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F1000Research ◽  
2022 ◽  
Vol 11 ◽  
pp. 20
Author(s):  
Narisara Phansila ◽  
Chaiyasit Sittiwet ◽  
Ranee Wongkongdech

Background: Cholangiocarcinoma (CCA) has a poor prognosis and is a major cause of mortality and suffering in Thailand’s Northeastern (Isaan) Region.   Methods: This prospective cohort study aimed to compare the health-related quality of life (HRQoL) among 72 newly diagnosed CCA patients; 42 patients who received cannabis treatment (CT) and 30 patients who received a standard palliative care treatment (ST). The study was carried out between 1st September 2019 to 31st October 2020.  Data were collected from patients from oncology clinics of six hospitals in five provinces of northeast Thailand. The HRQoL was measured at baseline, and at 2 and 4 months after diagnosis by the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life questionnaires QLQ-C30, and QLQ-BIL21. The Mann-Whitney U-test was performed to compare quality of life scores between the two patient groups and Wilcoxon signed rank test was performed to compare within groups QoL scores at pre-treatment, and 2 and 4 month follow-ups. Results: Global health status and functional scales, for both groups were high at pre-treatment. At 2 and 4 month follow-up, CT group patients had consistent statistically significantly better Palliative Performance Scale (PPS), and QoL scores, and many symptom scores than the ST group.   Conclusions: Medicinal cannabis may increase QoL for advanced CCA patients. Our findings support the importance of early access to palliative cannabis care clinic before the terminal and acceleration phase close to death.


Plants ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 140
Author(s):  
Danilo Crispim Massuela ◽  
Jens Hartung ◽  
Sebastian Munz ◽  
Federico Erpenbach ◽  
Simone Graeff-Hönninger

The definition of optimum harvest and pruning interventions are important factors varying inflorescence yield and cannabinoid composition. This study investigated the impact of (i) harvest time (HT) and (ii) pruning techniques (PT) on plant biomass accumulation, CBD and CBDA-concentrations and total CBD yield of a chemotype III medical cannabis genotype under indoor cultivation. The experiment consisted of four HTs between 5 and 11 weeks of flowering and three PTs-apical cut (T); removal of side shoots (L) and control (C), not pruned plants. Results showed that inflorescence dry weight increased continuously, while the total CBD concentration did not differ significantly over time. For the studied genotype, optimum harvest time defined by highest total CBD yield was found at 9 weeks of flowering. Total CBD-concentration of inflorescences in different fractions of the plant’s height was significantly higher in the top (9.9%) in comparison with mid (8.2%) and low (7.7%) fractions. The T plants produced significantly higher dry weight of inflorescences and leaves than L and C. Total CBD yield of inflorescences for PTs were significantly different among pruned groups, but do not differ from the control group. However, a trend for higher yields was observed (T > C > L).


2021 ◽  
Author(s):  
Sedigheh Khademi Habibabadi ◽  
Christine Hallinan ◽  
Yvonne Bonomo ◽  
Mike Conway

BACKGROUND Medicinal cannabis is increasingly being used for a variety of physical and mental health conditions. Social media and online health platforms provide a valuable real time and cost-effective surveillance resource for individuals who use cannabis for medicinal purposes. This is especially important considering evidence for the optimal use of medicinal cannabis is still emerging. Despite the online marketing of medicinal cannabis to consumers, currently, there is no robust, regulatory framework to measure clinical health benefit or individual experience of adverse events. OBJECTIVE We reviewed research approaches and methodologies of studies that utilize online user-generated text to study the use of cannabis as a medicine. METHODS We conducted the review using PRISMA guidelines, searching Medline, Scopus, Web of Science and Embase databases from their respective inceptions until May 2021. Studies were included if they aimed to understand online user-generated text related to health conditions where cannabis is used as a medicine, or where health was mentioned in general cannabis conversations. RESULTS Thirty-eight articles were included in the review. Of these, Twitter was used three times more than other computer-generated sources including Reddit, online forums, GoFundMe, YouTube, and Google Trends. Analytic methods included sentiment assessment, thematic analysis (manual and automatic), social network analysis, and geographic analysis. CONCLUSIONS This study is the first to systematically review techniques utilized by research on consumer-generated text for understanding cannabis as a medicine. It is increasingly evident that consumer-generated data offers opportunities for a greater understanding of individual behavior, population health outcomes. Yet research using this data has some limitations that include difficulties in establishing sample representativeness, and a lack of methodological best practice. To address these, publicly available de-identified annotated data sources; determination of posts origins (organizations, bots, power users, or ordinary individuals); and more powerful analytical techniques can be employed.


