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Aboriginal Cultural Tourism -Land Of The Fog-
Joanne Pyke,Keith G. Brown,David Johnson 한국문화관광학회 2008 문화관광연구 Vol.10 No.2
Cape Breton Island, is located off the eastern most portion of mainland Canada at roughly 47°N, 60°W (Brown, 2006). The indigenous peoples, the Mi`kmaq, have lived in the region for approximately 11,000 years and have had contact with Europeans for 400 hundred years. They call Cape Breton Island, Unama`ki, Land of the Fog (Milburn, 2004). Aboriginal cultural tourism and the importance of product authenticity is discussed. The paper provides a case narrative of Aboriginal cultural tourism involving five First Nations communities on Cape Breton Island, Nova Scotia, Canada. The island contains five reserves of the Mi`kmaq Nation, these being: Eskasoni, Membertou, Wagmatcook, We`kopaq/Waycobah, and Potlotek/Chapel Island. The combined population of these five communities is 7149, approximately 7% of the island`s population(INAC, 2007).
Aboriginal Cultural Tourism: Land of the Fog
Joanne Pyke,Keith G,Brown,David Johnson 세계문화관광학회 2008 Conference Proceedings Vol.9 No.0
Cape Breton Island, is located off the eastern most portion of mainland Canada at roughly 47°N, 60°W (Brown, 2006). The indigenous peoples, the Mi'kmaq, have lived in the region for approximately 11,000 years and have had contact with Europeans for 400 hundred years. They call Cape Breton Island, Unama'ki, Land of the Fog(Milburn, 2004). Aboriginal cultural tourism and the importance of product authenticity are discussed. The paper provides a case narrative of Aboriginal cultural tourism involving five First Nations communities on Cape Breton Island, Nova Scotia, Canada. The island contains five reserves of the Mi'kmaq Nation, these being: Eskasoni, Membertou, Wagmatcook, We'kopaq/Waycobah, and Potlotek/Chapel Island. The combined population of these five communities is 7149, approximately 7% of the island's population (INAC, 2007).
Robert E. Pyke, MD, PhD 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.5
Prostatism and erectile dysfunction (ED) are highly prevalent and closely comorbid. Prescription treatments are limitingly expensive but robust in mechanisms of action (MoA). Nutritional supplements (NS) are low-cost but inadequately supported by evidence. Do any NS use robust MoA? Could their efficacy be amplified via dosing, concentration of active principles, and/or use in combination? The goal is to develop an effective NS for prostatism and ED using the MoA of prescription treatments. Literature reviews were conducted on dietary supplements for prostatism or ED and MoA of relevant drugs. The most promising NS employing these MoA were chosen. A pilot study of a prototype combination was conducted. A protocol was created for an adequate dose-response trial to test the NS combination in men with ED and prostatism. The main measures were response rates, International Prostate Symptom Score, and International Index of Erectile Function. For drugs, the MoAs best proven for prostatism and ED were nitric oxide augmentation, mild androgen inhibition, and anti-inflammatory effects. The following NS best simulate these MoA and are best supported for efficacy; for prostatism: beta sitosterol; for ED: panax ginseng, arginine, and citrulline. Pilot clinical data provided support. A plan for a formal dose-response clinical trial was approved by a central institutional review board. NS using effective MoA might suffice for prostatism and ED. Pilot testing of a combination NS with the best-supported MoA supported further development. A dose-response trial should be conducted using adequate doses of L-citrulline, beta-sitosterol, ginseng, and vitamin D3.
Radioactive Waste Sampling for Characterisation - A Bayesian Upgrade
Caroline K. Pyke,Peter J. Hiller,Yoshikazu Koma,Keiichi Ohki 한국원자력학회 2022 Nuclear Engineering and Technology Vol.54 No.1
Presented in this paper is a methodology for combining a Bayesian statistical approach with Data QualityObjectives (a structured decision-making method) to provide increased levels of confidence in analyticaldata when approaching a waste boundary. Development of sampling and analysis plans for the characterisationof radioactive waste often use a simple, one pass statistical approach as underpinning for thesampling schedule. Using a Bayesian statistical approach introduces the concept of Prior informationgiving an adaptive sample strategy based on previous knowledge. This aligns more closely with theiterative approach demanded of the most commonly used structured decision-making tool in this area(Data Quality Objectives) and the potential to provide a more fully underpinned justification than themore traditional statistical approach. The approach described has been developed in a UK regulatorycontext but is translated to a waste stream from the Fukushima Daiichi Nuclear Power Station todemonstrate how the methodology can be applied in this context to support decision making regardingthe ultimate disposal option for radioactive waste in a more global context
Risk Factors for Poorer Breast Cancer Outcomes in Residents of Remote Areas of Australia
Roder, David,Zorbas, Helen,Kollias, James,Pyke, Chris,Walters, David,Campbell, Ian,Taylor, Corey,Webster, Fleur Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.1
To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.
Roder, David,Zorbas, Helen,Kollias, James,Pyke, Chris,Walters, David,Campbell, Ian,Taylor, Corey,Webster, Fleur Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.1
Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (${\leq}10$) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Conclusions: Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.
Roder, David,Silva, Primali de,Zorbas, Helen,Kollias, James,Malycha, Peter,Pyke, Chris,Campbell, Ian,Webster, Fleur Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4
Background: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand was investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Design: Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. Results: 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Conclusions: Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.
Roder, David M.,Silva, Primali De,Zorbas, Helen N.,Webster, Fleur,Kollias, James,Pyke, Chris M.,Campbell, Ian D. Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4
Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.