Lymphedema after breast or gynecological cancer : use and effectiveness of mainstream and complementary therapies

Objectives: The purpose of this study was to describe the use, as well as perceived effectiveness, of mainstream and complementary and alternative medicine (CAM) therapies in the treatment of lymphedema following breast or gynecological cancer. Further, the study assessed the relationship between the characteristics of lymphedema (including type, severity, stability, and duration), and the use of CAM and/or mainstream treatment. Methods: This was a cross-sectional study using a convenience sample of women with lymphedema following breast and gynecological cancers. A self-administered questionnaire was sent to 247 potentially eligible women. Of those returned (50%), 23 were ineligible and 6 were excluded due to level of missing data. Results: In the previous 12 months, the majority of women (90%) had used mainstream treatments to treat their lymphedema, with massage being the most commonly used (86%). One (1) in 2 women had used CAM to treat their lymphedema, and 98% of those using CAM were also using mainstream treatments. Over 27 types of CAM were reported, with use of a chi machine, vitamin E supplements, yoga, and meditation being the most commonly reported forms. The perceived effectiveness ratings (1–7 with 7 = completely effective) of mainstream(mean – standard deviation (SD): 5.3 – 1.5) and CAM therapies (mean – SD: 5.2 + 1.6) were considered high. Conclusions: These results demonstrate that mainstream and CAM treatment use is common, varied, and considered to be effective among women with lymphedema following breast or gynecological cancer. Furthermore, it highlights the immediate need for larger prospective studies assessing the inter-relationship between the use of mainstream and CAM therapies for treatment success.

Psychoanalytic perspectives on substance use and antisocial personality disorder

Psychoanalysis and related psychodynamic psychotherapies have historically had a limited engagement with substance use and antisocial personality disorders. This in part reflects an early preoccupation with ‘transference neuroses’ and in part reflects later de-emphasis of diagnosis and focus on therapeutic process. Nonetheless, psychoanalytic perspectives can usefully inform thinking about approaches to treatment of such disorders and there are psychoanalytic constructs that have specific relevance to their treatment. This paper reviews some prominent strands of psychoanalytic thinking as they pertain to the treatment of substance abuse and antisocial personality disorders. It is argued that, while Freudian formulations lead to a primarily pessimistic view of the prospect of treatment of such disorders, both the British object relations and the North American self psychology traditions suggest potentially productive approaches. Finally the limited empirical evidence from brief psychodynamically informed treatments of substance use disorders is reviewed. It is concluded that such treatments are not demonstrably effective but that, since no form of psychotherapy has established high efficacy with substance use disorders, brief psychdynamic therapies are not necessarily of lesser value than other treatments and may have specific value for particular individuals and in particular treatment contexts.

Conceptualising climate change in rural Australia : community perceptions, attitudes and (in) actions

Public engagement and support is essential for ensuring adaptation to climate change. The first step in achieving engagement is documenting how the general public currently perceive and understand climate change issues, specifically the importance they place on this global problem and identifying any unique challenges for individual communities. For rural communities, which rely heavily on local agriculture industries, climate change brings both potential impacts and opportunities. Yet, to date, our knowledge about how rural residents conceptualise climate change is limited. Thus, this research explores how the broader rural community – not only farmers – conceptualise climate change and responsive activities, focussing on documenting the understandings and risk perceptions of local residents from two small Australian rural communities. Twenty-three semi-structured interviews were conducted in communities in the Eden/Gippsland region on the border of New South Wales and Victoria, and the North-East of Tasmania. There are conflicting views on how climate change is conceptualised, the degree of concern and need for action, the role of local industry, who will 'win' and 'lose', and the willingness of rural communities to adapt. In particular, residents who believed in anthropogenic or human-induced factors described the changing climate as evidence of 'climate change', whereas those who were more sceptical termed it 'weather variability', suggesting that there is a divide in rural Australia that, unless urgently addressed, will hinder local and national policy responses to this global issue. Engaging these communities in the 21st century climate change debate will require a significant change in terminology and communication strategies.

