The development of the Canberra symptom scorecard: a tool to monitor the physical symptoms of patients with advanced tumours

BACKGROUND: Patients with advanced (incurable) tumours usually experience a diverse burden of symptoms. Although many symptom assessment instruments are available, we examined whether these addressed tumour-related symptoms. METHODS: We reviewed existing symptom assessment instruments and found a number of deficiencies such as instruments being too long or burdensome, too short, or measuring quality of life rather than tumour-related symptoms. Others focused on emotional, rather than physical symptoms. Therefore, we decided to devise a new symptom instrument. A list of 20 symptoms common in patients with advanced tumours generated from the literature and existing instruments, was ranked according to prevalence by 202 Australian clinicians. Following clinicians' responses, the list was revised and two severity assessment scales (functional severity and distress severity) added. The resultant 18-item list was assessed in 44 outpatients with advanced tumours. RESULTS: Patient responses indicated that a shorter questionnaire of 11 items, reflecting three main symptom clusters, provided a good representation of physical symptoms. An additional symptom that is an important predictor of survival was added, making a 12-item questionnaire, which was entitled "The Canberra Symptom Scorecard" (CSS). For symptom severity, the distress severity scale was more appropriate than the functional severity scale. CONCLUSION: The CSS focuses on tumour-related physical symptoms. It is about to be assessed in patients with advanced tumours receiving palliative treatments, when it will also be validated against existing instruments

Efficient Photometric Selection of Quasars from the Sloan Digital Sky Survey: 100,000 z<3 Quasars from Data Release One

We present a catalog of 100,563 unresolved, UV-excess (UVX) quasar candidates to g=21 from 2099 deg^2 of the Sloan Digital Sky Survey (SDSS) Data Release One (DR1) imaging data. Existing spectra of 22,737 sources reveals that 22,191 (97.6%) are quasars; accounting for the magnitude dependence of this efficiency, we estimate that 95,502 (95.0%) of the objects in the catalog are quasars. Such a high efficiency is unprecedented in broad-band surveys of quasars. This ``proof-of-concept'' sample is designed to be maximally efficient, but still has 94.7% completeness to unresolved, g<~19.5, UVX quasars from the DR1 quasar catalog. This efficient and complete selection is the result of our application of a probability density type analysis to training sets that describe the 4-D color distribution of stars and spectroscopically confirmed quasars in the SDSS. Specifically, we use a non-parametric Bayesian classification, based on kernel density estimation, to parameterize the color distribution of astronomical sources -- allowing for fast and robust classification. We further supplement the catalog by providing photometric redshifts and matches to FIRST/VLA, ROSAT, and USNO-B sources. Future work needed to extend the this selection algorithm to larger redshifts, fainter magnitudes, and resolved sources is discussed. Finally, we examine some science applications of the catalog, particularly a tentative quasar number counts distribution covering the largest range in magnitude (14.2<g<21.0) ever made within the framework of a single quasar survey.Comment: 35 pages, 11 figures (3 color), 2 tables, accepted by ApJS; higher resolution paper and ASCII version of catalog available at http://sdss.ncsa.uiuc.edu/qso/nbckde

Leveraging mHealth to mitigate the impact of COVID-19 in Black American communities: Qualitative analysis

BACKGROUND: COVID-19 remains an ongoing public health crisis. Black Americans remain underrepresented among those vaccinated and overrepresented in both COVID-19 morbidity and mortality. Medical misinformation, specifically related to COVID-19, has exacerbated the impact of the disease in Black American communities. Communication tools and strategies to build relationships and disseminate credible and trustworthy diagnostic and preventative health information are necessary to improve outcomes and equity for historically oppressed populations. OBJECTIVE: As the initial phase of a larger mixed methods project to develop, pilot, and evaluate a mobile health (mHealth) intervention among a population at high risk for COVID-19 and cardiovascular comorbidities, this study sought to explore COVID-19 information behavior among Black Americans. Specifically, this study examined (1) preferences for COVID-19 education via mHealth, (2) barriers and facilitators to COVID-19 education and diagnostic testing and routine care for associated cardiovascular and respiratory comorbidities in the local community, and (3) key content for inclusion in a COVID-19 mHealth app. METHODS: This qualitative study used principles of community-based participatory research and information systems research to conduct 7 focus groups across 3 sites. Focus groups were audio recorded and transcribed for thematic analysis using an abductive approach. RESULTS: The study sample included 54 individuals across sites with a mean age of 50.24 (SD 11.76; range 20-71) years. Participants were primarily female (n=42, 78%) and Black (n=54, 100%) with varied education levels. Over half (n=29, 54%) of the participants were employed full-time, and nearly three-fourths (n=40, 74%) had household incomes CONCLUSIONS: Increasing transparency and building trust are 2 key strategies that may improve the impact of health information messaging in Black communities. Focusing on content over context fails in the provision of critical health information and perpetuates health inequities by reinforcing systemic and structural racism. COVID-19 messaging must consider contextual information, patient needs and preferences, and patient information-seeking and information-search behaviors to establish trust and credibility, positively impact patient health outcomes, and improve health equity

