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Dance classes in urban settings may have a role in health-promotion programmes seeking to increase physical activity amongst young people. However, little is so far known about the motivations, experiences or health outcomes of those participating in dance classes. This qualitative study of young people attending recreational dance classes addressed motivations, the nature of the class experience, and implications for health and well-being. Data show that young dance participants' experiences of "the physical" are embedded in social, community/cultural or other values, and involve respect for older teachers and physical knowledge/expertise gained over the long term. Encouragement of dance-class participation may offer an important strategy for health promotion as long as the physical activity value of dance classes is not promoted in narrow, bio-mechanical terms.

Voluntary assisted dying laws have now been enacted in all six Australian States with reform being considered in the remaining two. While there is an emerging body of literature examining various aspects of regulation, there has been scant consideration of what these reforms mean for First Nations peoples, and to what extent their experiences have been considered in the process of developing legislation. This article provides a critical analysis of how Indigenous perspectives both contributed to, and were engaged with, during the law reform processes in Victoria and Western Australia, the first two States to grapple with this topic. Findings reveal the sophistication in how Indigenous organisations and individuals engaged with this issue and highlight the critical importance of not universalising Indigenous perspectives. Significantly, there was much greater engagement with Indigenous views in Western Australia than in Victoria. We conclude by considering how Indigenous voices can meaningfully influence Australian law reform processes. [ABSTRACT FROM AUTHOR]

Background: Complementary medicine (CM) use is a ubiquitous aspect of an increasingly consumer-driven model of healthcare delivery and plays an increasingly prominent role in the Australian health sector. Yet there is limited empirical research investigating the quality and integrity of protections for consumers in Australia. The aim of this study is to help address this gap in knowledge by exploring how members of the public engage with protection mechanisms related to CM use. Methods: This study utilised a cross-sectional online survey to recruit a sample of 1132 Australian adults aged 18 and over. Purposive convenience sampling was used to recruit participants from an existing database of Australian adults who had expressed interest in participating in research. Results: The majority of the participants (64.0%) had visited a CM practitioner in their lifetime. However, a minority of participants (36.9%) indicated they would feel confident in knowing where to complain if something went wrong with the treatment they received from a CM practitioner. Most participants (74.7%) had used a CM product in their lifetime. Specifically, 32.3% had ‘ever’ used an herbal product and 69.9% had ‘ever’ used a nutritional supplement. However, a minority of participants (32.7%) indicated they would feel confident knowing where to complain if something went wrong with a herbal or nutritional supplement they used. Most participants indicated a lack of knowledge about how CM practitioners and CM products are regulated in Australia. Conclusion: The findings of this study clearly highlight a concerning lack of knowledge by CM patients and consumers regarding the regulation of CM in Australia. From a policy perspective, it is necessary to seek proactive approaches that target complaint-related knowledge of the CM patients and consumers through education and advocacy efforts. [ABSTRACT FROM AUTHOR]

Healthcare encompasses multiple discourses to which health professionals, researchers, patients, carers and lay individuals contribute. Networks of patients and non‐professionals often act collectively to build capacity, enhance access to resources, develop understanding and improve provision of care. This article explores the concept of health collectives and three notable examples that have had an enduring and profound impact in the Australian context. [ABSTRACT FROM AUTHOR]

Obesity is considered a public health concern. In Australia, there are a greater number of overweight or obese men compared with women. The media is an important source of information about body weight and weight management. We undertook a qualitative study to analyse men's weight loss stories in a popular men's magazine. Between January 2009 and December 2012, we collected 47 men's weight loss stories from the Australian edition of Men's Health magazine. We undertook thematic analysis to examine the stories. Confession, personal responsibility, appearance and transformation were key themes. The stories describe the men's self-discipline and their monitoring and tracking of their behaviours as activities which supported their weight loss. In this way, the stories promote the importance of such panoptic self-surveillance and self-discipline to the readers. We consider how such stories contribute to the wider synoptic system of media messages about body weight. [ABSTRACT FROM AUTHOR]

Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through “herd immunity,” which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination. Despite relatively high compliance with the childhood vaccination schedule, however, the Australian government has determined that rates should be higher and has recently introduced policy that includes removing certain tax and childcare benefits for non-vaccinators and formally disallowing conscientious objection to vaccination (“No Jab No Pay”). In addition, it has raised the possibility of banning unvaccinated children from childcare centres (“No Jab No Play”). This article examines the impact of coercive approaches to childhood vaccination and raises the question of the ethical justification of health policy initiatives based on coercion. We consider the current evidence regarding childhood vaccination in Australia, the small but real risks associated with vaccination, the ethical requirement for consent for medical procedures, and the potential social harms of targeting non-vaccinators. We conclude that the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the author discusses the harmful effects of the use of drugs on the society despite strict drug policy and penalties in Australia. It talks about the consumption of cannabis, cocaine and ecstasy being common among young people in the modern society. It tells about the programs conducted to make the young people aware of the harmful effects of the use of illicit drugs.

The article focuses on a debate on universal electronic health record system called the ‘My Health Record', discussing its creation of records automatically for the individual citizens of Australia. It reports that the main motive behind the creation of My Health Record for the improvement of coordination of care, preventing duplication of services and investigations and helping avoid drug errors. The health record system benefits various sectors.

Objectives: Chinese medicine is a complex domain of theoretical and practical approaches that is being increasingly put under the research spotlight. The "Chinese Medicine in Australia"research project attempted to capture the clinical features of practitioners of Chinese medicine. Participants and Interventions: The project involved a national survey of Chinese medicine professional association members and registered practitioners in the state of Victoria, Australia (n = 655; response rate, 42%-55%) completed in 2012-2013. Design: The content and face validated survey was developed using new and previous workforce survey questions. Results: This paper reports on the workforce and practice characteristics of the survey respondents. Chinese medicine practitioners are highly educated, come from diverse backgrounds, and have chosen to practice predominantly in sole or multipractitioner private practice settings. An interest in the philosophy of Chinese medicine and previous experiences contributed to practitioners' decisions to study and practice Chinese medicine. Incorporating a variety of techniques, practitioners describe themselves as practicing predominantly Chinese acupuncture and herbal medicine. Conclusions: The results from this survey contribute to the understanding of the nature and description of Chinese medicine practice in Australia. [ABSTRACT FROM AUTHOR]

Aim. To identify end-of-life (EOL) decision making processes for patients with non-cancer illnesses in a major metropolitan hospital. Methods. A retrospective review using a case study framework of 47 randomly selected patient records over a 6-month period explored issues in EOL care planning. Results. Reviewed charts represented 53% of total deaths in the study period. All patients (aged 66-99) had co-morbid conditions. In 64%, the first record of EOL discussions occurred in the last 24 h of life. Four case groups were identified, ranging from a clear plan developed with patient/family involvement and fully implemented, to no plan with minimal patient/family involvement in decision making. Factors related to clearer EOL care planning according to expressed patient wishes included multiple previous admissions, shorter hospitalisations at EOL, living with a relative and involvement of family in decisions about care. Conclusion. This study has shown that the development and effective implementation of EOL plans is associated with the active involvement of both family members and health professionals. It also draws attention to the risks of delaying EOL discussions until late in the illness trajectory or later in life as well as pointing to challenges in acting on EOL developed outside the hospital environment. [ABSTRACT FROM AUTHOR]

Introduction In Australia the incidence of obesity is increasing rapidly and has become a significant public health concern. In addition to the many physical consequences of obesity many studies have reported significant mental health consequences, including major depression, mood and anxiety disorders. The purpose of this study was to explore the relationship between severity of obesity and perceived mental health in an Australian community sample. Methods A cross-sectional survey design was used. A total of 118 participants, aged between 19 and 75 years with a body mass index ( BMI) ≥ 30 kg/m2 returned a completed questionnaire. The SF-36 Health Survey, Kessler Psychological Distress Scale, Social Interaction Anxiety Scale and the Multidimensional Scale of Perceived Social Support were used. Results After adjusting for age, gender, perceived social support and physical health quality of life, obesity was not significantly associated with mental health quality of life ( SF-36). The strongest factor influencing mental health was perceived physical health. Mediation analyses suggest that physical health mediates the relationship between obesity and mental health quality of life. Discussion Our findings support the view that physical health mediates the relationship between obesity and mental health. Public health interventions should focus on reducing the impact of obesity on physical health by encouraging participation in healthy lifestyles, which in turn, may improve mental wellbeing. [ABSTRACT FROM AUTHOR]