Radioactive residues associated with water treatment, use and disposal in Australia

Water resources are known to contain radioactive materials, either from natural or anthropogenic sources. Treatment, including wastewater treatment, of water for drinking, domestic, agricultural and industrial purposes has the potential to concentrate radioactive materials. Inevitably concentrated radioactive material is discharged to the environment as a waste product, reused for soil conditioning, or perhaps recycled as a new potable water supply. This thesis, presented as a collection of peer reviewed scientific papers, explores a number of water / wastewater treatment applications, and the subsequent nature and potential impact of radioactive residues associated with water exploitation processes. The thesis draws together research outcomes for sites predominantly throughout Queensland, Australia, where it is recognised that there is a paucity of published data on the subject. This thesis contributes to current knowledge on the monitoring, assessment and potential for radiation exposure from radioactive residues associated with the water industry.

Influence of rainfall and catchment characteristics on urban stormwater quality

This thesis presents the outcomes of a comprehensive research study undertaken to investigate the influence of rainfall and catchment characteristics on urban stormwater quality. The knowledge created is expected to contribute to a greater understanding of urban stormwater quality and thereby enhance the design of stormwater quality treatment systems. The research study was undertaken based on selected urban catchments in Gold Coast, Australia. The research methodology included field investigations, laboratory testing, computer modelling and data analysis. Both univariate and multivariate data analysis techniques were used to investigate the influence of rainfall and catchment characteristics on urban stormwater quality. The rainfall characteristics investigated included average rainfall intensity and rainfall duration whilst catchment characteristics included land use, impervious area percentage, urban form and pervious area location. The catchment scale data for the analysis was obtained from four residential catchments, including rainfall-runoff records, drainage network data, stormwater quality data and land use and land cover data. Pollutants build-up samples were collected from twelve road surfaces in residential, commercial and industrial land use areas. The relationships between rainfall characteristics, catchment characteristics and urban stormwater quality were investigated based on residential catchments and then extended to other land uses. Based on the influence rainfall characteristics exert on urban stormwater quality, rainfall events can be classified into three different types, namely, high average intensity-short duration (Type 1), high average intensity-long duration (Type 2) and low average intensity-long duration (Type 3). This provides an innovative approach to conventional modelling which does not commonly relate stormwater quality to rainfall characteristics. Additionally, it was found that the threshold intensity for pollutant wash-off from urban catchments is much less than for rural catchments. High average intensity-short duration rainfall events are cumulatively responsible for the generation of a major fraction of the annual pollutants load compared to the other rainfall event types. Additionally, rainfall events less than 1 year ARI such as 6- month ARI should be considered for treatment design as they generate a significant fraction of the annual runoff volume and by implication a significant fraction of the pollutants load. This implies that stormwater treatment designs based on larger rainfall events would not be feasible in the context of cost-effectiveness, efficiency in treatment performance and possible savings in land area needed. This also suggests that the simulation of long-term continuous rainfall events for stormwater treatment design may not be needed and that event based simulations would be adequate. The investigations into the relationship between catchment characteristics and urban stormwater quality found that other than conventional catchment characteristics such as land use and impervious area percentage, other catchment characteristics such as urban form and pervious area location also play important roles in influencing urban stormwater quality. These outcomes point to the fact that the conventional modelling approach in the design of stormwater quality treatment systems which is commonly based on land use and impervious area percentage would be inadequate. It was also noted that the small uniformly urbanised areas within a larger mixed catchment produce relatively lower variations in stormwater quality and as expected lower runoff volume with the opposite being the case for large mixed use urbanised catchments. Therefore, a decentralised approach to water quality treatment would be more effective rather than an "end-of-pipe" approach. The investigation of pollutants build-up on different land uses showed that pollutant build-up characteristics vary even within the same land use. Therefore, the conventional approach in stormwater quality modelling, which is based solely on land use, may prove to be inappropriate. Industrial land use has relatively higher variability in maximum pollutant build-up, build-up rate and particle size distribution than the other two land uses. However, commercial and residential land uses had relatively higher variations of nutrients and organic carbon build-up. Additionally, it was found that particle size distribution had a relatively higher variability for all three land uses compared to the other build-up parameters. The high variability in particle size distribution for all land uses illustrate the dissimilarities associated with the fine and coarse particle size fractions even within the same land use and hence the variations in stormwater quality in relation to pollutants adsorbing to different sizes of particles.

