Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality

"Narrativa di frontiera". Fenomenologia di una forma aperta.

«Fiction of frontier». Phenomenology of an open form/voice. Francesco Giustini’s PhD dissertation fits into a genre of research usually neglected by the literary criticism which nevertheless is arousing much interest in recent years: the relationship between Literature and Space. In this context, the specific issue of his work consists in the category of the Frontier including its several implications for the XX century fiction. The preliminary step, at the beginning of the first section of the dissertation, is a semantic analysis: with precision, Giustini describes the meaning of the word “frontier” here declined in a multiplicity of cultural, political and geographical contexts, starting from the American frontier of the pioneers who headed for the West, to the exotic frontiers of the world, with whose the imperialistic colonization has come into contact; from the semi-uninhabited areas like deserts, highlands and virgin forests, to the ethnic frontiers between Indian and white people in South America, since the internal frontiers of the Countries like those ones between the District and the Capital City, the Centre and the Outskirts. In the next step, Giustini wants to focus on a real “ myth of the frontier”, able to nourish cultural and literary imagination. Indeed, the literature has told and chosen the frontier as the scenery for many stories; especially in the 20th Century it made the frontier a problematic space in the light of events and changes that have transformed the perception of space and our relationship with it. Therefore, the dissertation proposes a critical category, it traces the hallmarks of a specific literary phenomenon defined “ Fiction of the frontier” ,present in many literary traditions during the 20th Century. The term “Fiction” (not “Literature” or “Poetics”) does not define a genre but rather a “procedure”, focusing on a constant issue pointed out from the texts examined in this work : the strong call to the act of narration and to its oral traditions. The “Fiction of the Frontier” is perceived as an approach to the world, a way of watching and feeling the objects, an emotion that is lived and told through the story- a story where the narrator ,through his body and his voice, takes the rule of the witness. The following parts, that have an analytic style, are constructed on the basis of this theoretical and methodological reflection. The second section gives a wide range of examples into we can find the figure and the myth of the frontier through the textual analysis which range over several literary traditions. Starting from monographic chapters (Garcia Marquez, Callado, McCarthy), to the comparative reading of couples of texts (Calvino and Verga Llosa, Buzzati and Coetzee, Arguedas and Rulfo). The selection of texts is introduced so as to underline a particular aspect or a form of the frontier at every reading. This section is articulated into thematic voices which recall some actions that can be taken into the ambiguous and liminal space of the frontier (to communicate, to wait, to “trans-culturate”, to imagine, to live in, to not-live in). In this phenomenology, the frontier comes to the light as a physical and concrete element or as a cultural, imaginary, linguistic, ethnic and existential category. In the end, the third section is centered on a more defined and elaborated analysis of two authors, considered as fundamental for the comprehension of the “Fiction of the frontier”: Joseph Conrad and João Guimarães Rosa. Even if they are very different, being part of unlike literary traditions, these two authors show many connections which are pointed by the comparative analysis. Maybe Conrad is the first author that understand the feeling of the frontier , freeing himself from the adventure romance and from the exotic nineteenthcentury tradition. João Guimarães Rosa, in his turn, is the great narrator of Brazilian and South American frontier, he is the man of sertão and of endless spaces of the Centre of Brazil. His production is strongly linked to that one belonged to the author of Heart of Darkness.

Il rapporto madre-figlia nelle letterature femminili maghrebine (1980-2010)

La ricerca Il rapporto madre-figlia nelle letterature femminili maghrebine (1980-2010) comprende due sezioni: la prima analizza le principali caratteristiche del mondo maghrebino femminile e le peculiarità della scrittura dell’intellettuale nord-africana, la seconda è incentrata sull’analisi testuale dei romanzi maghrebini femminili più rappresentativi. Il lavoro di analisi verte sullo studio di varie autrici maghrebine che coprono un vasto ventaglio temporale: dal 1980 al 2010. Di ogni autrice vengono analizzati i romanzi in cui è possibile rinvenire la tematica oggetto della tesi: il rapporto madre-figlia. I romanzi studiati sono raggruppati secondo quattro macro direttrici tematiche: i romanzi in cui il rapporto filiale è caratterizzato dalla violenza; le opere in cui il rapporto madre-figlia è caratterizzato dall’assenza fisica della genitrice; i romanzi in cui il rapporto filiale è caratterizzato dall’incomprensione ed infine le produzioni in cui la relazionalità madre-figlia è caratterizzata da un rapporto di amore e sostegno reciproco.

