Consultation with complementary medicine practitioners by individuals with chronic conditions: Characteristics and reasons for consultation in Australian clinical settings.

The duration and complexity of chronic conditions leads patients to consult complementary medicine (CM) practitioners, yet such care-seeking by this clinical population has not been thoroughly examined. This study describes characteristics and reasons for consultation amongst those with chronic conditions who consult CM practitioners. A cross-sectional study surveyed patients in clinics of 39 CM practitioners from the five most accessed CM professions in Australia (chiropractic, massage, osteopathy, acupuncture, naturopathy). Between November 2018 and March 2019, CM practitioners invited 15 consecutive adult patients (n = 585 invited) to a self-administered, hard-copy survey covering socio-demographics, chronic condition diagnoses, CM service utilisation and reasons for consulting the CM practitioner. In total, 199 surveys were returned, producing a final sample of n = 191. Chronic conditions were reported by 153 (80.1%) participants, who were most commonly female (82.4%), aged over 65 years (29.0%), married (55.9%), vocational/trade qualified (40.1%), employed (62.5%), reported financial manageability as not too bad (48.0%), held private health insurance generally (79.0%) and specifically for CM (71.1%). Some socio-demographic differences were found depending on the profession consulted. Most participants (75.0%) had attended five or more consultations with the CM practitioner. The reasons most commonly given by participants with chronic conditions for consulting the CM practitioner were This healthcare professional is supportive and compassionate (n = 136, 97.1%), I believe this type of healthcare is safe (n = 131, 95.6%), Improve general wellbeing and prevent future health problems (n = 125, 89.3%) and This type of healthcare gives me hope about my future health (n = 108, 85.7%). These findings suggest that individuals with chronic conditions may consult CM practitioners to address unmet well-being or quality of life needs and for compassionate support. The role CM practitioners fill for those with chronic conditions requires further exploration to develop optimal policy and services to manage the growing challenges chronic conditions present to health systems

Cell survival in B16 melanoma after treatment with combinations of cytotoxic agents: lack of potentiation.

The extent of tumour, cell kill, produced by treating B16 melanomas with vincristine, cyclophosphamide, 5-fluorouracil and gamma-rays, alone and in combination, was determined using an in vitro colony assay. Cell kill by vincristine was revealed as a reduction in the yield of cells obtained by trypsinization, and as a decrease in the colony-forming ability of the extracted cells. The reduction in cell yield was interpreted as evidence of rapid cell lysis. Cyclophosphamide and gamma-rays also reduced both cell yield and surviving fraction, but in this case the small decrease in cell yield was due to an increase in cell volume. FU had no effect on cell yield, but surviving fraction was reduced. Tumour weight was also measured, and used in conjunction with cell yield and surviving fraction data to calculate the fraction of surviving cells per tumour following treatment with the agents. In combination studies, single doses of two different cytotoxic agents were given either simultaneously, or up to 24 h apart in either sequence, and assays were performed 24 h after the second drug was given. Combinations of vincristine + cyclophosphamide and 5-fluorouracil + gamma-rays were chosen because they had been shown by other workers to exhibit marked schedule dependency, including considerabl potentiation, against leukaemic cell lines. However, in the B16 melanoma there was no evidence of schedule-dependent cell killing with either of these combinations. For all sequences studied, the fraction of surviving cells per tumour was slightly greater than the predicted additive response calculated from single-drug controls

Characteristics of women who practice yoga in different locations during pregnancy

Objectives: Yoga practice during pregnancy is gaining increasing popularity. This study examined the characteristics of pregnant women who practiced yoga in regard to the different locations (at home, in yoga classes, or both). Design: The study sample was drawn from the Australian Longitudinal Study on Women's Health (ALSWH), a national longitudinal study of women to investigate multiple factors affecting health and wellbeing of women over a 20-year period. Setting: Postal survey. Participants: Women born between 1973 and 1978, who were randomly selected from the national Medicare database and identified as being pregnant or having recently given birth (n=2316). Outcome measures: Relationships between yoga use (attending yoga classes and/or practising yoga at home) and women's characteristics (demographic measures, pregnancy-related health concerns, health service utilisation, attitudes to complementary and alternative medicine). Results: Practising yoga both at home and in classes was associated with perceiving complementary and alternative medicine (CAM) as preventative (odds ratio (OR)=1.62); perceiving CAM as affording health control (OR=1.50); experiencing sadness (OR=1.72); preparing for labour (OR=2.31); birthing in a birth centre (OR=7.97); and experiencing less vomiting (OR=0.38). Practising at home only was associated with perceiving CAM as affording health control (OR=1.76); perceiving CAM as promoting a holistic health approach (OR=1.65); and birthing in a birth centre (OR=3.54). Practising in classes only was associated with experiencing stress (OR=1.97); and birthing in a birth centre (OR=4.85) (all p<0.05). Conclusions: The findings suggest that the location in which a woman practices yoga is associated with attitudinal, health-related and birth environmental factors

