Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist.

Use of the Rotterdam Symptom Checklist (RSCL) to measure psychological and physical distress as experienced by cancer patients, is discussed in this paper. The stability of the structure of the RSCL was assessed in principal component analyses in three studies: one concerning cancer patients during either chemotherapy or follow-up (n = 86), one done in patients undergoing chemotherapy for advanced ovarian cancer (n = 56), and the third dealing with cancer patients under treatment, disease-free 'patients', and 'normal' controls (n = 611). The psychological dimension proved to be stable across populations. A scale based on this factor was highly reliable (Cronbach's alpha 0.88-0.94). The physical distress is reflected by several dimensions in a homogeneous population (pain, fatigue, gastrointestinal complaints) and undimensionally in a heterogeneous population. Reliability of the physical distress scales is good (0.71-0.88). The current components of the RSCL and the use of individual and disease specific symptoms are discussed

Assessing measurement invariance of a health-related quality-of-life questionnaire in radiotherapy patients

Objective: If the assumption of measurement invariance is not tested, we cannot be sure whether differences observed are due to true differences in health-related quality-of-life (HRQoL), or are measurement artifacts. We aim to investigate this assumption in a sample of heterogeneous cancer patients, focusing on whether age, sex, previous treatment for cancer, and information regarding treatment preferences result in biased HRQoL scores. Methods: 155 cancer patients who were about to begin their first session of radiotherapy were included. HRQoL was measured using the EORTC QLQ-C30. Structural equation modeling was applied to assess whether there was a violation of the assumption of invariance. Results: A satisfactory single construct (Functioning HRQoL) measurement model was found and two violations of invariance were identified. Irrespective of patients’ Functioning HRQoL, older patients reported worse physical functioning and patients who had received treatment prior to radiotherapy reported worse emotional functioning than we would otherwise expect. Conclusions: In the present study, accounting for measurement bias lead to a substantial improvement in the overall fit of the model. By ignoring the bias, we would have concluded that the model fit was unsatisfactory. The findings underline the importance of investigating measurement invariance in scales designed for heterogeneous samples

Analytical study of the plasmonic modes of metal nanoparticle circular array

We analyze the plasmonic modes of a metal nanoparticle circular array. Closed form solutions to the eigenmode problem are given. For each polarization, the plasmonic mode with the highest quality is found to be an antiphase mode. We found that the significant suppression in radiative loss can be understood as the cancellation of the dipolar radiation term in the radiative linewidth. The remaining finite radiative linewidth decreases exponentially as the number of particle increases.Comment: 18 pages, 6 figure

A comparison between different propagative schemes for the simulation of tapered step index slab waveguides

The performance and accuracy of a number of propagative algorithms are compared for the simulation of tapered high contrast step index slab waveguides. The considered methods include paraxial as well as nonparaxial formulations of optical field propagation. In particular attention is paid to the validity of the paraxial approximation. To test the internal consistency of the various methods the property of reciprocity is verified and it is shown that for the paraxial algorithms the reciprocity can only be fulfilled if the paraxial approximation of the power flux expression using the Poynting vector is considered. Finally, modeling results are compared with measured fiber coupling losses for an experimentally realized taper structure

Fatigue and radiotherapy: (B) experience in patients 9 months following treatment.

