905 resultados para Nursing role


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This paper provides an outline of genre as we currently know it, and examines the changes occurring as games become more complex. Recent research we've undertaken suggests that our perception of which games fall into which genre category is subjective and that genre hybridization continues to blur our understanding of these categories. Consequently, it is becoming increasingly difficult to categorise game play experience based on traditional genre classifications. We examine the use of videogame activities as a useful mechanism for supplementing our understanding of videogame genre. Through considering activity as a means of classifying game experiences we may obtain a much more nuanced understanding of how players engage with games within a particular genre and across genres.

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Background: Small-cell lung cancer (SCLC) is an aggressive disease with a poor prognosis. The insulin-like growth factor-1 receptor (IGF-1R) is an autocrine growth factor and an attractive therapeutic target in many solid tumors, but particularly in lung cancer. Patients and Methods: This study examined tumor samples from 23 patients diagnosed with SCLC, 11 resected specimens and 12 nodal biopsies obtained by mediastinoscopy, for expression of IGF-1R using the monoclonal rabbit anti-IGF-1R (clone G11, Ventana Medical Systems, Tucson, AZ) and standard immunohistochemistry (IHC). Results: All 23 tumor samples expressed IGF-1R with a range of stain intensity from weak (1+) to strong (3+). Ten tumors had a score of 3+, 7 tumors 2+, and 6 tumors 1+. Patient survival data were available for all 23 patients. Two patients died < 30 days post biopsy, therefore, the intensity of anti-IGF-1R immunostaining for 21 patients was correlated to survival. Patients with 3+ immunostaining had a poorer prognosis (P = .003). The overall survival of patients who underwent surgical resection was significantly better (median survival not reached) than patients who were not resected (median survival, 7.4 months) (P = .006). Conclusion: IGF-1R targeted therapies may have a role in the treatment of SCLC in combination with chemotherapy or as maintenance therapy. Further studies on the clinical benefit of targeting IGF-1R in SCLC are needed.

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The majority of patients with non-small-cell lung cancer (NSCLC) present with advanced disease, with targeted therapies providing some improvement in clinical outcomes. The epidermal growth factor receptor (EGFR) tyrosine kinase (TK) plays an important role in the pathogenesis of NSCLC. Tyrosine kinase inhibitors (TKIs), which target the EGFR TK domain, have proven to be an effective treatment strategy; however, patient responses to treatment vary considerably. Therefore, the identification of patients most likely to respond to treatment is essential to optimise the benefit of TKIs. Tumour-associated activating mutations in EGFR can identify patients with NSCLC who are likely to have a good response to TKIs. Nonetheless, the majority of patients relapse within a year of starting treatment. Studies of tumours at relapse have demonstrated expression of a T790M mutation in exon 20 of the EGFR TK domain in approximately 50% of cases. Although conferring resistance to reversible TKIs, these patients may remain sensitive to new-generation irreversible/panerb inhibitors. A number of techniques have been employed for genotypic assessment of tumourassociated DNA to identify EGFR mutations, each of which has advantages and disadvantages. This review presents an overview of the current methodologies used to identify such molecular markers. Recent developments in technology may make the monitoring of changes in patients' tumour genotypes easier in clinical practice, which may enable patients' treatment regimens to be tailored during the course of their disease, potentially leading to improved patient outcomes.

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It is widely accepted in the literature on restorative justice that restorative practices emerged at least partly as a result of the recent shift towards recognising the rights of victims of crime, and increasing the involvement of victims in the criminal justice system. This article seeks to destabilise this claim. Although it accepts that there is a relationship between the emergence of a strong victims' rights movement and the emergence of restorative justice, it argues that this relationship is more nuanced, complex and contingent than advocates of restorative justice allow.

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A renewal of interest has occurred in the relationship between religion, penal policy, and systems of criminal justice in different countries. This has been manifested in the development of religious programmes in prison and community settings. The subject has also precipitated a substantial body of empirical research, in addition to theorising the impacts of religion upon offending behaviour. However, specific faith‐based measures have attracted limited attention, mainly because of the empirical complexity of measuring the relationship between faith and behavioural change. These issues are addressed in this article by considering the recentlyemerged practice of Circles of Support and Accountability (COSA).