The green mirid, Creontiades dilutus (Stal) (GM) is one of the important early season sucking pests in cotton in Australia. They prefer to feed on the growing parts of the cotton plant, particularly terminals and squares, causing shedding of squares and partial to complete wilting of terminals depending on the severity of feeding. GM feeding early in the season causes delay in maturity. Currently they are controlled mainly by the broad spectrum insecticides applied to control Helicoverpa spp., but this disrupts biological control of other major cotton pests. To increase our understanding of the pest, research on biology, behaviour, damage etiology and ecology of the GM was undertaken during the period 1994-97 in cotton growing areas of northern New South Wales.
C. dilutus was studied extensively on cotton plants under glasshouse and field conditions and its life cycle and biology was documented. Effects of temperature on female fecundity and egg and nyrnphal development were also studied. Both fecundity and development rate were found to be maximum at around 30°C. Threshold temperatures for development of eggs, individual stages of nymphs and the total nymphal period were calculated.
The oviposition pattern of GM on the cotton plants and the distribution of GM eggs in relation to the position of the main stern nodes were studied. GM preferred to deposit their eggs dorsally on the petiole end of 4 to 8 main stern node. Two factors, hardness and hairiness influence GM to discriminate preferred oviposition sites.
Damage etiology of GM on cotton was studied in detail under glasshouse and field conditions. Both nymphs and adults caused similar damage to the cotton plant. The damage caused by GM was cumulative and very apparent as nymphs entered the 4th instar. GM confined their attack to young growing parts of cotton plants, especially squares and terminals, causing squares to shed and terminals to wilt. The shedding of squares depended on feeding site, frequency of feeding and the size or age of the square. The amount of damage increased with the increase of insect number. Their feeding extended to the vascular bundle region and during feeding the insect released pectinase that destroyed surrounding cells of the feeding point. GM feeding in the field did not cause any significant yield loss in irrigated cotton. However, their feeding at early stages of plant growth caused significant delay in maturity.
The economic injury level for GM for the first time was calculated using maturity delay from field experiments by manipulating field population. An economic threshold (1 GM/m of row) was proposed which is higher than the currently recommended economic threshold and therefore will assist in the successful implementation of IPM programmes.
Extensive studies were made on GM ecology during 1994-97 in two locations. GM was more abundant in early to maximum squaring stage in all seasons in both locations. Analysis of GM population suggested that populations were regulated by contest competition during early cotton season (October - December) and scramble competition during middle and late cotton season (January - March). Egg populations may have been regulated by delayed density dependent factors, possibly predators. Insecticides targeted for Helicoverpa, temperature extremities, heavy rainfall along with strong wind, predators, alternative hosts, intraspecific competition and emigration may also have influenced GM populations in the field. Other than these factors, overwintering hosts allowed the build up of populations toward the end of spring, contributing to GM invasion of cotton. Study on the overwintering hosts also suggested that in northern NSW cotton growing regions, GM populations continued throughout the winter, though population growth was reduced.

BACKGROUND General practitioners have an expanding public health role in Australia. Improved training is recommended to optimise this involvement. An advanced post for GP registrars in population health was piloted in rural New South Wales. METHODS A reference group with experience in general practice and public health education advised on the development of the post, curriculum and qualitative evaluation framework. A part time GP registrar was employed within the local Division of General Practice and public health unit. RESULTS Effective collaboration between stakeholders promoted teaching, research and practice in population health within a rural area. The registrar developed skills in project design, data analysis and report writing during this training post. CONCLUSION This pilot demonstrates the feasibility of public health training for a GP registrar within a rural area. Projects in health promotion benefited from the input of a GP registrar among other stakeholders.

It would be a rarity to find a physician writing a piece for a book like this; in fact many of you may be nonplussed or even annoyed at finding an interloper. Yet while the discipline-specific approaches may markedly differ, the underlying goal for all health practitioners remains the same-to alleviate suffering. I know it sounds terribly cliched, but what fascinates e is the process, the personal journey that care providers make (or refuse to make) in accepting the limits of their power and their response to failure.

