A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings

The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies. This randomized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aimed to optimize patients' ability to manage pain. One week post-intervention, patients receiving the pain management intervention (PMI) had a significantly greater increase in self-reported pain knowledge, perceived control over pain, and number of pain treatments recommended. Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain, concerns about addiction and side effects, being a "good" patient, and tolerance to pain relieving medication. The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes, which can potentially act as barriers to effective pain management. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Intra-specific variation for host plant use in Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae): Implications for management

The polyphagous moth Helicoverpa armigera (Hubner) is one of the world's most important agricultural pests. A number of existing approaches and future designs for management of H. armigera rely on the assumption that moths do not exhibit either genetically and/or non-genetically based variation for host plant utilization. We review recent empirical evidence demonstrating that both these forms of variation influence host plant use in this moth. The significance of this variation in H. armigera in relation to current and future pest management strategies is examined. We provide recommendations on future research needs and directions for sustainable management of H. armigera, under a framework that includes consideration of intra.-specific variation for host use relevant in this and other similar pest species. (C) 2004 Elsevier Ltd. All rights reserved.

Cleaner fish use tactile dancing behavior as a preconflict management strategy

The most commonly asked question about cooperative interactions is how they are maintained when cheating is theoretically more profitable [1]. In cleaning interactions, where cleaners remove parasites from apparently cooperating clients, the classical question asked is why cleaner fish can clean piscivorous client fish without being eaten, a problem Trivers [2] used to explain reciprocal altruism. Trivers [2] suggested that predators refrain from eating cleaners only when the repeated removal of parasites by a particular cleaner results in a greater benefit than eating the cleaner. Although several theoretical models have examined cheating behavior in clients [3,4], no empirical tests have been done (but see Darcy [5]). It has been observed that cleaners are susceptible to predation [6, 7]. Thus, cleaners should have evolved strategies to avoid conflict or being eaten. In primates, conflicts are often resolved with conflict or preconflict management behavior [8]. Here, I show that cleaner fish tactically stimulate clients while swimming in an oscillating dancing manner (tactile dancing) more when exposed to hungry piscivorous clients than satiated ones, regardless of the client's parasite load. Tactile dancing thus may function as a preconflict management strategy that enables cleaner fish to avoid conflict with potentially dangerous clients.

Introduced mammals in Australian rangelands: Future threats and the role of monitoring programmes in management strategies

In the present paper, we have provided an initial assessment of the current and future threats to biodiversity posed by introduced mammals (predators and herbivores) inhabiting the Australian rangelands, exploring trends in populations and options for management. Notably, rabbits have declined in recent years in the wake of rabbit haemorrhagic disease, populations of feral camels have increased dramatically and foxes appear to have moved northwards, thereby threatening native fauna within an expanded range. Following on, we developed a framework for monitoring the impacts of introduced mammals in the Australian rangelands. In doing so, we considered the key issues that needed to be considered in designing a monitoring programme for this purpose and critically evaluated the role of monitoring in pest animal management. Finally we have provided a brief inventory of current best-practice methods of estimating the abundance of introduced mammal populations in the Australian rangelands with some comments on new approaches and their potential applications.

Population monitoring for kangaroo management

In wildlife management, the program of monitoring will depend on the management objective. If the objective is damage mitigation, then ideally it is damage that should be monitored. Alternatively, population size (N) can be used as a surrogate for damage, but the relationship between N and damage obviously needs to be known. If the management objective is a sustainable harvest, then the system of monitoring will depend on the harvesting strategy. In general, the harvest strategy in all states has been to offer a quota that is a constant proportion of population size. This strategy has a number of advantages over alternative strategies, including a low risk of over- or underharvest in a stochastic environment, simplicity, robustness to bias in population estimates and allowing harvest policy to be proactive rather than reactive. However, the strategy requires an estimate of absolute population size that needs to be made regularly for a fluctuating population. Trends in population size and in various harvest statistics, while of interest, are secondary. This explains the large research effort in further developing accurate estimation methods for kangaroo populations. Direct monitoring on a large scale is costly. Aerial surveys are conducted annually at best, and precision of population estimates declines with the area over which estimates are made. Management at a fine scale (temporal or spatial) therefore requires other monitoring tools. Indirect monitoring through harvest statistics and habitat models, that include rainfall or a greenness index from satellite imagery, may prove useful.