2021 ◽  
Author(s):  
Narisara Phansila ◽  
Ranee Wongkongdech ◽  
Chaiyasit Sittiwech

Abstract Introduction:Cholangiocarcinoma (CCA) incidence in Northeastern Thailand is very high, and a major cause of mortality CCA patients typically have a poor prognosis and short-term survival rate, due to late-stage diagnosis. . Thailand is , the first Southeast Asian country to approve medicinal cannabis treatment, especially for palliative care with advanced cancer patients..Patients and methods:A retrospectively cohort comparative study of , survival rates among 491 newly diagnosed advanced CCA patients was carried out between September 2019 and 30 July, 2021; (404 patients in a standard palliative care pain management treatment group (ST), and 87 in a medicinal cannabis treatment group (CT). CCA Patients were recruited from 4 tertiary hospitals and 2 secondary hospitals in five provinces of Northeast Thailand. The cumulative survival rates were calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression.Results:For ST patients there was a total follow-up time of 790 person-months, with a , mortality rate of 48.35/ 100 person-years. For CT patients the total follow-up time was 476 person-months, with mortality rate of 10.9./ 100 person-years. The median survival time after registration at a palliative clinic was 0.83 months (95%CI: 0.71-0.95) for ST and 5.66 months (95%CI: 1.94-9.38) for CT None of the demographic factors were significantly associated with survival time for either ST or CT. Comparing ST with CT, there was a difference statistically significant in age, sex, cancer treatment and period of diagnosis with advanced CCA,HCC to registration factors (p-value<0.05)Conclusions:The medicinal cannabis group had an increase post CCA diagnosis survival rate.. Our findings support the importance of early access to palliative cannabis clinic before caner’s terminal and accelerating phase close to death.


2021 ◽  
Author(s):  
◽  
Leo Mercer

<p>This research explores landowner preferences for various land use options suitable for Māori land in Te Tairāwhiti, on the East Coast of the North Island of Aotearoa-New Zealand (henceforth Aotearoa). A particular emphasis is placed on the applicability and feasibility of native forest carbon farming within the New Zealand Emissions Trading Scheme (NZ ETS) and opportunities, barriers and risks associated with this land use. Alongside this focus, is a wider investigation into the socio-cultural, environmental and economic co-benefits Māori landowners associate with traditional and emerging land uses in Te Tairāwhiti. This study uses a transformative research approach that is rooted in the spirit of kaupapa Māori research.  Some 90 percent of Māori land in Te Tairāwhiti has severe limitations which restrict land use options to plantation forestry or pastoral farming for most landowners. A response to these limitations, and a land development option favoured by government agencies, and the academy, is for ‘unproductive’ Māori land to be retired into permanent native forest carbon sinks – a solution frequently proffered as a positive means to address national climate change commitments and local environmental and socioeconomic issues. Whilst these objectives, and the land use preferences of Māori seemingly converge, the wider history of land loss and alienation influences perceptions of fairness and equity for Māori landowners who may feel pressured by the lack of attractive land use options to establish permanent carbon sinks, which can effectively constrain land use options for future generations.  Through case study analysis of a Māori sheep and beef farming incorporation participating in the NZ ETS, this study suggests an economic case for carbon farming in Te Tairāwhiti. However, institutional and socio-cultural barriers hinder the participation of Māori landowners in the NZ ETS. The second focus of this thesis has been an investigation into how native forest carbon farming is viewed when compared to other novel and existing land uses suitable for Māori land in the Waiapu catchment (a highly erodible catchment in Te Tairāwhiti). Interviews with key informants were employed to curate a set of land use options for Māori landowners to appraise, using multi-criteria analysis, at two wānanga. Four land use models were created for appraisal by 16 Māori landowner participants. The strength of association between a co-benefit and a land use was collectively deliberated upon in each of these models, and ratings were assigned to reflect this association. These ratings have aided in assessing the wider value of land uses for Māori in the region.   The results from this research indicate an overwhelming preference for native forests when compared to other suitable land uses. Native forests are most closely associated with environmental co-benefits (erosion control, water quality, biodiversity and withstanding and limiting climate change) and social and cultural co-benefits (skills development, employment, reconnecting with the land, and self-determination/autonomy). The strong performance of native forestry stands in stark contrast with other land uses under consideration such as exotic forestry (Pinus radiata within the study scenario) and sheep and beef farming which occupy the majority of ‘productive’ land in Te Tairāwhiti. Exotic forestry and sheep and beef farming are associated with few benefits beyond employment and skills development. There is also a clear perception in the quantitative and qualitative data that these uses disconnect Māori landowners from their land and reduce the ability of communities to be self-reliant.   Interestingly, other novel land uses under consideration such as perennial horticulture (including blueberries, macadamia nuts and apples), medicinal cannabis and hemp, and hunting and tourism were also valued more than exotic forestry and sheep and beef farming. These results indicate that existing land uses, sometimes implemented without express input from local communities, are now the least preferred land uses. In addition, novel and untested land uses such as medicinal cannabis and hemp, which do not exist at any scale in the region, are preferred over existing uses - even when there is scant evidence of success at any scale.   These results push back at the prevailing Pākehā dominated orthodoxy, which has existed from the early days of colonisation and holds that monoculture land uses, for profit above all else, are best suited to the land and the people. It is clear, from this study, that Māori landowners wish to move back to a vibrant multi-faceted land use regime – exemplified by diversity over homogeneity – that characterised the pre-colonisation Māori economy. This research accordingly introduces and explores a value articulating process that increases understanding of the aspirations and values of Māori landowners, and can assist Māori in progressing their land use futures.</p>


