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Edge of space emergency tests aviator’s skills

By Senior Airman Hailey Haux
Secretary of the Air Force Public Affairs Command Information

Imagine being at the cusp of the world, where everything flat warps and the earth’s curvature begins to appear.

Looking around on a bright and sunny day, the sky is a brilliant blue. The blue eventually turns to black as space comes within reach.

This is the view U-2 pilots like Maj. Jack Nelson witness each time they fly — they get to see the world from a different perspective. It can be a pleasant experience when all goes well, but not when dealing with an in-flight emergency.

Maj. Jack Nelson is honored during a Pentagon ceremony, May 25, 2016. Nelson, from the 9th Reconnaissance Wing, Osan Air Base, is this year’s recipient of the of the 2015 Koren Kolligian Jr. trophy for outstanding Airmanship by an aircrew member who by extraordinary skills averted or minimized the seriousness of an aircraft accident. (U.S. Air Force photo/Andy Morataya)

Nelson was flying high above the earth when the three multi-function displays that provide the information for the autopilot, navigation, primary heading and reference systems stopped working. To get home safely, he had to troubleshoot the issue while flying.

“Every aviator knows when you step out to a mission, there is an element of risk,” Nelson said. “There’s always risk that we accept. A lot of pilots don’t like to talk about it, and we don’t always want to think about it, but it’s definitely something that’s out there. Flying planes is a risky business, but it’s really great to know you have one of the best teams in the world that’s got your back when you are out there flying and something does go wrong.”

Nelson was able to reset the multi-function display; however, that wasn’t the end of his troubles. Shortly after the reset, the aircraft’s environmental control system malfunctioned, leaving the pilot flying in sub-zero temperatures.

Air Force Chief of Staff Gen. Mark A. Welsh III hosts Maj. Jack Nelson and his family prior to Nelson receiving the 2015 Koren Kolligian Jr. Trophy at the Pentagon in Washington, D.C., May 25, 2016. Nelson, from the 9th Reconnaissance Wing at Osan Air Base, South Korea, received the award for his exceptional piloting skills and ingenuity at a moment of crisis during a mission. (U.S. Air Force photo/Andy Morataya)

After landing, Nelson reflected on the fact that there was a huge team of Airmen, civilians and contractors working overtime to get him home safely, many of whom greeted him on the flightline.

“Seeing how much they cared, their commitment and how hard they were working to try and find a solution was really cool,” Nelson said.
For his efforts, Air Force Chief of Staff Gen. Mark A. Welsh III presented Nelson with the 2015 Koren Kolligian Jr. Trophy during a ceremony May 25 at the Pentagon.

The annual award, first presented in 1958, is given to an Air Force aircrew member who displays extraordinary skill, alertness and ingenuity in averting or minimizing the seriousness of a flight mishap.

Kolligian family representative Corey Kolligian and Air Force Chief of Staff Gen. Mark A. Welsh III congratulate Maj. Jack Nelson during a ceremony at the Pentagon in Washington, D.C., May 25, 2016. Nelson, from the 9th Reconnaissance Wing at Osan Air Base, South Korea, is the recipient of the 2015 Koren Kolligian Jr. Trophy for outstanding airmanship by an aircrew member who, by using extraordinary skills, averted or minimized the seriousness of an aircraft accident. (U.S. Air Force photo/Andy Morataya)

“It’s about taking a situation that’s not supposed to occur and turning it into normal, or at least as normal as you can get. For 59 years now, it’s 59 averted catastrophes; it’s 59 (intense) moments that became calm at some point. It’s 59 pilots or aircrew that came home to their families who might not have if they hadn’t been as prepared as they were,” Welsh said. “That’s what this award is all about. It’s real simple, and yet it’s magnificent.”

The award’s namesake, 1st Lt. Koren Kolligian Jr., was declared missing in the line of duty when his T-33 Shooting Star disappeared off the coast of California in 1955.

The Kolligian family attends and supports the award presentation every year, creating long-lasting friendships which are on display for all to see in three sets of photo albums. The family takes the citation and photos from the ceremony every year and places it in an album for the following year’s attendees to see.

