EAPC task force on education for psychologists in palliative care

It is argued that psychological aspects of care and psychosocial problems are essential components of palliative care. However, the provision of appropriate services remains somewhat arbitrary. Unlike medical and nursing care, which are clearly delivered by doctors and nurses respectively, psychological and psychosocial support in palliative care are not assigned exclusively to psychologists. It is generally expected that all professionals working in palliative care should have some knowledge of the psychological dynamics in terminal illness, as well as skills in communication and psychological risk assessment. On the one hand, palliative care education programmes for nurses and doctors comprise a considerable amount of psychological and psychosocial content. On the other hand, only a few palliative care associations provide explicit information on the role and tasks of psychologists in palliative care. Psychologists’ associations do not deal much with this issue either. If they refer to it at all, it is in the context of the care of the aged, end-of-life care or how to deal with grief

The SF36 as an outcome measure of services for end stage renal failure

OBJECTIVE: —To evaluate the use of the short form 36 (SF36) as a measure of health related quality of life of patients with end stage renal failure, document the results, and investigate factors, including mode of treatment, which may influence it. DESIGN: Cross sectional survey of patients with end stage renal failure, with the standard United Kingdom version of the SF36 supplemented by specific questions for end stage renal failure. SETTING: A teaching hospital renal unit. Subjects and methods—660 patients treated at the Sheffield Kidney Institute by haemodialysis, peritoneal dialysis, and transplantation. Internal consistency, percentage of maximal or minimal responses, SF36 scores, effect sizes, correlations between independent predictor variables and individual dimension scores of the SF36. Multiple regression analysis of the SF36 scores for the physical functioning, vitality, and mental health dimensions against treatment, age, risk (comorbidity) score, and other independent variables. RESULTS: A high response rate was achieved. Internal consistency was good. There were no floor or ceiling effects other than for the two “role” dimensions. Overall health related quality of life was poor compared with the general population. Having a functioning transplant was a significant predictor of higher score in the three dimensions (physical functioning, vitality, and mental health) for which multiple regression models were constructed. Age, sex, comorbidity, duration of treatment, level of social and emotional support, household numbers, and hospital dialysis were also (variably) significant predictors. CONCLUSIONS: The SF36 is a practical and consistent questionnaire in this context, and there is evidence to support its construct validity. Overall the health related quality of life of these patients is poor, although transplantation is associated with higher scores independently of the effect of age and comorbidity. Age, comorbidity, and sex are also predictive of the scores attained in the three dimensions studied. Further studies are required to ascertain whether altering those predictor variables which are under the influence of professional carers is associated with changes in health related quality of life, and thus confirm the value of this outcome as a measure of quality of care

How much does teenage parenthood affect long term outcomes? A systematic review.

Background: The rates of teenage pregnancy in the UK are relatively high. Although early entry to parenthood can be a positive experience, most studies find large adverse effects on long term outcomes for the mother, child and father, in addition to being costly for the NHS. This is why the government launched its Teenage Pregnancy Strategy in 1999. However, there is growing evidence that teenage pregnancy might be mainly an indicator of disadvantage which is the underlying cause of the negative outcomes. Methods: A systematic literature review was undertaken of studies which used a UK dataset to quantify any long term outcomes of a teenage birth upon the mother, father or child. Studies were included if they used appropriate methods to isolate the causal effect of early parenthood. The databases searched included Medline, Cochrane, EconLit and Web of Science. Results: Six studies were identified by the review; five studies considered the mother’s socioeconomic outcomes, one study reported the child’s outcomes, and no studies met the inclusion criteria for the father’s outcomes. The studies suggested that early motherhood accounts for relatively few of the negative long term socioeconomic outcomes and it is predominantly an indicator of a disadvantaged family background. Conclusion: Limited evidence is available to understand the long term outcomes associated with teenage birth within the UK for the mother, father and child. Current econometric studies suggest that effective interventions to prevent teenage pregnancies will not eradicate the poorer long term socioeconomic outcomes often associated with early motherhood. Thus policy should focus on reducing initial disadvantage in addition to preventing teenage pregnancy. Additional econometric analyses around the mothers’, fathers’ and children’s long term socioeconomic and health-related outcomes would be valuable

The prevalence of medical reasons for non-participation in the Scottish breast and bowel cancer screening programmes

Objective: Increasing uptake of cancer screening is a priority for health systems internationally, however, some patients may not attend because they are undergoing active treatment for the cancer of interest or have other medical reasons that mean participation would be inappropriate. This study aims to quantify the proportion of non-participants who have a medical reason for not attending cancer screening.<p></p> Methods: Medical reasons for not participating in breast and bowel screening were defined a priori on the basis of a literature review and expert opinion. The notes of 700 patients at two GP practices in Scotland were reviewed, to ascertain the prevalence of medical reasons amongst non-participants. Simple proportions and confidence intervals were calculated.<p></p> Results: 17.4% of breast and 2.3% of bowel screening non-participants had a medical reason to not participate. The two most common reasons were previous breast cancer follow up (8.86%) and recent mammogram (6.57%).<p></p> Conclusion: These patients may not benefit from screening while also being distressed by receiving an invitation. This issue also makes accurate monitoring and target-setting for improving uptake difficult. Further work is needed to estimate robustly the extent to which medical reasons account for screening non-participation in a larger population.<p></p&gt

New Consequences of Induced Transparency in a Double-Lambda scheme: Destructive Interference In Four-wave Mixing