Aligning sustainability and the Torrens register : challenges and recommendations for reform

‘Sustainability’ is a policy mantra of modern governments particularly in relation to natural resources. The traditional connection between land ownership and access to natural resources, such as forestry, flora, fauna, minerals, water and energy, has given rise to an unprecedented number of restrictions and obligations on land owners in their use of the land and resources. The growing numbers of statutory exceptions and restrictions on rights of ownership and use of a fee simple holder presents serious challenges for the utility of the Torrens register, which was originally designed to record private interests in land or affecting title to land. Advocates proposing uniform Torrens legislation should give consideration to an alignment of government policies emphasising sustainability as a core requirement of effective land use and management, and the core Torrens concepts of indefeasibility and security of title. This article examines the challenges for a uniform Torrens system created by increases statutory regulation of land ownership and makes recommendations about how an effective alignment of sustainability objectives and Torrens principles may be achieved.

Land fraud and inappropriate dealings in an electronic environment : An Australian and New Zealand perspective

The thesis presented in this paper is that the land fraud committed by Matthew Perrin in Queensland and inflicted upon Roger Mildenhall in Western Australia demonstrates the need for urgent procedural reform to the conveyancing process. Should this not occur, then calls to reform the substantive principles of the Torrens system will be heard throughout the jurisdictions that adopt title by registration, particularly in those places where immediate indefeasibility is still the norm. This paper closely examines the factual matrix behind both of these frauds, and asks what steps should have been taken to prevent them occurring. With 2012 bringing us Australian legislation embedding a national e-conveyancing system and a new Land Transfer Act for New Zealand we ask what legislative measures should be introduced to minimise the potential for such fraud. In undertaking this study, we reflect on whether the activities of Perrin and the criminals responsible for stealing Mildenhall's land would have succeeded under the present system for automated registration utilised in New Zealand.

The genesis of 'the new geography and the new imperialism : 1870-1918', or 'how I came to Jamaica and joined the UWI Geography Department

In this article, Brian Hudson relates how he came to write the paper published in the journal Antipode, for which he gained recognition as a radical geographer in the late 1970's. It is a tale of a journey in which the loves of his life, geography, history, travel and his wife of over 40 years, came together through living in a number of different places: the United Kingdom, Ghana, Hong Kong, and Jamaica. After leaving UWI, Brian and his family settled in Brisbane, Australia where he taught at Queensland University of Technology until his retirement.

Waterfall : Nature and Culture

Many people take pleasure in visiting waterfalls and much has been written on the subject. Numerous accounts of Niagara Falls were published after Hennepin's late seventeenth-centure descriptions, particularly from the early nineteenth century, but is was only later that other waterfalls became the subject of books. George Holley's Niagara and Other Famous Cataracts of the World, published in 1883, and John Gibson's Great Waterfalls, Cataracts and Geysers, published in 1887, are early examples of global accounts of major falls. Most books about waterfalls are guides to the falls of a particular country, state or region. Apart from a few slim illustrated volumes, few books have been puslished on the world's waterfalls since Edward Rashleigh's Among the Waterfalls (1935). Most of these are slim pictorial volumes, some aimed at the children's market. Geologist Richard Maxwell Pearl published a series of waterfall articles in his journal Earth Science between 1973 and 1975, apparently with the intention of turning them into a book, but this never materialized. My book, the culmination of more than a decade of waterfalls research, is comprehensive in its approach, but is not intended to describe as many of the world's waterfalls as possible. This is far from my aim, and readers may be disappointed at my omission of falls they feel deserved mention. What I have attempted to do is celebrate the delights of these beautiful wonders of nature by considering them from many points of view, emphasizing the roles that they play in the human experience. To be as representative as possible, I draw on examples of waterfalls from all over the world, some famous, many not. North and South America, Europe, Africa, Asia and Oceania and, with recent global warming, the Earth's polar regions, all feature in the discussion. Even though there are already enough books and articles about Niagara Falls to fill a large library, it has been impossible to avoid making frequent reference to this great cataract, which has been so important in the history of travel and tourism, power generation, urban development and art. Amoung the issues that I consider is the human impact on waterfalls, particularly the effects of hydropower schemes and tourism development. Also considered are artificial waterfalls, which have long been features of the designed landscape. Their contemporay role is poignantly exemplified in the design of the National September 11 Memorial, in which the footprints of the Twin Towers are traced by walls of waterfalls. A geographer and urban and regional planner by training, I have ventured into many other fields of knowledge that are outside my areas of expertise. I apologize for any errors that I may have made in my book and invite correction.