BACKGROUND: To date, relatively few representative data have been available to health planners and advocacy groups on the life expectancy of people with intellectual disability. A study of trends in the survival profiles of people with intellectual disability was undertaken to assist in the planning of appropriate medical and support services. METHODS: Since 1953, the Disability Services Commission of Western Australia has maintained a database of persons diagnosed with intellectual disability. The database was used to calculate survival probabilities on a total of 8724 individuals, 7562 of whom were still alive at the time of sampling in December 2000. RESULTS: Kaplan-Meier survival plots showed a strong negative association between severity of intellectual disability and survival, with median life expectancies of 74.0, 67.6, and 58.6 years for people with mild, moderate, and severe levels of handicap. Significant negative associations also were observed with male gender, Indigenous Australian parentage, and individuals diagnosed with a specific genetic disorder. CONCLUSIONS: The findings indicate a major and expanding increase in the service requirements of this aging, intellectually disabled population during the past two generations.

Pakistan along with many other West and South Asian countries has a very high prevalence of consanguineous, especially close cousin, marriages. Although there is substantial empirical information on offspring morbidity and mortality attributable to parental consanguinity, population-based information on how communities in general, and women in particular, perceive the health risks associated with consanguineous unions is limited. This paper considers community perceptions of health effects associated with consanguineous marriages using qualitative data from 15 focus group discussions and 294 in-depth interviews. The study was conducted in four low-income, multi-ethnic, and multi-religious communities in Karachi, the principal commercial center of Pakistan. The results show a general lack of awareness of the possible adverse health effects of consanguineous marriage. In cases where a link between consanguinity and ill health was acknowledged, it often centered on the familial origins of non-communicable disorders such as diabetes and hypertension or infectious diseases such as tuberculosis. Belief in fate and the "evil eye" was widespread across all ethnic and religious groups. Many respondents did not agree with medical explanations of a genetic mode of disease inheritance, even in cases where there was an affected child in the family. The absence of a uniform manifestation of disease among all children of a couple who were identified as carriers of a specific mutation added to the confusion among participants. The study highlights the need for further quantification of risks associated with consanguinity and a need for provision of appropriate information to primary-care clinicians and also to communities. The likely impact of increasing morbidity attributable to inbreeding on the health care system in resource poor settings is also discussed.

In a wheezy patient, bronchoconstriction by salmeterol does not rule out asthma, but other possibilities must be thought of.

OBJECTIVE: To facilitate the area's high school careers advisers' ability to effectively promote health careers to students. DESIGN: Three cross sectional evaluation surveys at the end of each one-day workshop. SETTING: Conference rooms in three regional centres (Armidale, Moree and Tamworth, New South Wales). SUBJECTS: Twenty-two high school careers advisers. INTERVENTION: One-day workshop. MAIN OUTCOME MEASURES: High school careers advisers' self-rated assessment in terms of the effective delivery of appropriate information and opportunities to network. RESULTS: Participants agreed that the workshop conveyed relevant information (3.8), were of high standard 3.5) and enabled them to identify students wanting to pursue health careers (2.9). Networking between health professionals and career advisers was rated as the most beneficial aspect by a majority of participants (60%). The scenario was rated as a useful tool to educate advisers about health careers (3.8). CONCLUSION: Collaborative workshops between advisers and health professionals are useful in facilitating networks to promote health careers in high schools in rural areas. The use of a farm injury scenario as a learning tool was effective in educating advisers about health careers. WHAT IS ALREADY KNOWN: Previous research carried out in the USA6 and Australia demonstrated that high school careers advisers needed to target high school students earlier in their studies before senior subjects were decided and that about a quarter of careers advisers indicated poor knowledge about health careers.10 WHAT THIS STUDY ADDS: Provision of practical support to high school careers advisers, such as distributing a mentorship directory and up-to-date health career kits as well as facilitating networking with health professionals constitute effective means to promote health careers to high school students.

