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The Impact of High-Fidelity Urinary Catheterization Simulation on Occupational Therapy Students in a Graduate Curriculum: A Pilot Study
Get PDFThe most recent estimate of the annual incidence of spinal cord injury (SCI) in the United States is approximately 54 cases per one million people. Occupational therapy (OT) students may not feel adequately prepared to treat and educate clients with SCIs about bladder management if they are not exposed to real-life scenarios during their graduate curriculum. Using high-fidelity simulations (HFS) offers a high level of interactivity and realism for the learner, often using human patient simulators and taking place in realistic, mock clinical settings. This study aims to examine the effects of a HFS on OT student\u27s confidence with urinary catheterization. Subjects (n=35) were first-year OT students recruited based on their participation in high-fidelity catheterization simulation. Participants completed the validated survey \u27Student Satisfaction and Confidence in Learning\u27 after completion of the HFS to reflect on their satisfaction with the simulation and confidence in performing catheterization on manikins. This study revealed two themes, including a greater need for OT services for individuals performing self-catheterization and incorporating HFSs into the graduate curriculum. Student satisfaction was rated extremely high, with all but 3% of the responses being either ‘agree’ or ‘strongly agree.’ Additionally, the responses to the statements regarding confidence showed heavy skewness, with an overwhelming majority of respondents answering ‘agree’ or ‘strongly agree.’ Responses from 35 OT graduate students suggest that learning the procedure for urinary catheterization is highly beneficial in increasing confidence levels, and high-fidelity catheterization simulations should be integrated into the OT curriculum
Comparing and Evaluating Contralateral Breast Dose Relative to Median PTV Tumor Bed Dose for Hypo-fractionated Breast Treatments Using Import High Dose Constraints.
Get PDFThis study is aimed to compare two different planning constraints for post-lumpectomy whole breast radiation treatments to evaluate whether or not the mean dose to the contralateral breast can be significantly reduced while maintaining plan quality for treatment. A total of 10 patients who had first undergone a lumpectomy were included into this study. Each patient’s initial treatment plan was created using a conventional approach with a mean dose constraint of \u3c 600 cGy (Plan A) and then was replanned using the Import High protocol of a mean dose constraint, aiming to further push for a mean dose \u3c 150 cGy (Plan B) to the contralateral breast. Both of these plans were analyzed for PTV coverage and dose to the surrounding critical structures. The results have shown that the contralateral mean dose was significantly reduced from an average of 216.32 in Plan A to 126.53 cGy in Plan B. All while meeting the target coverage of \u3e 95% isodose line. Statistical testing showed a significant difference between the two planning techniques of lowering the contralateral dose (p \u3c 0.0001), and normality testing supported the validity of the data analysis. In addition to a substantial dose reduction to the contralateral breast, Plan B maintained equal or improved dose constraint to other surrounding critical organs at risk, including the heart, lungs, spinal cord, and thyroid. The Import High protocol demonstrated consistent outcomes across diverse patient anatomies. These findings suggest that by using the Import High mean dose constraint, it is possible to maintain plan quality while reducing dose to the contralateral breast. This approach may help reduce the risk of long-term side effects and improve the patient’s overall outcomes in whole breast radiation treatments
Breaking the Cycle of Burnout in Financial Aid
Get PDFThe purpose of this project is to explore the causes and effects of burnout in financial aid staff and what potential strategies could be implemented to support staff experiencing burnout. Lack of work-life balance and increased work-related stress are a few causes of burnout seen throughout the literature. The intention of this project is to create a workshop that provides managers and directors with the necessary tools to identify the sign of burnout in their employees and provide the necessary support to mitigate the effects of burnout. Addressing and preventing burnout in financial aid staff will increase staff retention and overall student success
Preparing Educators to Meet the Unique Needs of Multilingual Learners
Get PDFEffectively educating multilingual learners requires knowledge of culturally and linguistically responsive teaching, as well as an understanding of translanguaging techniques. Research shows that the population of multilingual learners continues to grow in the United States, however, qualified educators with knowledge of the specific needs of this population are lacking. This project explores the need for ongoing support for secondary novice and non-ESL certified educators who teach multilingual students. Included in this project is a complete full year of professional development sessions ranging from culturally and linguistically responsive teaching practices, guidelines for accommodations and modifications, opportunities for classroom observations, and technology tools. Through the implementation of a yearlong professional development series on culturally and linguistically responsive practices, research shows that schools may improve teacher self-efficacy and job satisfaction, as well as lead to positive outcomes for multilingual learners
Evaluating dosimetric and treatment efficiency in esophageal cancer: a comparative study of volumetric modulated arc therapy, modified volumetric modulated arc therapy, and hybrid radiotherapy techniques
