949 research outputs found

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

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    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

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    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

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    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

    Fabrication of epitaxial CoSiâ‚‚ nanowires

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    We have developed a method for fabricatingepitaxialCoSiâ‚‚nanowires using only conventional optical lithography and standard silicon processing steps. This method was successfully applied to ultrathin epitaxialCoSiâ‚‚ layers grown on Si(100) and silicon-on-insulator substrates. A nitride mask induces a stress field near its edges into the CoSiâ‚‚/Siheterostructure and leads to the separation of the CoSiâ‚‚ layer in this region during a rapid thermal oxidation step. A subsequent etching step and a second oxidation generate highly homogenous silicide wires with dimensions down to 50 nm

    Langzeitergebnisse nach Ohranlegeplastik

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

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    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

    Costs of sea dikes – regressions and uncertainty estimates

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    Failure to consider the costs of adaptation strategies can be seen by decision makers as a barrier to implementing coastal protection measures. In order to validate adaptation strategies to sea-level rise in the form of coastal protection, a consistent and repeatable assessment of the costs is necessary. This paper significantly extends current knowledge on cost estimates by developing – and implementing using real coastal dike data – probabilistic functions of dike costs. Data from Canada and the Netherlands are analysed and related to published studies from the US, UK, and Vietnam in order to provide a reproducible estimate of typical sea dike costs and their uncertainty. We plot the costs divided by dike length as a function of height and test four different regression models. Our analysis shows that a linear function without intercept is sufficient to model the costs, i.e. fixed costs and higher-order contributions such as that due to the volume of core fill material are less significant. We also characterise the spread around the regression models which represents an uncertainty stemming from factors beyond dike length and height. Drawing an analogy with project cost overruns, we employ log-normal distributions and calculate that the range between 3x and x∕3 contains 95 % of the data, where x represents the corresponding regression value. We compare our estimates with previously published unit costs for other countries. We note that the unit costs depend not only on the country and land use (urban/non-urban) of the sites where the dikes are being constructed but also on characteristics included in the costs, e.g. property acquisition, utility relocation, and project management. This paper gives decision makers an order of magnitude on the protection costs, which can help to remove potential barriers to developing adaptation strategies. Although the focus of this research is sea dikes, our approach is applicable and transferable to other adaptation measures
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