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Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results
- Melissa Henry, Laura-Anne Habib, Matthew Morrison, Ji Wei Yang, Xuejiao Joanna Li, Shiru Lin, Anthony Zeitouni, Richard Payne, Christina MacDonald, Alexander Mlynarek, Karen Kost, Martin Black, Michael Hier
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- Journal:
- Palliative & Supportive Care / Volume 12 / Issue 6 / December 2014
- Published online by Cambridge University Press:
- 24 October 2013, pp. 481-493
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Objectives:
No study systematically has investigated the supportive care needs of general head and neck cancer patients using validated measures. These needs include physical and daily living needs, health system and information needs, patient care and support needs, psychological needs, and sexuality needs. Identifying the unmet needs of head and neck cancer patients is a necessary first step to improving the care we provide to patients seen in our head and neck oncology clinics. It is recommended as the first step in intervention development in the Pan-Canadian Clinical Practice Guideline of the Canadian Partnership Against Cancer (see Howell, 2009). This study aimed to identify: (1) met and unmet supportive care needs of head and neck cancer patients, and (2) variability in needs according to demographics, disease variables, level of distress, and quality-of-life domains.
Methods:Participants were recruited from the otolaryngology–head and neck surgery clinics of two university teaching hospitals. Self-administered questionnaires included sociodemographic and medical questions, as well as validated measures such as the Supportive Care Needs Survey–Short Form (SCNS-SF34), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy–General (FACT-G) and Head and Neck Module (FACT-H&N) (quality of life measures).
Results:One hundred and twenty-seven patients participated in the survey. 68% of them experienced unmet needs, and 25% revealed a clinically significant distress level on the HADS. The highest unmet needs were psychological (7 of top 10 needs). A multiple linear regression indicated a higher level of overall unmet needs when patients were divorced, had a high level of anxiety (HADS subscale), were in poor physical condition, or had a diminished emotional quality of life (FACT-G subscales).
Significance of results:The results of this study highlight the overwhelming presence of unmet psychological needs in head and neck cancer patients and underline the importance of implementing interventions to address these areas perceived by patients as important. In line with hospital resource allocation and cost-effectiveness, one may also contemplate screening patients for high levels of anxiety, as well as target patients who are divorced and present low levels of physical well-being, as these patients may have more overall needs to be met.
Microwave Volumetric Probe Measurements of Field localization, Zero and Negative Index within Photonic Bandgap Metamaterial Structures
- Eric Kuster, Ricky L. Moore, Stephen Blalock, Brian Cieszynski, John Swarner, Matthew Habib
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1343 / 2011
- Published online by Cambridge University Press:
- 08 September 2011, mrss11-1343-w04-04
- Print publication:
- 2011
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Electromagnetic mode localization within photonic bandgap (PBG) crystals has been evidenced by external measurement of enhanced optical emission from quantum dots or photoemissive polymers that are placed within the structure. In this paper wavelength is decreased and photonic crystal dimensions increased to allow insertion of a loop probe in the PBG to directly measure volumetric electromagnetic fields; thereby producing a volume -frequency map of field amplitude and phase within the PBG. The unit cells of the PBG are formed from arrays of Alumina strips which are supported by surrounding acrylic supports. Electromagnetic fields of single, two and three layer PBGs are predicted and these compare well with measurement.
Field localization within the PBG and transmission coefficients of the PBG, with and without electrical perturbations, are presented. Predictions assume layered unit cells formed from sections in which translational invariance along the Z-axis is assumed for zn-1 ≤ z ≤ zn for the nth section. Periodicity implies that field X dependence can be represented as a sum of Floquet modes and field solutions are found by mode matching techniques in combination with multimode cascade matrix formalism.
Transmission coefficient is measured using a focused beam, network analyzer based system and volumetric fields within the PBG are measured using a loop probe antenna inserted between Alumina strips and moved to different positions. Measurements at 1600 frequencies over the 4-18 GHz band at each of 100 positions are made. PBG fields are calibrated to probe measurements at identical positions and frequencies but absent the PBG.
Both electromagnetic model and measurement shows field localization and effective negative or zero indexes at multiple frequencies within the 4 to 18 GHz band. Volumetric field magnitudes increase by at least one order of magnitude and local field phase-frequency derivatives are negative or near zero near localization frequencies. Field localizations and transmission are sensitive to small perturbations of electrical properties or geometry. Wideband measurements of PBGs, perturbed by small cylindrical inserts placed at high field locations, allow precision measurements of an insert’s electromagnetic properties.