Differences in prevalence of pre-existing morbility between injured and non-injured populations

Objectives To identify and examine differences in pre-existing morbidity between injured and non-injured population-based cohorts. Methods Administrative health data from Manitoba, Canada, were used to select a population-based cohort of injured people and a sample of non-injured people matched on age, gender, aboriginal status and geographical location of residence at the date of injury. All individuals aged 18-64 years who had been hospitalized between 1988 and 1991 for injury (International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) code 800-995) (n = 21032), were identified from the Manitoba discharge database. The matched non-injured comparison group comprised individuals randomly selected 1: 1 from the Manitoba population registry. Morbidity data for the 12 months prior to the date of the injury were obtained by linking the two cohorts with all hospital discharge records and physician claims. Results Compared to the non-injured group, injured people had higher Charlson Comorbidity Index scores, 1.9 times higher rates of hospital admissions and 1.7 times higher rates of physician claims in the year prior to the injury. Injured people had a rate of admissions to hospital for a mental health disorder 9.3 times higher, and physician claims for a mental health disorder 3.5 times higher, than that of non-injured people. These differences were all statistically significant (P < 0.001). Conclusion Injured people were shown to differ from the general non-injured population in terms of pre-existing morbidity. Existing population estimates of the attributable burden of injury that are obtained by extrapolating from observed outcomes in samples of injured cases may overestimate the magnitude of the problem.

The effect of a reduction in heroin supply on fatal and non-fatal drug overdoses in New South Wales, Australia

Objective: To examine the impact of a sudden and dramatic decrease in heroin availability, concomitant with increases in price and decreases in purity, on fatal and non-fatal drug overdoses in New South Wales, Australia. Design and setting: Time-series analysis was conducted where possible on data on overdoses collected from NSW hospital emergency departments, the NSW Ambulance Service, and all suspected drug-related deaths referred to the NSW Coroner's court. Main outcome measures: The number of suspected drug-related deaths where heroin and other drugs were mentioned; ambulance calls to suspected opioid overdoses; and emergency department admissions for overdoses on heroin and other drugs. Results: Both fatal and non-fatal heroin overdoses decreased significantly after heroin supply reduced; the reductions were greater among younger age groups than older age groups. There were no clear increases in non-fatal overdoses with cocaine, methamphetamines or benzodiazepines recorded at hospital emergency departments after the reduction in heroin supply. Data on drug-related deaths suggested that heroin use was the predominant driver of drug-related deaths in NSW, and that when heroin supply was reduced overdose deaths were more likely to involve a wider combination of drugs. Conclusion: A reduction in heroin supply reduced heroin-related deaths, and did not result in a concomitant increase, to the same degree, in deaths relating to other drugs. Younger people were more affected by the reduction in supply.

Virtual learning communities beyond the classroom: perceptions of tertiary Chinese language and non-language learners

As class contact times are reduced as a result of fiscal restraints in the modern tertiary sector, language instructors are placed in the position of having to find new ways to provide experience and continuity in language learning. Extending 'learning communities'—sites of learner knowledge exchange, exposure to diverse learning styles and strategies, and mutual support—beyond the classroom is one solution to maintaining successful linguistic competencies amongst learners. This, however, can conflict with the diverse extra-curricular commitments faced by tertiary students. The flexibility of web-based learning platforms provides one means of overcoming these obstacles. This study investigates learner perceptions of the use of the WebCT platform's computer medicated communication (CMC) tools as a means of extending the community of learning in tertiary Chinese language and non-language courses. Learner responses to Likert and open-ended questionnaires show that flexibility and reduction of negative affect are seen as significant benefits to 'virtual' interaction and communication, although responses are notably stronger in the non-language compared with the language cohort. While both learner cohorts acknowledge positive learning outcomes, CMC is not seen to consistently further interpersonal rapport beyond that established in the classroom. Maintaining a balance between web-based and classroom learning emerges as a concern, especially amongst language learners. [Author abstract, ed]

Audit of selective and non-selective non-steroidal anti-inflammatory drug use in rural general practice

