Achieving optimal dose intensity with adjuvant chemotherapy in elderly breast cancer patients:A 10-year retrospective study in a UK institution

The study was to determine if breast cancer patients aged 65 and above could be given adjuvant chemotherapy safely while achieving an acceptable relative dose intensity of at least 85%. We identified all patients aged 65 and over who received adjuvant chemotherapy over the 10 year period, November 1999 to October 2009, and determined the proportion that achieved a relative dose intensity of at least 85% as well as the tolerability of their treatment. A total of 101 patients were identified, with a median age of 69 years (range 65-78).Of these, 25.7% of patients had at least one major comorbidity, 84.2% had a tumor size of 5 cm or less, 73.3% were node positive and 58.4% were hormone receptor positive. The chemotherapy regimens used were AC (Doxorubicin and Cyclophosphamide), FEC (Fluorouracil, Epirubicin, and Cyclophosphamide), CMF (Cyclophosphamide, Methotrexate, and Fluorouracil) and ECMF (Epirubicin followed by CMF). Seventy-nine patients (78.2%) achieved the relative dose intensity of at least 85%. With respect to toxicity, 11.9% of patients developed febrile neutropenia and 23.8% of patients required hospital admission during the treatment period, but there were no treatment-related deaths in the group. A significant proportion of patients aged 65 and above achieved the intended dose intensity of at least 85% over this 10-year period, with manageable toxicity levels. This supports the use of these regimens as adjuvant chemotherapy for breast cancer in this age group. © 2011 Wiley Periodicals, Inc.

Aproximación al manejo de la seguridad ambiental canadiense y estadounidense frente a la degradación del sistema de la los Grandes Lagos. Periodo 1995-2000

El propósito de la presente monografía es determinar la relación entre la degradación y navegación en los Grandes Lagos en la noción de seguridad ambiental de Estados Unidos y Canadá en un entorno de interdependencia entre 1995 - 2000. En ese sentido, se busca determinar como los recursos de poder de Canadá y Estados Unidos en la relación degradación-navegación transforma la noción de seguridad ambiental. De este modo, se analiza el concepto de seguridad ambiental desde la navegación, elemento esencial para entender la relación bilateral dentro del sistema de los Grandes Lagos. Esta investigación de tipo cualitativo que responde a las variables de la seguridad ambiental planteadas por Barry Buzan, Thomas Homer-Nixon, y Stephan Libiszewski, y a la teoría de la Interdependencia Compleja por Robert Keohane y Joseph Nye, pretende avanzar hacia la complejización de la dimensión ambiental lejos de la tradicional definición antropocéntrica.

Does the unemployment benefit institution affect the productivity of workers? evidence from a field experiment

We investigate whether and how the type of unemployment benefit institution affects productivity. We designed a field experiment to compare workers’ productivity under a welfare system, where the unemployed receive an unconditional monetary transfer, with their productivity under a workfare system, where the transfer is received conditional on the unemployed spending some time on ancillary activities. First, we find that having an unemployment benefit institution, regardless of whether it makes transfers conditional or unconditional, increases workers’ productivity. Second, we find that productivity is higher under Welfare than under Workfare. Becoming unemployed under Welfare comes at the psychological cost of a drop in self-esteem, presumably due to the shame or stigma associated with receiving an unconditional unemployment benefit. We document the empirical relevance of precisely this channel. The differences we observe in productivity suggest that this psychological cost acts as an extra nonmonetary incentive for workers under Welfare to put a higher effort in their work.

The Institution of Transmission Easement in Poland

The text presents an analysis of the institution of transmission easement, which is featured from the perspective of civil-law and public-law relations. The text does not address all the issues related to the institution of transmission easement, that is, no comprehensive analysis of the issues of the grounds for easement establishment, expiry, or remuneration and compensation for easement was conducted. The text presents a general description of the establishment of transmission easement against the backdrop of the Polish Civil Code and the Bill on Transmission Corridors of 18 July 2013, which is currently being drafted. The analysis of the easement institution, apart from the synthetic approach to legal provisions, features a functional and teleological interpretation. It is worth pointing out the aim that the legislator wished to achieve with respect to the work on new considerations both in the domain of the private and public law: 1. the legislator aimed to regulate the disorderly legal status of civil-law relations, but also to avoid dispute in the future, 2. with the aid of new regulations, the legislator wished to respond to the public interest.

The romanticism of contemporary theory : institution, aesthetics, nihilism

"Justin Clemens presents a valuable study of the links between Romanticism and contemporary theory. The central contention of this book is that contemporary theory is still essentially Romantic - despite all its declarations to the contrary, and despite all its attempts to elude or exceed the limits bequeathed it by Romantic thought." "This study will be of interest to literary theorists, philosophers, political theorists, and cultural studies scholars."--BOOK JACKET.

