Inverse planned constant dose rate volumetric modulated arc therapy (VMAT) as an efficient alternative to five-field intensity modulated radiation therapy (IMRT) for prostate

Purpose: The aim of this work was to determine if volumetric modulated arc therapy (VMAT) plans, created for constant dose-rate (cdrVMAT) delivery are a viable alternative to step and shoot five-field intensity modulated radiation therapy (IMRT). Materials and methods: The cdrVMAT plans, inverse planned on a treatment planning system with no solution to account for couch top or rails, were created for delivery on a linear accelerator with no variable dose rate control system. A series of five-field IMRT and cdrVMAT plans were created using dual partial arcs (gantry rotating between 260° and 100°) with 4° control points for ten prostate patients with the average rectal constraint incrementally increased. Pareto fronts were compared for the planning target volume homogeneity and average rectal dose between the two techniques for each patient. Also investigated were tumour control probability and normal tissue complication probability values for each technique. The delivery parameters [monitor units (MU) and time] and delivery accuracy of the IMRT and VMAT plans were also compared. Results: Pareto fronts showed that the dual partial arc plans were superior to the five-field IMRT plans, particularly for the clinically acceptable plans where average rectal doses were less for rotational plans (p = 0·009) with no statistical difference in target homogeneity. The cdrVMAT plans had significantly more MU (p = 0·005) but the average delivery time was significantly less than the IMRT plans by 42%. All clinically acceptable cdrVMAT plans were accurate in their delivery (gamma 99·2 ± 1·1%, 3%3 mm criteria). Conclusions Accurate delivery of dual partial arc cdrVMAT avoiding the couch top and rails has been demonstrated.

Navigating Grounded Theory:A critical and reflective response to the challenges of using grounded theory in an education PhD

This paper offers a critical reflection upon the use of a grounded theory approach within a doctoral study. As well as providing an outline of grounded theory, it begins by noting the existence of some powerful critiques of a grounded theory approach, in particular around the key concepts of ‘theory’, ‘discovery’ and ‘ground’. It is argued that, in some cases, grounded theory struggles to counter these challenges, especially in its ‘purist’ forms. However, with reference to research carried out as part of a PhD study of sharing education in Northern Ireland which employed a grounded theory approach, a case is made for an open and critical grounded theory based upon three principles: pragmatism; research as practice; and reflexivity. It is concluded that a reasonable case can be made for grounded theory where: grounded theory researchers maintain a balance between belonging to and critique of the grounded theory community; where there is an emphasis upon theorizing rather than the discovery of theory; and where the strengths of grounded theory as 'practice' and 'craft' are maximised.

Factors influencing success of clinical genome sequencing across a broad spectrum of disorders

To assess factors influencing the success of whole-genome sequencing for mainstream clinical diagnosis, we sequenced 217 individuals from 156 independent cases or families across a broad spectrum of disorders in whom previous screening had identified no pathogenic variants. We quantified the number of candidate variants identified using different strategies for variant calling, filtering, annotation and prioritization. We found that jointly calling variants across samples, filtering against both local and external databases, deploying multiple annotation tools and using familial transmission above biological plausibility contributed to accuracy. Overall, we identified disease-causing variants in 21% of cases, with the proportion increasing to 34% (23/68) for mendelian disorders and 57% (8/14) in family trios. We also discovered 32 potentially clinically actionable variants in 18 genes unrelated to the referral disorder, although only 4 were ultimately considered reportable. Our results demonstrate the value of genome sequencing for routine clinical diagnosis but also highlight many outstanding challenges.

