469 research outputs found
THE HISTORY OF THE ERADICATION OF THE WOLF IN MONTANA
Literature, myth and superstition portray the wolf as intelligent, cunning, cowardly and usually villainous. If man can apply his own characteristics to animals, the wolf indeed has all of these traits. Modern man also possesses a characteristic attitude toward the wolf - prejudice
Overseas GP recruitment: comparing international GP training with the UK and ensuring that registration standards and patient safety are maintained
This is the final version. Available from Royal College of General Practitioners via the DOI in this record.Background Ambitious overseas recruitment targets have been set by the UK government to help alleviate the current GP shortage. European Economic Area (EEA) doctors can join the UK’s GP register under European law. Non-EEA doctors must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained doctors. CEGPR applications can be time-consuming and burdensome. To meet overseas recruitment targets, it is important to facilitate the most efficient route into UK general practice while maintaining registration standards and patient safety.
Aim To develop a methodology to map postgraduate GP training and healthcare contextual data from an overseas country to the UK.
Design & setting Desk-based research and stakeholder interviews.
Method Four stages were undertaken: 1) developing a data collection template; 2) conducting a case study (using Australia as a test case); 3) refining the data collection template; and 4) creating a mapping framework. The case study used the 2016 curricula for the UK and Australia.
Results Five ‘domains’ were identified: healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation. The final data collection template comprised 49 mapping items across the domains. The methodology incorporated the application of a red, amber, or green (RAG) rating to indicate similarity of data across the five domains. Australia was rated ‘green’ for training pathway, curriculum, and assessment, and ‘amber’ for healthcare context and CPD and revalidation. The overall rating was ‘green’.
Conclusion Implementing this systematic methodology for mapping GP training between countries may support the UK’s ambitions to recruit more GPs, and alleviate current GP workforce pressures.NHS Englan
Running Genetic Algorithms in the Edge: A First Analysis
Nowadays, the volume of data produced by different kinds of devices is continuously growing, making even more difficult to solve the
many optimization problems that impact directly on our living quality. For instance, Cisco projected that by 2019 the volume of data will reach 507.5 zettabytes per year, and the cloud traffic will quadruple. This is not sustainable in the long term, so it is a need to move part of the intelligence from the cloud to a highly decentralized computing model. Considering this, we propose a ubiquitous intelligent system which is composed by different kinds of endpoint devices such as smartphones, tablets, routers, wearables, and any other CPU powered device. We want to use this to solve tasks useful for smart cities. In this paper, we analyze if these devices are suitable for this purpose and how we have to adapt the optimization algorithms to be efficient using heterogeneous hardware. To do this, we perform a set of experiments in which we measure the speed, memory usage, and battery consumption of these devices for a set of binary and combinatorial problems. Our conclusions reveal the strong and weak features of each device to run future algorihms in the border of the cyber-physical system.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.
This research has been partially funded by the Spanish MINECO and FEDER projects TIN2014-57341-R (http://moveon.lcc.uma.es), TIN2016-81766-REDT (http://cirti.es), TIN2017-88213-R (http://6city.lcc.uma.es), the Ministry of Education of Spain (FPU16/02595
El es enfático del español colombiano.
El llamado “es enfático” ha sido considerado una manifestación de la seudohendida con la marca de determinante y relativo omitida (lo que está estudiando es derecho > está estudiando es derecho). Este trabajo estudia el uso de tal construcción en un corpus del español colombiano conversacional, tomando en cuenta sus características sintácticas, semánticas y pragmáticas.
