Specialty Registrars’ Experience of Managing Head and Neck Cancer Patients

Objective The aim of this study was to collate and compare data on the training of Specialty Registrars in Restorative Dentistry (StRs) in the management of head and neck cancer (HANC) patients across different training units within the UK and Ireland. Methods Current trainees were invited to complete an online questionnaire by the Specialty Registrars in Restorative Dentistry Group (SRRDG). Participants were asked to rate their confidence and experience of assessing and planning treatment for HANC patients, attending theatre alone and manufacturing surgical obturators, and providing implants for appropriate cases. Respondents were also asked to appraise clinical and didactic teaching at their unit, and to rate their confidence of passing a future Intercollegiate Specialty Fellowship Examination (ISFE)-station assessing knowledge of head and neck cancer. Results Responses were obtained from 21 StRs (n=21) training within all five countries of the British Isles. Most respondents were based in England (76%), with one StR in each of Scotland, Wales, Northern Ireland and the Republic of Ireland. A third (33%) were in their 5th year of training. Almost half of the StRs indicated that they were confident of independently assessing (48%) new patients with HANC, with fewer numbers reporting confidence in treatment planning (38%). The majority (52%) of respondents indicated that they were not confident of attending theatre alone and manufacturing a surgical obturator. A third (33%) rated their experience of treating HANC patients with implants as ‘poor’ or ‘very poor’, including three StRs in their 5th year of training. Less than one third (<33%) rated didactic teaching in maxillofacial prosthodontics at their unit as ‘good’ or ‘excellent’, and only 7 StRs indicated that they were confident of passing an ISFE-station focused on HANC. Conclusion Experience and training regarding patients with head and neck cancer is inconsistent for StRs across the UK and Ireland with a number of trainees reporting a lack of clinical exposure.

Evaluation of Restorative Dentistry Specialty Registrars’ Clinical Experience of Developmental Disorders: A Survey

Background

Specialty Registrars in Restorative Dentistry (StRs) should be competent in the independent restorative management of patients with developmental disorders including hypodontia and cleft lip/palate upon completion of their specialist training.1 Knowledge and management may be assessed via the Intercollegiate Specialty Fellowship Examination (ISFE) in Restorative Dentistry.2

Objective

The aim of this study was to collate and compare data on the training and experience of StRs in the management of patients with developmental disorders across different training units within the British Isles.

Methods

Questionnaires were distributed to all StRs attending the Annual General Meeting of the Specialty Registrars in Restorative Dentistry Group, Belfast, in October 2015. Participants were asked to rate their confidence and experience of assessing and planning treatment for patients with developmental disorders, construction of appropriate prostheses, and provision of dental implants. Respondents were also asked to record clinical supervision and didactic teaching at their unit, and to rate their confidence of passing a future ISFE station assessing knowledge of developmental disorders.

Results

Responses were obtained from 32 StRs (n=32) training within all five countries of the British Isles. The majority of respondents were based in England (72%) with three in Wales, and two in each of Scotland, Northern Ireland, and the Republic of Ireland. Approximately one third of respondents (34%) were in the final years of training (years 4-6). Almost half of the StRs reported that they were not confident of independently assessing (44%) new patients with a developmental disorder, with larger numbers (72%) indicating a lack of confidence in treatment planning. Six respondents rated their experience of treating obturator patients as ‘poor’ or ‘very poor’. The majority (56%) rated their experience of implant provision in these cases as ‘good’ or ‘excellent’ with three-quarters (75%) rating clinical supervision at their unit as ‘good’ or ‘excellent’. Less than half (41%) rated the didactic teaching at their unit as ‘good’ or ‘excellent’, and only 8 StRs indicated that they were confident of passing an ISFE station focused on developmental disorders.

Conclusion

Experience and training regarding patients with developmental disorders is inconsistent for StRs across the British Isles with a number of trainees reporting a lack of clinical exposure.