2021 ◽  
Author(s):  
◽  
Leo Mercer

<p>This research explores landowner preferences for various land use options suitable for Māori land in Te Tairāwhiti, on the East Coast of the North Island of Aotearoa-New Zealand (henceforth Aotearoa). A particular emphasis is placed on the applicability and feasibility of native forest carbon farming within the New Zealand Emissions Trading Scheme (NZ ETS) and opportunities, barriers and risks associated with this land use. Alongside this focus, is a wider investigation into the socio-cultural, environmental and economic co-benefits Māori landowners associate with traditional and emerging land uses in Te Tairāwhiti. This study uses a transformative research approach that is rooted in the spirit of kaupapa Māori research.  Some 90 percent of Māori land in Te Tairāwhiti has severe limitations which restrict land use options to plantation forestry or pastoral farming for most landowners. A response to these limitations, and a land development option favoured by government agencies, and the academy, is for ‘unproductive’ Māori land to be retired into permanent native forest carbon sinks – a solution frequently proffered as a positive means to address national climate change commitments and local environmental and socioeconomic issues. Whilst these objectives, and the land use preferences of Māori seemingly converge, the wider history of land loss and alienation influences perceptions of fairness and equity for Māori landowners who may feel pressured by the lack of attractive land use options to establish permanent carbon sinks, which can effectively constrain land use options for future generations.  Through case study analysis of a Māori sheep and beef farming incorporation participating in the NZ ETS, this study suggests an economic case for carbon farming in Te Tairāwhiti. However, institutional and socio-cultural barriers hinder the participation of Māori landowners in the NZ ETS. The second focus of this thesis has been an investigation into how native forest carbon farming is viewed when compared to other novel and existing land uses suitable for Māori land in the Waiapu catchment (a highly erodible catchment in Te Tairāwhiti). Interviews with key informants were employed to curate a set of land use options for Māori landowners to appraise, using multi-criteria analysis, at two wānanga. Four land use models were created for appraisal by 16 Māori landowner participants. The strength of association between a co-benefit and a land use was collectively deliberated upon in each of these models, and ratings were assigned to reflect this association. These ratings have aided in assessing the wider value of land uses for Māori in the region.   The results from this research indicate an overwhelming preference for native forests when compared to other suitable land uses. Native forests are most closely associated with environmental co-benefits (erosion control, water quality, biodiversity and withstanding and limiting climate change) and social and cultural co-benefits (skills development, employment, reconnecting with the land, and self-determination/autonomy). The strong performance of native forestry stands in stark contrast with other land uses under consideration such as exotic forestry (Pinus radiata within the study scenario) and sheep and beef farming which occupy the majority of ‘productive’ land in Te Tairāwhiti. Exotic forestry and sheep and beef farming are associated with few benefits beyond employment and skills development. There is also a clear perception in the quantitative and qualitative data that these uses disconnect Māori landowners from their land and reduce the ability of communities to be self-reliant.   Interestingly, other novel land uses under consideration such as perennial horticulture (including blueberries, macadamia nuts and apples), medicinal cannabis and hemp, and hunting and tourism were also valued more than exotic forestry and sheep and beef farming. These results indicate that existing land uses, sometimes implemented without express input from local communities, are now the least preferred land uses. In addition, novel and untested land uses such as medicinal cannabis and hemp, which do not exist at any scale in the region, are preferred over existing uses - even when there is scant evidence of success at any scale.   These results push back at the prevailing Pākehā dominated orthodoxy, which has existed from the early days of colonisation and holds that monoculture land uses, for profit above all else, are best suited to the land and the people. It is clear, from this study, that Māori landowners wish to move back to a vibrant multi-faceted land use regime – exemplified by diversity over homogeneity – that characterised the pre-colonisation Māori economy. This research accordingly introduces and explores a value articulating process that increases understanding of the aspirations and values of Māori landowners, and can assist Māori in progressing their land use futures.</p>


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