Priority setting in health: origins, description and application of the Australian Assessing Cost-Effectiveness initiative

This article reports on the ‘Assessing Cost–Effectiveness’ (ACE) initiative in priority setting from Australia. It commences with why priority setting is topical and notes that a wide variety of approaches are available. In assessing these various approaches, it is argued that a useful first step is to consider what constitutes an ‘ideal’ approach to priority setting. A checklist to guide priority setting is presented based on guidance from economic theory, ethics and social justice, lessons from empirical experience and the needs of decision-makers. The checklist is seen as an important contribution because it is the first time that criteria from such a broad range of considerations have been brought together to develop a framework for priority setting that endeavors to be both realistic and theoretically sound. The checklist will then be applied to a selection of existing approaches in order to illustrate their deficiencies and to provide the platform for explaining the unique features of the ACE approach. A case study (ACE-Cancer) will then be presented and assessed against the checklist, including reaction from stakeholders in the cancer field. The article concludes with an overview of the full body of ACE research completed to date, together with some reflections on the ACE experience.

Endemic freshwater finfish of Asia : distribution and conservation status

Freshwater finfish species richness and level of endemism in East, and South and South-East Asia that included 17 nations were studied using available databases, and included nation-wise distribution, habitat types, and conservation status. The number of endemic finfish species in the region was 559, belonging to 47 families. Families Cyprinidae and Balitoridae accounted for 43.5% and 16.2% of the total number of endemic species in the region, respectively, followed by Sisoridae (25), Gobiidae (20), Melanotaeniidae (19), and Bagridae (16), and the other 41 families had at least one endemic species. Nation-wise the most number of endemic freshwater finfish species occur in India (191), followed by China (88), Indonesia (84), and Myanmar (60). In India, the endemic species accounted for 26.4% of the native freshwater fish fauna, followed by South Korea (16.9%), the Philippines, (16.3%) and Myanmar (15.7%).

Statistically significant relationships discerned between the number of indigenous and endemic species richness to land area (X_la in 10³ km²) of the nations in the region were, Y_in = 218.961 Ln(X_la) – 843.1 (R² = 0.735; P < 0.001) and Y_e = 28.445 Ln X_la−134.47 (R² = 0.534; P < 0.01), respectively, and between indigenous and endemic species richness was Y_e = 0.079X_n− 1.558 (R² = 0.235; P < 0.05).

The overall conservation status of endemic finfish in Asia was satisfactory in that only 92 species were in some state of vulnerability, of which 37 species (6.6%) are endangered or critically endangered. However, the bulk of these species (83.7%) were cave- and or lake-dwelling fish. However, nation-wise, the endemic freshwater finfish fauna of the Philippines and Sri Lanka, based on the imperilment index, were found to be in a highly vulnerable state. Among river basins, the Mekong Basin had the highest number of endemic species (31.3%). The discrepancies between databases are highlighted and the need to consolidate information among databases is discussed. It is suggested that the Mekong Basin be considered as a biodiversity hotspot, and appropriate management strategies be introduced in this regard.

Description and qualitative evaluation of Jigsaw, an integrated young persons' mental health program

Objective: The aim of this paper is to describe the establishment of an integrated young person’s mental health service and the findings of a qualitative evaluation conducted 2 years after its establishment.
Method: A qualitative evaluation of the service was undertaken using a semi-structured interview, a service satisfaction survey and partnership analysis tool.
Results: The major problems encountered in establishing the service were insufficient recognition of the cultural challenges in working together, difficulty in recruiting general practitioners, establishing a youth friendly environment and maintaining the quality of the relationship between partners.
Conclusion: Despite almost 3 years of preparation, many important aspects of change management were underestimated or inadequately attended to.

Palaeobiogeography and palaeogeographical implications of Permian marine bivalve faunas in Northeast Asia (Kolyma–Omolon and erkhoyansk–Okhotsk regions, northeastern Russia)

The paper considers the biogeography and palaeogeographic implications of the Permian marine bivalve faunas of Northeast Asia, with a focus on the dynamic relationships between biotic similarities and palaeogeographic distance through an interval of ca. 50 million years. A stage-by-stage time series analysis of the biotic similarities between two previously recognized biochores in Northeast Asia, the Kolyma–Omolon and Verkhoyan–Okhotsk provinces, has been carried out using both the Jaccard and Dice similarity indices based on the spatio-temporal distributions of 355 Permian marine bivalve species in Northeast Asia. The outcome of this analysis, combined with other empirical data and previously published tectonic, sedimentological and palaeontological information, suggests that (1) the bivalve faunas from these two provinces were distinctive from one another as two separate biochores throughout all but the earliest (Asselian) Permian stages and (2) the biotic similarities between the Verkhoyan–Okhotsk and Kolyma–Omolon provinces remained consistently low since Sakmarian, all falling well below the minimum threshold of the Jaccard index of 0.42 required for distinguishing marine biotic provinces. We interpret these below-threshold Jaccard biotic similarities as an indication of significant palaeogeographic separation between the Verkhoyan-Okhotsk and Kolyma–Omolon provinces, which is in turn considered to indicate rifting and seafloor spreading of the Omolon microcontinent and associated terranes and island arcs away from the North Asian craton, at least from the Sakmarian to the beginning of the Late Permian.
Palaeo-distance separation appears to be the primary and most significant biogeographic determinant in accounting for the differences in the spatial distribution of most Permian bivalve species in Northeast Asia. Several other variables also appear to have played a significant role, including regional climate conditions, ocean currents and merged island chains as geographic barriers. In particular, the relatively high biotic similarity between the Verkhoyan–Okhotsk and Kolyma–Omolon provinces during the Late Wuchiapingian and Changhsingian may have been related to the shallowing of the deep-water basins (Oimyakon, Ayan-Yuryakh, Balygychan and Sugoi basins) that had previously separated the two provinces and the flooding (submergence) of the Okhotsk–Taigonos volcanic arc system, thus allowing the invasion of lower latitude warm-water Palaeotethyan and even Gondwanan species into Northeast Asia.

Book review : Everyday life in Central Asia past and present

Review of Everyday life in Central Asia past and present, edited by Jeff Sahadeo and Russell Zanca, Bloomington, IN: Indiana University Press, 2007, 401 pp., £14.00/$24.99 (paperback), ISBN 978-0-253-21904-6