the osteotomy site and good integration of the implanted wedges were observed, showing good mechanical resistance. Concerning the final correction attained, the left knee revealed a satisfactory valgus of 10 degrees , but the right one only had a final value of 6 degrees . The clinical evaluation using International Knee Score (IKS) showed good outcome in all parameters with complete range of motion in both knees and climbing stairs without crutches with only slight pain.

Physicochemical degradation studies of calcium phosphate glass ceramic in the CaO-P2O5-MgO-TiO2 system.

The aim of this work was to evaluate the in vitro degradation behaviour of a 45CaO-37P(2)O(5)-5MgO-13TiO(2) (mol.%) glass ceramic, under two different simulated physiological conditions: normal physiological pH 7.4, and pH 3.0, which was designed to simulate the acidic conditions produced by osteoclast cells. The in vitro testing was carried out at 37 degrees C for up to 42 days for the pH 7.4 solution and for up to 1 day for the pH 3.0 solution. The incorporation of TiO(2) into the glass structure leads to the precipitation of specific crystalline phases in the glass matrix, namely alpha- and beta-Ca(2)P(2)O(7), TiP(2)O(7) and CaTi(4)(PO(4))(6). The degradation testing at pH 3.0 showed a higher weight loss compared with degradation testing at pH 7.4; the weight loss under the acidic condition after 1 day (24 h) was about 10 times higher than the weight loss after 42 days of immersion at pH 7.4. The ionic release profile of Ca(2+), PO(4)(3-), Mg(2+) and Ti(4+) showed a continuous increase in concentration over all immersion times for both testing solutions. After 1 day of immersion at pH 3.0, the concentration levels of Mg(2+), Ca(2+), PO(4)(3-) were about six times higher than the levels achieved after 42 days of immersion at pH 7.4. The glass ceramic showed similar degradation to hydroxyapatite, and therefore has potential to be used in certain clinical applications where relatively slow resorption of the implant and replacement by bone is required, e.g. cranioplasty.

In vivo performance of biodegradable calcium phosphate glass ceramics using the rabbit model: histological and SEM observation.

Two MK5 (45CaO-45P(2)O(5)-5MgO-5K(2)O, in mol%) and MT13 (45CaO-37P(2)O(5)-5MgO-13TiO(2), in mol%) glasses are prepared in the meta- and pyrophosphate regions and crystallized to obtain MK5B and MT13B, respectively. MK5B was obtained by controlled crystallization, and MT13B by powder sintering. As a result of these heat treatment processes, the crystalline phases precipitated in the glassy matrix are KCa(PO(3))(3), beta-Ca(PO(3))(2), beta-Ca(2)P(2)O(7) and Ca(4)P(6)O(19) phases for MK5B and CaTi(4)(PO(4))(6), TiP(2)O(7), alpha- and beta-Ca(2)P(2)O(7) phases for MT13B. To assess the in vivo biological behavior of these glass ceramics, a mixed granulometry in the range 250-355 mum and 355-425 mum with a ratio of 1/1 was implanted for 2, 4, and 12 weeks in the tibiae of Japanese white rabbits. The results showed that the in vivo behavior was strongly affected by their solubility. All implanted materials, MK5B and MT13B, and beta-tricalcium phosphate (beta-TCP) as control material, showed signs of degradation in vivo. However, the levels of degradation were quite different throughout the implantation periods. The highest degradation was observed for MK5B glass ceramic and the lowest for MT13B with beta-TCP in-between. All implanted materials allow for new bone formation in the bone defect area. At the longest implantation period (12 weeks), the MT13B and beta-TCP materials were almost completely surrounded by new bone tissue, whereas MK5B showed some unfilled spaces. This behavior is discussed in terms of the high degradation observed in previous studies.

In vitro studies of calcium phosphate glass ceramics with different solubility with the use of human bone marrow cells.

