Australia's health 2006 : the tenth biennial report of the Australian Institute of Health and Welfare

The report shows that Australians generally have good health and are privileged to have a range of health care services available to them. There are stark exceptions to this that can be confronting—even if well-known already—notably the generally much poorer health status of Indigenous Australians.

Health care service provider and funding arrangements are both increasingly complex and increasingly costly to both individuals and taxpayers. A continuing challenge is how to balance both the complementary and competitive perspectives of government and non-government agencies, professional groups, and small businesses. Overall, national expenditure on health was 9.7% of GDP in 2003–04; and average health expenditure per person has grown by an average 3.8% each year between 1997–98 to 2002–03. Expenditure on aids and appliances, health research and pharmaceuticals contributed more to this growth than other areas.

While the ageing of the population is having a significant impact on the number and type of health care services delivered, high quality services for children continue to be a priority. Australia’s health 2006 has a special chapter focusing on children and their health. The chapter highlights the fact that while our children are generally very healthy, there are concerns that their ongoing health could be affected by more and more of them becoming overweight or obese. Levels of diabetes are now rising among our children and it is a continuing concern that asthma and mental health problems affect so many of them.

Health system expenditure on disease and injury in Australia, 2000–01

This publication presents estimates of health expenditure on disease and injury in Australia in 2000-01, classified by disease or injury group, age and sex. The estimates are available by area of expenditure - hospitals, high-level residential aged care, medical services, other professional services, pharmaceuticals and research.The 2000-01 disease expenditure estimates were based on the 176 disease and injury conditions used in the first Australian burden of disease study (AIHW: Mathers et al. 1999), with the inclusion of some additional sub-categories. This report aggregates these conditions into the 19 broad disease groups used by the burden of disease study. Disease expenditure estimates are also presented for selected conditions in the seven National Health Priority Areas and by age and sex.

Economic implications of obesity among people with atherothrombotic disease

Objective: The purpose of this study was to ascertain the impact of obesity on the cost of disease management in people with or at high risk of atherothrombotic disease from a governmental perspective using a bottom-up approach to cost estimation. In addition, the aim was also to explore the causes of any differences found.

Method: The health-care costs of obesity were estimated from 2819 participants recruited into the nationwide Australian REACH Registry with established atherothrombotic disease or at least three risk factors for atherothrombosis. Enrollment was in 2004, through primary care general practices. Information was collected on the use of cardiovascular drugs, hospitalizations and ambulatory care services. Bottom-up costing was undertaken by assigning unit costs to each health-care item, based on Australian Government-reimbursed figures 2006-2007. Linear-mixed models were used to estimate associations between direct medical costs and body mass index (BMI) categories.

Results: Annual pharmaceutical costs per person increased with increasing BMI category, even after adjusting for gender, age, living place, formal education, smoking status, hypertension and diabetes. Adjusted annual pharmaceutical costs of overweight and obese participants were higher (7 (P0.004) and 144 (0.001), respectively) than those of the normal weight participants. This was due to participants in higher BMI categories receiving more pharmaceuticals than normal weight participants. There was no significant change across the BMI categories in annual ambulatory care costs and annual hospital costs.

Conclusion: In these participants with or at high risk of atherothrombotic disease, annual pharmaceutical costs were greater in participants of higher BMI category, but there was not such a gradient in the annual hospital or ambulatory care costs. The greater cardiovascular pharmaceutical costs for participants of higher BMI categories remained even after adjusting for a range of demographic factors and comorbidities. Our results suggest that these costs are explained by the higher number of drugs used among people with atherothrombotic disease. Further investigation is needed to understand the reasons for this level of drug use.

The politics of the pharmaceutical industry and access to medicines : world pharmacy and India

The Pharmaceutical Industry presents one of India’s most successful stories of economic expansion and improvements in public health. Indian firms have made access to quality medicines possible and affordable in many developing countries. Indian pharmaceuticals are also exported on a large scale to the United States and other highly regulated markets. A wave of mergers, acquisitions and tie-ups point to growing integration between Indian firms and global pharma multinationals.

The Politics of the Pharmaceutical Industry and Access to Medicines: World Pharmacy and India examines this important industry from different economic, social and political perspectives. Topics covered include the implications of TRIPS-compliant intellectual property rights, the role of flexibilities under TRIPS, the market regulation system, the role of Indian firms in exporting HIV/AIDS medications to Africa, the issue of free trade agreements, the power and reach of foreign pharmaceutical multinationals in India’s domestic market, and the sustainability of India as a major generics supplier.

Value relevance of information in hi-tech industries in Australia : accounting information and intangible asset disclosures

The main objective of this study is to test the value relevance of financial and non-financial information in high-tech industries in Australia. Ninety-one companies were selected from the sectors of Pharmaceuticals, Biotechnology and Life Sciences; Technology, Hardware and Equipment; and Telecommunication Services of ASX for the analysis. Both financial and non-financial sections of annual reports were scrutinized in order to obtain data for the analysis. The unaudited sections of annual reports were particularly analysed using NVivo to obtain the word-count of intangible assets. Ohlson’s (1995) Equity Valuation Model (modified for the intangible assets disclosures) was explicitly applied to examine the value relevance of financial and non-financial information. The overall results provide evidence that book value is the most significant factor and earnings are the least significant factor in deciding share prices in high-tech industries in Australia. This finding supports the previous studies that showed value relevance declined in earnings but increased in book value. This research proved that voluntary disclosures of intangible assets are value relevant, providing support for the previous US and Australian studies and the conclusion that investors probably increasingly rely upon alternative information sources.