External clinical teaching visits are an important component of general practitioner training in Australia. During these sessions, a senior general practitioner observes a registrar's consultations and reviews the surgery's equipment, policies, and procedures. Structured feedback is given to assist registrar learning. Visiting remote regions to perform external clinical teaching has its challenges. I recount here a story of when I visited a solo general practitioner registrar who worked in a small rural village in the rugged forested hinterland of the coast of New South Wales. I was impressed by the surgery's peaceful character. It was an old converted post office with aged cypress pine floors. The registrar was busy, with a clientele consisting mainly of elderly farmers from the valley. The waiting room was full, and the patients extended out on to the veranda. In a quieter moment, I asked about the new piece of wood that looked out of place nailed to the floor next to the registrar's desk. I was concerned that it might be a trip hazard for his patients. In explanation, the registrar recounted the tale of a farmer who had probably saved his life. A 70 year old farmer, "Joe," had come in for his blood pressure check and a chat. As they chatted about the weather and cattle markets, his patient had turned pale. "Hey, Doc," said the patient quietly. "Yes, Joe," said the registrar. "Don't move," said Joe. "Why?" "There's a brown next to your toe." A brown snake's head had slithered out of a knothole in the floorboards. Its head lay next to the registrar's now sweating sandalled foot as metres of snake body kept emerging. A long silence descended, as snake eyed registrar and registrar eyed snake. To everyone's relief, discretion over valour was decided as the better course of action by all. The snake returned to its subterranean environment beneath the surgery and the registrar to his desktop. As the registrar nailed the hole closed with a piece of wood, Joe's condition improved and he yelled to the waiting room, "Six foot brown!" Remarkably, all of the waiting patients improved and they ran off. This brown snake was useful in organising a patient­free day for the registrar. A stethoscope applied to the floorboards periodically during the day failed to locate its whereabouts. The brown snake elected to migrate that night to find another, safer habitat.

This paper investigates the sources of teacher stress for special educators working in an inclusive education setting. The study focused on one school using a case study design. All special educators working in the secondary special education unit were administered the 'Stress in the Teacher Profession Questionnaire' developed by Travers and Cooper (1996). The major sources of the special education teachers' stress related to: (1) the constant pressure of dealing with aggressive and unpredictable students; (2) poor working conditions and facilities; (3) role ambiguity, communication and support difficulties; and (4) administration and paperwork. These concerns were aggravated by poorly designed teaching spaces that exacerbated students' behaviour management problems. The pattern of concerns identified in this research is different from that identified by mainstream teachers. Issues associated with the inclusion of students into regular schools are discussed and how special educators' stress can be better managed.

Achieving change at any level of educational activity is not easy. In terms of teaching practice, developing a positive capacity for continuous improvement may involve deep change with the potential to threaten the core values and personal belief systems of staff and the students whom they teach. Recent theorising and discussion concerning conceptions of teaching and learning is an acknowledgement that the task of achieving change and the role of change supporters is not just a pragmatic one. This paper considers some of the issues faced by academic staff developers attempting to transform teaching practice. The author draws upon late twentieth century philosophy and extensive theorising about educational and organisational change with a view to suggesting this literature's potential to support the work of change supporters, such as academic staff developers.

A case report of a 64-year old woman who presented with recurrent pelvic and hip pain secondary to an intra-osseous lipoma of the acetabulum (with intra-articular extension) is reported. An acetabular labral tear developed in association with this tumour. There was no history of trauma. Usually intra-osseous lipomas are asymptomatic. To my knowledge, this is the first case report in the literature of an intra-osseous lipoma of the acetabulum causing severe pelvic pain requiring laparotomy. Hip pathology should be considered in the differential diagnosis of recurrent pelvic pain. Intra-osseous lipomas tend to resolve spontaneously by fat necrosis altering their radiological appearance. Consistent with this case, a negative bone scintigraph does not exclude their presence.

As stadiums are built to hold more people for an increasing range of events there is a demand placed by the public on event organisers to ensure their health and safety. This includes timely and appropriate medical care. This study demonstrates that people are being injured or becoming ill at mass gathering events, and that the number of people who are seriously injured is higher than has previously been estimated. This study indicates a need for specific plans that includes an increased level of care at mass gatherings and an availability of a multidisciplinary medical team to ensure the health and safety of the public.