Two glass ceramics in the CaO--P2O5--MgO system with the incorporation of K2O or TiO2 oxides were prepared with the goal of using them as potential bone graft substitutes. The incorporation of TiO2 and K2O led to the preparation of specific crystalline phases in the structure of the glass ceramics, which show different degrees of biodegradation. In fact, the 45CaO--45P2O5--5MgO--5K2O has been previously demonstrated to be much more soluble in aqueous solutions than the 45CaO--37P2O5--5MgO--13TiO2 glass ceramic. The in vitro biological activity of the two calcium phosphate glass ceramics was studied with the use of human bone marrow osteoblast cell cultures maintained for 28 days, and seeded materials were assessed for cell proliferation and function. The Ti-containing glass ceramic showed a stable surface throughout the culture time, on macroscopic and SEM observation. Osteoblast cells proliferated gradually, especially during the third week, with a high alkaline phosphatase activity and formation of a mineralized matrix. On SEM observation, attached cells appeared with a spread-polygonal morphology typical of the osteoblast cells, with extensive cell-to-cell contact. Cell behavior on the seeded material was similar to that found on cultures performed on tissue-culture-grade polystyrene; except for the presence of lower cell numbers during the first 2 weeks. By contrast, the K-containing glass ceramic showed a highly instable surface with dissolution/precipitation processes occurring throughout the culture time. Few cells adhered to the material surface, and subsequent proliferation was also hindered, especially from the first week onwards. Cell numbers were significantly lower than those observed in the Ti-containing glass ceramic during most of the incubation time. Results suggest that the different in vitro biological behavior of these two glass ceramics is mainly due to the significant differences in the surface degradation rate, which is directly correlated to the chemical composition of the mother glass.

[Knowledge and use of alternative medicine among elementary school students and teachers]. / Conhecimento e uso da medicina alternativa entra alunos e professores de primeiro grau.

The knowledge and use of popular cures was investigated as part of health education project in such a way as to develop and expand the existing possibilities for critical and constructive discussion in the school within the health program. It was hoped that this would result in the retrieval and in an increase in the value attributed to information concerning this nonsystematized knowledge present in a controversial and poorly accepted form in the practices of the population. One hundred and five teachers and 162 students of the 1st to 4th grades of the four primary schools on the outskirts of Belo Horizonte were interviewed. One hundred and five of the teachers answered the questions put. Twenty-three (32.4%) of the teachers said they believed in special cures, 69 (65.7%) thought that certain diseases could be treated with homemade remedies for these, 54 (78.3%) were able to associate a particular disease with a particular medicinal plant and 15 (21.7%) prescribed a treatment without any association with a particular disease, 36 (34.3%) cited a disease without relating this to a particular herb. One hundred and one (62.3%) of the students believed that homemade remedies are effective for certain diseases. Amongst the teachers and students various diseases were mentioned as well as different symptoms and organs that can be cured by medicinal plants, roots or traditional healers. A little more than 50% of the two groups of students (1st and 2nd grade, 3rd and 4th grade) live in families who make use of traditional healers to provide alternative cures.(ABSTRACT TRUNCATED AT 250 WORDS)

[Health education in 1st grade public schools at the periphery of Belo Horizonte, MG, Brazil. I. Evaluation of the program relative to schistosomiasis]. / Educação em saúde em escolas públicas de 1. grau da periferia de Belo Horizonte, MG, Brasil. I - Avaliação de um programa relativo à esquistossomose.

A project has been developed with the objective of implanting and testing new materials and methodologies related to health education in first level schools. The present study is being performed in 4 public schools of a periferic area of Belo Horizonte, in two regions, one of high and another of low prevalence of schistosomiasis. The experimental design includes 2 experimental schools and 2 of control. The procedure involves interviews with teachers and students before and after the experimental test of the new materials; stool surveys and treatment of the sample of students. The results of the first interviews demonstrated that the knowledge of schistosomiasis is almost absent among teachers and students, although the prevalence of this disease has been maintained for a long time (70 years) in one of the regions studied (Gorduras). Out of 3131 students of the 4 schools, 67.5% were examined and 235 (11.0%) were tested positively. When the new students of 1989 were not included the prevalence decrease to 9.0% demonstrating a significative difference (X2 - 5%) in relation to 1988, showing the consequence of the treatment performed. Comparing the 2 schools of high prevalence, the decrease of prevalence of the experimental one is higher than the control. Therefore, in relation to the schools of low prevalence, the same has not happened. Thus, it is only possible to suggest an initial effect of the educative strategy and the decreases of the prevalence in the schools of high prevalence. In relation to the knowledge about the disease transmission, the students from the experimental schools presented a significative increase of correct answers in 1989 than the control ones.