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Selected Abstracts


Pain interference impacts response to treatment for anxiety disorders

DEPRESSION AND ANXIETY, Issue 3 2009
Carrie Farmer Teh PhD
Abstract Background: Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. Methods: This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N=191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12-month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. Results: The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P=.01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood of responding to anxiety treatment (OR=.28; 95% CI=.12,.63) and higher health services use (26.1% with ,1 hospitalization versus 12.0%, P<.001). Conclusions: Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood of responding to treatment for PD/GAD. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source]


Suicidal feelings run high among mothers in refugee camps: a cross-sectional survey

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2003
A. Rahman
Objective: To study levels of mental distress in a sample of Afghan mothers caring for children in two refugee camps in North West Frontier Province (NWFP) of Pakistan. Method: Cross-sectional survey of 297 consecutive mothers with young children, attending primary care centres, using a psychiatric screening instrument, the Self-Reporting Questionnaire (SRQ-20). Results: One hundred and six (36%) of women in the sample screened positive for a common mental disorder. Ninety-six (91%) of those screening positive had had suicidal thoughts in the previous month, and nine (8%) rated suicidal feeling as their topmost concern. Conclusion: There is a high prevalence and severity of mental distress in Afghan mothers caring for young children in refugee camps. This may have serious long-term effects on the psychological and physical development of their children. [source]


A cohort study to examine whether time and risk preference is related to smoking cessation success

ADDICTION, Issue 6 2009
Rei Goto
ABSTRACT Aim To identify whether time and risk preference predicts relapse among smokers trying to quit. Design A cohort study of smokers who had recently started to quit. Time and risk preference parameters were estimated using a discrete choice experiment (DCE). Participants A total of 689 smokers who began quitting smoking within the previous month. Measurements Time discount rate, coefficient of risk-aversion measured at study entry and duration of smoking cessation measured for 6 months. Findings In the unadjusted model, Cox's proportional hazard regression showed that those with a high time discount rate were more likely to relapse [hazard ratio: 1.18, 95% confidence interval (CI): 1.11,1.25]. A high coefficient of risk-aversion reduced the hazard of relapse (0.96, 0.96,0.97). When adjusted for other predictors of relapse (age, gender, self-efficacy of quitting, health status, mood variation, past quitting experience, the use of nicotine replacement therapy, nicotine dependence), the hazard ratios of time discount rate and the coefficient of risk-aversion is 1.17 (95% CI: 1.10,1.24) and 0.98 (95% CI: 0.97,0.99), respectively. Conclusions Those who emphasize future rewards (time,patient preference) and those who give more importance to rewards that are certain (higher risk-aversion) were significantly more likely to continue to abstain from smoking. [source]


The oral health of street-recruited injecting drug users: prevalence and correlates of problems

ADDICTION, Issue 11 2008
Anne-Marie Laslett
ABSTRACT Aims To examine the effects of a series of injecting drug users' (IDU) characteristics and drug use behaviours upon the self-reported oral health of a sample of IDU. Design Cross-sectional survey. Setting Melbourne, Australia. Participants A total of 285 IDU recruited through needle and syringe programmes, snowballing and outreach across six sites. Measurements Structured survey that collected information on current drug use patterns, self-reported blood-borne virus status and general health factors, including open-ended questions on past-year dental health problems. Findings Sixty-eight per cent of the sample reported dental problems that were commonly severe and caused dental pain. Despite these reported problems, almost half the sample had not visited the dentist in the 12 months prior to the survey. Participants who were older, and reported homelessness, not eating every day and more common injection of amphetamines rather than heroin in the previous month, were more likely to report having a past-year dental problem. Conclusions Dental problems in IDUs are common but few receive treatment. Further, those using amphetamines, with poor housing, hygiene and poor nutrition, are most at risk. Programmes designed to improve the oral health of IDU need to be developed and implemented in a manner amenable to the varying social circumstances of this marginalized group in the community. [source]


GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales

ADDICTION, Issue 11 2004
Andy McEwen
ABSTRACT Aims Prescribing nicotine replacement therapy (NRT) or bupropion for smoking cessation is of considerable importance to public health but little is known about prescribing practices. This paper examines general practitioners' (GPs') prescribing patterns in Britain where these drugs are reimbursed. The results have implications for other health-care systems considering introducing reimbursement. Design, participants and setting Postal survey conducted in 2002 of a random sample of 1088 GPs in England and Wales, of whom 642 (59%) responded. Measures Number of requests GPs reported having received from patients for NRT and bupropion over the past month, the number of prescriptions they reported issuing and ratings of attitudes to these medications. Findings GPs reported receiving an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month. They reported issuing 3.5 prescriptions for NRT and 1.2 for bupropion. Almost all GPs accepted that NRT (95%) and bupropion (97%) should be reimbursable on National Health Service (NHS) prescription. However, a significant minority of those who received requests for prescriptions did not issue any (8% for NRT and 26% for bupropion). This was related to whether they thought these products should be available on NHS prescription for both NRT and bupropion (OR = 0.66, P < 0.05), which in turn was related to beliefs about whether smokers should have to pay for treatment themselves, the cost-effectiveness of NRT/bupropion and the low priority they would give NRT/bupropion in the drug budget. For bupropion, concern about side-effects independently predicted not prescribing [odds ratio (OR) = 1.46, P < 0.03]. Conclusion In the British health-care system, which has a well-established system for technology assessment and professionally endorsed guidelines, a significant minority of GPs decline all patient requests for stop-smoking medicines. [source]


Intensity of drug injection as a determinant of sustained injection cessation among chronic drug users: the interface with social factors and service utilization

ADDICTION, Issue 6 2004
Julie Bruneau
ABSTRACT Aims The objective of this study was to identify factors associated with sustained injection cessation and to examine further the relationship between the occurrence of sustained injection cessation of injection drug users (IDUs) and prior injection frequency. Design and setting IDUs in the Montreal St Luc Cohort who had at least three consecutive interviews between 1995 and 1999 were included. Sustained injection cessation was defined as a period of at least 7 consecutive months without injection. All IDUs completed interview-administered questionnaires on socio-demographic characteristics, drug and sexual behaviours and health-related issues. Logistic regression was used for analyses. Findings A total of 186/1004 (18.5%) IDUs reported a period of sustained injection cessation during the study period. In multivariate analysis, HIV-positive status, ,booting' and cumulative time spent in prison were negatively associated with injection cessation, while injection initiation after 35 years of age and frequent crack use were positively associated with injection cessation. We found a negative association between the occurrence of injection cessation and the frequency of injection; the odds ratios (OR) for cessation were 0.49 [95% confidence interval (CI): 0.03, 0.78] for IDUs who injected 30,100 times and 0.21 (95% CI: 0.10, 0.46) for IDUs who injected more than 100 times in the previous month. Attending needle exchange programmes (NEPs) or pharmacies appeared to be a modifier of the relation between cessation and prior injection frequency. The OR was 0.68 (95% CI: 0.42, 1.12) for IDUs who injected 30,100 times prior to injection and attended NEPs or pharmacies and was 0.07 (0.01, 0.30) for IDUs who did not use these services. Conclusions Overall, a fifth of IDUs experienced at least one episode of injection cessation of 7 months or more during a period of 4.5 years. Our data suggest that NEPs and pharmacies may have played a role in inducing injection cessation episodes in a subgroup of IDUs. Research is needed to better identify the characteristics of IDUs who could benefit from an injection cessation intervention strategy. This information is important for social and health policy planning. [source]


Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO): baseline characteristics of pan-regional observational data from more than 17,000 patients,

