Primary brain tumor patients’ supportive care needs and multidisciplinary rehabilitation, community and psychosocial support services: Awareness, referral and utilization

Primary brain tumors are associated with significant physical, cognitive and psychosocial changes. Although treatment guidelines recommend offering multidisciplinary rehabilitation and support services to address patients’ residual deficits, the extent to which patients access such services is unclear. This study aimed to assess patients’ supportive care needs early after diagnosis, and quantify service awareness, referral and utilization. A population-based sample of 40 adults recently diagnosed with primary brain tumors was recruited through the Queensland Cancer Registry, representing 18.9% of the eligible population of 203 patients. Patients or carer proxies completed surveys of supportive care needs at baseline (approximately three months after diagnosis) and three months later. Descriptive statistics summarized needs and service utilization, and linear regression identified predictors of service use. Unmet supportive care needs were highest at baseline for all domains, and highest for the physical and psychological needs domains at each time point. At follow-up, participants reported awareness of, referral to, and use of 32 informational, support, health professional or practical services. All or almost all participants were aware of at least one informational (100%), health professional (100%), support (97%) or practical service (94%). Participants were most commonly aware of speech therapists (97%), physiotherapists (94%) and diagnostic information from the internet (88%). Clinician referrals were most commonly made to physiotherapists (53%), speech therapists (50%) and diagnostic information booklets (44%), and accordingly, participants most commonly used physiotherapists (56%), diagnostic information booklets (47%), diagnostic information from the internet (47%), and speech therapists (43%). Comparatively low referral to and use of psychosocial services may limit patients’ abilities to cope with their condition and the changes they experience.

Institute for Community College Development Addresses Leadership Crisis

[Excerpt] It is projected that between 2001 and 2007, 47 percent of community college presidents will have left their positions. At a time when challenges are growing more complex, the senior administrators who typically moved into presidencies are also "aging out," leaving fewer qualified individuals in the pipeline. The Institute for Community College Development (ICCD), a partnership between the State University of New York (SUNY) and Cornell, was founded by a group of community college presidents to respond to this leadership crisis. ICCD has been part of ILR since 2001.

Stakeholder expectations for environmental assurance in agriculture: Lessons from the pastoral industry

This paper outlines the expectations of a wide range of stakeholders for environmental assurance in the pastoral industries and agriculture generally. Stakeholders consulted were domestic consumers, rangeland graziers, members of environmental groups, companies within meat and wool supply chains, and agricultural industry, environmental and consumer groups. Most stakeholders were in favour of the application of environmental assurance to agriculture, although supply chains and consumers had less enthusiasm for this than environmental and consumer groups. General public good benefits were more important to environmental and consumer groups, while private benefits were more important to consumers and supply chains. The 'ideal' form of environmental assurance appears to be a management system that provides for continuous improvement in environmental, quality and food safety outcomes, combined with elements of ISO 14024 eco-labelling such as life-cycle assessment, environmental performance criteria, third-party certification, labelling and multi-stakeholder involvement. However, market failure prevents this from being implemented and will continue to do so for the foreseeable future. In the short term, members of supply chains (the people that must implement and fund environmental assurance) want this to be kept simple and low cost, to be built into their existing industry standards and to add value to their businesses. As a starting point, several agricultural industry organisations favour the use of a basic management system, combining continuous improvement, risk assessment and industry best management practice programs, which can be built on over time to meet regulator, market and community expectations.

eResearch Archive: reaching global agricultural communities

Queensland Department of Primary Industries and Fisheries Library achieved a significant breakthrough in the provision of Open Access to Australian publicly funded research with the launch of its eResearch Archive (eRA). With more than one thousand publication records, journal articles, conferences papers and research reports now available to farmers, industry representatives, academics, researchers, students and members of the public throughout the world, the archive is the first web accessible multidisciplinary science institutional repository produced by an Australian government department.

