Patients who appreciate advance care planning were more inclined to strive for quality of life than other patients. Shortly after the diagnosis of cancer, patients typically seem to prefer life-prolonging treatment, whereas quality of life becomes more important when death is nearing.

We conclude that most patients feel sufficiently informed about important disease-specific issues and are satisfied with the information giving by health care professionals. Nevertheless, a considerable number of patients appreciate additional information.

Anxiety and depression are studied thoroughly in patients with advanced cancer. However, little is known about the nature of mood disorders in this stage of the disease. We studied positive and negative affect in patients who have had a diagnosis of advanced cancer, and examined how these are related to anxiety and depression, and to other patient and care factors. One hundred and five patients filled out a written questionnaire and were interviewed personally. The PANAS positive affect scores were lower than those in the general population, but the negative affect scores were fairly similar. We found a rather low prevalence of depression (13%) and anxiety (8%) as measured by the HADS. The emotional problems patients mentioned most frequently were anxiety about metastases (26%), the unpredictability of the future (18%) and anxiety about physical suffering (15%). Both positive and negative affect were most strongly related to patient's sense of meaning and peace. We conclude that distinguishing positive and negative affect enhances the understanding of psychological distress of patients with advanced cancer, that seems to be mainly caused by low levels of positive affect. Several theories are discussed to explain this finding, that may contribute to efforts to improve care for these patients.

We studied the dynamics of pure vergence shifts and vergence shifts combined with vertical and horizontal saccades. It is known from earlier studies that horizontal saccades accelerate horizontal vergence. We wanted to obtain a more complete picture of the interactions between version and vergence. Therefore we studied pure version (horizontal and vertical), pure vergence (divergence and convergence) and combinations of both in five adult subjects with normal binocular vision and little phoria (< 5 degrees). The visual targets were LED's in isovergence arrays presented at two distances (35 and 130 cm) in a dimly lit room. Two targets were continuously lit during each trial and gaze-shifts were paced by a metronome. The two subjects with a strong monocular preference made vergence eye movements together with small horizontal saccades during pure vergence tasks. The other subjects, who did not have a strong monocular preference, made pure vergence movements (without saccades). These findings, suggest that monocular preferences influence the oculomotor strategy during vergence tasks. Vergence was facilitated by both horizontal and vertical saccades but vergence peak-velocity during horizontal saccades was higher than during vertical saccades.