Guest editorial

No abstrac

In praise of professional judgement

Magic thinking seems common in healthcare and nowhere is this more apparent than when it comes to the workforce. Employers and policy makers continue to search for a solution to the intractable challenge of how we can deal with more complex demand with a deficit of both hands and skills. We’d argue that they don’t always understand the problem they are trying to solve

Stochastic Dominance in Mobility Analysis

This paper introduces a technique for mobility dominance and compares the degree of earnings mobility of men in the USA from 1970 to 1995. The highest mobility is found in the 1975–1980 or 1980–1985 periods

Structural Evidence for the Tetrameric Assembly of Chemokine CCL11 and the Glycosaminoglycan Arixtra™.

Understanding chemokine interactions with glycosaminoglycans (GAG) is critical as these interactions have been linked to a number of inflammatory medical conditions, such as arthritis and asthma. To better characterize in vivo protein function, comprehensive knowledge of multimeric species, formed by chemokines under native conditions, is necessary. Herein is the first report of a tetrameric assembly of the human chemokine CCL11, which was shown bound to the GAG Arixtra™. Isothermal titration calorimetry data indicated that CCL11 interacts with Arixtra, and ion mobility mass spectrometry (IM-MS) was used to identify ions corresponding to the CCL11 tetrameric species bound to Arixtra. Collisional cross sections (CCS) of the CCL11 tetramer-Arixtra noncovalent complex were compared to theoretical CCS values calculated using a preliminary structure of the complex deduced using X-ray crystallography. Experimental CCS values were in agreement with theoretical values, strengthening the IM-MS evidence for the formation of the noncovalent complex. Tandem mass spectrometry data of the complex indicated that the tetramer-GAG complex dissociates into a monomer and a trimer-GAG species, suggesting that two CC-like dimers are bridged by Arixtra. As development of chemokine inhibitors is of utmost importance to treatment of medical inflammatory conditions, these results provide vital insights into chemokine-GAG interactions

Quality of life in patients receiving platinum based chemotherapy for advanced non-small cell lung cancer.

Quality of life in patients receiving platinum based chemotherapy for advanced non-small cell lung cancer. Lung cancer is the cause of 34,000 deaths in the UK each year, with a five year survival rate of only 7.5%. The current treatment for advanced Non Small Cell Lung Cancer is combination chemotherapy but this confers only a small survival advantage. Quality of Life is often proposed as a secondary outcome to most chemotherapy studies as chemotherapy remains palliative. Quality of life is measured using a series of tools, such as the EORTC QLQ 30 that although established and tested for validity are functionally based or focus on physical symptoms. The aim of this study is to explore the meaning of quality of life in this group of patients. The study utilises use comparative methods (interview n=50, QLQ EORTC 30 data, clinical observation/field notes, medical notes, nursing notes and mapping) to examine the meaning of quality of life in this patient group. This is essentially a collaboration of medical and nursing practice with the aim of understanding what quality of life means to these patients, improving the experience of patients undergoing treatment and offering appropriate psycho-social support. Content analysis has generated a core theme of patient experience as having an impact on quality of life (negotiation of the treatment calendar, value of treatment broker and interactions with professionals) the overlapping themes are Lens of diagnosis (viewed as atrocity stories), The worth of treatment (despite physical side effects and poor life expectancy, chemotherapy is a focus of hope and allows for adjustment to poor prognosis) and Suffering (psychological and social, for example exclusion from social activities and loss of independence). This study has impacted on the service to cancer patients at a central London NHS Foundation Trust

Ultrasound and phakometry measurements of the primate eye Technical report, Aug. 1965

Ultrasonic testing and phakometry measurements of primate ey

Impact of proactive case management by multiple sclerosis specialist nurses on use of unscheduled care and emergency presentation in multiple sclerosis

The Version of Record is freely available on the publisher website at http://ijmsc.org/doi/full/10.7224/1537-2073.2014-011?= courtesy of the Consortium of Multiple Sclerosis Centers. © 2015 Consortium of Multiple Sclerosis Centers.Background: Multiple sclerosis (MS) affects approximately 100,000 people in the United Kingdom, with rising emergency admissions to the hospital. The multiple sclerosis specialist nurse plays a pivotal role in managing MS care in the United Kingdom, and there is anecdotal evidence that this role can help avoid emergency presentations and unnecessary hospital admissions. Methods: A retrospective service evaluation took place in one established MS nursing service. The impact of the introduction of proactive nurse-led management and a rapid response service on rates of emergency presentation, hospital admission, and bed use was examined. The primary intervention was the introduction of extra nursing hours (6 hours per week) and the reallocation of some routine administrative duties, which allowed the service to move to a proactive management model aimed at avoiding the need for unplanned care. In addition, a care pathway was implemented in the emergency department for patients with MS who did present. Results: Reduction in utilization was from a mean of 2700 bed-days per year (2002-2006) to a mean of 198 bed-days per year (2007-2013). Conclusions: During a 10-year period, moving from reactive management to proactive management demonstrated an increase in complex specialist nursing interventions and led to a decrease in emergency presentation and bed use at the local acute-care center

\u27A Time to Build\u27 - William W. Cook and His Architects: Edward York and Philip Sawyer

The following narrative outlines the role of donor William W. cook and the architects who built the Law Quadrangle 70 years ago. The report is excerpted and adapted from 94 Law Library Journal 395-425 (2002-26). The author is director of the University of Michigan Law School\u27s Law Library