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2009
J. Karagianis
Summary Objective:, To describe the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) patient population at study entry, focusing on illness burden and prescribing practices across regions. Methods:, The SOHO study was a 3-year, prospective, observational study designed to assess costs and outcomes associated with antipsychotic use in outpatients initiating or changing antipsychotic (with an emphasis on olanzapine compared with other antipsychotics). SOHO was conducted in 10 European countries and 27 other countries as Intercontinental SOHO (IC-SOHO). Data from all countries have been pooled to produce the W-SOHO dataset. Main outcomes measures:, Clinical Global Impression-Schizophrenia (CGI-SCH) severity scores, psychotropic medication use, adverse events, social interaction, housing and employment status, self-perceived health state (EuroQoL EQ-5D scale and Visual Analogue Scale, EQ-VAS), and reasons for initiation/change of antipsychotic. Results:, The W-SOHO database comprises 17,384 patients from six regions; East Asia (n = 1223), Central and Eastern Europe (n = 2175), Northern Europe (n = 4291), Southern Europe (n = 5788), Latin America (n = 2566), North Africa and the Middle East (n = 1341). Overall, patients were 38 ± 13 years old (mean ± SD), moderately ill (mean CGI-SCH overall score of 4.4 ± 1.0) with a median duration of illness of 7 years (interquartile range 1,16 years); 43% were female, 10% were receiving antipsychotic medication for the first time. Adverse events were prevalent across all regions; on average, 50% (range 41,59%) of patients taking antipsychotics exhibited extrapyramidal symptoms at baseline, and 62% (34,67%) of patients reported sexual dysfunction in the previous month. On average, only 19% (16,23%) of patients were in paid employment and as many as 69% were living in dependent housing. Conclusions:, Despite inherent diversity in these patients and the health care systems supporting them, there are striking cross-regional similarities in baseline characteristics for most measures. Not all countries are represented; regional comparisons may not be valid outside of the countries studied. [source]


Preoperative smoking cessation: a questionnaire study

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2007
D. Owen
Summary Background:, Preoperative smoking cessation has been shown to improve postoperative outcomes. Methods:, A total of 120 anonymous questionnaires were distributed to non-vascular surgeons practising in four centres in the UK asking about their smoking cessation advice practices, and whether they appreciated both the benefits of preoperative smoking cessation, and the efficacy of smoking cessation interventions. Results:, Eighty-three questionnaires were returned (response rate 69%). Twenty-three gastrointestinal surgeons, 11 orthopaedic surgeons, 9 breast surgeons, 12 plastic surgeons, 13 neurosurgeons and 15 urologists took part in this study. Eighty-eight per cent of respondents had not referred any elective patients to smoking cessation services in the previous month. Most non-vascular surgeons underestimated both the benefits of preoperative smoking cessation on outcome, and the efficacy of smoking cessation interventions. Conclusions:, This survey demonstrates that non-vascular surgeons underestimate the fact that preoperative smoking cessation can improve postoperative outcome, and that smoking cessation interventions are successful in helping patients to quit smoking. They largely do not refer patients to smoking cessation services. In order for patients to benefit postoperatively from this intervention it would be necessary to educate surgeons about the scale of the benefit, and the efficacy of smoking cessation interventions or to set up systematic frameworks to offer smoking cessation advice to preoperative patients who smoke. [source]


Mean Reversion in the Short Horizon Returns of UK Portfolios

JOURNAL OF BUSINESS FINANCE & ACCOUNTING, Issue 1-2 2001
Patricia Chelley-Steeley
This paper will show that short horizon stock returns for UK portfolios are more predictable than suggested by sample autocorrelation co-efficients. Four capitalisation based portfolios are constructed for the period 1976,1991. It is shown that the first order autocorrelation coefficient of monthly returns can explain no more than 10% of the variation in monthly portfolio returns. Monthly autocorrelation coefficients assume that each weekly return of the previous month contains the same amount of information. However, this will not be the case if short horizon returns contain predictable components which dissipate rapidly. In this case, the return of the most recent week would say a lot more about the future monthly portfolio return than other weeks. This suggests that when predicting future monthly portfolio returns more weight should be given to the most recent weeks of the previous month, because, the most recent weekly returns provide the most information about the subsequent months' performance. We construct a model which exploits the mean reverting characteristics of monthly portfolio returns. Using this model we forecast future monthly portfolio returns. When compared to forecasts that utilise the autocorrelation statistic the model which exploits the mean reverting characteristics of monthlyportfolio returns can forecast future returns better than the autocorrelation statistic, both in and out of sample. [source]