Uncertainty during organizational change: Types, consequences, and management strategies

This research tested a model that classifies change uncertainty into three interrelated types: strategic, structural, and job-related. We predicted that control would mediate the effects of job-related uncertainty upon psychological strain, and that management communication and participation in decision-making (PDM) would reduce uncertainty and increase feelings of control. The model was tested in a public sector organization and the results supported it. Control was found to mediate the effects of job-related uncertainty upon psychological strain. Management communication was negatively related to strategic uncertainty, whereas PDM was negatively related to structural and job-related uncertainty, suggesting different mechanisms to deal with the types of uncertainty during change. Finally, PDM was positively associated with feelings of control and negatively associated with psychological strain. These results suggest that PDM can short-circuit the damaging effects of uncertainty by allowing employees to have a say in change related organizational affairs, thereby instilling a sense of control over their circumstances.

Searching oligo sets of human chromosome 12 using evolutionary strategies

DNA Microarray is a powerful tool to measure the level of a mixed population of nucleic acids at one time, which has great impact in many aspects of life sciences research. In order to distinguish nucleic acids with very similar composition by hybridization, it is necessary to design microarray probes with high specificities and sensitivities. Highly specific probes correspond to probes having unique DNA sequences; whereas highly sensitive probes correspond to those with melting temperature within a desired range and having no secondary structure. The selection of these probes from a set of functional DNA sequences (exons) constitutes a computationally expensive discrete non-linear search problem. We delegate the search task to a simple yet effective Evolution Strategy algorithm. The computational efficiency is also greatly improved by making use of an available bioinformatics tool.

Nonalcoholic fatty liver disease: is all the fat bad?

Nonalcoholic fatty liver disease is now a major cause of liver disease in developed countries, largely as a result of an epidemic of obesity, diabetes and sedentary lifestyles. This has resulted in raised clinical awareness and diagnostic refinement. The entity encompasses several histologic patterns from benign steatosis to nonalcoholic steatohepatitis, the latter having a significant risk of progressive fibrosis and the development of cirrhosis. Labor-atory tests and imaging are not able to distinguish steatosis from steatohepatitis, which requires liver biopsy. However following an assessment of several risk factors, patients can be stratified for the potential risk of fibrosis, allowing the rational use of liver biopsy. This review will describe the various patterns of nonalcoholic fatty liver disease and relate this to disease pathogenesis and progression. Strategies for management, including experimental interventions, will be discussed.

Management effectiveness: Assessing management of protected areas?

To maximise the potential of protected areas, we need to understand the strengths and weaknesses in their management and the threats and stresses that they face. There is increasing pressure on governments and other bodies responsible for protected areas to monitor their effectiveness. The reasons for assessing management effectiveness include the desire by managers to adapt and improve their management strategies, improve planning and priority setting and the increasing demands for reporting and accountability being placed on managers, both nationally and internationally. Despite these differing purposes for assessment, some common themes and information needs can be identified, allowing assessment systems to meet multiple uses. Protected-area management evaluation has a relatively short history. Over the past 20 years a number of systems have been proposed but few have been adopted by management agencies. In response to a recognition of the need for a globally applicable approach to this issue, the IUCN World Commission on Protected Areas developed a framework for assessing management effectiveness of both protected areas and protected area systems. This framework was launched at the World Conservation Congress in Jordan in 2000. The framework provides guidance to managers to develop locally relevant assessment systems while helping to harmonise assessment approaches around the world. The framework is strongly linked to the protected area management process and is adaptable to different types and circumstances of protected areas around the world. Examples from Fraser Island in Australia and the Congo Basin illustrate the use of the framework.