Oltre Oceano: Altri orizzonti del possibile. Epistemiologie di Abya Yala e progettualità esistenziale “Lekil Kuxlejal,Sumak Kawsay, Kajkrasa Ruyina”. Filosofie della Terra per una Pedagogia del Buen Vivir

Questo elaborato propone alcune riflessioni sulla necessità urgente di un nuovo paradigma educativo, mediante la re-organizzazione delle scienze della conoscenza, scienze in parole di Morin, “disgiunte e frazionate, inadeguate ad affrontare problemi che richiedono oggi approcci multidisciplinari”. La sfida: affrontare i nuovi problemi di una convivenza planetaria, attraverso le connessioni del pensiero ecologico, in questo studio asse centrale delle cosmovisioni e della Sapienza ancestrale dei Popoli di AbyaYala (America Latina). Popoli in cui la Vita come orizzonte di Armonia ed Equilibrio si concretizza in pratiche di Vita Quotidiana grazie ad una Pedagogia del BuenVivir, inclusiva e partecipativa, rispettosa della diversità biologica e delle differenze culturali, nonché della Sacralità della Terra e della Vita in tutte le sue manifestazioni. La cornice teorica considerata fa riferimento in modo particolare a: L’Ecologia della Mente (Bateson); Il problematicismo Pedagogico e l’Educazione alla Progettualità Esistenziale (G.M.Bertin, Contini); l’Ecologia dei Saperi e le Epistemologie del Sud (Boaventura di Sousa Santos, sociologo portoghese), in modo da tessere ponti di dialogo fra le diverse discipline, in particolare fra la pedagogia, la geografia, l’antropologia, la filosofia, la sociologia, la letteratura, il diritto e anche con le neuroscienze.

Pedagogia e immaginario: Fiction e giovani dell'eta' post-moderna

La ricerca prende in esame le produzioni narrative, in particolare quelle dedicate agli adolescenti e ai giovani adulti, nei cui linguaggi e nelle cui trame si insinuano modelli di vita, comportamenti, valori, stereotipie, ecc. Attraverso le fiction dell'ultimo decennio, sono offerte interpretazioni alle costanti e alle variabili che percorrono i diversi prodotti culturali e che sono metafore di caratteristiche e di dinamiche della società post-moderna. Nella ricerca si studiano le trame e i personaggi delle narrazioni e, in parallelo, si individuano le correlazioni con studi pedagogici interessati alle ultime generazioni giovanili. La comparazione ha portato ad un sistema di decifrazione per individuare il giovane dell'era post-moderna tra gli elementi di finzione. Si sono prese in esame le più importanti icone dell'immaginario che, pur attraverso innumerevoli riscritture, continuano ad imporsi come metafore per identificazione, abnegazione, catarsi. Rispetto al passato, molte icone presenti nelle ultime produzioni di fiction subiscono alterazioni leggibili come spie (i.e. Ginzburg). È in queste trasformazioni, spinte fino alla metamorfosi dell'icona, che è possibile rintracciare alcune caratteristiche proprie del mondo giovanile in rapporto con la società contemporanea. L'immaginario può dunque essere lo specchio in cui l'uomo e la società possono riconoscersi, e studiarlo apre possibilità per sviluppare prospettive di interpretazione verso nuovi orizzonti.