Climate drives temporal replacement and nested‐resultant richness patterns of Scottish coastal vegetation

Beta diversity quantifies spatial and/or temporal variation in species composition. It is comprised of two distinct components, species replacement and nestedness, which derive from opposing ecological processes. Using Scotland as a case study and a β-diversity partitioning framework, we investigate temporal replacement and nestedness patterns of coastal grassland species over a 34-yr time period. We aim to 1) understand the influence of two potentially pivotal processes (climate and land-use changes) on landscape-scale (5 × 5 km) temporal replacement and nestedness patterns, and 2) investigate whether patterns from one β-diversity component can mask observable patterns in the other.

We summarised key aspects of climate driven macro-ecological variation as measures of variance, long-term trends, between-year similarity and extremes, for three important climatic predictors (minimum temperature, water-balance and growing degree-days). Shifts in landscape-scale heterogeneity, a proxy of land-use change, was summarised as a spatial multiple-site dissimilarity measure. Together, these climatic and spatial predictors were used in a multi-model inference framework to gauge the relative contribution of each on temporal replacement and nestedness patterns.

Temporal β-diversity patterns were reasonably well explained by climate change but weakly explained by changes in landscape-scale heterogeneity. Climate was shown to have a greater influence on temporal nestedness than replacement patterns over our study period, linking nestedness patterns, as a result of imbalanced gains and losses, to climatic warming and extremes respectively. Important climatic predictors (i.e. growing degree-days) of temporal β-diversity were also identified, and contrasting patterns between the two β-diversity components revealed.

Results suggest climate influences plant species recruitment and establishment processes of Scotland's coastal grasslands, and while species extinctions take time, they are likely to be facilitated by climatic perturbations. Our findings also highlight the importance of distinguishing between different components of β-diversity, disentangling contrasting patterns than can mask one another.

Eutrophication and some European waters of restricted exchange

Regions of Restricted Exchange (RREs) are an important feature of the European coastline. They are historically preferred sites for human settlement and aquaculture and their ecosystems, and consequent human use, may be at risk from eutrophication. The OAERRE project (EVK3-CT1999-0002 concerns ‘Oceanographic Applications to Eutrophication in Regions of Restricted Exchange’. It began in July 2000, and studies six sites. Four of these sites are fjords: Kongsfjorden (west coast of Spitzbergen); Gullmaren (Skagerrak coast of Sweden); Himmerfj.arden (Baltic coast of Sweden); and the Firth of Clyde (west coast of Scotland). Two are bays sheltered by sand bars: Golfe de Fos (French Mediterranean); and Ria Formosa (Portuguese Algarve). Together they exemplify a range of hydrographic and enrichment conditions. The project aims to understand the physical, biogeochemical and biological processes, and their interactions, that determine the trophic status of these coastal marine RRE through the development of simple screening models to define, predict and assess eutrophication. This paper introduces the sites and describes the component parts of a basic screening model and its application to each site using historical data. The model forms the starting point for the OAERRE project and views an RRE as a well-mixed box, exchanging with the sea at a daily rate E determined by physical processes, and converting nutrient to phytoplankton chlorophyll at a fixed yield q: It thus uses nutrient levels to estimate maximum biomass; these preliminary results are discussed in relation to objective criteria used to assess trophic status. The influence of factors such as grazing and vertical mixing on key parameters in the screening model are further studied using simulations of a complex‘research’ model for the Firth of Clyde. The future development of screening models in general and within OAERRE in particular is discussed. In addition, the paper looks ahead with a broad discussion of progress in the scientific understanding of eutrophication and the legal and socioeconomic issues that need to be taken into account in managing the trophic status of RREs.

