2,409 research outputs found
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 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 ( 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
A List of Bright Interferometric Calibrators measured at the ESO VLTI
In a previous publication (Richichi & Percheron 2005) we described a program
of observations of candidate calibrator stars at the ESO Very Large Telescope
Interferometer (VLTI), and presented the main results from a statistical point
of view. In the present paper, we concentrate on establishing a new homogeneous
group of bright interferometric calibrators, based entirely on publicly
available K-band VLTI observations carried out with the VINCI instrument up to
July 2004. For this, we have defined a number of selection criteria for the
quality and volume of the observations, and we have accordingly selected a list
of 17 primary and 47 secondary calibrators. We have developed an approach to a
robust global fit for the angular diameters using the whole volume of
quality-controlled data, largely independent of a priori assumptions. Our
results have been compared with direct measurements, and indirect estimates
based on spectrophotometric methods, and general agreement is found within the
combined uncertainties. The stars in our list cover the range K=-2.9 to +3.0
mag in brightness, and 1.3 to 20.5 milliarcseconds in uniform-disk diameter.
The relative accuracy of the angular diameter values is on average 0.4% and 2%
for the primary and secondary calibrators respectively. Our calibrators are
well suited for interferometric observations in the near-infrared on baselines
between ~20m and ~200m, and their accuracy is superior, at least for the
primary calibrators, to other similar catalogues. Therefore, the present list
of calibrators has the potential to lead to significantly improved
interferometric scientific results
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 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 m region.Comment: Accepted to ApJ Letter
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