Reconstructing pedigrees: some identifiability questions for a recombination-mutation model

Pedigrees are directed acyclic graphs that represent ancestral relationships between individuals in a population. Based on a schematic recombination process, we describe two simple Markov models for sequences evolving on pedigrees - Model R (recombinations without mutations) and Model RM (recombinations with mutations). For these models, we ask an identifiability question: is it possible to construct a pedigree from the joint probability distribution of extant sequences? We present partial identifiability results for general pedigrees: we show that when the crossover probabilities are sufficiently small, certain spanning subgraph sequences can be counted from the joint distribution of extant sequences. We demonstrate how pedigrees that earlier seemed difficult to distinguish are distinguished by counting their spanning subgraph sequences.Comment: 40 pages, 9 figure

The Josephson plasmon as a Bogoliubov quasiparticle

We study the Josephson effect in alkali atomic gases within the two-mode approximation and show that there is a correspondence between the Bogoliubov description and the harmonic limit of the phase representation. We demonstrate that the quanta of the Josephson plasmon can be identified with the Bogoliubov excitations of the two-site Bose fluid. We thus establish a mapping between the Bogoliubov approximation for the many-body theory and the linearized pendulum Hamiltonian.Comment: 9 pages, LaTeX, submitted to J. Phys.

Disclosure of conventional and complementary medicine use to medical doctors and complementary medicine practitioners: A survey of rates and reasons amongst those with chronic conditions.

Chronic conditions are prolonged and complex, leading patients to seek multiple forms of care alongside conventional treatment, including complementary medicine (CM). These multiple forms of care are often used concomitantly, requiring patient-provider communication about treatments used in order to manage potential risks. In response, this study describes rates and reasons for disclosure/non-disclosure of conventional medicine use to CM practitioners, and CM use to medical doctors, by individuals with chronic conditions. A survey was conducted online in July and August 2017 amongst the Australian adult population. Participants with chronic conditions were asked about their disclosure-related communication with CM practitioners (massage therapist, chiropractor, acupuncturist, naturopath) and medical doctors. Patients consulting different professions reported varying disclosure rates and reasons. Full disclosure (disclosed ALL) to medical doctors was higher (62.7%-79.5%) than full disclosure to CM practitioners (41.2%-56.9%). The most strongly reported reason for disclosing to both MDs and CM practitioners was I wanted them to fully understand my health status, while for non-disclosure it was They did not ask me about my CM/medicine use. Reasons regarding concerns or expectations around the consultation or patient-provider relationship were also influential. The findings suggest that patient disclosure of treatment use in clinical consultation for chronic conditions may be improved through patient education about its importance, direct provider inquiry, and supportive patient-provider partnerships. Provision of optimal patient care for those with chronic conditions requires greater attention to patient-provider communication surrounding patients' wider care and treatment use

Quantum state of two trapped Bose-Einstein condensates with a Josephson coupling

We consider the precise quantum state of two trapped, coupled Bose Einstein condensates in the two-mode approximation. We seek a representation of the state in terms of a Wigner-like distribution on the two-mode Bloch sphere. The problem is solved using a self-consistent rotation of the unknown state to the south pole of the sphere. The two-mode Hamiltonian is projected onto the harmonic oscillator phase plane, where it can be solved by standard techniques. Our results show how the number of atoms in each trap and the squeezing in the number difference depend on the physical parameters. Considering negative scattering lengths, we show that there is a regime of squeezing in the relative phase of the condensates which occurs for weaker interactions than the superposition states found by Cirac et al% (quant-ph/9706034, 13 June 1997). The phase squeezing is also apparent in mildly asymmetric trap configurations.Comment: 26 pages, 11 figure

Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study

We compared the distribution by wealth of self-reported illness burden (estimated from validated scales, biomarker and reported symptoms) for angina, cataract, depression, diabetes and osteoarthritis, with the distribution of self-reported medical diagnosis and treatment. We aimed to determine if the greater illness burden borne by poorer participants was matched by appropriately higher levels of diagnosis and treatment