A cost-effectiveness analysis of buprenorphine-assisted heroin withdrawal

The purpose of this study was to conduct a cost - effectiveness analysis of detoxification from heroin using buprenorphine in a specialist clinic versus a shared care setting. A randomized controlled trial was conducted with a total of 115 heroin-dependent patients receiving a 5-day treatment regime of buprenorphine. The specialist clinic was a community-based treatment agency in inner-city Sydney. Shared care involved treatment by a general practitioner supplemented by weekend dispensing and some concurrent counselling at the specialist clinic. Quanti. cation of resource use was limited to inputs for treatment provision. The primary outcome measure used in the economic analysis was the proportion of each group that completed detoxification and achieved an initial 7-day period of abstinence. Buprenorphine detoxification in the shared care setting was estimated to be $24 more expensive per patient than treatment at the clinic, which had an average treatment cost of $332 per patient. Twenty-three per cent of the shared care patients and 22% of the clinic patients reported no opiate use during the withdrawal period. These results suggest that the provision of buprenorphine treatment for heroin dependence in shared care and clinic appear to be equally cost - effective.

Evidence-based medicine is affordable: The cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis

Objective. To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Method. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented cut-rent evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. Results. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of $19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden. with a cost-effectiveness ratio of $12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of $25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of $25,000 per YLD averted. Conclusion. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.

Aboriginal and Torres Strait Islander Studies Unit Annual Report

Welcome to the 2002 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2002 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally funded Aboriginal Tutorial Assistance Scheme (ATAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.

Aboriginal and Torres Strait Islander Studies Unit Annual Report 2003

Welcome to the 2003 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2003 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally funded Aboriginal Tutorial Assistance Scheme (ATAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.

Aboriginal and Torres Strait Islander Studies Unit Annual Report 2005

Welcome to the 2005 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2005 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally-funded Indigenous Tutorial Assistance Scheme (ITAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.

Nature-based tourism and the valuation of its environmental resources: Economic and other aspects

Nature-based tourism has grown in importance in recent decades, and strong links have been established between it and ecotourism. This reflects rising incomes, greater levels of educational attainment and changing values, especially in the Western world. Nature-based tourism is quite varied. Different types of such tourism are identified and their consequences for sustainability of their resource-base are briefly considered. The development and management of nature-based tourism involves many economic aspects, several of which are discussed. For example, one must consider the economics of reserving or protecting land for this type of tourism. What economic factors should be taken into account? Economists stress the importance of taking into account the opportunity costs involved in such a decision. This concept is explained. However, determining the net economic value of an area used for tourism is not straightforward. Techniques for doing this, such as the travel cost method and stated value methods, are introduced. Natural areas reserved for tourism may have economic value not only for tourism but also jointly for other purposes, such as conserving wildlife, maintaining hydrological cycles and so on. These other purposes, should be taken into account when considering the use of land for nature-based tourism. According to one economic point of view, land should be used in a way that maximises its total economic value. While this approach has its merits, it does not take into account the distribution of benefits from land use and its local impacts on income and employment. These can be quite important politically and for nature conservation, and are discussed. Finally, there is some discussion of whether fees charged to tourists for access to environmental resources should discriminate between domestic tourists and foreigners.

Cost-benefit analysis of alternative forms of hedgerow intercropping in the Philippine uplands

Considerable resources have been expended promoting hedgerow intercropping with shrub legumes to farmers in the Philippine uplands. Despite the resources committed to research and extension, persistent adoption by farmers has been limited to low cost versions of the technology including natural vegetation and grass strips. In this paper, cost-benefit analysis is used to compare the economic returns from traditional open-field maize farming with returns from intercropping maize between leguminous shrub hedgerows, natural vegetation strips and grass strips. An erosion/productivity model, Soil Changes Under Agroforestry, was used to predict the effect of erosion on maize yields. Key informant surveys with experienced maize farmers were used to derive production budgets for the alternative farming methods. The economic incentives revealed by the cost-benefit analysis help to explain the adoption of maize farming methods in the Philippine uplands. Open-field farming without hedgerows has been by far the most popular method of maize production, often with two or more fields cropped in rotation. There is little persistent adoption of hedgerow intercropping with shrub legumes because sustained maize yields are not realised rapidly enough to compensate farmers for establishment and maintenance costs. Natural vegetation and grass strips are more attractive to farmers because of lower establishment costs, and provide intermediate steps to adoption. Rural finance, commodity pricing and agrarian reform policies influence the incentives for maize farmers in the Philippine uplands to adopt and maintain hedgerow intercropping.

