Supportive care of patients diagnosed with high grade glioma and their carers in Australia.

PURPOSE: This study aimed to: determine the supportive care available for Australian patients with High Grade Glioma (HGG) and their carers; identify service gaps; and inform changes needed to implement guidelines and Optimal Care Pathways. METHODS: This cross-sectional online survey recruited multidisciplinary health professionals (HPs) who were members of the Cooperative Trials Group for Neuro-Oncology involved in management of patients diagnosed with HGG in Australian hospitals. Descriptive statistics were calculated. Fisher's exact test was used to explore differences between groups. RESULTS: 42 complete responses were received. A majority of MDT meetings were attended by a: neurosurgeon, radiation oncologist, medical oncologist, radiologist, and care coordinator. Less than 10% reported attendance by a palliative care nurse; physiotherapist; neuropsychologist; or speech therapist. Most could access referral pathways to a cancer care coordinator (76%), neuropsychologist (78%), radiation oncology nurse (77%), or psycho-oncologist (73%), palliative care (93-100%) and mental health professionals (60-85%). However, few routinely referred to an exercise physiologist (10%), rehabilitation physician (22%), dietitian (22%) or speech therapist (28%). Similarly, routine referrals to specialist mental health services were not standard practice. Nearly all HPs (94%) reported HGG patients were advised to present to their GP for pre-existing conditions/comorbidities; however, most HPs took responsibility (≤ 36% referred to GP) for social issues, mental health, symptoms, cancer complications, and treatment side-effects. CONCLUSIONS: While certain services are accessible to HGG patients nationally, improvements are needed. Psychosocial support, specialist allied health, and primary care providers are not yet routinely integrated into the care of HGG patients and their carers despite these services being considered essential in clinical practice guidelines and optimal care pathways

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

AGRICULTURE AND BIOLOGY JOURNAL OF NORTH AMERICA Socio-economic factors influencing rice production among male and female farmers in Northern Guinea Savanna Nigeria: lessons for promoting gender equity in action research

ABSTRACT This paper examined the performance of male and female farmers in rice farming in the Northern Guinea Savannah of Nigeria, with a view to determining the parameters for promoting gender equity in farmers' access to opportunities for improved livelihoods from rice production. Data were obtained from 624 farmers selected by stratified random technique from twelve villages in Katsina and Kaduna States of Nigeria; using structured interview and focus group discussion. The data were analyzed using descriptive statistics and regression model of double log form. Results indicated that land, variable inputs, and experience were significant at 1 percent and 5 percent levels; implying that these variables would greatly influence productivity of rice for both male and female farmers in the area; while age would influence rice production negatively, implying that the older the rice farmers the less the vigour for farming. Also, the coefficient for marital status of women was negative; implying that married women within reproductive age were more likely to be constrained in their production by their multiple roles and cultural practices that prevented women from direct field production activities. It was concluded that policies that would enhance farmers access to land, fertilizers, improved seeds, herbicides and labour; coupled with strategies for substituting women's time on production activities for non-entrepreneurial activities would likely enhance rice production and gender equity among rice farmers in the Northern Guinea Savanna, Nigeria

AGRICULTURE AND BIOLOGY JOURNAL OF NORTH AMERICA Soil moisture stress mitigation for sustainable upland rice production in the Northern Guinea Savanna of Nigeria

ABSTRACT Northern Guinea Savanna (NGS) of Nigeria cultivable lands have sandy loam to loamy sand surface textures, low organic matter and are susceptible to erosion (wind and water). To mitigate crop moisture stress, on-farm trials involving contour-ridge-tying and contour ridging were carried out in Albasur and Dansoda villages in Dandume Local Government Area of Katsina State (NGS) to conserve soil against erosion and moisture for crop use in 2008 and 2009. The area (NGS) witness poor rainfall distribution, dry spells lasting beyond twenty one days occurring between June and July and low rainfall amounts (<900 to 1300mm per annum). These result in upland crops like rice (NERICA 2 var.) witnessing deficit soil moisture to undergo proper growth and production, low yields or complete crop failure. Also, soil erosion and runoff deplete water that could be available for crops and degrade farmlands for continued cultivation on the land. In this trial farmers ranked their rice grain yields while physical and agronomic data collected were statistically analysed using ANOVA and Duncan multiple range tests to separate means. Results show that cross-banded ridge resulted in significantly higher rice grain yields than the other treatments and was followed by contoured ridge. Socio-economic data collected were analyzed using descriptive statistics and budgeting technique. Costs and returns analysis results show that labour and fertilizer inputs accounted for greater proportion of total variable costs incurred in contour (15.72%), contour plus tie ridging (15.72%), planting on flat land and farmers ridging practice (16.43 and 16.55 % respectively). Costs and returns analysis result shows that rice cultivation using contour and contour plus tie ridging is more profitable, implying feasible sustainable rice production through contour farming