Inasmuch as treatments for advanced prostate cancer may have identical clinical outcomes but very different meanings to patients, we sought to compare the impact of surgical and medical castration (orchiectomy versus injected goserelin acetate Zoladex) on quality of life and psychosocial status. A total of 147 men with Stage D prostate cancer participated in the study: 115 selected treatment with goserelin acetate, and 32 chose orchiectomy. Quality of life, as measured by the Functional Living Index: Cancer (FLIC), improved at both the 3 and the 6 month follow-up in the goserelin acetate group (p = 0.0001), but did not change from baseline at 6 months in the orchiectomy group (p = 0.54). These findings were paralleled by improvement from baseline in psychosocial status, as measured by the Profile of Mood States (POMS), at 6 month follow-up (p = 0.01 in the goserelin acetate group versus p = 0.60 in the orchiectomy group). This investigation, which is among the first to evaluate patients' appraisals of their lives following treatment choices for advanced prostatic cancer, argues compellingly for including quality of life in assessments of therapy.
Solutions are needed to keep pigs under commercial conditions without tail biting outbreaks (TBOs). However, as TBOs are inevitable, even in well managed farms, it is crucial to know how to manage TBOs when they occur. We evaluated the effectiveness of multi-step intervention protocols to control TBOs. Across 96 pens (1248 undocked pigs) managed on fully-slatted floors, 40 TBOs were recorded (≥3 out of 12–14 pigs with fresh tail wounds). When an outbreak was identified, either the biters or the victims were removed, or enrichment (three ropes) was added. If the intervention failed, another intervention was randomly used until all three interventions had been deployed once. Fifty percent of TBOs were controlled after one intervention, 30% after 2–3 interventions, and 20% remained uncontrolled. A high proportion of biters/victims per pen reduced intervention success more so than the type of intervention. When only one intervention was used, adding ropes was the fastest method to overcome TBOs. Removed biters and victims were successfully reintroduced within 14 days back to their home pens. In conclusion, 80% of TBOs were successfully controlled within 18.4 ± 1.7 days on average using one or multiple cost-effective intervention strategies.
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