Use of complementary and alternative medicine and quality of life: changes at the end of life

The purpose of this study was to compare the physical, psychological and social dimensions associated with quality-of-life outcomes over the last year of life, between advanced cancer users and nonusers of complementary and alternative medicine. One hundred and eleven patients were identified through Queensland Cancer Registry records, and followed up every four to six weeks until close to death using standardized protocols. Outcome measures were symptom burden, psychological distress, subjective wellbeing, satisfaction with conventional medicine and need for control over treatment decisions. At the initial interview, 36 (32%) participants had used complementary/ alternative medicine the previous week; mainly vitamins, minerals and tonics and herbal remedies. Among all participants, 53 (48%) used at least one form of complementary/ alternative medicine over the study period. Only six (11%) visited alternative practitioners on a regular basis. Overall, complementary/ alternative medicine users reported higher levels of anxiety and pain, less satisfaction with conventional medicine and lower need for control over treatment decisions compared with nonusers. These differences tend to change as death approaches. A more rigorous assessment of complementary/ alternative medicine use, psychological distress, pain and subjective wellbeing among patients with advanced cancer is needed in the clinical setting.

The other side of the coin: safety of complementary and alternative medicine

Most consumers consider complementary and alternative medicine (CAM) products inherently safe. The growing simultaneous use of CAM products and pharmaceutical drugs by Australian consumers increases the risk of CAM-drug interactions. The Therapeutic Goods Administration (TGA) has a two-tier, risk-based regulatory system for therapeutic goods - CAM products are regulated as low risk products and are assessed for quality and safety; and sponsors of products must hold the evidence for any claim of efficacy made about them. Adverse reactions to CAM products can be classified as intrinsic (innate to the product), or extrinsic (where the risk is not related to the product itself, but results from the failure of good manufacturing practice). Adverse reactions to CAM practices can be classified as risks of commission (which includes removal of medical therapy) and risks of omission (which includes failure to refer when appropriate). While few systematic studies of adverse events with CAM exist, and under-reporting is likely, most CAM products and practices do not appear to present a high risk; their safety needs to be put into the perspective of wider safety issues. A priority for research is to rigorously define the risks associated with both CAM products and practices so that their potential impact on public health can be assessed.

Crisis management and risk communication: Why the food industry must get it right

There is public unease about food-related issues including food additives, food poisoning bacteria and GM ingredients. The public wants evidence of no risks, but all regulators can ever offer is no evidence of risk or evidence of a very small risk. The situation is complex because experts and non-experts can perceive the same risk in vastly different ways. The way in which the food industry manages crises and communicates risks will determine the public acceptance and success of new technologies such as GM foods and nanomaterials. There is a need for the food industry (including regulators and scientific experts) to sharpen up their risk communication skills to ensure that technical innovations are accepted by consumers, and crises such as food recalls do not undermine the public's confidence in the food industry. The AIFST has a key role to play in driving the risk communication process and allaying public unease about food-related issues.

Social identity, self-categorization, and the communication of group norms

We articulate the role of norms within the social identity perspective as a basis for theorizing a number of manifestly communicative phenomena. We describe how group norms are cognitively represented as context-dependent prototypes that capture the distinctive properties of groups. The same process that governs the psychological salience of different prototypes, and thus generates group normative behavior, can be used to understand the formation, perception, and diffusion of norms, and also how some group members, for example, leaders, have more normative influence than others. life illustrate this process across a number of phenomena and make suggestions for future interfaces between the social identity perspective and communication research. We believe that the social identity approach represents a truly integrative force for the communication discipline.

The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004

Objective: To survey the use, cost, beliefs and quality of life of users of complementary and alternative medicine (CAM). Design: A representative population survey conducted in 2004 with longitudinal comparison to similar 1993 and 2000 surveys. Participants: 3015 South Australian respondents over the age of 15 years (71.7% participation). Results: In 2004, CAMs were used by 52.2% of the population. Greatest use was in women aged 25-34 years, with higher income and education levels. CAM therapists had been visited by 26.5% of the population. In those with children, 29.9% administered CAMs to them and 17.5% of the children had visited CAM therapists. The total extrapolated cost in Australia of CAMs and CAM therapists in 2004 was AUD$1.8 billion, which was a decrease from AUD$2.3 billion in 2000. CAMs were used mostly to maintain general health. The users of CAM had lower quality-of-life scores than non-users. Among CAM users, 49.7% used conventional medicines on the same day and 57.2% did not report the use of CAMs to their doctor. About half of the respondents assumed that CAMs were independently tested by a government agency; of these, 74.8% believed they were tested for quality and safety, 21.8% for what they claimed, and 17.9% for efficacy. Conclusions: Australians continue to use high levels of CAMs and CAM therapists. The public is often unaware that CAMs are not tested by the Therapeutic Goods Administration for efficacy or safety.

Impact of social group processes and functional diversity on communication in networked organizations

This study examines the role of social group processes in perceptions of effective communication in Australian Cooperative Research Centres (CRCs). Communication professionals in 25 CRCs discussed the barriers and opportunities for communication in their diverse networked organizations. Thematic analysis of the transcripts highlighted the contribution of social group processes to both barriers and opportunities. Communication challenges implicated the social identity of organizational members, many of which were associated with distinct structural aspects of these organizations. Opportunities for communication frequently involved features that implicated social identity, including taking advantage of existing organizational or industry identities, preventing conflicting identities from becoming salient, and promoting a collective CRC identity.

"We do it, but they don't": Multiple categorizations and work team communication

The present study adopted an intergroup approach to information sharing and ratings of work team communication in a public hospital (N = 142) undergoing large-scale restructuring. Consistent with predictions, ratings of communication followed a double ingroup serving bias: while team members reported sending about the same levels of information to double ingroup members (same work team/same occupational group) as they did to partial ingroup members (same work team/different occupational group), they reported receiving less information from partial ingroup members than from double ingroup members and rated the communication that they received from partial ingroup members as less effective. We discuss the implication of these results for the management of information sharing and organizational communication.