Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders

Background. The present paper describes a component of a large Population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder). Method. Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. Results. Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at $400 million, resulting in a cost per YLD averted ranging from $7761 for generalized anxiety disorder to $34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < $20 000 for all disorders. Conclusions. Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.

Water characteristics in cooked beef as influenced by ageing and high-pressure treatment -an NMR micro imaging study

The water characteristics in cooked pressure-heat treated (45 degreesC for 45 min prior to pressurisation at 150 MPa for 30 min) and non-pressurised, cooked (control) samples of beef Longissimus aged for 1, 3, 8 or 16 days were studied by nuclear magnetic resonance microscopy. A multi-echo sequence was used to obtain T2 images, and independent of ageing period, the T2 values were found to be lower in pressure-heat treated meat revealing alterations in water characteristics of pressure-treated, cooked meat compared with cooked meat. With increasing ageing duration, the T2 values in both pressure-treated, cooked and cooked meat decreased indicating that the water became more tightly trapped in the protein network. In addition, independent of length of ageing period the relationship between cooking loss in the cooked meat and transverse relaxation differed between non-pressurised and pressure-treated meat. which reveals that the mechanisms changing the water properties in beef during ageing are different from those occuring during pressure-heat treatment of meat. (C) 2003 Elsevier Ltd. All rights reserved.

Therapeutic effects and possible mechanisms of a snake venom preparation in the fibrotic rat liver

The effects of a Chinese snake venom preparation from Agkistrodon halys pallas, used for treatment of hepatic fibrosis/cirrhosis in China, was investigated in an {in vivo} rat model and using in situ hepatic perfusion. Four groups were used in the experiments: (i) healthy, (ii) healthy/venom-treated, (iii) carbon tetrachloride (CCl4)-treated, and (iv) CCl4/venom-treated. Treatment effects were assessed by determining hepatic histopathology, biochemistry and fibrosis index parameters, bile production, biliary taurocholate recovery, hepatic mRNA expression of four bile salt transporters (Ntcp, Bsep, Oatp-1, and Oatp-3), comparison of hepatic microcirculation, fibrinolytic activity, and antithrombotic effects. Liver histopathology, biochemistry, and fibrosis index showed a dramatic improvement in venom-treated animals. There were significant differences in bile production between healthy/venom-treated and all other experimental groups and between CCl4/venom-treated and CCl4-treated animals, but no significant differences were found between CCl4/venom-treated and healthy animals. Biliary taurocholate recovery was significantly increased in healthy/venom-treated and CCl4/venom-treated animals. The expression of mRNA levels of the four bile salt transporters showed an increase after venom treatment. The hepatic microcirculation studies showed normalized sinusoidal beds in CCl4/venom-treated animals compared to healthy animals, whereas CCl4-treated animals showed abnormal profiles to the healthy and the CCl4/AHPV-treated animals. The fibrinogen and plasma thromboxane B-2 levels of healthy rats decreased with increasing dose after venom treatment. It was concluded that snake venom treatment may be therapeutic in treatment of hepatic fibrosis/cirrhosis by possibly a combination of increased bile flow and improved hepatic microcirculation, changes in bile salt transporter expression, and fibrinolytic and antithrombotic effects of the snake venom preparation.

Effects of hatchery shading and nest depth on the development and quality of Chelonia mydas hatchlings: implications for hatchery management in Peninsular, Malaysia

One of the decisions made by hatchery managers around the world is what degree of shading and nest depth are required to maximise the production of high-quality hatchlings at optimal sex ratios. The primary objectives of this study were to determine the effects of (1) hatchery shading and nest depth on nest temperatures and emergence lag, and (2) nest temperatures and nest depth on hatchling sex ratio and quality. In 2001, 26 Chelonia mydas clutches from Ma'Daerah beach, Terengganu, Malaysia, were relocated alternatively at depths of 50 cm and 75 cm into a 70%-shaded and a 100%-shaded hatchery. Data loggers were placed into the centre of each relocated clutch to record the temperature every hour over the course of incubation. When the hatchlings emerged, a sample of the clutch was run, measured and weighed and a separate sample was examined histologically for sex characteristics. Nest temperatures ranged between 28 degrees C and 30 degrees C and generally showed increases over the second half of incubation due to metabolic heating of the clutch. There was no significant correlation found between nest temperature and any of the hatchling parameters measured. Hatchlings from 75-cm-deep nests had a longer emergence lag (46.4 (+/- 10.2) h) than hatchlings from 50-cm-deep nests. Hatch and emergence success were similar to those of natural populations and hatchling sex ratios were male dominant, with an average of 72% males. There was a poor correlation between mean middle-third incubation temperatures and sex ratio. Hatchlings from 75-cm-deep nests had similar running speeds but lower condition index than their conspecifics from 50-cm-deep nests.

Heat-induced and other chemical changes in commercial UHT milks

The properties of commercial directly and indirectly heated UHT milks, both after heating and during storage at room temperature for 24 weeks, were studied. Thermally induced changes were examined by changes in lactulose, furosine and acid-soluble whey proteins. The results confirmed previous reports that directly heated UHT milks suffer less heat damage than indirectly heated milk. During storage, furosine increased and bovine serum albumin in directly heat-treated milks decreased significantly. The changes in lactulose, alpha-lactalbumin and beta-lactoglobulin were not statistically significant. The data suggest that heat treatment indicators should be measured as soon as possible after processing to avoid any misinterpretations of the intensity of the heat treatment.

The effects of a song-singing programme on the affective speaking intonation of people with traumatic brain injury

Primary objective: To examine changes in the relationship between intonation, voice range and mood following music therapy programmes in people with traumatic brain injury. Research design: Data from four case studies were pooled and effect size, ANOVA and correlation calculations were performed to evaluate the effectiveness of treatment. Methods and procedures: Subjects sang three self-selected songs for 15 sessions. Speaking fundamental frequency, fundamental frequency variability, slope, voice range and mood were analysed pre- and post-session. Results: Immediate treatment effects were not found. Long-term improvements in affective intonation were found in three subjects, especially in fundamental frequency. Voice range improved over time and was positively correlated with the three intonation components. Mood scale data showed that immediate effects were in the negative direction whereas there weres increases in positive mood state in the longer-term. Conclusions: Findings suggest that, in the long-term, song singing can improve vocal range and mood and enhance the affective intonation styles of people with TBI.

Characterization of heat-treated porous carbons using argon adsorption

The microstructural variation of Norit RI Extra activated carbon, progressively heated at 1373 K, was explored in terms of pore size and pore wall thickness distributions, for various periods of heating time, determined by argon adsorption at 87 K, both using an infinite as well as and finite wall thickness model. The latter approach has recently been developed in our laboratory and has been applied to several virgin carbons. The current results show significant variations in small pore size regions (< 7 angstrom) in association with strong growth of thick walls having at least three carbon sheets, as a result of heat treatment. In particular, shrinkage of the smallest pores due to strong interaction between their opposite walls as well as smoothening of carbon wall surfaces due to an increase in graphitization degree under thermal treatment have been found. Further, the results of pore wall thickness distribution are well corroborated by X-ray diffraction. The results of pore size and pore wall thickness distributions are also shown to be consistent with transmission electron microscopy analyses. (c) 2005 Elsevier Ltd. All rights reserved.

Thermostability profile of Newcastle disease virus (strain I-2) following serial passages without heat selection

I-2 is an avirulent strain of Newcastle disease virus. During establishment of the I-2 strain master vaccine seed, a series of selection procedures was carried out at 56 degrees C in order to enhance heat resistance. This master seed is used to produce a working seed, which is then employed to produce the vaccine. These two passages are done without further heat selection; however, it is not known how rapidly and to what extent thermostable variants would be lost during further passage. The study was therefore conducted to determine the effect of passage on thermostability of strain I-2. The virus was serially passaged and at various passage levels samples were subjected to heat treatment at 56 degrees C for 120 min. The inactivation rates for infectivity and haemagglutinin (HA) titres were assayed by use of chicken embryonated eggs and HA test, respectively. Thermostability of HA and infectivity of I-2 virus were reduced after 10 and 5 passages, respectively, without heat selection at 56 degrees C. These results suggest that 5 more passages could be carried out between the working seed and vaccine levels without excessive loss of thermostability. This would result in increased vaccine production from a single batch of a working seed.

Adsorption characteristics of phenolic compounds onto coal-reject-derived adsorbents

Carbonaceous adsorbents were prepared by heat treatment of coal reject at 600 degrees C, after chemical treatment in HNO3, H2SO4, and NaOH at 25 and 75 degrees C. Pore structure characterization and the phenol adsorption capacities of the adsorbents showed that nitric acid pretreatment significantly enhanced the surface properties, consequently the adsorption capacities of the adsorbents. A number of samples were subsequently prepared by carbonizing coal reject at 600 degrees C, after pretreatment in HNO3 under various conditions. The acid concentration, residence time, and reaction temperature were varied to obtain adsorbents with various pore structures. The adsorption capacities of the derived adsorbents for phenol, p-nitrophenol, and benzene were measured to gain further insights into the pore structure evolution. Adsorption isotherms of phenol, p-nitrophenol, and p-chlorophenol on the best adsorbent prepared were determined and correlated with theoretical isotherm equations, such as the Langmuir, Freundlich, and Redlich-Peterson equations.

On the use of trace additions of Sn to enhance sintered 2xxx series Al powder alloys

The mechanical properties of a typical sintered aluminium alloy (Al-4.4Cu-0.8Si-0.5Mg) have been improved by the simultaneous use of trace additions of Sn, high sintering temperatures and modified heat treatments. Tin increases densification, but the Sn concentration is limited to less than or equal to 0.1wt% because incipient melting occurs during solution treatment at higher Sn levels. A sintering temperature of 620 degrees C increases the liquid volume over that formed at the conventional 590 degrees C sintering temperature. However, the higher sintering temperature results in the formation of an embrittling phase which can be eliminated if solution treatment is incorporated into the sintering cycle (a modified TS heat treatment). These conditions produce a tensile strength of 375 MPa, an increase of nearly 20% over the unmodified alloy. (C) 1999 Elsevier Science S.A. All rights reserved.

Age gelation of UHT milk - A review

Gelation of UHT milk during storage (age gelation) is a major factor limiting its shelf-life. The gel which forms is a three-dimensional protein matrix initiated by interactions between the whey protein beta -lactoglobulin and the kappa -casein of the casein micelle during the high heat treatment. These interactions lead to the formation of a beta -lactoglobulin-kappa -casein complex (beta kappa -complex). A feasible mechanism of age gelation is based on a two-step process; in the first step, the beta kappa -complexes dissociate from the casein micelles due to the breakdown of multiple anchor sites on kappa -casein, and in the second step, these complexes aggregate into a three-dimensional matrix. When a critical volume concentration of the beta kappa -complex is attained, a gel of custard-like consistency is formed. Significant factors which influence the onset of gelation include the nature of the heat treatment, proteolysis during storage, milk composition and quality, seasonal milk production factors and storage temperature. In this review, age gelation is discussed in terms of these factors, causative mechanisms and procedures for controlling it.

Thermal stability of mixed-cation alpha-sialon ceramics

A series of alpha-sialon (alpha') compositions containing mixed stabilising cations were prepared, by introducing additional CaO to a basic Sm alpha-sialon compositions. The thermal stability of these Sm-Ca-containing alpha-sialon phases was investigated using XRD, SEM and EDXS techniques. It was found that the addition of calcium into the Sm alpha-sialon systems greatly improved the stability of the alpha-sialon phases. Calcium was found to be incorporated into the alpha-sialon structure, coexistent with the samarium, and partitioning of the calcium and samarium was observed between the alpha' phase and grain boundary phases. This indicates a technique which may be used to improve the thermal stability of the alpha' phase while maintaining good refractory phases at the gialon grain boundaries. (C) 2003 Elsevier Science B.V. All rights reserved.

α′ phase stability in Nd-Li-sialon systems

The formability and stability of the alpha-sialon (alpha') phase was investigated in multi-cation Nd-Li-sialon systems. Four samples were prepared, ranging from a pure Nd-sialon to a pure Li-sialon, with two intermediate samples being prepared with either lithium or neodymium replacing the other alpha'-stabilising additive by 20 eq.%, as to maintain an equivalent design composition in all samples. After sintering, all samples were subsequently heat treated up to 192 h at 1450 and 1300 degreesC. While significant quantities of the beta'-sialon (beta' phase were found in most samples, the high-lithium Li-Nd-sialon sample was found to be almost pure a' phase after sintering. Furthermore, the long-term stability of the a' phase on heat treatment was also found to be superior in both multi-cation samples than in either of the single-alpha'-stabilising-cation samples. This is thought to be related to improved retention of the lithium in the multi-cation systems, as much of the lithium was found to volatilise during sintering in the neodymium-free sample. (C) 2002 Elsevier Science Ltd. All rights reserved.

Mode of action of back-line application of spinosad, a non-systemic parasiticide, on sheep

Spinosad, applied as a jetting solution or dip is an efficacious, non-systemic treatment for the control of Bovicola ovis in sheep. This paper describes the effect of back-line treatment width and group housing of animals on the efficacy of spinosad for the control of lice. A 0.4 mg/kg liveweight dose was found to be the suboptimal dose of spinosad for the control of body lice in a dose titration study and was used to investigate application and housing effects in a second study. Lousy Merino sheep were treated with either a narrow 3-cm application of spinosad or with a wider 25-cm swathe. After treatment they were either kept alone or in groups of 6 sheep per pen. Lice were counted at day 0 and every 14 days to 70 days after treatment before estimation of the percentage of lice control and analysis of treatment effects. A much higher percentage of lice control was achieved with 0.4 mg/kg in the second study than in the first, possibly because of differences in formulation used. The wider application width gave significantly higher (P < 0.05) control of lice than the narrow application when sheep were either housed alone or in groups up to day 42 post-treatment. Greater control of lice was seen in group-housed sheep compared with sheep housed individually (P < 0.05) up to day 70. Using broader application widths combined with holding the animals together after treatment with pour-on formulations may optimise the delivery and efficacy of ectoparasiticides for livestock.

A transformation toughening white cast iron

An experimental white cast iron with the unprecedented fracture tough ness of 40 MPa m(1/2) is currently being studied to determine the mechanisms of toughening. This paper reports the investigation of the role of strain-induced martensitic (SIM) transformation. The dendritic microconstituent in the toughened alloy consists primarily of retained austenite, with precipitated M(7)C(3) carbides and some martensite. Refrigeration experiments and differential scanning calorimetry (DSC) were used to demonstrate, firstly, that this retained austenite has an ''effective'' sub-ambient M(S) temperature and, secondly, that SIM transformation can occur at ambient temperatures. Comparison between room temperature and elevated temperature K-Ic tests showed that the observed SIM produces a transformation toughening response in the alloy, contributing to, but not fully accounting for, its high tough ness. SIM as a mechanism for transformation toughening has not previously been reported for white cast irons. Microhardness traverses on crack paths and X-ray diffraction (XRD) on fracture surfaces confirmed the interpretation of the K-Ic experiments. Further DSC and quantitative XRD showed that, as heat-treatment temperature is varied, there is a correlation between fracture toughness and the volume fraction of unstable retained austenite.