Effects of incubation temperature on the energetics of embryonic development and hatchling morphology in the Brisbane river turtle Emydura signata

Incubation temperature and the amount of water taken up by eggs from the substrate during incubation affects hatchling size and morphology in many oviparous reptiles. The Brisbane river turtle Emydura signata lays hard-shelled eggs and hatchling mass was unaffected by the amount of water gained or lost during incubation. Constant temperature incubation of eggs at 24 degrees C, 26 degrees C, 28 degrees C and 31 degrees C had no effect on hatchling mass, yolk-free hatchling mass, residual yolk mass, carapace length, carapace width, plastron length or plastron width. However, hatchlings incubated at 26 degrees C and 28 degrees C had wider heads than hatchlings incubated at 24 degrees C and 31 degrees C. Incubation period varied inversely with incubation temperature, while the rate of increase in oxygen consumption during the first part of incubation and the peak rate of oxygen consumption varied directly with incubation temperature. The total amount of oxygen consumed during development and hatchling production cost was significantly greater at 24 degrees C than at 26 degrees C, 28 degrees C and 31 degrees C. Hatchling mass and dimensions and total embryonic energy expenditure was directly proportional to initial egg mass.

Cost functions and duality for stochastic technologies

Cost functions dual to stochastic production technologies are derived and their properties are discussed. These cost functions are shown to be consistent with expected-utility maximization without placing serious structural restrictions on the underlying technology.

Economic incentives for farmers in the Philippine uplands to adopt hedgerow intercropping

Land degradation in the Philippine uplands is severe and widespread. Most upland areas are steep, and intense rainfall on soils disturbed by intensive agriculture can produce high rates of soil loss. This has serious implications for the economic welfare of a growing upland population with few feasible livelihood alternatives. Hedgerow intercropping can greatly reduce soil loss from annual cropping systems and has been considered an appropriate technology for soil conservation research and extension in the Philippine uplands. However; adoption of hedgerow intercropping has been sporadic and transient, rarely continuing once external support has been withdrawn. The objective of this paper is to investigate the economic incentives for farmers in the Philippine uplands to adopt hedgerow intercropping relative to traditional open-field maize farming. Cost-benefit analysis is used to compare the economic viability of hedgerow intercropping, as it has been promoted to upland farmers, with the viability of traditional methods of open-field farming. The APSIM and SCUAF models were used to predict the effect of soil erosion on maize yields from open-field farming and hedgerow intercropping. The results indicate that there have been strong economic incentives for farmers with limited planning horizons to reject hedgerow intercropping because the benefits of sustained yields are not realized rapidly enough to compensate for high establishment costs. Alternative forms of hedgerow intercropping such as natural vegetation and grass strips reduce establishment and maintenance costs and are therefore more economically attractive to farmers than hedgerow intercropping with shrub legumes. The long-term economic viability of hedgerow intercropping depends on the economic setting and the potential for hedgerow intercropping to sustain maize production relative to traditional open-field farming. (C) 1998 Academic Press.

The cost of life expectancy and the implicit social valuation of life

A new method of estimating the economic value of life is proposed. Using cross-country data, an equation is estimated to explain life expectancy as a function of real consumption of goods and services. The associated cost function for life expectancy in terms of the prices of specific goods and services is used to estimate the cost of a reduction in age-specific mortality rates sufficient to save the life of one person. The cost of saving a life in OECD countries is as much as 1000 times that in the poorest countries. Ethical implications are discussed.