Introduction This study explores what types of information obese individuals search for on the Internet, their motivations for seeking information and how they apply it in their daily lives. Method In-depth telephone interviews with an Australian community sample of 142 individuals with a BMI ≥ 30 were conducted. Theoretical, purposive and strategic samplings were employed. Data were analysed using a constant comparative method. Results Of the 142 individuals who participated in the study, 111 (78%) searched for information about weight loss or obesity. Of these, about three quarters searched for weight loss solutions. The higher the individual's weight, the more they appeared to search for weight loss solutions. Participants also searched for information about health risks associated with obesity ( n = 28), how to prevent poor health outcomes ( n = 30) and for peer support forums with other obese individuals ( n = 25). Whilst participants visited a range of websites, including government-sponsored sites, community groups and weight loss companies, they overwhelmingly acted upon the advice given on commercial diet websites. However, safe, non-judgemental spaces such as the Fatosphere (online fat acceptance community) provided much needed solidarity and support. Conclusions The Internet provides a convenient source of support and information for obese individuals. However, many turn to the same unsuccessful solutions online (e.g. fad dieting) they turn to in the community. Government and community organisations could draw upon some lessons learned in other consumer-driven online spaces (e.g. the Fatosphere) to provide supportive environments for obese individuals that resonate with their health and social experiences, and address their needs. [ABSTRACT FROM AUTHOR]

Objectives: To investigate obese men's health behaviors and strategies for change. Methods: Qualitative interviews with 36 men (BMI 30 and over). Results: All men felt personally responsible for their weight gain. Sedentary lifestyles, stress, lack of worklife balance and weight-based stigma were all significant causes of weight gain and barriers to weight loss. These factors also contributed to men's unwillingness to seek help for their overweight. Conclusion: Addressing the self-blame and stigma associated with obesity is important in developing strategies to improve the health and well-being of obese men. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the dynamics within second medical opinion consultations in patients with cancer. Semi-structured interviews were held with four oncologists and were subjected to a thematic analysis to define the broad issues. These formed the basis of a survey distributed to Australian medical oncologists. Overall 65 surveys were returned representing an overall response rate of 30% (10% and 63% electronic and hardcopy response rates, respectively). The dynamics in giving second medical opinions are influenced by the collegiate relationships of the doctors. Nearly two-thirds of oncologists believed that the first doctors' treatment and recommendations influenced the outcome of the second opinion, more than one-third believed the outcome was influenced by the relationship between the two doctors, and 41% believed the public nature of a second opinion was influential. In each case, these figures were more than double their assessments of patients' beliefs of these influences. Care was taken not to criticise the primary doctor. Second medical opinions provide an opportunity for oncologists to review medical care and engage in enhanced communication with patients who have additional needs. These consultations do not, however, occur in a vacuum but are influenced by the need to attend to relationships between the patient and their primary doctor and between the doctors themselves. The second medical opinion is embedded within a network of relationships and within the illness journey. [ABSTRACT FROM AUTHOR]

The rise of the 'obesity epidemic' in Western societies has led to an increased public gaze on obese individuals. Yet there is limited research that explores through qualitative methods the increased impact it has had on obese individuals' perceptions of self, body image and coping strategies, using their own words. This paper presents the findings of interviews with a community sample of 142 obese adults in Australia. We examined how obese individuals felt about themselves and their bodies, what influenced these feelings, and the subsequent coping strategies employed. While participants were able to identify many positive characteristics about their inner self, the vast majority used negative language to describe their physical appearance. Many participants described feelings of 'guilt', 'shame' and 'blame' associated with their weight. Coping strategies included striving for perfection in other areas of their life, social isolation, maximising aspects of their appearance and 'fat' acceptance. This study shows that, while different groups of obese adults experience, cope with and compensate for the influence of weight-based stereotyping in many different ways, they still feel an unrelenting otherness and difference associated with their weight. [ABSTRACT FROM AUTHOR]

