844 resultados para Patient Care--history--Massachusetts--18th Century
Resumo:
Design support for typeface design: collaborative work commissioned by Adobe, Inc. Published 2011. The original Bickham typeface was based on the hands of the 18th century writing master George Bickham. The ornate script represented the apogee of the art of formal writing with a steel nib, and defined the visual style for decorated, formal documents. In 2010 Adobe revised and extended the typeface, with the express purpose of making it a showcase for OpenType technology, demonstrating the visual importance of using different glyph forms in different contexts, employing contextual substitution rules. Although Bickham had published a single example of a Greek style, it was a standalone exercise, never intended to match the Latin. The key challenge was to identify historical records for appropriate Greek writing, preferably by writers familiar with the language, adapt them for digital typography and the particularities of contextual substitution, in a manner that would not make the Greek a ‘second-class citizen’. Research involved uncovering and analysing appropriate contemporary and later writing examples to identify both the range of writing styles of the period, and the manner of joining letters in written Greek with both pointed pens and broad nibs. This work was essential to make up for the comparative lack of relevant material by Bickham, as well as investigating the possible range of stylistic variants that were approved for the final typeface, which attempted to emulate a written texture through complex substitutions. This aspect of the work is highly original for implementing a substantial number of contextual alternates and ligatures. These were reviewed in the context of use, bringing together an analysis of occurring letter combinations and patterns, and the design of stylistic alternates to imitate natural handwriting.
Resumo:
Multiple subclonal populations of tumor cells can coexist within the same tumor. This intra-tumor heterogeneity will have clinical implications and it is therefore important to identify factors that drive or suppress such heterogeneous tumor progression. Evolutionary biology can provide important insights into this process. In particular, experimental evolution studies of microbial populations, which exist as clonal populations that can diversify into multiple subclones, have revealed important evolutionary processes driving heterogeneity within a population. There are transferrable lessons that can be learnt from these studies that will help us to understand the process of intra-tumor heterogeneity in the clinical setting. In this review, we summarize drivers of microbial diversity that have been identified, such as mutation rate and environmental influences, and discuss how knowledge gained from microbial experimental evolution studies may guide us to identify and understand important selective factors that promote intra-tumor heterogeneity. Furthermore, we discuss how these factors could be used to direct and optimize research efforts to improve patient care, focusing on therapeutic resistance. Finally, we emphasize the need for longitudinal studies to address the impact of these potential tumor heterogeneity-promoting factors on drug resistance, metastatic potential and clinical outcome.
Resumo:
This edited volume explores the origins of the term small wars and traces it to special operations. In the 17th century, such "guerrilla/petite guerre" special operations grew out of training and winter operations of the regular forces as practiced in the 16th century. In the 18th century, they fused with a tradition going back to Antiquity, of employing special ethnic groups (such as the Hungarian Hussars) for special operations. Side by side with these special operations, however, there was the even older genealogy of uprisings and insurgencies, which since the Spanish Guerrilla of 1808-1812 has been associated with this term. All three traditions have influenced each other.
Resumo:
BACKGROUND: Using continuing professional development (CPD) as part of the revalidation of pharmacy professionals has been proposed in the UK but not implemented. We developed a CPD Outcomes Framework (‘the framework’) for scoring CPD records, where the score range was -100 to +150 based on demonstrable relevance and impact of the CPD on practice. OBJECTIVE: This exploratory study aimed to test the outcome of training people to use the framework, through distance-learning material (active intervention), by comparing CPD scores before and after training. SETTING: Pharmacy professionals were recruited in the UK in Reading, Banbury, Southampton, Kingston-upon-Thames and Guildford in 2009. METHOD: We conducted a randomised, double-blinded, parallel-group, before and after study. The control group simply received information on new CPD requirements through the post; the active intervention group also received the framework and associated training. Altogether 48 participants (25 control, 23 active) completed the study. All participants submitted CPD records to the research team before and after receiving the posted resources. The records (n=226) were scored blindly by the researchers using the framework. A subgroup of CPD records (n=96) submitted first (before-stage) and rewritten (after-stage) were analysed separately. MAIN OUTCOME MEASURE: Scores for CPD records received before and after distributing group-dependent material through the post. RESULTS: Using a linear-regression model both analyses found an increase in CPD scores in favour of the active intervention group. For the complete set of records, the effect was a mean difference of 9.9 (95% CI = 0.4 to 19.3), p-value = 0.04. For the subgroup of rewritten records, the effect was a mean difference of 17.3 (95% CI = 5.6 to 28.9), p-value = 0.0048. CONCLUSION: The intervention improved participants’ CPD behaviour. Training pharmacy professionals to use the framework resulted in better CPD activities and CPD records, potentially helpful for revalidation of pharmacy professionals. IMPACT: • Using a bespoke Continuing Professional Development outcomes framework improves the value of pharmacy professionals’ CPD activities and CPD records, with the potential to improve patient care. • The CPD outcomes framework could be helpful to pharmacy professionals internationally who want to improve the quality of their CPD activities and CPD records. • Regulators and officials across Europe and beyond can assess the suitability of the CPD outcomes framework for use in pharmacy CPD and revalidation in their own setting.