Il dilemma femminista dell'uso politico della violenza in Italia negli anni Settanta e Ottanta: tra pensiero politico e caso storico

Degli anni Settanta si parla, ormai quasi canonicamente, come gli anni della crisi, una crisi che compare quasi simultaneamente fuori e dentro i confini nazionali, e si configura come vera e propria crisi di sistema. Considerando il turning point rappresentato dai Seventies, è diffusa l'interpretazione nel contesto italiano del paradigma politologico secondo il quale è nella mancanza e nelle assenze del sistema politico-istituzionale alle domande di modernizzazione democratica provenienti dalle soggettività che emergono in quella che è stata definita la “stagione dei movimenti” che andrebbero individuate le radici prima della scelta della violenza come strumento di lotta politica e poi del cosiddetto “riflusso”. Questo studio cerca di analizzare le dinamiche e gli sviluppi nella relazione tra movimento femminista e violenza politica in Italia tra anni settanta e anni ottanta. Per comprendere ed analizzare le dinamiche di tale sviluppo è stato necessario prima ricostruire la genealogia del concetto di violenza politica elaborato dalla filosofia politica nel XX secolo e poi confrontarlo con il concetto di violenza proposto dal pensiero femminista nello stesso arco temporale. Allo stesso tempo si è considerato il fenomeno della violenza politicamente motivata agita nel decennio settanta, analizzando le specificità del femminismo stesso, ma anche, la possibilità di individuare lo scarto – politico, ideologico e esistenziale – tra le definizioni date dalla pratica femminista alla categoria di violenza e le peculiarità degli altri movimenti che si muovevano nella scena politica e sociale tra anni settanta e anni ottanta

Ricerche sul lessico della provvidenza in Agostino

Questa ricerca è un’indagine semasiologica del lessico agostiniano della provvidenza divina, costituito dalle parole-chiave prouidentia, prouideo, prouidens, prouidus, prouisio, prouisor, prouisus, e dai lessemi in relazione logico-sintattica diretta con esse. La prospettiva è sia sincronica (si considerano tutte le attestazioni delle parole-chiave presenti nel corpus agostiniano), sia diacronica: si soppesano di volta in volta analogie e differenze agostiniane rispetto agli antecedenti, nell’intento di arricchire il panorama dei possibili modelli lessicali latini (pagani, biblici, patristici) di Agostino. I dati lessicali sono stati raccolti in una banca dati appositamente costituita, selezionati secondo i criteri di frequenza e pregnanza semantica, e analizzati per nuclei tematici, coincidenti in parte con i capitoli della tesi. Si studiano dapprima i lessemi che esprimono il governo della provvidenza (le famiglie lessicali di administro, guberno e rego, e altri lessemi che designano l’azione della provvidenza); sono poi analizzati lessemi e iuncturae in cui prevale l’idea del mistero della provvidenza. Gli ultimi due capitoli sono dedicati al tema della cura divina, e a quello della cosiddetta “pedagogia divina”: attraverso i segni esteriori, la provvidenza ‘richiama’ l’uomo a rientrare in se stesso. Un’appendice approfondisce infine l’uso agostiniano di Sap 6,16 e Sap 8,1. L’apporto di Agostino al lessico filosofico latino va individuato a livello semantico più che nell’innovazione lessicale. Accanto a suffissazione, composizione, calco, la metafora svolge un ruolo essenziale nella formazione del lessico dell’Ipponate, e proviene spesso da altre lingue tecniche oppure è radicata nel patrimonio di immagini tradizionali della religione pagana. Il debito di Agostino è indubbiamente verso Cicerone, ma anche verso Seneca, per l’uso in ambito esistenziale-biografico di alcuni lessemi. Agostino li trasferisce però dal piano umano a quello divino, come nel caso del concetto di admonitio: parte integrante del programma filosofico senecano; ‘richiamo’ della provvidenza per Agostino, concetto che risente anche dell’apporto di retorica ed esegesi.

Un’applicazione di elaborazione del linguaggio naturale per il gioco di "Indovina chi?" su robot umanoide

