Determinants of public trust in complementary and alternative medicine

BACKGROUND: In the Netherlands, public trust in conventional medicine is relatively high. There is reason to believe that public trust in complementary and alternative medicine (CAM) is rated lower. The aim of this study is to gain insight into public trust in CAM and the determinants that lie at the root of it. We hypothesized that public trust in CAM is related to (perceived) institutional guarantees, media information on CAM, information from people's social network, personal experiences, the role of general practitioners (GPs) and trust in conventional medicine. METHODS: A postal questionnaire on public trust in CAM was mailed to 1358 members of the Health Care Consumer Panel. 65% of the questionnaires were returned. Data were analysed using frequencies, ANOVA, post hoc testing and linear regression analyses. RESULTS: In the total sample, the level of public trust in CAM was a 5.05 on average on a scale of 1-10. 40.7% was CAM user (current or past) and displayed significantly higher levels of trust toward CAM than CAM non users. In the total sample, public trust in CAM was related to institutional guarantees, negative media information, positive and negative information reported by their social network and people's personal experiences with CAM. For non users, trust is mostly associated with institutional guarantees. For users, personal experiences are most important. For both users and non users, trust levels in CAM are affected by negative media information. Public trust in CAM is for CAM users related to positive information and for non users to negative information from their network. CONCLUSIONS: In the Netherlands, CAM is trusted less than conventional medicine. The hypotheses on institutional guarantees, media information, information from the network and people's personal experiences are confirmed by our study for the total sample, CAM non users and users. The other hypotheses are rejected

Precessional cyclicity of seawater Pb isotopes in the late Miocene Mediterranean

Astronomical tuning in the Mediterranean region is primarily based on organically‐mediated proxies, such as cyclicity of organic rich layers or changes in foraminiferal assemblages. Both during and post deposition, organic proxies can be affected by complex processes not immediately related to the changes in precession (insolation) they are assumed to reflect. Here we present an isotopic proxy which exhibits precessional cyclicity yet is inorganic. Seawater lead (Pb) isotope records over four precessional cycles between 6.6 and 6.5 Ma, from bulk sediment leachates of three Messinian, circum‐Mediterranean marginal locations, show variations consistent with precessional cyclicity. During insolation minima, the Pb isotope signatures from all three sites converge to similar values, suggesting a regional process is affecting all three locations at that time. Data from the marginal sites are compared with new data from ODP Site 978 and published data from a variety of geological archives from the Mediterranean region to determine the mechanism(s) causing the observed variability. While the comparisons are not fully conclusive, the timing of events suggest that increased dust production from North Africa during insolation minima is the most likely control. This hypothesis implies that authigenic marine Pb isotope records have the potential to provide a reliable inorganic tie point for Mediterranean cyclostratigraphy where sub‐precessional resolution is required. An inorganic tie point could also provide the means to resolve long‐standing problems in Mediterranean stratigraphy on precessional and sub‐precessional timescales which have been obscured due to post‐depositional changes (e.g., sapropel burn‐down) or suboptimal ecological conditions (e.g., the Messinian Salinity Crisis)

Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimens compared to diagnosis by wet mount microscopy, culture, and fluorescent staining

Four vaginal cotton swab specimens were obtained from each of 804 women visiting the outpatient sexually transmitted disease clinic of the Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands, for validation of various forms of Trichomonas vaginalis diagnostic procedures. One swab specimen was immediately examined by wet mount microscopy, a second swab was placed in Kupferberg's Trichosel medium for cultivation, and two swabs were placed in phosphate-buffered saline (PBS), pH 7.2. The resulting PBS suspension was used for direct staining with acridine orange and fluorescence microscopy, inoculation of modified Diamond's culture medium, and a PCR specific for T. vaginalis. A total of 70 samples positive in one or more of the tests were identified: 31 (3.8%) infections were detected by wet mount microscopy, and 36 (4.4%) were

Differences in treatment of stage I colorectal cancers:A population-based study of colorectal cancers detected within and outside of a screening program

