Quality of life (QoL) as predictive mediator variable for survival in patients with intracerebral neoplasma during radiotherapy

Background: The prognosis for patients with malignant astrocytoma or brain metastases is often fatal despite intensive therapy. Therefore we wished to elucidate whether the quality of life (QoL) is a determinant of overall survival (OAS). Patients and Methods: From 1997 to 2000 153 patients with brain tumours were screened; 39 patients (26%) refused to participate and further 47 patients were excluded (cerebral impairment 14%, amaurosis/language problems 3%, Karnofsky performance score < 50% 7%, death 8%, non-compliance 7%). Thus, 57 patients were analysed (33 with primary brain tumours, 24 with brain metastases). With the FACT-G questionnaire cancer-specific aspects of health-related QoL were assessed. Results: Patients with metastases showed a lower QoL in the physical sphere than patients with astrocytoma, but there were no significant differences in OAS. Median survival of patients with good QoL was 31.3 months versus 14.2 months in patients with bad QoL. Only the two variables `living with a spouse' and FACT-G sum score had a statistically significant influence on survival (p = 0.033 and p = 0.003) modelled by the Cox-PH regression. Patients who did not live with a spouse had shorter survival times than the other patients. Conclusion: Health-related QoL can serve to identify a patient group with higher risks of death

Coping of cancer patients during and after radiotherapy - a follow-up of 2 years

Aim: We wanted to understand coping strategies specific to different phases up to two years after radiotherapy, to identify patients who are at higher risk of mood disturbances and to characterise the association between coping strategies and psychosocial adaptation. Patients and Methods: From 1997 to 2001, 2,169 patients with different diagnoses were screened (27.8% refused to participate). Data of 276 patients from the beginning of radiotherapy (ti1) and 5 follow-up investigations (ti6/2 years) could be analysed. With the FKV ( Freiburg Questionnaire Coping with Disease) cancer-specific coping aspects were assessed. The association between coping styles and psychosocial adaptation was evaluated using the Questionnaire on Stress in Cancer Patients (QSC) and the questionnaire on Functional Assessment of Cancer Treatment (FACT-G). Results: `Active problem-orientated' coping and `distractions' are the most important coping strategies. Only `active problem-orientated' and `depressive' coping showed a significant decrease. We observed higher means on the scales of the FKV in women. Marital status ( single, married, divorced/widowed) had a significant influence on active problem-orientated coping and spirituality. Age, children, education, T/M status and curative/ palliative intention of treatment had no influence on coping styles. Breast cancer patients and lymphoma patients demonstrated the highest use of coping strategies after radiotherapy with a significant decrease of `active problem-orientated coping'. Depressive coping and minimizing importance at ti1 were associated with high psychosocial distress and low quality of life (QoL) at ti6. Conclusion: The correlation of coping mechanisms at the beginning of radiotherapy with low QoL and high psychosocial stress at 2 years could help to identify patients at risk for low psychosocial adaptation. Psychooncologically trained teams of physicians would best correspond to this profile of needs and would contribute significantly to an ameliorated adaptation of patients to cancer which could lead to higher life satisfaction

Physical education as Olympic education

Introduction In a recent paper (Parry, 1998, p. 64), I argued that the justification of PE activities lies in their capacity to facilitate the development of certain human excellences of a valued kind. Of course, the problem now lies in specifying those ‘human excellences of a valued kind’, and (for anyone) this task leads us into the area of philosophical anthropology. I suggested that the way forward for Physical Education lies in the philosophical anthropology (and the ethical ideals) of Olympism, which provide a specification of a variety of human values and excellences which: •have been attractive to human groups over an impressive span of time and space •have contributed massively to our historically developed conceptions of ourselves •have helped to develop a range of artistic and cultural conceptions that have defined Western culture. •have produced a range of physical activities that have been found universally satisfying and challenging. Although physical activities are widely considered to be pleasurable, their likelihood of gaining wide acceptance lies rather in their intrinsic value, which transcends the simply hedonic or relative good. Their ability to furnish us with pleasurable experiences depends upon our prior recognition in them of opportunities for the development and expression of valued human excellences. They are widely considered to be such opportunities for the expression of valued human excellences because, even when as local instantiations, their object is to challenge our common human propensities and abilities. I claimed that Olympic ideals may be seen not merely as inert ‘ideals’, but living ideas which have the power to remake our notions of sport in education, seeing sport not as mere physical activity but as the cultural and developmental activity of an aspiring, achieving, well-balanced, educated and ethical individual. This paper seeks to make good that claim by trying to develop a case for Physical Education as Olympic Education. I begin by setting out various accounts and conceptions of the Olympic Idea; then I suggest a unifying and organising account of the philosophical anthropology of Olympism; and this is followed by the practical application of that account in two examples of current ethical issues. Finally, I seek to present an account of Physical Education as Olympic Education

Nanopatterning of epitaxial CoSi₂ using oxidation in a local stress field and fabrication of nanometer metal-oxide-semiconductor field-effect transistors