Widespread pain symptoms and psychological distress in southern Chinese with orofacial pain

JOURNAL OF ORAL REHABILITATION, Issue 1 2010
A. S. MCMILLAN
Summary, The study investigated the experience of widespread pain (WP) symptoms and psychological distress in southern Chinese with orofacial pain (OFP). A community-based, cross-sectional case,control study involving people aged 35,70 registered with the Hospital Authority/University of Hong Kong Family Medicine Clinic served as the sampling frame. People with recent OFP symptoms and a group without OFP took part. Standard questions were asked about OFP conditions in the previous month. Psychological status was evaluated through depression, and non-specific physical symptoms (NPS) scores were measured with depression and somatization sub-scales of the Symptom Checklist-90. Widespread pain was determined using body outline drawings to identify painful sites prior to a standard clinical examination. Two hundred people with OFP and 200 without OFP participated. Compared with 5·0% in the comparison group (P = 0·005), 13·5% of participants with OFP had WP (OFP/WP). Multiple OFP symptoms were more common in the OFP/WP sub-group than the OFP sub-group without WP (OFP/No WP) (P < 0·002). Sixty-three percent of the OFP/WP sub-group had moderate/severe depression scores compared with 26·0% in the OFP/No WP sub-group (P < 0·001). When pain items were included and excluded, 92·6% and 88·9% of the OFP/WP sub-group had moderate/severe NPS scores, respectively compared with 68·5% and 65·0% in the OFP/No WP sub-group (P = 0·004). Co-morbid WP occurred relatively often in southern Chinese with OFP. Psychological distress was common in OFP sufferers, particularly those with WP. A multidisciplinary approach to treatment including cognitive/behavioural therapy should be considered in Chinese people with OFP as part of a WP pattern. [source]


General practitioners: Their contact with maternal and child health nurses in postnatal care

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 2 2000
C Mbwili-Muleya
Objective: To assess the level of contact of general practitioners (GP) with maternal and child health nurses (MCHN) in postnatal care. Methodology: A postal survey of 1104 Victorian GP was used, with a response rate of 70%. To account for the clustered sampling frame, hierarchical data analysis techniques were used. Results: Half of the GP (351/710) had no contact with their local MCHN in the previous month; and one in 10 had four or more contacts. Eighty-eight per cent of GP described the contact as helpful. In 56% of cases the MCHN was reported as the usual initiator of the contact. The most common reason for contact concerned the baby's physical problems (42%). After adjusting for the number of women seen for the routine 6-week postnatal review and other GP characteristics, male GP were as likely as female GP to report MCHN contact (odds ratio (OR) = 1.00; 95% confidence interval (CI) = 0.67,1.62). General practitioners aged 31,40 years were more likely to report contact with MCHN than GP aged 51,60 (OR = 0.45; 95% CI = 0.22,0.86) as were GP with the FRACGP qualification (OR = 1.64; 95% CI = 1.21,2.45). Conclusions: This study provides baseline information on the level of GP contact with MCHN as they provide postnatal care. Although there were GP in Victoria who maintained a level of contact with MCHN, almost half reported no contact in the previous month. Most GP who reported contact with MCHN found it useful. This finding should encourage GP and MCHN coordination to improve continuity and postnatal care outcomes. [source]


Associated factors of rehospitalization among schizophrenic patients

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2003
YURIKO SUZUKI md
Abstract, The purpose of the present study was to identify the associated factors of rehospitalization in schizophrenic patients. A case-control study was conducted. The cases consisted of rehospitalized patients (n = 67) and controls selected from the outpatients who were matched by age, gender, and the period after the last discharge (n = 62). In the multiple logistic regression analysis, no clinic visits in the second month prior to entry, the number of clinic visits in the previous month, and junior high school graduation as education level were significantly (P < 0.01) associated with rehospitalization after controlling their present function as assessed by the Global Assessment of Functioning. Close monitoring of clinic visits and outreach service appear to be important in preventing rehospitalization of schizophrenic patients. These identified modifiable factors suggest further needs for development and implementation of integrated mental health services in the community. [source]