Background: Previous studies of public perceptions of obesity interventions have been quantitative and based on general population surveys. This study aims to explore the opinions and attitudes of obese individuals towards population and individual interventions for obesity in Australia.Methods: Qualitative methods using in-depth semi-structured telephone interviews with a community sample of obese adults (Body Mass Index >or=30). Theoretical, purposive and strategic recruitment techniques were used to ensure a broad sample of obese individuals with different types of experiences with their obesity. Participants were asked about their attitudes towards three population based interventions (regulation, media campaigns, and public health initiatives) and three individual interventions (tailored fitness programs, commercial dieting, and gastric banding surgery), and the effectiveness of these interventions.Results: One hundred and forty two individuals (19-75 years) were interviewed. Participants strongly supported non-commercial interventions that were focused on encouraging individuals to make healthy lifestyle changes (regulation, physical activity programs, and public health initiatives). There was less support for interventions perceived to be invasive or high risk (gastric band surgery), stigmatising (media campaigns), or commercially motivated and promoting weight loss techniques (commercial diets and gastric banding surgery).Conclusion: Obese adults support non-commercial, non-stigmatising interventions which are designed to improve lifestyles, rather than promote weight loss. [ABSTRACT FROM AUTHOR]

Background: We are a society that is fixated on the health consequences of 'being fat'. Public health agencies play an important role in 'alerting' people about the risks that obesity poses both to individuals and to the broader society. Quantitative studies suggest people comprehend the physical health risks involved but underestimate their own risk because they do not recognise that they are obese.Methods: This qualitative study seeks to expand on existing research by exploring obese individuals' perceptions of public health messages about risk, how they apply these messages to themselves and how their personal and social contexts and experiences may influence these perceptions. The study uses in depth interviews with a community sample of 142 obese individuals. A constant comparative method was employed to analyse the data.Results: Personal and contextual factors influenced the ways in which individuals interpreted and applied public health messages, including their own health and wellbeing and perceptions of stigma. Individuals felt that messages were overly focused on the physical rather than emotional health consequences of obesity. Many described feeling stigmatised and blamed by the simplicity of messages and the lack of realistic solutions. Participants described the need for messages that convey the risks associated with obesity while minimising possible stigmatisation of obese individuals. This included ensuring that messages recognise the complexity of obesity and focus on encouraging healthy behaviours for individuals of all sizes.Conclusion: This study is the first step in exploring the ways in which we understand how public health messages about obesity resonate with obese individuals in Australia. However, much more research--both qualitative and quantitative--is needed to enhance understanding of the impact of obesity messages on individuals. [ABSTRACT FROM AUTHOR]

Objective To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity. Design Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ≥30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included. Results Seventy-six individuals (aged 16–72) were interviewed. Most had struggled with their weight for most of their lives ( n = 45). Almost all had experienced stigma and discrimination in childhood ( n = 36), as adolescents ( n = 41) or as adults ( n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ‘blame’ against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight. Discussion and Conclusion There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities. [ABSTRACT FROM AUTHOR]

The article discusses the ongoing debate concerning whether voluntary euthanasia or assisted suicide should be permitted by law in Australia. It mentions that the Australian Medical Association and other professional associations have opposed the legalisation of euthanasia in any form. It further suggests removing uncertainty from considerations of best practice.

The article discusses the challenge faced by medical facilities in Australia and New Zealand concerning the confusion over brand name and generic medicines. It says that increasing brand substitution caused by the development and sale of generic drugs could affect the efficient medication of patients. According to the authors, such practice could improve confusion among nurses, physicians, pharmacists as well as patients regarding the treatment combinations for their illnesses.

A letter to the editor is presented which concerns the Australian Medical Council's (AMC) draft code of professional conduct.