La tesi è stata incentrata sul gioco «Indovina chi?» per l’identificazione da parte del robot Nao di un personaggio tramite la sua descrizione. In particolare la descrizione avviene tramite domande e risposte L’obiettivo della tesi è la progettazione di un sistema in grado di capire ed elaborare dei dati comunicati usando un sottoinsieme del linguaggio naturale, estrapolarne le informazioni chiave e ottenere un riscontro con informazioni date in precedenza. Si è quindi programmato il robot Nao in modo che sia in grado di giocare una partita di «Indovina chi?» contro un umano comunicando tramite il linguaggio naturale. Sono state implementate regole di estrazione e categorizzazione per la comprensione del testo utilizzando Cogito, una tecnologia brevettata dall'azienda Expert System. In questo modo il robot è in grado di capire le risposte e rispondere alle domande formulate dall'umano mediante il linguaggio naturale. Per il riconoscimento vocale è stata utilizzata l'API di Google e PyAudio per l'utilizzo del microfono. Il programma è stato implementato in Python e i dati dei personaggi sono memorizzati in un database che viene interrogato e modificato dal robot. L'algoritmo del gioco si basa su calcoli probabilistici di vittoria del robot e sulla scelta delle domande da proporre in base alle risposte precedentemente ricevute dall'umano. Le regole semantiche realizzate danno la possibilità al giocatore di formulare frasi utilizzando il linguaggio naturale, inoltre il robot è in grado di distinguere le informazioni che riguardano il personaggio da indovinare senza farsi ingannare. La percentuale di vittoria del robot ottenuta giocando 20 partite è stata del 50%. Il data base è stato sviluppato in modo da poter realizzare un identikit completo di una persona, oltre a quello dei personaggi del gioco. È quindi possibile ampliare il progetto per altri scopi, oltre a quello del gioco, nel campo dell'identificazione.

[Ethics, empiricism and uncertainty]

Accidents can lead to difficult boundary situations. Such situations often take place in the emergency units. The medical team thus often and inevitably faces professional uncertainty in their decision-making. It is essential to communicate these uncertainties within the medical team, instead of downplaying or overriding existential hurdles in decision-making. Acknowledging uncertainties might lead to alert and prudent decisions. Thus uncertainty can have ethical value in treatment or withdrawal of treatment. It does not need to be covered in evidence-based arguments, especially as some singular situations of individual tragedies cannot be grasped in terms of evidence-based medicine.

Liberation as Revolutionary Praxis: Rethinking Buddhism Materialism

While it is only in recent decades that scholars have begun to reconsider and problematize Buddhist conceptions of “freedom” and “agency,” the thought traditions of Asian Buddhism have for many centuries struggled with questions related to the issue of “liberation”—along with its fundamental ontological, epistemological and ethical implications. With the development of Marxist thought in the mid to late nineteenth century, a new paradigm for thinking about freedom in relation to history, identity and social change found its way to Asia, and confronted traditional religious interpretations of freedom as well as competing Western ones. In the past century, several attempts have been made—in India, southeast Asia, China and Japan—to bring together Marxist and Buddhist worldviews, with only moderate success (both at the level of theory and practice). This paper analyzes both the possibilities and problems of a “Buddhist materialism” constructed along Marxian lines, by focusing in particular on Buddhist and Marxist conceptions of “liberation.” By utilizing the theoretical work of Japanese “radical Buddhist” Seno’o Girō, I argue that the root of the tension lies with conceptions of selfhood and agency—but that, contrary to expectations, a strong case can be made for convergence between Buddhist and Marxian perspectives on these issues, as both traditions ultimately seek a resolution of existential determination in response to alienation. Along the way, I discuss the work of Marx, Engels, Gramsci, Lukàcs, Sartre, and Richard Rorty in relation to aspects of traditional (particularly East Asian Mahāyāna) Buddhist thought.

Hinterlands

The poems in Hinterlands are products of my interest in landscape. They feature complex territories that are constructs of the mind, emerging from the language of place. The term “existential territories” seems to fit my work because it suggests that the poems are products of language, spaces, and existential states coming together. The territories exist not as geographic places, but in the psyche, and their physical texture comes from using both the substantive quality of language and the ways language points to place. I do not think the resulting dream-like quality renders them unreal, but rather presents the adventure of navigating a reality unique to the world of the poem. Readers and the personae in these poems map themselves onto the world as the world maps itself onto them.

