The impact of a reduction in drug supply on demand for and compliance with treatment for drug dependence

Background: In early 2001, Australia experienced a sudden, dramatic and;sustained decrease in heroin availability that was accompanied by sharp increases in price and decreases in street level purity-the so-called heroin shortage. These unprecedented changes occurred in a context of widespread treatment availability, which made it possible for the first time to examine the impact of a sharp reduction in heroin supply in New South Wales (NSW) on entry to and adherence with treatment for heroin dependence. Given the evidence of drug substitution by some users. the current paper also examines the effects of the shortage on entry to treatment for other forms of drug dependence. Methods: Interrupted time-series analysis of the number of persons entering opioid pharmacotherapy and other treatment modalities in NSW for heroin dependence and for the treatment for other types of drug dependence. Findings: The heroin shortage was associated with a reduction in the number of younger persons entering opioid pharmacotherapy. There was a dramatic decrease in the number of persons entering heroin withdrawal or assessment only treatment episodes. There appear to have been small improvements in adherence to and retention in heroin treatment after the reduction in heroin supply. Relatively small increases were observed in numbers being treated for cocaine dependence. Conclusions: In the context of good treatment provision, a reduction in heroin supply appeared to produce modest improvements in intermediate outcomes. Supply and demand reduction measures, when both are implemented successfully, may be complementary. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Phylogeography of an east Australian wet-forest bird, the satin bowerbird (Ptilonorhynchus violaceus), derived from mtDNA, and its relationship to morphology

Australian wet forests have undergone a contraction in range since the mid-Tertiary, resulting in a fragmented distribution along the east Australian coast incorporating several biogeographical barriers. Variation in mitochondrial DNA and morphology within the satin bowerbird was used to examine biogeographical structure throughout almost the entire geographical extent of these wet forest fragments. We used several genetic analysis techniques, nested clade and barrier analyses, that use patterns inherent in the data to describe the spatial structuring. We also examined the validity of the two previously described satin bowerbird subspecies that are separated by well-defined biogeographical barriers and tested existing hypotheses that propose divergence occurs within each subspecies across two other barriers, the Black Mountain corridor and the Hunter Valley. Our data showed that the two subspecies were genetically and morphologically divergent. The northern subspecies, found in the Wet Tropics region of Queensland, showed little divergence across the Black Mountain corridor, a barrier found to be significant in other Wet Tropics species. Biogeographical structure was found through southeastern Australia; three geographically isolated populations showed genetic differentiation, although minimal divergence was found across the proposed Hunter Valley barrier. A novel barrier was found separating inland and coastal populations in southern New South Wales. Little morphological divergence was observed within subspecies, bar a trend for birds to be larger in the more southerly parts of the species' range. The results from both novel and well-established genetic analyses were similar, providing greater confidence in the conclusions about spatial divergence and supporting the validity of these new techniques.

Burial depth and cultivation influence emergence and persistence of Phalaris paradoxa seed in an Australian sub-tropical environment

Emergence and persistence characteristics of Phalaris paradoxa seeds in no- and minimum-till situations and at different burial depths were studied in a sub-tropical environment. Three experiments were carried out using naturally shed seeds. In the first experiment, seedlings emerged from May through to September each year, although the majority of seedlings emerged in July. In the second experiment with greater seed density, cultivation in March of each year stimulated seedling emergence, altered the periodicity of emergence and accelerated the decline of seeds in the seedbank compared with plots that received no cultivation. The majority of seedlings in the cultivated plots emerged in May whereas the majority of seedlings in the undisturbed plots emerged in July. Emergence accounted for only 4-19% of the seedbank in both experiments over 2 years. Seed persistence was short in both field experiments, with less than 1% remaining 2 years after seed shed. In the third experiment, burial depth and soil disturbance significantly influenced seedling emergence and persistence of seed. Seedlings emerged most from seed mixed in the top 10 cm when subjected to annual soil disturbance, and from seed buried at 2.5 and 5.0 cm depths in undisturbed soil. Emergence was least from seed on the soil surface, and buried at 10 and 15 cm depths in undisturbed soil. Seeds persisted longest when shed onto the soil surface and persisted least when the soil was tilled. These results suggest that strategic cultivation may be a useful management tool, as it will alter the periodicity of emergence allowing use of more effective control options and will deplete the soil seedbank more rapidly.

Thomas Mitchell and the Wellington caves: The relationship among science, religion, and aesthetics in early-nineteenth-century Australia

THOMAS MITCHELL (1792–1855), explorer and Surveyor-General in New South Wales between 1828 and 1855, was a talented and competent draughtsman who was responsible for the original sketches and even some of the lithographs he used to illustrate his two journals of exploration, published in 1838 and 1848. In this paper, I will be concerned with the 1838 journal, entitled Three Expeditions into the Interior of Eastern Australia; with descriptions of the recently explored region of Australia Felix, and of the Present Colony of New South Wales. On the whole, it is a detailed and lavishly illustrated account of the land Mitchell encountered, along with its inhabitants and natural history. My particular interest is in offering an explanation for differences between a sepia sketch depicting a cave at Wellington, NSW, that Mitchell prepared as one of the illustrations for geological material included in this journal, and the final lithograph.

