Everybody wants it done but nobody wants to do it. An exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer

Background: This study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context. Methods: Health professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation. Results: Five interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology. Conclusions: The five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services

Gangs and guilt: Towards a new theory of horror film

The most basic and unanimous statement made in scholarship on horror films is that horror films are ‘about’ fear: the primary purpose of horror films is to scare viewers. Based on horror films from the 1970s until the present in which child gangs play a significant part, this essay advances a new theory of horror film, namely that horror films primarily seek to elicit not fear but guilt. The analysis focuses on four topics: themes, camera angles, horror’s cinematic casting of ‘abnormality,’ and the rift, unique to the horror genre, between audience ‘alignment’ and ‘allegiance.

3-D reconstructions of the early-November 2004 CDAW geomagnetic storms: analysis of Ooty IPS speed and density data

Interplanetary scintillation (IPS) remote-sensing observations provide a view of the solar wind covering a wide range of heliographic latitudes and heliocentric distances from the Sun between ~0.1 AU and 3.0 AU. Such observations are used to study the development of solar coronal transients and the solar wind while propagating out through interplanetary space. They can also be used to measure the inner-heliospheric response to the passage of coronal mass ejections (CMEs) and co-rotating heliospheric structures. IPS observations can, in general, provide a speed estimate of the heliospheric material crossing the observing line of site; some radio antennas/arrays can also provide a radio scintillation level. We use a three-dimensional (3-D) reconstruction technique which obtains perspective views from outward-flowing solar wind and co-rotating structure as observed from Earth by iteratively fitting a kinematic solar wind model to these data. Using this 3-D modelling technique, we are able to reconstruct the velocity and density of CMEs as they travel through interplanetary space. For the time-dependent model used here with IPS data taken from the Ootacamund (Ooty) Radio Telescope (ORT) in India, the digital resolution of the tomography is 10° by 10° in both latitude and longitude with a half-day time cadence. Typically however, the resolutions range from 10° to 20° in latitude and longitude, with a half- to one-day time cadence for IPS data dependant upon how much data are used as input to the tomography. We compare reconstructed structures during early-November 2004 with in-situ measurements from the Wind spacecraft orbiting the Sun-Earth L<sub>1</sub>-Point to validate the 3-D tomographic reconstruction results and comment on how these improve upon prior reconstructions

From Surveillance to Witnessing: Revanche, Red Road, and the Anti-Revenge Film

This essay examines recent European art films that reinterpret the revenge plot and radically challenge the possibility of legitimized violence. I argue that what I term “anti-revenge” films, in particular Andrea Arnold’s Red Road (2006), and Götz Spielmann’s Revanche (2008), frustrate the desire for vengeance (both the protagonist’s and the spectator’s), replacing violent spectacle with uneasy engagement that inhibits revenge, gesturing instead toward the possibility, however remote, of forgiveness. In both films prolonged surveillance, surveillance ostensibly in the service of retribution, inadvertently becomes a means for ethical engagement that actually prohibits violence. In their failure to conform to generic conventions and their depiction of the collapse of the retributive drive, these films challenge the moral legitimacy of revenge, substituting uneasy, often inconclusive moments of potential forgiveness for violent spectacle

Nova light curves from the Solar Mass Ejection Imager (SMEI) - II. The extended catalogue

We present the results from observing nine Galactic novae in eruption with the Solar Mass Ejection Imager (SMEI) between 2004 and 2009. While many of these novae reached peak magnitudes that were either at or approaching the detection limits of SMEI, we were still able to produce light curves that in many cases contained more data at and around the initial rise, peak, and decline than those found in other variable star catalogs. For each nova, we obtained a peak time, maximum magnitude, and for several an estimate of the decline time (t2). Interestingly, although of lower quality than those found in Hounsell et al. (2010a), two of the light curves may indicate the presence of a pre-maximum halt. In addition the high cadence of the SMEI instrument has allowed the detection of low amplitude variations in at least one of the nova light curves

Consumption of endophyte-infected fescue seed during the dry period does not decrease milk production in the following lactation.

Ergot alkaloids in endophyte-infected grasses inhibit prolactin (PRL) secretion and may reduce milk production of cows consuming these grasses. We investigated the effects of consuming endophyte-infected fescue seed during late lactation and the dry period on mammary growth, differentiation, and milk production. Twenty-four multiparous Holstein cows were randomly assigned to 3 treatment groups. Starting at 90±4 d prepartum, cows were fed endophyte-free fescue seed (control; CON), endophyte-free fescue seed plus 3×/wk subcutaneous injections of bromocriptine (0.1mg/kg of body weight, positive control; BROMO), or endophyte-infected fescue seed (INF) as 10% of the diet on an as fed basis. Although milk yield of groups did not differ before treatment, at dry off (-60 d prepartum) INF and BROMO cows produced less milk than CON. Throughout the treatment period, basal concentrations of PRL and the prepartum increase in plasma PRL were reduced in INF and BROMO cows compared with CON cows. Three weeks after the end of treatment, circulating concentrations of PRL were equivalent across groups. In the subsequent lactation milk yield was not decreased; in fact, BROMO cows exhibited a 9% increase in milk yield relative to CON. Evaluation of mammary tissue during the dry period and the subsequent lactation, by quantitative histology and immunohistochemical analysis of proliferation markers and putative mammary stem or progenitor cell markers, indicated that feeding endophyte-infected fescue seed did not significantly affect mammary growth and development. Feeding endophyte-infected grasses during the dry period may permit effective utilization of feed resources without compromising milk production in the next lactation