“Since 1958 our family has been honored to be invited to the Pentagon,” said Koren Kolligian II, Lt. Kolligian’s nephew. “Every year we get to meet remarkable pilots, spending time with them and their families, sharing stories and creating friendships. Coming here every year is a powerful reminder of how truly fortunate we are to be Americans. We leave energized, infused with the pride, professionalism and dedication of everyone we meet throughout the day. We are appreciative and thankful to the men and women who ensure this ceremony continues to inspire all who attend.”

Nelson, a former wing safety officer, put his years of training and experience to the test, remaining calm under intense pressure.

“Our safety record in the Air Force is grounded on Airmen taking action based on training, experience and instinct to overcome challenges in mission accomplishment,” said Maj. Gen. Andrew M. Mueller, the Air Force chief of safety. “Skill, alertness and ingenuity are the hallmarks of our Kolligian award winners, and can often make the difference in the severity of a mishap. Maj. Jack Nelson was able to utilize all of these traits to respond to a unique and dangerous in-flight event. I am proud to stand with the Air Force chief of staff and the Kolligian family as this Air Force award is given.”

“Alone and unafraid” is a common term used in the U-2 enterprise. Think about being in an aircraft barely large enough to stretch your legs in, on the cusp of space, looking down on Earth can be daunting. However, Nelson said he was never alone. He had a team who assisted him in one of the most difficult days of his life.

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from Armed with Science http://ift.tt/1RMwEfB

By Senior Airman Hailey Haux
Secretary of the Air Force Public Affairs Command Information

Imagine being at the cusp of the world, where everything flat warps and the earth’s curvature begins to appear.

Looking around on a bright and sunny day, the sky is a brilliant blue. The blue eventually turns to black as space comes within reach.

After landing, Nelson reflected on the fact that there was a huge team of Airmen, civilians and contractors working overtime to get him home safely, many of whom greeted him on the flightline.

The award’s namesake, 1st Lt. Koren Kolligian Jr., was declared missing in the line of duty when his T-33 Shooting Star disappeared off the coast of California in 1955.

Nelson, a former wing safety officer, put his years of training and experience to the test, remaining calm under intense pressure.

Follow U.S. Department of Defense on Twitter!

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Deciphering mysterious honey bee decline

Working bee colonies. Image via Elina L. Nino

By Elina L. Niño, University of California, Davis

Honey bees are arguably our most important commercially available pollinator. They are responsible for pollinating numerous food plants that make our diets more exciting and nutritious, including many fruits, vegetables and nuts.

Beekeepers expect some of their bees to die off from season to season – typically, around 17 percent annually. But in recent years, losses have been more than twice as high.

As an extension apiculturist for the University of California Cooperative Extension, I talk to many people, from beekeepers and growers to members of the general public, about honey bees. Most of my audiences are concerned about how honey bee losses could affect the security of our food supply. While the massive and sudden colony collapses that occurred a decade ago have abated, honey bees are still dying at troubling rates. Laboratories like mine are working to understand the many factors stressing bees and develop strategies for protecting them.

Impacts of honey bee losses

In 2006 beekeepers in the United States reported that a mysterious affliction, dubbed Colony Collapse Disorder (CCD), was causing widespread die-offs of bees. In colonies affected by CCD, adult workers completely disappeared, although plentiful brood (developing bees) and the queen remained. Beekeepers found no adult bees in and around the hives, and noted that pests and bees from neighboring hives did not immediately raid the affected hives, as might be expected.

Scientists now agree that CCD was likely caused by a combination of environmental and biological factors, but nothing specific has been confirmed or proven. CCD is no longer causing large-scale colony death in North America, but beekeepers all over the United States are still reporting troubling colony losses – as high as 45 percent annually.

Overwinter colony losses (Oct 1 – April 1) of managed honey bee colonies in the United States. Image via U.S. Department of Agriculture

While beekeepers can recoup their losses by making new colonies from existing ones, it is becoming increasingly costly to keep them going. They are using more inputs, such as supplemental food and parasite controls, which raises their operating costs. In turn, they have to charge growers higher prices for pollinating their crops.

Multiple stresses

Beekeepers’ biggest challenge today is probably Varroa destructor, an aptly named parasitic mite that we call the vampire of the bee world. Varroa feeds on hemolymph (the insect “blood”) of adult and developing honey bees. In the process it transmits pathogens and suppresses bees’ immune response. They are fairly large relative to bees: for perspective, imagine a parasite the size of a dinner plate feeding on you. And individual bees often are hosts to multiple mites.