The article focuses on a code of professional conduct proposed by the Australian Medical Council (AMC) in Australia. According to the article, the code declares itself to be describing what is expected of all doctors registered to practise medicine in the country and setting the standard of ethical and professional conduct expected of doctors. It cites several reasons why the code's benign appearance is deceptive, such as its contribution to authoritarianism.

Abstract: Obesity stigma exists within many institutions and cultural settings. Most studies suggest that stigmatising experiences have a negative impact on individuals’ health and social behaviours and outcomes. However, some studies indicate that obesity stigma can motivate individuals to lose weight. Limited research has examined weight-based stigma from the perspective of obese individuals, including their perceptions of, and responses to, the different types of weight-based stigma they face in their daily lives. This study advances knowledge about weight-based stigma by documenting how obese adults (mostly female) described the different types of obesity stigma that they faced, how they responded to this stigma, and how different types of stigma impact on health and social wellbeing. Semi-structured, qualitative interviews were conducted between April 2008 and March 2009 with a diverse sample of 141 obese Australian adults. Guided by categorisation of different types of discrimination, participants’ experiences could be grouped into three distinct types of stigma: 1) Direct (e.g. being abused when using public transport); 2) Environmental (e.g. not being able to fit into seats on planes); and 3) Indirect (e.g. people staring at the contents of their supermarket trolley). Participants described that more subtle forms of stigma had the most impact on their health and social wellbeing. However, it was the interaction between direct, environmental and indirect stigma that created a barrier to participation in health-promoting activities. Participants rarely challenged stigma and often blamed themselves for stigmatising experiences. They also avoided situations where they perceived they would be stigmatised and constantly thought about how they could find a solution to their obesity. [Copyright &y& Elsevier]

The NSW Government has proposed a blanket lifting of COVID-19 restrictions when the proportion of fully vaccinated people rate reaches 70% of the adult population. If implemented, this would have devastating effects on Aboriginal populations. At the present time, vaccination rates in Aboriginal communities remain low. Once restrictions are lifted, unvaccinated people will be at high risk of infection. The risks of serious illness and death among Aboriginal people from a variety of medical conditions are significantly greater than for the wider population. This is also the case with COVID-19 in First Nations populations around the world. The vulnerability of Aboriginal people is an enduring consequence of colonialism and is exacerbated by the fact that many live in overcrowded and poorly maintained houses in communities with under-resourced health services. A current workforce crisis and the demographic structure of the population have further hindered the effectiveness of vaccination programmes. Aboriginal organisations have called on state and federal governments to delay any substantial easing of restrictions until full vaccination rates among Aboriginal and Torres Strait Islander populations aged 16 years and older reach 90-95%. They have also called for additional support in the form of supply of vaccines, enhancement of workforce capacity and appropriate incentives to address hesitancy. Australia remains burdened by the legacy of centuries of harm and damage to its First Nations people. Urgent steps must be taken to avoid a renewed assault on Aboriginal and Torres Strait Islander health., (© 2021 Royal Australasian College of Physicians.)

At least half of all heart failure (CHF) patients will have a comorbidity that could be undertreated, requires additional speciality input and/or polypharmacy. These patients are then at risk of iatrogenic and disease-related complications and readmissions if not closely supervised. Common comorbidities of relevance are cardiorenal and cardiometabolic syndromes (DM, obesity, OSA), chronic airways disease, elderly age, and accompanying pharmacotherapies. The structure of community practice often leaves primary, speciality, and allied health care in silos. For example, cardiology speciality training in Australia creates excellent sub-specialists to deliver diagnostic and therapeutic advances. A casualty of this process has been the gradual alienation of general cardiology toward general internal medical specialists and primary care practitioners. The consequences are largely noticed in community practice. The issue is compounded by suboptimal communication of information. This review explores these issues from a cardiology sub-speciality lens; firstly cross speciality areas that are important for cardiologists to maintain their skill, and finally, to obtain a brief overview of disease management and identify game-changing common denominators such as endothelial dysfunction and self-management., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Obesity is considered a public health concern. In Australia, there are a greater number of overweight or obese men compared with women. The media is an important source of information about body weight and weight management. We undertook a qualitative study to analyse men's weight loss stories in a popular men's magazine. Between January 2009 and December 2012, we collected 47 men's weight loss stories from the Australian edition of Men's Health magazine. We undertook thematic analysis to examine the stories. Confession, personal responsibility, appearance and transformation were key themes. The stories describe the men's self-discipline and their monitoring and tracking of their behaviours as activities which supported their weight loss. In this way, the stories promote the importance of such panoptic self-surveillance and self-discipline to the readers. We consider how such stories contribute to the wider synoptic system of media messages about body weight.