Land condition monitoring information for reef catchments: a new era

Land condition monitoring information is required for the strategic management of grazing land and for a better understanding of ecosystem processes. Yet, for policy makers and those land managers whose properties are situated within north-eastern Australia's vast Great Barrier Reef catchments, there has been a general lack of geospatial land condition monitoring information. This paper provides an overview of integrated land monitoring activity in rangeland areas of two major Reef catchments in Queensland: the Burdekin and Fitzroy regions. The project aims were to assemble land condition monitoring datasets that would assist grazing land management and support decision-makers investing public funds; and deliver these data to natural resource management(NRM) community groups, which had been given increased responsibility for delivering local environmental outcomes. We describe the rationale and processes used to produce new land condition monitoring datasets derived from remotely sensed Landsat thematic mapper (TM) and high resolution SPOT 5 satellite imagery and from rapid land condition ground assessment. Specific products include subcatchment groundcover change maps, regional mapping of indicative very poor land condition, and stratified land condition site summaries. Their application, integration, and limitations are discussed. The major innovation is a better understanding of NRM issues with respect to land condition across vast regional areas, and the effective transfer of decision-making capacity to the local level. Likewise, with an increased ability to address policy questions from an evidence-based position, combined with increased cooperation between community, industry and all levels of government, a new era has emerged for decision-makers in rangeland management.

Sense of Community in Web Environment

The study of social phenomena in the World Wide Web has been rather fragmentary, andthere is no coherent, reseach-based theory about sense of community in Web environment. Sense of community means part of one's self-concept that has to do with perceiving oneself belonging to, and feeling affinity to a certain social grouping. The present study aimed to find evidence for sense of community in Web environment, and specifically find out what the most critical psychological factors of sense of community would be. Based on known characteristics of real life communities and sense of community, and few occational studies of Web-communities, it was hypothesized that the following factors would be the most critical ones and that they could be grouped as prerequisites, facilitators and consequences of sense of community: awareness and social presence (prerequisites), criteria for membership and borders, common purpose, social interaction and reciprocity, norms and conformity, common history (facilitators), trust and accountability (consequences). In addition to critical factors, the present study aimed to find out if this kind of grouping would be valid. Furthermore, the effect of Web-community members' background variables to sense of community was of interest. In order to answer the questions, an online-questionnaire was created and tested. It included propositions that reflect factors that precede, facilitate and follow the sense of community in Web environment. A factor analysis was calculated to find out the critical factors and analyses of variance were calculated to see if the grouping to prerequisites, facilitators and consequences was right and how the background variables would affect the sense of community in Web environment. The results indicated that the psychological structure of sense of community in Web environment could not be presented with critical variables grouped as prerequisites, facilitators and consequences. Most factors did facilitate the sense of community, but based on this data it could not be argued that some of the factors chronologically precedesense of community and some follow it. Instead, the factor analysis revealed that the most critical factors in sense of community in Web environment are 1) reciprocal involvement, 2) basic trust for others, 3) similarity and common purpose of members, and 4) shared history of members. The most influencing background variables were the member's own participation activity (indicated with reading and writing messages) and the phase in membership lifecycle (from visitor to leader). The more the member participated and the further in membership life cycle he was, the more he felt sense of community. There are many descreptions of sense of community, but the present study was one of the first to actually measure the phenomenon in Web environment, and that gained well documented, valid results based on large data, proving that sense of community in Web environment is possible, and clarifying its psychological structure, thus enhancing the understanding of sense of community in Web environment. Keywords: sense of community, Web-community, psychology of the Internet

The big pond debate.

Over recent decades, Australian piggeries have commonly employed anaerobic ponds to treat effluent to a standard suitable for recycling for shed flushing purposes and for irrigation onto nearby agricultural land. Anaerobic ponds are generally sized according to the Rational Design Standard (RDS) developed by Barth (1985), resulting in large ponds, which can be expensive to construct, occupy large land areas, and are difficult and expensive to desludge, potentially disrupting the whole piggery operation. Limited anecdotal and scientific evidence suggests that anaerobic ponds that are undersized according to the RDS, operate satisfactorily, without excessive odour emission, impaired biological function or high rates of solids accumulation. Based on these observations, this paper questions the validity of rigidly applying the principles of the RDS and presents a number of alternate design approaches resulting in smaller, more highly loaded ponds that are easier and cheaper to construct and manage. Based on limited data of pond odour emission, it is suggested that higher pond loading rates may reduce overall odour emission by decreasing the pond volume and surface area. Other management options that could be implemented to reduce pond volumes include permeable pond covers, various solids separation methods, and bio-digesters with impermeable covers, used in conjunction with biofilters and/or systems designed for biogas recovery. To ensure that new effluent management options are accepted by regulatory authorities, it is important for researchers to address both industry and regulator concerns and uncertainties regarding new technology, and to demonstrate, beyond reasonable doubt, that new technologies do not increase the risk of adverse impacts on the environment or community amenity. Further development of raw research outcomes to produce relatively simple, practical guidelines and implementation tools also increases the potential for acceptance and implementation of new technology by regulators and industry.