‘Reading Aran knitting: stitches, text andinterpretation’

The densely textured surfaces of Aran knitting seem to invite interpretation. They have been ‘read’ as identity documents, family trees, references to natural and spiritual phenomena, or even maps. This paper traces the search for meaning in Aran knitting, examining how these stitch patterns have been ‘read’ in the contexts of tourism, fine art and fashion. As Jo Turney (2013:55) argues, the idea of knitted textiles as communicative media in non-literate societies ‘consigns the garments to a preindustrial era of more rural and simple times’, situating them in an imagined state of ‘stasis’. Thus the ways in which Aran stitches are ‘read’ sometimes obscure the processes through which they are ‘written’, whether in terms of individual authorship and creativity, or in terms of their manufacture. Regardless of the historical veracity of claims that particular Aran stitch patterns index features of the social, natural or spiritual worlds, analysing the ways they have been ‘read’ in the context of comparable textile traditions, other crafts which have taken on ‘heritage’ souvenir status, and Irish national identity, reveals how Aran knitting has performed broader communicative functions (see Sonja Andrew 2008), which continue to be subverted and elaborated by fine artists, and translated into couture and mass market fashion products.

Gatekeepers to the profession: recruitment to initial teacher education in the United Kingdom

We develop a framing for research on the relationship between context, process and outcomes in recruitment to the teaching profession. We do this through a ‘home international’ comparison of policies, outcomes and recruitment processes in England, Northern Ireland, Scotland and Wales. There is plenty of movement between these countries in the graduate labour market, but the contexts for teacher supply and demand vary in terms of: (i) scale, (ii) excess supply or demand, (iii) reliance of policy on market forces or bureaucracy and (iv) beliefs of policymakers about whether teaching is a craft or a profession. Recent changes in England and Wales have highlighted the importance of recruitment to initial teacher education (ITE as a policy issue whilst also creating further points of comparison which are useful for research. We draw on trends in data on recruitment to teaching and in-depth interviews with gatekeepers to the profession in each country.

Unsettling modernity: Shifting values and changing housing styles in the Kathmandu Valley

Abstract

Culture has always been important for the character of the cities, as have the civic and public institutions that sustain a lifestyle and provide an identity. Substantial evidence of the unique historical, urban civilisation remains within the traditional settlements in the Kathmandu Valley in Nepal; manifested in houses, palaces, temples, rest houses, open spaces, festivals, rituals, customs and cultural institutions. Indigenous knowledge and practices prescribed the arrangement of houses, roads and urban spaces giving the city a distinctive physical form, character and a unique oriental nativeness. In technical sense, these societies did not have written rules for guiding development. In recent decades, the urban culture of the city has been changing with the forces of urbanisation and globalisation and the demand for new buildings and spaces. New residential design is increasingly dominated by distinctive patterns of Western suburban ideal comprising detached or semi-detached homes and high rise tower blocks. This architectural iconoclasm can be construed as a rather crude response to the indigenous culture and built form. The paper attempts to dismantle the current tension between traditional and contemporary ‘culture’ (and hence society) and housing (or built form) in the Kathmandu Valley by engaging in a discussion that cuts across space, time and meaning of architecture as we know it.

Seasons, Family and Nation in American Horror Story

Arguably, the title of American Horror Story sets out an agenda for the program: this is not just a horror story, but it is a particularly American one. This chapter examines the way that the program uses seasonal celebrations as a way of expressing that national identity, with special emphasis on the importance of family to those celebrations. The particular seasonal celebrations focused on are those of Halloween and Christmas, each of which has associations with the supernatural. However, the use of the supernatural at those seasons is one which is particularly associated with the US, presenting Halloween as a time of supernatural incursion and horror, and of disruption to society and the normal order of things, while Christmas is presented more as a time of unity for the family. Where the supernatural emerges in American Christmas television, it is typically as a force to encourage togetherness and reconciliation, rather than as a dark reminder of the past. While these interpretations of these festivals have been broadcast abroad by American cultural products, not least American television, they have different associations and implications elsewhere, as will be shown. So the particular uses of these festivals is part of what marks American Horror Story out as American, as is the way that the program's narratives have been structured to fit in with US television scheduling. This chapter, then, argues that the structures of the narratives combines with their use of the festivals of Halloween and Christmas in order to enhance the sense of this series as a particularly American horror story.