Multidimensional rehabilitation programmes for adult cancer survivors

This is the protocol for a review and there is no abstract. The objectives are as follows:

To assess the effectiveness of multidimensional rehabilitation programs in terms of maintaining or improving the physical and psychosocial well-being of adult cancer survivors.

The review will evaluate the extent to which:

Professionally led multidimensional rehabilitation programs achieve better outcomes than standard services for patients with cancer and their caregivers
Rehabilitation programmes exert a different impact on different domains (e.g. psychological health, physical functioning)
Different modes of delivery and different settings influence outcomes
There is relationship between the number, duration and intensity of rehabilitation sessions and degree of change in measured outcomes.

Europeanization of Inequality and Europeanization of Reference Groups

In this article we take advantage of the availability of European Union Statistics on Income and Living Conditions (EU-SILC) data to address both weak and strong versions of the Europeanization of reference groups thesis. The former proposes that common standards of evaluation emerge as a consequence of knowledge of conditions in other societies. The latter argues that people increasingly perceive themselves as part of a larger European stratification system. Our analysis leads us to reject both versions of the thesis. Material deprivation rather than having a uniform effect is highly dependent on national context. If a process of convergence is underway, it is one that as yet has had a limited impact. In circumstances where the Europeanization of inequality is raising issues relating to both national and transnational forms of legitimacy, it is important to understand that there is no necessary relationship between such Europeanization and the Europeanization of reference groups.

"New" and "Old" Social Risks: Life Cycle and Social Class Perspectives on Social Exclusion in Ireland

The life cycle concept has come to have considerable prominence in Irish social policy debate. However, this has occurred without any systematic effort to link its usage to the broader literature relating to the concept. Nor has there been any detailed consideration of how we should set about operationalising the concept. In this paper we argue the need for "macro" life cycle perspectives that have been influenced by recent challenges to the welfare state to be combined with "micro" perspectives focusing on the dynamic and multidimensional nature of social exclusion. We make use of Irish EU-SILC 2005 data in developing a life cycle schema and considering its relationship to a range of indicators of social exclusion. At the European level renewed interest in the life cycle concept is associated with the increasing emphasis on the distinction between "new" and "old" social risks and the notion that the former are more "individualised". Inequality and poverty rather than being differentially distributed between social classes are thought to vary between phases in the average work life. Our findings suggest the "death of social class" thesis is greatly overblown. A more accurate appreciation of the importance of new and old social risks requires that we systematically investigate the manner in which factors such as social class and the life cycle interact.

Economic vulnerability, multidimensional deprivation and social cohesion in an enlarged European community

In this article we have sought to combine regional and social exclusion perspectives on economic exclusion in the enlarged European Community. Our analysis, based on the European Quality of Life Survey, confirms that while the economically vulnerable, identified through latent class analysis, constitute substantially larger groups in the poorer economic clusters, they are much more sharply differentiated from others in the richer clusters. While the economically vulnerable are also disadvantaged in relation to measures of multidimensional deprivation and social cohesion, between economic clusters differences on these dimensions cannot be accounted for by corresponding variations in levels and intensity of economic vulnerability. In fact, the impact of such vulnerability on social cohesion is greater in the more affluent clusters. Copyright © 2005 SAGE Publications.

Multidimensional modelling of X-ray spectra for AGN accretion disc outflows - III. Application to a hydrodynamical simulation

We perform multidimensional radiative transfer simulations to compute spectra for a hydrodynamical simulation of a line-driven accretion disc wind from an active galactic nucleus. The synthetic spectra confirm expectations from parametrized models that a disc wind can imprint a wide variety of spectroscopic signatures including narrow absorption lines, broad emission lines and a Compton hump. The formation of these features is complex with contributions originating from many of the different structures present in the hydrodynamical simulation. In particular, spectral features are shaped both by gas in a successfully launched outflow and in complex flows where material is lifted out of the disc plane but ultimately falls back. We also confirm that the strong Fe Ka line can develop a weak, red-skewed line wing as a result of Compton scattering in the outflow. In addition, we demonstrate that X-ray radiation scattered and reprocessed in the flow has a pivotal part in both the spectrum formation and determining the ionization conditions in the wind. We find that scattered radiation is rather effective in ionizing gas which is shielded from direct irradiation from the central source. This effect likely makes the successful launching of a massive disc wind somewhat more challenging and should be considered in future wind simulations. © 2010 The Authors. Journal compilation © 2010 RAS.

