Epidemiological analysis of electroconvulsive therapy in Victoria, Australia

Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998-1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age-sex specific utilization rates were calculated using this statutory data for the 1998-1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age-sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.

Redescription of the gnathostome fish fauna from the mid-Palaeozoic Silverband Formation, the Grampians, Victoria

Gnathostome vertebrate remains from fine-grained sandstones of the Silverband Formation in the Grampians, Victoria include dissociated fin spines, scales and teeth. These elements arc assigned herein to the acanthodians Sinacanthus? micracanthus (fin spines) and Radioporacanthodes sp. cf. R. qujingensis (scales and tooth whorls). This fauna indicates a Late Silurian (?late Ludlow) age for the vertebrate-beating Stratum. Under current systematic groupings, the two gnathostome taxa from the Silverband Formation belong to two different families, the Sinacanthidae and the Poracanthodidae. However. the preserved association could indicate that the three element types derived from the same biological species. The possibility that the Sinacanthidae is a sister group to the Climatiidae and the Poracanthodidae is raised by this scenario. The Sinacanthidae is tentatively reassigned to the Acanthodii, as it is considered to lack diagnostic chondrichthyan characters.

Substance-use disorders and psychological distress among police arrestees

Objectives: To determine the 12-month prevalence of substance-use disorders and psychological morbidity in an Australian arrestee population. Design: Cross-sectional descriptive study. Participants and setting: 288 police arrestees at the Brisbane City Police Watch House in February and March 2001. Outcome measures: Prevalence of drug and alcohol disorders; psychological caseness according to the 28-item General Health Questionnaire; demographics and index offences. Results: 86% of the arrestees had at least one substance-use disorder; most had multiple disorders. More than 80% were substance dependent. The predominant substances used were amphetamines, marijuana, opioids and alcohol. 82% of the men and 94% of the women were suffering significant psychological distress. Conclusions: Development of services for detoxification and treatment of this population is a pressing need. The findings provide crucial information for the planning and implementation of drug courts and court diversion systems.

Nonfatal heroin overdoses in Queensland, Australia: an analysis of ambulance data

In the past decade, the utilization of ambulance data to inform the prevalence of nonfatal heroin overdose has increased. These data can assist public health policymakers, law enforcement agencies, and health providers in planning and allocating resources. This study examined the 672 ambulance attendances at nonfatal heroin overdoses in Queensland, Australia, in 2000. Gender distribution showed a typical 70/30 male-to-female ratio. An equal number of persons with nonfatal heroin overdose were between 15 and 24 years of age and 25 and 34 years of age. Police were present in only 1 of 6 cases, and 28.1% of patients reported using drugs alone. Ambulance data are proving to be a valuable population-based resource for describing the incidence and characteristics of nonfatal heroin overdose episodes. Future studies could focus on the differences between nonfatal heroin overdose and fatal heroin overdose samples.

Diplacanthid acanthodians from the Aztec Siltstone (late Middle Devonian) of southern Victoria Land, Antartica

One articulated and several partial, semi-articulated specimens of acanthodians were collected in 1970 from the freshwater deposits of the Aztec Siltstone (Middle Devonian; Givetian), Portal Mountain, southern Victoria Land, Antarctica, during a Victoria University of Wellington Antarctic Expedition. The Portal Mountain fish fauna, preserved in a finely laminated, non-calcareous siltstone, includes acanthodians, palaeoniscoids, and bothriolepid placoderms. The articulated acanthodian specimens are the most complete fossil fish remains documented so far from the Aztec assemblage, which is the most diverse fossil vertebrate fauna known from Antarctica. They are described as a new taxon, Milesacanthus antarctica gen. et sp. nov., which is assigned to the family Diplacanthidae. Its fin spines show some similarities to spine fragments named Byssacanthoides debenhami from glacial moraine at Granite Harbour, Antarctica, and much larger spines named Antarctonchus glacialis from outcrops of the Aztec Siltstone in the Boomerang Range, southern Victoria Land. Both of these are reviewed, and retained as form taxa for isolated spines. Various isolated remains of fin spines and scales are described from Portal Mountain and Mount Crean (Lashly Range), and referred to Milesacanthus antarctica gen. et sp. nov. The histology of spines and scales is documented for the first time, and compared with acanthodian material from the Devonian of Australia and Europe. Distinctive fin spines from Mount Crean are provisionally assigned to Culmacanthus antarctica Young, 1989b. Several features on the most complete of the new fish specimens - in particular, the apparent lack of an enlarged cheek plate - suggest a revision of the diagnosis for the Diplacanthidae.

Was an increase in cocaine use among injecting drug users in New South Wales, Australia, accompanied by an increase in violent crime?

Background: A sharp reduction in heroin supply in Australia in 2001 was followed by a large but transient increase in cocaine use among injecting drug users (IDU) in Sydney. This paper assesses whether the increase in cocaine use among IDU was accompanied by increased rates of violent crime as occurred in the United States in the 1980s. Specifically, the paper aims to examine the impact of increased cocaine use among Sydney IDU upon police incidents of robbery with a weapon, assault and homicide. Methods: Data on cocaine use among IDU was obtained from the Illicit Drug Reporting System (IDRS). Monthly NSW Police incident data on arrests for cocaine possession/ use, robbery offences, homicides, and assaults, were obtained from the Bureau of Crime Statistics and Research. Time series analysis was conducted on the police data series where possible. Semi-structured interviews were conducted with representatives from law enforcement and health agencies about the impacts of cocaine use on crime and policing. Results: There was a significant increase in cocaine use and cocaine possession offences in the months immediately following the reduction in heroin supply. There was also a significant increase in incidents of robbery where weapons were involved. There were no increases in offences involving firearms, homicides or reported assaults. Conclusion: The increased use of cocaine among injecting drug users following the heroin shortage led to increases in violent crime. Other States and territories that also experienced a heroin shortage but did not show any increases in cocaine use did not report any increase in violent crimes. The violent crimes committed did not involve guns, most likely because of its stringent gun laws, in contrast to the experience of American cities that have experienced high rates of cocaine use and violent crime.