Paranoia.Ada: A diagnostic program to evaluate Ada floating-point arithmetic

Many essential software functions in the mission critical computer resource application domain depend on floating point arithmetic. Numerically intensive functions associated with the Space Station project, such as emphemeris generation or the implementation of Kalman filters, are likely to employ the floating point facilities of Ada. Paranoia.Ada appears to be a valuabe program to insure that Ada environments and their underlying hardware exhibit the precision and correctness required to satisfy mission computational requirements. As a diagnostic tool, Paranoia.Ada reveals many essential characteristics of an Ada floating point implementation. Equipped with such knowledge, programmers need not tremble before the complex task of floating point computation

Quality of life and symptom intensity over time in people with cancer receiving palliative care : results from the international European Palliative Care Cancer Symptom study

Background People with advanced cancer experience multiple symptoms during their illness trajectory, which can fluctuate in intensity. Aim To describe the course of self-reported quality of life, emotional functioning, physical functioning and symptom intensity over time in cancer patients receiving palliative care. Design Longitudinal study with monthly assessments, using the EORTC QLQ-C15-PAL. Data were analysed (1) prospectively, from baseline to >= 8-month follow-up; and (2) retrospectively, by taking death as index date and comparing results from three cross-sectional subsamples at different stages of illness (time to death >= 6, 5-3 and 2-0 months). Linear mixed models were calculated. Setting/participants A total of 1739 patients (mean age 66, 50% male) from 30 palliative care centers in 12 countries were included. Results In prospective analyses, quality of life, functioning and symptoms-except nausea/vomiting-remained generally stable over time. In retrospective analyses, patients 2-0 months before death reported significantly lower quality of life and physical functioning scores than those 5-3 months before death, who in turn scored lower than those >= 6 months before death, suggesting progressive decline. Emotional functioning remained initially unchanged, but decreased in the last months. Pain, fatigue and appetite loss showed a stable increase in intensity towards death. Dyspnea, insomnia and constipation increased from 5-3 to 2-0 months before death. Nausea/vomiting only increased when comparing those >= 6 months before death with those 2-0 months before death. Conclusion While the prospective approach showed predominantly stable patterns for quality of life, functioning and symptom severity throughout study duration, retrospective analyses indicated that deterioration was already apparent before the terminal phase and accelerated close to death. Our findings support the importance of early symptom identification and treatment in this population, and highlight the need for further studies to explore what characterizes those with either lower or higher symptom burden at different time points towards death

Influence of meteorological parameters on the distribution of precipitation across central Colorado mountains, The

May 1970.Includes bibliographical references.Sponsored by the National Science Foundation GA-11574

Predictors and trajectory of performance status in patients with advanced cancer: A secondary data analysis of the international European Palliative Care Cancer Symptom study.

Background: Performance status, a predictor of cancer survival, and ability to maintain independent living deteriorate in advanced disease. Understanding predictors of performance status trajectory could help identify those at risk of functional deterioration, target support for independent living and reduce service costs. The relationship between symptoms, analgesics and performance status is poorly delineated. Aim: The aim of this study is to determine whether demographics, analgesics, disease characteristics, quality-of-life domains and C-reactive protein predict the trajectory of Karnofsky Performance Status (KPS) in patients with advanced cancer. Design: The study design is the secondary data analysis of the international prospective, longitudinal European Palliative Care Cancer Symptom study (ClinicalTrials.gov: NCT01362816). A multivariable regression model was built for KPS area under the curve per day (AUC). Setting and participants: This included adults with advanced, incurable cancer receiving palliative care, without severe cognitive impairment and who were not imminently dying (n = 1739). Results: The mean daily KPS AUC (n = 1052) was 41.1 (standard deviation = 14.1). Opioids (p < 0.001), co-analgesics (p = 0.023), poorer physical functioning (p < 0.001) and appetite loss (p = 0.009) at baseline were explanatory factors for lower KPS AUC. A subgroup analysis of participants with C-reactive protein data (n = 240) showed that only C-reactive protein (p = 0.040) and physical function (p < 0.001) were associated with lower KPS AUC. Conclusion: This study is novel in determining explanatory factors for subsequent functional trajectories in an international dataset and identifying systemic inflammation as a candidate therapeutic target to improve functional performance. The effect of interventions targeting physical function, appetite and inflammation, such as those used for cachexia management, on maintaining functional status in patients with advanced cancer needs to be investigated

Potensielle innsparinger og effektivitetsgevinster fra sammenslåing innen norsk bompengesektor. En ex-ante fusjonsanalyse med DEA