Bee carrying two Varroa mites at right, next to a healthy bee. Image via Bernardo D. Niño

Beekeepers often must use miticides to control Varroa. Miticides are designed specifically to control mites, but some widely used products have been shown to have negative effects on bees, such as physical abnormalities, atypical behavior and increased mortality rates. Other currently used commercial miticides have lost or are rapidly losing their efficacy because Varroa are developing resistance to them.

Our laboratory is evaluating several novel biopesticides for effectiveness against Varroa and safety to bees. These products are mostly plant-based, and are designed to be used as part of an integrated pest management (IPM) plan. IPM emphasizes prevention and monitoring of pests and using a range of control methods to minimize negative effects on the environment.

Another potential strategy is breeding Varroa-resistant bees. Our research explores biological processes that regulate the honey bee queen mating process. To breed pathogen- and parasite-resistant honey bee stock, we often need to use
instrumental (artificial) insemination. We hope to help improve that process by understanding which seminal fluid proteins from male honey bees (drones) cause specific post-mating changes in queens, such as triggering egg-laying or contributing to queen bees’ longevity.

Honey bees also are exposed to viruses, bacterial diseases and fungi. For example, deformed wing virus (DWV) causes wing deformities that prevent bees from performing normal work functions such as foraging for food. Viruses have been implicated as an important factor in honey bee health declines, but we are just starting to understand how honey bees’ immune systems fight against them. We may be able to help strengthen bees’ immune responses by making diverse foraging resources, such as a variety of wildflowers, easily accessible.

Artificial insemination of a queen bee. Image via Kris Fricke/Flickr

Pesticide impacts

Questions about how pesticides affect honey bee health have spurred passionate debate. One key issue is whether neonicotinoids, a class of insecticides that affect insects’ nervous systems, are causing widespread bee deaths. The U.S. Environmental Protection Agency is currently reviewing possible risks to pollinators from neonicotinoids. Its first results, released earlier this year, found that the pesticide imidacloprid can have negative effects when it is present at concentrations above thresholds that can sometimes be found in certain crops, including citrus and cotton.

There are many gaps in our knowledge about neonicotinoids and other types of pesticides. We have little understanding about the impacts of pesticide combinations and how they affect developing bees and other pollinators. To fill some of those gaps, our lab is testing combinations of various agriculturally important pesticides on adult worker survival and queen development.

Studies show that when bees have access to optimal nutrition, they are better able to deal with diseases and pesticides. But intensive farming and urbanization have reduced the amount of readily available forage that bees need to thrive. Research labs at UC-Davis and elsewhere are analyzing what types of flowering plants provide the best supplemental forage for bees. Growers can support bees by planting these species near their crops.

Be bee-friendly

Many people who are not beekeepers or growers want to know how they can help. One easy step is to grow forage plants, especially varieties that bloom at different times during the year. For suggestions, see our Häagen-Dazs Honey Bee Haven Plant List.

Second, reduce your pesticide use for gardening and landscaping, and follow guidelines to reduce bee exposure. Finally, you can support local beekeepers by buying their honey. Ultimately, however, making our society more pollinator-friendly will likely require some drastic and long-term changes in our environmental and agricultural practices.

Elina L. Niño, Assistant Extension Apiculturist, University of California, Davis

This article was originally published on The Conversation. Read the original article.

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Working bee colonies. Image via Elina L. Nino

By Elina L. Niño, University of California, Davis

Beekeepers expect some of their bees to die off from season to season – typically, around 17 percent annually. But in recent years, losses have been more than twice as high.

Impacts of honey bee losses

Overwinter colony losses (Oct 1 – April 1) of managed honey bee colonies in the United States. Image via U.S. Department of Agriculture

Multiple stresses

Bee carrying two Varroa mites at right, next to a healthy bee. Image via Bernardo D. Niño

Artificial insemination of a queen bee. Image via Kris Fricke/Flickr

Pesticide impacts

Be bee-friendly

Elina L. Niño, Assistant Extension Apiculturist, University of California, Davis

This article was originally published on The Conversation. Read the original article.

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Are you prepared for a hurricane?

