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

E-government actor’s perspective: a case of local municipalities in South Africa

The public sector in developing countries experience various challenges that have stagnated the implementation of e-government-for-citizens especially in local municipalities. The specific focal point is to highlight the egovernment actor’s viewpoint on what causes the failures of egovernment implementation within local municipalities. The actors are perceived as the creators and transformers on systems and their input is critical in providing a critical reflection on e-government. A purposive sample of 35 egovernment actors was interviewed to give their perspectives on factors that hinder the implementation of fully functional egovernment portals at the municipal level

Follow-Up Observations of PTFO 8-8695: A 3 MYr Old T-Tauri Star Hosting a Jupiter-mass Planetary Candidate

We present Spitzer 4.5\micron\ light curve observations, Keck NIRSPEC radial velocity observations, and LCOGT optical light curve observations of PTFO~8-8695, which may host a Jupiter-sized planet in a very short orbital period (0.45 days). Previous work by \citet{vaneyken12} and \citet{barnes13} predicts that the stellar rotation axis and the planetary orbital plane should precess with a period of $300 - 600$ days. As a consequence, the observed transits should change shape and depth, disappear, and reappear with the precession. Our observations indicate the long-term presence of the transit events ($>3$ years), and that the transits indeed do change depth, disappear and reappear. The Spitzer observations and the NIRSPEC radial velocity observations (with contemporaneous LCOGT optical light curve data) are consistent with the predicted transit times and depths for the $M_\star = 0.34\ M_\odot$ precession model and demonstrate the disappearance of the transits. An LCOGT optical light curve shows that the transits do reappear approximately 1 year later. The observed transits occur at the times predicted by a straight-forward propagation of the transit ephemeris. The precession model correctly predicts the depth and time of the Spitzer transit and the lack of a transit at the time of the NIRSPEC radial velocity observations. However, the precession model predicts the return of the transits approximately 1 month later than observed by LCOGT. Overall, the data are suggestive that the planetary interpretation of the observed transit events may indeed be correct, but the precession model and data are currently insufficient to confirm firmly the planetary status of PTFO~8-8695b.Comment: Accepted for publication in The Astrophysical Journa

Kepler Observations of the Three Pre-Launch Exoplanet Candidates: Discover of Two Eclipsing Binaries and a New Exoplanet

Three transiting exoplanet candidate stars were discovered in a ground-based photometric survey prior to the launch of NASA's Kepler mission. Kepler observations of them were obtained during Quarter 1 of the Kepler mission. All three stars are faint by radial velocity follow-up standards, so we have examined these candidates with regard to eliminating false positives and providing high confidence exoplanet selection. We present a first attempt to exclude false positives for this set of faint stars without high-resolution radial velocity analysis. This method of exoplanet confirmation will form a large part of the Kepler mission follow-up for Jupiter-sized exoplanet candidates orbiting faint stars. Using the Kepler light curves and pixel data, as well as medium-resolution reconnaissance spectroscopy and speckle imaging, we find that two of our candidates are binary stars. One consists of a late-F star with an early M companion, while the other is a K0 star plus a late M-dwarf/brown dwarf in a 19 day elliptical orbit. The third candidate (BOKS-1) is an r = 15 G8V star hosting a newly discovered exoplanet with a radius of 1.12 R_(Jupiter) in a 3.9 day orbit

First Spitzer Space Telescope Observations of Magnetic Cataclysmic Variables: Evidence for Excess Emission at 3--8 microns

We present the first observations of magnetic cataclysmic variables with the Spitzer Space Telescope. We used the Infrared Array Camera to obtain photometry of the polars EF Eri, GG Leo, V347 Pav, and RX J0154.0-5947 at 3.6, 4.5, 5.8, and 8.0 $\mu$m. In all of our targets, we detect excess mid-infrared emission over that expected from the component stars alone. We explore the origin of this IR excess by examining bremsstrahlung, cyclotron emission, circumbinary dust, and L/T brown dwarf secondary stars. Bremsstrahlung and cyclotron emission appear unlikely to be significant contributors to the observed fluxes. At present, the most likely candidate for the excess emission is dust that is probably located in a circumbinary disk with an inner temperature near 800 K. However, a simple dust disk plus any reasonable low mass or brown dwarf-like secondary star is unable to fully explain the observed flux densities in the 3--8 $\mu$m region.Comment: Accepted to ApJ Letter