Aim: To identify the demographics and risk factors in a selected patient population prescribed non-selective and cyclo-oxygenase-2 (COX- 2) selective non-steroidal anti-inflammatory drugs (NSAIDs). Method: A structured clinical self-audit form was distributed in January to March 2001 to 155 interested general practitioners (GPs) in rural Queensland. Results: Seventy one GPs participated in the audit and contributed 1417 patient records - 790 patients had received nonselective NSAIDs and 627 had received COX-2 inhibitors (celecoxib or rofecoxib). Patients who received COX-2 inhibitors were significantly older, more likely to have clinically important concomitant illness, and more likely to be taking medication known to interact with NSAIDs. They were also twice as likely to have two or more risk factors for adverse effects. The most common reasons for switching from an NSAID to a COX-2 inhibitor were reported to be a previous side effect from an NSAID (primarily related to gastrointestinal effects) or the doctor's perception of the superior efficacy of COX-2 inhibitor therapy. Conclusions: This study has shown that COX-2 inhibitors were used in a distinctly different patient population compared to non-selective NSAIDs. There were significant variations in the demographics and number of risk factors - for example, cardiovascular and renal - between the two identified populations. These differences may be due to doctors selecting COX-2 inhibitors for patients at high risk of gastrointestinal complications. However, the prescribing pattern may also be partly due to misconceptions about the relative safety and efficacy of COX-2 inhibitor drugs.

Responses to neighbours and non-neighbours in the buff-banded rail (Gallirallus philippensis): no dear-enemy relationships

Territorial individuals often respond less aggressively to intrusions by their neighbours than to intrusions by unfamiliar individuals. This commonly observed strategy, the dear-enemy phenomenon, is thought to minimise the costs associated with territory defence. This study determined whether an insular population of territory-holding buff-banded rails (Gallirallus philippensis) exhibits dear-enemy relationships and whether males and females differ in their responses to neighbours and non-neighbours. Playback techniques were used to examine and compare the vocalisations and movements of focal individuals in response to the territorial advertisement calls of their neighbours and of unfamiliar individuals (non-neighbours). Results showed that focal birds did not respond differently to the calls of neighbours and non-neighbours; thus, no evidence for the dear-enemy phenomenon was found in this species. We suggest that this result is due to the significant threats posed by neighbours to territory owners in this territorial system, in addition to a high level of territorial instability in the population. Males and females were shown to differ qualitatively in their general territorial response to intruders but not in their relative responses to neighbours and non-neighbours, suggesting that the relative threats posed by neighbours and non-neighbours do not differ between the sexes.

Spider ballooning in soybean and non-crop areas of southeast Queensland

Ballooning is a form of aerial movement practiced by most miniature and some adult spiders. Very few studies have investigated the composition and rate of spider ballooning in Australian agroecosystems. Water traps were used to compare ballooning rates in irrigated soybean crops and nearby non-crop areas in southeast Queensland over two summer seasons. The highest ballooning rate (14.8 spiders/m(2) per day) was recorded in a soybean field, non-crop areas (7.0 spiders/m(2) per day) and a dry land mungbean field (6.8 spiders/m(2) per day) having similar rates. Spider ballooning in soybean increased throughout the season and showed three peaks and intervening troughs. A similar pattern in ballooning peaks was observed in non-crop areas however the numbers were lower. Peaks in ballooning activity where synchronised across habitat types and some spider groups. Composition of the ballooning fauna was different from that of the ground-dwelling fauna, some families being present in both. Ballooning is an important behaviour in terms of population dynamics for a number of spider groups in soybean and the implications for pest control are discussed. (C) 2004 Elsevier BN. All rights reserved.

Potential interactions between humans and non-breeding shorebirds on a subtropical intertidal flat

The primary aim of this study was to investigate whether bait harvesting, with all its inherent effects, occurring in the intertidal zone of a subtropical estuary, had an impact on a migratory shorebird, the eastern curlew Numenius madagascariensis. In a large-scale manipulative study (units of experiment were 1 ha plots), callianassid shrimp Trypaea australiensis populations were harvested simulating the technique (manual pumping) and the levels of harvesting intensity per unit area (347 shrimp per hectare per harvesting event) exhibited by bait-collectors in SE Australia and South Africa. It was found that at present levels of harvesting intensity per unit area (approximately 1% of standing stock removed per harvesting event) there is no threat to the stocks of Trypaea exploited by the curlews in Moreton Bay, Australia. However, the results show that the curlews themselves apply a considerable predation pressure on Trypaea. Based on the birds' foraging rates and densities, it was estimated that they would consume up to 100% of the initial Trypaea stock over the course of a non-breeding season (October to March). However, the stable seasonal trend in the density of the size-cohort of Trypaea preyed upon by the curlews indicates that the existing rates of predation are easily counterbalanced, e.g. through continuous density-dependent recruitment of these crustaceans. We suggest that this mechanism will provide for a stable foraging environment for both the shorebirds and bait collectors.