Hurricane Alex as seen on January 14, 2016, by the the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Terra satellite. Image via NASA Earth Observatory.

June 1 is the start of the Atlantic hurricane season each year. Now, early in the season, is the time to make a plan to stay safe if a hurricane approaches your area. If you live along the Gulf of Mexico or East Coast and don’t have a plan, I hope this post will prepare you. Sit down with your family and figure something out – now. Follow the links below to learn more:

How to create a supply kit

If a hurricane is imminent …

Find the Summer Triangle in June

Photo by EarthSky friend Susan Jensen in Odessa, Washington

June is here. In the N. Hemisphere, the days are long, the sun is at its most intense for the year, and the weather is warm, but not as warm as it will be later this summer. And the summer sky is with us, too. The famous asterism known as the Summer Triangle is ascending in the eastern sky on these June evenings.

The Summer Triangle is not a constellation. Instead, this pattern consists of three bright stars in three separate constellations – Deneb in the constellation Cygnus the Swan, Vega in the constellation Lyra the Harp, and Altair in the constellation Aquila the Eagle.

Learn to recognize the Summer Triangle asterism now, and you can watch it all summer as it shifts higher in the east, then finally appears high overhead in the late northern summer and early northern autumn sky.

How can you learn to recognize it? First, just go outside in early evening, face east, and try to notice three particularly bright stars. Those stars will probably be Vega, Deneb and Altair.

Look for these three bright stars in a triangle pattern, ascending in the east on June evenings.

The Summer Triangle, ascending in the east on June evenings.

An asterism isn’t the same thing as a constellation, by the way. Constellations generally come to us from ancient times. In the 1930s, the International Astronomical Union officially drew the boundaries of the 88 constellations we recognize today.

On the other hand, asterisms are whatever you want them to be. They’re just patterns on the sky’s dome. You can also make up your own asterisms, in much the same way you can recognize shapes in puffy clouds on a summer day.

But some asterisms are so obvious that they’re recognized around the world. The Summer Triangle – a large triangular pattern consisting of three bright stars in three different constellations – is one of these.

So watch for the summer triangle. On June evenings, you’ll find it in the east at nightfall. It swings high overhead in the wee hours after midnight and sits rather high in the west at daybreak.

View larger. | EarthSky friend on Google+ – Scott MacNeill of Exit Pupil Creative Workshop – captured this photo of the Summer Triangle, constellation Hercules, bright Milky Way, and the bright red star Antares among more. Thank you, Scott!

Bottom line: It’s nearly summer in the Northern Hemisphere. Look for the Summer Triangle – three bright stars in three separate constellations – ascending in the east on June evenings.

A Chinese perspective on summer

from EarthSky http://ift.tt/1WwpuUK

Photo by EarthSky friend Susan Jensen in Odessa, Washington

How can you learn to recognize it? First, just go outside in early evening, face east, and try to notice three particularly bright stars. Those stars will probably be Vega, Deneb and Altair.

The Summer Triangle, ascending in the east on June evenings.

So watch for the summer triangle. On June evenings, you’ll find it in the east at nightfall. It swings high overhead in the wee hours after midnight and sits rather high in the west at daybreak.

Bottom line: It’s nearly summer in the Northern Hemisphere. Look for the Summer Triangle – three bright stars in three separate constellations – ascending in the east on June evenings.

A Chinese perspective on summer

from EarthSky http://ift.tt/1WwpuUK

The quackery that is “naturopathic oncology” [Respectful Insolence]

With a bill to license naturopaths (HB 4531) wending its way through the Michigan legislature supported by supplement manufacturers, its current status being in consideration by the full House of Representatives, periodically I feel the need to provide ammunition to the bill’s opponents, because we need to protect the patients in the state of Michigan from the naturopathic quackery that would be unleashed if this bill were to be passed into law.