Environmental assessment and biomonitoring of the Twelve Mile Creek watershed, Niagara Peninsula, Ontario

In light of the heavy reliance of the people of the Niagara Peninsula on the T\\'elve Mile Creek (TMC) watershed for recreational activities and for municipal and industrial uses ( e.g., drinking water, shipping and discharge of effluents), it was deemed prudent to assess the envirol1tnental health of the system by analysing the sediments total and exchangeable metal, and TPH contents. The MOEE has set guidelines with limits for the protection and management of aquatic sediments, and the sediments from the headwaters of the TMC have total metal and TPH (subset of O&G) contents well below the lower provincial limits. Areas of environmental concern where total metal contents in sediments, either individually or collectively, exceed the guideline, are the south side of Lake Gibson, the Old WeIland Canal, a segment of TMC just south of the QEW and Martindale Pond. The total metal content of sediments does not in all instances identify areas of biological concern. Instead, it has been found that the exchangeable metal fraction of sediments is a better indicator of metal availability and thus potential accumulation in organisms. In some instances, the exchangeable metal fraction agrees with the total metal fraction defining areas of environmental concern, but it does vary from site to site reflecting the natural variability of the ambient environment. Overall, the exchangeable metal fraction of sediments appears to be a better indicator of anthropogenic pollution and ecosystem impact. A histochemical study of Anodon.ta sp., Elliptio sp. and zebra mussels (Dreissena polyn'101pha) was done in conjunction with passive biomonitoring of zebra and quagga mussels (Dreissena bugensis) from the Twelve Mile Creek watershed and Lake 51. Clair (Jeanette's Creek, Chatham, Ontario). The highest concentrations of divalent metals such as Cu, Ni, Cd, and Zn, and trivalent Al appear to accumulate in gill and kidney tissues. Metal contents of organ tissues in Anodonta sp. vary with size class. Organ metal content varies among size classes, thus requiring consideration of size in biomonitoring studies. Shucked zebra and quagga mussel tissues, exhibited similar size class to Al content trends. In addition they reflected the Al content trends of top (approximately 10 cm) most sediments in the Twelve Mile Creek watershed. Quagga mussels appear to have higher Al concentrations than zebra mussels, thus suggesting that quagga mussels may be better passive biomonitors of AI. Cd content in zebra mussel tissues, seemed to increase with size class trends. This was not demonstrated in the quagga mussel tissues. This suggests that Cd may be regulated by quagga mussels and not by zebra mussels, and that zebra mussels may be better passivebiomonitors of Cd than are quagga mussels. Zebra mussel, quagga mussel, Anodonta sp., and Elliptio sp. were used in a two part, active (translocated) biomonitoring study of the Twelve Mile Creek watershed. There was no statistical difference in death rates between zebra and quagga mussels after 65 days of biomonitoring. However there does appear to be a difference of death rates between sites. Unfortunately the data base did not permit us to differentiate between sites. Relative to Port Colborne Harbour (Port Colborne, Ontario), the Twelve Mile Creek watershed appears to be elevated in bioavailable AI. An area near the terminus of the Twelve Mile Creek appears to be an area of environmental concern since mussels seemed to have accumulated relatively large concentrations of Cd, Zn, and Pb. In addition to possible metal loading from a nearby outfalls, or possible upstream outfalls, road salt runoff from storm sewers may have contributed to metal accumulation through cation exchanges processes. Similar trends in cumulative quagga mussel metal concentrations during the two time periods (65 and 159 days), suggest that quagga mussels may reach equilibrium within 65 days of translocation. Differences in bioaccumulated metal concentrations of the two dreissenid species demonstrate that active biomonitoring studies must use a variety of organisms to adequately assess the environmental situation of specific waterways and/or bodies.

I.O.D.E. Earl Mountbatten Chapter Fonds, 1945-2007

The I.O.D.E. as we currently know it today was founded in 1900 by Margaret Polson Murray of Montreal, who recognized a need for loyal support of Canadians departing to fight in the Boer War with the Empire forces in South Africa. She encouraged the formation of a federation of women to promote patriotism, loyalty and service to others. The first chapter was formed in Fredericton, New Brunswick on January 15th 1900. Primary chapters were formed in quick succession across Canada. In 1901, Edith Boulton Nordheimer was elected the first national president, the location of the head office became Toronto, Ontario and the federation was incorporated as Imperial Order Daughters of the Empire and Children of the Empire Junior Branch. The Earl Mountbatten Chapter was formed in 1947 and is continuing to be a functioning chapter at the time of writing this finding aid. During the 1970’s the name I.O.D.E. was officially adopted. It is a federally chartered not-for-profit, charitable organization. Structured to report under the jurisdiction of the National chapter are the Provincial chapters, the Municipal chapters and the Primary chapters. The I.O.D.E. is associated with the Victory League in England and Daughters of the British Empire in the United States and it is proud of its heritage and traditions. Queen Elizabeth II is the current patron of the organization and although chapters sometimes disband there are always new chapters forming, including e-chapters that meet through 21st century electronics.