The media play a key role in promoting the thin ideal. A qualitative study, in which we used in depth interviews and thematic analysis, was undertaken to explore the attitudes of 142 obese individuals toward media portrayals of the thin ideal. Participants discussed the thin ideal as a social norm that is also supported through the exclusion of positive media portrayals of obese people. They perceived the thin ideal as an 'unhealthy' mode of social control, reflecting on their personal experiences and their concerns for others. Participants' perceptions highlighted the intersections between the thin ideal and gender, grooming and consumerism. Participants' personal responses to the thin ideal were nuanced--some were in support of the thin ideal and some were able to critically reflect and reject the thin ideal. We consider how the thin ideal may act as a form of synoptical social control, working in tandem with wider public health panoptical surveillance of body weight., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

In 1628, William Harvey presented his revolutionary theory of the circulation to ears at the Royal College of Physicians that had been deafened by the unquestionable authority of Galen's teachings, from one and a half millennia in the past. Harvey's theory was initially rejected, despite his faith in his colleagues being eager for truth and knowledge, and never regarding themselves as so well informed that they would not welcome "further information". Recently Rodney Syme, the retired Melbourne urologist who for a long time has agitated for the legalisation of assisted dying, and also challenged the authorities to apply the current law in response to his admitted assistance to a number of individuals, was invited to address the 2015 Congress of the Royal Australasian College of Physicians. At the eleventh hour, the invitation to speak was withdrawn. In this column, we trace the course of events leading to this withdrawal of the invitation, and describe some of the correspondence to and from the College in response to the withdrawal. We draw parallels between the experiences of Harvey and Syme, and point to lessons to be learnt from the recent episode of apparent unwillingness, on the part of an institution that seeks to present itself as outward-looking, progressive and socially aware, to fulfil this promise in the increasingly important area of the end-of-life.

The last two decades have seen remarkable advances in and acceptance of bariatric surgery. These advances include quality assurance, certification of surgeons and their institutions and the development of national bariatric registries. Yet, in spite of these advances, an urgent need to improve ethical standards in bariatric surgery remains. In particular, surgical innovation must be subjected to adequate scrutiny and sufficient safeguards. New procedures and the processes by which they are assessed should be subject to review and approval by the ethics committees operating under clearly defined guidelines. The public must be able to have confidence that the surgery itself, and the innovative practices that are introduced within it, are not subject to distortions associated with personal, wider professional, industry or institutional interests.

T89 (Dantonic) is a modern herbal medicine currently used in Chinese hospitals for the management of ischemic heart disease. This dose-escalation clinical trial aims to assess tolerability of Western people to T89. Healthy Australian adults of non-Asian background orally took a single dosage of 6, 8, 10, 12, 13, 14, 15, or 16 T89 capsules (6 people for each dose) and were assessed with respect to symptoms and physical signs, electrocardiogram, hematology, plasma biochemistry, and urinalysis. Secondary objectives were to determine the dose-limiting toxicity and maximum-tolerated dose. It found that a single dose of T89 up to 16 capsules was not associated with significant adverse events or abnormalities in clinical laboratory tests and electrocardiogram parameters, except minor symptoms reported included mild and transient dizziness, stomach discomfort, diarrhea, and involuntary muscular contraction. The incident rate of these symptoms was generally low (1/30, 3.3%) but increased (7/18, 38.9%) in higher dose (≥14 capsules) groups. No defined dose-limiting toxicity events occurred; so the study could not define the maximum-tolerated dose. In conclusion, a single dose of T89 up to 13 capsules, 4 times of a regular therapeutic dosage, is generally safe and tolerated by individuals of non-Asian background.