Social Policy Facing the Problems of Youth Employment

Rumiana Stoilova (Bulgaria). Social Policy Facing the Problems of Youth Employment. Ms. Stoilova is a researcher in the Institute of Sociology in Sofia and worked on this project from October 1996 to September 1998. This project involved collecting both statistical and empirical data on the state of youth employment in Bulgaria, which was then compared with similar data from other European countries. One significant aspect was the parallel investigation of employment and unemployment, which took as a premise the continuity of professional experience where unemployment is just a temporary condition caused by external and internal factors. These need to be studied and changed on a systematic basis so as to create a more favourable market situation and to improve individuals' resources for improving their market opportunities. A second important aspect of the project was an analysis of the various entities active on the labour market, including government and private institutions, associations of unemployed persons, of employers or of trade unions, all with their specific legal powers and interests, and of the problems in communication between these. The major trends in youth unemployment during the period studied include a high proportion of the registered unemployed who are not eligible for social assistance, a lengthening of the average period of unemployment, an increase in the percentage of people who are unemployed for the first time and an increasing percentage of these who are not eligible for assistance, particularly among newly registered young people. At the same time the percentage of those for who work has been found is rising and during the last three years an increasing number of the unemployed have started some independent economic activity. Regional differences are also considerable and in the case of the Haskovo region represent a danger of losing the youngest generation, with resulting negative demographic effects. One major weakness of the existing institutional structure is the large scale of the black labour market, with clear negative implications for the young people drawn into it. The role of non-governmental organisations in providing support and information for the unemployed is growing and the government has recently introduced special preferences for organisations offering jobs to unemployed persons. Social policy in the labour market has however been largely restricted to passive measures, mostly because of the risk that poverty poses to people continuously excluded from the labour market. Among the active measures taken, well over half are concerned with providing jobs for the unemployed and there are very limited programmes for providing or improving qualifications. The nature of youth employment in Bulgaria can be seen in the influence of sustained structures (generation) and institutions (family and school). Ms. Stoilova studied the situation of the modern generation through a series of profiles, mostly those of continuously unemployed and self-employed persons, but also distinguishing between students and the unemployed, and between high school and university students. The different categories of young people were studied in separate mini-studies and the survey was carried out in five town in order to gather objective and subjective information on the state of the labour market in the different regions. She conducted interviews with several hundred young people covering questions of family background, career plans, attitudes to the labour situation and government measures to deal with it, and such questions as independence, mobility, attitude to work, etc. The interviews with young people unemployed for a long period of time show the risk involved in starting work and its link with dynamics of economic development. Their approval of structural reforms, of the financial restrictions connected with the introduction of a currency board and the inevitability of unemployment was largely declarative. The findings indicate that the continuously unemployed need practical knowledge and skills to "translate" the macroeconomic realities in concrete alternatives of individual work and initiative. The unemployed experience their exclusion from the labour market not only as a professional problem but also as an existential threat, of poverty, forced mobility and dependence on their parents' generation. The exclusion from the market of goods and services means more than just exercising restraint in their consumption, as it places restrictions on their personal development. Ms. Stoilova suggests that more efficient ways of providing financial aid and mobilisation are needed to counteract the social disintegration and marginalisation of the continuously unemployed. In measuring the speed of reform, university students took both employment opportunities and the implementation of the meritocratic principle in employment into account. When offered a hypothetical choice between a well-paid job and work in one's own profession, 62% would prefer opt for the well-paid job and for working for a company that offered career opportunities rather than employment in a family or own company. While most see the information gained during their studies as useful and interesting, relatively few see their education as competitive on a wider level and many were pessimistic about employment opportunities based on their qualifications. Very similar attitudes were found among high school students, with differences being due rather to family and personal situations. The unemployed, on the other hand, placed greater emphasis on possibilities of gaining or improving qualifications on a job and for the opportunities it would offer for personal contacts. High school students tend to attribute more significance to opportunities for personal accomplishment. A significant difference that five times fewer high school students were willing to work for state-owned companies, and many fewer expected to find permanent employment or to find a job in the area where they lived, Within the family situation, actual support for children seems to be higher than the feelings of confidence expressed in interviews. The attitudes of the families towards past experience seems to be linked with their ability to cope with the difficulties of the present, with those families which show an optimistic and active attitude towards the future having a greater respect for parents experience and tolerance in communication between parents and children.

