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We developed a specific cognitive–existential intervention to improve existential distress in nonmetastatic cancer patients. The present study reports the feasibility of implementing and evaluating this intervention, which involved 12 weekly sessions in both individual and group formats, and explores the efficacy of the intervention on existential and global quality of life (QoL) measures.
Some 33 nonmetastatic cancer patients were randomized between the group intervention, the individual intervention, and the usual condition of care. Evaluation of the intervention on the existential and global QoL of patients was performed using the existential well-being subscale and the global scale of the McGill Quality of Life (MQoL) Questionnaire.
All participants agreed that their participation in the program helped them deal with their illness and their personal life. Some 88.9% of participants agreed that this program should be proposed for all cancer patients, and 94.5% agreed that this intervention helped them to reflect on the meaning of their life. At post-intervention, both existential and psychological QoL improved in the group intervention versus usual care (p = 0.086 and 0.077, respectively). At the three-month follow-up, global and psychological QoL improved in the individual intervention versus usual care (p = 0.056 and 0.047, respectively).
Significance of results:
This pilot study confirms the relevance of the intervention and the feasibility of the recruitment and randomization processes. The data strongly suggest a potential efficacy of the intervention for existential and global quality of life, which will have to be confirmed in a larger study.
The presence of residual neurological deficits after neurological symptoms is important information for making a diagnosis of Transient Ischemic Attack (TIA) versus stroke. The purpose of this study was to establish the reliability of the referring physician (non neurologist) to report focal neurological deficits in the context of an urgent referral for TIA.
Prospectively recorded urgent physician-to-physician phone referrals for TIA through the Southern Alberta TIA hotline from March 2009 to July 2010 were reviewed. “Has the neurological deficit completely resolved?” was asked to the referring physician (family or emergency room physician) and recorded prospectively as a yes/no response. Patients were included if a neurological examination was performed by a neurologist on the same day as referral. The neurologist's assessment of whether the deficit had resolved was compared to that of the referring physician.
78 patients were included in this study. 62 patients had resolved as per the referring physician's assessment. Of these 62 patients, 16 (25.8% 95%CI 16-38) had evidence of persisting neurological deficits on the neurologist's assessment. A wide variety of mild neurological deficits were identified. None of these deficits appeared to be explained by progression of symptoms.
Physicians referring patients with TIA syndromes for emergent assessment do not reliably detect mild residual deficits in one-quarter of patients. We are questioning the validity of neurological deficit resolution as a triage rule. The findings suggest that studies of TIA likely include a proportion of minor stroke patients and this should be remembered when extrapolating the results to other populations.
Radiocarbon dating of the carbonate remaining in calcined bones is widely regarded as a viable alternative to date skeletal remains in situations where collagen is no longer present. However, anomalously low δ13C values measured in calcined bones prompted questions about the origin of the carbon used for dating. The goal of this study was to quantify the magnitude of carbon isotope exchange between bone carbonate and environmental CO2 for bones calcined under natural conditions. Four archaeological bones ranging in age between the Neolithic and the Medieval period were combusted on a separate open fire for up to 4 hr and subsamples of calcined bones were taken every hour. All the bones experienced a significant increase in IRSF values and decrease in carbonate content and δ13C values. 14C ages measured in the carbonate fraction of well-calcined bones indicate that 67 ± 3% to 91 ± 8% of the carbon present in bone carbonate was replaced by carbon from the atmosphere of combustion. This finding confirms previous results obtained under laboratory conditions and has serious implications for 14C dating of calcined bones found in archaeological contexts. The 14C age obtained on a calcined bone will only reflect the true age of the bone sample if the age difference between the bone and the charcoal can be neglected. Our results show also that δ13C values of calcined bones can be used to estimate the degree of C exchange and control for post-burial diagenetic alteration.