From slum to suburbia : examining a spectrum of planned and unplanned urban morphology in humid sub-tropical regions of the world

The current rapid urban growth throughout the world manifests in various ways and historically cities have grown, similarly, alternately or simultaneously between planned extensions and organic informal settlements (Mumford, 1989). Within cities different urban morphological regions can reveal different contexts of economic growth and/or periods of dramatic social/technological change (Whitehand, 2001, 105). Morpho-typological study of alternate contexts can present alternative models and contribute to the present discourse which questions traditional paradigms of urban planning and design (Todes et al, 2010). In this study a series of cities are examined as a preliminary exploration into the urban morphology of cities in ‘humid subtropical’ climates. From an initial set of twenty, six cities were selected: Sao Paulo, Brazil; Jacksonville, USA; Maputo, Mozambique; Kanpur, India; Hong Kong, China; and Brisbane, Australia. The urban form was analysed from satellite imagery at a constant scale. Urban morphological regions (types) were identified as those demonstrating particular consistant characteristics of form (density, typology and pattern) different to their surroundings when examined at a constant scale. This analysis was correlated against existing data and literature discussing the proliferation of two types of urban development, ‘informal settlement’ (defined here as self-organised communities identifiable but not always synonymous with ‘slums’) and ‘suburbia’ (defined here as master planned communities of generally detached houses prevalent in western society) - the extreme ends of a hypothetical spectrum from ‘planned’ to ‘spontaneous’ urban development. Preliminary results show some cities contain a wide variety of urban form ranging from the highly organic ‘self-organised’ type to the highly planned ‘master planned community’ (in the case of Sao Paulo) while others tend to fall at one end of the planning spectrum or the other (more planned in the cases of Brisbane and Jacksonville; and both highly planned and highly organic in the case of Maputo). Further research will examine the social, economical and political drivers and controls which lead to this diversity or homogeneity of urban form and speculates on the role of self-organisation as a process for the adaptation of urban form.

Travel behavior of workers in Dhaka and their attitude towards road pricing

Dhaka, the capital of Bangladesh, is facing severe traffic congestion. Owing to the flaws in past land use and transport planning decisions, uncontrolled population growth and urbanization, Dhaka’s traffic condition is worsening. Road space is widely regarded in the literature as a utility, so a common view of transport economists is that its usage ought to be charged. Road pricing policy has proven to be effective in managing travel demand, in order to reduce traffic congestion from road networks in a number of cities including London, Stockholm and Singapore. Road pricing as an economic mechanism to manage travel demand can be more effective and user-friendly when revenue is hypothecated into supply alternatives such as improvements to the transit system. This research investigates the feasibility of adopting road pricing in Dhaka with respect to a significant Bus Rapid Transit (BRT) project. Because both are very new concepts for the population of Dhaka, public acceptability would be a principal issue driving their success or failure. This paper explores the travel behaviour of workers in Dhaka and public perception toward Road Pricing with regards to work trips- based on worker’s travel behaviour. A revealed preference and stated preference survey has been conducted on sample of workers in Dhaka. They were asked limited demographic questions, their current travel behaviour and at the end they had been given several hypothetical choices of integrated BRT and road pricing to choose from. Key finding from the survey is the objective of integrated road pricing; subsidies Bus rapid Transit by road pricing to get reduced BRT fare; cannot be achieved in Dhaka. This is because most of the respondent stated that they would choose the cheapest option Walk-BRT-Walk, even though this would be more time consuming and uncomfortable as they have to walk from home to BRT station and also from BRT station to home. Proper economic analysis has to be carried out to find out the appropriate fare of BRT and road charge with some incentive for the low income people.