What\u27s missing in missing data? Omissions in survey responses among parents of children with advanced cancer

Background: Missing data is a common phenomenon with survey-based research; patterns of missing data may elucidate why participants decline to answer certain questions. Objective: To describe patterns of missing data in the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) study, and highlight challenges in asking sensitive research questions. Design: Cross-sectional, survey-based study embedded within a randomized controlled trial. Setting: Three large children\u27s hospitals: Dana-Farber/Boston Children\u27s Cancer and Blood Disorders Center (DF/BCCDC); Children\u27s Hospital of Philadelphia (CHOP); and Seattle Children\u27s Hospital (SCH). Measurements: At the time of their child\u27s enrollment, parents completed the Survey about Caring for Children with Cancer (SCCC), including demographics, perceptions of prognosis, treatment goals, quality of life, and psychological distress. Results: Eighty-six of 104 parents completed surveys (83% response). The proportion of missing data varied by question type. While 14 parents (16%) left demographic fields blank, over half (n=48; 56%) declined to answer at least one question about their child\u27s prognosis, especially life expectancy. The presence of missing data was unrelated to the child\u27s diagnosis, time from progression, time to death, or parent distress (p>0.3 for each). Written explanations in survey margins suggested that addressing a child\u27s life expectancy is particularly challenging for parents. Conclusions and Relevance: Parents of children with cancer commonly refrain from answering questions about their child\u27s prognosis, however, they may be more likely to address general cure likelihood than explicit life expectancy. Understanding acceptability of sensitive questions in survey-based research will foster higher quality palliative care research. © Copyright 2014, Mary Ann Liebert, Inc. 2014

Local Density Approximation for proton-neutron pairing correlations. I. Formalism

In the present study we generalize the self-consistent Hartree-Fock-Bogoliubov (HFB) theory formulated in the coordinate space to the case which incorporates an arbitrary mixing between protons and neutrons in the particle-hole (p-h) and particle-particle (p-p or pairing) channels. We define the HFB density matrices, discuss their spin-isospin structure, and construct the most general energy density functional that is quadratic in local densities. The consequences of the local gauge invariance are discussed and the particular case of the Skyrme energy density functional is studied. By varying the total energy with respect to the density matrices the self-consistent one-body HFB Hamiltonian is obtained and the structure of the resulting mean fields is shown. The consequences of the time-reversal symmetry, charge invariance, and proton-neutron symmetry are summarized. The complete list of expressions required to calculate total energy is presented.Comment: 22 RevTeX page

Gamow Shell Model Description of Weakly Bound Nuclei and Unbound Nuclear States

We present the study of weakly bound, neutron-rich nuclei using the nuclear shell model employing the complex Berggren ensemble representing the bound single-particle states, unbound Gamow states, and the non-resonant continuum. In the proposed Gamow Shell Model, the Hamiltonian consists of a one-body finite depth (Woods-Saxon) potential and a residual two-body interaction. We discuss the basic ingredients of the Gamow Shell Model. The formalism is illustrated by calculations involving {\it several} valence neutrons outside the double-magic core: $^{6-10}$He and $^{18-22}$O.Comment: 19 pages, 20 encapsulated PostScript figure

Barriers and needs in paediatric palliative home care in Germany: a qualitative interview study with professional experts

<p>Abstract</p> <p>Background</p> <p>In North-Rhine Westphalia (Germany) a pilot project for an extensive service provision of palliative care for children and adolescents has been implemented. Accompanying research was undertaken with the aim to assess the status quo of service delivery at the outset of the project and to evaluate the effects of the pilot project. As part of the research, barriers and needs with respect to paediatric palliative home care in the target region were explored.</p> <p>Methods</p> <p>Semi-structured interviews with 24 experts in the field of paediatrics, palliative and hospice care have been conducted and were analysed by qualitative content analysis.</p> <p>Results</p> <p>Four main categories emerged from the interviews: (1) specific challenges and demands in palliative care for children and adolescents, (2) lack of clear legal and financial regulations, (3) gaps in the existing care delivery, and (4) access to services. Generally the interviews reflected the observation that the whole field is currently expanding and that certain deficits are temporary barriers that will be resolvable in the medium-term perspective.</p> <p>Conclusions</p> <p>Predominant barriers were seen in the lack of clear legal and financial regulations which take into account the specific challenges of palliative care in children and adolescents, as well as in a shortcoming of specialist services for a local based care provision throughout the federal country.</p