Fossil vertebrates from the Cabao Formation discovered in the area of Nalut in northwestern Libya include the hybodont shark Priohybodus, the crocodilian Sarcosuchus, an abelisaurid, a baryonichine spinosaurid and a large sauropod with spatulate teeth. The Cabao Formation may be Hauterivian to Barremian in age, although an earlier Berriasian to Valanginian age cannot be excluded. Its dinosaur assemblage is reminiscent of that of the El Rhaz and Tiouraren formations of Niger and strongly differs from both the Cenomanian assemblages of Morocco and Egypt and the Late Aptian to Albian fauna of Tunisia. Fossil vertebrates may be an important tool to establish the stratigraphical framework of the poorly dated Early Cretaceous continental deposits of Africa.
A passive seismic study was carried out underneath Glacier d’Argentière, Mont Blanc, France, where an array of seismometers was installed in a subglacial access tunnel. The data show a very high emissivity from the glacier. Fracturing can be discriminated from serac falls using the signal characteristics. We apply seismic array methods to locate the sources of these signals, using a two-step grid search in the parameter space. Four clusters of activity are found close to the network, showing that this fracturing does not take place uniformly over the glacier, but rather in isolated small zones. We compute a local magnitude using regional earthquakes for calibration. The magnitudes follow a classical Gutenberg–Richter law in the range ML = −3 to 0.15, showing that no characteristic size events dominate the process. We suggest that those spatial clusters of icequakes could reveal the heterogeneous nature of the friction at the base of the glacier, with patches of high frictional stresses locally generating intense fracturing within the ice mass.
In the early 1990s, the development of information sharing among individuals on the Internet seemed pervasive. Individuals started to share music files, to communicate word-of-mouth about products and the like. More than ever before a new technology enabled consumers to share information on a large scale and on a spontaneous basis. Most of the attention was then focused on the emergence of online consumers communities (OCCs) and their expected benefits (Wellman and Gulia 1999; Hagel and Armstrong 1997). According to Hagel and Armstrong (1997), OCCs were supposed to offer companies a chance to know their customers much better than ever before, through giving the latter the ability to easily interact with each other and with the company itself: firms organizing OCCs could use what they learned from communities to achieve “viral marketing” and merely create undreamed of customer loyalty.
However, rather little attention had been devoted to identifying potential obstacles to the sustainability of OCCs seen as economic entities providing an informational public good. Yet, shared resources and public goods are shown to give rise to a “tragedy of the commons” (Hardin 1968) since agents' private interest dictates individual behaviors that are eventually harmful to general interest. More precisely, individuals tend to under-invest in a public good because its non-excludability and non-rivalry give private incentives to free-ride, free-riders expecting to benefit from the shared resource even if not contributing to its provision.
This article presents a method for the management of catastrophic risks generated by industrial activities. The multi-criteria decision-making tool which we have developed does not suffer from the same limitations as decision theory or the standard approach to risk assessment and management. Our quantitative risk analysis takes into account three factors: (1) the analysis of the relative acceptability of risks to society; (2) the minimization of the mathematical expectation of financial losses using a catastrophe aversion coefficient; and (3) the preference for flexibility expressed by industrial managers. This method has been applied to the comparison between two catastrophic risks on a French chemical site.
Investigating “Spinozism” teaches at least as much about interpretations of Spinoza by other movements - both those approving him and (more often) opposing him - as it does about Spinoza's thought itself. More than other philosophies, Spinoza's has been held up like a mirror to the great currents of thought, a mirror in which their distorted images can be seen. Its first reception was accomplished in the midst of polemics; the modalities of its influence have always suffered from this, so that, at every period, the recovery of the exact situation of Spinozism from under the accumulation of abuses and misunderstandings is an effective intellectual instrument for analyzing the disposition of forces within the domain of ideas, its dominant and dominated ideas, and the battle they wage against one another. In this way one can see Calvinism, Cartesianism, the Enlightenment, and other movements, look upon their reflections, and see their own contradictions revealed in it.
THE SEVENTEENTH CENTURY
For a century and a half after his life, the first figure Spinoza assumed was that of the atheist or impious person. Leo Back (1895), P. Verniere (1954), and W. Schroder (1987) have studied the formation of this image. For many years, Spinoza was discussed primarily for refutation; it was even asserted that he must be read only with that intention. Alternatively, if he awakened some positive interest, it was with thinkers who already looked upon official religion with a critical eye. Both the orthodox and the libertine, however, concurred in conceiving him as atheistic or impious.
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