Additional Ultracool White Dwarfs Found in the Sloan Digital Sky Survey

We identify seven new ultracool white dwarfs discovered in the Sloan Digital Sky Survey (SDSS). The SDSS photometry, spectra, and proper motions are presented, and additional BVRI data are given for these and other previously discovered ultracool white dwarfs. The observed colors span a remarkably wide range, qualitatively similar to colors predicted by models for very cool white dwarfs. One of the new stars (SDSS J1251+44) exhibits strong collision-induced absorption (CIA) in its spectra, while the spectra and colors of the other six are consistent with mild CIA. Another of the new discoveries (SDSS J2239+00A) is part of a binary system -- its companion is also a cool white dwarf, and other data indicate that the companion exhibits an infrared flux deficiency, making this the first binary system composed of two CIA white dwarfs. A third discovery (SDSS J0310-00) has weak Balmer emission lines. The proper motions of all seven stars are consistent with membership in the disk or thick disk.Comment: Accepted for Astrophysical Journal. 16 pages (includes 3 figures

Masked Bobwhite Recovery: The Need for a Multifaceted Approach

Masked bobwhite (Colinus virginianus ridgwayi) is a critically endangered quail historically found in the Sonoran grasslands of southern Arizona, USA and Sonora, Mexico. Native populations of masked bobwhite may already be extinct in the wild, but captive populations exist in the United States at G. M. Sutton Avian Research Center (Oklahoma, USA), Buenos Aires National Wildlife Refuge (Arizona, USA), and various zoos. The 47,000-hectare Buenos Aires National Wildlife Refuge, located in south-central Arizona, was established primarily for reintroduction of this bird. Recovery efforts within the refuge boundary in the 1980s and 1990s were initially successful but suffered debilitating setbacks that ultimately resulted in failure. Substantial releases were suspended in 2005. Improved habitat restoration efforts and promising conditioning and release techniques led to the belief that reintroductions could again be attempted and successful. In 2016–2017 plans were developed to increase captive propagation and reinitiate release efforts. Releases began in 2018. Over-winter survival of birds released in 2018–2019 was encouraging, and reproduction of wild birds was documented in 2019. An existing base of wild birds established from these releases could help masked bobwhite populations recover in the state. Habitat restoration, better methods of rearing, release, and conditioning, and improved production from captive facilities also inspire hope that a full recovery of the species in Arizona is possible

Impact of a physician intervention program to increase breast cancer screening

In order to improve compliance with the National Cancer Institute\u27s breast cancer screening guidelines, we developed a multifaceted intervention designed to alter physician screening practice. A pre-post test, two-community design was used. Primary care physicians in one community served as the control. Data were collected by two mailed surveys (1987 and 1990). Response rates were 61% and 64%, respectively. The physician intervention program consisted of a hospital-based continuing medical education program and an outreach component which focused on implementing a reminder system. Outcome measures were self-reported attitudinal, knowledge, and screening practices changes. In spite of an impressive change in comparison community physicians\u27 practice, the difference in change over time in the intervention community physicians\u27 ordering of annual mammography compared to the change in the comparison community physicians\u27 ordering was significant (P = 0.04). The adjusted odds ratio is nearly 8. We conclude that our in-service continuing medical education program was successful in improving breast cancer screening practices among primary care physicians

