1,016 research outputs found
Robert Malcolm Waugh Correspondence
No full textEntries include brief biographical information, a typed biographical excerpt, a typed letter from the Maine State Library introducing Waugh to the Maine Author Collection on reading of his forthcoming French literature textbook, a typed letter from Waugh presenting his book with some biographical information, and a typed letter from the Maine State Library to Waugh on receipt of his book gift of En Amèrique for the Maine Author Collection
I remember teaching English at Seabrook
No full textIn this "I remember" memoir, Isabell Waugh, a former teacher at Seabrook, compares and constrasts the different groups of students she taught. She remembers that native-born American teenagers tended to be more concerned with athletics and social activities, than academic matters. In comparison, Estonian and Japanese parents did not tolerate low academic performance, so students from the two groups often competed intensely with each other for academic achievement and recognition. Isabelle recalls that the Estonians were, in general, more sophisticated and better educated. Most of the children knew 3-5 languages, and were more advanced in math and science. She sensed that some Estonian parents felt that their homes at Seabrook were temporary, and that they would be returning to Estonia at some point. The Seabrook Educational and Cultural Center has been soliciting current and past residents of Seabrook Farms for an "I remember" project. Residents are asked to create narratives regarding their experiences at Seabrook Farms. These memories help preserve the history and multi-cultural heritage of Seabrook Farms
Adecuación extensión-intensional en la temporalización de la novela personal o memorias ficticias. Análisis sintáctico-intensional de «Brideshead Revisited,» de Evelyn Waugh
No full textEl propósito de este estudio es determinar el éxito comunicativo de una obra literaria en tanto que la ordenación temporal de los elementos temáticos sea adecuada a la realización textual artística y encuentre así al cauce ideal de expresión. Mediante el análisis sintáctico intensional de la novela personal Brideshead Revisited, de Evelyn Waugh, en el que se atiende a la relación del narrador homodiegético con la distorsión temporal cronológica de la fábula presente en el discurso, se concluye que dichas alteraciones juegan a favor de la mejor recepción de la obra como memorias ficticias, y facilitan, en este caso, la adecuación de res a verba, lo que depara en una mejor accesibilidad para el lector, por su mayor verosimilitud, coherencia y significación, consiguiendo así la felicidad comunicativa
The Waugh Factor
No full textA new biography of Evelyn Waugh, based in part on a treasure trove gathered by his grandson, tries to unravel 'distortions and misconceptions' about the famous author, writes Donat Gallagher
The Waugh Factor
No full textA new biography of Evelyn Waugh, based in part on a treasure trove gathered by his grandson, tries to unravel 'distortions and misconceptions' about the famous author, writes Donat Gallagher
Minority government in Victoria
No full textThis is an electronic, pre-publication version of an article published in Public Law Review 2000 published by Lawbook Co. http://www.thomsonreuters.com.au/catalogue/ProductDetails.asp?ID=1197State elections in Victoria, Australia, in September 1999 resulted in a hung parliament. This comment notes the constitutional situation that followed the election and the agreement between the Opposition and three independent members of parliament that led to a change of government
Blocking supply in Victoria
No full textThis is an electronic, pre-publication version of an article published in Public Law Review 2002 published by Lawbook Co. http://www.thomsonreuters.com.au/catalogue/ProductDetails.asp?ID=1197In Australian parliaments, the power to block supply (where it survives) is the ultimate weapon of an upper house majority that wants to force the Government to call an election. Its effect is to cut off the Government authority to continue the part of its spending that Parliament must authorise afresh each year. This article comments on the distinctive law and history concerning supply deadlocks in Victoria, where the upper house has blocked supply more often than in any other Australian parliament
Government control of royal assent in Victoria
No full textThe giving of royal assent to proposed laws was the centre of a controversy in Victoria in 2005. These events directed fresh attention to the power of the Queen's representative, the Governor, and of the Victorian Government, over Bills that have passed both Houses of Parliament but not yet become law. This article comments on the legal basis of royal assent and the question of whether the government can advise the Governor to withhold assent to a Bill that has passed both Houses
DISQUALIFICATION OF MEMBERS OF PARLIAMENT IN VICTORIA
No full textLaws restricting eligibility for membership apply to all Australian parliaments, but their meaning and effect are often uncertain. The laws governing membership of the Parliament of Victoria are particularly archaic and confused. Successive amendments have been poorly integrated, creating awkward problems of interpretation. Most of the grounds of disqualification were originally derived from British models, but some have remained in Victorian law long after their abolition in the United Kingdom. Questions about their effect arise regularly, but few cases reach the courts, partly because of limitations on justiciability. This article explores the Victorian disqualifications, considering in particular the position of government office-holders and government contractors, and avenues for raising disqualification questions.28
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
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