Promoting better use of the PSA test in general practice: Randomized controlled trial of educational strategies based on outreach visits and mailout

Background. Prostate-specific antigen (PSA) testing for prostate cancer is controversial. Demand for PSA testing is likely to rise in the UK, Australia and other western countries. Primary care needs to develop appropriate strategies to respond to this demand. Objectives. Our aim was to compare the effectiveness of educational outreach visits (EOVs) and mailout strategies targeting PSA testing in Australian primary care. Methods. A randomized controlled trial was conducted in general practices in southern Adelaide. The main outcome measures at baseline, 6 months and 12 months post-intervention were PSA testing rates and GP knowledge in key areas relating to prostate cancer and PSA testing. Results. The interventions were able to demonstrate a change in clinical practice. In the 6 months post-intervention, median PSA testing rate in the EOV group was significantly lower than in the postal group, which in turn was significantly lower than the control group (P < 0.001). Statistically significant differences were not, however, maintained in the 6-12 month post-intervention period. The EOV group, at 6 months follow-up, had a significantly greater proportion of 'correct' responses than the control group to questions about prostate cancer treatment effectiveness (P = 0.004) and endorsement of PSA screening by professional bodies (P = 0.041). Conclusions. Primary care has a central role in PSA testing for prostate cancer. Clinical practice in this area is receptive to evidence-based interventions.

A Review of the Environmental and Health Effects of Termiticides under Australian Conditions

There exists a major cost issue as regards termite damage to wooden structures. A factor in this cost has been the increasing trend towards slab-on-ground construction. Current literature has been reviewed in relation to concerns about the possible public/environmental health consequences of the repeated use of termiticides in large quantities. The previous, current and projected future use patterns of termiticides are reviewed in the context of techniques appropriate for termite control and treatment priorities. The phasing out of organochlorine termiticides in Australia was undertaken to minimise impact of these substances on the environment and to a lesser extent on public health. These persistent chemicals were replaced by substances with high activity but relatively low persistence in the soil. There has also been an increase in the use of alternative methods (e.g. physical barriers) for the control of termites. The transition away from organochlorine termiticides has led to a realisation that significant information gaps exist with regard to replacement chemicals and other technologies. Although relatively persistent, the organochlorine chemicals have a limited lifespan in soils. Their concentrations are gradually attenuated by processes such as transport away from the point of application and biodegradation. Wooden structures originally treated with these substances will, with the passing of time, be at risk of termite infestation. The only available option is re-treatment with chemicals currently registered for termite control. Thus, there are likely to be substantial future increases associated with the cost of re-treatment and repairs of older slab-on-ground dwellings. More information is required on Australian termite biology, taxonomy and ecology. The risks of termite infestation need to be evaluated, both locally and nationally so that susceptible or high risk areas, structures and building types can be identified and preventive measures taken in terms of design and construction. Building regulations and designs need to be able to reduce or eliminate high-risk housing; and eliminate or reduce conditions that are attractive to termites and/or facilitate termite infestation.

Comparability of perceptual analysis of speech characteristics in Australian and Swedish speakers with multiple sclerosis

The aims of the present study were to compare the perceptual assessments of deviant speech signs (dysarthria) exhibited by Australian and Swedish speakers with multiple sclerosis (MS) and to explore whether judgements of dysarthria differed depending on whether the speakers and the judges spoke the same or different languages. Ten Australian and 10 Swedish individuals with MS (matched as closely as possible for age, gender, progression type and severity of dysarthria) were assessed by 2 Australian and 2 Swedish clinically experienced judges using a protocol including 33 speech parameters. Results show that the following perceptual dimensions were identified by both pairs of judges in both groups of speakers to a just noticeable or moderate degree: imprecise consonants, inappropriate pitch level, reduced general rate, and glottal fry. The reliability (Spearman rank-order correlation) of the consensus ratings from the Australian and the Swedish judges was high, with a mean rho of 85.7 for the Australian speakers and mean rho of 84.3 for the Swedish speakers. The most difficult perceptual parameters to assess (i.e. to agree on) included harshness, level of pitch and loudness, precision of consonants and general stress pattern. The study indicated that perceptual assessments of speech characteristics in individuals with MS are informative and can be achieved with high inter-judge reliability irrespective of the judge's knowledge of the speaker's language. Copyright (C) 2003 S. Karger AG, Basel.

