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Our aim was to compare the efficacy of the Therabite ® jaw motion rehabilitation system (Atos Medical) with that of wooden spatulas to relieve and prevent trismus in patients who have had radiotherapy for stage three and four oral and oropharyngeal cancer. Secondary aims were to assess the feasibility and the impact of exercise on health-related quality of life (QoL), and the use of health services after treatment. We designed a randomised, open-label, controlled, three-centre feasibility study to compare the effectiveness and cost of the Therabite ® and wooden spatulas. We studied compliance with exercises and health-related QoL, assessed cost using three health economics measures, and conducted semistructured interviews with patients. Patients were randomised into two groups: the Therabite ® group (n = 37) and the wooden spatula group (n = 34). All patients had some sense of jaw tightening before the study started. Mean mouth opening after six months increased in both groups, but the difference between the groups was not significant (p = 0.39). Completion rates for the three economic measures were good. There was no significant difference between the two groups in frequency of contact with care services or in QoL. Exercises during and after radiotherapy can ameliorate trismus in patients with stage three and four oral and oropharygeal cancers, but differences between groups in efficacy, compliance, QoL, or use of hospital or community health services, were not significant. [ABSTRACT FROM AUTHOR]

Abstract: Rivers and streams that support anadromous salmonids are an important part of land management planning in southeastern Alaska and the Pacific Northwest of North America. Land managers and planners require a consistent set of protocols that include both the physical and biological aspects of the stream for effectiveness monitoring procedures to evaluate management activities in forested watersheds. We apply a quantitative method to estimate salmonid populations and link these estimates to a set of physical variables used in an assessment of channel condition at the reach scale. We are able to obtain precise estimates of juvenile salmonid populations at the habitat and reach scale; however, we find a lack of strong relationships between channel condition variables and salmonid densities. Nonetheless, a few trends appear, such as relationships between coho salmon and both pools and large wood. A significant and positive relationship exists between coho salmon fry density and two measures of pool frequency. Our results suggest that the response of fish populations to changes in the amount and quality of habitat can be measured by using the tested procedures. Complexity in habitat use, seasonal effects, and external factors tend to mask close relationships between fish populations and physical variables. We also discuss the implications for trophic status for fish populations and how this information may provide a more robust evaluation of land management activities on the aquatic biota in managed watersheds. [Copyright &y& Elsevier]