Feeding strategies for grain-fed cattle in a hot environment

Six Bos taurus (Hereford) steers (body weight 324 22 kg) were used in a 45-day study with a replicated 3 x 3 Latin-square design. Three treatments [ad libitum feeding (ADLIB); limit feeding, 85% of ad libitum (LIMIT); bunk management feeding where steers were only given access to feed from 1600 to 0800 hours the following day (BUNK)] were imposed over 3 periods, with 2 steers assigned to each treatment in each period. Cattle were managed in a temperature-controlled metabolism unit and were exposed to both thermoneutral (17.7degreesC-26.1degreesC) and hot (16.7degreesC-32.9degreesC) environmental conditions. By design, during the thermoneutral period, the ADLIB cattle displayed greater intake (P < 0.05) than the LIMIT group, with the BUNK group being intermediate. However, during the hot period, both the LIMIT and BUNK treatment groups increased feed intake 4-5%, whereas feed intake of the ADLIB treatment group declined nearly 2%. During both periods respiration rate (RR, breath/min) followed the same pattern that was observed for feed intake, with the greatest (P < 0.05) RR found in the ADLIB treatment group (81.09 and 109.55, thermoneutral and hot, respectively) and lowest (P < 0.05) RR in the LIMIT treatment group (74.47 and 102.76, thermoneutral and hot, respectively). Rectal temperature (RT) did not differ among treatments during the thermoneutral period or the first hot day, although during the thermoneutral period the ADLIB treatment group did tend to display a lower RT, possibly as a result of other physiological processes (pulse rate and RR) aiding to keep RT lower. During the hot period, differences in RT were found on Day 5, with the LIMIT cattle having lower (P < 0.10) RT (38.92degreesC) than the ADLIB (39.18degreesC) cattle, with BUNK cattle RT (39.14degreesC) being intermediate. However, when hourly data were examined, the ADLIB cattle had greater(P < 0.05) RT than the BUNK and LIMIT at 1800 hours and greater RT (P < 0.05) than the LIMIT group at 1400, 1500, and 1600 hours. Clearly, a change in diurnal RT pattern was obtained by using the LIMIT and BUNK feeding regimen. Both of these groups displayed a peak RT during the hot conditions, between 2100 and 2200 hours, whereas the ADLIB group displayed a peak RT between 1400 and 1500 hours, a time very close to when peak climatic stress occurs. Based on these results it is apparent that feedlot managers could alleviate the effects of adverse hot weather on cattle by utilising either a limit-feeding regimen or altering bunk management practices to prevent feed from being consumed several hours prior to the hottest portion of the day.

Encouraging practitioners to use resources: evaluation of the national implementation of a resource to improve the clinical management of alcohol-related problems in Indigenous primary care settings

This paper reports on the evaluation of the implementation of the National Recommendations for the Clinical Management of Alcohol-Related Problems in Indigenous Primary Care Settings undertaken in 2001 through 74 standardized workshops, which sought to determine: ( 1) whether this approach to implementation influenced the likelihood that the National Recommendations would be used; ( 2) whether it influenced participants' willingness to engage with Indigenous patients regarding alcohol-related issues; and ( 3) whether the implementation as a whole influenced both practice and clinicians' willingness to engage. Evaluation included pre-/post-workshop and follow-up questionnaires and a focus group. The findings presented indicate that distribution of clinical resources alone is not sufficient to ensure use and that, particularly for medical practitioners, appropriate introduction not only increases use but also positively influences willingness to engage with alcohol-related problems as part of primary clinical care. Further, the enthusiasm for guideline production should be tempered by the need to develop effective implementation strategies.

Body-mass management of Australian lightweight rowers prior to and during competition

Purpose: Although the body-mass management strategies of athletes in high-participation weight-category sports such as wrestling have been thoroughly investigated, little is known about such practices among lightweight rowers. This study examined the body-mass management practices of lightweight rowers before competition and compared these with current guidelines of the International Federation of Rowing Association (FISA). Quantification of nutrient intake in the 1-2 h between weigh-in and racing was also sought. Methods: Lightweight rowers (N = 100) competing in a national regatta completed a questionnaire that assessed body-mass management practices during the 4 wk before and throughout a regatta plus recovery strategies after weigh-in. Biochemical data were collected immediately after weigh-in to validate questionnaire responses. Responses were categorized according to gender and age category (Senior B or younger than 23 yr old, i.e., U23, Senior A or OPEN, i.e., open age limit) for competition. Results: Most athletes (male U23 76.5%, OPEN 92.3%; female U23 84.0%, OPEN 94.1%) decreased their body mass in the weeks before the regatta at rates compliant with FISA guidelines. Gradual dieting, fluid restriction, and increased training load were the most popular methods of body-mass management. Although the importance of recovery after weigh-in was recognized by athletes, nutrient intake and especially sodium (male U23 5.3 &PLUSMN; 4.9, OPEN 7.7 &PLUSMN; 5.9; female U23 5.7 &PLUSMN; 6.8, OPEN 10.2 &PLUSMN; 5.4 mg-kg(-1)) and fluid intake (male U23 12.1 &PLUSMN; 7.1, OPEN 13.5 &PLUSMN; 8.1; female U23 9.4 &PLUSMN; 7.4, OPEN 14.8 &PLUSMN; 6.9 mL.kg(-1)) were below current sports nutrition recommendations. Conclusion: Few rowers were natural lightweights; the majority reduced their body mass in the weeks before a regatta. Nutritional recovery strategies implemented by lightweight rowers after weigh-in were not consistent with current guidelines.