Study of the Reliability and Validity of the Community Health Intensity Rating Scale (CHIRS) in the Turkish Community

PUBLIC HEALTH NURSING, Issue 3 2007
Aysun Çelebio
ABSTRACT The purpose of this study was to examine the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) that was translated into the Turkish language and applied in the Turkish community. The CHIRS is a tool that assesses the intensity of need for care of persons/families in the community. The original version of the tool was translated into Turkish, examined for face validity and language appropriateness by the Turkish experts, and then applied to 372 families living in Odemis, Turkey. Significant correlations were found between total scale score (TSS) and total number of household members, and between the TSS and the total number of visits to any health institution within the previous month. In addition, the self-health care needs evaluation scores supported predictive validity. For reliability, min,max values, standard errors and deviations, skewness, and kurtosis coefficients of parameter scores, domain scores, and TSS were examined. The mean TSS was 26.7 (± 5.32) and the mean age of the participants was 35.0 years. For internal consistency, Cronbach's , (.525) and Guttman split-half coefficient (.629) values were established for the TSS. In conclusion, the reliability and validity of the Turkish version of CHIRS have been established. [source]


Pubic Hair Removal among Women in the United States: Prevalence, Methods, and Characteristics

THE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010
Debra Herbenick PhD
ABSTRACT Introduction., Although women's total removal of their pubic hair has been described as a "new norm," little is known about the pubic hair removal patterns of sexually active women in the United States. Aims., The purpose of this study was to assess pubic hair removal behavior among women in the United States and to examine the extent to which pubic hair removal methods are related to demographic, relational, and sexual characteristics, including female sexual function. Methods., A total of 2,451 women ages 18 to 68 years completed a cross-sectional Internet-based survey. Main Outcome Measures., Demographic items (e.g., age, education, sexual relationship status, sexual orientation), cunnilingus in the past 4 weeks, having looked closely at or examined their genitals in the past 4 weeks, extent and method of pubic hair removal over the past 4 weeks, the Female Genital Self-Image Scale (FGSIS) and the Female Sexual Function Index (FSFI). Results., Women reported a diverse range of pubic hair-grooming practices. Women's total removal of their pubic hair was associated with younger age, sexual orientation, sexual relationship status, having received cunnilingus in the past 4 weeks, and higher scores on the FGSIS and FSFI (with the exception of the orgasm subscale). Conclusion., Findings suggest that pubic hair styles are diverse and that it is more common than not for women to have at least some pubic hair on their genitals. In addition, total pubic hair removal was associated with younger age, being partnered (rather than single or married), having looked closely at one's own genitals in the previous month, cunnilingus in the past month, and more positive genital self-image and sexual function. Herbenick D, Schick V, Reece M, Sanders S, and Fortenberry JD. Pubic hair removal among women in the United States: Prevalence, methods and characteristics. J Sex Med 2010;7:3322,3330. [source]


Prevalence and Characteristics of Vibrator Use by Women in the United States: Results from a Nationally Representative Study