If there is one area that naturopaths have been invading with a vengeance and even gaining enough seeming legitimacy to propose what they risibly refer to as “evidence-based guidelines,” it’s oncology. Many are the times I’ve written about how much naturopaths, who use the abbreviation “ND” (which from my perspective means “not a doctors”) and have formed their own specialty of “naturopathic oncology,” signified by FABNO (which I like to refer to as, “FAB? NO!”) subject patients to. Not surprisingly, one organization that’s really embraced naturopathic oncology is the Cancer Treatment Centers of America, a for-profit hospital chain that’s made its name advertising the “integration” of quackery with real medicine, known as “integrative medicine.” Depressingly, the Society for Integrative Oncology (SIO), an organization supporting the integration of “complementary and alternative medicine” (CAM) modalities (i.e., quackery) with real oncology, seems to accept naturopathy as a valid specialty, as two naturopaths were among the authors of the aforementioned SIO guidelines for the integrative treatment of breast cancer. As I found out, their naivete is profound, as evidenced by the SIO’s surprised and indignant reaction to my dwelling on homeopathy in my critique of integrative oncology. The SIO responded by accusing me of dwelling on the modalities with the “weakest evidence bases” (like homeopathy), apparently unaware that naturopathic training includes a lot of homeopathy and the naturopathic licensing examination (the NPLEX) has a whole section on homeopathy, and that one of the naturopaths who wrote the SIO guidelines for breast cancer was running a clinical trial of homeopathy at the time. Heck, an ex-naturopath has even revealed a scary practice question for the exam. That’s not even counting what naturopathic oncologists say when they think no one’s listening and the quackery to which they subject their patients.

Naturopathic oncologists even brag about it. They’re proud of it, so much so that they’re more than happy to publish what they do, as they did in this article for Integrative Cancer Therapies entitled Breast Cancer Integrative Oncology Care and Its Costs. But wait. I bet you’re thinking, “But, Orac, integrative oncology and naturopathic oncology are not the same things.” Right you are! Two of the authors of this paper are FABNOs, and they declare in the abstract, “Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO),” and state specifically that the purpose of this study is to “To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians.” So, yes, this paper is about naturopathic oncology more than “integrative” oncology. Sure, there’s a fair amount of overlap, but not all integrative oncology is naturopathic oncology, although all naturopathic oncology is integrative oncology; that is, if you accept the nomenclature, which I do not.

Nor do I accept this premise of the study:

Because of their training and their licensed scope of practice, ND, FABNO are among those able to offer comprehensive whole-person integrative cancer care. For this reason, IO clinics directed by ND, FABNOs are a source of high-quality data for describing these therapies and their costs and measuring clinical outcomes. IO clinics are a rich source of data for cost-effectiveness research. Such care consists of a whole-person-oriented approach, including a variety of evidence-based complementary and integrative medicine practices that include a diversity of nutrient and botanical natural products, diet and exercise plans, acupuncture, hyperthermia, and mind-body medicine. Many of these therapies are based on clinical evi- dence. Although cost and cost-benefit analyses of CAM and integrated health care have been conducted5, and CAM use among breast cancer patients described, neither IO care nor its costs as it is practiced in community settings has been well described. Description of IO medical services is a required step toward evaluating its impact on disease-free and overall survival in breast cancer as well as measuring its cost-effectiveness.

Of course, to measure cost-effectivness, there has to be effectiveness to be begin with. With the vast majority of naturopathic treatments, the evidence of efficacy is sketchy at best, usually nonexistent, or at worst contradictory to any claims of efficacy. In any case, there were 324 patients with breast cancer treated at one of six naturopathic oncology clinics in the Seattle area, who agreed to be enrolled in a five year observational outcomes study. Of course, given that there’s no control group and any outcomes observed would have to be compared to historical controls, this trial design virtually guarantees that naturopathy won’t be embarrassed by poor outcomes, mainly because it’s likely that women attracted would be a select group. Indeed, I note that only 3.7% of the participants had stage IV disease when they sought out naturopathic treatment, and only 9.9% were stage III. Thus, the vast majority of the subjects had early stage disease. In fairness, though, I do note that only 6.2% of the patients had stage 0 disease (ductal carcinoma in situ, or DCIS, which is premalignant and noninvasive), a lower percentage than at most cancer centers.

