396,727 research outputs found
Regional samverkan specialistsjuksköterskor : Penta Plus
No full textSyftet med föreliggande projekt var att söka flexibla utbildningslösningar isamverkan inom specialistsjuksköterskeutbildningarna vid Karlstads universitet,Högskolan Dalarna, Högskolan i Gävle, Mälardalens högskola ochÖrebro universitet.Frågeställningar1. Hur ser regionens personalförsörjning och behov ut?2. Vilka utbildningsformer och vilken lärarkompetens finns?3. Vilka antagningsvolymer finns?4. Hur kan samordning ske?Projektet baseras på en kartläggning av Penta Plus regionens personalförsörjning,behov och befintligt utbildningsutbud.Preliminärresultatet visar att anställda specialist- och handledarutbildadesjuksköterskor inom distriktssjukvård, vård av äldre och psykiatri ärförhållandevis lågt jämfört med anställda specialist- och handledarutbildadeinom anestesi-, intensiv- och operationssjukvård.Campusförlagd utbildning och distansutbildning på heltid och eller i annan studietaktförekommer vid lärosätena. Tre olika lärplattformar används: Fronter,First Class och två versioner av Blackboard. Lärarkompetensen i form av disputeradeinom respektive specialistutbildning är inte till alla delar kongruent i relationtill lärosätenas utbildningsutbud.Nuvarande antagningsvolymer är relaterade till antalet tillgängliga vfu platser,logistiken inom regionen i relation till lärosätenas kursutbud och kursstarer harmöjligheter till viss expansion inom vissa specialistutbildningar.Samordning där företrädesvis lärosätenas kursstarer, kursinnehåll och valbarakurser logistiskt korrelerar är ett mål för framtida arbete och medveten samverkan
Nature Plus Plus Inspired Computing - The Superset of Nature Inspired Computing
No full textThe term Nature Plus Plus Inspired Computing is coined by us in this article The abbreviation for this new term is N IC Just like the C programming language is a superset of C programming language Nature Plus Plus Inspired Computing N IC field is a superset of the Nature Inspired Computing NIC field We defined and introduced Nature Plus Plus Inspired Computing Field in this work Several interesting opportunities in N IC Field are shown for Artificial Intelligence Field Scientists and Students We show a literature review of the N IC Field after showing the definition of Nature Inspired Computing NIC Field The primary purpose of publishing this innovative article is to show a new path to NIC Field Scientists so that they can come up with various innovative algorithms from scratch As the focus of this article is to introduce N IC to researchers across the globe we added N IC Field concepts to the Particle Swarm Optimization algorithm and created the Children Cycle Riding Algorithm CCR Algorithm Finally results obtained by CCR Algorithm are shown followed by Conclusion
Marketing Turistikog Odredista
No full textTuristi danas imaju na raspolaganju pregršt mogućih odredišta za godišnji odmor. Na današnjem izrazito kompetitivnom turističkom tržištu, za konkurentnost odredišta nužna je učinkovita organizacija marketinga. Knjiga “Marketing turističkog odredišta” bavi se izazovima vezanim uz promociju odredišta na dinamičnim i heterogenim tržištima, te na razliku između onih koji se turizmom bave praktično i onih koji se njime bave akademski. Pisan od strane jednog “praktičara”, “Marketing turističkog odredišta” spaja turizam kao poslovni sektor i polje akademskog znanja, sintetizirajući mnoštvo akademske literature od izuzetnog praktičnog značaja za organizacije za upravljanje turističkim odredištima
Recibo, 1925 abr. 13, Madrid, de Editorial Plus-Ultra a D. M. Rien Puente
No full textRecibo impreso en azul y rojo, manuscrito en tinta negra, con número "1727"Alcance y contenido: Versa sobre la cantidad abonada por el destinatario, que se corresponde con el importe de saldo de su cuentaEn el membrete: "Editorial Plus-Ultra / Argensola, 2 / Madrid"Recibo firmado y rubricado por el Gerente de la Editorial, con firma ilegibleMembrete con los datos del nombre, la actividad y la dirección del establecimiento, en distintas líneas. Todo ello enmarcado con una cenefa en color verde y con fondo de colores. A la izquierda del recibo, Estado de Cuenta del destinatarioPapel color crema, perteneciente a un tac
Dr. Duane M. Jackson, Morehouse College, July 2011
No full textThis video is a conversation with Dr. Duane M. Jackson. Dr. Jackson talks about his paper, "Recall and the Serial Position Effect: The Role of Primacy and Recency on Accounting Students' Performance." Jackie Daniel, AUC Woodruff Library, is the interviewer
A rapid and systematic review of the clinical effectiveness and cost-effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small-cell lung cancer
No full textBACKGROUND:
The incidence of lung cancer is declining following a drop in smoking rates, but it is still the leading cause of death from cancer in England and Wales, with about 30,000 deaths a year. Survival rates for lung cancer are poor everywhere, but they appear to be better in the rest of the European Community and the USA than in the UK. Only about 5 per cent of people with lung cancer survive for 5 years, and nearly all of these are cured by surgery after fortuitously early diagnosis. At present, only a small proportion of patients (probably about 5 per cent) with non-small-cell lung cancer are being given chemotherapy. Some centres treat a greater proportion.