Multifunctional polymer/porous boron nitride nanosheet membranes for superior trapping emulsified oils and organic molecules

Effective oil/water separation and removal of organic molecules from water are of worldwide importance for water source protection. Multifunctional sorbent materials with excellent sorption capacity, stability, and recyclability properties need to be developed. Here, flexible and multifunctional polymer/porous boron nitride nanosheets (BNNSs) membranes with high water permeability, exhibiting high effectiveness and stability in the purification of simulated wastewater tainted with either oil/water emulsion or organic molecules, are reported. Remarkably, the flexible nature of these porous membranes enables simplicity of operation for water remediation processing and ease of post-processing collection. The composite membrane also displays a remarkably high permeability of 8 × 10⁴ L μm m^-2 h^-1 bar^-1, roughly three orders of magnitude higher than pure polymer, and excellent filter efficiencies for the pharmaceuticals ciprofloxacin, chlortetracycline, and carbamazepine (up to 14.2 L g^-1 of BNNSs in the composite membrane for a concentration of 10 mg L^-1 ciprofloxacin) and the dye methylene blue (up to 9.3 L g^-1 of BNNSs in the composite membrane at a concentration of 30 mg L^-1). Exhausted membranes can be readily rejuvenated by simple washing with retention of their high-performance characteristics. The results demonstrate the potential efficacy and practicality of these membranes for water cleaning.

Superior adsorption of pharmaceutical molecules by highly porous BN nanosheets

Highly porous boron nitride nanosheets (BNNSs) were tested as a re-usable adsorbent for the removal of pharmaceuticals from aqueous solution. The BNNSs exhibit both unprecedentedly high adsorption capacities and excellent recyclability while maintaining their high adsorption capacity by a simple regeneration process. These advantages render BNNSs a promising material for water remediation applications.

Influence of base on nitro-aldol (Henry) reaction products for alternative clandestine pathways

Australian clandestine drug laboratories are constantly utilising alternative methods to produce methamphetamine, in part as restrictions are placed by Government on, for example, chemicals such as phenyl-2-propanone (P2P) (in the early 1980s), or on pseudoephedrine-containing pharmaceuticals, from the mid-2000s. This paper discusses the nitro-aldol reaction occurring between nitroethane and benzaldehyde, which can be utilised in a number of differing routes, in the presence of different bases. The resulting products, namely phenyl-2-nitropropene (P2P pathway) and 2-nitro-1-phenyl-1-propanol (ephedrine pathway) are directly dependant on which base is used; as such, the base may be used to provide an indication of a possible manufacture pathway of methamphetamine at a clandestine laboratory.

Antioxidative peptides derived from food proteins

The search for natural antioxidants is an ongoing endeavour as an aid to combat the harmful effects of free radicals. Research advances in the past few decades have shown that, by controlled enzymatic hydrolysis, natural antioxidants can be produced from food proteins. In this chapter, the role of certain antioxidative peptides derived from food proteins is discussed in relation to their prospect in the prevention of oxidative stress. The molecular diversity of these food peptides is described together with their pharmacological effects and mechanisms of action in relation to antioxidation. The production of these peptides and the elucidation of their antioxidative peptides are also presented. Owing to their therapeutic potential, antioxidative peptides derived from food proteins can be incorporated as ingredients in functional foods, nutraceuticals and pharmaceuticals, where their biological activities may inhibit product oxidation or assist in the control and prevention of diseases induced by free radicals. However, further insightful research is needed to overcome certain scientific challenges and thereby increase and promote consumer acceptance of these natural antioxidants.

Ocean governance and risk management

The high seas have always engendered a range of emotions and reactions from humans. Curiosity, fear, even terror, of this great expanse of ocean which cover 70 % of Earth the blue planet. Yet the sheer size of the oceans and the difficulty of transporting across them meant the high seas were largely ignored by the vast majority of humans for centuries. Humans were largely confined to land with the only interest in the seas being as trade routes and the defence of the land. In fact all the way up to the last quarter of the twentieth century a nations territorial sea extended only three nautical miles off shore the distance that a cannon ball could be fired.

This almost casual relationship to the oceans changed dramatically in the 1960s and 1970s as technology played an ever icnreasing role in the exploitation of the natural resources of the seas. Fishing was made far easier by being able to use sophisticated sonar systems to detect the fish and by advanced nets and vessels. But it was probably the technological ability to first find and then extract oil and gas off shore on continental shelfs, and at increasing depths, which stimulated interest in exploiting marine resources. Dreams of other deep sea mineral resources (e.g. manganese nodules) simply fuelled interest in the oceans, not to mentino some of the pharmaceuticals that were being discovered.

Should patients in a persistent vegetative state be allowed to die? Guidelines for a new standard of care in Australian hospitals

In this article we will be arguing in favour of legislating to protect doctors who bring about the deaths of PVS patients, regardless of whether the death is through passive means (e.g. the discontinuation of artificial feeding and respiration) or active means (e.g. through the administration of pharmaceuticals known to hasten death in end-of-life care). We will first discuss the ethical dilemmas doctors and lawmakers faced in the more famous PVS cases arising in the US and UK, before exploring what the law should be regarding such patients, particularly in Australia. We will continue by arguing in favour of allowing euthanasia in the interests of PVS patients, their families, and finally the wider community, before concluding with some suggestions for how these ethical arguments could be transformed into a set of guidelines for medical practice in this area.