Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study

AIMS/ HYPOTHESIS:
There is limited information about the impact of type 1 diabetes on life expectancy in a contemporary population. We examined the life expectancy of type 1 diabetic patients and explored the contribution of mortality at different ages and of different causes of death to years of life lost (YLL) compared with the general population.

METHODS:
We derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking the NDSS to the National Death Index. The Chiang method was used to estimate life expectancy and Arriaga's method was used to estimate the contributions of age-specific and cause-specific mortality to the YLL.

RESULTS:
A total of 5,981 deaths were identified during the 902,136 person-years of follow up. Type 1 diabetic patients had an estimated life expectancy at birth of 68.6 years (95% CI 68.1, 69.1), which was 12.2 years (95% CI 11.8, 12.7) less than that in the general population. The improvement in life expectancy at birth in 2004-2010 compared with 1997-2003 was similar for both type 1 diabetic patients (men, 1.9 years [95% CI 0.4, 3.3]; women, 1.5 years [95% CI 0.0, 3.2]) and the general population (men, 2.2 years; women, 1.4 years). Deaths at age <60 years accounted for 60% of the YLL from type 1 diabetes for men and 45% for women. The major contribution to YLL was mortality from endocrine and metabolic disease at age 10-39 years (men, 39-59%; women, 35-50%) and from circulatory disease at age ≥40 years (men, 43-75%; women, 34-75%).

CONCLUSIONS/ INTERPRETATION:
Data from 1997 to 2010 showed that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2 years compared with the general population.

Competition and efficiency : overseas students and technical efficiency in Australian and New Zealand universities

Economic theory suggests that competitive pressures will impact on organisational efficiency. In recent years, universities in Australia and New Zealand have faced increased competition for students. The aim of this paper is to explore the efficiency of Australian and New Zealand public universities and to investigate the impact of competition for students from overseas on efficiency. Output distance functions are estimated using panel data for the period 1995-2002 for Australia and 1997-2003 for New Zealand. The results show that competition for overseas students has led to increased efficiency in Australian universities. However, competition for overseas students appears to have had no effect on efficiency in New Zealand.

Some recent strategic additions to Victoria`s protected area system 1997-2002

The development of a comprehensive, adequate and representative reserve system is an objective of all Australian states and territories. In Victoria, land purchase is one means of increasing the reservation levels of some of the State’s most endangered ecosystems. This article outlines the biological features of some new land purchases for addition to the Victorian protected area system.

Change in the prevalence of overweight and obesity among young Australian, 1969-1997

BACKGROUND: Effective public policy requires information on the prevalence of overweight and obesity. OBJECTIVE: We determined changes in the population prevalence of overweight and obesity among young Australians (aged 7-15 y) from 1969 to 1985 to 1997. DESIGN: Data from 5 independent population surveys were analyzed: the Australian Youth Fitness Survey, 1969; the Australian Health and Fitness Survey, 1985; the South Australian Schools Fitness and Physical Activity Survey, 1997; the New South Wales Schools Fitness and Physical Activity Survey, 1997; and the Health of Young Victorians Study, 1997. Measured body mass index was used as the index of adiposity, and recently published body mass index cutoff values were used to categorize each subject as nonoverweight, overweight, obese, or either overweight or obese. RESULTS: For 1985-1997, the population prevalence of overweight increased by 60-70%, obesity increased 2-4-fold, and the combined overweight and obesity categories doubled. The findings were consistent across data sets and between the sexes. For 1969-1985, there was no change in the prevalence of overweight or obesity among girls, but among boys the prevalence of overweight increased by 35%, the prevalence of obesity trebled, and the prevalence of overweight and obesity combined increased by 60%. CONCLUSIONS: The data show that in 1985-1997, the prevalence of overweight and obesity combined doubled and that of obesity trebled among young Australians, but the increase over the previous 16 y was far smaller. These results should increase our sense of urgency in identifying and implementing effective responses to this major threat to public health.

Audit quality : earnings management in the context of the 1997 Asian crisis

This study assumes that evidence regarding audit quality can be derived from the level of earnings management reflected in reported abnormal or discretionary accruals. Given this assumption, audit quality is examined in the context of the 1997 Asian financial crisis using data from Malaysia. Examining audit quality in its association with earnings management across differential macroeconomic periods provides insights that may be otherwise masked. The period of the crisis is partitioned between pre-crisis (1994-1996), crisis (1997-1998) and post-crisis (1999). Using a robust approach to the measurement of abnormal accruals, the association of Big 5/non-Big 5 and Industry Specialist/Industry non-specialist auditors with both the levels of, and change in levels of, abnormal accruals is investigated across and within the crisis sub-periods from 1994-1999. Audit quality is found to be associated with abnormal accruals, and differentially so across macroeconomic period with greater constraint evident post-crisis.