Selective attention for threatening information in anxious mood states

Attention for threatening information was investigated using a computerised version of the emotional Stroop. The study examined the influence of state and trait anxiety in an unselected student sample assigned to high trait anxious (HTA) or low trait anxious (LTA) groups on the basis questionnaire scores. State anxiety was manipulated within participants through the threat of electric shock. Threatening words that were either unrelated (e.g., cancer, danger) or related to the source of the threat (e.g., electrocute, shock) were presented to participants both within and outside of awareness. In the latter condition, a backward masking procedure was used to prevent awareness of the stimulus material. In the masked condition, despite chance performance in identification of the lexical status of stimulus items, HTA participants showed facilitated colour naming for all threat words relative to control items under threat of shock, but this effect was not evident in the shock safe condition. For unmasked trials the HTA group showed significant interference in colour naming for all threat words relative to controls under the threat of shock, but not in the shock safe condition. Neither valence of the items nor the threat of shock influenced colour naming latencies for the LTA group. [ABSTRACT FROM AUTHOR]

General language abilities following management of childhood supratentorial tumour: Part 1

Background. To date few studies have investigated the impact of management for supratentorial tumour on the language abilities of children. In reporting children with brain tumour as part of a larger cohort of various aetiologies of brain injury, such studies have failed to differentiate between the causes of acquired childhood language disorders, or specifically report associated information relating to site and treatment. Material and methods. The present study examined the general language abilities of six children managed for supratentorial tumour, using a comprehensive standardized general language assessment battery, including receptive and expressive components, receptive vocabulary, and naming. Results. At a group level, children managed for supratentorial tumour performed below an individually matched control group in the area of general expressive language. However, at an individual case level it was revealed that only two cases exhibited specific language deficits. Reduced performance in the area of expressive language and syntax was evident in the language profile of one child treated surgically for a left parietal astrocytoma, while a child treated surgically for an optic nerve glioma demonstrated difficulties in receptive semantic abilities. The remaining four cases with similar treatments and locations demonstrated intact general language abilities. Conclusions. Factors such as site, long-term presence of tumour prior to diagnosis, young age at diagnosis, and variations in time post treatment were considered to have contributed to the findings. The need for long-term monitoring of language abilities post treatment as well as larger group sizes and the investigation of higher-level abilities was highlighted

Shoemaker impact structure, Western Australia

The Shoemaker impact structure, on the southern margin of the Palaeoproterozoic Earaheedy Basin, with an outer diameter of similar to30 km, consists of two well-defined concentric ring structures surrounding a granitoid basement uplift. The concentric structures, including a ring syncline and a ring anticline, formed in sedimentary rocks of the Earaheedy Group. In addition, aeromagnetic and geological field observations suggest that Shoemaker is a deeply eroded structure. The central 12 km-diameter uplift consists of fractured Archaean basement granitoids of syenitic composition (Teague Granite). Shock-metamorphic features include shatter cones in sedimentary rocks and planar deformation features in quartz crystals of the Teague Granite. Universal-stage analysis of 51 sets of planar deformation features in 18 quartz grains indicate dominance of sets parallel to omega (10 (1) over bar3}, but absence of sets parallel to pi (10 (1) over bar2}, implying peak shock pressures in the range of 10-20 GPa for the analysed sample. Geophysical characteristics of the structure include a -100 mus(-2) gravity anomaly coincident with the central uplift and positive circular trends in both magnetic and gravity correlating with the inner ring syncline and outer ring anticline. The Teague Granite is dominated by albite-quartz-K-feldspar with subordinate amounts of alkali pyroxene. The alkali-rich syenitic composition suggests it could either represent a member of the Late Archaean plutonic suite or the product of alkali metasomatism related to impact-generated hydrothermal activity. In places, the Teague Granite exhibits partial to pervasive silicification and contains hydrothermal minerals, including amphibole, garnet, sericite and prehnite. Recent isotopic age studies of the Teague Granite suggest an older age limit of ca 1300 Ma (Ar-Ar on K-feldspar) and a younger age limit of ca 568 Ma (K-Ar on illite-smectite). The significance of the K-Ar age of 568 Ma is not clear, and it might represent either hydrothermal activity triggered by impact-related energy or a possible resetting by tectonothermal events in the region.

Joining forces - Combining cognition-targeted motor control training with group or individual pain physiology education: A successful treatment for chronic low back pain

Chronic unremittent low back pain (LBP) is characterised by cognitive barriers to treatment. Combining a motor control training approach with individualised education about pain physiology is effective in this group of patients. This randomized comparative trial (i) evaluates an approach to motor control acquisition and training that considers the complexities of the relationship between pain and motor output, and (ii) compares the efficacy and cost of individualized and group pain physiology education. After an "ongoing usual treatment" period, patients participated in a 4-week motor control and pain physiology education program. Patients received four one-hour individualized education sessions (IE) or one 4-hour group lecture (GE). Both groups reduced pain (numerical rating scale) and disability (Roland Morris Disability Questionnaire). IE showed bigger decreases, which were maintained at 12 months (P < 0.05 for all). The combined motor control and education approach is effective. Although group education imparts a lesser effect, it may be more cost-efficient. [ABSTRACT FROM AUTHOR]

Functionally partitioned module-based programmable architecture for wireless base-band processing