I.O.D.E. Second Dragoons Chapter Fonds, 1967-1983

The I.O.D.E. as we currently know it today was founded in 1900 by Margaret Polson Murray of Montreal, who recognized a need for loyal support of Canadians departing to fight in the Boer War with the Empire RG310 page 2 forces in South Africa. She encouraged the formation of a federation of women to promote patriotism, loyalty and service to others. The first chapter was formed in Fredericton, New Brunswick on January 15th 1900. Primary chapters were formed in quick succession across Canada. In 1901, Edith Boulton Nordheimer was elected the first national president, the location of the head office became Toronto, Ontario and the federation was incorporated as Imperial Order Daughters of the Empire and Children of the Empire Junior Branch. The Second Dragoons Chapter was formed in 1933 and was disbanded in 1983, which was their 50th anniversary. During the 1970’s the name I.O.D.E. was officially adopted. It is a federally chartered not-for-profit, charitable organization. Structured to report under the jurisdiction of the National chapter are the Provincial chapters, the Municipal chapters and the Primary chapters. The I.O.D.E. is associated with the Victory League in England and Daughters of the British Empire in the United States and it is proud of its heritage and traditions. Queen Elizabeth II is the current patron of the organization and although chapters sometimes disband there are always new chapters forming, including e-chapters that meet through 21st century electronics

Marriage Certificate - Percy Carruthers Band and Margaret Julia Woodruff

A marriage certificate of Percy Carruthers Band of the city of New York, U.S.A. and Margaret Julia Woodruff of St. Catharines, Ontario, November 25, 1919. The witnesses are C.S. Band and M.S. Walker. The marriage is registered in St. George's Church.

Predicting the Risk of Lung Cancer in Never-smokers

Despite being considered a disease of smokers, approximately 10-15% of lung cancer cases occur in never-smokers. Lung cancer risk prediction models have demonstrated excellent ability to discriminate cases from non-cases, and have been shown to be more efficient at selecting individuals for future screening than current criteria. Existing models have primarily been developed in populations of smokers, thus there was a need to develop an accurate model in never-smokers. This study focused on developing and validating a model using never-smokers from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cox regression analysis, with six-year follow-up, was used for model building. Predictors included: age, body mass index, education level, personal history of cancer, family history of lung cancer, previous chest X-ray, and secondhand smoke exposure. This model achieved fair discrimination (optimism corrected c-statistic = 0.6645) and good calibration. This represents an improvement on existing neversmoker models, but is not suitable for individual-level risk prediction.

Indenture between Jacob Huffman and Margaret Huffman

Indenture of bargain and sale between Jacob Huffman and Margaret Huffman formerly of Bertie Township but moved to Grand Island, New York to Benjamin Troup and John Troup, both of Bertie Township regarding approximately 50 acres of land in Lot no. 3 of the 5th Concession in the Township of Bertie - instrument no. 2295. This was registered on June 25, 1845 in Book E folios 321, 322 and 323, June 25, 1845.

Indenture between Julia Cleveland Woodruff and Margaret Julia Band

Indenture of Release of Dower between Julia Cleveland Woodruff of St. Catharines (widow of Hamilton K. Woodruff) and Margaret Julia Band of Toronto (wife of Percy K. Band). On Jan.28, 1926 Hamilton K. Woodruff granted and conveyed to Margaret Julia Band 1 acre in the Township of Sherbourne composed of Woodruff Island in St. Nora’s Lake opposite lot no.2 in the 1st concession of Sherborne, except the pine trees on the island. There were also 75 acres in the town of Sherborne composed of St. Margaret’s Island in St. Nora’s Lake. Julia Cleveland did not join in the execution of this conveyance but has agreed to execute this indenture in order to release her dower in said lands. Margaret Julia Band paid $1 to Julia Cleveland Woodruff to complete this transaction, Dec. 1947.

