Potential of St John's Wort for the treatment of depression : the economic perspective

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.

Nonprofit organisations and public policy : exploring the research role of the Brotherhood of St Laurence

This paper begins to explore the role of the Brotherhood of St Laurence as a nonprofit welfare organisation and its influence on public policy in Australia. The Brotherhood's impact on Australian social policy has been evident through a range of actions: the production of research on relevant social issues; the preparation of submissions and position papers and involvement in consultations with governments on social policy; and the personal influence of many of the charismatic (mostly) men who have led the organisation throughout its history. This paper highlights the Brotherhood’s research aspect and speculates upon the impact of its considerable research contribution. The Brotherhood has been involved in service delivery through a range of often innovative programs throughout its history, but the organisation's involvement in research and advocacy has rendered it unique in comparison to any other nonprofit welfare organisation in Australia. This paper finds that different kinds of research can be utilised in different ways; by studying the output of the Brotherhood it will explore and highlight how knowledge utilisation takes place. [Introduction]

Using an ‘interpretative model’ for contextual design of heritage landscape databases: The case of St Helena Island National Park in Queensland, Australia

Due to the increasing speed of landscape changes and the massive development of computer technologies, the methods of representing heritage landscapes using digital tools have become a worldwide concern in conservation research. The aim of this paper is to demonstrate how an ‘interpretative model’ can be used for contextual design of heritage landscape information systems. This approach is explored through building a geographic information system database for St Helena Island national park in Moreton Bay, South East Queensland, Australia. Stakeholders' interpretations of this landscape were collected through interviews, and then used as a framework for designing the database. The designed database is a digital inventory providing contextual descriptions of the historic infrastructure remnants on St Helena Island. It also reveals the priorities of different sites in terms of historic research, landscape restoration, and tourism development. Additionally, this database produces thematic maps of the intangible heritage values, which could be used for landscape interpretation. This approach is different from the existing methods because building a heritage information system is deemed as an interpretative activity, rather than a value-free replication of the physical environment. This approach also shows how a cultural landscape methodology can be used to create a flexible information system for heritage conservation. The conclusion is that an ‘interpretative model’ of database design facilitates a more explicit focus on information support, and is a potentially effective approach to user-centred design of geographic information systems.

Application of Mesenchymal Stem Cells for repair and regeneration of cartilage and bone

Australian efforts to provide orthopaedic surgeons with living, load-bearing scaffolds suitable for current joint (knee and hip) replacement surgery, non-union fracture repair, and miniscal and growth plate cartilage regeneration are being lead by teams at the Institute for Medical and Veterinary Science and Women's and Children's Hospital in Adelaide; the Peter MacCallum and St Vincent's Medical Research Institutes in Melbourne; and the Mater Medical Research Institute and new Institute for Health and Biomedical Innovation at QUT, Brisbane. In each case multidisciplinary teams are attempting to develop autologous living tissue constructs, utilising mesenchymal stem cells (MSC), with the intention of effecting seamless repair and regeneration of skeletal trauma and defects. In this article we will briefly review current knowledge of the phenotypic properties of MSC and discuss the potential therapeutic applications of these cells as exemplified by their use in cartilage repair and tissue engineering based approaches to the treatment of skeletal defects.

Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment–elevation myocardial infarction in Australia

Background Improving timely access to reperfusion is a major goal of ST-segment–elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. Methods and Results Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services’ response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. Conclusions Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas.

The affordances of social technology : a BPM perspective

Increasingly, organizations are looking to employ Social Technology (ST) to enhance their capability with Business Process Improvement (BPI). However, little is known about how the characteristics or qualities of ST actually influence an organizations' capability at Business Process Improvement (BPI). This paper discusses the potential role of ST in process improvement by presenting an a-priory model derived by an investigation of extant research. First, the qualities of social technology that potentially support high level action possibilities related to BPI are presented (we refer to these as affordances), next these affordances are mapped to the De Bruin (2009) BPM Maturity model as a first step to understanding how ST influences BPI. This work is expected to contribute to our knowledge and understanding of the relationship between ST and BPI, and will extend existing theory on Business Process Management capability and maturity.

Echolocation calls and wing morphology of bats from the West Indies

Echolocation calls of 119 bats belonging to 12 species in three families from Antillean islands of Puerto Rico, Dominica, and St. Vincent were recorded by using time-expansion methods. Spectrograms of calls and descriptive statistics of five temporal and frequency variables measured from calls are presented. The echolocation calls of many of these species, particularly those in the family Phyllostomidae, have not been described previously. The wing morphology of each taxon is described and related to the structure of its echolocation calls and its foraging ecology. Of slow aerial-hawking insectivores, the Mormoopidae and Natalidae Mormoops blainvillii, Pteronotus davyi davyi, P. quadridens fuliginosus, and Natalus stramineus stramineus can forage with great manoeuvrability in background-cluttered space (close to vegetation), and are able to hover. Pteronotus parnellii portoricensis is able to fly and echolocate in highly-cluttered space (dense vegetation). Among frugivores, nectarivores and omnivores in the family Phyllostomidae, Brachyphylla cavernarum intermedia is adapted to foraging in the edges of vegetation in background-cluttered space, while Erophylla bombifrons bombifrons, Glossophaga longirostris rostrata, Artibeus jamaicensis jamaicensis, A. jamaicensis schwartzi and Stenoderma rufum darioi are adapted to foraging under canopies in highly-cluttered space and do not have speed or efficiency in commuting flight. In contrast, Monophyllus plethodon luciae, Sturnira lilium angeli and S. lilium paulsoni are adapted to fly in highly-cluttered space, but can also fly fast and efficiently in open areas.

Adjuvant use of nutritional and herbal medicines with antidepressants, mood stabilizers and benzodiazepines

Adjuvant use of nutritional and herbal medicines has potential to increase the efficacy of synthetic pharmaceuticals, and perhaps also decrease their side-effects by allowing lower doses to be prescribed. We evaluated current evidence for adjuvant use of nutritional and herbal medicines with antidepressants, mood stabilizers and benzodiazepines; and explored novel future areas of research. The paper also critiques current evidence for co-administration of St. John’s wort with synthetic antidepressants. We performed a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane database, China National Knowledge Infrastructure and the Chinese Science Citation Database. Search results were supplemented by a review of reference lists and a forward search using the Web of Science. Where possible we calculated effect sizes. Encouraging evidence exists for the use of omega-3 fatty acids, SAMe, folic acid and l-tryptophan adjuvantly with antidepressants to enhance response and improve efficacy. Various nutrients also have emerging evidence as effective adjuncts with antipsychotics and mood stabilizers. While some evidence supports nutritional adjuvancy with various psychopharmacotherapies, adjuvant use of herbal therapies has not been sufficiently studied to warrant standard clinical application. This remains a promising area of research via robust, safety-conscious studies.