Faint High-Latitude Carbon Stars Discovered by the Sloan Digital Sky Survey: An Initial Catalog

A search of more than 3,000 square degrees of high latitude sky by the Sloan Digital Sky Survey has yielded 251 faint high-latitude carbon stars (FHLCs), the large majority previously uncataloged. We present homogeneous spectroscopy, photometry, and astrometry for the sample. The objects lie in the 15.6 < r < 20.8 range, and exhibit a wide variety of apparent photospheric temperatures, ranging from spectral types near M to as early as F. Proper motion measurements for 222 of the objects show that at least 50%, and quite probably more than 60%, of these objects are actually low luminosity dwarf carbon (dC) stars, in agreement with a variety of recent, more limited investigations which show that such objects are the numerically dominant type of star with C_2 in the spectrum. This SDSS homogeneous sample of ~110 dC stars now constitutes 90% of all known carbon dwarfs, and will grow by another factor of 2-3 by the completion of the Survey. As the spectra of the dC and the faint halo giant C stars are very similar (at least at spectral resolution of 1,000) despite a difference of 10 mag in luminosity, it is imperative that simple luminosity discriminants other than proper motion be developed. We use our enlarged sample of FHLCs to examine a variety of possible luminosity criteria, including many previously suggested, and find that, with certain important caveats, JHK photometry may segregate dwarfs and giants.Comment: Accepted for publication in The Astronomical Journal, Vol. 127, May 2004, 37 pages, 12 figure

Two More Candidate AM Canum Venaticorum (AM CVn) Binaries from the Sloan Digital Sky Survey

AM CVn systems are a select group of ultracompact binaries with the shortest orbital periods of any known binary subclass; mass-transfer is likely from a low-mass (partially-)degenerate secondary onto a white dwarf primary, driven by gravitational radiation. In the past few years, the Sloan Digital Sky Survey (SDSS) has provided five new AM CVns. Here we report on two further candidates selected from more recent SDSS data. SDSS J1208+3550 is similar to the earlier SDSS discoveries, recognized as an AM CVn via its distinctive spectrum which is dominated by helium emission. From the expanded SDSS Data Release 6 (DR6) spectroscopic area, we provide an updated surface density estimate for such AM CVns of order 10^{-3.1} to 10^{-2.5} per deg^2 for 15<g<20.5. In addition, we present another new candidate AM CVn, SDSS J2047+0008, that was discovered in the course of followup of SDSS-II supernova candidates. It shows nova-like outbursts in multi-epoch imaging data; in contrast to the other SDSS AM CVn discoveries, its (outburst) spectrum is dominated by helium absorption lines, reminiscent of KL Dra and 2003aw. The variability selection of SDSS J2047+0008 from the 300 deg^2 of SDSS Stripe 82 presages further AM CVn discoveries in future deep, multicolor, and time-domain surveys such as LSST. The new additions bring the total SDSS yield to seven AM CVns thus far, a substantial contribution to this rare subclass, versus the dozen previously known.Comment: 19 pages, 5 figures, 1 table; submitted to A

Faint High Latitude Carbon Stars Discovered by the Sloan Digital Sky Survey: Methods and Initial Results

We report the discovery of 39 Faint High Latitude Carbon Stars (FHLCs) from Sloan Digital Sky Survey commissioning data. The objects, each selected photometrically and verified spectroscopically, range over 16.6 < r* < 20.0, and show a diversity of temperatures as judged by both colors and NaD line strengths. At the completion of the Sloan Survey, there will be many hundred homogeneously selected and observed FHLCs in this sample. We present proper motion measures for each object, indicating that the sample is a mixture of extremely distant (>100 kpc) halo giant stars, useful for constraining halo dynamics, plus members of the recently-recognized exotic class of very nearby dwarf carbon (dC) stars. Motions, and thus dC classification, are inferred for 40-50 percent of the sample, depending on the level of statistical significance invoked. The new list of dC stars presented here, although selected from only a small fraction of the final SDSS, doubles the number of such objects found by all previous methods. (Abstract abridged).Comment: Accepted for publication in The Astronomical Journal, Vol. 124, Sep. 2002, 40 pages, 7 figures, AASTeX v5.