OBJECTIVES:
This review examines the clinical effectiveness and cost-effectiveness of four of the newer drugs - vinorelbine, gemcitabine, paclitaxel and docetaxel - used for treating the most common type of lung cancer (non-small-cell lung cancer). The first three drugs are used for first-line treatment, but at present docetaxel is used only after first-line chemotherapy has failed.
METHODS:
This report was based on a systematic literature review and economic modelling, supplemented by cost data. RESULTS - NUMBER AND QUALITY OF STUDIES: A reasonable number of randomised trials were found - three for docetaxel, six for gemcitabine, five for paclitaxel and 13 for vinorelbine. The quality of the trials was variable but good overall. There was a wide range of comparators. Some trials compared chemotherapy with best supportive care (BSC), which involves care that aims to control symptoms, with palliative radiotherapy if needed, but not to prolong life. Others compared the newer drugs against previous drugs or combinations. RESULTS - SUMMARY OF BENEFITS: The gains in duration of survival with the new drugs are modest - a few months - but worthwhile in a condition for which the untreated survival is only about 5 months. There are also gains in quality of life compared with BSC, because on balance the side-effects of some forms of chemotherapy have less effect on quality of life than the effects of uncontrolled spread of cancer. RESULTS - COSTS: The total cost to the NHS of using these new drugs in England and Wales might be about GBP 10 million per annum, but is subject to a number of factors. There would be non-financial constraints on any increase in chemotherapy for the next few years, such as staffing; the number of patients choosing to have the newer forms of chemotherapy is not yet known; and the costs of the drugs may fall, for example, as generic forms appear. RESULTS - COST PER LIFE-YEAR GAINED: The available data did not provide an entirely satisfactory basis for cost-effectiveness calculations. The main problem was the lack of direct comparisons of the new drugs. In order to strengthen the analysis, three different modelling approaches were used: pairwise comparisons using trial data; cost-minimisation analysis, as if all the new regimens were of equal efficacy; and cost-effectiveness analysis pooling the results of several trials with different comparators, giving indirect comparisons of the new drugs by using BSC as the common comparator. A number of different scenarios were explored through extensive sensitivity analysis in each model. Outcomes were expressed in incremental cost per life-year saved or incremental cost, versus BSC. There was insufficient evidence from which to derive cost per quality-adjusted life-year. In first-line treatment, vinorelbine, gemcitabine, and the lower-dose paclitaxel plus cisplatin combinations generally performed well against BSC under a range of different scenarios and especially when given as a maximum of 3 cycles. Incremental cost per life-year gained (LYG) versus BSC varied depending on scenario, but baseline figures based on trial data and protocols were: single-agent vinorelbine, pound 2194 per LYG; vinorelbine plus cisplatin, pound 5206; single-agent gemcitabine, pound 5690; gemcitabine plus cisplatin, pound 10,041; and paclitaxel plus cisplatin, pound 8537. In second-line chemotherapy, docetaxel gave a cost per LYG of pound 17,546, again well within the range usually accepted as cost-effective. However, in routine care, the impact of therapy would be regularly reviewed, and continuation would depend on response, side-effects, patient choice and clinical judgement. Chemotherapy would be stopped in non-responders, making chemotherapy more cost-effective. A 'real-life' scenario in which 60 per cent of patients receive only 1 or 2 cycles of chemotherapy gives much lower costs per LYG, with single-agent gemcitabine, single-agent vinorelbine, and paclitaxel plus platinum appearing to be cost-saving compared with BSC; the incremental cost of gemcitabine plus cisplatin would be pound 2478 per LYG, and of vinorelbine plus cisplatin, pound 2808. At the very least, gains in duration of survival were achieved without diminution of quality of life (at best, they improved quality) and with relatively low incremental cost. Comparisons among the individual drugs should be viewed