Multidimensional modelling of X-ray spectra for AGN accretion disc outflows

We use a multidimensional Monte Carlo code to compute X-ray spectra for a variety of active galactic nucleus (AGN) disc-wind outflow geometries. We focus on the formation of blueshifted absorption features in the Fe K band and show that line features similar to those which have been reported in observations are often produced for lines of sight through disc-wind geometries. We also discuss the formation of other spectral features in highly ionized outflows. In particular, we show that, for sufficiently high wind densities, moderately strong Fe K emission lines can form and that electron scattering in the flow may cause these lines to develop extended red wings. We illustrate the potential relevance of such models to the interpretation of real X-ray data by comparison with observations of a well-known AGN, Mrk 766. Journal compilation © 2008 RAS.

Multidimensional simulations of radiative transfer in Type Ia supernovae

A three-dimensional Monte Carlo code for modelling radiation transport in Type Ia supernovae is described. In addition to tracking Monte Carlo quanta to follow the emission, scattering and deposition of radiative energy, a scheme involving volume-based Monte Carlo estimators is used to allow properties of the emergent radiation field to be extracted for specific viewing angles in a multidimensional structure. This eliminates the need to compute spectra or light curves by angular binning of emergent quanta. The code is applied to two test problems to illustrate consequences of multidimensional structure on the modelling of light curves. First, elliptical models are used to quantify how large-scale asphericity can introduce angular dependence to light curves. Secondly, a model which incorporates complex structural inhomogeneity, as predicted by modern explosion models, is used to investigate how such structure may affect light-curve properties. © 2006 RAS.

Multidimensional modelling of X-ray spectra for AGN accretion disc outflows - II

Highly ionized fast accretion disc winds have been suggested as an explanation for a variety of observed absorption and emission features in the X-ray spectra of active galactic nuclei. Simple estimates have suggested that these flows may be massive enough to carry away a significant fraction of the accretion energy and could be involved in creating the link between supermassive black holes and their host galaxies. However, testing these hypotheses, and quantifying the outflow signatures, requires high-quality theoretical spectra for comparison with observations. Here, we describe extensions of our Monte Carlo radiative transfer code that allow us to generate realistic theoretical spectra for a much wider variety of disc wind models than that was possible in our previous work. In particular, we have expanded the range of atomic physics simulated by the code so that L- and M-shell ions can now be included. We have also substantially improved our treatment of both ionization and radiative heating such that we are now able to compute spectra for outflows containing far more diverse plasma conditions. We present example calculations that illustrate the variety of spectral features predicted by parametrized outflow models and demonstrate their applicability to the interpretation of data by comparison with observations of the bright quasar PG1211+143. We find that the major features in the observed 2-10 keV spectrum of this object can be well reproduced by our spectra, confirming that it likely hosts a massive outflow. © 2010 The Authors. Journal compilation © 2010 RAS.

Pain in the preterm neonate:behavioural and physiological indices

The impact of invasive procedures on preterm neonates has received little systematic attention. We examined facial activity, body movements, and physiological measures in 56 preterm and full-term newborns in response to heel lancing, along with comparison preparatory and recovery intervals. The measures were recorded in special care and full-term nurseries during routine blood sampling. Data analyses indicated that in all measurement categories reactions of greatest magnitude were to the lancing procedure. Neonates with gestational ages as short as 25-27 weeks displayed physiological responsivity to the heel lance, but only in the heart rate measure did this vary with gestational age. Bodily activity was diminished in preterm neonates in general, relative to full-term newborns. Facial activity increased with the gestational age of the infant. Specificity of the response to the heel lance was greatest on the facial activity measure. Identification of pain requires attention to gestational age in the preterm neonate.