A patterning method for the generation of epitaxialCoSi₂nanostructures was developed based on anisotropic diffusion of Co∕Si atoms in a stress field during rapid thermal oxidation (RTO). The stress field is generated along the edge of a mask consisting of a thin SiO₂ layer and a Si₃N₄ layer. During RTO of the masked silicide structure, a well-defined separation of the silicide layer forms along the edge of the mask. The technique was used to make 50-nm channel-length metal-oxide-semiconductor field-effect transistors(MOSFETs). These highly uniform gaps define the channel region of the fabricated device. Two types of MOSFETs have been fabricated: symmetric transistor structures, using the separated silicide layers as Schottky source and drain, and asymmetric transistors, with n+ source and Schottky drain. The asymmetric transistors were fabricated by an ion implantation into the unprotected CoSi₂ layer and a subsequent out diffusion to form the n+ source. The detailed fabrication process as well as the I–V characteristics of both the symmetric and asymmetric transistor structures will be presented

Modelling of the effect of scale on the compressibility parameters of fine-grained soils

The effect of sample scale represents a challenge when obtaining engineering parameters in the laboratory compared to those obtained in the field. This study aimed at contributing to existing knowledge numerically using the finite element software PLAXIS 2D. The investigations were analysed in terms of height scale (HS) and diameter scale (DS) through a series of laboratory tests. Its effect on compressibility parameters such as coefficient of consolidation (cv) was noted experimentally and showed that the sample scale greatly influences soil parameters most particularly at DS. The soil behaviour was found to be dependent on both DS and HS with a correlation factor of 0.650 and 0.062, respectively. The experimental data were validated in PLAXIS and a new proposed model was developed in PLAXIS 2D under the DS. The new proposed model developed was found to show no significant difference with the laboratory data

Effects of Compression and Collective Expansion on Particle Emission from Central Heavy-Ion Reactions

Conditions under which compression occurs and collective expansion develops in energetic reactions of heavy nuclei, are analyzed, together with their effects on emitted light baryons and pions. Within transport simulations, it is shown that shock fronts perpendicular to beam axis form in head-on reactions. The fronts separate hot compressed matter from normal. As impact parameter increases, the angle of inclination of the fronts relative to beam axis decreases, and in-between the fronts a weak tangential discontinuity develops. Hot matter exposed to the vacuum in directions perpendicular to shock motion (and parallel to fronts), starts to expand sideways, early within reactions. Expansion in the direction of shock motion follows after the shocks propagate through nuclei, but due to the delay does not acquire same strength. Expansion affects angular distributions, mean-energy components, shapes of spectra and mean energies of different particles emitted into any one direction, and further particle yields. Both the expansion and a collective motion associated with the weak discontinuity, affect the magnitude of sideward flow within reaction plane. Differences in mean particle energy components in and out of the reaction plane in semicentral collisions, depend sensitively on the relative magnitude of shock speed in normal matter and speed of sound in hot matter.Comment: 71 pages, 33 figures (available on request), report MSUCL-94

Searching for the Nuclear Liquid-Gas Phase Transition in Au + Au Collisions at 35 MeV/nucleon

Within the framework of Classical Molecular Dynamics, we study the collision Au + Au at an incident energy of 35 MeV/nucleon. It is found that the system shows a critical behaviour at peripheral impact parameters, revealed through the analysis of conditional moments of charge distributions, Campi Scatter Plot, and the occurrence of large fluctuations in the region of the Campi plot where this critical behaviour is expected. When applying the experimental filters of the MULTICS-MINIBALL apparatus, it is found that criticality signals can be hidden due to the inefficiency of the experimental apparatus. The signals are then recovered by identifying semi-peripheral and peripheral collisions looking to the velocity distribution of the largest fragment, then by selecting the most complete events.Comment: RevTex file, 21 pages + 19 figures available upon request from [email protected]

Impact of propofol on mid-latency auditory-evoked potentials in children†

Background Propofol is increasingly used in paediatric anaesthesia, but can be challenging to titrate accurately in this group. Mid-latency auditory-evoked potentials (MLAEPs) can be used to help titrate propofol. However, the effects of propofol on MLAEP in children are unclear. Therefore, we investigated the relationship between propofol and MLAEP in children undergoing anaesthesia. Methods Fourteen healthy children aged 4-16 yr received anaesthesia for elective surgery. Before surgery, propofol was administered in three concentrations (3, 6, 9 µg ml−1) through a target-controlled infusion pump using Kataria and colleagues' model. MLAEPs were recorded 5 min after having reached each target propofol concentration at each respective concentration. Additionally, venous propofol blood concentrations were assayed at each measuring time point. Results Propofol increased all four MLAEP peak latencies (peaks Na, Pa, Nb, P1) in a dose-dependent manner. In addition, the differences in amplitudes were significantly smaller with increasing propofol target concentrations. The measured propofol plasma concentrations correlated positively with the latencies of the peaks Na, Pa, and Nb. Conclusions Propofol affects MLAEP latencies and amplitudes in children in a dose-dependent manner. MLAEP measurement might therefore be a useful tool for monitoring depth of propofol anaesthesia in childre

C9 ORF 72 expansion in a family with bipolar disorder

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98405/1/bdi12063.pd