Weak Senses as a Type of Semantic Information

'Weak senses' are a specific type of semantic information as opposed to assertions and presuppositions. The universal trait of weak senses is that they assume 'if' modality in negative contexts. In addition they exhibit several other diagnostic properties, e.g. they fill at least one of their valency places with a semantic element sensitive to negation (i.e. with an assertion or other weak sense), they normally do not fall within the scope of functors, do not play any role in causal relations, and resist intensification. As weak senses are widespread in lexical, grammatical and referential semantics, this notion holds the clue to phenomena as diverse as the oppositions little - a little, few - a few, edva ('hardly') - cut' ('slightly), where a little, a few, cut, convey 'weakly' approximately what little, few, and edva do in an assertive way, the semantics of the Russian perfect aspect, and the formation rules for conjunction strings. Zeldovich outlines a typology of weak senses, the main distinction being between weak senses unilaterally dependent upon the truthfulness of what they saturate their valency with, and weak senses exerting their own influence on the main situation. The latter, called, non-trivial, are instantiated by existential quantifiers involved in the semantics of indefinite pronouns, iterative verbs, etc.

Multimodal viral communication: a social semiotic analysis of the popular Spanish "Ola ke ase" meme

Multimodality – the interdependence of semiotic resources in text – is an existential element of today’s media. The term multimodality attends systematically to the social interpretation of a wide range of communicational forms used in meaning making. A primary focus of social- semiotic multimodal analysis is on mapping how modal resources are used by people in a given social context. In November 2012 the “Ola ke ase” catchphrase, which is a play on “Hola ¿qué hace?”, appeared for the first time in Spain and immediately has been adopted as a Twitter hashtag and an image macro series. Its viral spread on social networks has been tremendous, being a trending topic in various Spanish-speaking countries. The objective of analysis is how language and image work together in the “Ola ke ase” meme. The interplay between text and image in one of the original memes and some of its variations is quantitatively analysed applying a social-semiotic approach. Results demonstrate how the “Ola ke ase” meme functions through its multimodal character and the non-standard orthography. The spread of uncountable variations of the meme shows the social process that goes on in the meaning making of the semiotic elements.

A quality of life subscale for terminally ill cancer patients

A subscale was developed to assess the quality of life of cancer patients with a life expectancy of six months or less. Phase I of this study identified the major concerns of 74 terminally ill cancer patients (19 with breast cancer, 19 with lung cancer, 18 with colorectal cancer, 9 with renal cell cancer, 9 with prostate cancer), 39 family caregivers, and 20 health care professionals. Patients interviewed were being treated at the University of Texas M. D. Anderson Cancer Center or at the Hospice at the Texas Medical Center in Houston. In Phase II, 120 patients (30 with breast cancer, 30 with lung cancer, 30 with colorectal cancer, 15 with prostate cancer, and 15 with renal cell cancer) rated the importance of these concerns for quality of life. Items retained for the subscale were rated as "extremely important" or "very important" by at least 60% of the sample and were reported as being applicable by at least two-thirds of the sample. The 61 concerns that were identified were formatted as a questionnaire for Phase III. In Phase III, 356 patients (89 with breast cancer, 88 with lung cancer, 88 with colorectal cancer, 44 with prostate cancer, and 47 with renal cell cancer) were interviewed to determine the subscale's reliability and sensitivity to change in clinical status. Both factor analysis and item response theory supported the inclusion of the same 35 items for the subscale. Internal consistency reliability was moderate to high for the subscale's domains: spiritual (0.87), existential (0.76), medical care (0.68), symptoms (0.67), social/family (0.66), and emotional (0.61). Test-retest correlation coefficients also were high for the domains: social/family (0.86), emotional (0.83), medical care (0.83), spiritual (0.75), existential (0.75), and symptoms (0.81).^ In addition, concurrent validity was supported by the high correlation between the subscale's symptom domain and symptom items from the European Organization for Research and Treatment of Cancer (EORTC) scale (r = 0.74). Patients' functional status was assessed with the Eastern Cooperative Oncology Group (ECOG) Performance status rating. When ECOG categories were compared to subscale domains, patients who scored lower in functional status had lower scores in the spiritual, existential, social/family, and emotional domains. Patients who scored lower in physical well-being had higher scores in the symptom domain. Patient scores in the medical care domain were similar for each ECOG category. The results of this study support the subscale's use in assessing quality of life and the outcomes of palliative treatment for cancer patients in their last six months of life. ^