We investigate a four-state system interacting with long and short laser pulses in a weak probe beam approximation. We show that when all lasers are tuned to the exact unperturbed resonances, part of the four-wave mixing (FWM) field is strongly absorbed. The part which is not absorbed has the exact intensity required to destructively interfere with the excitation pathway involved in producing the FWM state. We show that with this three-photon destructive interference, the conversion efficiency can still be as high as 25%. Contrary to common belief,our calculation shows that this process, where an ideal one-photon electromagnetically induced transparency is established, is not most suitable for high efficiency conversion. With appropriate phase-matching and propagation distance, and when the three-photon destructive interference does not occur, we show that the photon flux conversion efficiency is independent of probe intensity and can be close to 100%. In addition, we show clearly that the conversion efficiency is not determined by the maximum atomic coherence between two lower excited states, as commonly believed. It is the combination of phase-matching and constructive interference involving the two terms arising in producing the mixing wave that is the key element for the optimized FWM generation. Indeed, in this scheme no appreciable excited state is produced, so that the atomic coherence between states |0> and |2> is always very small.Comment: Submitted to Phys. Rev. A, 7 pages, 4 figure

The accelerating influence of humans on mammalian macroecological patterns over the late Quaternary

The transition of hominins to a largely meat-based diet ~1.8 million years ago led to the exploitation of other mammals for food and resources. As hominins, particularly archaic and modern humans, became increasingly abundant and dispersed across the globe, a temporally and spatially transgressive extinction of large-bodied mammals followed; the degree of selectivity was unprecedented in the Cenozoic fossil record. Today, most remaining large-bodied mammal species are confined to Africa, where they coevolved with hominins. Here, using a comprehensive global dataset of mammal distribution, life history and ecology, we examine the consequences of “body size downgrading” of mammals over the late Quaternary on fundamental macroecological patterns. Specifically, we examine changes in species diversity, global and continental body size distributions, allometric scaling of geographic range size with body mass, and the scaling of maximum body size with area. Moreover, we project these patterns toward a potential future scenario in which all mammals currently listed as vulnerable on the IUCN\u27s Red List are extirpated. Our analysis demonstrates that anthropogenic impact on earth systems predates the terminal Pleistocene and has grown as populations increased and humans have become more widespread. Moreover, owing to the disproportionate influence on ecosystem structure and function of megafauna, past and present body size downgrading has reshaped Earth\u27s biosphere. Thus, macroecological studies based only on modern species yield distorted results, which are not representative of the patterns present for most of mammal evolution. Our review supports the concept of benchmarking the “Anthropocene” with the earliest activities of Homo sapiens

Componential coding in the condition monitoring of electrical machines Part 2: application to a conventional machine and a novel machine

This paper (Part 2) presents the practical application of componential coding, the principles of which were described in the accompanying Part 1 paper. Four major issues are addressed, including optimization of the neural network, assessment of the anomaly detection results, development of diagnostic approaches (based on the reconstruction error) and also benchmarking of componential coding with other techniques (including waveform measures, Fourier-based signal reconstruction and principal component analysis). This is achieved by applying componential coding to the data monitored from both a conventional induction motor and from a novel transverse flux motor. The results reveal that machine condition monitoring using componential coding is not only capable of detecting and then diagnosing anomalies but it also outperforms other conventional techniques in that it is able to separate very small and localized anomalies

Magnetic structure of free cobalt clusters studied with Stern-Gerlach deflection experiments

We have studied the magnetic properties of free cobalt clusters in two semi-independent Stern-Gerlach deflection experiments at temperatures between 60 and 307 K. We find that clusters consisting of 13 to 200 cobalt atoms exhibit behavior that is entirely consistent with superparamagnetism, though complicated by finite-system fluctuations in cluster temperature. By fitting the data to the Langevin function, we report magnetic moments per atom for each cobalt cluster size and compare the results of our two measurements and all those performed previously. In addition to a gradual decrease in moment per atom with increasing size, there are oscillations that appear to be caused by geometrical shell structure. We discuss our observations in light of the two competing models for Langevin-like magnetization behavior in free clusters, superparamagnetism and adiabatic magnetization, and conclude that the evidence strongly supports the superparamagnetic model

Deuteron Dipole Polarizabilities and Sum Rules

The scalar, vector, and tensor components of the (generalized) deuteron electric polarizability are calculated, as well as their logarithmic modifications. Several of these quantities arise in the treatment of the nuclear corrections to the deuterium Lamb shift and the deuterium hyperfine structure. A variety of second-generation potential models are used and a (subjective) error is assigned to the calculations. The zero-range approximation is used to analyze a subset of the results, and a simple relativistic version of this approximation is developed.Comment: 14 pages, LaTex - submitted to Physical Review

Multifrequency Radio Observations of a SNR in the LMC. The Case of SNR J0527-6549 (DEM l204)

We present a detailed study and results of new Australia Telescope Compact Array (ATCA) observations of supernova remnant, SNR J0527-6549. This Large Magellanic Cloud (LMC) ob ject follows a typical supernova remnant (SNR) horseshoe morphology with a diameter of D=(66x58)+-1 pc which is among the largest SNRs in the LMC. Its relatively large size indicates older age while a steeper than expected radio spectral index of aplha=-0.92+-0.11 is more typical for younger and energetic SNRs. Also, we report detections of regions with a high order of polarization at a peak value of ~54+-17% at 6 cm.Comment: 9 Pages, 6 figures, accepted for publication in SA