Perspectives of Complementary and Alternative Medicine use by cancer patients in a regional hospital in North Queensland, Australia

Objectives: This study aimed to investigate CAMs used, and reasons for and disclosure of this use by cancer patients in a regional hospital in North Queensland, Australia. Methods: Patients attending the Day Oncology Unit of the Townsville University Hospital were invited to participate in a self-completed questionnaire or telephone interview regarding perspectives of their CAM use. Data were analysed using descriptive statistics and chi-squared and independent t-tests were performed to allow comparison between the responses by CAM users and non-users. Results: 102 completed questionnaires were used in the analysis, where 40.2 % of respondents were found to be using some form of CAM. Cannabis, magnesium, and massage were the most prominent therapies used, with cannabis use in cancer, not commonly reported in prior literature. The main reasons given for using CAM were to treat symptoms of cancer, side-effects of treatment or to improve general health. Two-thirds of these respondents disclosed their CAM use to health professionals mostly to obtain a professional opinion or due to concerns of interactions with cancer treatment. CAM users were statistically more likely to have used CAM prior to their cancer diagnosis and have lower emotional wellbeing than non-users. Non-CAM users indicated that a lack of knowledge of CAM or concerns regarding interactions with cancer treatment were the most popular reasons for not adopting these therapies. Conclusion: While lower than the averages of previously published CAM use, our study highlights that there is still a significant group of cancer patients in the North Queensland region using CAMs

Knowledge, attitudes, and practices of Australian oncology health professionals on complementary medicines

Background: Approximately half of people with cancer are using complementary and alternative medicine (CAM), presenting safety concerns due to potential interactions with conventional cancer treatment. Oncology staff have a role to play in ensuring the safe use of CAMs and so, this study examined their knowledge, attitudes, and practices regarding CAMs. Aim: This study aimed to assess the knowledge, attitudes, and practices of Australian doctors, nurses, and pharmacists regarding CAM use in oncology. Method: Members of three national oncology professional associations took part in an online questionnaire, which determined their knowledge, attitudes, and practices regarding CAM. Results: Ninety-nine completed surveys were obtained from nine doctors, 70 nurses, and 20 pharmacists. Most respondents (68.4%) felt that they did not have adequate knowledge of CAMs to respond to patients' questions. Assessment of attitudes found respondents generally believed that CAMs have a complementary role in oncology but indicated their concerns for the safety of patients. Respondents indicated in practice they would discuss CAMs with less than half of patients (40.6%), with a lack of scientific data and guidelines for CAM use presenting significant barriers to these discussions. Conclusion: Our study suggests that oncology health professionals' knowledge of CAMs potentially leads to a lack of confidence in providing advice to patients and concerns for patient safety. This impacts their discussion of CAMs and lack of disclosure from patients about their use of CAMs. Education on CAMs in oncology would assist in increasing professionals' confidence in discussing these therapies, leading to increased patient disclosure of CAMs and safer treatment decision making for people with cancer

A near-infrared survey of Miras and the distance to the Galactic Centre

We report the results of a near-infrared survey for long-period variables in a field of view of 20 arcmin by 30 arcmin towards the Galactic Centre (GC). We have detected 1364 variables, of which 348 are identified with those reported in Glass et al. (2001). We present a catalogue and photometric measurements for the detected variables and discuss their nature. We also establish a method for the simultaneous estimation of distances and extinctions using the period-luminosity relations for the JHKs bands. Our method is applicable to Miras with periods in the range 100--350 d and mean magnitudes available in two or more filter bands. While J-band means are often unavailable for our objects because of the large extinction, we estimated distances and extinctions for 143 Miras whose H- and Ks-band mean magnitudes are obtained. We find that most are located at the same distance to within our accuracy. Assuming that the barycentre of these Miras corresponds to the GC, we estimate its distance modulus to be 14.58+-0.02(stat.)+-0.11(syst.) mag, corresponding to 8.24+-0.08(stat.)+-0.42(syst.) kpc. We have assumed the distance modulus to the LMC to be 18.45 mag, and the uncertainty in this quantity is included in the systematic error above. We also discuss the large and highly variable extinction. Its value ranges from 1.5 mag to larger than 4 mag in A(Ks) except towards the thicker dark nebulae and it varies in a complicated way with the line of sight. We have identified mid-infrared counterparts in the Spitzer/IRAC catalogue of Ramirez et al. (2008) for most of our variables and find that they follow rather narrow period-luminosity relations in the 3.6 to 8.0 micrometre wavelength range.Comment: Accepted for publication in MNRAS, 22 pages (28 tables, 11 figures). Figure 7 and tables 6, 7 and 9 will be published in full online onl