Delivery of child development services by videoconferencing: a review of four years' experience in Queensland

In 2001 the Child Development Unit (CDU) in Brisbane piloted a series of monthly multidisciplinary case discussions via videoconference in the area of child development. During 2001 two sessions were provided; during 2004 there were 40. The substantial growth in 2004 was due to the expansion of child development services to include special interest group meetings and multipoint case conference meetings. In 2004, a total of 49 h of videoconferencing was conducted. The average session length was 75 min. Education and training sessions were delivered to 32 hospitals and health centres in Queensland and northern New South Wales. The maximum number of sites involved during a single videoconference was 25. The average number of attendees for each videoconference was five per site, including allied health staff, nurses and paediatricians. The delivery of child development services via videoconference has been shown to be useful in Queensland, especially for allied health staff working in regional and remote areas. The growth of the programme indicates its acceptance as a mainstream child development service in Queensland.

The interaction of nitrogen application and temperature during reproductive stage on spikelet sterility in field-grown rice

Increased grain yield in response to high rates of application of nitrogen (N) fertiliser is often limited by increased spikelet sterility, particularly under low temperature conditions in the New South Wales ( NSW) rice industry. In 3 field experiments, different N rates were applied for different sowing dates to investigate the interaction between N rate and temperature during microspore development on spikelet sterility and grain yield. In one experiment the effect of water depth on spikelet sterility was also investigated. Engorged pollen production, spikelet sterility, and yield and its components were recorded. Application of N affected a few different processes that lead into spikelet sterility. Application of N at both pre-flood (PF) and panicle initiation ( PI) significantly reduced the number of engorged pollen grains per anther, which was negatively correlated with spikelet sterility. Application of N and low temperature during microspore development with the absence of deep water also decreased pollen engorgement efficiency ( the percentage of pollen grains that were engorged). Application of N further increased spikelet density, which, in turn, increased both spikelet sterility and grain yield. The combined effect of spikelet density and low temperature during microspore development explained the 44% of variation in the number of engorged pollen grains per anther. Grain yield was decreased by low temperature during microspore development in the shallow water when N was applied. Spikelet sterility as a result of late sowing was strongly correlated with minimum temperature during flowering. It is concluded that N application reduced pollen number per anther as a result of increased spikelet density, and this made the spikelets more susceptible to low temperature, causing increased spikelet sterility.

Modeling the economic losses from pressure ulcers among hospitalized patients in Australia

The objective of this study was to predict the number of cases of pressure ulcer, the bed days lost, and the economic value of these losses at Australian public hospitals. All adults (>= 18 years of age) with a minimum stay of 1 night and discharged from selected clinical units from all Australian public hospitals in 2001-02 were included in the study. The main outcome measures were the number of cases of pressure ulcer, bed days lost to pressure ulcer, and economic value of these losses. We predict a median of 95,695 cases of pressure ulcer with a median of 398,432 bed days lost, incurring median opportunity costs of AU$285 M. The number of cases, and so costs, were greatest in New South Wales and lowest in Australian Capitol Territory. We conclude that pressure ulcers represent a serious clinical and economic problem for a resource-constrained public hospital system. The most cost-effective, risk-reducing interventions should be pursued up to a point where the marginal benefit of prevention is equalized with marginal cost. By preventing pressure ulcers, public hospitals can improve efficiency and the quality of the patient's experience and health outcome.

Epidemiology of recreational exposure to freshwater cyanobacteria - an international prospective cohort study

Background: Case studies and anecdotal reports have documented a range of acute illnesses associated with exposure to cyanobacteria and their toxins in recreational waters. The epidemiological data to date are limited; we sought to improve on the design of some previously conducted studies in order to facilitate revision and refinement of guidelines for exposure to cyanobacteria in recreational waters. Methods: A prospective cohort study was conducted to investigate the incidence of acute symptoms in individuals exposed, through recreational activities, to low ( cell surface area < 2.4 mm(2)/mL), medium ( 2.4 - 12.0 mm(2)/mL) and high (> 12.0 mm(2)/mL) levels of cyanobacteria in lakes and rivers in southeast Queensland, the central coast area of New South Wales, and northeast and central Florida. Multivariable logistic regression analyses were employed; models adjusted for region, age, smoking, prior history of asthma, hay fever or skin disease ( eczema or dermatitis) and clustering by household. Results: Of individuals approached, 3,595 met the eligibility criteria, 3,193 (89%) agreed to participate and 1,331 (37%) completed both the questionnaire and follow-up interview. Respiratory symptoms were 2.1 (95% CI: 1.1 - 4.0) times more likely to be reported by subjects exposed to high levels of cyanobacteria than by those exposed to low levels. Similarly, when grouping all reported symptoms, individuals exposed to high levels of cyanobacteria were 1.7 ( 95% CI: 1.0 - 2.8) times more likely to report symptoms than their low-level cyanobacteria-exposed counterparts. Conclusion: A significant increase in reporting of minor self-limiting symptoms, particularly respiratory symptoms, was associated with exposure to higher levels of cyanobacteria of mixed genera. We suggest that exposure to cyanobacteria based on total cell surface area above 12 mm(2)/mL could result in increased incidence of symptoms. The potential for severe, life-threatening cyanobacteria-related illness is likely to be greater in recreational waters that have significant levels of cyanobacterial toxins, so future epidemiological investigations should be directed towards recreational exposure to cyanotoxins.