How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis

Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

Bivariate meta-analysis of predictive values of diagnostic tests can be an alternative to bivariate meta-analysis of sensitivity and specificity

Meta-analysis of predictive values is usually discouraged because these values are directly affected by disease prevalence, but sensitivity and specificity sometimes show substantial heterogeneity as well. We propose a bivariate random-effects logitnormal model for the meta-analysis of the positive predictive value (PPV) and negative predictive value (NPV) of diagnostic tests.

Design and Use of an Alternative Fuel Testing Apparatus and Assessment of the Feasibility of Biodiesel

Petroleum supply and environmental pollution issues constantly increase interest in renewable low polluting alternative fuels. Published test results show decreased pollution with similar power output and fuel consumption from Internal Combustion Engines (ICE) burning alternative fuels. More specifically, diesel engines burning biodiesel derived from plant oils and animal fats not only reduce harmful exhaust emissions but are renewable and environmentally friendly. To validate these claims and assess the feasibility of alternative fuels, independent engine dynamometer and emissions testing was performed. A testing apparatus capable of making relevant measurements was designed, built, and used to test and determine the feasibility of biodiesel. The apparatus marks the addition of a valuable testing tool to the University and provides a foundation for future experiments. This thesis will discuss the background of biodiesel, testing methods, design and function of the testing apparatus, experimental results, relevant calculations, and conclusions.

Economic and Social Changes in Czech Society after 1989: an Alternative View

The group presents an analysis of the development of the Czech society and economy during the 1990s. They believe that the Czech neo-liberal strategy of transformation led to a partial and uneven modernisation and that this strategy is unable to provide a firm basis for a complex process of modernisation. The increasing developmental problems encountered during 1996-1999 can be seen as empirical evidence of the inadequacy of the neo-liberal transformation strategy. These problems are connected to institutional shortcomings due to the excessive speed of privatisation, its form with certain important Czech innovations (particularly the voucher method and an attempt to resuscitate the Czech national capital) and with the overlooking of the importance of the legal framework and its enforcement. The overly hasty privatisation has created a type of 'recombinant property' which lacks the economic order necessary to stimulate efficiency in an atmosphere of prevailing social justice. A second reason for the present difficulties is the long-term lag behind the civilisation and cultural standards typical of the advanced European countries. The first steps of the Czech transformation concentrated mainly on changes in the institutions important for the distribution of power and wealth and largely neglected the necessity of deep-reaching modernisation of Czech society and the economy. The neo-liberal strategy created conditions conducive to predatory and speculative behaviour at the expense of creative behaviour. Inherited principles of egalitarianism combined with undeserved economic privileges survived and were reinforced by important new developments in the same direction. This situation hinders the assertion of meritocratic motivations. The group advocates the development and implementation of a complex strategy of modernisation based on deliberate reforms, institutional changes and restructuring on the basis of strategic planning, and structural and regional policies which stress the role of cultivation of the institutional order and of the most important factors of economic growth and development.

Effects of Landscape Segregation on Livelihood Vulnerability: Moving From Extensive Shifting Cultivation to Rotational Agriculture and Natural Forests in Northern Laos

This study investigates four decades of socio-economic and environmental change in a shifting cultivation landscape in the northern uplands of Laos. Historical changes in land cover and land use were analyzed using a chronological series of remote sensing data. Impacts of landscape change on local livelihoods were investigated in seven villages through interviews with various stakeholders. The study reveals that the complex mosaics of agriculture and forest patches observed in the study area have long constituted key assets for the resilience of local livelihood systems in the face of environmental and socio-economic risks. However, over the past 20 years, a process of segregating agricultural and forest spaces has increased the vulnerability of local land users. This process is a direct outcome of policies aimed at increasing national forest cover, eradicating shifting cultivation and fostering the emergence of more intensive and commercial agricultural practices. We argue that agriculture-forest segregation should be buffered in such a way that a diversity of livelihood opportunities and economic development pathways can be maintained.

Educating...for what?: Livelihood and Vocation

Higgins School of the Humanities/Difficult Dialogues: Video Recording from 10/18/2011 event featuring Lynn Pasquerella and David Angel titled "Livlihood and Vocation" Event Description: Some of the most vocal challenges to higher education imply that a liberal education does not have direct vocational application. What good is it? the critics ask. Bill Gates and Mark Zuckerberg didn’t finish college. What is the responsibility of a college or university in ensuring that students have membership in an economy? And what actually best prepares them to do so? How do we define economy? Is the best preparation for a career the same or different than preparation for a discerning and meaningful life? In what ways do the humanities contribute to all these kinds of development? How can we better assist our students in joining their work with their ideals? Our guests for a conversation on livelihood are Lynn Pasquerella, President of Mount Holyoke College, and David Angel, President of Clark University.

Hemophilia A pseudoaneurysm in a patient with high responding inhibitors complicating total knee arthroplasty: embolization: a cost-reducing alternative to medical therapy

Joint hemorrhages are very common in patients with severe hemophilia. Inhibitors in patients with hemophilia are allo-antibodies that neutralize the activity of the clotting factor. After total knee replacement, rare intra-articular bleeding complications might occur that do not respond to clotting factor replacement. We report a 40-year-old male with severe hemophilia A and high responding inhibitors presenting with recurrent knee joint hemorrhage after bilateral knee prosthetic surgery despite adequate clotting factor treatment. There were two episodes of marked postoperative hemarthrosis requiring extensive use of substitution therapy. Eleven days postoperatively, there was further hemorrhage into the right knee. Digital subtraction angiography diagnosed a complicating pseudoaneurysm of the inferior lateral geniculate artery and embolization was successfully performed. Because clotting factor replacement therapy has proved to be excessively expensive and prolonged, especially in patients with inhibitors, we recommend the use of cost-effective early angiographic embolization.