Clinical practice guidelines on the evidenceâ based use of integrative therapies during and after breast cancer treatment

Answer questions and earn CME/CNEPatients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatmentâ related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapyâ induced nausea and vomiting, lymphedema, chemotherapyâ induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapyâ induced nausea and vomiting. Acetylâ Lâ carnitine is not recommended to prevent chemotherapyâ induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatmentâ related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mindâ body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194â 232. © 2017 American Cancer Society.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136746/1/caac21397_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136746/2/caac21397.pd

Trends in Forest Fire Occurrence in the Ilmensky Nature Reserve, Southern Urals, Russia, between 1948 and 2014

We analyzed the spatial distribution and temporal dynamics of 1083 forest fires within the Ilmensky Reserve (Southern Urals, Russia) over 1948–2014. We observed a significant increase in the number of forest fires over the studied period, with the locations of the most frequently burned sections of the reserve changing over time. The average number of fires over the whole period increased by a factor of 1.9; there were 0.41 fires per compartment per 10 years in 1948–1970, there were 0.58 fires per compartment per 10 years in 1971–1990, and there were 0.77 fires per compartment per 10 years in 1991–2014. In parallel, the spatial pattern of ignitions became more aggregated. The fire frequency increased across the reserve, with the most pronounced change being observed along the reserve borders. Human-related fires dominate the modern fire activity within the Ilmensky Reserve, which is modulated by the local conditions

Trends in Forest Fire Occurrence in the Ilmensky Nature Reserve, Southern Urals, Russia, between 1948 and 2014

We analyzed the spatial distribution and temporal dynamics of 1083 forest fires within the Ilmensky Reserve (Southern Urals, Russia) over 1948–2014. We observed a significant increase in the number of forest fires over the studied period, with the locations of the most frequently burned sections of the reserve changing over time. The average number of fires over the whole period increased by a factor of 1.9; there were 0.41 fires per compartment per 10 years in 1948–1970, there were 0.58 fires per compartment per 10 years in 1971–1990, and there were 0.77 fires per compartment per 10 years in 1991–2014. In parallel, the spatial pattern of ignitions became more aggregated. The fire frequency increased across the reserve, with the most pronounced change being observed along the reserve borders. Human-related fires dominate the modern fire activity within the Ilmensky Reserve, which is modulated by the local conditions