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Recent policy statements have stressed the need for fundamental changes to the NHS, especially to the hospital care of older people. Person-centred care underpins such changes. If practitioners are to deliver person-centred care, then they need to learn more about the patient as an individual. One way that this might be achieved is through biographical approaches. This paper describes the findings of a developmental study undertaken over a 6-month period to investigate the introduction of a biographical approach to care on a unit in a NHS hospital. It concentrates on the views of the practitioners who used the approach. The study aimed to explore whether a biographical approach - in the form of storytelling - might be used to encourage person-centred practice. Using a practice development approach, the study explored the views of older people, their family carers and practitioners regarding their participation in life story work. Initial data were collected by focus groups with staff from a nursing home who regularly used life stories as a basis for care planning. Further data were collected through focus groups, semistructured interviews and observation - undertaken before and after the introduction of life story work - with older people, family carers and practitioners. Findings revealed that life stories helped practitioners to see patients as people, to understand individuals more fully and to form closer relationships with their families. Support workers also said how much they enjoyed using the approach to inform their care. Further longitudinal research is required to investigate biographical approaches more fully and to work more closely with practitioners to explore how biographical approaches can be undertaken as part of standard practice and be integrated into the culture and management of care.

When managing nonseminomatous germ cell tumors, contralateral lung abnormalities ≤ 10 mm can be observed if histology of unilateral PM demonstrates complete tumor necrosis. 17. When managing nonseminomatous germ cell tumors, PM is indicated for select patients with limited number of lung abnormalities after first or second-line platin-based chemotherapy suspected of containing viable nonseminomatous cancer and/or malignant transformation of teratoma into non-germ cell cancer. 18. In breast cancer patients, PM can be considered within a MDT construct. Pulmonary metastasectomy literature characteristics Since 1980, greater than 1000 publications addressed pulmonary metastasectomy, without a single randomized controlled trial (RCT). The overwhelming majority is surgical series, usually single institution, and includes single or multiple pathologies. The pool of patients from which metastasectomy patients derive is not reported, allowing no comparative survival analysis. Historical controls are used or metastatic disease survival is assumed to be zero, a contention not supported by the literature. Yet metastasectomy is infrequently performed (1-6.5%) when sizable populations of cancer patients are reported. [1-3] Thus surgical case series manifest inherent selection bias and do not clarify the role of metastasectomy in prolongation of survival or cure. The literature is further hampered by inconsistent or absent description of other local or systemic therapies and variable length of follow up. Finally, the literature fails to distinguish between prognostic (indolent disease which will do well with any or no treatment) or predictive

Amino acids enter rabbit jejunal brush border membrane vesicles via three major transport systems: (1) simple passive diffusion; (2) Na-independent carriers; and (3) Na-dependent carriers. The passive permeability sequence of amino acids is very similar to that observed in other studies involving natural and artificial membranes. Based on uptake kinetics and cross-inhibition profiles, at least two Na-independent and three Na-dependent carrier-mediated pathways exist. One Na-independent pathway, similar to the classical L system, favors neutral amino acids, while the other pathway favors dibasic amino acids such as lysine. One Na-dependent pathway primarily serves neutral L-amino acids including 2-amino-2-norbornanecarboxylic acid hemihydrate (BCH), but not beta-alanine or alpha-methylaminoisobutyric acid (MeAIB). Another Na-dependent route favors phenylalanine and methionine, while the third pathway is selective for imino acids and MeAIB. Li is unable to substitute for Na in these systems. Cross-inhibition profiles indicated that none of the Na-dependent systems conform to classical A or ACS paradigms. Other notable features of jejunal brush border vesicles include (1) no beta-alanine carrier, and (2) no major proline/glycine interactions.