Homeopathy for depression: a systematic review of the research evidence

Objective: To systematically review the research evidence on the effectiveness of homeopathy for the treatment of depression and depressive disorders. Methods: A comprehensive search of major biomedical databases including MEDLINE, EMBASE, ClNAHL, PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative medicine (CAM) databases including AMED, CISCOM and Hom-Inform were also searched. Additionally, efforts were made to identify unpublished and ongoing research using relevant sources and experts in the field. Relevant research was categorised by study type and appraised according to study design. Clinical commentaries were obtained for studies reporting clinical outcomes. Results: Only two randomised controlled trials (RCTs) were identified. One of these, a feasibility study, demonstrated problems with recruitment of patients in primary care. Several uncontrolled and observational studies have reported positive results including high levels of patient satisfaction but because of the lack of a control group, it is difficult to assess the extent to which any response is due to specific effects of homeopathy. Single case reports/studies were the most frequently encountered clinical study type. We also found surveys, but no relevant qualitative research studies were located. Adverse effects reported appear limited to 'remedy reactions' ('aggravations') including temporary worsening of symptoms, symptom shifts and reappearance of old symptoms. These remedy reactions were generally transient but in one study, aggravation of symptoms caused withdrawal of the treatment in one patient. Conclusions: A comprehensive search for published and unpublished studies has demonstrated that the evidence for the effectiveness of homeopathy in depression is limited due to lack of clinical trials of high quality. Further research is required, and should include well designed controlled studies with sufficient numbers of participants. Qualitative studies aimed at overcoming recruitment and other problems should precede further RCTs. Methodological options include the incorporation of preference arms or uncontrolled observational studies. The highly individualised nature of much homeopathic treatment and the specificity of response may require innovative methods of analysis of individual treatment response

Effect of consuming endophyte-infected fescue seed on transcript abundance in the mammary gland of lactating and dry cows, as assessed by RNA sequencing

Ergot alkaloids in endophyte-infected grasses inhibit prolactin secretion and reduce milk production in lactating cows. However, we previously showed that prepartum consumption of infected seed throughout the dry period did not inhibit subsequent milk production and prior exposure to bromocriptine (ergot peptide) actually increased production in the next lactation. To identify changes in the transcriptome and molecular pathways mediating the mammary gland's response to ergot alkaloids in the diet, RNA sequencing (RNA-seq) was performed on mammary tissues obtained from 22 multiparous Holstein cows exposed to 1 of 3 treatments. Starting at 90 ± 4 d prepartum, cows were fed endophyte-free fescue seed (control; CON), endophyte-free fescue seed plus 3×/wk subcutaneous injections of bromocriptine (BROMO; 0.1 mg/kg of BW), or endophyte-infected fescue seed (INF) as 10% of the diet. Cows were dried off 60 ± 2 d prepartum. Mammary biopsies from 4 (BROMO, INF) or 5 (CON) cows/treatment at each of the 3 phases were obtained: 7 d before dry off during the initial lactation (L1), mid-dry period (D), and 10 d postpartum (L2). Although tissue from the same cow was preferentially used at 3 phases (L1, D, L2), tissue from additional cows were used to as necessary to provide RNA of sufficient quality. Individual samples were used to generate individual RNA-seq libraries. Normalized reads of the RNA-seq data were organized into technical and biological replicates before processing with the RSEM software package. Each lactation phase was processed separately and genes that differed between any of 3 treatments were identified. A large proportion of genes differentially expressed in at least 1 treatment (n = 866) were found to be similarly expressed in BROMO and INF treatments, but differentially expressed from CON (n = 575, total for 3 phases). Of genes differentially expressed compared with CON, 104 genes were common to the L1 and L2 phases. Consistent with the production findings, networks most affected by treatments in L1 and L2 included lipid metabolism, small molecule biochemistry, and molecular transport, whereas networks related more to developmental and cellular functions and maintenance were evident during D phase. Similar patterns of expression in BROMO and INF during late and early lactation suggest involvement of similar cell signaling pathways or mechanisms of action for BROMO and INF and the importance of prolactin messaging pathways