A specialised reconfigurable architecture is targeted at wireless base-band processing. It is built to cater for multiple wireless standards. It has lower power consumption than the processor-based solution. It can be scaled to run in parallel for processing multiple channels. Test resources are embedded on the architecture and testing strategies are included. This architecture is functionally partitioned according to the common operations found in wireless standards, such as CRC error correction, convolution and interleaving. These modules are linked via Virtual Wire Hardware modules and route-through switch matrices. Data can be processed in any order through this interconnect structure. Virtual Wire ensures the same flexibility as normal interconnects, but the area occupied and the number of switches needed is reduced. The testing algorithm scans all possible paths within the interconnection network exhaustively and searches for faults in the processing modules. The testing algorithm starts by scanning the externally addressable memory space and testing the master controller. The controller then tests every switch in the route-through switch matrix by making loops from the shared memory to each of the switches. The local switch matrix is also tested in the same way. Next the local memory is scanned. Finally, pre-defined test vectors are loaded into local memory to check the processing modules. This paper compares various base-band processing solutions. It describes the proposed platform and its implementation. It outlines the test resources and algorithm. It concludes with the mapping of Bluetooth and GSM base-band onto the platform.

How cost efficient are Australia's mining industries?

This paper uses a stochastic translog cost frontier model and a panel data of five key mining industries in Australia over 1968-1969 to 1994-1995 to investigate the sources of output growth and the effects of cost inefficiency on total factor productivity (TFP) growth. The results indicate that mining output growth was largely input-driven rather than productivity-driven. Although there were some gains from technological progress and economics of scale in production, cost inefficiency which barely exceeded 1.1% since the mid-1970s in the mining industries was the main factor causing low TFP growth. (C) 2002 Elsevier Science B.V. All rights reserved.

Causes and Implications of the Decline of the Economics Majors: A Focus on Australia

This paper analyses the causes and implications of declining economics major in Australia. Based on a brief review of the relevant literature and an analysis of the Australian time series data, it is found that economics continues to be less attractive to students in relative terms. Three major factors contribute to this phenomenon: less than appropriate product for an increasingly diverse clientele, the introduction of more attractive and business, commerce and industry-oriented programs such as finance, accounting and commerce, and business majors geared to the needs of the real world, and the use of less experienced teaching staff in lower undergraduate courses. It is argued that stemming the tide against the economics discipline would require a significant rethink of development of products more vocational and real world-oriented, market segmentation for different clientele types, and marshalling of more experienced and capable teaching staff for lower undergraduate levels.

Integrating spatial optimization and cellular automata for evaluating urban change

Urban growth and change presents numerous challenges for planners and policy makers. Effective and appropriate strategies for managing growth and change must address issues of social, environmental and economic sustainability. Doing so in practical terms is a difficult task given the uncertainty associated with likely growth trends not to mention the uncertainty associated with how social and environmental structures will respond to such change. An optimization based approach is developed for evaluating growth and change based upon spatial restrictions and impact thresholds. The spatial optimization model is integrated with a cellular automata growth simulation process. Application results are presented and discussed with respect to possible growth scenarios in south east Queensland, Australia.

The independent effects of attention and lead stimulus properties on the acoustic blink reflex

The effects of attention to a lead stimulus and of its sensory properties on modulation of the acoustic blink reflex were investigated. Participants performed a reaction time task cued by an acoustic or a visual lead stimulus. In Experiment 1, half the participants were presented with sustained lead stimuli. For the remainder, the lead stimulus was discrete and consisted of two brief presentations that marked the onset and offset of a stimulus-free interval. In Experiment 2, sustained lead stimuli were presented at a low or high intensity. The attentional demands of the task enhanced blink latency and magnitude modulation during acoustic and visual lead stimuli, with blink modulation being largest at a late point during the lead stimulus. Independent of the attentional effects, blink latency and magnitude modulation were larger during sustained than during discrete acoustic lead stimuli, whereas there was no difference for visual lead stimuli. Increases in the intensity of the lead stimulus enhanced blink modulation regardless of lead stimulus modality. Attention to a lead stimulus and the properties of the lead stimulus appear to have independent effects on blink reflex modulation.

Attentional blink modulation in a reaction time task: performance feedback, warning stimulus modality, and task difficulty

The present research investigated the effect of performance feedback on the modulation of the acoustic startle reflex in a Go/NoGo reaction time task. Experiment 1 (n = 120) crossed warning stimulus modality (acoustic, visual, and tactile) with the provision of feedback in a between subject design. Provision of performance feedback increased the number of errors committed and reduced reaction time, but did not affect blink modulation significantly. Attentional blink latency and magnitude modulation was larger during acoustic than during visual and larger during visual than during tactile warning stimuli. In comparison to control blinks, latency shortening was significant in all modality conditions whereas magnitude facilitation was not significant during tactile warning stimuli. Experiment 2 (n = 80) employed visual warning stimuli only and crossed the provision of feedback with task difficulty. Feedback and difficulty affected accuracy and reaction time. Whereas blink latency shortening was not affected, blink magnitude modulation was smallest in the Easy/No Feedback and the Difficult/Feedback conditions. (C) 2002 Elsevier Science B.V. All rights reserved.