Paediatric palliative medicine

In November 2013, the International Children’s Palliative Care Network (ICPCN), based in South Africa, and the United Nations Children’s Fund (UNICEF) released a document entitled Assessment of the Need for Palliative Care for Children. Three Country Report: South Africa, Kenya and Zimbabwe. It reported that, even though an underestimate, >800 000 children in South Africa were in need of generalised palliative care and >300 000 in need of specialised palliative care. Moreover, it was estimated that only 5% of children requiring specialised care were being reached. This low coverage was a result of ‘inadequate inclusion of children’s palliative care within policy and strategy frameworks; widespread lack of knowledge and adequate understanding among health professionals; narrow target focus of services being provided already; the reluctance of health workers to prescribe and/or administer morphine despite the availability of essential palliative care pharmaceutical agents, resulting in a major barrier for access to comprehensive pain management; funding constraints and attendant poor integration of palliative care into the health system’

Physician self-care

Many of us have worked in the interminable queues of outpatient departments. After a long day, we are greeted with the hopeful, tired faces of families with their ill loved ones. We are meant to be able to heal and cure. Yet, we often run out of options, treatments seem ineffective, and we have to hold the hands of those who are dying. Doctors have mostly been trained to cure. They make significant sacrifices in family life, sleep, personal time and hobbies to be able to pursue this ideal. Moving away from cure to compassionate care of dying patients, is a paradigm shift. This can be particularly difficult when caring for children with terminal illness. It is easier to accept death in the elderly as it is part of the natural order of life. Caring for dying children can, however, be draining on both staff and families. 

An analysis of a QND speed-meter interferometer

In the quest to develop viable designs for third-generation optical interferometric gravitational-wave detectors (e.g. LIGO-III and EURO), one strategy is to monitor the relative momentum or speed of the test-mass mirrors, rather than monitoring their relative position. This paper describes and analyzes the most straightforward design for a {\it speed meter interferometer} that accomplishes this -- a design (due to Braginsky, Gorodetsky, Khalili and Thorne) that is analogous to a microwave-cavity speed meter conceived by Braginsky and Khalili. A mathematical mapping between the microwave speed meter and the optical interferometric speed meter is developed and is used to show (in accord with the speed being a Quantum Nondemolition [QND] observable) that {\it in principle} the interferometric speed meter can beat the gravitational-wave standard quantum limit (SQL) by an arbitrarily large amount, over an arbitrarily wide range of frequencies, and can do so without the use of squeezed vacuum or any auxiliary filter cavities at the interferometer's input or output. However, {\it in practice}, to reach or beat the SQL, this specific speed meter requires exorbitantly high input light power. The physical reason for this is explored, along with other issues such as constraints on performance due to optical dissipation. This analysis forms a foundation for ongoing attempts to develop a more practical variant of an interferometric speed meter and to combine the speed meter concept with other ideas to yield a promising LIGO-III/EURO interferometer design that entails low laser power.Comment: 12 pages, 5 figures; corrected formula and some values describing power requirement

A Roadmap for Using the UN Decade of Ocean Science for Sustainable Development in Support of Science, Policy, and Action

The health of the ocean, central to human well-being, has now reached a critical point. Most fish stocks are overexploited, climate change and increased dissolved carbon dioxide are changing ocean chemistry and disrupting species throughout food webs, and the fundamental capacity of the ocean to regulate the climate has been altered. However, key technical, organizational, and conceptual scientific barriers have prevented the identification of policy levers for sustainability and transformative action. Here, we recommend key strategies to address these challenges, including (1) stronger integration of sciences and (2) ocean-observing systems, (3) improved science-policy interfaces, (4) new partnerships supported by (5) a new ocean-climate finance system, and (6) improved ocean literacy and education to modify social norms and behaviors. Adopting these strategies could help establish ocean science as a key foundation of broader sustainability transformations

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

To evaluate the effects of an eight week Mindfulness Based Stress Reduction (MBSR) programme on quality of life in palliative care cancer patients

Includes bibliographical references (leaves 87-91).Before a training programme for the staff can be planned and implemented it is necessary to assess the value and benefit of such a programme for the patients. The research question asked if an eight week MBSR programme improves the quality of life of palliative care cancer patients. Quality of life is closely affected by the physical function, emotional or psychological function, social function and symptoms of disease or its subsequent treatment