with caution because they have had to be based on indirect comparisons. RESULTS - LIMITATIONS OF THE ANALYSIS: Each of the three models had limitations. The cost-effectiveness estimates from the pairwise comparisons were based on single studies. The cost-minimisation analysis assumed that the regimens have equal efficacy in practice. The cost-effectiveness analysis had to be based on pooling data from individual trials. The costs of BSC, inpatient stay and outpatient visits were from Scottish data. Median rather than mean data on duration of survival have been used in the analysis, because most of the trials reported only median data. Median survival and number of drug cycles were calculated by averaging across a number of studies, rather than being reliant on one particular study. The costs of the less expensive antiemetics cited in the trials were omitted. The use of more modern and costly antiemetics would have a modest detrimental effect on cost-effectiveness. In the absence of published data, an estimate was made of the cost of side-effects of chemotherapy, in particular hospital admissions, and applied to all the new regimens. In practice, admissions related to side-effects and their respective costs are likely to vary by regimen.
CONCLUSIONS:
The new drugs for non-small-cell lung cancer extend life by only a few months compared with BSC, but appear to do so without net loss in quality of life and at a cost per LYG that is much lower than for many other NHS activities. Depending on assumptions used, these new drugs range from being cost-effective, as conventionally accepted, to being cost-saving. CONCLUSIONS - IMPLICATIONS OF THE NEWER DRUGS: One of the present constraints on chemotherapy is availability of inpatient beds. The advent of newer and gentler forms of chemotherapy given on an outpatient basis would not only overcome this, but it would allow more patients to be treated. This might apply particularly to older patients. The treatment of more patients would increase workload for oncologists, cancer nurses and pharmacists. The Government has already announced increased expenditure on staff for cancer care. The previously pessimistic attitudes to chemotherapy in non-small-cell lung cancer are changing in the wake of the newer agents, and this shift is likely to increase referral. CONCLUSIONS - NEED FOR FURTHER RESEARCH: Recent advances in chemotherapy are welcome, but their effects remain small for patients with non-small-cell lung cancer. Much more research is needed into better drugs, better combinations, new ways of assessing the likelihood of response and especially direct comparisons between the new regimens. This research would be aided by having a greater proportion of patients involved in trials, but there will be infrastructure implications of increased participation
"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States" By M. Carey.
No full text"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States: containing bried sketches of the moral and political character of those states.
By M. Carey, member of the American philosophical, and of the American Antiquarian Society, and author of The Olive Branch, Cindiciae Hibernicae, essays on banking, on political economy, and on internal improvement.
To which are now added the English editor's comments on the subject; together with Important Advice to Emigrants, and Cautions Against Impositions Practiced in the Outports
Simultaneous Analysis in S-PLUS: The SimultAn Package
No full textIn this paper we describe the SimultAn package dedicated to simultaneous analysis. Simultaneous analysis is a new factorial methodology developed for the joint treatment of a set of several data tables. Since the first stage of simultaneous analysis requires a correspondence analysis of each table the package comprises two parts, one for correspondence analysis and one for simultaneous analysis. The package can be used to perform classical correspondence analysis of frequency/contingency tables as well as to perform simultaneous analysis of a set of frequency/contingency tables. In this package, functions for computation, summaries and graphical visualization in two dimensions are provided, including options to display partial rows and supplementary points.
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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