Reproductive benefits of no-take marine reserves vary with region for an exploited coral reef fish.

No-take marine reserves (NTMRs) are expected to benefit fisheries via the net export of eggs and larvae (recruitment subsidy) from reserves to adjacent fished areas. Quantifying egg production is the first step in evaluating recruitment subsidy potential. We calculated annual egg production per unit area (EPUA) from 2004 to 2013 for the commercially important common coral trout, Plectropomus leopardus, on fished and NTMR reefs throughout the Great Barrier Reef (GBR), Australia. Geographic region, NTMR status, fish size, and population density were all found to affect EPUA. The interactions among these factors were such that, EPUA on NTMR reefs compared to reefs open to fishing was 21% greater in the southern GBR, 152% greater in the central GBR, but 56% less in the northern GBR. The results show that while NTMRs can potentially provide a substantial recruitment subsidy (central GBR reefs), they may provide a far smaller subsidy (southern GBR), or serve as recruitment sinks (northern GBR) for the same species in nearby locations where demographic rates differ. This study highlights the importance of considering spatial variation in EPUA when assessing locations of NTMRs if recruitment subsidy is expected from them.

Public opinion on systems for feeding back views to the National Health Service.

OBJECTIVES: To explore public opinions about different systems for feeding back views about health services to the National Health Service. DESIGN: Questionnaire survey. SETTING: NHS Grampian, Scotland, UK. PARTICIPANTS: A random sample of 10 000 adults registered with a general practitioner in Grampian was invited to opt in to the study; 2449 were sent questionnaires. OUTCOME MEASURES: Opinions about different feedback mechanisms and their likely effectiveness in three scenarios; reasons for preferring particular mechanisms. RESULTS: Of 1951 respondents, over 80% thought patient representatives would be a good way for people to pass on their ideas about the NHS and would help to improve it. Patient representatives were the most widely preferred course of action for two out of three scenarios. People explained their preferences for particular feedback systems mainly in terms of their ease of use, the perception that they would be listened to, and the likelihood of anything being done about what they said. However, people varied in their judgements about the likely effectiveness of different feedback systems. Preferences for particular systems varied according to the types of situation considered. Some people are reluctant to approach clinical staff with concerns about healthcare quality. A substantial minority have no confidence that their concerns would be listened to or acted upon, however they were expressed. CONCLUSION: The "patient representative" function has substantial popular support and could facilitate local learning and action to improve the quality of health services from users' perspectives. Feedback systems must demonstrate their effectiveness if they are to gain and retain public confidence.

Changes in public awareness of, attitudes to, and use of complementary therapy in North East Scotland: surveys in 1993 and 1999.

OBJECTIVE: To assess changes in awareness of, use of, attitudes to, and opinions about complementary and alternative medicine (CAM) amongst residents of North East Scotland and to obtain details about CAM use from respondents. STUDY DESIGN: Population survey carried out in 1999, 6 years after the initial study. Postal survey to 800 people to examine eight CAMs; acupuncture, aromatherapy, chiropractic, herbalism, homeopathy, hypnotherapy, osteopathy, and reflexology. RESULTS: A total of 432/800 (54%) responded, of whom 175 (41%) had used at least one type of CAM compared to 29% in 1993. Increases in use were statistically significant for aromatherapy (18% versus 9%), acupuncture (10% versus 6%) and reflexology (9% versus 3%). A greater proportion of 1999 respondents thought CAM should be available on the NHS but a smaller proportion of respondents had concerns about using CAM (25% in 1993 and 20% in 1999). Overall concerns about effectiveness of therapies had increased from 36 to 45%, but fewer individuals were concerned about the cost of therapy in the 1999 survey (52% in 1993 to 22% in 1999). A total of 175 individuals provided details about one CAM they had used. The self-reported primary reasons for using CAM were relief of pain due to headaches or musculoskeletal problems, and for relaxation and relief of stress. The majority of CAM was therapist administered (103/166) as opposed to a bought product. Effectiveness ratings were self-reported but overall 80/166 found CAM very effective and 62/166 partially effective. A total of 65% had consulted their GP about their health problem before using CAM, 59/157 indicated their GP knew they were using CAM and of these, 14 indicated their GP was administering the therapy. CONCLUSIONS: The study has provided further baseline data on which to assess trends in CAM use and highlighted issues for patients and the NHS about the use of CAM to relieve health problems. Results indicate a greater proportion of the population of North East Scotland are both aware of and using CAM to relieve health problems. More research into the implications for the NHS of concurrent use of CAM with conventional medicine is required.