Table 5 is the money table. It shows the types of treatments received by the subjects in the cohort who had at least two office visits. These included, predictably, a whole boatload of supplements, such as Coriolus, also known as Yun Zhi, Turkey tail, or Trametes versicolor, which an astonishing 62.7% of the patients received. I was unfamiliar with this particular herbal medicine. Basically, it’s a mushroom used in traditional Chinese medicine as a tonic. There are studies that suggest antitumor activity for some cancers, but the results in breast cancer have been unimpressive. The rest of the supplements included the usual suspects, such as melatonin, vitamin D3, digestive pancreatic enzymes, green tea, seaweed poultice, black cohosh, and many others. About 12.3% of patients received various injectables:

Of the 287 women described in Tables 4 to 6, 76 (26%) were prescribed some type of injectable therapy. Injectable IO therapies included subcutaneous injections of mistletoe (Viscum album) and a diversity of parenteral therapies that included vitamin B complex intramuscularly (12%), IV high-dose ascorbate (12%), IV artemisinin (7%), and IV nutrition and hydration (4%). Injectable therapies were used almost exclusively in stage 4 breast cancer patients (data not shown).

Other than hydration, the vast majority of these treatments range from quackery to unproven. Worse, they’re used for the patients who can’t be cured and would be expected to be most desperate. I’ve discussed high dose vitamin C/ascorbate on many occasions. It almost certainly doesn’t work for any cancer, and even if it does it requires incredibly high doses for incredibly underwhelming effects. As for nutrition, which is supposed to be the strong point of naturopaths, who castigate MDs every chance they get for supposedly not knowing much about nutrition and not emphasizing it enough in their treatments, this is what the naturopaths provided:

Whereas some patients (20%) were referred for nutritional counseling by a certified nutritionist, most received dietary advice from the IO physician within the visit. Dietary recommendations included increased green tea as a drink (24%), increased vegetables (17%), broth fast (16%), increased protein (13%), increased water (15%), reduced simple sugars (8%), increased fish (7%), and decreased mammalian fat (5%).

None of these are likely to be harmful, other than a broth fast, which is not a great idea for a cancer patient undergoing chemotherapy. Be that as it may, there were other recommendations that are less helpful, such as juice fasts, eliminating dairy, eliminating wheat, and the like. Of course, one can’t help but note that the 20% referred to nutritionists were almost certainly referred to woo nutritionists, as real nutritional counselors practicing evidence-based nutrition counseling are called dieticians.

In any case, the remainder of the modalities examined were of the “mind-body”variety, including massage, meditation, unspecified “mind-body” therapy, and qi gong, which aren’t likely to be harmful, but 6.8% were also referred for the quackery known as craniosacral therapy.

Now let’s look at the cost:

The direct costs of care include medical visits (naturopathic oncology consultation and mind-body medicine visits), procedures (acupuncture), and pharmacy. Pharmacy includes nutritional and botanical medicines administered orally, intravenously, subcutaneously, intramuscularly, or topically. Yearly cost for office visits ranged from $512/year to $1084/year. Stage 3 women had the most visits and the highest visit costs compared with women at other stages of breast cancer at diagnosis.

That doesn’t sound so bad. However, this does:

We asked the ND, FABNOs to describe an ideal core protocol for IO care for each stage and type of breast cancer. We then calculated the cost of IO pharmacy for 1 year of care for a stage 4 cancer patient. Table 8 presents an IO core therapy program for 1 year of treatment for a stage 4 breast cancer patient. Total cost of the medicines used in this treatment plan for 1 year is approximately $27137. Parenteral therapies were the most costly of IO treatments, and few stage 4 breast cancer patients completed such an idealized treatment. Total costs (visits and IO pharmacy and procedures) of 1 year of IO treatment for a women with progress- ing stage 4 breast cancer is approximately $31662/year. ND, FABNO visits cost approximately $4525/year (see Table 3). Office visits are reimbursed by medical insurance providers, including Medicaid but not Medicare.

Naturopaths will say that chemotherapy costs more, and that much is true. The difference, however, is that chemotherapy is an effective adjuvant therapy for early stage breast cancer and for stage III, while it can, when judiciously used, be a good palliative treatment for stage IV breast cancer. Nothing in the list of intravenous treatments for breast cancer listed in Table 8 is proven, either as an adjuvant therapy or palliative therapy. Certainly nothing in Table 8 is curative.

So how does one justify spending $30,000 a year on intravenous therapies that do nothing? The funny thing about this article is that it doesn’t even try. It is simply an observational study, which reported what treatments were received by this cohort of 324 breast cancer patients and how much it cost. The naturopathic oncologists and other authors of the paper seem to have simply assumed that these treatments are worthwhile and effective. They do not question them. From my perspective, doing studies like this is totally putting the cart before the horse. Efficacy should be established first, and then utilization and cost are worth studying. In the world of naturopathic oncology, it doesn’t matter if the treatments being studied work or not.