THE JOURNAL OF SEXUAL MEDICINE, Issue 7 2009
Debra Herbenick PhD
ABSTRACT Introduction., Although vibrators are commonly recommended by clinicians as adjunct to treatment for female sexual dysfunction, and for sexual enhancement, little is known about their prevalence or correlates of use. Aim., The aim of this study was to determine the lifetime and recent prevalence of women's vibrator use during masturbation and partnered sex, and the correlates of use related to sociodemographic variables, health behaviors, and sexual function. Methods., A nationally representative sample of 3,800 women aged 18,60 years were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. Main Outcome Measures., The prevalence of vibrator use, the relationship between vibrator use and physical and psychological well-being (as assessed by the Centers for Disease Control and Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship between vibrator use and women's scores on the Female Sexual Function Index, and an assessment of the frequency and severity of side effects potentially associated with vibrator use. Results., The prevalence of women's vibrator use was found to be 52.5% (95% CI 50.3,54.7%). Vibrator users were significantly more likely to have had a gynecologic exam during the past year (P < 0.001) and to have performed genital self-examination during the previous month (P < 0.001). Vibrator use was significantly related to several aspects of sexual function (i.e., desire, arousal, lubrication, orgasm, pain, overall function) with recent vibrator users scoring higher on most sexual function domains, indicating more positive sexual function. Most women (71.5%) reported having never experienced genital symptoms associated with vibrator use. There were no significant associations between vibrator use and participants' scores on the CDC Healthy Days Measures. Conclusions., Vibrator use among women is common, associated with health-promoting behaviors and positive sexual function, and rarely associated with side effects. Clinicians may find these data useful in responding to patients' sexual issues and recommending vibrator use to improve sexual function. Further research on the relationships between vibrator use and sexual health is warranted. Herbenick D, Reece M, Sanders S, Dodge B, Ghassemi A, and Fortenberry JD. Prevalence and characteristics of vibrator use by women in the United States: Results from a nationally representative study. J Sex Med 2009;6:1857,1866. [source]


Monitoring local trends in Indigenous tobacco consumption

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009
David P. Thomas
Abstract Objective: To compare two methods of monitoring tobacco consumption in remote Indigenous communities. Methods: We examined the monthly difference between wholesale invoice and point-of-sale data for tobacco products from three stores from remote Aboriginal communities in the Northern Territory. We assessed three measures of wholesale data. Results: The average monthly difference between the sale data and the average of wholesale invoices for the previous, same and following month was -33 cigarettes per day (95% CI -157, 92). This average of three months' wholesale invoices provided a more precise estimate than either wholesale invoices from the same or previous month. Conclusion: Tobacco wholesale data provided a close estimate of sales data in these stores. Implications: This wholesale data could be used to monitor local trends in remote Indigenous tobacco consumption, facilitating the evaluation of the impact of tobacco control activities and informing future work to reduce Indigenous smoking and its harms. [source]


Price elasticity of water allocations demand in the Goulburn,Murray Irrigation District,

AUSTRALIAN JOURNAL OF AGRICULTURAL & RESOURCE ECONOMICS, Issue 1 2008
Sarah Wheeler
Bid prices for the demand and supply of water allocations between 2001 and 2007, and average monthly prices paid for water allocations from 1997 to 2007 in the Goulburn,Murray Irrigation District are analysed to estimate price elasticities. Based on bid prices, the price elasticity of demand for water allocations appears highly elastic, with elasticities strongly influenced by the season and drought. The price elasticity of supply for water allocations is also elastic, albeit less elastic than demand. Using actual prices paid, water demand is negatively related to price and is inelastic, and appears to be most influenced by demand the previous month, drought and seasonality factors. [source]


AN ADAPTIVE LEARNING FRAMEWORK FOR FORECASTING SEASONAL WATER ALLOCATIONS IN IRRIGATED CATCHMENTS

NATURAL RESOURCE MODELING, Issue 3 2010
SHAHBAZ KHAN
Abstract This paper describes an adaptive learning framework for forecasting end-season water allocations using climate forecasts, historic allocation data, and results of other detailed hydrological models. The adaptive learning framework is based on artificial neural network (ANN) method, which can be trained using past data to predict future water allocations. Using this technique, it was possible to develop forecast models for end-irrigation-season water allocations from allocation data available from 1891 to 2005 based on the allocation level at the start of the irrigation season. The model forecasting skill was further improved by the incorporation of a set of correlating clusters of sea surface temperature (SST) and the Southern oscillation index (SOI) data. A key feature of the model is to include a risk factor for the end-season water allocations based on the start of the season water allocation. The interactive ANN model works in a risk-management context by providing probability of availability of water for allocation for the prediction month using historic data and/or with the incorporation of SST/SOI information from the previous months. All four developed ANN models (historic data only, SST incorporated, SOI incorporated, SST-SOI incorporated) demonstrated ANN capability of forecasting end-of-season water allocation provided sufficient data on historic allocation are available. SOI incorporated ANN model was the most promising forecasting tool that showed good performance during the field testing of the model. [source]