Towards institution-wide online teaching and learning systems: trends, drivers and issues

Universities worldwide are consolidating and enhancing their commitments to various models of e-learning. These activities are leading to the adoption of corporate-wide e-learning systems, and accompanying changes in structures, processes and infrastructure requirements. The professed ideal is to identify narrowly defined corporate IT solutions which can deliver the full range of educational, administrative and student support features to meet the organisational need to expand e-learning activities globally. The trend seems to be away from locally driven and controlled IT development and adoption towards investments in Instructional Management Systems (IMS). In reality, however, universities generally are developing and using a broader array of solutions to meet their needs than may be deemed desirable under a more centralised, corporatised IT approach. This paper examines these trends by analysing the drivers shaping corporate approaches to IT implementation, and reflects critically on some of the educational, economic and organisational tensions and issues evident in institutional approaches to establishing such systems. The paper highlights the ongoing need for innovative, dynamic organisational solutions to progress the e-learning agenda, and the thoughtful reconciliation of centralised and decentralised approaches to achieving desired ends.

New forms of organising : changing structures, processes and boundaries in a public sector institution

Globalisation, deregulation, privatisation, and advances in communications technologies have intensified competition and impacted on the structures, processes and boundaries that define organisations. Increased competition at both the local and global level calls for increased responsiveness and flexibility, and continuous improvement and innovation. As organisations endeavour to become more attentive and responsive to environmental trends, and customer needs and expectations, they are experimenting with different forms of organising. This has included flattening structures, devolving decision-making responsibility and encouraging greater collaboration and knowledge transfer across functional areas.

The William Angliss Institute of TAFE operates in the post-secondary sector which has experienced significant changes over the past decade as a result of: wide-ranging public sector reforms imposed by successive governments; budgetary cutbacks; accountability and performance improvement pressures; increased national and international competition, industrial relations changes and more demanding, sophisticated customers. This paper draws on the INNFORM Study's three organisational design dimensions of structure, process, and boundaries to examine the nature and degree of change that has taken place at the Institute. Case study findings indicate that while William Angliss has implemetted changes across the three design dimensions, the depth and breadth of these vary and this has impacted on overall performance outcomes. Its experience suggests that even when an organisation adopts a systemic approach and implements changes simultaneously across structure, process and boundaries, optimal performance benefits will not accrue unless these elemental changes are mutually reinforcing and complementary. It also suggests that improvement to processes, particularly communications and human resources practices must be an overarching consideration, as complementary change across all three design dimensions depends ultimately on the contribution and commitment organisational members are prepared to make.

Managing academic support for international students: the appropriateness of a learning support unit in an Australian tertiary institution

The higher education environment in Australia has undergone a radical change since the 1980s with the phenomenal increase in the intake of international students, particularly from what are referred to as Confucian Heritage Cultures (CHC): China, Korea, Japan, Malaysia and Singapore. Students from these countries view the Australian higher education system very favourably. The present increase in the proportion of full-fee paying students at Australian universities is also a result of decreasing government funding to the Australian higher education sector, which has now risen to be one of the most important elements of the Australian economy. These push-pull factors have drawn more Australian tertiary institution providers into the market place, as they seek more international student enrolments for their domestic campuses and also establish campuses overseas. Potential higher education students are becoming more discerning in their choices and are choosing learning environments that offers them both relevant and stimulating educational experiences and good qualifications, along with a range of both IT and academic support services that cater to their individual learning needs. Increasing competition, both within Australia and internationally, calls for a focus on student satisfaction in order to sustain the existence of the providers. This paper addresses the issue of what international students seek in terms of academic support and demonstrates that present levels of cost efficient services by Australian higher education providers, generally characterized by IT and language support services, are inadequate and do not meet the specific needs of the students.

Evaluation of a large group method in an educational Institution : the World café versus Large Group facilitation.

This article reports on the use of a large group method, theWorld Café, compared to large group facilitation in an educational institutional setting in Oman. Change is central to many educational institutions as they aspire to ensure quality procedures and processes are implemented and maintained. One of the difficulties of introducing change within this context is the number of stakeholders involved, as well as the inherent hierarchical nature of these settings. Large group methods (LGM) are one such intervention for change that seeks to involve a maximum number of stakeholders and minimise hierarchies, while at the same time encouraging participation and creating engagement. To evaluate LGM within this setting, the study compared two different workshop techniques: one workshop was run using the LGM theWorld Café, while the other was conducted using large group facilitation (LGF). Results indicated that theWorld Café was superior to LGF in terms of increases in participant knowledge and understanding. Participants who took part in the LGM were also significantly more likely to indicate that the technique was beneficial to their learning, compared to those who took part in the LGF. Qualitative data in the form of comments also provide support for LGM. Further research is needed to assess the applicability of the findings in educational settings in other countries. Moreover, more stringent research is required to assess over time, changes in behaviours occurring following LGM, to provide further evidence as to their value in facilitating change in institutional settings.

Institution building problems in East Timor, 1999-2002

Institution building in East Timor from 1999 to 2002 was undermined by numerous ineffective practices. These ineffective practices were partly due to international organizations' conflicting priorities, including donors' preference for short program timelines, some individuals' preference for "the easy path", and UNTAET'S preoccupation with maintaining security and administering the territory.