From the environment into the biomass: microplastic uptake in a protected lamprey species.

The relationship between the ubiquitous presence of microplastics in the environment and exposure of biota needs to be better understood, particularly for vulnerable species and their habitats. In this study, we address the presence of microplastics in the riverine habitat of a threatened lamprey species (Lampetra sp.), both in habitats with protective interventions in place (designated as Special Areas of Conservation), and those without these protective interventions. By sampling both riverbed sediments and larval lamprey, we provide a direct comparison of the microplastic loadings in both, and insights into how knowledge of sediment loadings might predict biological uptake. Microplastic particles, analysed using micro-Fourier transform infrared (µFTIR) spectroscopy, were detected in all samples of lamprey larvae and paired sediment, ranging in abundance from 1.00 to 27.47 particles g-1 in dry lamprey gastrointestinal tract (GIT) tissue, and 0.40 to 105.41 particles g-1 in dry sediment. The most urbanised catchment exhibited the highest average microplastic particle count in both lamprey and sediment. Across sites, the microplastic abundance in lamprey GIT tissue was not correlated with that of the surrounding sediment, suggesting that either specific polymer types are retained or other factors such as larvae residence time within sediment patches may influence biological uptake. The most encountered polymer types in lamprey from their immediate habitat were polyurethane, polyamide, and cellulose acetate. To the best of our knowledge, this is the first study to document microplastic contamination of larval lamprey in-situ, contributing another potential stressor to the population status of a vulnerable species. This highlights where further research on the impacts of plastic contamination of freshwater environments is needed to aid conservation management of this ecologically important species.

Uterine papillary serous carcinoma: patterns of failure and survival.

OBJECTIVE: To evaluate the outcome in patients with uterine papillary serous carcinoma (UPSC). METHODS: A retrospective review of women treated for UPSC between 1995 and 2006 in Westmead Hospital, Sydney. The patients were treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy and surgical staging. The majority of the patients had platinum-based adjuvant chemotherapy and radiotherapy. Sites of initial recurrence were documented. Overall survival (OS) and progression free survival (PFS) were estimated using Kaplan-Meier method. Univariate and multivariate analysis was performed using Cox regression analysis to test the effects of multiple prognostic factors on survival. RESULTS: Two-year and five-year OS was 65% and 43%. The median OS was 39 months. Two-year and five-year PFS was 60% and 35%. Macroscopic residual disease at the completion of surgery was the only significant prognostic factor associated with worse OS on both univariate and multivariate analysis (P < 0.001). The median OS was only 11 months if patients had macroscopic residual disease, and all patients died within 18 months despite adjuvant therapies. Twenty-one patients relapsed. The site(s) of initial recurrence were: vagina (five patients), pelvic lymph nodes (four patients), abdomen (11 patients), para-aortic lymph nodes (six patients), inguinal lymph nodes (two patients) and distant metastases in seven patients. Only one of 16 patients who received vaginal brachytherapy failed in the vagina, but three of seven patients who received external beam pelvic radiotherapy failed in the vagina. CONCLUSION: We recommend optimal cytoreduction surgery with the aim of leaving no macroscopic disease at the end of the operation. Vaginal brachytherapy should be considered as a component of adjuvant radiotherapy. Abdominal failure was the commonest mode of failure in our cohort of patients.

A 'Catch Up' Plan for radiotherapy in New South Wales to 2012.

In New South Wales (NSW) from 1996 to 2006, only 34-37% of newly diagnosed cancer patients were treated with radiotherapy instead of the 50% proposed by NSW Health in Radiotherapy Plans released in 1991, 1995 and 2003. As a consequence, over 50 000 cancer patients were not treated and has resulted in the estimated premature death of over 8000 patients and over 40 000 years of life lost. In 2008, there were 42 linear accelerators in NSW rather than the 62 recommended. Based on cancer incidence projections, NSW will require 69 linear accelerators in 2012--a shortfall of 27 linear accelerators. Already 15 linear accelerators have been approved. NSW Health has funding for seven extra linear accelerators, and eight extra linear accelerators are to be funded by the private sector. To make up the shortfall, a 'Catch Up' Plan is proposed for an additional 12 linear accelerators by the end of fiscal year 2012. This is estimated to cost $200 million over 4 years for one-off establishment costs for buildings and equipment plus $50 million per year for recurrent operating costs such as staff salaries. The 'Catch Up' Plan will create five new departments of radiation oncology in country hospitals and three new departments in metropolitan hospitals. These will be in addition to those already approved by NSW Health and will markedly improve access for treatment and result in an improvement in cancer survival. This significant increase in departments and equipment can only be achieved by the creation of an NSW Radiotherapy Taskforce similar to that proposed in the Baume report of 2002, 'A vision for radiotherapy'. Even if the 'Catch Up' Plan bridges the gap in service provision, forward planning beyond 2012 should commence immediately as 76 linear accelerators will be required for NSW in 2015 and 81 linear accelerators in 2017.

Evaluation of patient preferences towards treatment during extended hours for patients receiving radiation therapy for the treatment of cancer: a time trade-off study.

BACKGROUND: To reduce the waiting time between diagnosis and the start of radiation therapy, some departments have introduced appointments outside of conventional working hours, but the inconvenience this may cause to patients is unknown. We examined, from the patient's perspective, whether reduced waiting times to treatment would be sufficient to trade off against potentially inconvenient appointment times. METHOD: We interviewed patients receiving radiation therapy at a major teaching hospital between January and May 2005. Two patient groups were considered: those treated during conventional working hours (8.30 am to 4.30 pm), and those treated outside these hours. Patients were asked to trade a reduction in waiting time to the start of treatment against treatment outside conventional working hours. RESULTS: Of 129 patients interviewed, 77 were treated during conventional working hours and 52 outside these hours. Fifty-seven (44%) were male and 52 (40%) were aged over 60 years. To prefer treatment out of working hours, patients being treated during conventional working hours required a larger reduction in waiting time (odds ratio 2.36, 95% CI 0.97-5.76). Patients with curable disease and those who had made few changes in their lifestyle throughout the treatment were more likely to accept treatment outside of conventional working hours. CONCLUSION: It is impractical to satisfy the treatment-time preferences of all patients. However, many patients prefer treatment outside of normal treatment times if this would reduce the time until the start of radiation therapy. Evaluating the effect of waiting times on patients' perceptions of their disease control provides important information in allocating treatment hours and appointment times.

Parental schemata in the management of children with attention deficit-hyperactivity disorder.

The authors describe the management schemata held by parents of children diagnosed with attention deficit-hyperactivity disorder (ADHD). They conducted semistructured interviews with 10 mothers of children who had ADHD and used interpretative, phenomenological analysis on the interview transcriptions to identify the schemata that guided the parents' management practices. The predominant schemata were the perceived difference of children with ADHD, parental aspirations, the necessity of medication, psychological management, parental authority, role of the father, mothering concept, and community support. The authors discuss these schemata in the context of the current controversy as to whether ADHDis best regarded as a medical or a developmental disorder. They conclude that the parents' schemata conformed to current child-raising theory, but as a consequence, the parents might not consider social factors involved in the development of ADHD sufficiently. The authors suggest that this restricted perspective limits the parents' options for managing the condition.