Survival in 176 patients with inoperable non small cell lung cancer treated initially with chemotherapy in a district general hospital

In advanced non-small cell lung cancer (NSCLC) platinum based chemotherapy with second generation drugs improves median survival (MS) to 8 months and 29% and 10% at 1 and 2 years. Platinum with a third generation drug can improve survival further (BMJ 1995;311: 899) (Spiro et al. Thorax 2004;59:828 Big Lung Trial; N Engl J Med 2003;346:92 ECOG study). NICE now recommends chemotherapy with platinum and a third generation drug for inoperable NSCLC as the first treatment modality. Methods: We audited survival of 176/461 consecutive patients referred for at least 3 courses of platinum and either gemcitabine or vinorelbine from July 2001 to December 2005. Minimal follow up 17 months. Chemotherapy was given on site. Radical radiotherapy for stage IIIA, palliative radiotherapy and second line drugs were given as felt appropriate. Results: 64% were male. 30 (17%) were <55 years ; 66 (37.5%) age 55–65 years; 63 (35.8%) aged 66–75 and 16 (9.1%) >75 years. 5 (2.8%) were stage II; 46 (26%) stage IIIA; 68 (38%) stage IIIB and 55 (30.8%) stage IV. 68 (38%) had 0– 2 courses; 63 (36%) 3 courses and 44 (25%) had 4 or more.

The role of joint training in practitioner development for learning disability services

The presentation explores and evaluates an innovation in education and training in which two different professional trainings (nursing and social work) are integrated to produce jointly qualified specialist practitioners.

Fostering 'habits of reflection, independent study and free inquiry': an analysis of the short-lived phenomenon of General/Liberal Studies in English vocational education and training

In 1957, 12 years after the end of World War II, the Ministry of Education issued Circular 323 to promote the development of an element of ‘liberal studies’ in courses offered by technical and further education (FE) colleges in England. This was perceived to be in some ways a peculiar or uncharacteristic development. However, it lasted over 20 years, during which time most students on courses in FE colleges participated in what were termed General or Liberal Studies classes that complemented and/or contrasted with the technical content of their vocational programmes. By the end of the 1970s, these classes had changed in character, moving away from the concept of a ‘liberal education’ towards a prescribed diet of ‘communication studies’. The steady decline in apprenticeship numbers from the late 1960s onwards accelerated in the late 1970s, resulting in a new type of student (the state-funded ‘trainee’) into colleges whose curriculum would be prescribed by the Manpower Services Commission. This paper examines the Ministry’s thinking and charts the rise and fall of a curriculum phenomenon that became immortalised in the ‘Wilt’ novels of Tom Sharpe. The paper argues that the Ministry of Education’s concerns half a century ago are still relevant now, particularly as fresh calls are being made to raise the leaving age from compulsory education to 18, and in light of attempts in England to develop new vocational diplomas for full-time students in schools and colleges.

Continuous Plankton Records: General Introduction to the 1938-39 Survey

The Bulletins in this volume, except the last, deal entirely with the results of this expanded survey of 1938 and 1939. They show for the first time, month by month, the main changes in the plankton over practically the whole of the North Sea for a year and eight months. They form an important basis for comparison with the results of the post-war survey, revived on an even more extensive scale and to be described in later volumes.

A general framework for aquatic biogeochemical models

One of the most of challenging steps in the development of coupled hydrodynamic-biogeochemical models is the combination of multiple, often incompatible computer codes that describe individual physical, chemical, biological and geological processes. This “coupling” is time-consuming, error-prone, and demanding in terms of scientific and programming expertise. The open source, Fortran-based Framework for Aquatic Biogeochemical Models addresses these problems by providing a consistent set of programming interfaces through which hydrodynamic and biogeochemical models communicate. Models are coded once to connect to FABM, after which arbitrary combinations of hydrodynamic and biogeochemical models can be made. Thus, a biogeochemical model code works unmodified within models of a chemostat, a vertically structured water column, and a three-dimensional basin. Moreover, complex biogeochemistry can be distributed over many compact, self-contained modules, coupled at run-time. By enabling distributed development and user-controlled coupling of biogeochemical models, FABM enables optimal use of the expertise of scientists, programmers and end-users.