Farmers' strategies for managing acid upland soils in Southeast Asia: an evolutionary perspective

The acid soils of the uplands of Southeast Asia have resisted intensive agricultural use for centuries. In recent decades, however, due to rapid population growth, escalating market demand for agricultural produce, and govemment policies for land development and settlement, the acid uplands have become the focus of more intensive land-use systems, placing greater demands on farmers and requiring the development and dissemination of improved practices for soil management. In order to develop appropriate soil management technologies and plan effective interventions to facilitate their adoption, it is important to understand the goals and circumstances of farmers in the acid uplands, the range of farming systems they have developed, and the variety of socio-economic factors and trends influencing the evolution of these farming systems. Building on Boserup's model of agrarian change, an evolutionary framework is developed and applied to five case studies: a long-fallow (shifting) cultivation system in Sarawak, Malaysia; a short-fallow system in South Kalimantan, Indonesia; a continuous cropping system in Bukidnon, Philippines; a tree crop (with intercropping) system in Southern Thailand; a livestock grazing system in Daclac, Vietnam. The framework provides a useful tool to interpret and categorise farmers' evolving soil management strategies and to plan more effective soil management research and interventions. (c) 2004 Elsevier B.V. All rights reserved.

Central hypersensitivity in whiplash: Implications for physiotherapy assessment and management

It is emerging that whiplash-associated disorder (WAD) is a complex condition characterised by a variety of physical and psychological features. Generalised sensory hypersensitivity is one of these features and its presence reflects augmented central pain processing mechanisms. Whilst most studies have investigated these processes in chronic WAD, it is becoming clear that in some of the whiplash injured, sensory disturbances are present from soon after injury, and are associated with both poor recovery and recalcitrance to multimodal physiotherapy interventions. Evidence for sensory hypersensitivity in WAD and possible underlying mechanisms of these phenomena are reviewed. Physiotherapists play an important role in the evaluation and management of whiplash injury. It is important that sensory disturbances be identified early in the clinical assessment of the whiplash injured patient and that ensuing management strategies address these changes, if the aim of treatment is to prevent the transition to chronicity.

Revegetation strategies for bauxite refinery residue: A case study of Alcan Gove in Northern Territory, Australia

Alumina extraction from bauxite ore with strong alkali produces waste bauxite refinery residue consisting of residue sand and red mud. The amount and composition of refinery residue depend on the purity of the bauxite ore and extraction conditions, and differs between refineries. The refinery residue is usually stored in engineered disposal areas that eventually have to be revegetated. This is challenging because of the alkaline and sodic nature of the residue. At Alcan Gove's bauxite refinery in Gove, Northern Territory, Australia, research into revegetation of bauxite residue has been conducted since the mid-1970s. In this review, we discuss approaches taken by Alcan Gove to achieve revegetation outcomes (soil capping of refinery residue) on wet-slurry disposal areas. Problems encountered in the past include poor drainage and water logging during the wet season, and salt scalding and capillary rise during the dry season. The amount of available water in the soil capping is the most important determinant of vegetation survival in the seasonally dry climate. Vegetation cover was found to prevent deterioration of the soil cover by minimising capillary rise of alkalinity from the refinery residue. The sodicity and alkalinity of the residue in old impoundments has diminished slightly over the 25 years since it was deposited. However, development of a blocky structure in red mud, presumably due to desiccation, allows root penetration, thereby supplying additional water to salt and alkali-tolerant plant species. This has led to the establishment of an ecosystem that approaches a native woodland.