Cancer patients taking herbal medicines: a review of clinical purposes, associated factors, and perceptions of benefit or harm

Ethnopharmacological relevance: Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. Materials and methods: the international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. Results: Medline yielded 5,638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. Conclusions: Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.

The impact of the abrupt 8.2 ka cold event on the Mesolithic population of western Scotland: a Bayesian chronological analysis using ‘activity events’ as a population proxy

The potential impact of the abrupt 8.2 ka cold event on human demography, settlement patterns and culture in Europe and the Near East has emerged as a key theme in current discussion and debate. We test whether this event had an impact on the Mesolithic population of western Scotland, a case study located within the North Atlantic region where the environmental impact of the 8.2 ka event is likely to have been the most severe. By undertaking a Bayesian analysis of the radiocarbon record and using the number of activity events as a proxy for the size of the human population, we find evidence for a dramatic reduction in the Mesolithic population synchronous with the 8.2 ka event. We interpret this as reflecting the demographic collapse of a low density population that lacked the capability to adapt to the rapid onset of new environmental conditions. This impact of the 8.2 ka event in the North Atlantic region lends credence to the possibility of a similar impact on populations in Continental Europe and the Near East.