1,163 research outputs found
The Ages of Elliptical Galaxies in a Merger Model
The tightness of the observed colour-magnitude and Mg- velocity
dispersion relations for elliptical galaxies has often been cited as an
argument against a picture in which ellipticals form by the merging of spiral
disks. A common view is that merging would mix together stars of disparate ages
and produce a large scatter in these relations. Here I use semi-analytic models
of galaxy formation to derive the distribution of the mean ages, colours and
metallicities of the stars in elliptical galaxies formed by mergers in a flat
CDM universe. It is seen that most of the stars in ellipticals form at
relatively high redshift (z > 1.9) and that the predicted scatter in the
colour-magnitude and Mg_2 - sigma relations falls within observational bounds.
I conclude that the apparent homogeneity in the properties of the stellar
populations of ellipticals is not inconsistent with a merger scenario for the
origin of these systems.Comment: latex file, figures available upon reques
Interventions for involving older patients with multimorbidity in decision‐making during primary care consultations (protocol)
This is the final version of the article. Available from Wiley via the DOI in this recordThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
To explore the effectiveness of interventions delivered with the aim of involving older patients with multimorbidity in decision-making
about their health care during primary care consultations
Interventions for involving older patients with multimorbidity in decision‐making during primary care consultations
This is the final version. Available from Wiley via the DOI in this record. Background
The number of older people with more than one long-term health problem is steadily increasing worldwide. Such individuals can have
complicated healthcare needs. Although they frequently want to be involved in making decisions about their health care, they are less
often involved than younger, healthier people. As a result, they may not be offered the same treatment options.
Review question
We reviewed available evidence about the effects of interventions intended to involve older people with more than one long-term health
problem in decision-making about their health care during primary care consultations.
Study characteristics
We included research published up until August 2018. We found three relevant studies involving 1879 participants. These studies were
reported from three countries. Participants were over 65 years of age with three or more long-term health problems on average. Interventions investigated included:
· patient workshops and individual patient coaching;
· patient coaching including cognitive-behavioural therapy; and
Selection criteria
We sought randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of interventions to involve patients in decision-making about
their health care versus usual care/control/another intervention, for patients aged 65 years and older with multi-morbidity in primary care.
Data collection and analysis
We used standard Cochrane methodological procedures. Meta-analysis was not possible; therefore we prepared a narrative synthesis.
Main results
We included three studies involving 1879 participants: two RCTs and one cluster-RCT. Interventions consisted of:
· patient workshop and individual coaching using behaviour change techniques;
· whole-person patient review, practitioner training, and organisational changes.
All studies were funded by national research bodies.
Key results
None of the studies reported the main outcome ‘patient involvement in decision-making about their health care’ nor whether there was
less patientinvolvement as a result ofthe intervention. Interventions were notfound to increase adverse outcomes such as death, anxiety,
emergency department attendance, or hospital admissions..
We are uncertain whetherinterventions forinvolving older people with more than one long-term health problem in decision-making about
their health care can improve their self-rated health or healthcare engagement, or make any difference in self-efficacy (one's belief in
one's ability to succeed in specific situations) or in the overall number of general practice visits. We can report that these interventions
probably make little or no difference in patients' quality of life but probably increase the number of patients discussing their priorities, and
are associated with more patient consultations with nurses, when compared to usual care. Interventions may be associated with more
changes in the management of health conditions when considered from the patient’s perspective when compared with a control group.
The quality of the evidence was limited by small studies, and by studies choosing to measure different outcomes, resulting in lack of data
that could be combined in analyses.