Little is known regarding the prevalence and course of fatigue in cancer patients after treatment has ended and no recurrence found. The present study examines fatigue in disease-free cancer patients after being treated with radiotherapy (n = 154). The following questions are addressed. First, how do patients describe their fatigue 9 months after radiotherapy and is this different from fatigue in a nonselective sample from the general population (n = 139)? Secondly, to what degree is fatigue in patients associated with sociodemographic, medical, physical and psychological factors? Finally, is it possible to predict which patients will suffer from fatigue 9 months after radiotherapy? Results indicated that fatigue in disease-free cancer patients did not differ significantly from fatigue in the general population. However, for 34% of the patients, fatigue following treatment was worse than anticipated, 39% listed fatigue as one of the three symptoms causing them most distress, 26% of patients worried about their fatigue and patients' overall quality of life was negatively related to fatigue (r = -0.46). Fatigue in disease-free patients was significantly associated with: gender, physical distress, pain rating, sleep quality, functional disability, psychological distress and depression, but not with medical (diagnosis, prognosis, co-morbidity) or treatment-related (target area, total radiation dose, fractionation) variables. The degree of fatigue, functional disability and pain before radiotherapy were the best predictors of fatigue at 9-month follow-up, explaining 30%, 3% and 4% of the variance respectively. These findings are in line with the associations found with fatigue during treatment as reported in the preceding paper in this issue. The significant associations between fatigue and both psychological and physical variables demonstrate the complex aetiology of this symptom in patients and point out the necessity of a multidisciplinary approach for its treatment

Do patients’ information needs decrease over the course of radiotherapy?

PURPOSE: We aimed to investigate if cancer patients’ information needs decrease during radiotherapy and if so, which patient, consultation and radiation oncologist characteristics are associated with a decrease in information needs over time. METHODS: In this longitudinal study, patients (n = 104) completed a baseline questionnaire a week before the initial radiotherapy consultation, immediately following this initial consultation, and 1 week prior to the first follow-up visit, which took place on average 3–5 weeks after the initial visit. Besides information needs, measured by the Information Preference for Radiotherapy Patients scale, the questionnaire assessed patient, consultation and radiation oncologist characteristics. RESULTS: Information needs decreased over time, but remained at a high level. Being religious, being male, having low health literacy and higher perceived involvement during the consultation were all statistically significantly associated to a decrease in information needs on specific domains (e.g. procedures or side effects). CONCLUSIONS: Cancer patients’ information needs decline between the initial consultation and the first follow-up visit, but remain high. It is therefore advised to investigate the patients’ information needs at every radiotherapy visit and not rely on giving information just once. Furthermore, radiation oncologists should check if the information given at first consultation is understood and remembered. By those means, tailored information giving becomes possible

Переходная зона между шельфом и континентальным склоном северной части Чёрного моря. Ландшафтный подход

На основе данных, полученных с применением обитаемых подводных аппаратов, рассмотрена проблема положения бровки шельфа как важной структурно фациальной границы морского бассейна. Описана ландшафтная фациальная зональность в диапазоне глубин 70–220 м в северной части Черного моря. Выявлено, что смена фаций в переходной зоне между шельфом и материковым склоном от бровки шельфа до глубины около 200 м находится в тесной связи с усилением гипоксии до полной аноксии.На основі даних, отриманих із застосуванням підводних апаратів, розглянуто проблему положення бровки шельфу як важливої структурно фаціальної межі морського басейну. Описано ландшафтну фаціальну зональність в діапазоні глибин 70–20 м у північній частині Чорного моря. Виявлено, що зміна фацій у перехідній зоні між шельфом і материковим схилом від бровки шельфу до глибини близько 200 м тісно пов’язана із збільшенням гіпоксії до повної аноксії.The problem of continental shelf break position as an important structural – facial marine basin boundary discussed on the basis of manned submersibles’ data. The range and setting of Northern Black Sea facial zones in the depths interval 70 220m are described. It’s found that the facial changes are related closely with hypoxia increasing to complete anoxia from the shelf break to the depth of about 200 m

Requirements for IT Governance in Organizations Experiencing Decentralization

International audienceDecentralization of organizations and subsequent change of their management and operation styles require changes in organization's processes and heavily involve IT. Enterprise Architecture (EA) frameworks fit to primarily centralized organizational structures, and as such have shortcomings when used in decentralized organizations. We illustrate this idea on the example of one organization in the Higher Education sector that faces decentralization of its structure and has to adapt to it. Overcoming these challenges requires some new principles to be introduced and incorporated into the EA knowledge. In particular for IT governance, in this study we argue that peer-to-peer principles can offer more suitable governance over current EA frameworks as they are able to better align with decentralized components of an organizational structure