I 2018 ble seksti bompengeselskap slått sammen til fem regionale bompengeselskap for å redusere kostnader og skape mer effektiv drift som en del av bompengereformen. Tidligere studier viser til ubenyttede stordriftsfordeler i sektoren, men det ikke er gjort eksplisitte analyser om sammenslåingen har potensialet til å øke effektivitet i bompengesektoren. Denne studien undersøker potensielle innsparinger og effektivitetsgevinster fra sammenslåingen i bompengesektoren, ex ante. Studien benytter Data Envelopment Analysis (DEA) for å beregne effektivitet ved 35 norske bompengeprosjekter, med gjennomsnitt av datamateriale for perioden 2013-2015. Studien er todelt, først undersøkes effektivitet og eventuelle stordriftsfordeler i bompengesektoren, deretter gjennomføres en fusjonsanalyse av bompengeselskapene for å predikere potensielle effekter av sammenslåingen til de regionale bompengeselskapene. Gevinstene fra fusjonen dekomponere i form av skalaeffekter og harmoniseringseffekter, i tillegg til individuelt forbedringspotensial i form av læringseffekten fra å følge beste praksis. Effektivitetsanalysen viser at det er en klar sammenheng mellom effektivitet og størrelse. Det er også stor variasjon i effektivitet, hvor det er forskjeller i effektivitet mellom selskaper av tilsvarende størrelser. Det fremkommer store innsparingspotensialer i sektoren på 178 millioner kroner, som hovedsakelig kommer fra kostnader knyttet til drift og innkreving. Fusjonsanalysen viser store gevinster fra skalaeffekten i form av ubenyttede stordriftsfordeler, og harmoniseringsgevinster på 71 millioner kroner i form av breddefordeler, hvor omfang og gevinster varierer per selskap. I tillegg eksisterer det et innsparingspotensial på 178 millioner kroner i læringseffekten dersom alle selskap fulgte beste praksis og var like effektive. Studien konkluderer med at hensikten med sammenslåing for å øke effektivitet i bompengesektoren var tilstede. Bompengereformen vil dermed kunne bidra til at mer av bompengene som kreves inn går til finansiering av vei, og en mindre andel til administrasjon og drift av bompengeselskapene. Nøkkelord: Benchmarking, effektivitet, Data Envelopment Analysis, fusjon, bompenge

Symptoms in advanced pancreatic cancer are of importance for energy intake

Purpose Cancer cachexia and low energy intake (EI) probably contribute to weight loss in advanced pancreatic cancer (PC). However, little is known about the actual EI in this disease. Aims were to assess EI, weight loss and symptoms during the disease course and investigate associations between symptoms and EI. Methods Thirty-nine patients (21 males) with advanced PC were consecutively included and followed every 4 weeks until the end of life. A 24-h dietary recall was used to assess EI. The Edmonton Symptom Assessment System (ESAS) and the PC-specific health-related quality of life questionnaire (QLQ-PAN26) were used for symptom assessment. Results Median age was 62 years (48–88), WHO performance status 1 (0–2) and survival 5 months (1–25). Seventeen (44 %) patients had unresectable cancer, 16 (41 %) metastatic and six (15 %) recurrent disease. Upon inclusion, 37 (95 %) reported weight loss (median 4.0 kg per month). During follow-up, median weight loss per month was <1.0 kg. Forty to 65 % had EI <29 kcal/kg/day (cut-off value for weight maintenance) during the observation period but they did not lose more weight than patients with EI ≥ 29 kcal. Strong negative correlations (r range) were found between EI and pain (0.51–0.61), fatigue (0.54–0.67), oral dryness (0.61–0.64) and loss of appetite (0.53–0.71). Conclusion In this study, several symptoms influenced EI negatively. Low EI did not completely explain weight loss in this patient group, but careful monitoring and early follow-up of symptoms may be important interventions to reduce weight loss in advanced PC

Sleep quality with WHO Step III opioid use for cancer pain

Peer reviewedPostprin

Doloplus-2, a valid tool for behavioural pain assessment?

Research articl

The Queensland cancer risk study: General population norms for the Functional Assessment of Cancer Therapy-General (FACT-G)

Objective: To derive Australian normative scores for the Functional Assessment of Cancer Therapy-General Population (FACT-GP) and to confirm its factor structure. Methods: Quality of life (QoL) data (as measured by the FACT-GP) were collected within the Queensland Cancer Risk Study (QCRS) in 2004. The QCRS explored cancer screening and cancer risk behaviours among 9419 English-speaking residents of Queensland aged 20–75 years. Information was collected through computer-assisted telephone interviews and augmented by mailed, Self-Administered Questionnaires (SAQ). A total of 2727 participants largely comparable to the general population of Queensland self-completed the FACT-GP; however, participants were somewhat higher educated, more likely to have had cancer and less likely to be of indigenous heritage. Results: The Queensland population reported a FACT-GP summary score of 85.9 (SD515.1), with subscale scores (range: 19.2 for social well-being to 25.1 for physical wellbeing (PWB)). In this study, men and women within different age groups reported similar QoL. QoL was clinically and significantly lower among participants not married, with a body mass index (BMI) deviating from normal weight and with one or more self-reported morbidities. A four-factor solution was confirmed with good goodness-of-fit indices (RSMEAo0.05 for all three age groups). Conclusions: The reference values from the general population reported here can be used for comparison with the QoL measured in populations of cancer patients, providing a benchmark against which clinicians can evaluate the impact of the disease and/or the treatments on QoL

Can cancer patients assess the influence of pain on functions? A randomised, controlled study of the pain interference items in the Brief Pain Inventory

BACKGROUND: The Brief Pain Inventory (BPI) is recommended as a pain measurement tool by the Expert Working Group of the European Association of Palliative Care. The BPI is designed to assess both pain severity and interference with functions caused by pain. The purpose of this study was to investigate if pain interference items are influenced by other factors than pain. METHODS: We asked adult cancer patients to complete the original and a revised BPI on two study days. In the original version of the BPI the patients were asked how, during the last 24 hours, pain has interfered with functions. In the revised BPI this question was changed to how, during the last 24 hours, these functions are affected in general. Heath related quality of life was assessed at both study days applying the European Organization for Research and Treatment of Cancer quality of life questionnaire. RESULTS: Forty-eight of the 55 included patients completed both assessments. The BPI pain intensities scores and the health related quality of life scores were similar at the two study days. Except for mood this study observed no significant distinctions between the patients' BPI interference items scores in the original (pain influence on function) and the revised BPI (function in general). Seventeen patients reported higher influence from pain on functions than the total influence on function from all causes. CONCLUSION: We observed similar scores in the original BPI interference scores (pain influence on function) compared with the revised BPI interference scores (decreased function in general). This finding might imply that the BPI interference scale measures are partly responded to as more of a global interference measure