The effect of age on referral to and use of specialist palliative care services in adult cancer patients: a systematic review

Objective: to investigate variations in the use of specialist palliative care (SPC) services for adult cancer patients, in relation to age.Design: systematic review of studies examining use of or referral to SPC services in adult cancer patients.Search strategy and selection criteria: six electronic databases (Medline, Embase, Web of Science, HMIC, SIGLE and AgeInfo) were searched for studies published between 1966 and March 2005, and references in the articles identified were also examined. Inclusion criteria were all studies which provided data on age in relation to use of or referral to SPC. Two reviewers independently selected studies, extracted data and assessed methodological quality according to defined criteria.Main outcome measures: use of or referral to SPC services, determined from all sources of report (patient, informal carer, health care professional, health care records).Results: 14 studies were identified. All reported a statistically significant lower use of SPC among older cancer patients (65 and above or older) at a univariate level [crude odds ratios ranged from 0.33 (0.15-0.72) to 0.82 (0.80-0.82)]. However, there were important methodological weaknesses in all of the studies identified; most crucially, studies failed to consider variations in use in relation to need for SPC.Conclusions: there is some evidence that older people are less likely to be referred to, or to use, SPC. These findings require confirmation in studies using prospectively collected data which control for patient's need for SPC

Strategies for maximizing sugarcane yield with limited water in the Bundaberg district

Between 1995 and 2003 sugarcane farmers in Bundaberg had access to limited irrigation water. Over this time water allocations were effectively a quarter of the requirements for a fully irrigated crop. In response to this problem irrigation strategies were developed to assist farmers. Field investigations focused on the performance of water winch and furrow irrigation systems, which make up 91 percent of the irrigated area in the district. As most of these application systems have insufficient capacity to meet crop demands, opportunities to schedule irrigations were limited to start up after rain. Improvements in irrigation system performance were found to provide the greatest potential to increase sugarcane yield under conditions of limited water. Investigations identified that irrigation performance could be significantly improved through relatively minor adjustment. Timing of irrigation start up after rain influenced how much water could be applied to the field. Even with relatively low allocations delayed start up strategies could lead to a situation where water was left over at the end of the season

The future direction of on-farm irrigation technologies and practice research

The Cooperative Research Centre for Irrigation Futures mission is to facilitate cooperative research and training networks and programs which continuously improve irrigation policy, tools, practices and processes. This paper provides an introduction to the current and planned research activities within the CRCIF with a particular focus on the tools and practices of relevance to improving on-farm water use efficiency. A key focus of this research is the delivery of research outcomes via toolkits which enhance the irrigation sector's ability to measure, monitor and manage the water balance at the field and farm scales, improve the precision of in-field irrigation applications and maximize agronomic responses to irrigation

Mapping and analysis of changes in the riparian landscape structure of the Lockyer Valley Catchment, Queensland, Australia

[Abstract]: A case study of the Lockyer Valley catchment in Queensland, Australia, was conducted to develop appropriate mapping and assessment techniques to quantify the nature and magnitude of riparian landscape structural changes within a catchment. The study employed digital image processing techniques to produce land cover maps from the 1973 and 1997 Landsat imagery. Fixed and variable width buffering of streams were implemented using a geographic information system (GIS) to estimate the riparian zone and to subsequently calculate the landscape patterns using the Patch Analyst (Grid) program (a FRAGSTATS interface). The nature of vegetation clearing was characterised based on land tenure, slope and stream order. Using the Pearson chi-square test and Cramer’s V statistic, the relationships between the vegetation clearing and land tenure were further assessed. The results show the significant decrease in woody vegetation areas mainly due to conversion to pasture. Riparian vegetation corridors have become more fragmented, isolated and of much smaller patches. Land tenure was found to be significantly associated with the vegetation clearing, although the strength of association was weak. The large proportion of deforested riparian zones within steep slopes or first-order streams raises serious questions about the catchment health and the longer term potential for land degradation by upland clearing. This study highlights the use of satellite imagery and geographic information systems in mapping and analysis of landscape structural change, as well as the identification of key issues related to sensor spatial resolution, stream buffering widths, and the quantification of land transformation processes