Massive Stars in the Quintuplet Cluster

We present near-infrared photometry and K-band spectra of newly-identified massive stars in the Quintuplet Cluster, one of the three massive clusters projected within 50 pc of the Galactic Center. We find that the cluster contains a variety of massive stars, including more unambiguously identified Wolf-Rayet stars than any cluster in the Galaxy, and over a dozen stars in earlier stages of evolution, i.e., LBV, Ofpe/WN9, and OB supergiants. One newly identified star is the second ``Luminous Blue Variable'' in the cluster, after the ``Pistol Star.'' Given the evolutionary stages of the identified stars, the cluster appears to be about 4 \pm 1 Myr old, assuming coeval formation. The total mass in observed stars is \sim 10^3 \Msun, and the implied mass is \sim 10^4 \Msun, assuming a lower mass cutoff of 1 \Msun and a Salpeter initial mass function. The implied mass density in stars is at least a few thousand \Msun pc^{-3}. The newly-identified stars increase the estimated ionizing flux from this cluster by about an order of magnitude with respect to earlier estimates, to 10^{50.9} photons/s, or roughly what is required to ionize the nearby ``Sickle'' HII region (G0.18 - 0.04). The total luminosity from the massive cluster stars is $\approx 10^{7.5}$ \Lsun, enough to account for the heating of the nearby molecular cloud, M0.20 - 0.033. We propose a picture which integrates most of the major features in this part of the sky, excepting the non-thermal filaments. We compare the cluster to other young massive clusters and globular clusters, finding that it is unique in stellar content and age, except, perhaps, for the young cluster in the central parsec of the Galaxy. In addition, we find that the cluster is comparable to small ``super star clusters.'

Reversible maps and composites of involutions in groups of piecewise linear homeomorphisms of the real line

An element of a group is reversible if it is conjugate to its own inverse, and it is strongly reversible if it is conjugate to its inverse by an involution. A group element is strongly reversible if and only if it can be expressed as a composite of two involutions. In this paper the reversible maps, the strongly reversible maps, and those maps that can be expressed as a composite of involutions are determined in certain groups of piecewise linear homeomorphisms of the real line

Evidence for genetic variance in resistance to tuberculosis in Great Britain and Irish Holstein-Friesian populations

peer-reviewedBackground: Here, we jointly summarise scientific evidence for genetic variation in resistance to infection with Mycobacterium bovis, the primary agent of bovine tuberculosis (TB), provided by two recent and separate studies of Holstein-Friesian dairy cow populations in Great Britain (GB) and Ireland. Methods: The studies quantified genetic variation within archived data from field and abattoir surveillance control programmes within each country. These data included results from the single intradermal comparative tuberculin test (SICTT), abattoir inspection for TB lesions and laboratory confirmation of disease status. Threshold animal models were used to estimate variance components for responsiveness to the SICTT and abattoir confirmed M. bovis infection. The link functions between the observed 0/1 scale and the liability scale were the complementary log-log in the GB, and logit link function in the Irish population. Results and discussion: The estimated heritability of susceptibility to TB, as judged by responsiveness to the SICTT, was 0.16 (0.012) and 0.14 (0.025) in the GB and Irish populations, respectively. For abattoir or laboratory confirmation of infection, estimates were 0.18 (0.044) and 0.18 (0.041) from the GB and the Irish populations, respectively. Conclusions: Estimates were all significantly different from zero and indicate that exploitable variation exists among GB and Irish Holstein Friesian dairy cows for resistance to TB. Epidemiological analysis suggests that factors such as variation in exposure or imperfect sensitivity and specificity would have resulted in underestimation of the true values

Detection of the pandemic norovirus variant GII.4 Sydney 2012 in Rio Branco, state of Acre, northern Brazil

Noroviruses (NoVs) are important cause of gastroenteritis in humans worldwide. Genotype GII.4 is responsible for the majority of outbreaks reported to date. This study describes, for the first time in Brazil, the circulation of NoV GII.4 variant Sydney 2012 in faecal samples collected from children aged less than or equal to eight years in Rio Branco, state of Acre, northern Brazil, during July-September 2012

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy