Attaching unit costs to Australia's National Survey of Mental Health and Wellbeing

Background: In mental health, policy-makers and planners are increasingly being asked to set priorities. This means that health economists, health services researchers and clinical investigators are being called upon to work together to define and measure costs. Typically, these researchers take available service utilisation data and convert them to costs, using a range of assumptions. There are inefficiencies, as individual groups of researchers frequently repeat essentially similar exercises in achieving this end. There are clearly areas where shared or common investment in the development of statistical software syntax, analytical frameworks and other resources could maximise the use of data. Aims of the Study: This paper reports on an Australian project in which we calculated unit costs for mental health admissions and community encounters. In reporting on these calculations, our purpose is to make the data and the resources associated with them publicly available to researchers interested in conducting economic analyses, and allow them to copy, distribute and modify them, providing that all copies and modifications are available under the same terms and conditions (i.e., in accordance with the 'Copyleft' principle), Within this context, the objectives of the paper are to: (i) introduce the 'Copyleft' principle; (ii) provide an overview of the methodology we employed to derive the unit costs; (iii) present the unit costs themselves; and (iv) examine the total and mean costs for a range of single and comorbid conditions, as an example of the kind of question that the unit cost data can be used to address. Method: We took relevant data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), and developed a set of unit costs for inpatient and community encounters. We then examined total and mean costs for a range of single and comorbid conditions. Results: We present the unit costs for mental health admissions and mental health community contacts. Our example, which explored the association between comorbidity and total and mean costs, suggested that comorbidly occurring conditions cost more than conditions which occur on their own. Discussion: Our unit costs, and the materials associated with them, have been published in a freely available form governed by a provision termed 'Copyleft'. They provide a valuable resource for researchers wanting to explore economic questions in mental health. Implications for Health Policies: Our unit costs provide an important resource to inform economic debate in mental health in Australia, particularly in the area of priority-setting. In the past, such debate has largely, been based on opinion. Our unit costs provide the underpinning to strengthen the evidence-base of this debate. Implications for Further Research: We would encourage other Australian researchers to make use of our unit costs in order to foster comparability across studies. We would also encourage Australian and international researchers to adopt the 'Copyleft' principle in equivalent circumstances. Furthermore, we suggest that the provision of 'Copyleft'-contingent funding to support the development of enabling resources for researchers should be considered in the planning of future large-scale collaborative survey work, both in Australia and overseas.

Pain relief for neonates in Australian hospitals: A need to improve evidence-based practice

Objective: To ascertain the extent to which neonatal analgesia was used in Australia for minor invasive procedures as an indicator of evidence-based practice in neonatology. Methods: A cross-sectional telephone survey of hospitals in all Australian states and territories with more than 200 deliveries per year was carried out. Questions were asked regarding awareness of the benefits and the use of analgesia for minor invasive procedures in term and near term neonates. Analysis was undertaken according to state and territory, annual birth numbers and the level of neonatal nursery care available. Results: Data were available from 212 of 214 eligible hospitals. Of the total respondents, 51% and 70% respectively were aware of the benefits of sucrose and breast-feeding for neonatal analgesia. Eleven per cent of units administered sucrose before venepuncture and 25% of units used breast-feeding. Ten per cent of units used sucrose before heel prick with 49% utilizing breast-feeding. Expressed breast milk was used in 10% of units. Analgesia was given less frequently before intravenous cannulation compared to venepuncture and heel prick. Awareness and implementation of neonatal analgesia varied widely in the states and territories. There was a trend for hospitals providing a higher level of neonatal care to have a greater awareness of sucrose as an analgesic (P < 0.0001) and the use of sucrose for venepuncture (P = 0.029), heel prick (P = 0.025) and intravenous catheter insertion (P = 0.013). Similar trends were found on analysis according to birth number of the maternity units. Smaller units had a greater usage of breast-feeding as an analgesic for heel prick (P = 0.017). Conclusion: Despite good evidence for the administration of sucrose and breast milk in providing effective analgesia for newborn infants, it is not widely used in Australia. It is imperative that the gap between research findings and clinical practice with regard to neonatal analgesia be addressed.

Psychosocial risk factors for pregnancy risk-taking in young women in emerging adulthood: Evidence from the Australian Longitudinal Study on Women's Health

This study represents the first longitudinal investigation of distal psychosocial predictors of pregnancy risk-taking in young Australian women. Participants were from the Australian Longitudinal Study on Women's Health. Two mail-out surveys assessing sociodemographic, education/competence, psychosocial wellbeing, and aspiration/identity factors, were completed at ages 18 and 22 by 1647 young women in emerging adulthood, and a third survey assessing pregnancy risk-taking behaviour was completed by a subsample of 90 young women at age 24. Higher psychosocial distress at age 22 was a risk factor for pregnancy risk-taking at age 24 (beta=0.29-0.38). Post hoc analyses suggested that the strongest component of psychosocial distress when predicting pregnancy risk-taking was higher depressive symptoms (beta=0.44-0.68). Demographic, education, unemployment, and future aspirations factors at age 18 and 22 were unrelated to pregnancy risk-taking at age 24.

The 2df SDSS LRG and QSO survey: evolution of the luminosity function of luminous red galaxies to z=0.6

We present new measurements of the luminosity function (LF) of luminous red galaxies (LRGs) from the Sloan Digital Sky Survey (SDSS) and the 2dF SDSS LRG and Quasar (2SLAQ) survey. We have carefully quantified, and corrected for, uncertainties in the K and evolutionary corrections, differences in the colour selection methods, and the effects of photometric errors, thus ensuring we are studying the same galaxy population in both surveys. Using a limited subset of 6326 SDSS LRGs (with 0.17 < z < 0.24) and 1725 2SLAQ LRGs (with 0.5 < z < 0.6), for which the matching colour selection is most reliable, we find no evidence for any additional evolution in the LRG LF, over this redshift range, beyond that expected from a simple passive evolution model. This lack of additional evolution is quantified using the comoving luminosity density of SDSS and 2SLAQ LRGs, brighter than M-0.2r - 5 log h(0.7) = - 22.5, which are 2.51 +/- 0.03 x 10(-7) L circle dot Mpc(-3) and 2.44 +/- 0.15 x 10(-7) L circle dot Mpc(-3), respectively (< 10 per cent uncertainty). We compare our LFs to the COMBO-17 data and find excellent agreement over the same redshift range. Together, these surveys show no evidence for additional evolution (beyond passive) in the LF of LRGs brighter than M-0.2r - 5 log h(0.7) = - 21 ( or brighter than similar to L-*).. We test our SDSS and 2SLAQ LFs against a simple 'dry merger' model for the evolution of massive red galaxies and find that at least half of the LRGs at z similar or equal to 0.2 must already have been well assembled (with more than half their stellar mass) by z similar or equal to 0.6. This limit is barely consistent with recent results from semi-analytical models of galaxy evolution.

The survey for ionization in neutral gas galaxies. II. The star formation rate density of the local universe