Simulation of site-specific irrigation control strategies with sparse input data

Crop and irrigation water use efficiencies may be improved by managing irrigation application timing and volumes using physical and agronomic principles. However, the crop water requirement may be spatially variable due to different soil properties and genetic variations in the crop across the field. Adaptive control strategies can be used to locally control water applications in response to in-field temporal and spatial variability with the aim of maximising both crop development and water use efficiency. A simulation framework ‘VARIwise’ has been created to aid the development, evaluation and management of spatially and temporally varied adaptive irrigation control strategies (McCarthy et al., 2010). VARIwise enables alternative control strategies to be simulated with different crop and environmental conditions and at a range of spatial resolutions. An iterative learning controller and model predictive controller have been implemented in VARIwise to improve the irrigation of cotton. The iterative learning control strategy involves using the soil moisture response to the previous irrigation volume to adjust the applied irrigation volume applied at the next irrigation event. For field implementation this controller has low data requirements as only soil moisture data is required after each irrigation event. In contrast, a model predictive controller has high data requirements as measured soil and plant data are required at a high spatial resolution in a field implementation. Model predictive control involves using a calibrated model to determine the irrigation application and/or timing which results in the highest predicted yield or water use efficiency. The implementation of these strategies is described and a case study is presented to demonstrate the operation of the strategies with various levels of data availability. It is concluded that in situations of sparse data, the iterative learning controller performs significantly better than a model predictive controller

Factors that Influence the Way Communities Respond to Proposals for Major Changes to Local Emergency Services: A Qualitative Study

According to policy commentators, decisions about how best to organise care involve trade-offs between factors relating to care quality, workforce, cost, and patient access. In England, proposed changes such as Emergency Department closures often face public opposition. This study examined the way communities respond to plans aimed at reorganising emergency services, including the trade-offs inherent in such decisions

The impact of rain water on soil pore networks following irrigation with saline-sodic water

The soil pore network is an important factor affecting soil hydraulic conductivity (Ksat). In this study we examine the effect on the soil pore network of a Red Ferrosol caused by irrigation with good quality irrigation water (GQW), as well as saline-sodic water with varying sodium absorption ratios (SAR; 10, 50 and 120) and constant electrical conductivity (EC; 2 dS m-1), followed by application of distilled water (simulating rain water). The Ksat was measured for the different waters before and after applying the rain water to the soil. Soil samples were taken from different depths (1, 4 and 8 cm) for exchangeable cations measurement and the changes in ESP of the soil. Soil horizontal cross-sections were taken from the first 2 cm of the soil cores after drying with acetone and impregnation with polyester resin mixed with green fluorescent dye catalyst and hardener. These sections were polished and visualized under a microscope to investigate the changes in the soil pore network. By increasing the SAR of the water applied from 0.11 (GQW) to SAR 50 and 120, a significant reduction in Ksat was found, alongside a significant increase in the ESP of the soil from 3 to 10 and 11, respectively; this was most evident near the soil surface. After applying rain water, the Ksat reduced significantly approaching 0 mm h-1 where soil was treated with water of SAR 120. Visualisation of the soil pore network of the treated soils following the application of deionised water clearly showed a reduction in soil macroporosity where water quality of SAR ≥10 was applied, even where soils were non-sodic. Where irrigation occurred with good quality, low SAR water, this reduction was not evident

Quantification of food intake in Drosophila

Measurement of food intake in the fruit fly Drosophila melanogaster is often necessary for studies of behaviour, nutrition and drug administration. There is no reliable and agreed method for measuring food intake of flies in undisturbed, steady state, and normal culture conditions. We report such a method, based on measurement of feeding frequency by proboscis-extension, validated by short-term measurements of food dye intake. We used the method to demonstrate that (a) female flies feed more frequently than males, (b) flies feed more often when housed in larger groups and (c) fly feeding varies at different times of the day. We also show that alterations in food intake are not induced by dietary restriction or by a null mutation of the fly insulin receptor substrate chico. In contrast, mutation of takeout increases food intake by increasing feeding frequency while mutation of ovoD increases food intake by increasing the volume of food consumed per proboscis-extension. This approach provides a practical and reliable method for quantification of food intake in Drosophila under normal, undisturbed culture conditions