In the Women's Health Australia (WHA) study, women from rural and remote areas were more likely than women from urban areas to have ever lived with a violent partner or spouse. Women who had ever experienced domestic violence were significantly less physically and psychologically healthy than women who had never experienced domestic violence. To elaborate on the health and psychosocial impacts of experiencing domestic violence, a qualitative interview study was conducted using a sub-sample of mid-aged women from WHA who had experienced domestic abuse while living in small rural communities, or on isolated properties and who had since left the violent relationship. Of the 28 women who took part, 17 had lived in a rural or remote community for at least a proportion of the violent relationship. The semi-structured telephone interviews focussed on the impact of domestic abuse on health, and psychosocial factors that were perceived to improve or harm health. Results of the qualitative interviews indicate that most women experienced a decline in their physical health, and all of them experienced decreased emotional well-being. The major themes that emerged for women from rural and remote areas included: - Privacy and confidentiality - 'Small town gossip' - Poor access to confidential services, particularly counselling services - Responses of health workers - Poor access to friends/family - Isolation - Demanding responsibilities related to working on a property Conclusions: Issues of privacy and confidentially are key issues for abused women in rural and remote communities. All of the women said that the one thing that would have helped them during their abusive relationship would have been having someone to talk to, supporting abundant research on the importance of social support. However, women who have lived with an abusive partner often have difficulty with trusting people, and assurances of confidentiality were disbelieved by some of the women. Therefore, it is recommended that providing access to confidential counselling and mental health services in rural and remote areas is a pressing issue. To address privacy and confidentiality concerns, the feasibility of providing counselling services by people who do not live in the towns that they service should be investigated.

This paper discusses how the management of educational change can be affected by the fundamental beliefs about the formation and communication of knowledge that stakeholders bring to the process of implementing change. A curriculum change designed to embed vocational education into the senior years of secondary schooling was investigated from the perspective of the teachers, principals and consultants (the implementers) whose task it was to implement policy derived from the Australian National Training Agenda. The practitioners' impressions were sought regarding a range of matters including their expectations, experiences and perceptions of management strategies supporting their work. Using a qualitative approach that included a purposefully designed questionnaire, the study gathered data from structured and unstructured questions and post-script interviews. The data from the study indicated that continuation of the initiative was uncertain in many sites, despite its popularity with students and teachers. The most prominent criticisms related to resources and staff development. Respondents reported inadequate access to, or provision of, industry standard equipment and facilities, ongoing professional development for teachers and financial support. The belief systems of administrators did appear to influence the management strategies that underpinned implementation. Judged against current theorising, these strategies were not as efficacious as they might have been.

Practical skills are needed in general practice to provide comprehensive care to patients. General practitioners find this work rewarding, particularly in rural areas where procedural medicine is an important part of job satisfaction. A sustainable Australian general practice workforce requires practical skills to be taught to registrars and medical students aspiring to become GPs. General practitioner supervisors act as important role models and mentors to this group; part of their role is to plan teaching to facilitate skills acquisition and opportunities for ongoing practice of these skills under supervision. Rural GPs perform procedures with safety in small Australian communities. A major initiative in training has been to require all registrars to experience rural general practice motivating some to train specifically for procedural practice. At the same time, the work environment of rural general practice is changing; fewer GPs are involved in procedural medicine. Part of the challenge for supervisors is to promote the professional rewards of procedural medicine to registrars. Appropriate initial training is central to developing psychomotor skills, however, confidence to continue to practise skills are also related to caseload and the attitudes of peers and patients.5 Several developments have decreased the amount of practical skills teaching in general practice including medicolegal issues, concerns about higher complication rates with novice practitioners, limited time, and the fact that some important procedures occur rarely, limiting teaching opportunities. Undergraduates and junior medical officers complain about a lack of opportunities to learn skills during their prevocational training. This has placed a greater reliance on GP supervisors to teach registrars during their postgraduate training. The philosophy of 'see one, do one, teach one' as the most effective means of skills training is changing. Work based training linking skills training to assessment of competence is needed. This article develops a framework for teaching and assessing procedural skills and their assessment in general practice.