I’d just like to leave with a question and an answer. The question is: Who funded this study? The answer: The National Center for Complementary and Integrative Health. Yes, the NCCIH continues to waste taxpayer money on pointless studies like this.

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Nor do I accept this premise of the study:

Because of their training and their licensed scope of practice, ND, FABNO are among those able to offer comprehensive whole-person integrative cancer care. For this reason, IO clinics directed by ND, FABNOs are a source of high-quality data for describing these therapies and their costs and measuring clinical outcomes. IO clinics are a rich source of data for cost-effectiveness research. Such care consists of a whole-person-oriented approach, including a variety of evidence-based complementary and integrative medicine practices that include a diversity of nutrient and botanical natural products, diet and exercise plans, acupuncture, hyperthermia, and mind-body medicine. Many of these therapies are based on clinical evi- dence. Although cost and cost-benefit analyses of CAM and integrated health care have been conducted5, and CAM use among breast cancer patients described, neither IO care nor its costs as it is practiced in community settings has been well described. Description of IO medical services is a required step toward evaluating its impact on disease-free and overall survival in breast cancer as well as measuring its cost-effectiveness.

Of the 287 women described in Tables 4 to 6, 76 (26%) were prescribed some type of injectable therapy. Injectable IO therapies included subcutaneous injections of mistletoe (Viscum album) and a diversity of parenteral therapies that included vitamin B complex intramuscularly (12%), IV high-dose ascorbate (12%), IV artemisinin (7%), and IV nutrition and hydration (4%). Injectable therapies were used almost exclusively in stage 4 breast cancer patients (data not shown).

Whereas some patients (20%) were referred for nutritional counseling by a certified nutritionist, most received dietary advice from the IO physician within the visit. Dietary recommendations included increased green tea as a drink (24%), increased vegetables (17%), broth fast (16%), increased protein (13%), increased water (15%), reduced simple sugars (8%), increased fish (7%), and decreased mammalian fat (5%).

Now let’s look at the cost:

The direct costs of care include medical visits (naturopathic oncology consultation and mind-body medicine visits), procedures (acupuncture), and pharmacy. Pharmacy includes nutritional and botanical medicines administered orally, intravenously, subcutaneously, intramuscularly, or topically. Yearly cost for office visits ranged from $512/year to $1084/year. Stage 3 women had the most visits and the highest visit costs compared with women at other stages of breast cancer at diagnosis.

That doesn’t sound so bad. However, this does:

We asked the ND, FABNOs to describe an ideal core protocol for IO care for each stage and type of breast cancer. We then calculated the cost of IO pharmacy for 1 year of care for a stage 4 cancer patient. Table 8 presents an IO core therapy program for 1 year of treatment for a stage 4 breast cancer patient. Total cost of the medicines used in this treatment plan for 1 year is approximately $27137. Parenteral therapies were the most costly of IO treatments, and few stage 4 breast cancer patients completed such an idealized treatment. Total costs (visits and IO pharmacy and procedures) of 1 year of IO treatment for a women with progress- ing stage 4 breast cancer is approximately $31662/year. ND, FABNO visits cost approximately $4525/year (see Table 3). Office visits are reimbursed by medical insurance providers, including Medicaid but not Medicare.

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International Space Station over Tenerife

View larger. | Photo by Roberto Porto.

Roberto Porto posted this photo at EarthSky Facebook in late May, 2016. It’s a pass of International Space Station (ISS) over Tenerife, one of Spain’s Canary Islands. The large plant is a tajinaste rojo, an endemic plant of this island. Roberto said the tajinaste plants typically blossom in May on this island, and he said some grow as high as 10 feet (3 meters). Of his photo, he wrote:

In this picture the startrail of a bright ISS passes in perpendicular direction to the trails of the rising stars.

The tajinaste is illuminated by the traffic lights of the many cars that drive late in the park to take pictures of these fantastic plants in Teide National Park.

I used a Nikon D5300, with Nikkor fisheye … to take 40 exposures with changing exposure times as the natural light was changing.