Conclusions
Further research in this developing area is required before firm conclusions can be drawnNational Institute for Health Research (NIHR
Factors predicting clinically significant fatigue in women following treatment for primary breast cancer
Cancer-related fatigue is common, complex, and distressing. It affects 70–100% of patients receiving chemotherapy and a significant number who have completed their treatments. We assessed a number of variables in women newly diagnosed with primary breast cancer (BrCa) to determine whether biological and/or functional measures are likely to be associated with the development of clinically significant fatigue (CSF). Two hundred twenty-three women participated in a study designed to document the impact of the diagnosis and treatment of primary breast cancer on function. Forty-four had complete data on all variables of interest at the time of confirmed diagnosis but prior to treatment (baseline) and ≥9 months post-diagnosis. Objective measures and descriptive variables included history, physical examination, limb volume, hemoglobin, white blood cell count, and glucose. Patient-reported outcomes included a verbal numerical rating of fatigue (0–10, a score of ≥4 was CSF), five subscales of the SF-36, Physical Activity Survey, and Sleep Questionnaire. At baseline, the entire cohort (n = 223) and the subset (n = 44) were not significantly different for demographic, biological, and self-reported data, except for younger age (p = 0.03) and ER+ (p = 0.01). Forty-five percent had body mass index (BMI) ≥ 25, 52% were post-menopause, and 52% received modified radical mastectomy, 39% lumpectomy, 52% chemotherapy, 68% radiation, and 86% hormonal therapy. Number of patients with CSF increased from 1 at baseline to 11 at ≥9 months of follow-up. CSF at ≥9 months significantly correlated with BMI ≥ 25, abnormal white blood cell count, and increase in limb volume and inversely correlated with vigorous activity and physical function (p < 0.05). Fatigue increases significantly following the treatment of BrCa. Predictors of CSF include high BMI and WBC count, increase in limb volume, and low level of physical activity. These are remediable
Boundaries of Semantic Distraction: Dominance and Lexicality Act at Retrieval
Three experiments investigated memory for semantic information with the goal of determining boundary conditions for the manifestation of semantic auditory distraction. Irrelevant speech disrupted the free recall of semantic category-exemplars to an equal degree regardless of whether the speech coincided with presentation or test phases of the task (Experiment 1) and occurred regardless of whether it comprised random words or coherent sentences (Experiment 2). The effects of background speech were greater when the irrelevant speech was semantically related to the to-be-remembered material, but only when the irrelevant words were high in output dominance (Experiment 3). The implications of these findings in relation to the processing of task material and the processing of background speech is discussed
The inevitable youthfulness of known high-redshift radio galaxies
Radio galaxies can be seen out to very high redshifts, where in principle
they can serve as probes of the early evolution of the Universe. Here we show
that for any model of radio-galaxy evolution in which the luminosity decreases
with time after an initial rapid increase (that is, essentially all reasonable
models), all observable high-redshift radio-galaxies must be seen when the
lobes are less than 10^7 years old. This means that high-redshift radio
galaxies can be used as a high-time-resolution probe of evolution in the early
Universe. Moreover, this result helps to explain many observed trends of
radio-galaxy properties with redshift [(i) the `alignment effect' of optical
emission along radio-jet axes, (ii) the increased distortion in radio
structure, (iii) the decrease in physical sizes, (iv) the increase in radio
depolarisation, and (v) the increase in dust emission] without needing to
invoke explanations based on cosmology or strong evolution of the surrounding
intergalactic medium with cosmic time, thereby avoiding conflict with current
theories of structure formation.Comment: To appear in Nature. 4 pages, 2 colour figures available on request.
Also available at http://www-astro.physics.ox.ac.uk/~km
Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue - results of a three-armed pragmatic trial in a comprehensive cohort design
Survival from testicular cancer in England and Wales up to 2001
www.bjcancer.com For many years testicular cancer has been the prime example of the tumour that is chemocurable, even when metastatic. The disappointment in oncology is that these results have so far not been replicated in the more common solid tumours. Why this should be is not clear but germ-cell tumours retain sensitivity to chemotherapy in vitro and a number of mechanisms including reduced DNA repair capacity and proneness to apoptosis have been proposed (Mayer et al, 2003). Most patients with testicular cancer present after finding a lump in the testicle that may or may not be painful. A small proportion of patients present with symptoms of metastatic disease. With the exception of some patients with metastatic disease, initial treatment after first assessment is to remove the tumour by inguinal orchidectomy. Patients are staged by tumour marke
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