Get PDFThis study evaluated and compared the dosimetric outcomes and treatment efficiency of three radiation therapy techniques, Hybrid volumetric arc therapy (H-VMAT), Modified volumetric arc therapy (M-VMAT), and traditional Three-Arc volumetric arc therapy (T-VMAT), in the treatment of lower-third esophageal cancer. Ten patients with esophageal cancer located in the lower third of the esophagus were retrospectively replanned using each technique. H-VMAT combined 3-dimensional anterior-posterior/posterior-anterior (AP/PA) fields with two partial VMAT arcs. The M-VMAT technique included two full arcs and one arc with avoidance sectors. The T-VMAT technique used three full arcs. Each plan was prescribed 5040 cGy in 28 fractions using 6 MV photons. The dose constraints evaluated included lung V5, lung V20, mean heart dose, heart V40, spinal cord maximum dose, integral lung dose, maximum dose, monitor units, and estimated treatment time. Statistical analysis was performed using repeated-measures ANOVA, and Bonferroni-adjusted post hoc tests were employed to assess statistical significance. It was found that H-VMAT significantly reduced the dose to the lungs compared to M-VMAT and T-VMAT, but resulted in significantly higher doses to the heart and spinal cord. H-VMAT required fewer monitor units (MUs) and had the shortest treatment time. Additionally, M-VMAT provided a favorable balance between dose conformity, sparing of organs at risk (OAR), and delivery efficiency. These findings support the selection of individualized techniques based on patient anatomy and clinical priorities
Impact of prostate volume on dose fall-off and organ-at-risk exposure in VMAT for prostate cancer
Get PDFProstate cancer remains one of the most prevalent malignancies among men, with radiotherapy, particularly VMAT—playing a central role in its management. VMAT allows for highly conformal dose delivery, but treatment planning must strike a careful balance between achieving steep dose gradients around the prostate and minimizing radiation exposure to nearby organs at risk (OARs), such as the bladder and rectum. This study aimed to evaluate how prostate volume influences dose fall-off characteristics and OAR dose exposure in VMAT treatment plans, providing insights into optimizing radiotherapy for patients with varying prostate sizes. A retrospective analysis was conducted on 50 prostate cancer patients treated with VMAT. Dose-volume histograms and relative dose fall-off metrics (R30, R50, R70, R90, R95) were used to quantify spatial dose gradients beyond the planning target volume (PTV). Statistical analyses, including linear regression and Pearson correlation tests, assessed the relationship between PTV size and both dose fall-off behavior and OAR exposure. Results showed that larger prostate volumes were associated with steeper dose gradients, particularly at intermediate dose levels, suggesting improved conformity. However, this benefit was offset by a concurrent increase in radiation exposure to the bladder and rectum, as demonstrated by significantly higher V30 and V50 values. These findings highlight a clinically relevant trade-off: as prostate volume increases, treatment plans may achieve better dose conformity but at the cost of greater OAR exposure. This underscores the importance of personalized planning approaches—such as the use of rectal spacers, adaptive therapy, or image-guided techniques—to mitigate toxicity risks in patients with large prostates
The Trouble With Community Engagement: From Power Sharing to Power Shifting Through the Community Bill of Rights
Get PDFReflecting a growing consensus that meaningful change doesn’t come without the involvement of those most impacted, funders have signed on to efforts to “listen,” “get proximate,” and “empower.”
In this article, the authors draw on their lived expertise and research to describe how even well-intentioned community engagement efforts can become extractive, tokenizing, and undermine existing community assets. As a meaningful alternative, the authors suggest “centering community” as an orientation to all philanthropic work and the Community Bill of Rights (CBR) as a tool to guide the required change (Black et al., 2022).
Drawing on case examples from healthcare, urban planning, and other fields, the authors suggest an imperative for philanthropy to join government and community change agents in using the CBR to shift its approach to one where community is treated not as a stakeholder but as the primary owner of process, outcomes, and futures
Listening as an Adaptive Practice to Transform Philanthropy
Get PDFA growing number of grantmaking institutions (GMIs) recognize that listening to communities in which they invest—especially those to, and most affected by, the challenges being addressed—is crucial to achieve their equity goals. Despite investments and intent to listen, there is a gap in implementation.
Genuine listening for equity requires that foundation leaders view the shift as adaptive and not merely technical. A technical change entails adoption of specified methods whereas adaptive changes require a fundamental shift in values and beliefs. Solely implementing new “listening” techniques without shifting values and beliefs could leave gaps between intention and action. But current resources on listening for equity stop short of describing the necessary mindsets and how they manifest when applied in practice. In this paper, we provide a description of three mindsets and related practices GMIs can use for authentic listening, offering the Hartford Foundation for Public Giving as a case study
Dosimetric comparison of BioProtect balloon and Barrigel hydrogel rectal spacers in proton therapy for prostate cancer
No full textAbstract Purpose Rectal spacers are used in prostate cancer radiotherapy to reduce rectal dose and subsequent toxicity. This study aimed to directly compare the Barrigel hydrogel spacer and the BioProtect balloon spacer in terms of rectal dose reduction in the context of proton therapy. Methods A total of 30 prostate cancer cases treated at a single institution were retrospectively analyzed, evenly split between Barrigel and BioProtect arms (n=15 each). Each patient had both a prostateonly and a whole pelvis proton treatment plan created for this investigation. Dosimetric data were generated using uniform scanning and pencil beam scanning in RayStation 2023B. Prostate and rectal structures were contoured on MRI and CT, and dose-volume parameters (V70, V60, V50) were extracted for comparative analysis. Spacer volume and maximum anterior-posterior separation were also recorded. Statistical comparisons were performed using t-tests and MannWhitney U tests. Results BioProtect produced significantly greater prostate-rectum separation (18.3 ± 1.3 mm vs. 14.5 ± 2.9 mm) and larger spacer volumes (15.4 ± 1.7 cc vs. 9.9 ± 1.6 cc) than Barrigel. In pelvis plans, BioProtect reduced rectal V70 by 82%, V60 by 76%, and V50 by 74% compared to Barrigel (p\u3c 0.001). In prostate-only plans, reductions were 60% for V60 and 52% for V50 (p\u3c 0.01). Conclusion The BioProtect balloon spacer demonstrated superior and more consistent rectal dose sparing compared to Barrigel in proton therapy plans, suggesting potential for improved toxicity outcomes and quality of life