Guaiac versus immunochemical tests: Faecal occult blood test screening for colorectal cancer in a rural community

Objective: To describe patient participation and clinical performance in a colorectal cancer (CRC) screening program utilising faecal occult blood test (FOBT). Methods: A community-based intervention was conducted in a small, rural community in north Queensland, 2000/01. One of two FOBT kits – guaiac (Hemoccult-ll) or immunochemical (Inform) – was assigned by general practice and mailed to participants (3,358 patients aged 50–74 years listed with the local practices). Results: Overall participation in FOBT screening was 36.3%. Participation was higher with the immunochemical kit than the guaiac kit (OR=1.9, 95% Cl 1.6-2.2). Women were more likely to comply with testing than men (OR=1.4, 95% Cl 1.2-1.7), and people in their 60s were less likely to participate than those 70–74 years (OR=0.8, 95% Cl 0.6-0.9). The positivity rate was higher for the immunochemical (9.5%) than the guaiac (3.9%) test (χ2=9.2, p=0.002), with positive predictive values for cancer or adenoma of advanced pathology of 37.8% (95% Cl 28.1–48.6) for !nform and 40.0% (95% Cl 16.8–68.7) for Hemoccult-ll. Colonoscopy follow-up was 94.8% with a medical complication rate of 2–3%. Conclusions: An immunochemical FOBT enhanced participation. Higher positivity rates for this kit did not translate into higher false-positive rates, and both test types resulted in a high yield of neoplasia. Implications: In addition to type of FOBT, the ultimate success of a population-based screening program for CRC using FOBT will depend on appropriate education of health professionals and the public as well as significant investment in medical infrastructure for colonoscopy follow-up.

Podcast: Community wide interventions for increasing physical activity

If the amount of physical activity in a society increased, it should improve public health; but uncertainties remain about how to achieve this. Professor Philip Baker from the Queensland University of Technology in Australia describes the findings from the January 2015 update of the Cochrane review of the evidence on community-wide interventions.

#20 [updated] Community wide interventions for increasing physical activity - Clinical Version

People who are physically active have higher levels of health related fitness, and a lower risk profile for developing a number of disabling medical conditions and chronic diseases. However, despite considerable evidence of the benefits of regular physical activity, global levels of physical inactivity remain stubbornly high. In response, governments are looking to find ways to increase the physical activity of their populations.

Developing sustainable banana production systems: a case study from tropical Australia

The north Queensland banana industry is under pressure from government and community expectations to exhibit good environmental stewardship. The industry is situated on the high-rainfall north Queensland coast adjacent to 2 natural icons, the Great Barrier Reef to the east and World Heritage-listed rain forest areas to the west. The main environmental concern is agricultural industry pollutants harming the Great Barrier Reef. In addition to environmental issues the banana industry also suffers financial pressure from declining margins and production loss from tropical cyclones. As part of a broader government strategy to reduce land-based pollutants affecting the Great Barrier Reef, the formation of a pilot banana producers group to address these environmental and economic pressures was facilitated. Using an integrated farming systems approach, we worked collaboratively with these producers to conduct an environmental risk assessment of their businesses and then to develop best management practices (BMP) to address environmental concerns. We also sought input from technical experts to provide increased rigour for the environmental risk assessment and BMP development. The producers' commercial experience ensured new ideas for improved sustainable practices were constantly assessed through their profit-driven 'filter' thus ensuring economic sustainability was also considered. Relying heavily on the producers' knowledge and experience meant the agreed sustainable practices were practical, relevant and financially feasible for the average-sized banana business in the region. Expert input and review also ensured that practices were technically sound. The pilot group producers then implemented and adapted selected key practices on their farms. High priority practices addressed by the producers group included optimizing nitrogen fertilizer management to reduce runoff water nitrification, developing practical ground cover management to reduce soil erosion and improving integrated pest management systems to reduce pesticide use. To facilitate wider banana industry understanding and adoption of the BMP's developed by the pilot group, we conducted field days at the farms of the pilot group members. Information generated by the pilot group has had wider application to Australian horticulture and the process has been subsequently used with the north Queensland sugar industry. Our experiences have shown that integrated farming systems methodologies are useful in addressing complex issues like environmental and economic sustainability. We have also found that individual horticulture businesses need on-going technical support for change to more sustainable practices. One-off interventions have little impact, as farm improvement is usually an on-going incremental process. A key lesson from this project has been the need to develop practical, farm scale economic tools to clarify and demonstrate the financial impact of alternative management practices. Demonstrating continued profitability is critical to encourage widespread industry adoption of environmentally sustainable practices

Landscape structure influences tree density patterns in fragmented woodlands in semi-arid eastern Australia.