We derive observed H alpha and R-band luminosity densities of an H I-selected sample of nearby galaxies using the SINGG sample to be l'(H alpha) = (9.4 +/- 1.8) x 10(38) h(70) ergs s(-1) Mpc(-3) for H alpha and l'(R) = (4.4 +/- 9.7) x 10(37) h(70) ergs s(-1) angstrom(-1) Mpc(-3) in the R band. This R-band luminosity density is approximately 70% of that found by the Sloan Digital Sky Survey. This leads to a local star formation rate density of log ((rho)over dot(SFR) [M-circle dot yr(-1) Mpc(-3)]) = -1.80(-0.07)(+0.13)(random) +/- 0.03(systematic) + log (h(70)) after applying a mean internal extinction correction of 0.82 mag. The gas cycling time of this sample is found to be t(gas) = 7.5(-2.1)(+1.3) Gyr, and the volume-averaged equivalent width of the SINGG galaxies is EW(H alpha) = 28.8(-4.7)(+7.2) angstrom (21.2-3.5+4.2 angstrom without internal dust correction). As with similar surveys, these results imply that (rho)over dot(SFR)(z) decreases drastically from z similar to 1.5 to the present. A comparison of the dynamical masses of the SINGG galaxies evaluated at their optical limits with their stellar and H I masses shows significant evidence of downsizing: the most massive galaxies have a larger fraction of their mass locked up in stars compared with H I, while the opposite is true for less massive galaxies. We show that the application of the Kennicutt star formation law to a galaxy having the median orbital time at the optical limit of this sample results in a star formation rate decay with cosmic time similar to that given by the. (rho)over dot(SFR)(z) evolution. This implies that the (rho)over dot(SFR)(z) evolution is primarily due to the secular evolution of galaxies, rather than interactions or mergers. This is consistent with the morphologies predominantly seen in the SINGG sample.

A community-based wildlife survey: the knowledge and attitudes of residents of suburban Brisbane, with a focus on bandicoots

Within the expanding city of Brisbane in south-east Queensland, numerous fragments of native and regrowth vegetation are scattered across the largely urbanised landscape. These fragments provide refuge to a great diversity of native wildlife, and, provide residents with the opportunity to experience nature on their doorstep. To assess the diversity and abundance of this wildlife, recent changes in these parameters, and the value of wildlife and bushland fragments to residents of Brisbane, a questionnaire survey was distributed to 300 households each located adjacent to one of 38 urban bushland fragments. A total of 172 surveys (57%) were returned, producing 768 records of 83 fauna species, dominated by birds and mammals; bandicoots were widely reported from the 38 fragments. Several historical records provided evidence of recent local extinctions within fragments, highlighting the continuing declines in various species of native wildlife within Brisbane. Several human-wildlife conflicts were identified, but overall residents were tolerant of such conflicts. Bandicoots were disliked by a small minority (3%) of residents owing to the holes they dig in lawns and gardens in search of food. and their potential as vectors of ticks. Most respondents expressed ail appreciation for the presence of native wildlife (96%) and bushland fragments (97%) in their local area, emphasising the importance of incorporating human dimension values into the management of this urban biodiversity.

A survey of regular ecstasy users' knowledge and practices around determining pill content and purity: Implications for policy and practice.

Objective: To examine the methods used by a sample of regular ecstasy users to determine the content and purity of ecstasy pills, their knowledge of the limitations of available pill testing methods, and how pill test results would influence their drug use behaviour. Method: Data were collected from regular ecstasy users (n = 810) recruited from all eight capital cities of Australia. Data were analysed using multiple logistic regression and chi-square (chi(2)) tests of association. Open-ended responses were coded for themes. Results: The majority of the sample(84%) reported attempting to find out the content and purity of ecstasy at least some of the time, most commonly asking friends or dealers. Less than one quarter (22%) reported personal use of testing kits. There was a moderate level of awareness of the limitations of testing kits among those who reported having used them. Over half (57%) of those reporting personal use of testing kits reported that they would not take a pill if test results indicated that it contained ketamine and over three quarters (76%) reported that they would not take an "unknown" pill (producing no reaction in a reagent test). Finally, a considerable majority (63%) expressed interest in pill testing should it be more widely available. Conclusions: The majority of regular ecstasy users sampled in this Australian study report previous attempts to determine the content and purity of pills sold as ecstasy. Although only a small proportion have used testing kits, many report that they would do so if they were more widely available. The results of pill tests may influence drug use if they indicate that pills contain substances which ecstasy users do not want to ingest or are of unknown content. More detailed research examining ways in which pill testing may influence drug use is required to inform evidence-based policy. (c) 2006 Elsevier B.V. All rights reserved.