Genetic association study of plasma creatine kinase levels in the Montreal Heart Institute Hospital Cohort

Il a déjà été démontré que les statines (ou inhibiteurs de la HMG-CoA réductase) sont efficaces pour réduire le LDL-cholestérol et elles se sont depuis établies comme étant le pilier dans le traitement de la dyslipidémie. Toutefois, environ 10 pourcent des utilisateurs de statines souffrent d'effets indésirables, généralement sous forme de myopathie qui est souvent accompagnée d’un taux élevé de la créatine kinase (CK) plasmatique. Il est fréquent que les patients doivent arrêter les statines à cause d’un taux de CK dépassant un seuil de référence. Nous avons examiné le taux de CK de près de 6000 participants de la biobanque de l’ICM, qui ont récemment été génotypés à l'aide de la micropuce d'ADN ExomChip d'Illumina. Des études antérieures ont démontré une association significative entre le taux de CK plasmatique et des polymorphismes génétiques et nous avons cherché à répliquer ces résultats par association génétique et à l'aide du test SKAT pour les polymorphismes rares. Nous avons répliqué les résultats dans le gène CKM (rs11559024, p=1.59x10-23) et le gène LILRB5 (rs12975366, p=1.44x10-26) dans le chromosome 19. Nous espérons que ces résultats seront éventuellement utilisés en clinique pour la prédiction des taux de référence de CK personnalisés selon le profil génétique des patients utilisateurs de statines.

Exploration of geological variability and possible processes through the use of compositional data analysis: an example using scottish metamorphosed

Developments in the statistical analysis of compositional data over the last two decades have made possible a much deeper exploration of the nature of variability, and the possible processes associated with compositional data sets from many disciplines. In this paper we concentrate on geochemical data sets. First we explain how hypotheses of compositional variability may be formulated within the natural sample space, the unit simplex, including useful hypotheses of subcompositional discrimination and specific perturbational change. Then we develop through standard methodology, such as generalised likelihood ratio tests, statistical tools to allow the systematic investigation of a complete lattice of such hypotheses. Some of these tests are simple adaptations of existing multivariate tests but others require special construction. We comment on the use of graphical methods in compositional data analysis and on the ordination of specimens. The recent development of the concept of compositional processes is then explained together with the necessary tools for a staying- in-the-simplex approach, namely compositional singular value decompositions. All these statistical techniques are illustrated for a substantial compositional data set, consisting of 209 major-oxide and rare-element compositions of metamorphosed limestones from the Northeast and Central Highlands of Scotland. Finally we point out a number of unresolved problems in the statistical analysis of compositional processes

A description of the FAMOUS (version XDBUA) climate model and control run

FAMOUS is an ocean-atmosphere general circulation model of low resolution, capable of simulating approximately 120 years of model climate per wallclock day using current high performance computing facilities. It uses most of the same code as HadCM3, a widely used climate model of higher resolution and computational cost, and has been tuned to reproduce the same climate reasonably well. FAMOUS is useful for climate simulations where the computational cost makes the application of HadCM3 unfeasible, either because of the length of simulation or the size of the ensemble desired. We document a number of scientific and technical improvements to the original version of FAMOUS. These improvements include changes to the parameterisations of ozone and sea-ice which alleviate a significant cold bias from high northern latitudes and the upper troposphere, and the elimination of volume-averaged drifts in ocean tracers. A simple model of the marine carbon cycle has also been included. A particular goal of FAMOUS is to conduct millennial-scale paleoclimate simulations of Quaternary ice ages; to this end, a number of useful changes to the model infrastructure have been made.