El análisis indica que la construcción no se limita a marcar contraste, como se había propuesto, sino que puede marcar también información no contrastiva, siempre y cuando ésta sea nueva. Sugerimos que a pesar de la variabilidad en la forma del verbo ser en la construcción (sea es, fue o era), éste funciona como una partícula y no como una forma finita del verbo cópula ser, por lo que concluimos que la construcción es independiente de la seudohendida
Exploring the role of nurses in after-hours telephone services in regional areas; A scoping review
Introduction
The management of patients who need chronic and complex care is a focus of attention internationally, brought about by an increase in chronic conditions, requiring significantly more care over longer periods of time. The increase in chronic conditions has placed pressure on health services, financially and physically, bringing about changes in the way care is delivered, with hospital avoidance and home-based care encouraged. In this environment, nurses play an important role in co-ordinating care across services. This review formed one part of a funded project that explored the nurse navigator role within a proposed 24-hour telephone-call service in one regional area that has a diverse population in terms of cultural identity and geographical location in relation to service access.
Aim
The review reports on the extant literature on the nurse’s role in the provision of afterhours telephone services for patients with chronic and complex conditions. The specific aim was to explore the effectiveness of services for patients in geographically isolated locations.
Methods
The methodological approach to the review followed the Preferred Reporting System for Meta-Analyses (PRISMA) guidelines. A thematic analysis was used to identify themes with chronic care models underpinning analysis.
Results
Three themes were identified; nurse-led decision making; consumer profile; and program outcomes. Each theme was divided into two sub-themes. The two sub-themes for decision making were: the experience of the staff who provided the service and the tool or protocol used. The two sub-themes for consumers profile were; the geographic/demographic identity of the consumers, and consumer satisfaction. The final theme of outcomes describes how the effectiveness of the service is measured, broken into two sub-themes: the economic/workforce outcomes and the consumer outcomes.
Discussion
The provision of an after-hours telephone service, in whatever model used should align with a Chronic Care Model. In this way, after-hours telephone services provided by experienced nurses, supported by ongoing professional development and relevant protocols, form part of the ongoing improvement for chronic and complex care management as a health priority
Relative domain folding and stability of a membrane transport protein
There is a limited understanding of the folding of multidomain membrane proteins. Lactose permease (LacY) of Escherichia coli is an archetypal member of the major facilitator superfamily of membrane transport proteins, which contain two domains of six transmembrane helices each. We exploit chemical denaturation to determine the unfolding free energy of LacY and employ Trp residues as site-specific thermodynamic probes. Single Trp LacY mutants are created with the individual Trps situated at mirror image positions on the two LacY domains. The changes in Trp fluorescence induced by urea denaturation are used to construct denaturation curves from which unfolding free energies can be determined. The majority of the single Trp tracers report the same stability and an unfolding free energy of approximately + 2 kcal mol- 1. There is one exception; the fluorescence of W33 at the cytoplasmic end of helix I on the N domain is unaffected by urea. In contrast, the equivalent position on the first helix, VII, of the C-terminal domain exhibits wild-type stability, with the single Trp tracer at position 243 on helix VII reporting an unfolding free energy of + 2 kcal mol- 1. This indicates that the region of the N domain of LacY at position 33 on helix I has enhanced stability to urea, when compared the corresponding location at the start of the C domain. We also find evidence for a potential network of stabilising interactions across the domain interface, which reduces accessibility to the hydrophilic substrate binding pocket between the two domains
A phase II, multicentre, UK study of vinorelbine in advanced breast cancer.
Thirty-four evaluable patients were treated with vinorelbine, a novel, semisynthetic vinca alkaloid, as first-line chemotherapy for advanced breast cancer. They received vinorelbine 25 mg m-2 i.v. given weekly for a maximum of 16 cycles. Two patients achieved a complete remission and 15 a partial remission, giving a response rate of 17/34 (50%; 95% CI of 34-66%); median response duration was 5.8 months. The median progression-free interval was 4.4 months and median survival 9.9 months. Treatment was generally well tolerated. Fatigue was the most common side-effect. The main reason for dose adjustments was myelosuppression; 68% of patients had WHO grade 3 or 4 neutropenia and there was one death attributed to neutropenic sepsis. Nausea/vomiting and neuropathy were mild and alopecia was uncommon. This study confirms vinorelbine as a highly active, well-tolerated agent in advanced breast cancer worthy of evaluation in combination chemotherapy regimens
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