Landscape and local-scale influences are important drivers of plant community structure. However, their relative contribution and the degree to which they interact remain unclear. We quantified the extent to which landscape structure, within-patch habitat and their confounding effects determine post-clearing tree densities and composition in agricultural landscapes in eastern subtropical Australia. Landscape structure (incorporating habitat fragmentation and loss) and within-patch (site) features were quantified for 60 remnant patches of Eucalyptus populnea (Myrtaceae) woodland. Tree density and species for three ecological maturity classes (regeneration, early maturity, late maturity) and local site features were assessed in one 100 × 10 m plot per patch. All but one landscape characteristic was determined within a 1.3-km radius of plots; Euclidean nearest neighbour distance was measured inside a 5-km radius. Variation in tree density and composition for each maturity class was partitioned into independent landscape, independent site and joint effects of landscape and site features using redundancy analysis. Independent site effects explained more variation in regeneration density and composition than pure landscape effects; significant predictors were the proportion of early and late maturity trees at a site, rainfall and the associated interaction. Conversely, landscape structure explained greater variation in early and late maturity tree density and composition than site predictors. Area of remnant native vegetation within a landscape and patch characteristics (area, shape, edge contrast) were significant predictors of early maturity tree density. However, 31% of the explained variation in early mature tree differences represented confounding influences of landscape and local variables. We suggest that within-patch characteristics are important in influencing semi-arid woodland tree regeneration. However, independent and confounding effects of landscape structure resulting from previous vegetation clearing may have exerted a greater historical influence on older cohorts and should be accounted for when examining woodland dynamics across a broader range of environments.

Tools to manage climate risk in cropping (Australia).

Because of the variable and changing environment, advisors and farmers are seeking systems that provide risk management support at a number of time scales. The Agricultural Production Systems Research Unit, Toowoomba, Australia has developed a suite of tools to assist advisors and farmers to better manage risk in cropping. These tools range from simple rainfall analysis tools (Rainman, HowWet, HowOften) through crop simulation tools (WhopperCropper and YieldProphet) to the most complex, APSFarm, a whole-farm analysis tool. Most are derivatives of the APSIM crop model. These tools encompass a range of complexity and potential benefit to both the farming community and for government policy. This paper describes, the development and usage of two specific products; WhopperCropper and APSFarm. WhopperCropper facilitates simulation-aided discussion of growers' exposure to risk when comparing alternative crop input options. The user can readily generate 'what-if' scenarios that separate the major influences whilst holding other factors constant. Interactions of the major inputs can also be tested. A manager can examine the effects of input levels (and Southern Oscillation Index phase) to broadly determine input levels that match their attitude to risk. APSFarm has been used to demonstrate that management changes can have different effects in short and long time periods. It can be used to test local advisors and farmers' knowledge and experience of their desired rotation system. This study has shown that crop type has a larger influence than more conservative minimum soil water triggers in the long term. However, in short term dry periods, minimum soil water triggers and maximum area of the various crops can give significant financial gains.

Woody plant responses to various clearing strategies imposed on a poplar box (Eucalyptus populnea) community at Dingo in central Queensland

The efficacy of individual tree treatment (stem-injection), aerially applied root-absorbed herbicide and mechanical felling (with and without subsequent fire) in controlling woody plants was compared in a poplar box (Eucalyptus populnea) woodland community in central Queensland, Australia. All treatments reduced woody plant populations and basal area relative to the untreated control. Chemical control and 'mechanical felling plus fire' treatments were equally effective in reducing woody plant basal area 7 years after the treatments were imposed. However, mechanical felling alone was less effective. There was a clear tendency for the scattered tree (80% thinning) treatment to recover woody plant basal area towards pre-treatment levels faster than other clearing strategies, although this response was not significantly different from 20% clump retention and mechanical felling (without burning) treatments.