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Digital elevation and magnetic data from the southern Victorian basins (Otway, Port Phillip, Gippsland Basins) have enabled the recognition of a vast Late Miocene – Pliocene strandplain succession that is a correlative of the Murray Basin Loxton – Parilla strandplain. A combination of ferricrete formation and erosional dissection has made the strandline geometries visible on geophysical images and allowed the mapping of strandlines across most of the onshore Otway (often under continuous basalt cover), Port Phillip and Gippsland Basins. Strontium isotope ages from well-preserved molluscan assemblages of the exposed strandplain successions indicates the earliest sediments were deposited above the Upper Miocene unconformity at around 5.8 ± 0.2 Ma (latest Miocene, Beaumaris). The youngest exposed strandplain sediments (from the Jemmys Point Formation, Gippsland) are Late Pliocene ( ca 3.0 – 2.5 Ma), although younger strandlines occur offshore. Elevation differences across the strandplain of the Victorian basins give a quantitative measure of cumulative Plio-Pleistocene uplift. A broad east – west axis of regional uplift is present along the Western Highlands – Dundas Tablelands, with maximum uplift in the range of 250  m being indicated. The western extension of this axis affects the Mt Gambier coastal plain (Gambier Axis). The Padthaway High forms another uplift trending northwest from the Dundas Tablelands into the Murray Basin. The unconformable relationship between the Pliocene and Quaternary strandline systems across Victoria may be caused by intensified latest Pliocene Quaternary uplift and/or eustatic changes associated with the development of the Quaternary glacial episode. The strandplain successions of southern Victoria have probably developed during the latest Miocene and Pliocene in response to a period of relatively stable base-level (little uplift or eustatic fluctuation). Recognition of the southern Victorian strandline successions may provide potential new targets for heavy-mineral exploration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We examined the reach and impact of five decision aids (DAs) routinely distributed to breast cancer patients as part of a shared decision making demonstration project. METHODS: From 2005 to 2008, we surveyed patients' change in knowledge and decisional conflict (DC) before and after their review of DAs. Using bivariate tests, we identified significant predictors of change in knowledge or decisional conflict and entered significant predictors into a multivariate regression model. RESULTS: We distributed 1553 DAs to 1098 patients and received 549 completed surveys. The DAs were associated with increased knowledge and decreased DC. For knowledge, significant predictors of above-average change included: lower baseline knowledge and viewing the surgery decision aid. For decisional conflict, significant predictors of above-average change included: higher decisional conflict; viewing any of the early-stage cancer DAs; and Hispanic ethnicity. CONCLUSIONS: DAs used in routine care were associated with significant knowledge gains and reductions in decisional conflict. Some subsets of patients (those reporting low baseline knowledge, high DC, or Hispanic ethnicity) may benefit more than others. PRACTICE IMPLICATIONS: Breast cancer patients benefit overall from routine distribution of DAs. Our exploratory findings may be useful in generating hypotheses to identify target populations who would most benefit from reviewing DAs. [ABSTRACT FROM AUTHOR]

Women who do not have a documented germline mutation or who do not have a strong family history suspicious for a germline mutation are considered to be at average risk of ovarian cancer. Women who have confirmed deleterious BRCA1 and BRCA2 germline mutations are high risk of ovarian cancer. In addition, women who have a strong family history of either ovarian or breast cancer may carry a deleterious mutation and must be presumed to be at higher-than-average risk, even if they have not been tested, because there could be other mutations that are either untested or yet undiscovered that confirm higher-than-average risk of these diseases. We reviewed studies pertaining to prophylactic bilateral salpingo-oophorectomy in women at average risk of ovarian cancer who are undergoing hysterectomy for benign disease. We also reviewed the role of prophylactic bilateral salpingo-oophorectomy in preventing ovarian cancer based on the level of risk of the patient. For women at average risk of ovarian cancer who are undergoing a hysterectomy for benign conditions, the decision to perform prophylactic bilateral salpingo-oophorectomy should be individualized after appropriate informed consent, including a careful analysis of personal risk factors. Several studies suggest an overall negative health effect when prophylactic bilateral salpingo-oophorectomy is performed before the age of menopause. Ovarian conservation before menopause may be especially important in patients with a personal or strong family history of cardiovascular or neurological disease. Conversely, women at high risk of ovarian cancer should undergo risk-reducing bilateral salpingo-oophorectomy. [ABSTRACT FROM AUTHOR]

BACKGROUND: While data are conflicting, studies have appeared in the literature suggesting that mental intentions sent from a distance (eg, intercessory prayer, spiritual healing) can possibly influence clinical outcomes in patients suffering from an array of medical conditions. The purpose of this study was to examine the potential efficacy of distant healing in a population of patients with human immunodeficiency virus (HIV)/aquired immune deficiency syndrome (AIDS). METHODS: One hundred fifty-six patients with a history of AIDS category C and at least one AIDS-defining opportunistic infection were randomized to 1 of 3 study arms: (1) 10 weeks of prayer/distant healing from professional healers, (2) 10 weeks of prayer/distant healing from nurses with no prior training or experience in distant healing, or, (3) no distant healing. RESULTS: No significant treatment effects of distant healing were observed for either professional healers or nurses on any of the primary or secondary outcomes. Despite being blind to group assignment, subjects receiving distant healing (from healers or nurses) were significantly more likely to guess that they had been receiving healing than were subjects randomized to the no-treatment control group. CONCLUSIONS: Distant healing or prayer from a distance does not appear to improve selected clinical outcomes in HIV patients who are on a combination antiretroviral therapy. [ABSTRACT FROM AUTHOR]