Background:Screen-detected colorectal cancers (CRCs) are often treated less invasively than stage-matched nonscreen-detected CRCs, but the reasons for this are not fully understood. This study evaluated the treatment of stage I CRCs detected within and outside of the screening program in the Netherlands. Methods:Data from the Netherlands Cancer Registry for all stage I CRCs diagnosed between January 1, 2008 and December 31, 2020 were analyzed, comparing patient, tumor, and treatment characteristics of screen-detected and nonscreen-detected stage I CRCs. Multivariable logistic regression was used to assess the association between treatment (local excision only vs. surgical oncologic resection) and patient and tumor characteristics, stratified for T stage and tumor location. Results:Screen-detected stage I CRCs were relatively more often T1 than T2 compared with non-screen-detected stage I CRCs (66.9 % vs. 53.3 %; P 0.001). When only T1 tumors were considered, both screen-detected colon and rectal cancers were more often treated with local excision only than non-screen-detected T1 cancers (odds ratio [OR] 2.19, 95%CI 1.93 2.49; and OR 1.29, 95 %CI 1.05 1.59, respectively), adjusted for sex, tumor location, lymphovascular invasion (LVI) status, and tumor differentiation. Conclusions:Less invasive treatment of screen-detected stage I CRC is partly explained by the higher rate of T1 cancers compared with non-screen-detected stage I CRCs. T1 stage I screen-detected CRCs were also more likely to undergo less invasive treatment than non-screen-detected CRCs, adjusted for risk factors such as LVI and tumor differentiation. Future research should investigate whether the choice of local excision was related to unidentified cancerrelated factors or the expertise of the endoscopists.</p

Evolution of the gulf of Cadiz margin and southwest Portugal contourite depositional system : Tectonic, sedimentary and paleoceanographic implications from IODP expedition 339

Acknowledgments This research used samples and data collected through the Integrated Ocean Drilling Program (IODP). The research was partially supported through the CTM 2008-06399-C04/MAR, CTM 2012-39599-C03, CGL2011-26493, CTM2012-38248, SA263U14, IGCP-619, INQUA 1204 and FWF P25831-N29 Projects. Some data were collected with 94-1090-C03-03 (FADO) and MAR-98-0209 (TASYO) Projects. Research was conducted in the framework of the Continental Margins Research Group of the Royal Holloway University of London, People and the Program (Marie Curie Actions) of the European Union's Seventh Framework Program FP7/2007-2013/ under REA Grant Agreement No. 290201 MEDGATE’. We are very grateful to REPSeOL, TGS–NOPEC, and the CSIC-Institut Jaume Almera (http://geodb.ictja.csic.es) for allowing us to use an unpublished seismic data from the Gulf of Cadiz. We thank J. Aguire (UGR, Spain) for comments and suggestions concerning the Pliocene and Quaternary outcrops, B. van den Berg (USAL) for organizing a thought-provoking field-trip to Cadiz, Spain in November, 2014, M. Ángel Caja, L. García Diego, and J. Tritlla (REPSOL) for provenance and diagenetic analysis of early Pliocene sandstones and debrites, and L.J. Lourens (Utrecht University) for providing us the eccentricity and 200-Kys glacio-eustatic sea-level curves included in the Figure 16. Both Prof. D.A.V. Stow (Heriot-Watt Univ., UK) and F.J. Hernández-Molina (RHUL, UK), as the main co-proponents of the IODP Proposal 644 and the co-chiefs of the IODP Exp. 339, thanks to IODP, Exp. IODP 339 Scientists; JR crew and technicians, as well as all people, institutions and companies involved in making IODP a success since 2003. Finally, we also thank the editor, Gert J. De Lange and the reviewers T. Mulder (Bourdeaux Univ.); D. Van Rooij (Ghent Univ) and J. Duarte (Monash Univ.) for their very positive and helpful feedback and discussions in publishing this research.Peer reviewedPublisher PD