Then I used starstack software and ligthroom CC for final adjustments.

Thank you, Roberto!

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View larger. | Photo by Roberto Porto.

In this picture the startrail of a bright ISS passes in perpendicular direction to the trails of the rising stars.

The tajinaste is illuminated by the traffic lights of the many cars that drive late in the park to take pictures of these fantastic plants in Teide National Park.

I used a Nikon D5300, with Nikkor fisheye … to take 40 exposures with changing exposure times as the natural light was changing.

Then I used starstack software and ligthroom CC for final adjustments.

Thank you, Roberto!

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Watch these 3 planets on June evenings

Tonight – June 1, 2016 – and throughout this month, watch for three planets in the evening sky. Mars, Jupiter and Saturn adorn the June 2016 sky, all month long.

Look first for the king planet Jupiter, the brightest starlike object in the June evening sky. It beams quite high up at dusk and nightfall. From northerly latitudes in the Northern Hemisphere, Jupiter appears in the southwest sky at nightfall. From southerly latitudes in the Southern Hemisphere, Jupiter is found in the northern sky as darkness falls.

For all of us, Jupiter sets in the west quite late, after the midnight hour.

As seen from around the world, Mars and Saturn sit very low the southeast sky at nightfall. If you have obstructions along your eastern horizon, you might have to wait an hour or so after darkness falls before seeing these two worlds shining quite close together.

Fortunately, you have almost all night long to view Mars and Saturn, which travel westward across the night sky from dusk until dawn.

Three planets light up the June 2016 evening all month long. The green line depicts the ecliptic – the sun’s yearly path in front of the constellations of the zodiac.

You can distinguish Mars from Saturn because Mars is, by far, the more brilliant of these two bright worlds. Mars ranks as the second-brightest starlike object to light up the evening sky, after Jupiter.

Although you could possibly confuse the star Antares for Saturn, you can differentiate Saturn from Antares by color. Antares displays a ruddy hue while Saturn appears golden.

Best of all, Mars was closest to Earth for the year on May 30, and Saturn will be at its closest on June 3, so these two worlds will be especially bright in the June evening sky.

The other two bright planets – Mercury and Venus – are nowhere to be found in the June 2016 evening sky. If you live in the Southern Hemisphere, you can view Mercury in the east before morning dawn for the next several weeks. In the Northern Hemisphere, Mercury sits low in the glare of twilight and is hard to spot in the June morning sky.

The slender waning crescent moon and Mercury, from the perspective of middle latitudes in the Northern Hemisphere. The Southern Hemisphere enjoys a much better view of Mercury in the morning sky because Mercury rises before morning dawn in that part of the world.

In an ironic twist, Venus – the brightest planet of them all – is the only bright planet (Mercury, Venus, Mars, Jupiter and Saturn) that can’t be seen at all this month. Venus hides in the glare of the sun all month long. Its superior conjunction – when it’s on the far side of the sun from Earth for this orbit – occurs on June 6, 2016. Venus will actually pass directly behind the sun during this particular superior conjunction, exactly four years after Venus swung directly in front of the sun’s disk at inferior conjunction on June 6, 2012 – and then 8 years before that, swung directly in front of the sun on June 8, 2004.

Diagram of Venus’ orbit around the sun

Venus passes in between the Earth and sun at inferior conjunction

Venus phase cycle 1900-2050

Venus is well known for its 8-year cycles. The sun last covered over (occulted) Venus at superior conjunction some 8 years ago, on June 9, 2008, and it will do so again some 8 years from now, on June 4, 2024. An occultation of Venus by the sun at superior conjunction happens much more frequently than a transit of Venus at inferior conjunction. The next transit of Venus won’t happen until December 11, 2117.

By the way, Venus has five superior conjunctions in a period of 8 years, and five inferior conjunctions in a period of 8 years. In other words, one complete cycle from superior (or inferior) conjunction to the following superior (or inferior) conjunction lasts 1.6 (8/5) years.

In the meantime, while Venus is absent from the June 2016 nighttime sky, enjoy the presence of three planets – Jupiter, Mars and Saturn – as soon as darkness falls all month long.

Bottom line: There three bright planets – Jupiter, Mars and Saturn – light up the June 2016 evenings, throughout the month.

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