Introduction: Second medical opinions (SMOs) are common in oncology practice, but the nature of these consultations has received relatively little attention. This study examines the views of patients with advanced cancer and their physicians of SMOs., Method: Parallel, concurrent surveys were developed for patients and physicians. The first was distributed to outpatients with advanced cancer-attending specialist clinics in an Australian quaternary hospital. The second survey, developed on the basis of results of exploratory interviews with medical oncologists, was distributed to medical oncologists in Australia., Results: Seventeen of fifty two (33%) patients had sought a SMO, most commonly prompted by concerns around communication with their first doctor, the extreme and desperate nature of their medical condition and the need for reassurance. Most (94%) patients found the SMO helpful, with satisfaction related to improved communication and reassurance. Patients were concerned that seeking a second medical opinion may affect their relationship with their primary doctor. Most physicians (82%) reported seeing between one and five SMO per month, with patients being motivated by the need for additional information and reassurance. Physicians regarded SMO patients as having greater information needs (84%), greater psychosocial needs (58%) and requiring more of the physician's time and energy (77%) than other patients., Conclusion: SMOs are common in cancer care with most patients motivated by the need for improved communication, additional information and reassurance. Physicians identify patients who seek SMOs as having additional psychosocial needs compared with other oncology patients.

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30-39.9) and severe (BMI > or = 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could "lose weight" if they needed to, distanced themselves from the word obesity, and stigmatized those "fatter" than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being "at war" with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults.

Background: Toyohari meridian therapy (TMT) is a Japanese system of acupuncture. Acupoint selection follows diagnosis of the primary and secondary patterns of disharmony (sho) and disturbances in the yang channels. Pulse diagnosis and abdominal palpation diagnosis are the two main diagnostic methods used. Little is known about the reliability of pulse, abdominal, and pattern diagnosis in TMT. This is important since diagnosis of the sho determines acupoint treatment. If diagnosis is unreliable, there can be less confidence that the patient will receive optimal treatment., Objective: The objective of this study is to assess the level of agreement between two TMT practitioners on pulse diagnosis, abdominal diagnosis, and diagnosis of the primary and secondary sho., Methods: An inter-rater reliability study was conducted. Two (2) TMT practitioners separately conducted a TMT examination and completed an assessment form, choosing from a range of possible responses relating to pulse characteristics, abdominal diagnosis, and diagnosis of primary sho and secondary sho. The kappa coefficient was used as a measure of inter-rater reliability of the outcome variables., Results: Sixty-two (62) Australians (22 males, 40 females) aged 20-65 years participated (mean age 49.2 +/- 12.2 years). Level of agreement for pulse diagnosis was 57%, 61%, and 77% for pulse depth, speed, and strength, respectively. For abdominal diagnosis, the level of agreement for involvement of the Lung, Kidney, Spleen, and Liver abdominal regions was 58%, 53%, 35%, and 10%, respectively. The overall level of agreement on primary sho diagnosis was 48% and for secondary sho diagnosis, 44%., Conclusions: Overall, there was a reasonable level of agreement on basic pulse characteristics and on abdominal diagnosis for two of the abdominal regions. Level of agreement on primary and secondary sho diagnosis suggests room for improvement. Further studies are required in order to gain a greater understanding of the reliability of diagnosis in TMT.

The Indian Ocean tsunami of 26 December 2004 has drawn attention to the need for a process to ensure that health aid is provided in an efficient, coordinated and appropriate manner. In response to this, and with support from various medical colleges and the Australian Government, we have established the Australian Health Alliance to Assist with Post-tsunami Reconstruction. In Sri Lanka, some of the current challenges include shortages of medical staff, damaged infrastructure and changing demands due to population shifts. Psychological services are particularly scarce. The psychological and cultural implications of disaster require specific attention when designing aid programs. The goals of the Health Alliance include providing a forum for discussion, identifying specific local needs, coordinating health services and helping local organisations to develop action plans.